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• This the first study to investigate AZLI in the acute exacerbation setting. • We found AZLI use was associated with positive clinical outcomes. • Neither IV antibiotics nor AZLI consistently reduced P. aeruginosa load. • AZLI appeared to disturb the core lung microbiota less than IV antibiotics. • AZTEC-CF will inform the design of larger trials of inhaled antibiotics in the acute setting The objective of this study was to explore the clinical and microbiological outcomes associated with substituting inhaled aztreonam lysine for an intravenous antibiotic in the treatment of acute pulmonary exacerbations of CF. An open-label randomised crossover pilot trial was conducted at a UK CF centre among 16 adults with CF and P. aeruginosa infection. Median [IQR] age was 29.5 [24.5-32.5], mean ± SD forced expiratory volume in 1 second (FEV1) was 52.4 ± 14.7 % predicted. Over the course of two exacerbations, participants were randomised to sequentially receive 14 days of inhaled aztreonam lysine plus IV colistimethate (AZLI+IV), or dual IV antibiotics (IV+IV). Primary outcome was absolute change in % predicted FEV1. Other outcomes evaluated changes in quality of life, bacterial load and the lung microbiota. The difference between mean change in lung function at day 14 between AZLI+IV and IV+IV was +4.6% (95% CI 2.1-7.2, p =0.002). The minimum clinically important difference of the Cystic Fibrosis Revised Questionnaire (CFQ-R) was achieved more frequently with AZLI+IV (10/12, 83.3%) than IV+IV (7/16, 43.8%), p =0.05. No differences were observed for modulation of serum white cell count, C-reactive protein or sputum bacterial load. Microbiome compositional changes were observed with IV+IV (Bray-Curtis r2=0.14, p=0.02), but not AZLI+IV (r2=0.03, p=0.64). In adults with CF and P. aeruginosa infection experiencing an acute pulmonary exacerbation, AZLI+IV improved lung function and quality of life compared to the current standard treatment. These findings support the need for larger definitive trials of inhaled antibiotics in the acute setting. EudraCT 2016-002832-34 ClinicalTrials.org NCT02894684 [ABSTRACT FROM AUTHOR]

Introduction: The critical sociodemographic, lifestyle and diseases factors influencing sarcopenia, defined by the current European Working Group on Sarcopenia 2 (EWGSOP2) classification and cut-off points, have not yet been fully elucidated. This study aimed, therefore, to determine sociodemographic, anthropometric, lifestyle and health-related factors associated with sarcopenia using the new EWGSOP2 definition.Study Design: 396,283 participants (52.8 % women, age 38-73 years) were included in this cross-sectional study. The potential factors associated with sarcopenia were allocated to four categories: sociodemographic (sex, age, education, income and professional qualification), anthropometric (nutritional status, abdominal obesity, body fat and birth weight), lifestyle (physical activity, smoking, sleeping, sitting time, TV viewing, alcohol, and dietary intakes) and health status (self-reported prevalent diseases). P-values were corrected for multiple testing using the Bonferroni method.Results: Age, women, lower education, higher deprivation, underweight, lower birth weight, and chronic diseases such as rheumatoid arthritis, chronic bronchitis and osteoporosis were associated with a higher likelihood of sarcopenia. Conversely, overweight, obesity, as well as a self-reported higher intake of energy, protein, vitamins (B12 and B9) and minerals (potassium, calcium and magnesium) were associated with lower odds of sarcopenia.Conclusion: Women, people aged over 65 years, underweight people and those with rheumatoid arthritis were most likely to have sarcopenia. Considering the increase in the ageing population, sarcopenia is likely to become more prevalent. Identifying factors associated with sarcopenia could inform future strategies for early identification of individuals at high risk of sarcopenia and therefore the implementation of preventive strategies against the disease. [ABSTRACT FROM AUTHOR]

Chronic bronchitis refers to a chronic condition that is characterized by long-term inflammation of the bronchi. It is of great importance to understand the contributing risk factors for chronic bronchitis because it is associated with adverse outcomes such as healthcare burden and mortality. We aimed to understand if the personality traits could predict ever and the 7-year risk of clinically diagnosed chronic bronchitis in a large cohort of participants from the UK. We analyzed data from Understanding Society: the UK Household Longitudinal Study, which consists of 15,387 middle-aged or older participants for the cross-sectional analysis and 8783 middle-aged or older adults for the longitudinal analysis using two binary logistic regressions. We found that Neuroticism (OR = 1.36, p < 0.001, 95% C.I. [1.23, 1.51]), Conscientiousness (OR = 0.87, p = 0.014, 95% C.I. [0.78, 0.97]), and Extraversion (OR = 1.15, p = 0.009, 95% C.I. [1.04, 1.29]) are related to a higher chance of ever clinically diagnosed chronic bronchitis. However, Agreeableness and Openness were not related to the chance of ever clinically diagnosed chronic bronchitis. Moreover, Conscientiousness (OR = 0.72, p = 0.012, 95% C.I. [0.55, 0.93]) was related to a lower risk of future clinical diagnosis of chronic bronchitis whereas Extraversion (OR = 1.35, p = 0.024, 95% C.I. [1.04, 1.76]) was associated with a higher risk of future chronic bronchitis. However, Neuroticism, Agreeableness, and Openness were not related to change of ever clinically diagnosed chronic bronchitis. We showed that personality can identify people who are at greater risk of chronic bronchitis, which has translational utility for healthcare of middle-aged and older adults. • Neuroticism is positively associated with ever chronic bronchitis. • Conscientiousness is negatively related to ever and future chronic bronchitis. • Extraversion is positively associated with ever and future chronic bronchitis. [ABSTRACT FROM AUTHOR]

We aim to: 1) investigate whether starting cardiac rehabilitation (CR) during the COVID-19 period was influential on new-onset depressive symptoms, 2) examine the relationship between sociodemographic and medical factors with the new-onset of depressive symptoms before and during the COVID-19 period in UK patients commencing CR. The national audit of cardiac rehabilitation (NACR) data were used and the two years of data before COVID-19 and during COVID-19 were analysed (Feb,2018 – Nov,2021). Hospital Anxiety and Depression Scale measurement was used to assess depressive symptoms. Bivariate analysis and logistic regression were conducted to examine the influence of the COVID-19 period on new-onset depressive symptoms and the patient characteristics associated with it. 71055 patients screened for new-onset depressive symptoms were included in the analysis. Based on multivariate analysis, patients commencing CR during COVID-19 were 8% more likely to have new onset depressive symptoms compared to patients commencing before COVID-19. Smoking (OR: 1.26, 95%CI: 1.11, 1.43), physical inactivity (OR: 1.86, 95%CI: 1.74, 1.98), high anxiety (OR: 1.45, 95%CI: 1.44, 1.46), being male (OR: 1.21, 95%CI: 1.12, 1.30), single (OR: 1.25, 95%CI: 1.16, 1.35), having comorbidities of arthritis, diabetes, chronic bronchitis, emphysema, claudication (OR range: 1.19 to 1.60), receiving CABG treatment (OR: 1.47, 95%CI: 1.25, 1.73), and having heart failure (OR: 1.33, 95%CI: 1.19, 1.48) were the factors associated with having new-onset depressive symptoms at the start of CR. Our findings have shown that starting CR during the COVID-19 period was associated with increased odds of having new-onset depressive symptoms. • 71,055 patients screened for new onset depression during cardiac rehabilitation (CR). • Attending CR during the COVID-19 pandemic was associated with new onset depression. • Having heart failure was associated with new onset depression. • Receiving CABG treatment was associated with new onset depression. • Several comorbid conditions were associated with new onset depression. [ABSTRACT FROM AUTHOR]