scholarly journals Idiopathic Pulmonary Fibrosis in the United Kingdom: Analysis of the British Thoracic Society Electronic Registry between 2013 and 2019

2020 ◽  
pp. 00187-2020
Author(s):  
LG Spencer ◽  
M Loughenbury ◽  
C Chaudhuri ◽  
M Spiteri ◽  
H Parfrey
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Biopsy ◽  
Clinical Characteristics ◽  
Treatment Strategies ◽  
British Thoracic Society ◽  
The United Kingdom ◽  
Number Of Patients ◽  
The Uk ◽  
Over Time

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and terminal interstitial lung disease (ILD) with a median survival of 3–5 years. The British Thoracic Society (BTS) established the UK IPF Registry in 2013 as a platform to collect data on clinical characteristics, treatments and outcomes for this cohort in the UK.Between 1st January 2013 and 31st October 2019, 2474 cases were registered. Most patients were male (79%) with a mean (sd) age of 74±8.3 and 66% were ex-smokers. Over time we observed an increase in the number of patients aged over 70. However, we have not seen a trend towards earlier presentation as symptoms of breathless and/or cough were present for more than 12 months in 63% of the cohort. At presentation, mean (sd) percent predicted FVC was 78.2±18.3, median 76.2 (IQR 65.888.2) and TLco 48.4±16.0, median 47.5 (IQR 37.3, 57.4). Most cases were discussed at an ILD multi-disciplinary meeting, with an increase over this time in the number of cases reported as having possible UIP pattern on HRCT thorax. We noted a reduction in the number of patients undergoing surgical lung biopsy or bronchoalveolar lavage. Although more patients were prescribed anti-fibrotic therapies from 2013 to 2019, 43% were ineligible for treatment based upon NICE prescribing criteria. Hypertension, ischaemic heart disease, diabetes mellitus and gastro-oesophageal reflux were the most common co-morbidities.In conclusion, we have presented baseline demographics as well as diagnostic and treatment strategies from the largest single-country IPF registry, reflecting changes in UK practices over this period.

scholarly journals Resource and waste quantification scenarios for wind turbine decommissioning in the United Kingdom

2020 ◽  
Author(s):  
Kiran Tota-Maharaj ◽  
Alexander McMahon
Keyword(s):  
United Kingdom ◽  
Waste Management ◽  
Wind Turbine ◽  
End Of Life ◽  
Wind Turbines ◽  
Rapid Rise ◽  
The United Kingdom ◽  
Management Procedures ◽  
The Uk ◽  
Over Time

AbstractWind power produces more electricity than any other form of renewable energy in the United Kingdom (UK) and plays a key role in decarbonisation of the grid. Although wind energy is seen as a sustainable alternative to fossil fuels, there are still several environmental impacts associated with all stages of the lifecycle of a wind farm. This study determined the material composition for wind turbines for various sizes and designs and the prevalence of such turbines over time, to accurately quantify waste generation following wind turbine decommissioning in the UK. The end of life stage is becoming increasingly important as a rapid rise in installation rates suggests an equally rapid rise in decommissioning rates can be expected as wind turbines reach the end of their 20–25-year operational lifetime. Waste data analytics were applied in this study for the UK in 5-year intervals, stemming from 2000 to 2039. Current practices for end of life waste management procedures have been analysed to create baseline scenarios. These scenarios have been used to explore potential waste management mitigation options for various materials and components such as reuse, remanufacture, recycling, and heat recovery from incineration. Six scenarios were then developed based on these waste management options, which have demonstrated the significant environmental benefits of such practices through quantification of waste reduction and greenhouse gas (GHG) emissions savings. For the 2015–2019 time period, over 35 kilotonnes of waste are expected to be generated annually. Overall waste is expected to increase over time to more than 1200 kilotonnes annually by 2039. Concrete is expected to account for the majority of waste associated with wind turbine decommissioning initially due to foundations for onshore turbines accounting for approximately 80% of their total weight. By 2035–2039, steel waste is expected to account for almost 50% of overall waste due to the emergence of offshore turbines, the foundations of which are predominantly made of steel.

Impact of Lung Biopsy on Lung Function in Idiopathic Pulmonary Fibrosis

Respiration ◽  
2020 ◽  
pp. 1-8
Author(s):  
Pierre-Henri Aussedat ◽  
Nader Chebib ◽  
Kais Ahmad ◽  
Jean-Charles Glerant ◽  
Gabrielle Drevet ◽  
...  
Keyword(s):  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Forced Vital Capacity ◽  
Lung Biopsy ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Surgical Lung Biopsy ◽  
Before And After ◽  
The Impact

<b><i>Background:</i></b> Video-assisted surgical lung biopsy (SLB) is performed in 10–30% of cases to establish the diagnosis of idiopathic pulmonary fibrosis (IPF). <b><i>Objectives:</i></b> The aim of the study was to analyze the impact of SLB on lung function in patients eventually diagnosed with IPF. <b><i>Methods:</i></b> This is an observational, retrospective, monocentric study of all consecutive patients eventually diagnosed with IPF in multidisciplinary discussion who underwent SLB over 10 years in a specialized center. The primary end point was the variation in forced vital capacity (FVC) before and after the SLB. The secondary end points were the variations in forced expiratory volume in one second (FEV1), total lung capacity (TLC), carbon monoxide diffusion capacity (DLCO), and morbidity and mortality associated with the SLB. <b><i>Results:</i></b> In 118 patients who underwent SLB and were diagnosed with IPF, a relative decrease in FVC of 4.8% (<i>p</i> &#x3c; 0.001) was found between measurements performed before and after the procedure. The mean FVC decrease was 156 ± 386 mL in an average period of 185 days, representing an annualized decline of 363 ± 764 mL/year. A significant decrease was also observed after SLB in FEV1, TLC, and DLCO. Complications within 30 days of SLB occurred in 14.4% of patients. Two patients (1.7%) died within 30 days, where one of them had poor lung function. Survival at 1 year was significantly poorer in patients with FVC &#x3c;50% at baseline. <b><i>Conclusion:</i></b> In this uncontrolled study in patients ultimately diagnosed with IPF, SLB was followed by a significant decline in FVC, which appears to be numerically greater than the average decline in the absence of treatment in the literature. <b><i>Summary at a Glance:</i></b> This study evaluated the change in lung function in 118 consecutive patients diagnosed with idiopathic pulmonary fibrosis by surgical lung biopsy. Forced vital capacity decreased by 156 ± 386 mL in a mean of 185 days between the last measurement before and first measurement after biopsy, representing an annualized decline of 363 ± 764 mL/year.

scholarly journals P196 Healthcare utilisation by patients with Idiopathic Pulmonary Fibrosis; observations from the UK pirfenidone Named Patient Programme

Thorax ◽  
2013 ◽  
Vol 68 (Suppl 3) ◽  
pp. A164.3-A165 ◽  
Author(s):  
H Parfrey ◽  
C Leonard ◽  
MA Gibbons ◽  
E Armstrong ◽  
E Harris ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Healthcare Utilisation ◽  
Named Patient Programme ◽  
The Uk

scholarly journals Clinical characteristics, comorbidities, and outcomes in patients with idiopathic pulmonary fibrosis

2020 ◽  
Vol 15 (4) ◽  
pp. 208
Author(s):  
EsamH Alhamad ◽  
JosephG Cal ◽  
NuhaN Alrajhi ◽  
WaleedM Aharbi ◽  
AmmarC AlRikabi ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Clinical Characteristics

scholarly journals Concordance between sequential transbronchial lung cryobiopsy and surgical lung biopsy in patients with diffuse interstitial lung disease

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yoshiaki Zaizen ◽  
Yasuo Kohashi ◽  
Kishio Kuroda ◽  
Kazuhiro Tabata ◽  
Yuka Kitamura ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lung Disease ◽  
Lung Biopsy ◽  
Usual Interstitial Pneumonia ◽  
Airway Disease ◽  
Surgical Lung Biopsy ◽  
High Concordance ◽  
Transbronchial Lung Cryobiopsy

Abstract Background Increasing evidence indicates the utility of transbronchial lung cryobiopsy (TBLC) for the diagnosis of interstitial lung disease (ILD). However, only one study has compared TBLC and surgical lung biopsy (SLB) performed on the same patients. Methods We identified seven patients with ILD with TBLC and SLB. We evaluated the clinical characteristics and made a pathological diagnosis based on the official ATS/ERS/JRS/ALAT clinical practice guideline of idiopathic pulmonary fibrosis with both TBLC and SLB. Results Six cases were diagnosed as Usual interstitial pneumonia (UIP) in both TBLC and SLB. One case was diagnosed as indeterminate for UIP with TBLC and probable UIP with SLB. Etiological diagnosis with TBLC and SLB were concordant in 2 cases of idiopathic pulmonary fibrosis (IPF) but discordant for other diagnoses. Major histological findings of UIP including dense fibrosis, peripheral distribution, and fibroblastic foci showed high concordance between TBLC and SLB, which implies that TBLC can reliably detect these features. In contrast, loose fibrosis, cellular infiltration, and airway disease showed poor concordance between the two methods. Conclusion Our study showed that TBLC is useful for UIP diagnosis but not for other ILD. With a multidisciplinary approach, diagnosis of IPF may be determined by TBLC, whereas ILD other than IPF may require SLB.

scholarly journals Differences in Clinical Characteristics and Outcomes Between Men and Women With Idiopathic Pulmonary Fibrosis

CHEST Journal ◽  
2020 ◽  
Vol 158 (1) ◽  
pp. 245-251
Author(s):  
Tanzira Zaman ◽  
Teng Moua ◽  
Eric Vittinghoff ◽  
Jay H. Ryu ◽  
Harold R. Collard ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Clinical Characteristics ◽  
Men And Women
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