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  1. Article ; Online: Diagnostic delay in IPF impacts progression-free survival, quality of life and hospitalisation rates

    Elisabeth Bendstrup / Saher Burhan Shaker / Nils Hoyer / Thomas Skovhus Prior

    BMJ Open Respiratory Research, Vol 9, Iss

    2022  Volume 1

    Abstract: Background The diagnosis of idiopathic pulmonary fibrosis (IPF) is often delayed up to several years. The objective of this study was to assess the impact of the diagnostic delay on progression-free survival, quality of life and hospitalisation rates ... ...

    Abstract Background The diagnosis of idiopathic pulmonary fibrosis (IPF) is often delayed up to several years. The objective of this study was to assess the impact of the diagnostic delay on progression-free survival, quality of life and hospitalisation rates.Methods A total of 264 incident patients with IPF were included immediately after their diagnosis and followed for up to 5 years, with regular collection of clinical data, quality-of-life questionnaires and assessment of disease progression. Hospitalisation data were extracted from electronic patient records. Analyses were performed on the entire cohort and strata according to forced vital capacity (FVC) at diagnosis.Results A long diagnostic delay (>1 year) was associated with worse progression-free survival compared with a short diagnostic delay (<1 year) (HR: 1.70, 95% CI: 1.18 to 2.46, p=0.004) especially in patients with mild disease at the time of diagnosis (FVC>80% predicted). Mean total scores of the St. George’s respiratory questionnaire (SGRQ), a derived IPF-specific version of the SGRQ and the chronic obstructive pulmonary disease assessment test (CAT) were consistently higher in patients with long diagnostic delays, indicating worse quality of life. Mean hospitalisation rates were higher during the first year after diagnosis (Incidence rate ratio [IRR]: 3.28, 95% CI: 1.35 to 8.55, p=0.01) and during the entire follow-up (IRR: 1.74, 95% CI: 1.01 to 3.02, p=0.04).Conclusion A diagnostic delay of more than 1 year negatively impacts progression-free survival, quality of life and hospitalisation rates in patients with IPF. These findings highlight the importance of an early diagnosis for proper management of IPF.Trial registration number NCT02755441.
    Keywords Medicine ; R ; Diseases of the respiratory system ; RC705-779
    Subject code 610
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge

    Natascha Josephine Ulstrand Fuglebjerg / Tomas Oestergaard Jensen / Nils Hoyer / Camilla Koch Ryrsø / Birgitte Lindegaard / Zitta Barrella Harboe

    International Journal of Infectious Diseases, Vol 99, Iss , Pp 100-

    2020  Volume 101

    Abstract: Objective: To assess the degree of hypoxia and subjective dyspnea elicited by a 6-minute walking test (6MWT) in COVID-19 patients prior to discharge. Methods: A 6MWT was performed in 26 discharge-ready COVID-19 patients without chronic pulmonary disease ... ...

    Abstract Objective: To assess the degree of hypoxia and subjective dyspnea elicited by a 6-minute walking test (6MWT) in COVID-19 patients prior to discharge. Methods: A 6MWT was performed in 26 discharge-ready COVID-19 patients without chronic pulmonary disease or cardiac failure. Heart rate, oxyhemoglobin saturation (SpO2), respiratory rate, and subjective dyspnea measured on the Borg CR-10 scale were measured before and immediately after the 6MWT, with continuous monitoring of SpO2 and heart rate during the 6MWT. The 6MWT was terminated if SpO2 dropped below 90%. A historical cohort of 204 patients with idiopathic pulmonary fibrosis (IPF) was used for comparison. Results: 13 (50%) of the COVID-19 patients developed exercise-induced hypoxia (SpO2 < 90%) during the 6MWT, of which one third had pulmonary embolism. COVID-19 patients experienced less hypoxia-related dyspnea during the 6MWT compared with patients with IPF. Conclusion: The 6MWT is a potential tool in the diagnosis of asymptomatic exercise-induced hypoxia in hospitalized COVID-19 patients prior to discharge. Due to important methodological limitations, further studies are needed to confirm our findings and to investigate their clinical consequences.
    Keywords COVID-19 ; Hypoxia ; Dyspnea ; Exercise test ; Discharge ; Infectious and parasitic diseases ; RC109-216 ; covid19
    Subject code 610
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: TOB-STOP-COP (TOBacco STOP in COPd trial)

    Mohamad Isam Saeed / Pradeesh Sivapalan / Josefin Eklöf / Charlotte Suppli Ulrik / Charlotta Pisinger / Therese Lapperre / Philip Tønnesen / Nils Hoyer / Julie Janner / Marie Lavesen Karlsson / Charlotte Sandau Bech / Kristoffer Marså / Nina Godtfredsen / Eva Brøndum / Birgit Munk / Merete Raaschou / Andrea Browatzski / Pernille Lütken / Jens-Ulrik Stæhr Jensen

    Trials, Vol 21, Iss 1, Pp 1-

    study protocol—a randomized open-label, superiority, multicenter, two-arm intervention study of the effect of “high-intensity” vs. “low-intensity” smoking cessation intervention in active smokers with chronic obstructive pulmonary disease

    2020  Volume 10

    Abstract: Abstract Background Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD), and it contributes to the development of many other serious diseases. Smoking cessation in COPD patients is known to improve survival and reduce ... ...

    Abstract Abstract Background Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD), and it contributes to the development of many other serious diseases. Smoking cessation in COPD patients is known to improve survival and reduce the number of hospitalization-requiring acute exacerbations of COPD. However, smoking cessation interventions in these patients have only been successful for approximately 15–20% for consistent smoking abstinence in 12 months. Thus, more effective interventions are needed for this patient group. The aim of this study is to determine whether a high-intensity intervention compared to a low-intensity intervention can increase the proportion of persistent (> 12 months) anamnestic and biochemical smoking cessation in active smokers with COPD. Methods This study is a randomized controlled trial. A total of 600 active smokers with COPD will be randomly assigned 1:1 to either a standard treatment (guideline-based municipal smoking cessation program, “low intensity” group) or an intervention (“high-intensity” group) group, which consists of group sessions, telephone consultations, behavior design, hotline, and “buddy-matching” (smoker matched with COPD patient who has ceased smoking). Both groups will receive pharmacological smoking cessation. The primary endpoint is anamnestic and biochemical (cotinine analysis in urine) validated smoking cessation after 12 months. Discussion The potential benefit of this project is to improve smoking cessation rates and thereby reduce smoking-related exacerbations of COPD. In addition, the project can potentially benefit from increasing the quality of life and longevity of COPD patients and reducing the risk of other smoking-related diseases. Trial registration ClinicalTrials.gov NCT04088942 . Registered on 13 September 2019
    Keywords COPD ; Randomized controlled trial ; Smoking cessation ; Exacerbations ; Varenicline ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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