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  1. Article ; Online: Disparities in lung transplantation in children.

    Brugha, Rossa / Wu, Diana / Spencer, Helen / Marson, Lorna

    Pediatric pulmonology

    2023  

    Abstract: Lung transplantation is a recognized therapy for end-stage respiratory failure in children and young people. It is only available in selected countries and is limited by access to suitable organs. Data on disparities in access and outcomes for children ... ...

    Abstract Lung transplantation is a recognized therapy for end-stage respiratory failure in children and young people. It is only available in selected countries and is limited by access to suitable organs. Data on disparities in access and outcomes for children undergoing lung transplantation are limited. It is clear from data from studies in adults, and from studies in other solid organ transplants in children, that systemic inequities exist in this field. While data relating specifically to pediatric lung transplantation are relatively sparse, professionals should be aware of the risk that healthcare systems may result in disparities in access and outcomes following lung transplantation in children.
    Language English
    Publishing date 2023-12-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26813
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    Zs.A 2143: Show issues Location:
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  2. Article: Diagnosis and management of pulmonary hypertension in infants with bronchopulmonary dysplasia: a guide for paediatric respiratory specialists.

    Chan, Sarah / Brugha, Rossa / Quyam, Sadia / Moledina, Shahin

    Breathe (Sheffield, England)

    2023  Volume 18, Issue 4, Page(s) 220209

    Abstract: Pulmonary hypertension (PH) can develop in babies with bronchopulmonary dysplasia (BPD). PH is common in those with severe BPD and is associated with a high mortality rate. However, in babies surviving beyond 6 months, resolution of PH is likely. There ... ...

    Abstract Pulmonary hypertension (PH) can develop in babies with bronchopulmonary dysplasia (BPD). PH is common in those with severe BPD and is associated with a high mortality rate. However, in babies surviving beyond 6 months, resolution of PH is likely. There is currently no standardised screening protocol for PH in BPD patients. Diagnosis in this group relies heavily on transthoracic echocardiography. Management of BPD-PH should be led by a multidisciplinary team and focus on optimal medical management of the BPD and associated conditions that may contribute to PH. PH-targeted pharmacotherapies have been used in BPD-PH. To date, these have not been investigated in clinical trials and evidence of their efficacy and safety is absent.
    Educational aims: To identify those BPD patients most at risk of developing PH.To be aware of detection, multidisciplinary management, pharmacological treatment and monitoring strategies for BPD-PH patients.To understand the potential clinical course for patients with BPD-PH and that evidence on efficacy and safety of PH-targeted pharmacotherapy in BPD-PH is limited.
    Language English
    Publishing date 2023-02-14
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2562899-9
    ISSN 2073-4735 ; 1810-6838
    ISSN (online) 2073-4735
    ISSN 1810-6838
    DOI 10.1183/20734735.0209-2022
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  3. Article ; Online: Mycobacterium abscessus

    Brugha, Rossa / Spencer, Helen

    Science (New York, N.Y.)

    2021  Volume 372, Issue 6541, Page(s) 465–466

    MeSH term(s) Cystic Fibrosis ; Humans ; Microbial Sensitivity Tests ; Mycobacterium Infections, Nontuberculous/drug therapy ; Mycobacterium Infections, Nontuberculous/epidemiology ; Mycobacterium abscessus
    Language English
    Publishing date 2021-04-17
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 128410-1
    ISSN 1095-9203 ; 0036-8075
    ISSN (online) 1095-9203
    ISSN 0036-8075
    DOI 10.1126/science.abi5695
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    Zs.A 27: Show issues Location:
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  4. Article ; Online: Safety and efficacy of elexacaftor/tezacaftor/ivacaftor in people with Cystic Fibrosis following liver transplantation: A systematic review.

    Testa, Ilaria / Indolfi, Giuseppe / Brugha, Rossa / Verkade, Henkjan J / Terlizzi, Vito

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2024  

    Abstract: Background & aims: Cystic Fibrosis (CF) liver disease progresses to liver failure requiring transplantation in about 3 % of patients, 0.7 % of CF patients are post liver transplant. The prognosis of CF has improved with the introduction of elexacaftor/ ... ...

    Abstract Background & aims: Cystic Fibrosis (CF) liver disease progresses to liver failure requiring transplantation in about 3 % of patients, 0.7 % of CF patients are post liver transplant. The prognosis of CF has improved with the introduction of elexacaftor/tezacaftor/ivacaftor (ETI). Due to the paucity of data and concerns regarding interactions with immunosuppressive drug regimens, there is no general consensus on use of ETI post liver transplantation. The aim of this review is to report the safety and efficacy of ETI in CF patients who underwent liver transplantation.
    Methods: A systematic review was conducted through MEDLINE/Pubmed and EMBASE databases. English-written articles reporting clinical data on liver transplanted CF patients treated with ETI were included. Article quality was evaluated using the Critical Appraisal Checklist for Case Reports.
    Results: Twenty cases were retrieved from 6 reports. Temporary discontinuation and/or dose reduction due to elevated transaminases was required in 5 cases. ETI restarted on a reduced dose was tolerated in 3 out of 5 patients, 1 patient tolerated full dose. Tacrolimus dose change was required in 14 cases, in 1 case ETI was discontinued due to tacrolimus toxicity. Improvement in percentage predicted FEV1 was noted in 15/19 patients (median +17 %, range 8 %-38 %).
    Conclusions: In the majority of liver transplanted patients ETI is well tolerated, although adverse events and liver function abnormalities may occur. Close monitoring of liver function and tacrolimus level is warranted. Significant improvement in lung function after ETI initiation is confirmed, highlighting the importance of accessing this medication for this group of patients.
    Language English
    Publishing date 2024-04-13
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2024.04.006
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  5. Article ; Online: Atypical cause of lobar collapse.

    Sunther, Meera / Ruiz, Gary / Audi, Nadia / Brugha, Rossa

    BMJ case reports

    2021  Volume 14, Issue 3

    MeSH term(s) Humans ; Pneumonia ; Pulmonary Atelectasis
    Language English
    Publishing date 2021-03-17
    Publishing country England
    Document type Journal Article ; Case Reports
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-236952
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  6. Article ; Online: Outdoor air pollution and cystic fibrosis.

    Brugha, Rossa / Edmondson, Claire / Davies, Jane C

    Paediatric respiratory reviews

    2018  Volume 28, Page(s) 80–86

    Abstract: Outdoor air pollution is increasingly identified as a contributor to respiratory and cardiovascular disease. Pro-inflammatory particles and gases are inhaled deep into the lungs, and are associated with impaired lung growth and exacerbations of chronic ... ...

    Abstract Outdoor air pollution is increasingly identified as a contributor to respiratory and cardiovascular disease. Pro-inflammatory particles and gases are inhaled deep into the lungs, and are associated with impaired lung growth and exacerbations of chronic respiratory diseases. The magnitude of these effects are of interest to patients and families, and have been assessed in studies specific to CF. Using systematic review methodology, we sought to collate these studies in order to summarise the known effects of air pollution in cystic fibrosis, and to present information on decreasing personal air pollution exposures.
    MeSH term(s) Air Pollution ; Cystic Fibrosis ; Disease Progression ; Humans ; Inflammation ; Particulate Matter ; Pseudomonas Infections
    Chemical Substances Particulate Matter
    Language English
    Publishing date 2018-04-11
    Publishing country England
    Document type Journal Article ; Systematic Review
    ZDB-ID 2147664-0
    ISSN 1526-0550 ; 1526-0542
    ISSN (online) 1526-0550
    ISSN 1526-0542
    DOI 10.1016/j.prrv.2018.03.005
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    Zs.A 5919: Show issues Location:
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  7. Article ; Online: It ain't necessarily so: a surprising lower airway infection.

    Brugha, Rossa / Hall, Anne / Bush, Andrew

    Thorax

    2016  Volume 72, Issue 1, Page(s) 96–97

    MeSH term(s) Child, Preschool ; Cystic Fibrosis/complications ; Humans ; Influenza Vaccines/adverse effects ; Influenza, Human/diagnosis ; Influenza, Human/etiology ; Influenza, Human/therapy ; Alphainfluenzavirus/isolation & purification ; Male
    Chemical Substances Influenza Vaccines
    Language English
    Publishing date 2016-10-31
    Publishing country England
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 204353-1
    ISSN 1468-3296 ; 0040-6376
    ISSN (online) 1468-3296
    ISSN 0040-6376
    DOI 10.1136/thoraxjnl-2016-209230
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  8. Article ; Online: Two Bronchogenic Cysts Causing Tracheal Stenosis in an Infant.

    Brugha, Rossa / Semple, Tom / Cook, James / Dusmet, Michael / Rosenthal, Mark

    American journal of respiratory and critical care medicine

    2018  Volume 197, Issue 2, Page(s) 261–262

    MeSH term(s) Bronchogenic Cyst/complications ; Bronchogenic Cyst/diagnostic imaging ; Bronchogenic Cyst/surgery ; Bronchoscopy/methods ; Female ; Follow-Up Studies ; Humans ; Infant ; Magnetic Resonance Imaging/methods ; Rare Diseases ; Severity of Illness Index ; Tomography, X-Ray Computed/methods ; Tracheal Stenosis/diagnostic imaging ; Tracheal Stenosis/etiology ; Tracheal Stenosis/surgery ; Treatment Outcome
    Language English
    Publishing date 2018-02-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201708-1611IM
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  9. Article ; Online: Favipiravir induces HuNoV viral mutagenesis and infectivity loss with clinical improvement in immunocompromised patients.

    Kreins, Alexandra Y / Roux, Emma / Pang, Juanita / Cheng, Iek / Charles, Oscar / Roy, Sunando / Mohammed, Reem / Owens, Stephen / Lowe, David M / Brugha, Rossa / Williams, Rachel / Howley, Evey / Best, Timothy / Davies, E Graham / Worth, Austen / Solas, Caroline / Standing, Joseph F / Goldstein, Richard A / Rocha-Pereira, Joana /
    Breuer, Judith

    Clinical immunology (Orlando, Fla.)

    2024  Volume 259, Page(s) 109901

    Abstract: Chronic human norovirus (HuNoV) infections in immunocompromised patients result in severe disease, yet approved antivirals are lacking. RNA-dependent RNA polymerase (RdRp) inhibitors inducing viral mutagenesis display broad-spectrum in vitro antiviral ... ...

    Abstract Chronic human norovirus (HuNoV) infections in immunocompromised patients result in severe disease, yet approved antivirals are lacking. RNA-dependent RNA polymerase (RdRp) inhibitors inducing viral mutagenesis display broad-spectrum in vitro antiviral activity, but clinical efficacy in HuNoV infections is anecdotal and the potential emergence of drug-resistant variants is concerning. Upon favipiravir (and nitazoxanide) treatment of four immunocompromised patients with life-threatening HuNoV infections, viral whole-genome sequencing showed accumulation of favipiravir-induced mutations which coincided with clinical improvement although treatment failed to clear HuNoV. Infection of zebrafish larvae demonstrated drug-associated loss of viral infectivity and favipiravir treatment showed efficacy despite occurrence of RdRp variants potentially causing favipiravir resistance. This indicates that within-host resistance evolution did not reverse loss of viral fitness caused by genome-wide accumulation of sequence changes. This off-label approach supports the use of mutagenic antivirals for treating prolonged RNA viral infections and further informs the debate surrounding their impact on virus evolution.
    MeSH term(s) Animals ; Humans ; Norovirus/genetics ; Antiviral Agents/pharmacology ; Antiviral Agents/therapeutic use ; Zebrafish ; Mutagenesis ; Viruses ; RNA-Dependent RNA Polymerase/genetics ; Immunocompromised Host ; Amides ; Pyrazines
    Chemical Substances favipiravir (EW5GL2X7E0) ; Antiviral Agents ; RNA-Dependent RNA Polymerase (EC 2.7.7.48) ; Amides ; Pyrazines
    Language English
    Publishing date 2024-01-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1459903-x
    ISSN 1521-7035 ; 1521-6616
    ISSN (online) 1521-7035
    ISSN 1521-6616
    DOI 10.1016/j.clim.2024.109901
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  10. Article: Impact of Centor scores on determining antibiotic prescribing in children.

    Freer, Joseph / Ally, Tasneem / Brugha, Rossa

    International journal of health care quality assurance

    2017  Volume 30, Issue 4, Page(s) 319–326

    Abstract: Purpose The purpose of this paper is to establish the effect of incorporating Centor scoring into antibiotic prescribing in primary care in London, UK, before and after the introduction of an educational package and prescribing software tool. Design/ ... ...

    Abstract Purpose The purpose of this paper is to establish the effect of incorporating Centor scoring into antibiotic prescribing in primary care in London, UK, before and after the introduction of an educational package and prescribing software tool. Design/methodology/approach A quality improvement project with analysis of all sore throat presentations in patients aged 3-14 years, in two phases. Phase 1 (retrospective): 1 January-31 December 2013, followed by an intervention (software tool/education package) and Phase 2 (prospective): 1 March 2014-28 February 2015. Findings In the initial analysis, 162 out of 202 (80.2 per cent) patients were prescribed antibiotics. Following the educational/software intervention, 191 out of 231 (82.7 per cent) patients were prescribed antibiotics ( p=0.56, χ
    Language English
    Publishing date 2017-05-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 645125-1
    ISSN 0952-6862 ; 1366-0756
    ISSN 0952-6862 ; 1366-0756
    DOI 10.1108/IJHCQA-08-2016-0114
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