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  1. Article ; Online: Consensus study defining occupational asthma and confirming the diagnosis.

    Niven, R McL / Burge, S / Fishwick, D / Francis, H C

    Occupational and environmental medicine

    2008  Volume 65, Issue 3, Page(s) 215–216

    MeSH term(s) Asthma/diagnosis ; Consensus ; Humans ; Occupational Diseases/diagnosis ; Respiratory Function Tests/standards
    Language English
    Publishing date 2008-02-11
    Publishing country England
    Document type Comment ; Letter
    ZDB-ID 1180733-7
    ISSN 1470-7926 ; 1351-0711
    ISSN (online) 1470-7926
    ISSN 1351-0711
    DOI 10.1136/oem.2007.036459
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Evaluation of nebulised hypertonic saline (7%) as an adjunct to physiotherapy in patients with stable bronchiectasis.

    Kellett, F / Redfern, J / Niven, R McL

    Respiratory medicine

    2004  Volume 99, Issue 1, Page(s) 27–31

    Abstract: Sputum clearance is of prime importance in the management of patients with bronchiectasis. While nebulised normal isotonic saline (0.9%) (IS) has been anecdotally used to treat patients with tenacious sputum, the use of hypertonic saline (7%) (HS) could ... ...

    Abstract Sputum clearance is of prime importance in the management of patients with bronchiectasis. While nebulised normal isotonic saline (0.9%) (IS) has been anecdotally used to treat patients with tenacious sputum, the use of hypertonic saline (7%) (HS) could have potential muco-protective and clearance properties. 24 patients with bronchiectasis were randomised to receive four single treatment schedules in random order: (1) active cycle breathing technique (ACBT) alone, (2) nebulised terbutaline then ACBT, (3) nebulised terbutaline, nebulised IS then ACBT and (4) nebulised terbutaline, nebulised HS then ACBT. Sputum weights were significantly higher after HS than IS (P = 0.002). Ease of expectoration also differed overall (P < 0.0001) and was significantly lower with HS than with IS (P = 0.0005). Sputum viscosity differed between treatment phases, with a significant linear trend to reduced sputum viscosity with HS (P = 0.0002). These changes were associated with small but statistically significant differences in FEV1 (P = 0.043) and FVC (P = 0.011) between treatment phases. Nebulised hypertonic saline can be used safely and effectively as an adjunct to physiotherapy in selected patients. A long-term prospective trial is now indicated to determine its effectiveness on long-term infection rate, quality of life and lung function.
    MeSH term(s) Aged ; Breathing Exercises ; Bronchiectasis/physiopathology ; Bronchiectasis/rehabilitation ; Bronchiectasis/therapy ; Combined Modality Therapy ; Cross-Over Studies ; Expectorants/therapeutic use ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Nebulizers and Vaporizers ; Physical Therapy Modalities ; Saline Solution, Hypertonic/therapeutic use ; Sputum/physiology ; Viscosity ; Vital Capacity
    Chemical Substances Expectorants ; Saline Solution, Hypertonic
    Language English
    Publishing date 2004-09-03
    Publishing country England
    Document type Clinical Trial ; Journal Article ; Randomized Controlled Trial
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2004.05.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Defining and investigating occupational asthma: a consensus approach.

    Francis, H C / Prys-Picard, C O / Fishwick, D / Stenton, C / Burge, P S / Bradshaw, L M / Ayres, J G / Campbell, S M / Niven, R McL

    Occupational and environmental medicine

    2007  Volume 64, Issue 6, Page(s) 361–365

    Abstract: Background: At present there is no internationally agreed definition of occupational asthma and there is a lack of guidance regarding the resources that should be readily available to physicians running specialist occupational asthma services.: Aims: ...

    Abstract Background: At present there is no internationally agreed definition of occupational asthma and there is a lack of guidance regarding the resources that should be readily available to physicians running specialist occupational asthma services.
    Aims: To agree a working definition of occupational asthma and to develop a framework of resources necessary to run a specialist occupational asthma clinic.
    Method: A modified RAND appropriateness method was used to gain a consensus of opinion from an expert panel of clinicians running specialist occupational asthma clinics in the UK.
    Results: Consensus was reached over 10 terms defining occupational asthma including: occupational asthma is defined as asthma induced by exposure in the working environment to airborne dusts vapours or fumes, with or without pre-existing asthma; occupational asthma encompasses the terms "sensitiser-induced asthma" and "acute irritant-induced asthma" (reactive airways dysfunction syndrome (RADS)); acute irritant-induced asthma is a type of occupational asthma where there is no latency and no immunological sensitisation and should only be used when a single high exposure has occurred; and the term "work-related asthma" can be used to include occupational asthma, acute irritant-induced asthma (RADS) and aggravation of pre-existing asthma. Disagreement arose on whether low dose irritant-induced asthma existed, but the panel agreed that if it did exist they would include it in the definition of "work-related asthma". The panel agreed on a set of 18 resources which should be available to a specialist occupational asthma service. These included pre-bronchodilator FEV1 and FVC (% predicted); peak flow monitoring (and plotting of results, OASYS II analysis); non-specific provocation challenge in the laboratory and specific IgE to a wide variety of occupational agents.
    Conclusion: It is hoped that the outcome of this process will improve uniformity of definition and investigation of occupational asthma across the UK.
    MeSH term(s) Asthma/diagnosis ; Humans ; Occupational Diseases/diagnosis ; Professional Practice ; Surveys and Questionnaires
    Language English
    Publishing date 2007-06
    Publishing country England
    Document type Consensus Development Conference ; Journal Article
    ZDB-ID 1180733-7
    ISSN 1470-7926 ; 1351-0711
    ISSN (online) 1470-7926
    ISSN 1351-0711
    DOI 10.1136/oem.2006.028902
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Monocyte CD14 response following endotoxin exposure in cotton spinners and office workers.

    Fishwick, D / Raza, S N / Beckett, P / Swan, J R M / Pickering, C A C / Fletcher, A M / Niven, R McL / Francis, H / Rawbone, R / Curran, A D

    American journal of industrial medicine

    2002  Volume 42, Issue 5, Page(s) 437–442

    Abstract: Background: Monocyte cell surface CD14 acts as the major lipopolysaccharide (LPS) binding structure, and as such is of interest in the etiology of LPS induced disease.: Methods: The objective was to assess change in monocyte cell surface CD14 and CD4+ ...

    Abstract Background: Monocyte cell surface CD14 acts as the major lipopolysaccharide (LPS) binding structure, and as such is of interest in the etiology of LPS induced disease.
    Methods: The objective was to assess change in monocyte cell surface CD14 and CD4+ CD25+ lymphocytes in a group of cotton workers exposed to LPS over a working week, and to compare this to changes in office workers. Twenty-five cotton workers and nine office workers were studied. Monocyte CD14 fluorescence was measured by flow cytometry, on samples taken pre-shift on a Monday morning (baseline/pre-exposure), and subsequently after 6 and 72 hr. The majority of cotton workers were exposed to at least 1 EU/m(3) of endotoxin over a working shift, and some highly exposed (between 100 and 400 EU/m(3)).
    Results: After 6 hr of work in the mill, cotton workers developed a significant upregulation in CD14 in comparison to office workers (P = 0.016), whereas CD14 expression had returned to levels not significantly differing from the office workers at 72 hr after first work exposure (P = 0.426).
    Conclusions: We propose that CD14 expression on monocytes may help to determine the mechanism of action of lipopolysaccharide in producing respiratory ill health, and may ultimately play a role in monitoring the health effect associated with LPS exposure in the workplace.
    MeSH term(s) Adult ; Biomarkers ; CD4-Positive T-Lymphocytes/metabolism ; Cell Separation ; Dust ; Endotoxins/adverse effects ; Endotoxins/metabolism ; Female ; Flow Cytometry ; Gossypium/adverse effects ; Gossypium/metabolism ; Humans ; Lipopolysaccharide Receptors/metabolism ; Lipopolysaccharides/metabolism ; Male ; Monocytes/metabolism ; Occupational Exposure ; Receptors, Interleukin-2/metabolism ; Textile Industry ; Time Factors ; Up-Regulation/physiology
    Chemical Substances Biomarkers ; Dust ; Endotoxins ; Lipopolysaccharide Receptors ; Lipopolysaccharides ; Receptors, Interleukin-2
    Language English
    Publishing date 2002-11
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 604538-8
    ISSN 1097-0274 ; 0271-3586
    ISSN (online) 1097-0274
    ISSN 0271-3586
    DOI 10.1002/ajim.10132
    Database MEDical Literature Analysis and Retrieval System OnLINE

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