GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Non-invasive ventilation for SARS-CoV-2 acute respiratory failure: a subanalysis from the HOPE COVID-19 registry
    BMJ ; 2021
    In:  Emergency Medicine Journal Vol. 38, No. 5 ( 2021-05), p. 359-365
    Details
    In: Emergency Medicine Journal, BMJ, Vol. 38, No. 5 ( 2021-05), p. 359-365
    Abstract: The COVID-19 pandemic has seriously challenged worldwide healthcare systems and limited intensive care facilities, leading to physicians considering the use of non-invasive ventilation (NIV) for managing SARS-CoV-2-related acute respiratory failure (ARF). Methods We conducted an interim analysis of the international, multicentre HOPE COVID-19 registry including patients admitted for a confirmed or highly suspected SARS-CoV-2 infection until 18 April 2020. Those treated with NIV were considered. The primary endpoint was a composite of death or need for intubation. The components of the composite endpoint were the secondary outcomes. Unadjusted and adjusted predictors of the primary endpoint within those initially treated with NIV were investigated. Results 1933 patients who were included in the registry during the study period had data on oxygen support type. Among them, 390 patients (20%) were treated with NIV. Compared with those receiving other non-invasive oxygen strategy, patients receiving NIV showed significantly worse clinical and laboratory signs of ARF at presentation. Of the 390 patients treated with NIV, 173 patients (44.4%) met the composite endpoint. In-hospital death was the main determinant (147, 37.7%), while 62 patients (15.9%) needed invasive ventilation. Those requiring invasive ventilation had the lowest survival rate (41.9%). After adjustment, age (adjusted OR (adj(OR)) for 5-year increase: 1.37, 95% CI 1.15 to 1.63, p 〈 0.001), hypertension (adj(OR) 2.95, 95% CI 1.14 to 7.61, p=0.03), room air O 2 saturation 〈 92% at presentation (adj(OR) 3.05, 95% CI 1.28 to 7.28, p=0.01), lymphocytopenia (adj(OR) 3.55, 95% CI 1.16 to 10.85, p=0.03) and in-hospital use of antibiotic therapy (adj(OR) 4.91, 95% CI 1.69 to 14.26, p=0.003) were independently associated with the composite endpoint. Conclusion NIV was used in a significant proportion of patients within our cohort, and more than half of these patients survived without the need for intubation. NIV may represent a viable strategy particularly in case of overcrowded and limited intensive care resources, but prompt identification of failure is mandatory to avoid harm. Further studies are required to better clarify our hypothesis. Trial registration numbers NCT04334291 /EUPAS34399.
    Type of Medium: Online Resource
    ISSN: 1472-0205 , 1472-0213
    URL: Article
    DOI: 10.1136/emermed-2020-210411
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2027092-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Faster lung function decline in people living with HIV despite adequate treatment: a longitudinal matched cohort study
    BMJ ; 2023
    In:  Thorax Vol. 78, No. 6 ( 2023-06), p. 535-542
    Details
    In: Thorax, BMJ, Vol. 78, No. 6 ( 2023-06), p. 535-542
    Abstract: Chronic lung disease is common among people living with HIV (PLWH). We hypothesised that PLWH receiving antiretroviral therapy (ART) have faster lung function decline than matched controls. Methods We performed a prospective matched cohort study by including ART-treated PLWH from the Copenhagen Co-morbidity in HIV Infection Study (n=705) and the INSIGHT Strategic Timing of Antiretroviral Treatment Pulmonary Substudy (n=425) and frequency matched population controls from the Copenhagen General Population Study (n=2895) in a 1:3 ratio. Eligible participants were ≥25 years old and had two spirometry tests separated by at least 2 years of follow-up. Forced expiratory volume in 1 s (FEV 1 ) decline (mL/year) was compared between PLWH and controls using a linear mixed model adjusted for age, sex, ethnicity and smoking status. Effect modification by smoking was investigated in subgroup analyses. Results The majority of PLWH were virally suppressed (96.1%). The adjusted mean annual decline in FEV 1 was faster in PLWH than in controls with 36.4 (95% CI 33.7 to 39.1) vs 27.9 (95% CI 26.9 to 28.8) mL/year, yielding a difference of 8.5 (95% CI 5.6 to 11.4) mL/year. The association between HIV and FEV 1 decline was modified by smoking, with the largest difference in current smokers (difference: 16.8 (95% CI 10.5 to 23.0) mL/year) and the smallest difference in never-smokers (difference: 5.0 (95% CI 0.7 to 9.3) mL/year). FEV 1 decline 〉 40 mL/year was more prevalent in PLWH (adjusted OR: 1.98 (95% CI 1.67 to 2.34)). Conclusion Well-treated PLWH have faster lung function decline than controls and smoking seems to modify this association, suggesting that smoking may lead to more rapid lung function decline in PLWH than in controls.
    Type of Medium: Online Resource
    ISSN: 0040-6376 , 1468-3296
    URL: Article
    DOI: 10.1136/thorax-2022-218910
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 1481491-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    TRPC6 inhibitor (BI 764198) to reduce risk and severity of ARDS due to COVID-19: a phase II randomised controlled trial
    BMJ ; 2023
    In:  Thorax Vol. 78, No. 8 ( 2023-08), p. 816-824
    Details
    In: Thorax, BMJ, Vol. 78, No. 8 ( 2023-08), p. 816-824
    Abstract: Despite the availability of COVID-19 vaccinations, there remains a need to investigate treatments to reduce the risk or severity of potentially fatal complications of COVID-19, such as acute respiratory distress syndrome (ARDS). This study evaluated the efficacy and safety of the transient receptor potential channel C6 (TRPC6) inhibitor, BI 764198, in reducing the risk and/or severity of ARDS in patients hospitalised for COVID-19 and requiring non-invasive, supplemental oxygen support (oxygen by mask or nasal prongs, oxygen by non-invasive ventilation or high-flow nasal oxygen). Methods Multicentre, double-blind, randomised phase II trial comparing once-daily oral BI 764198 (n=65) with placebo (n=64) for 28 days (+2-month follow-up). Primary endpoint: proportion of patients alive and free of mechanical ventilation at day 29. Secondary endpoints: proportion of patients alive and discharged without oxygen (day 29); occurrence of either in-hospital mortality, intensive care unit admission or mechanical ventilation (day 29); time to first response (clinical improvement/recovery); ventilator-free days (day 29); and mortality (days 15, 29, 60 and 90). Results No difference was observed for the primary endpoint: BI 764198 (83.1%) versus placebo (87.5%) (estimated risk difference –5.39%; 95% CI –16.08 to 5.30; p=0.323). For secondary endpoints, a longer time to first response (rate ratio 0.67; 95% CI 0.46 to 0.99; p=0.045) and longer hospitalisation (+3.41 days; 95% CI 0.49 to 6.34; p=0.023) for BI 764198 versus placebo was observed; no other significant differences were observed. On-treatment adverse events were similar between trial arms and more fatal events were reported for BI 764198 (n=7) versus placebo (n=2). Treatment was stopped early based on an interim observation of a lack of efficacy and an imbalance of fatal events (Data Monitoring Committee recommendation). Conclusions TRPC6 inhibition was not effective in reducing the risk and/or severity of ARDS in patients with COVID-19 requiring non-invasive, supplemental oxygen support. Trial registration number NCT04604184 .
    Type of Medium: Online Resource
    ISSN: 0040-6376 , 1468-3296
    URL: Article
    DOI: 10.1136/thorax-2022-219668
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 1481491-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    SAT0523 BIOLOGICAL THERAPY IN REFRACTORY ATYPICAL OPTIC NEURITIS. MULTICENTER STUDY
    BMJ ; 2020
    In:  Annals of the Rheumatic Diseases Vol. 79, No. Suppl 1 ( 2020-06), p. 1217.1-1218
    Details
    In: Annals of the Rheumatic Diseases, BMJ, Vol. 79, No. Suppl 1 ( 2020-06), p. 1217.1-1218
    Abstract: Optic Neuritis (ON) is an inflammation of the optic nerve. Its most common presentation is demyelinating typical ON. Atypical ON is rare, severe, non-demyelinating and can be isolated or associated to different diseases including autoimmune diseases. If it is not treated, it can lead to devastating visual results. Conventional treatment includes systemic corticosteroids and conventional immunosuppressants (CIS). Objectives: Our aim was to assess the efficacy of biological therapy in atypical ON refractory to conventional treatment. Methods: Open-label multicenter study including 19 patients diagnosed with atypical ON refractory to systemic corticosteroids and at least one CIS. The main outcomes assessed were Best Corrected Visual Acuity (BCVA) and optic nerve and ganglionar cells Optical Coherence Tomography (OCT). These outcome variables were recorded at baseline, 1 week, 2 weeks, 1 month, 3 months and 6 months and 1 year after biological therapy onset. FIGURE Results: We studied 19 patients (12 women/7 men); mean age of 34.8 ± 13.9 years. The underlying diseases were idiopathic (n=7), Behçet´s disease (n=5), systemic lupus erythematosus (n=2), neuromyelitis optica (n=3), sarcoidosis (n=1) and relapsing polychondritis (n=1) (TABLE). Before biological therapy and besides systemic corticosteroids, patients had received different CIS. Biological therapy was adalimumab (n=6), rituximab (n=6), infliximab (n=5) and tocilizumab (n=4). After biological therapy, an improvement in ocular parameters was observed: BCVA [0.7±0.3 to 0.8±0.3; p= 0.03], optic nerve OCT [123.2±58.3 to 190.5±175.4; p= 0.11] , and ganglionar cells OCT [369.6±137.4 to 270.7±23.2; p= 0.03] at one year (FIGURE ). After a mean follow-up of 29.1 ±19.2 months, there were no severe adverse effects observed. Conclusion: Biological therapy may be effective in patients with refractory atypical ON. TABLE Case Gender/ Age Underlying disease Laterality IV steroids dose (g) Maximum prednisone oral dose (g) Conventional immunosuppressants Biological therapy Adverse effects 1 F/29 Idiopathic Unilateral 4 60 AZA TCZ No 2 F/26 Idiopathic Bilateral 5.5 30 AZA TCZ No 3 F/13 Idiopathic Bilateral - 10 MTX ADA No 4 F/25 Idiopathic Bilateral 4 60 MTX IFX, TCZ No 5 F/24 Idiopathic Bilateral 0.5 60 MTX, AZA ADA No 6 M/14 Idiopathic Bilateral - 10 MTX ADA No 7 F/30 Vasculitis ANCA+ Unilateral 3 60 AZA, MMF, LFM, CFM RTX Yes 8 M/21 Behçet Bilateral - 60 MTX, AZA ADA Nausea Vomits 9 M/25 Behçet Unilateral 0.5 60 MTX, CyA ADA No 10 M/39 Behçet Unilateral 3 80 MTX, MMF IFX No 11 M/40 Behçet Unilateral - 80 MMF IFX No 12 M/37 Behçet Unilateral - 60 CyA IFX No 13 F/68 NMO Unilateral 2.5 30 CFM, AZA RTX No 14 F/41 NMO Unilateral 3 60 CFM RTX Infection 15 F/43 NMO Bilateral 5 60 AZA RTX Infusion reaction 16 F/56 SLE Unilateral - 60 HCQ, MMF, CFM RTX No 17 F/47 SLE Unilateral 5 60 HCQ, MMF RTX No 18 F/43 Relapsing polychondritis Bilateral 3 60 MTX, CFM IFX, TCZ No 19 M/41 Sarcoidosis Bilateral 3 40 AZA ADA No Disclosure of Interests: Alba Herrero Morant: None declared, Carmen Álvarez Reguera: None declared, Vanesa Calvo del Rio Grant/research support from: MSD and Roche, Speakers bureau: Abbott, Lilly, Celgene, Grünenthal, UCB Pharma, Olga Maíz Alonso: None declared, Ana Blanco Speakers bureau: Abbvie, J. Narváez: None declared, Santos Castañeda: None declared, Esther Vicente Speakers bureau: BMS, Roche., Susana Romero-Yuste: None declared, Rosalía Demetrio-Pablo: None declared, ANA URRUTICOECHEA-ARANA: None declared, J. L. García Serrano: None declared, J. L. Callejas Rubio: None declared, Norberto Ortego: None declared, Julio Sánchez: None declared, Paula Estrada: None declared, Iñigo Rua-Figueroa: None declared, David Martínez-López: None declared, José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Janssen and Celgene, Speakers bureau: Pfizer and Lilly, Miguel Á. González-Gay Grant/research support from: AbbVie, MSD and Roche, Speakers bureau: AbbVie, MSD and Roche, Ricardo Blanco Grant/research support from: Abbvie, MSD and Roche, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Lilly and MSD
    Type of Medium: Online Resource
    ISSN: 0003-4967 , 1468-2060
    URL: Article
    DOI: 10.1136/annrheumdis-2020-eular.5122
    RVK:
    XA 10000
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 1481557-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Impact of smoking on COVID-19 outcomes: a HOPE Registry subanalysis
    BMJ ; 2021
    In:  BMJ Nutrition, Prevention & Health Vol. 4, No. 1 ( 2021-06), p. 285-292
    Details
    In: BMJ Nutrition, Prevention & Health, BMJ, Vol. 4, No. 1 ( 2021-06), p. 285-292
    Abstract: Smoking has been associated with poorer outcomes in relation to COVID-19. Smokers have higher risk of mortality and have a more severe clinical course. There is paucity of data available on this issue, and a definitive link between smoking and COVID-19 prognosis has yet to be established. Methods We included 5224 patients with COVID-19 with an available smoking history in a multicentre international registry Health Outcome Predictive Evaluation for COVID-19 ( NCT04334291 ). Patients were included following an in-hospital admission with a COVID-19 diagnosis. We analysed the outcomes of patients with a current or prior history of smoking compared with the non-smoking group. The primary endpoint was all-cause in-hospital death. Results Finally, 5224 patients with COVID-19 with available smoking status were analysed. A total of 3983 (67.9%) patients were non-smokers, 934 (15.9%) were former smokers and 307 (5.2%) were active smokers. The median age was 66 years (IQR 52.0–77.0) and 58.6% were male. The most frequent comorbidities were hypertension (48.5%) and dyslipidaemia (33.0%). A relevant lung disease was present in 19.4%. In-hospital complications such sepsis (23.6%) and embolic events (4.3%) occurred more frequently in the smoker group (p 〈 0.001 for both). All cause-death was higher among smokers (active or former smokers) compared with non-smokers (27.6 vs 18.4%, p 〈 0.001). Following a multivariate analysis, current smoking was considered as an independent predictor of mortality (OR 1.77, 95% CI 1.11 to 2.82, p=0.017) and a combined endpoint of severe disease (OR 1.68, 95% CI 1.16 to 2.43, p=0.006). Conclusion Smoking has a negative prognostic impact on patients hospitalised with COVID-19.
    Type of Medium: Online Resource
    ISSN: 2516-5542
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1136/bmjnph-2021-000269
    DOI: 10.1136/bmjnph-2021-000269.supp1
    DOI: 10.1136/bmjnph-2021-000269.supp2
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2938786-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Cardiovascular disease in HIV patients: from bench to bedside and backwards
    BMJ ; 2015
    In:  Open Heart Vol. 2, No. 1 ( 2015-03), p. e000174-
    Details
    In: Open Heart, BMJ, Vol. 2, No. 1 ( 2015-03), p. e000174-
    Type of Medium: Online Resource
    ISSN: 2053-3624
    URL: Article
    DOI: 10.1136/openhrt-2014-000174
    Language: English
    Publisher: BMJ
    Publication Date: 2015
    detail.hit.zdb_id: 2747269-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...