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1. Prevalence of chronic cough, its risk factors and population attributable risk in the Burden of Obstructive Lung Disease (BOLD) study: a multinational cross-sectional studyResearch in context

Author: Hazim Abozid, Jaymini Patel, Peter Burney, Sylvia Hartl, Robab Breyer-Kohansal, Kevin Mortimer, Asaad A. Nafees, Mohammed Al Ghobain, Tobias Welte, Imed Harrabi, Meriam Denguezli, Li Cher Loh, Abdul Rashid, Thorarinn Gislason, Cristina Barbara, Joao Cardoso, Fatima Rodrigues, Terence Seemungal, Daniel Obaseki, Sanjay Juvekar, Stefanni Nonna Paraguas, Wan C. Tan, Frits M.E. Franssen, Filip Mejza, David Mannino, Christer Janson, Hamid Hacene Cherkaski, Mahesh Padukudru Anand, Hasan Hafizi, Sonia Buist, Parvaiz A. Koul, Asma El Sony, Marie-Kathrin Breyer, Otto C. Burghuber, Emiel F.M. Wouters, Andre F.S. Amaral, Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla, Rezarta Kazasi, Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh, Nadia Ait-Khaled, Christine Jenkins, Guy Marks, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Michael Studnicka, Torkil Dawes, Bernd Lamprecht, Lea Schirhofer, Akramul Islam, Syed Masud Ahmed, Shayla Islam, Qazi Shafayetul Islam, Mesbah-Ul-Haque, Tridib Roy Chowdhury, Sukantha Kumar Chatterjee, Dulal Mia, Shyamal Chandra Das, Mizanur Rahman, Nazrul Islam, Shahaz Uddin, Nurul Islam, Luiza Khatun, Monira Parvin, Abdul Awal Khan, Maidul Islam, Herve Lawin, Arsene Kpangon, Karl Kpossou, Gildas Agodokpessi, Paul Ayelo, Benjamin Fayomi, Bertrand Mbatchou, Atongno Humphrey Ashu, Wen Wang, NanShan Zhong, Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang, Jin-ping Zheng, Yumin Zhou, Rain Jogi, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Ayola Akim Adegnika, Isabelle Bodemann, Henning Geldmacher, Alexandra SchwedaLinow, Bryndis Benedikdtsdottir, Kristin Jorundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gudmundsson, Mahesh Rao, Sajjad Malik, Nissar A. Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Althea Aquart-Stewart, Akosua Francia Aikman, Talant M. Sooronbaev, Bermet M. Estebesova, Meerim Akmatalieva, Saadat Usenbaeva, Jypara Kydyrova, Eliza Bostonova, Ulan Sheraliev, Nuridin Marajapov, Nurgul Toktogulova, Berik Emilov, Toktogul Azilova, Gulnara Beishekeeva, Nasyikat Dononbaeva, Aijamal Tabyshova, Wezzie Nyapigoti, Ernest Mwangoka, Mayamiko Kambwili, Martha Chipeta, Gloria Banda, Suzgo Mkandawire, Justice Banda, Li-Cher Loh, Siti Sholehah, Mohamed C. Benjelloun, Chakib Nejjari, Mohamed Elbiaze, Karima El Rhazi, E.F.M. Wouters, G.J. Wesseling, Gregory Erhabor, Olayemi Awopeju, Olufemi Adewole, Amund Gulsvik, Tina Endresen, Lene Svendsen, Muhammad Irfan, Zafar Fatmi, Aysha Zahidie, Natasha Shaukat, Meesha Iqbal, Luisito F. Idolor, Teresita S. de Guia, Norberto A. Francisco, Camilo C. Roa, Fernando G. Ayuyao, Cecil Z. Tady, Daniel T. Tan, Sylvia Banal-Yang, Vincent M. Balanag, Jr., Maria Teresita N. Reyes, Renato B. Dantes, Lourdes Amarillo, Lakan U. Berratio, Lenora C. Fernandez, Gerard S. Garcia, Sullian S. Naval, Thessa Reyes, Camilo C. Roa, Jr., Flordeliza Sanchez, Leander P. Simpao, Ewa Nizankowska-Mogilnicka, Jakub Frey, Rafal Harat, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Herminia Dias, João Almeida, Maria Joao Matos, Paula Simão, Moutinho Santos, Reis Ferreira, M. Al Ghobain, H. Alorainy, E. El-Hamad, M. Al Hajjaj, A. Hashi, R. Dela, R. Fanuncio, E. Doloriel, I. Marciano, L. Safia, Eric Bateman, Anamika Jithoo, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Kirthi Gunasekera, Rajitha Wickremasinghe, Asma Elsony, Hana A. Elsadig, Nada Bakery Osman, Bandar Salah Noory, Monjda Awad Mohamed, Hasab Alrasoul Akasha Ahmed Osman, Namarig Moham ed Elhassan, Abdel Mu’is El Zain, Marwa Mohamed Mohamaden, Suhaiba Khalifa, Mahmoud Elhadi, Mohand Hassan, Dalia Abdelmonam, Inga Sif Olafsdottir, Katarina Nisser, Ulrike SpetzNystrom, Gunilla Hagg, GunMarie Lund, Fallon Lutchmansingh, Liane Conyette, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Ali Kocabas, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Peter G.J. Burney, Louisa Gnatiuc, Hadia Azar, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, Risha Dudhaiya, A. Sonia Buist, Mary Ann McBurnie, William M. Vollmer, Suzanne Gillespie, Sean Sullivan, Todd A. Lee, Kevin B. Weiss, Robert L. Jensen, Robert Crapo, Paul Enright, David M. Mannino, John Cain, Rebecca Copeland, Dana Hazen, and Jennifer Methvin
Subjects: Chronic cough, Epidemiology, Global health, Excess risk, Medicine (General), R5-920
Abstract: Summary: Background: Chronic cough is a common respiratory symptom with an impact on daily activities and quality of life. Global prevalence data are scarce and derive mainly from European and Asian countries and studies with outcomes other than chronic cough. In this study, we aimed to estimate the prevalence of chronic cough across a large number of study sites as well as to identify its main risk factors using a standardised protocol and definition. Methods: We analysed cross-sectional data from 33,983 adults (≥40 years), recruited between Jan 2, 2003 and Dec 26, 2016, in 41 sites (34 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We estimated the prevalence of chronic cough for each site accounting for sampling design. To identify risk factors, we conducted multivariable logistic regression analysis within each site and then pooled estimates using random-effects meta-analysis. We also calculated the population attributable risk (PAR) associated with each of the identifed risk factors. Findings: The prevalence of chronic cough varied from 3% in India (rural Pune) to 24% in the United States of America (Lexington,KY). Chronic cough was more common among females, both current and passive smokers, those working in a dusty job, those with a history of tuberculosis, those who were obese, those with a low level of education and those with hypertension or airflow limitation. The most influential risk factors were current smoking and working in a dusty job. Interpretation: Our findings suggested that the prevalence of chronic cough varies widely across sites in different world regions. Cigarette smoking and exposure to dust in the workplace are its major risk factors. Funding: Wellcome Trust.
Published: 2024
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2. Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update

Author: Mark L. Levy, Leonard B. Bacharier, Eric Bateman, Louis-Philippe Boulet, Chris Brightling, Roland Buhl, Guy Brusselle, Alvaro A. Cruz, Jeffrey M. Drazen, Liesbeth Duijts, Louise Fleming, Hiromasa Inoue, Fanny W. S. Ko, Jerry A. Krishnan, Kevin Mortimer, Paulo M. Pitrez, Aziz Sheikh, Arzu Yorgancıoğlu, and Helen K. Reddel
Subjects: Diseases of the respiratory system, RC705-779
Abstract: Abstract The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with “mild” asthma) as combination ICS–formoterol taken as needed for symptom relief. For patients with moderate–severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS–formoterol. Asthma treatment is not “one size fits all”; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications.
Published: 2023
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3. Addressing the quality of paediatric primary care: health worker and caregiver perspectives from a process evaluation of PACK child, a health systems intervention in South Africa

Author: Robyn Curran, Jamie Murdoch, Max Bachmann, Eric Bateman, Ruth Cornick, Sandra Picken, Makhosazana Lungile Simelane, and Lara Fairall
Subjects: Paediatric primary care, PACK, Process evaluation, IMCI, Health systems strengthening, Educational outreach, Pediatrics, RJ1-570
Abstract: Abstract Background The WHO’s Integrated Management of Childhood Illness (IMCI) has resulted in progress in addressing infant and child mortality. However, unmet needs of children continue to present a burden upon primary healthcare services. The capacity of services and quality of care offered require greater support to address these needs by extending and integrating curative and preventive care for the child with a long-term health condition and the child older than 5, not prioritised in IMCI. In response to these needs, the PACK Child intervention was developed and piloted in October 2017–February 2019 in the Western Cape Province of South Africa. We report health worker and caregiver perspectives of the existing paediatric primary care context as well as the extent to which PACK Child functions to address perceived problems within the current local healthcare system. Methods This process evaluation involved 52 individual interviews with caregivers, 10 focus group discussions with health workers, 3 individual interviews with trainers, and 31 training observations. Interviews and focus groups explored participants’ experiences of paediatric primary care, perspectives of the PACK Child intervention, and tensions with implementation in each context. Inductive thematic analysis was used to analyse verbatim interview and discussion transcripts. Results Perspectives of caregivers and health workers suggest an institutionalised focus of paediatric primary care to treating children’s symptoms as acute episodic conditions. Health workers’ reports imply that this focus is perpetuated by interactions between contextual features such as, IMCI policy, documentation-driven consultations, overcrowded clinics and verticalised care. Whilst these contextual conditions constrained health workers’ ability to translate skills developed within PACK Child training into practice, the intervention initiated expanded care of children 0–13 years and those with long-term health conditions, enhanced professional competence, improved teamwork and referrals, streamlined triaging, and facilitated probing for psychosocial risk. Conclusion PACK Child appears to be catalysing paediatric primary care to address the broader needs of children, including long-term health conditions and the identification of psychosocial problems. However, to maximise this requires primary care to re-orientate from risk minimisation on the day of attendance towards a view of the child beyond the day of presentation at clinics.
Published: 2021
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4. Addressing the quality and scope of paediatric primary care in South Africa: evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

Author: Jamie Murdoch, Robyn Curran, Ruth Cornick, Sandy Picken, Max Bachmann, Eric Bateman, Makhosazana Lungile Simelane, and Lara Fairall
Subjects: Child health, Health systems evaluation, Paediatrics, Prevention strategies, Other study design, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Despite significant reductions in mortality, preventable and treatable conditions remain leading causes of death and illness in children in South Africa. The PACK Child intervention, comprising clinical decision support tool (guide), training strategy and health systems strengthening components, was developed to expand on WHO’s Integrated Management of Childhood Illness programme, extending care of children under 5 years to those aged 0–13 years, those with chronic conditions needing regular follow-up, integration of curative and preventive measures and routine care of the well child. In 2017–2018, PACK Child was piloted in 10 primary healthcare facilities in the Western Cape Province. Here we report findings from an investigation into the contextual features of South African primary care that shaped how clinicians delivered the PACK Child intervention within clinical consultations. Methods Process evaluation using linguistic ethnographic methodology which provides analytical tools for investigating human behaviour, and the shifting meaning of talk and text within context. Methods included semi-structured interviews, focus groups, ethnographic observation, audio-recorded consultations and documentary analysis. Analysis focused on how mapped contextual features structured clinician-caregiver interactions. Results Primary healthcare facilities demonstrated an institutionalised orientation to minimising risk upheld by provincial documentation, providing curative episodic care to children presenting with acute symptoms, and preventive care including immunisations, feeding and growth monitoring, all in children 5 years or younger. Children with chronic illnesses such as asthma rarely receive routine care. These contextual features constrained the ability of clinicians to use the PACK Child guide to facilitate diagnosis of long-term conditions, elicit and manage psychosocial issues, and navigate use of the guide alongside provincial documentation. Conclusion Our findings provide evidence that PACK Child is catalysing a transition to an approach that strikes a balance between assessing and minimising risk on the day of acute presentation and a larger remit of care for children over time. However, optimising success of the intervention requires reviewing priorities for paediatric care which will facilitate enhanced skills, knowledge and deployment of clinical staff to better address acute illnesses and long-term health conditions of children of all ages, as well as complex psychosocial issues surrounding the child.
Published: 2020
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5. Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Author: J. Jean Bousquet, Holger J. Schünemann, Alkis Togias, Marina Erhola, Peter W. Hellings, Torsten Zuberbier, Ioana Agache, Ignacio J. Ansotegui, Josep M. Anto, Claus Bachert, Sven Becker, Martin Bedolla-Barajas, Michael Bewick, Sinthia Bosnic-Anticevich, Isabelle Bosse, Louis P. Boulet, Jean Marc Bourrez, Guy Brusselle, Niels Chavannes, Elisio Costa, Alvaro A. Cruz, Wienczyslawa Czarlewski, Wytske J. Fokkens, Joao A. Fonseca, Mina Gaga, Tari Haahtela, Maddalena Illario, Ludger Klimek, Piotr Kuna, Violeta Kvedariene, L. T. T. Le, Desiree Larenas-Linnemann, Daniel Laune, Olga M. Lourenço, Enrica Menditto, Joaquin Mullol, Yashitaka Okamoto, Nikos Papadopoulos, Nhân Pham-Thi, Robert Picard, Hilary Pinnock, Nicolas Roche, Regina E. Roller-Wirnsberger, Christine Rolland, Boleslaw Samolinski, Aziz Sheikh, Sanna Toppila-Salmi, Ioanna Tsiligianni, Arunas Valiulis, Erkka Valovirta, Tuula Vasankari, Maria-Teresa Ventura, Samantha Walker, Sian Williams, Cezmi A. Akdis, Isabella Annesi-Maesano, Sylvie Arnavielhe, Xavier Basagana, Eric Bateman, Anna Bedbrook, K. S. Bennoor, Samuel Benveniste, Karl C. Bergmann, Slawomir Bialek, Nils Billo, Carsten Bindslev-Jensen, Leif Bjermer, Hubert Blain, Mateo Bonini, Philippe Bonniaud, Jacques Bouchard, Vitalis Briedis, Christofer E. Brightling, Jan Brozek, Roland Buhl, Roland Buonaiuto, Giorgo W. Canonica, Victoria Cardona, Ana M. Carriazo, Warner Carr, Christine Cartier, Thomas Casale, Lorenzo Cecchi, Alfonso M. Cepeda Sarabia, Eka Chkhartishvili, Derek K. Chu, Cemal Cingi, Elaine Colgan, Jaime Correia de Sousa, Anne Lise Courbis, Adnan Custovic, Biljana Cvetkosvki, Gennaro D’Amato, Jane da Silva, Carina Dantas, Dejand Dokic, Yves Dauvilliers, Antoni Dedeu, Giulia De Feo, Philippe Devillier, Stefania Di Capua, Marc Dykewickz, Ruta Dubakiene, Motohiro Ebisawa, Yaya El-Gamal, Esben Eller, Regina Emuzyte, John Farrell, Antjie Fink-Wagner, Alessandro Fiocchi, Jean F. Fontaine, Bilun Gemicioğlu, Peter Schmid-Grendelmeir, Amiran Gamkrelidze, Judith Garcia-Aymerich, Maximiliano Gomez, Sandra González Diaz, Maia Gotua, Nick A. Guldemond, Maria-Antonieta Guzmán, Jawad Hajjam, John O’B Hourihane, Marc Humbert, Guido Iaccarino, Despo Ierodiakonou, Juan C. Ivancevich, Guy Joos, Ki-Suck Jung, Marek Jutel, Igor Kaidashev, Omer Kalayci, Przemyslaw Kardas, Thomas Keil, Mussa Khaitov, Nikolai Khaltaev, Jorg Kleine-Tebbe, Marek L. Kowalski, Vicky Kritikos, Inger Kull, Lisa Leonardini, Philip Lieberman, Brian Lipworth, Karin C. Lodrup Carlsen, Claudia C. Loureiro, Renaud Louis, Alpana Mair, Gert Marien, Bassam Mahboub, Joao Malva, Patrick Manning, Esteban De Manuel Keenoy, Gailen D. Marshall, Mohamed R. Masjedi, Jorge F. Maspero, Eve Mathieu-Dupas, Poalo M. Matricardi, Eric Melén, Elisabete Melo-Gomes, Eli O. Meltzer, Jacques Mercier, Neven Miculinic, Florin Mihaltan, Branislava Milenkovic, Giuliana Moda, Maria-Dolores Mogica-Martinez, Yousser Mohammad, Steve Montefort, Ricardo Monti, Mario Morais-Almeida, Ralf Mösges, Lars Münter, Antonella Muraro, Ruth Murray, Robert Naclerio, Luigi Napoli, Leila Namazova-Baranova, Hugo Neffen, Kristoff Nekam, Angelo Neou, Enrico Novellino, Dieudonné Nyembue, Robin O’Hehir, Ken Ohta, Kimi Okubo, Gabrielle Onorato, Solange Ouedraogo, Isabella Pali-Schöll, Susanna Palkonen, Peter Panzner, Hae-Sim Park, Jean-Louis Pépin, Ana-Maria Pereira, Oliver Pfaar, Ema Paulino, Jim Phillips, Davor Plavec, Ted A. Popov, Fabienne Portejoie, David Price, Emmanuel P. Prokopakis, Benoit Pugin, Filip Raciborski, Rojin Rajabian-Söderlund, Sietze Reitsma, Xavier Rodo, Antonino Romano, Nelson Rosario, Menahenm Rottem, Dermot Ryan, Johanna Salimäki, Mario M. Sanchez-Borges, Juan-Carlos Sisul, Dirceu Solé, David Somekh, Talant Sooronbaev, Milan Sova, Otto Spranger, Cristina Stellato, Rafael Stelmach, Charlotte Suppli Ulrik, Michel Thibaudon, Teresa To, Ana Todo-Bom, Peter V. Tomazic, Antonio A. Valero, Rudolph Valenta, Marylin Valentin-Rostan, Rianne van der Kleij, Olivier Vandenplas, Giorgio Vezzani, Frédéric Viart, Giovanni Viegi, Dana Wallace, Martin Wagenmann, De Y. Wang, Susan Waserman, Magnus Wickman, Dennis M. Williams, Gary Wong, Piotr Wroczynski, Panayiotis K. Yiallouros, Arzu Yorgancioglu, Osman M. Yusuf, Heahter J. Zar, Stéphane Zeng, Mario Zernotti, Luo Zhang, Nan S. Zhong, Mihaela Zidarn, the ARIA Study Group, and the MASK Study Group
Subjects: Health care transformation, Care pathways, Rhinitis, ARIA, MASK, POLLAR, Immunologic diseases. Allergy, RC581-607
Abstract: Abstract Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
Published: 2019
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6. Efficacy and safety of tiotropium Respimat® SMI in COPD in two 1-year randomized studies

Author: Eric Bateman, Dave Singh, David Smith, and et al
Subjects: Diseases of the respiratory system, RC705-779
Abstract: Eric Bateman1, Dave Singh2, David Smith3, Bernd Disse4, Lesley Towse5, Dan Massey5, Jon Blatchford5, Demetri Pavia5, Rick Hodder61Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa; 2University Hospital of South Manchester Foundation Trust, University of Manchester, Manchester, UK; 3North Bristol Lung Centre, Southmead Hospital, Bristol, UK; 4Boehringer Ingelheim, GmbH, Ingelheim, Germany; 5Boehringer Ingelheim, Ltd., Bracknell, Berkshire, UK; 6Divisions of Pulmonary and Critical Care Medicine, University of Ottawa, Ottawa, Ontario, CanadaAbstract: Two 1-year studies evaluated the long-term efficacy and safety of tiotropium 5 or 10 μg versus placebo, inhaled via the Respimat® Soft MistTM Inhaler (SMI). The two studies were combined and had 4 co-primary endpoints (trough FEV1 response, Mahler Transition Dyspnea Index [TDI] and St George’s Respiratory Questionnaire scores all at week 48, and COPD exacerbations per patient-year). A total of 1990 patients with COPD participated (mean FEV1: 1.09 L). The mean trough FEV1 response of tiotropium 5 or 10 μg relative to placebo was 127 or 150 mL, respectively (both P < 0.0001). The COPD exacerbation rate was significantly lower with tiotropium 5 μg (RR = 0.78; P = 0.002) and tiotropium 10 μg (RR = 0.73; P = 0.0008); the health-related quality of life and Mahler TDI co-primary endpoints were significantly improved with both doses (both P < 0.0001). Adverse events were generally balanced except anticholinergic class effects, which were more frequent with active treatment. Fatal events occurred in 2.4% (5 μg), 2.7% (10 μg), and 1.6% (placebo) of patients; these differences were not significant. Tiotropium Respimat® SMI 5 μg demonstrated sustained improvements in patients with COPD relative to placebo and similar to the 10 μg dose but with a lower frequency of anticholinergic adverse events.Keywords: COPD, exacerbations, FEV1, quality of life, Respimat®, tiotropium
Published: 2010

7. Development of a simple reliable radiographic scoring system to aid the diagnosis of pulmonary tuberculosis.

Author: Lancelot M Pinto, Keertan Dheda, Grant Theron, Brian Allwood, Gregory Calligaro, Richard van Zyl-Smit, Jonathan Peter, Kevin Schwartzman, Dick Menzies, Eric Bateman, Madhukar Pai, and Rodney Dawson
Subjects: Medicine, Science
Abstract: Chest radiography is sometimes the only method available for investigating patients with possible pulmonary tuberculosis (PTB) with negative sputum smears. However, interpretation of chest radiographs in this context lacks specificity for PTB, is subjective and is neither standardized nor reproducible. Efforts to improve the interpretation of chest radiography are warranted.To develop a scoring system to aid the diagnosis of PTB, using features recorded with the Chest Radiograph Reading and Recording System (CRRS).Chest radiographs of outpatients with possible PTB, recruited over 3 years at clinics in South Africa were read by two independent readers using the CRRS method. Multivariate analysis was used to identify features significantly associated with culture-positive PTB. These were weighted and used to generate a score.473 patients were included in the analysis. Large upper lobe opacities, cavities, unilateral pleural effusion and adenopathy were significantly associated with PTB, had high inter-reader reliability, and received 2, 2, 1 and 2 points, respectively in the final score. Using a cut-off of 2, scores below this threshold had a high negative predictive value (91.5%, 95%CI 87.1,94.7), but low positive predictive value (49.4%, 95%CI 42.9,55.9). Among the 382 TB suspects with negative sputum smears, 229 patients had scores
Published: 2013
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8. Increased production of IL-4 and IL-12p40 from bronchoalveolar lavage cells are biomarkers of Mycobacterium tuberculosis in the sputum.

Author: Anna Nolan, Elaine Fajardo, Maryann L Huie, Rany Condos, Anil Pooran, Rodney Dawson, Keertan Dheda, Eric Bateman, William N Rom, and Michael D Weiden
Subjects: Medicine, Science
Abstract: Tuberculosis (TB) causes 1.45 million deaths annually world wide, the majority of which occur in the developing world. Active TB disease represents immune failure to control latent infection from airborne spread. Acid-fast bacillus (AFB) seen on sputum smear is a biomarker for contagiousness.We enrolled 73 tuberculosis patients with extensive infiltrates into a research study using bronchoalveolar lavage (BAL) to sample lung immune cells and assay BAL cell cytokine production. All patients had sputum culture demonstrating Mycobacterium tuberculosis and 59/73 (81%) had AFB identified by microscopy of the sputum. Compared with smear negative patients, smear positive patients at presentation had a higher proportion with smoking history, a higher proportion with temperature >38.5(0) C, higher BAL cells/ml, lower percent lymphocytes in BAL, higher IL-4 and IL-12p40 in BAL cell supernatants. There was no correlation between AFB smear and other BAL or serum cytokines. Increasing IL-4 was associated with BAL PMN and negatively associated with BAL lymphocytes. Each 10-fold increase in BAL IL-4 and IL-12p40 increased the odds of AFB smear positivity by 7.4 and 2.2-fold, respectively, in a multi-variable logistic model.Increasing IL-4 and IL-12p40 production by BAL cells are biomarkers for AFB in sputum of patients who present with radiographically advanced TB. They likely reflect less effective immune control of pathways for controlling TB, leading to patients with increased infectiousness.
Published: 2013
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9. Immunomodulation with recombinant interferon-gamma1b in pulmonary tuberculosis.

Author: Rod Dawson, Rany Condos, Doris Tse, Maryann L Huie, Stanley Ress, Chi-Hong Tseng, Clint Brauns, Michael Weiden, Yoshihiko Hoshino, Eric Bateman, and William N Rom
Subjects: Medicine, Science
Abstract: BACKGROUND:Current treatment regimens for pulmonary tuberculosis require at least 6 months of therapy. Immune adjuvant therapy with recombinant interferon-gamma1b (rIFN-gammab) may reduce pulmonary inflammation and reduce the period of infectivity by promoting earlier sputum clearance. METHODOLOGY/PRINCIPAL FINDINGS:We performed a randomized, controlled clinical trial of directly observed therapy (DOTS) versus DOTS supplemented with nebulized or subcutaneously administered rIFN-gamma1b over 4 months to 89 patients with cavitary pulmonary tuberculosis. Bronchoalveolar lavage (BAL) and blood were sampled at 0 and 4 months. There was a significant decline in levels of inflammatory cytokines IL-1beta, IL-6, IL-8, and IL-10 in 24-hour BAL supernatants only in the nebulized rIFN-gamma1b group from baseline to week 16. Both rIFN-gamma1b groups showed significant 3-fold increases in CD4+ lymphocyte response to PPD at 4 weeks. There was a significant (p = 0.03) difference in the rate of clearance of Mtb from the sputum smear at 4 weeks for the nebulized rIFN-gamma1b adjuvant group compared to DOTS or DOTS with subcutaneous rIFN-gamma1b. In addition, there was significant reduction in the prevalence of fever, wheeze, and night sweats at 4 weeks among patients receiving rFN-gamma1b versus DOTS alone. CONCLUSION:Recombinant interferon-gamma1b adjuvant therapy plus DOTS in cavitary pulmonary tuberculosis can reduce inflammatory cytokines at the site of disease, improve clearance of Mtb from the sputum, and improve constitutional symptoms. TRIAL REGISTRATION:ClinicalTrials.gov NCT00201123.
Published: 2009
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10. Contemporary Challenges in the Management of Asthma and Chronic Obstructive Pulmonary Disease: Expert Perspectives on Optimising Outcomes Through Guidelines Implementation, Inhaler Selection, and Patient Engagement

Author: Tuula Vasankari, Federico Lavorini, Christer Janson, Lauri Lehtimäki, Eric Bateman, Dave Singh, Charlotte Suppli Ulrik, Ashley Woodcock, and Alvar Agusti
Abstract: Asthma and chronic obstructive pulmonary disease (COPD) affect millions of people throughout Europe, being one of the leading causes of death in the continent. Both conditions also impose considerable morbidity on patients, adversely affecting individuals’ physical and psychological wellbeing, and their capacity to live and work normally. Asthma and COPD also impose a substantial economic burden on healthcare providers and wider society through both direct and indirect costs of care. Inhaler-delivered therapy has been central to the successful management of both conditions for several decades. Advances in device technology and understanding of the pathophysiology of both conditions (while theoretically introducing greater flexibility and responsiveness into the repertoire of inhalation therapies) have also added complexity and sometimes confusion into the task of identifying the precise combination of medication and delivery device best suited to the needs of individual patients. Recently published multinational consensus reports have set out best-practice frameworks for the management of both asthma and COPD. Presentations at the two symposia summarised in this report examined the implications of these guidelines for the treatment of both conditions. Special focus was on dry power inhalers (DPI) as a means of delivering effective treatment that combines ease of use and widespread acceptance among patients, with the potential to reduce medically-related emissions of greenhouses gases compared with pressurised metered-dose inhalers (pMDI). The authors emphasised the importance of patient partnership in determining the care plan, including the choice of both inhaler device and treatment; the benefits of regular monitoring of adherence to the treatment for both patients with asthma and COPD; and the benefits of simplicity, using one type of inhaler where possible to minimise critical errors in inhalation technique.
Published: 2022
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11. Efficacy of dupilumab in patients with moderate-to-severe asthma and persistent airflow obstruction

Author: Nicola A. Hanania, Mario Castro, Eric Bateman, Ian D. Pavord, Alberto Papi, J. Mark FitzGerald, Jorge F. Maspero, Constance H. Katelaris, Dave Singh, Nadia Daizadeh, Arman Altincatal, Nami Pandit-Abid, Xavier Soler, Shahid Siddiqui, Elizabeth Laws, Juby A. Jacob-Nara, Paul J. Rowe, David J. Lederer, Megan Hardin, and Yamo Deniz
Subjects: Pulmonary and Respiratory Medicine, Immunology, Immunology and Allergy
Abstract: The 52-week, phase 3 LIBERTY ASTHMA QUEST study (NCT02414854) in patients aged above or equal to 12 years with uncontrolled, moderate-to-severe asthma demonstrated the efficacy and safety of dupilumab 200 mg and 300 mg every 2 weeks vs matched placebo.To assess whether dupilumab improves clinical outcomes in QUEST patients with persistent airflow obstruction (PAO) defined as post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio less than 0.7 at baseline.End points were annualized rate of severe exacerbations, pre and post-bronchodilator forced expiratory volume in 1 second over time, proportion achieving reversal of PAO, and quality of life. Efficacy was evaluated in patients with or without PAO at baseline in subpopulations with eosinophils ≥ 150 cells/µL or fractional exhaled nitric oxide (FeNO) ≥ 25 ppb or eosinophils ≥ 300 cells/µL and FeNO ≥ 25 ppb.Of 1902 patients enrolled in QUEST, 1039 (55%) had PAO at baseline. Dupilumab vs placebo rapidly and significantly improved lung function in patients with PAO and elevated type 2 inflammatory biomarkers at baseline. Dupilumab improved probability of reversing airflow obstruction (hazard ratio vs placebo 1.616 [95% confidence interval, 1.272-2.052] and 1.813 [1.291-2.546]; both P.001) and significantly reduced severe exacerbations by 69% (relative risk, 0.411; 95% confidence interval [0.327-0.516]; P.0001) and by 75% (0.252 [0.178-0.356]; P.0001) in patients with PAO with eosinophils ≥ 150 cells/µL or FeNO ≥ 25 ppb and eosinophils ≥ 300 cells/µL and FeNO ≥ 25 ppb, respectively. Similar results were observed in patient subgroups without PAO.In patients with uncontrolled moderate-to-severe asthma, treatment with dupilumab facilitates reversal of PAO status and improves clinical outcomes.ClinicalTrials.gov identifier: NCT02414854.
Published: 2022

12. COPD

Author: Michael Studnicka, Andreas Horner, Lea Sator, A. Sonia Buist, Bernd Lamprecht, NanShan Zhong, Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang, Jingping Zheng, Yumin Zhou, Ali Kocabaş, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Torkil Dawes, Eric Bateman, Anamika Jithoo, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Thorarinn Gislason, Bryndis Benedikdtsdottir, Kristin Jörundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gundmundsson, Ewa Nizankowska-Mogilnicka, Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Tobias Welte, Isabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Amund Gulsvik, Tina Endresen, Lene Svendsen, Wan C. Tan, Wen Wang, David M. Mannino, John Cain, Rebecca Copeland, Dana Hazen, Jennifer Methvin, Renato B. Dantes, Lourdes Amarillo, Lakan U. Berratio, Lenora C. Fernandez, Norberto A. Francisco, Gerard S. Garcia, Teresita S. de Guia, Luisito F. Idolor, Sullian S. Naval, Thessa Reyes, Camilo C. Roa, Ma. Flordeliza Sanchez, Leander P. Simpao, Christine Jenkins, Guy Marks, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Peter G.J. Burney, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, E.F.M. Wouters, G.J. Wesseling, Cristina Bárbara, Fátima Rodrigues, Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos, Reis Ferreira, Christer Janson, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz-Nyström, Gunilla Hägg, Gun-Marie Lund, Rain Jõgi, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Parvaiz A. Koul, Sajjad Malik, Nissar A. Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Imed Harrabi, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Fernando G. Ayuyao, Cecil Z. Tady, Daniel T. Tan, Sylvia Banal-Yang, Vincent M. Balanag, Maria Teresita N. Reyes, Renato. B. Dantes, Sanjay Juvekar, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Daniel Obaseki, Gregory Erhabor, Olayemi Awopeju, and Olufemi Adewole
Subjects: Pulmonary and Respiratory Medicine, Spirometry, medicine.medical_specialty, COPD, medicine.diagnostic_test, business.industry, MEDLINE, Pulmonary disease, Critical Care and Intensive Care Medicine, medicine.disease, medicine, Cardiology and Cardiovascular Medicine, Intensive care medicine, business
Published: 2020
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13. Overdiagnosis of COPD in Subjects With Unobstructed Spirometry

Author: Lea Sator, Andreas Horner, Michael Studnicka, Bernd Lamprecht, Bernhard Kaiser, Mary Ann McBurnie, A. Sonia Buist, Luisa Gnatiuc, David M. Mannino, Christer Janson, Eric D. Bateman, Peter Burney, NanShan Zhong, Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang, Jingping Zheng, Yumin Zhou, Ali Kocabaş, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Torkil Dawes, Eric Bateman, Anamika Jithoo, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Thorarinn Gislason, Bryndis Benedikdtsdottir, Kristin Jörundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gundmundsson, Ewa Nizankowska-Mogilnicka, Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Tobias Welte, Isabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Amund Gulsvik, Tina Endresen, Lene Svendsen, Wan C. Tan, Wen Wang, John Cain, Rebecca Copeland, Dana Hazen, Jennifer Methvin, Renato B. Dantes, Lourdes Amarillo, Lakan U. Berratio, Lenora C. Fernandez, Norberto A. Francisco, Gerard S. Garcia, Teresita S. de Guia, Luisito F. Idolor, Sullian S. Naval, Thessa Reyes, Camilo C. Roa, Ma. Flordeliza Sanchez, Leander P. Simpao, Christine Jenkins, Guy Marks, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Peter G.J. Burney, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, E.F.M. Wouters, G.J. Wesseling, Cristina Bárbara, Fátima Rodrigues, Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos, Reis Ferreira, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz-Nyström, Gunilla Hägg, Gun-Marie Lund, Rain Jõgi, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Parvaiz A. Koul, Sajjad Malik, Nissar A. Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Imed Harrabi, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Fernando G. Ayuyao, Cecil Z. Tady, Daniel T. Tan, Sylvia Banal-Yang, Vincent M. Balanag, Maria Teresita N. Reyes, Sanjay Juvekar, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Daniel Obaseki, Gregory Erhabor, Olayemi Awopeju, and Olufemi Adewole
Subjects: Pulmonary and Respiratory Medicine, Spirometry, medicine.medical_specialty, Chronic bronchitis, Population, Critical Care and Intensive Care Medicine, 03 medical and health sciences, FEV1/FVC ratio, 0302 clinical medicine, Internal medicine, Wheeze, medicine, 030212 general & internal medicine, Overdiagnosis, education, Asthma, education.field_of_study, COPD, medicine.diagnostic_test, business.industry, medicine.disease, respiratory tract diseases, 030228 respiratory system, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Background There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012. Methods A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC Results Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. Conclusions False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.
Published: 2019
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14. Prevalence and population-attributable risk for chronic airflow obstruction in a large multinational study

Author: Peter Burney, Jaymini Patel, Cosetta Minelli, Louisa Gnatiuc, André F. S. Amaral, Ali Kocabaş, Hamid Hacene Cherkaski, Amund Gulsvik, Rune Nielsen, Eric Bateman, Anamika Jithoo, Kevin Mortimer, Talant M. Sooronbaev, Hervé Lawin, Chakib Nejjari, Mohammed Elbiaze, Karima El Rhazi, Jin-Ping Zheng, Pixin Ran, Tobias Welte, Daniel Obaseki, Gregory Erhabor, Asma Elsony, Nada Bakri Osman, Rana Ahmed, Ewa Nizankowska-Mogilnicka, Filip Mejza, David M. Mannino, Cristina Bárbara, Emiel F. M. Wouters, Luisito F. Idolor, Li-Cher Loh, Abdul Rashid, Sanjay Juvekar, Thorarinn Gislason, Mohamed Al Ghobain, Michael Studnicka, Imed Harrabi, Meriam Denguezli, Parvaiz A. Koul, Christine Jenkins, Guy Marks, Rain Jõgi, Hasan Hafizi, Christer Janson, Wan C. Tan, Althea Aquart-Stewart, Bertrand Mbatchou, Asaad Ahmed Nafees, Kirthi Gunasekera, Terry Seemungal, Mahesh Padukudru Anand, Paul Enright, William M. Vollmer, Marta Blangiardo, Fadlalla G. Elfadaly, A. Sonia Buist, Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla, Rezarta Kazasi, Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh, Nadia Ait-Khaled, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Torkil Dawes, Bernd Lamprecht, Lea Schirhofer, Akramul Islam, Syed Masud Ahmed, Shayla Islam, Qazi Shafayetul Islam, Tridib Roy Chowdhury, Sukantha Kumar Chatterjee, Dulal Mia, Shyamal Chandra Das, Mizanur Rahman, Nazrul Islam, Shahaz Uddin, Nurul Islam, Luiza Khatun, Monira Parvin, Abdul Awal Khan, Maidul Islam, Herve Lawin, Arsene Kpangon, Karl Kpossou, Gildas Agodokpessi, Paul Ayelo, Benjamin Fayomi, Atongno Humphrey Ashu, Wen Wang, NanShan Zhong, Shengming Liu, Jiachun Lu, Dali Wang, Jin-ping Zheng, Yumin Zhou, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Ayola Akim Adegnika, Isabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Bryndis Benedikdtsdottir, Kristin Jörundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gudmundsson, Mahesh Rao, Sajjad Malik, Nissar A. Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Akosua Francia Aikman, Bermet M. Estebesova, Meerim Akmatalieva, Saadat Usenbaeva, Jypara Kydyrova, Eliza Bostonova, Ulan Sheraliev, Nuridin Marajapov, Nurgul Toktogulova, Berik Emilov, Toktogul Azilova, Gulnara Beishekeeva, Nasyikat Dononbaeva, Aijamal Tabyshova, Wezzie Nyapigoti, Ernest Mwangoka, Mayamiko Kambwili, Martha Chipeta, Gloria Banda, Suzgo Mkandawire, Justice Banda, Siti Sholehah, Mohamed C. Benjelloun, Mohamed Elbiaze, E. F. M. Wouters, G. J. Wesseling, Olayemi Awopeju, Olufemi Adewole, Tina Endresen, Lene Svendsen, Asaad A. Nafees, Teresita S. de Guia, Norberto A. Francisco, Camilo C. Roa, Fernando G. Ayuyao, Cecil Z. Tady, Daniel T. Tan, Sylvia Banal-Yang, Vincent M. Balanag, Maria Teresita N. Reyes, Renato. B. Dantes, Renato B. Dantes, Lourdes Amarillo, Lakan U. Berratio, Lenora C. Fernandez, Gerard S. Garcia, Sullian S. Naval, Thessa Reyes, Ma. Flordeliza Sanchez, Leander P. Simpao, Jakub Frey, Rafal Harat, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Fátima Rodrigues, Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos, Reis Ferreira, M. Al Ghobain, H. Alorainy, E. El-Hamad, M. Al Hajjaj, A. Hashi, R. Dela, R. Fanuncio, E. Doloriel, I. Marciano, L. Safia, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Rajitha Wickremasinghe, Hana A. Elsadig, Nada Bakery Osman, Bandar Salah Noory, Monjda Awad Mohamed, Hasab Alrasoul Akasha Ahmed Osman, Namarig Moham ed Elhassan, Abdel Mu‘is El Zain, Marwa Mohamed Mohamaden, Suhaiba Khalifa, Mahmoud Elhadi, Mohand Hassan, Dalia Abdelmonam, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz-Nyström, Gunilla Hägg, Gun-Marie Lund, Terence Seemungal, Fallon Lutchmansingh, Liane Conyette, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Peter G. J. Burney, Hadia Azar, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, Risha Dudhaiya, Mary Ann McBurnie, Suzanne Gillespie, Sean Sullivan, Todd A. Lee, Kevin B. Weiss, Robert L. Jensen, Robert Crapo, John Cain, Rebecca Copeland, Dana Hazen, Jennifer Methvin, RS: NUTRIM - R3 - Respiratory & Age-related Health, Pulmonologie, MUMC+: MA Longziekten (3), and Wellcome Trust
Subjects: Pulmonary and Respiratory Medicine, wa_754, Vital capacity, Passive smoking, multinational study, Respiratory System, AMERICAN THORACIC SOCIETY, Critical Care and Intensive Care Medicine, medicine.disease_cause, LOWER LIMIT, population-attributable risk, Environmental health, medicine, Burden of Obstructive Lung Disease (BOLD) study, PULMONARY-DISEASE, COPD, Population attributable risk, Risk factor, 11 Medical and Health Sciences, History of tuberculosis, business.industry, MORTALITY, ASSOCIATION, GLOBAL BURDEN, medicine.disease, Obstructive lung disease, REFERENCE VALUES, wf_20, chronic airflow obstruction, NEVER-SMOKERS, Relative risk, Attributable risk, OCCUPATION, wf_200, business, wf_600, wb_200
Abstract: Rationale: The Global Burden of Disease program identified smoking and ambient and household air pollution as the main drivers of death and disability from chronic obstructive pulmonary disease (COPD). Objective: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors. Methods: The Burden of Obstructive Lung Disease study is a cross-sectional study of adults, aged ≥40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a postbronchodilator FEV1-to-FVC ratio less than the lower limit of normal, and the relative risks associated with different risk factors. Local relative risks were estimated using a Bayesian hierarchical model borrowing information from across sites. From these relative risks and the prevalence of risk factors, we estimated local population attributable risks. Measurements and Main Results: The mean prevalence of CAO was 11.2% in men and 8.6% in women. The mean population attributable risk for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for ≥10 years, low body mass index, and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: Although smoking remains the most important risk factor for CAO, in some areas, poor education, low body mass index, and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.
Published: 2021

15. Airflow Obstruction and Use of Solid Fuels for Cooking or Heating BOLD (Burden of Obstructive Lung Disease) Results

Author: André F. S. Amaral, Jaymini Patel, Bernet S. Kato, Daniel O. Obaseki, Hervé Lawin, Wan C. Tan, Sanjay K. Juvekar, Imed Harrabi, Michael Studnicka, Emiel F. M. Wouters, Li-Cher Loh, Eric D. Bateman, Kevin Mortimer, A. Sonia Buist, Peter G. J. Burney, NanShan Zhong, Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang, Jingping Zheng, Yumin Zhou, Ali Kocabaş, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Torkil Dawes, Bernd Lamprecht, Lea Schirhofer, Eric Bateman, Anamika Jithoo, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Thorarinn Gislason, Bryndis Benedikdtsdottir, Kristin Jörundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gundmundsson, Ewa Nizankowska-Mogilnicka, Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Tobias Welte, Isabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Amund Gulsvik, Tina Endresen, Lene Svendsen, Wen Wang, David M. Mannino, John Cain, Rebecca Copeland, Dana Hazen, Jennifer Methvin, Renato B. Dantes, Lourdes Amarillo, Lakan U. Berratio, Lenora C. Fernandez, Norberto A. Francisco, Gerard S. Garcia, Teresita S. de Guia, Luisito F. Idolor, Sullian S. Naval, Thessa Reyes, Camilo C. Roa, Ma. Flordeliza Sanchez, Leander P. Simpao, Christine Jenkins, Guy Marks, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Peter GJ Burney, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, E. F. M. Wouters, G. J. Wesseling, Cristina Bárbara, Fátima Rodrigues, Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos, Reis Ferreira, Christer Janson, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz-Nyström, Gunilla Hägg, Gun-Marie Lund, Rain Jõgi, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Parvaiz A Koul, Sajjad Malik, Nissar A Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Fernando G. Ayuyao, Cecil Z. Tady, Daniel T. Tan, Sylvia Banal-Yang, Vincent M. Balanag, Maria Teresita N. Reyes, Renato. B. Dantes, Sanjay Juvekar, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Mohamed C Benjelloun, Chakib Nejjari, Mohamed Elbiaze, Karima El Rhazi, Daniel Obaseki, Gregory Erhabor, Olayemi Awopeju, Olufemi Adewole, M. Al Ghobain, H. Alorainy, E. El-Hamad, M. Al Hajjaj, H. Ayan, D. Rowena, F. Rofel, E. Elizabeth, I. Imelda, H. Safia, null Lyla, Talant M. Sooronbaev, Bermet M. Estebesova, Meerim Akmatalieva, Saadat Usenbaeva, Jypara Kydyrova, Eliza Bostonova, Ulan Sheraliev, Nuridin Marajapov, Nurgul Toktogulova, Berik Emilov, Toktogul Azilova, Gulnara Beishekeeva, Nasyikat Dononbaeva, null AijamalTabyshova, Wezzie Nyapigoti, Ernest Mwangoka, Mayamiko Kambwili, Martha Chipeta, Gloria Banda, Suzgo Mkandawire, Justice Banda, Asma Elsony, Hana A. Elsadig, Nada Bakery Osman, Bandar Salah Noory, Monjda Awad Mohamed, Hasab Alrasoul Akasha Ahmed Osman, Namarig Moham ed Elhassan, Abdel Mu‘is El Zain, Marwa Mohamed Mohamaden, Suhaiba Khalifa, Mahmoud Elhadi, Mohand Hassan, Dalia Abdelmonam, Hasan Hafizi, Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla, Rezarta Kazasi, Hamid Hacene Cherkaski, Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh, Nadia Ait-Khaled, Akramul Islam, Syed Masud Ahmed, Shayla Islam, Qazi Shafayetul Islam, null Mesbah-Ul-Haque, Tridib Roy Chowdhury, Sukantha Kumar Chatterjee, Dulal Mia, Shyamal Chandra Das, Mizanur Rahman, Nazrul Islam, Shahaz Uddin, Nurul Islam, Luiza Khatun, Monira Parvin, Abdul Awal Khan, Maidul Islam, Abdul Rashid, Siti Sholehah, Herve Lawin, Arsene Kpangon, Karl Kpossou, Gildas Agodokpessi, Paul Ayelo, Benjamin Fayomi, Pulmonologie, MUMC+: MA Longziekten (3), and RS: NUTRIM - R3 - Respiratory & Age-related Health
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Chronic bronchitis, solid fuels (biomass), Pulmonary disease, Biomass smoke, urologic and male genital diseases, Critical Care and Intensive Care Medicine, Airflow obstruction, airflow obstruction, Lower limit, chronic obstructive pulmonary disease, LOWER LIMIT, 03 medical and health sciences, 0302 clinical medicine, BIOMASS SMOKE, POLLUTION, low-income countries, Internal medicine, YOUNG-ADULTS, PULMONARY-DISEASE, Medicine, 030212 general & internal medicine, CHIMNEY STOVE INTERVENTION, COPD, business.industry, Original Articles, medicine.disease, Solid fuel, REFERENCE VALUES, respiratory tract diseases, CHRONIC-BRONCHITIS, 030228 respiratory system, NEVER-SMOKERS, Reference values, Cardiology, RISK-FACTORS, business
Abstract: Rationale: Evidence supporting the association of chronic obstructive pulmonary disease or airflow obstruction with use of solid fuels is conflicting and inconsistent. Objectives: To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating. Methods: We analyzed 18,554 adults from the BOLD (Burden of Obstructive Lung Disease) study, who had provided acceptable post-bronchodilator spirometry measurements, and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analyzed. We performed similar analyses for spirometric restriction, chronic cough, and chronic phlegm. Measurements and Main Results: We found no association between airflow obstruction and use of solid fuels for cooking or heating (odds ratio [OR] for men, 1.20 [95% confidence interval (CI), 0.94–1.53]; OR for women, 0.88 [95% CI, 0.67–1.15]). This was true for low-/middle- and high-income sites. Among never-smokers, there was also no evidence of an association of airflow obstruction with use of solid fuels (OR for men, 1.00 [95% CI, 0.57–1.76]; OR for women, 1.00 [95% CI, 0.76–1.32]). Overall, we found no association of spirometric restriction, chronic cough, or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never-smokers and those who had been exposed for 20 years or longer. Conclusions: Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.
Published: 2018
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16. Strengthening the quality and scope of paediatric primary care in South Africa: Evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

Author: Jamie Murdoch, Robyn Curran, Ruth Cornick, Sandy Picken, Max Bachmann, Eric Bateman, Makhosazana Lungile Simelane, and Lara Fairall
Abstract: Background: Despite significant reductions in mortality, preventable and treatable conditions remain leading causes of death and illness in children aged under five in South Africa. The PACK Child intervention, comprising a clinical decision support tool (guide), training strategy and health systems strengthening components, was developed to expand on WHO’s Integrated Management of Childhood Illness programme, and in 2017-2018 was piloted in 10 primary healthcare facilities in the Western Cape Province. Here we report findings from an investigation into the contextual features of South African primary care that shaped how clinicians delivered the PACK Child intervention within clinical consultations. Methods: Process evaluation using semi-structured interviews, focus groups, observation, audio-recorded consultations and documentary analysis. Linguistic ethnographic analysis of relationship between primary care contextual features and clinician-caregiver interactions.Results: Primary healthcare facilities demonstrated dominance of a risk minimisation approach upheld by provincial documentation, providing curative episodic care to children presenting with acute symptoms, and preventive care including immunisations, feeding and growth monitoring, all in children 5 years or younger. Children with chronic illnesses such as asthma rarely received routine care. These contextual features constrained the ability of clinicians to use the PACK Child intervention to facilitate diagnosis of long-term conditions, elicit and manage psychosocial issues, and navigate use of the guide alongside provincial documentation. Conclusion: Our findings provide evidence that PACK Child is catalysing a transition to an approach that strikes a balance between risk minimisation on the day of an acute presentation and a larger remit of care for the child over time. However, to optimise success of the intervention requires reviewing priorities for paediatric care which will facilitate enhanced skills, knowledge and deployment of clinical staff to better address acute illnesses and long-term health conditions of children of all ages, as well as complex psychosocial issues surrounding the child.
Published: 2019
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17. Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

Author: Dorairaj Prabhakaran, Shuchi Anand, David Watkins, Thomas Gaziano, Yangfeng Wu, Jean Claude Mbanya, Rachel Nugent, Vamadevan S Ajay, Ashkan Afshin, Alma Adler, Mohammed K Ali, Eric Bateman, Janet Bettger, Robert O Bonow, Elizabeth Brouwer, Gene Bukhman, Fiona Bull, Peter Burney, Simon Capewell, Juliana Chan, Eeshwar K Chandrasekar, Jie Chen, Michael H Criqui, John Dirks, Sagar B Dugani, Michael Engelgau, Meguid El Nahas, Caroline HD Fall, Valery Feigin, F Gerald R Fowkes, Amanda Glassman, Shifalika Goenka, Rajeev Gupta, Babar Hasan, Fred Hersch, Frank Hu, Mark D Huffman, Samer Jabbour, Deborah Jarvis, Panniyammakal Jeemon, Rohina Joshi, Jemima H Kamano, Andre Pascal Kengne, Preeti Kudesia, R Krishna Kumar, Kalyanaraman Kumaran, Estelle V Lambert, Edward S Lee, Chaoyun Li, Rong Luo, Matthew Magee, Vasanti S Malik, J Antonio Marin-Neto, Guy Marks, Bongani Mayosi, Helen McGuire, Renata Micha, J Jaime Miranda, Pablo Aschner Montoya, Andrew E Moran, Dariush Mozaffarian, Saraladevi Naicker, Nadraj G Naidoo, KM Venkat Narayan, Irina Nikolic, Martin O'Donnell, Churchill Onen, Clive Osmond, Anushka Patel, Rogelio Perez-Padilla, Neil Poulter, Michael Pratt, Miriam Rabkin, Vikram Rajan, Anis Rassi, Ishita Rawal, Giuseppe Remuzzi, Miguel Riella, Greg A Roth, Ambuj Roy, Adolfo Rubinstein, Yuna Sakuma, Uchechukwu KA Sampson, Karen R Siegel, Karen Sliwa, Marc Suhrcke, Nikhil Tandon, Bernadette Thomas, Claudia Vaca, Rajesh Vedanthan, Stéphane Verguet, Michael Webb, Mary Beth Weber, Laurie Whitsel, Gary Wong, Lijing L Yan, Clyde W Yancy, Ping Zhang, Dong Zhao, and Yishan Zhu
Subjects: Inequality, Cost effectiveness, media_common.quotation_subject, Respiratory Tract Diseases, Psychological intervention, MEDLINE, Developing country, 030204 cardiovascular system & hematology, Cardiovascular, Medical and Health Sciences, Article, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, General & Internal Medicine, Humans, Medicine, 030212 general & internal medicine, Developing Countries, Disease burden, media_common, Disease Control Priorities-3 Cardiovascular, Sustainable development, Public economics, Health Priorities, business.industry, Prevention, Financial risk, and Related Disorders Author Group, General Medicine, Health Services, Good Health and Well Being, Cardiovascular Diseases, Respiratory, business
Abstract: Cardiovascular, respiratory, and related disorders (CVRDs) are the leading causes of adult death worldwide, and substantial inequalities in care of patients with CVRDs exist between countries of high income and countries of low and middle income. Based on current trends, the UN Sustainable Development Goal to reduce premature mortality due to CVRDs by a third by 2030 will be challenging for many countries of low and middle income. We did systematic literature reviews of effectiveness and cost-effectiveness to identify priority interventions. We summarise the key findings and present a costed essential package of interventions to reduce risk of and manage CVRDs. On a population level, we recommend tobacco taxation, bans on trans fats, and compulsory reduction of salt in manufactured food products. We suggest primary health services be strengthened through the establishment of locally endorsed guidelines and ensured availability of essential medications. The policy interventions and health service delivery package we suggest could serve as the cornerstone for the management of CVRDs, and afford substantial financial risk protection for vulnerable households. We estimate that full implementation of the essential package would cost an additional US$21 per person in the average low-income country and $24 in the average lower-middle-income country. The essential package we describe could be a starting place for low-income and middle-income countries developing universal health coverage packages. Interventions could be rolled out as disease burden demands and budgets allow. Our outlined interventions provide a pathway for countries attempting to convert the UN Sustainable Development Goal commitments into tangible action.
Published: 2018

18. Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Nigeria

Author: Ajibola Awotiwon, Charlie Sword, Tracy Eastman, Christy Joy Ras, Prince Ana, Ruth Vania Cornick, Lara Fairall, Eric Bateman, Audry Dube, Robyn Curran, Inemesit Udoekwere, Unyime-Obong Essien, Okorie Assem, Theresa Sylvester Edu, Hajia Binta Ismail, Olalekan Olugbenga Olubajo, and Joseph Ana
Subjects: Practice, 03 medical and health sciences, 0302 clinical medicine, treatment, 030503 health policy & services, Health Policy, public health, Public Health, Environmental and Occupational Health, 030212 general & internal medicine, InformationSystems_MISCELLANEOUS, 0305 other medical science, health systems
Abstract: Nigeria, in its quest to strengthen its primary healthcare system, is faced with a number of challenges including a shortage of clinicians and skills. Methods are being sought to better equip primary healthcare clinicians for the clinical demands that they face. Using a mentorship model between developers in South Africa and Nigerian clinicians, the Practical Approach to Care Kit (PACK) for adult patients, a health systems strengthening programme, has been localised and piloted in 51 primary healthcare facilities in three Nigerian states. Lessons learnt from this experience include the value of this remote model of localisation for rapid localisation, the importance of early, continuous stakeholder engagement, the need expressed by Nigeria’s primary healthcare clinicians for clinical guidance that is user friendly and up-to-date, a preference for the tablet version of the PACK Adult guide over hard copies and the added value of WhatsApp groups to complement the programme of face-to-face continuous learning. Introduction of the PACK programme in Nigeria prompted uptake of evidence-informed recommendations within primary healthcare services.
Published: 2018
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19. Innovating to improve primary care in less developed countries: towards a global model

Author: Lara, Fairall, Eric, Bateman, Ruth, Cornick, Gill, Faris, Venessa, Timmerman, Naomi, Folb, Max, Bachmann, Merrick, Zwarenstein, and Richard, Smith
Subjects: Terminal Care, Review, Accessible, Affordable, Global Health, Delivery
Abstract: One of the biggest problems in global health is the lack of well trained and supported health workers in less developed settings. In many rural areas there are no physicians, and it is important to find ways to support and empower nurses and other health workers. The Knowledge Translation Unit of the University of Cape Town Lung Institute has spent 14 years developing a series of innovative packages to support and empower nurses and other health workers. PACK (Practical Approach to Care Kit) Adult comprises policy-based and evidence-informed guidelines; onsite, team and case-based training; non-physician prescribing; and a cascade system of scaling up. A series of randomised trials has shown the effectiveness of the packages, and methods are now being developed to respond cost-effectively and sustainably to global demand for implementing PACK Adult. Global health would probably benefit from less time and money spent developing new innovations and more spent on finding ways to spread those we already have.
Published: 2015

20. Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty--a BOLD analysis

Author: Peter, Burney, Anamika, Jithoo, Bernet, Kato, Christer, Janson, David, Mannino, Ewa, Nizankowska-Mogilnicka, Michael, Studnicka, Wan, Tan, Eric, Bateman, Ali, Koçabas, William M, Vollmer, Thorarrin, Gislason, Guy, Marks, Parvaiz A, Koul, Imed, Harrabi, Louisa, Gnatiuc, Sonia, Buist, and Georg, Harnoncourt
Subjects: Adult, Male, Tobacco and the lung, Adolescent, Respiratory Medicine and Allergy, Lung Physiology, Vital Capacity, Respiratory Epidemiology, Global Health, Risk Assessment, Pulmonary Disease, Chronic Obstructive, Young Adult, Sex Factors, Risk Factors, Forced Expiratory Volume, Prevalence, Humans, Poverty, Lungmedicin och allergi, Smoking, Middle Aged, United Kingdom, respiratory tract diseases, Survival Rate, Female, COPD epidemiology
Abstract: Background Chronic obstructive pulmonary disease (COPD) is a commonly reported cause of death and associated with smoking. However, COPD mortality is high in poor countries with low smoking rates. Spirometric restriction predicts mortality better than airflow obstruction, suggesting that the prevalence of restriction could explain mortality rates attributed to COPD. We have studied associations between mortality from COPD and low lung function, and between both lung function and death rates and cigarette consumption and gross national income per capita (GNI). Methods National COPD mortality rates were regressed against the prevalence of airflow obstruction and spirometric restriction in 22 Burden of Obstructive Lung Disease (BOLD) study sites and against GNI, and national smoking prevalence. The prevalence of airflow obstruction and spirometric restriction in the BOLD sites were regressed against GNI and mean pack years smoked. Results National COPD mortality rates were more strongly associated with spirometric restriction in the BOLD sites ( Conclusions Smoking remains the single most important cause of obstruction but a high prevalence of restriction associated with poverty could explain the high ‘COPD’ mortality in poor countries
Published: 2013

21. Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI—UnitedHealth Global Health Centers of Excellence Program

Author: Michael M. Engelgau, Uchechukwu K. Sampson, Cristina Rabadan-Diehl, Richard Smith, Jaime Miranda, Gerald S. Bloomfield, Deshiree Belis, K.M. Venkat Narayan, Adolfo Rubinstein, Jiang He, Dewan S. Alam, David H. Peters, Yangfeng Wu, Lijing L. Yan, Michael Merson, Manuel Ramirez, Benjamin Caballero, Denis Xavier, Salim Yusuf, Dorairaj Prabhakaran, Sylvester Kimaiyo, Eric Velazquez, Catalina A. Denman, Elsa Cornejo, Jill De Zapien, Cecilia Rosales, J. Jaime Miranda, Robert H. Gilman, Naomi Levitt, Thomas A. Gaziano, Hassen Ghannem, Tiina Laatikainen, Uchechukwu Sampson, Nancy L. Dianis, Tracy L. Wolbach, Gabriela Matta, Laura Gutierrez, Natalia Elorriaga, Rosana Poggio, Vilma Irazola, Lydia Bazzano, Abbas Bhuiya, Abdul Wazed, Alfazal Khan, Ali T. Siddiquee, Anwar Islam, Jahangir A.M. Khan, Jasim Uddin, Khaled Hasan, Masuma A. Khanam, Mohammad Yunus, Muhammad A.H. Chowdhury, Nazratun N. Monalisa, Nurul Alam, Peter K. Streatfield, Shyfuddin Ahmed, Sonia Parvin, Taslim Ali, Louis W. Niessen, Mohammad D. Hossain, Tracey L.P. Koehlmoos, Hilary Standing, Henry Lucas, Sara N. Bleich, Gerard F. Anderson, Antonio J. Trujillo, Andrew J. Mirelman, Jesse Hao, Jing Zhang, Maoyi Tian, Polly Huang, Rong Luo, Weigang Fang, Xian Li, Xiangxian Feng, Zhifang Li, Kelly Deal, Eric Peterson, Elizabeth DeLong, Bo Zhou, Jingpu Shi, Bruce Neal, Stephen Jan, Nicole Li, Stephen McMahon, Jianxin Zhang, Jixin Sun, Paul Elliot, Yi Zhao, Yuhong Zhang, Chen Yao, Ningling Huang Sun, Qide Han, Ruqun Shen, Wenyi Niu, Yanfang Wang, Yang Ke, Yining Huang, Stephen Leeder, Alan Lopez, Ruijuan Zhang, Yan Yu, Ana V. Roman, Carlos Mendoza, Dina Roche, Gabriela Mejicano, Maria A. Cordova, Maria F. Kroker, Meredith Fort, Paola Letona, Rebecca Kanter, Regina Garcia, Sandra Murillo, Violeta Chacon, Rafael Montero, Erika J. Lopez, Liz Peña, Maricruz Castro, Ana L. Dengo, Emilce Ulate, Nadia Alvarado, Josefina Sibrian, Astarte Alegria, Ana M. Gutierrez, Flavia Fontes, Alben Sigamani, Deepak Kamath, Freeda Xavier, K.B. Deepthi, M. Anupama, Nandini Mathu, Nisha George, Pranjali Rahul, Prem Pais, Preeti Girish, Seena Thomas, T. Usha, Tinku Thomas, Rajnish Joshi, N. Chidambaram, Rajeev Gupta, Clara Chow, Janice Pogue, Martin O'Donnell, P.J. Devereaux, Dominic Misquith, Twinkle Agrawal, Farah N. Fathima, Kolli Srinath Reddy, Roopa Shivashankar, Vamadevan S. Ajay, Hassan M. Khan, M. Masood Kadir, Muhammad Q. Masood, Zafar Fatmi, Anand Krishnan, Kavita Singh, Nikhil Tandon, Rajesh Khadgawat, V. Usha Menon, Bipin Kumar Sethi, A.G. Unnikrishnan, Mark L. Hutcheson, Mohammed K. Ali, Solveig A. Cunningham, Shivani A. Patel, Unjali Gujral, Ankush Desai, Deepa Mohan, R. Guha Pradeepa, V. Mohan, Vijay Viswanathan, Rakesh Sahay, Seema Shah, Ganapathi Bantwal, Premlata K. Varthakavi, Manisha Nair, Constantine Akwanalo, David Lagat, Felix Barasa, Myra Koech, Wilson Sugut, Belinda Korir, Priscah Mosol, Shamim Ali, Charles B. Sherman, Jane Carter, Gerald Bloomfield, Cynthia Binanay, Rajesh Vedanthan, A. Bernabé-Ortiz, F. León-Velarde, George D. Smith, Germán Málaga, Héctor H. García, Juan P. Casas, Katherine Sacksteder, Liam Smeeth, Luis Huicho, María Rivera, Raúl Gamboa, Shah Ebrahim, Víctor M. Montori, Robert A. Wise, William Checkley, Gregory B. Diette, Beatrice Nojilana, Buyelwa Majikela-Dlangamandla, Carmelita Sylvester, Johanna Malan, Katherine Murphy, Krisela Steyn, Lindi Van Niekerk, Robert Mash, Thandi Puoane, Grace Kim, Ankur Pandya, Shafika Abrahams-Gessel, Hilary Rhode, Michael Pather, Alvaro R. Andrade, Beatriz Garcia, Carlos Velasco, David Medina, Delia Bravo, Diana Munguia, Eric Bateman, Francisco Castro, Helen Schneider, Ilse Ibarra, Jabulisiwe Zulu, Joel Felix, Karla Tribe, Kirsten Bobrow, Lara Fairall, Naomi Folb, Norma Murillo, Norma Pacheco, Paloma Rodriguez, Paola Navarro, Reyna Flores, Richard Van Zyl Smit, Rosario Meddoza, Sameer Surka, Serena Van Haght, Yanira Hernandez, Lungiswa Tsolekile, Gouider Jeridi, Imed Harrabi, Jihen Maatoug, Lamia Boughammoura, Larbi Chaieb, Nejib Mrizek, Rafika Gaha, Khalifa Limam, Souad Amimi, Karima Gaha, Habib Gamra, Mustafa Al'Absi, Erkki Vartiainen, Cornelius Moore, Debi Spillan, Kristiane Cooper, Megan Mitchell, Ruth Kirby, Yunling Gao, and Emmanuel Aluko
Subjects: Gerontology, Economic growth, Biomedical Research, Epidemiology, media_common.quotation_subject, Developing country, 030204 cardiovascular system & hematology, Global Health, Public-Private Sector Partnerships, Article, 03 medical and health sciences, 0302 clinical medicine, Excellence, Global network, Global health, Humans, Medicine, 030212 general & internal medicine, Developing Countries, media_common, Community and Home Care, business.industry, Academies and Institutes, Achievement, United States, Noncommunicable disease, Lung disease, General partnership, National Heart, Lung, and Blood Institute (U.S.), Cardiology and Cardiovascular Medicine, business, Commons
Abstract: Effectively tackling the growing noncommunicable disease (NCD) burden in low- and middle-income countries (LMIC) is a major challenge. To address research needs in this setting for NCDs, in 2009, National Heart, Lung, and Blood Institute (NHLBI) and UnitedHealth Group (UHG) engaged in a public-private partnership that supported a network of 11 LMIC-based research centers and created the NHLBI-UnitedHealth Global Health Centers of Excellence (COE) Program. The Program’s overall goal was to contribute to reducing the cardiovascular and lung disease burdens by catalyzing in-country research institutions to develop a global network of biomedical research centers. Key elements of the Program included team science and collaborative approaches, developing research and training platforms for future investigators, and creating a data commons. This Program embraced a strategic approach for tackling NCDs in LMICs and will provide capacity for locally driven research efforts that can identify and address priority health issues in specific countries’ settings.HighlightsA public-private partnership created the Program.Forming the Program captured all the elements of team science.The Program used best practices of collaborative science.Research training for future investigators was a high priority.
Published: 2016
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22. Efficacy and safety of the long-acting muscarinic antagonist GSK233705 delivered once daily in patients with COPD

Author: Eric, Bateman, Gregory, Feldman, Sally, Kilbride, Jean, Brooks, Rashmi, Mehta, Stephanie, Harris, Claire, Maden, and Glenn, Crater
Subjects: Male, Dose-Response Relationship, Drug, Muscarinic Antagonists, Middle Aged, Severity of Illness Index, Drug Administration Schedule, Statistics, Nonparametric, Bronchodilator Agents, Respiratory Function Tests, Pulmonary Disease, Chronic Obstructive, Treatment Outcome, Double-Blind Method, Reference Values, Delayed-Action Preparations, Forced Expiratory Volume, Administration, Inhalation, Confidence Intervals, Humans, Female, Prospective Studies, Aged, Follow-Up Studies
Abstract: GSK233705 is a recently developed inhaled anticholinergic being investigated for the potential treatment of chronic obstructive pulmonary disease (COPD).This dose-ranging, parallel-group, double-blind study compared the bronchodilator efficacy, safety and pharmacokinetics of GSK233705 with placebo in patients with moderate-to-severe COPD.Patients were randomised to receive 12.5 µg, 25 µg, 50 µg, 100 µg or 200 µg of GSK233705 or placebo once daily for 28 days. The primary endpoint was change from baseline in trough forced expiratory volume in 1 s (FEV(1)) on day 29.The intent-to-treat population consisted of 576 patients (mean predicted FEV(1) 51%; mean age 62 years). Treatment with GSK233705 produced statistically significant improvements in pulmonary function compared with placebo. Only the 200 µg dose exceeded the predefined target threshold of 130-mL difference compared with placebo for the primary endpoint of change from baseline in trough FEV(1) on day 29. No clear pattern of dose response was observed for the other doses. Serial FEV(1) (0-24 h) showed a peak effect around 2 h postdose and tended to decline to clinically insignificant levels compared with placebo at 23 and 24 h. Each dose of GSK233705 was well tolerated. The incidence of adverse events was low and similar across all treatment groups. There were no clinically significant effects on laboratory parameters, vital signs or electrocardiograms.All doses of GSK233705 demonstrated bronchodilatory activity and were well tolerated. Although the onset of bronchodilation was rapid, it was not sustained over 24 h making it unsuitable for once-daily dosing.
Published: 2012

23. P255 ATTAIN: twice-daily aclidinium bromide in patients with moderate to severe chronic obstructive pulmonary disease

Author: E. Garcia Gil, R. Lamarca, Dave Singh, G de Miquel, Cynthia Caracta, Paul W. Jones, Eric Bateman, and Alexandre Escolà Agustí
Subjects: Pulmonary and Respiratory Medicine, COPD, Exacerbation, business.industry, Vital signs, Muscarinic antagonist, medicine.disease, Placebo, Aclidinium bromide, Anesthesia, Clinical endpoint, medicine, Adverse effect, business, medicine.drug
Abstract: Introduction and Objectives The Phase III ATTAIN study investigated the effect of two twice daily doses of aclidinium bromide, a second-generation, long-acting muscarinic antagonist with low systemic activity, in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Methods In this 24-week, double-blind study, patients were randomised (1:1:1) to receive aclidinium (200 μg, 400 μg) or placebo, twice daily. The primary endpoint was change from baseline in trough forced expiratory volume in 1 second (FEV 1 ) at Week 24. Other study assessments at 24 weeks included: change from baseline in peak FEV 1 ; percentage of patients achieving a clinically meaningful improvement in St George9s Respiratory Questionnaire total score and Transition Dyspnoea Index; COPD symptoms as assessed by the EXACT Respiratory Symptoms score; exacerbation rate based on two definitions (healthcare resource utilisation and EXAcerbations of Chronic pulmonary disease Tool). Adverse events (AEs), clinical laboratory measures, vital signs and ECGs were also assessed. Results A total of 819 patients were included in intention-to-treat (ITT) and safety populations. At Week 24, aclidinium 200 μg and 400 μg significantly improved trough FEV 1 from baseline compared with placebo (by 99 ml and 128 ml, respectively; both p Conclusion Aclidinium 200 μg and 400 μg twice daily provided clinically meaningful improvements in bronchodilation, health status, symptoms, breathlessness and exacerbation rate. Aclidinium was well tolerated with a similar safety profile for both doses; the incidence of AEs was similar to placebo.
Published: 2011
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24. Once-Daily QVA149 Improves Lung Function, Dyspnea, and Health Status Independent of Disease Severity and Prior Medications: The SHINE Study

Author: Donald Banerji, Eric Bateman, Kenneth R. Chapman, Nicola Gallagher, and Huilin Hu
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Disease severity, business.industry, Severity of illness, medicine, Once daily, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Intensive care medicine, business, Lung function, Pulmonary function testing
Published: 2014
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25. ATTAIN: Efficacy and Safety of Twice-Daily Aclidinium Bromide in Chronic Obstructive Pulmonary Disease (COPD)

Author: Eric Bateman, Cynthia Caracta, David Singh, R. Lamarca, Gonzalo de Miquel, Esther Garcia Gil, Paul W. Jones, and Alvar Agusti
Subjects: Pulmonary and Respiratory Medicine, COPD, medicine.medical_specialty, Aclidinium bromide, business.industry, Internal medicine, medicine, Pulmonary disease, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, medicine.disease, business
Published: 2011
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26. Aclidinium Bromide in Patients With Chronic Obstructive Pulmonary Disease (COPD): Reduction in Exacerbations as Defined by Health-care Utilization and the EXACT Diary Card

Author: Paul W. Jones, R. Lamarca, Gonzalo de Miquel, Eric Bateman, Esther Garcia Gil, Cynthia Caracta, David Singh, and Alvar Agusti
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, COPD, business.industry, Pulmonary disease, Diary card, Critical Care and Intensive Care Medicine, medicine.disease, Aclidinium bromide, Health care, medicine, In patient, Cardiology and Cardiovascular Medicine, Intensive care medicine, business
Published: 2011
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27. REPORT ON THREE CASES OF PROGRESSIVE MYOPIA AND ONE CASE OF HYPERPHORIA

Author: Eric Bateman
Subjects: Ophthalmology, medicine.medical_specialty, business.industry, Medicine, business, Hyperphoria, Optometry
Published: 1937
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28. THE CANTONNET SYSTEM FROM THE VIEWPOINT OF GENERAL PSYCHOLOGY*

Author: Eric Bateman
Subjects: Ophthalmology, General psychology, Humans, Vision, Low, Orthoptic training, Philosophy of psychology, Blindness, Psychology, Vision, Ocular, Orthoptics, Optometry, Epistemology
Published: 1946
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29. SOME INTERESTING CASE REPORTS

Author: Eric Bateman
Subjects: Ophthalmology, Optometry
Published: 1937
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30. COMMENT ON THE TREATMENT OF MYOPIA

Author: Eric Bateman
Subjects: Ophthalmology, Myopia, Humans, Psychology, Optometry
Published: 1948
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31. CORRESPONDENCE

Author: ERIC BATEMAN
Subjects: Ophthalmology, Optometry
Published: 1948
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32. COLOR TRANSPARENCIES OF OPTOMETRIC OFFICES

Author: Eric Bateman
Subjects: Ophthalmology, Engineering, Optics, business.industry, Optometry, business
Published: 1968
Full Text: View/download PDF

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32 results on '"Eric Bateman"'

1. Prevalence of chronic cough, its risk factors and population attributable risk in the Burden of Obstructive Lung Disease (BOLD) study: a multinational cross-sectional studyResearch in context

2. Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update

3. Addressing the quality of paediatric primary care: health worker and caregiver perspectives from a process evaluation of PACK child, a health systems intervention in South Africa

4. Addressing the quality and scope of paediatric primary care in South Africa: evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

5. Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

6. Efficacy and safety of tiotropium Respimat® SMI in COPD in two 1-year randomized studies

7. Development of a simple reliable radiographic scoring system to aid the diagnosis of pulmonary tuberculosis.

8. Increased production of IL-4 and IL-12p40 from bronchoalveolar lavage cells are biomarkers of Mycobacterium tuberculosis in the sputum.

9. Immunomodulation with recombinant interferon-gamma1b in pulmonary tuberculosis.

10. Contemporary Challenges in the Management of Asthma and Chronic Obstructive Pulmonary Disease: Expert Perspectives on Optimising Outcomes Through Guidelines Implementation, Inhaler Selection, and Patient Engagement

11. Efficacy of dupilumab in patients with moderate-to-severe asthma and persistent airflow obstruction

12. COPD

13. Overdiagnosis of COPD in Subjects With Unobstructed Spirometry

14. Prevalence and population-attributable risk for chronic airflow obstruction in a large multinational study

15. Airflow Obstruction and Use of Solid Fuels for Cooking or Heating BOLD (Burden of Obstructive Lung Disease) Results

16. Strengthening the quality and scope of paediatric primary care in South Africa: Evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

17. Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

18. Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Nigeria

19. Innovating to improve primary care in less developed countries: towards a global model

20. Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty--a BOLD analysis

21. Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI—UnitedHealth Global Health Centers of Excellence Program

22. Efficacy and safety of the long-acting muscarinic antagonist GSK233705 delivered once daily in patients with COPD

23. P255 ATTAIN: twice-daily aclidinium bromide in patients with moderate to severe chronic obstructive pulmonary disease

24. Once-Daily QVA149 Improves Lung Function, Dyspnea, and Health Status Independent of Disease Severity and Prior Medications: The SHINE Study

25. ATTAIN: Efficacy and Safety of Twice-Daily Aclidinium Bromide in Chronic Obstructive Pulmonary Disease (COPD)

26. Aclidinium Bromide in Patients With Chronic Obstructive Pulmonary Disease (COPD): Reduction in Exacerbations as Defined by Health-care Utilization and the EXACT Diary Card

27. REPORT ON THREE CASES OF PROGRESSIVE MYOPIA AND ONE CASE OF HYPERPHORIA

28. THE CANTONNET SYSTEM FROM THE VIEWPOINT OF GENERAL PSYCHOLOGY*

29. SOME INTERESTING CASE REPORTS

30. COMMENT ON THE TREATMENT OF MYOPIA

31. CORRESPONDENCE

32. COLOR TRANSPARENCIES OF OPTOMETRIC OFFICES

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32 results on '"Eric Bateman"'

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