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\n  \n 2022\n \n \n (6)\n \n \n
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\n \n\n \n \n \n \n \n \n Current role of high dose vitamin C in sepsis management: A concise review.\n \n \n \n \n\n\n \n Juneja, D.; Nasa, P.; and Jain, R.\n\n\n \n\n\n\n World Journal of Critical Care Medicine, 11(6): 349–363. November 2022.\n \n\n\n\n
\n\n\n\n \n \n \"CurrentPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@article{juneja_current_2022,\n\ttitle = {Current role of high dose vitamin {C} in sepsis management: {A} concise review},\n\tvolume = {11},\n\tissn = {2220-3141},\n\tshorttitle = {Current role of high dose vitamin {C} in sepsis management},\n\turl = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693906/},\n\tdoi = {10.5492/wjccm.v11.i6.349},\n\tabstract = {Sepsis and septic shock are common diagnoses for patients requiring intensive care unit admission and associated with high morbidity and mortality. In addition to aggressive fluid resuscitation and antibiotic therapy, several other drugs have been tried as adjuvant therapies to reduce the inflammatory response and improve outcomes. Vitamin C has been shown to have several biological actions, including anti-inflammatory and immunomodulatory effects, which may prove beneficial in sepsis management. Initial trials showed improved patient outcomes when high dose vitamin C was used in combination with thiamine and hydrocortisone. These results, along with relative safety of high-dose (supra-physiological) vitamin C, encouraged physicians across the globe to add vitamin C as an adjuvant therapy in the management of sepsis. However, subsequent large-scale randomised control trials could not replicate these results, leaving the world divided regarding the role of vitamin C in sepsis management. Here, we discuss the rationale, safety profile, and the current clinical evidence for the use of high-dose vitamin C in the management of sepsis and septic shock.},\n\tnumber = {6},\n\turldate = {2024-03-07},\n\tjournal = {World Journal of Critical Care Medicine},\n\tauthor = {Juneja, Deven and Nasa, Prashant and Jain, Ravi},\n\tmonth = nov,\n\tyear = {2022},\n\tpmid = {36439321},\n\tpmcid = {PMC9693906},\n\tpages = {349--363},\n}\n\n
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\n Sepsis and septic shock are common diagnoses for patients requiring intensive care unit admission and associated with high morbidity and mortality. In addition to aggressive fluid resuscitation and antibiotic therapy, several other drugs have been tried as adjuvant therapies to reduce the inflammatory response and improve outcomes. Vitamin C has been shown to have several biological actions, including anti-inflammatory and immunomodulatory effects, which may prove beneficial in sepsis management. Initial trials showed improved patient outcomes when high dose vitamin C was used in combination with thiamine and hydrocortisone. These results, along with relative safety of high-dose (supra-physiological) vitamin C, encouraged physicians across the globe to add vitamin C as an adjuvant therapy in the management of sepsis. However, subsequent large-scale randomised control trials could not replicate these results, leaving the world divided regarding the role of vitamin C in sepsis management. Here, we discuss the rationale, safety profile, and the current clinical evidence for the use of high-dose vitamin C in the management of sepsis and septic shock.\n
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\n \n\n \n \n \n \n \n \n Perspectives of mild asthma patients on maintenance versus as-needed preventer treatment regimens: a qualitative study.\n \n \n \n \n\n\n \n Foster, J.; Beasley, R.; Braithwaite, I.; Harrison, T.; Holliday, M.; Pavord, I.; and Reddel, H.\n\n\n \n\n\n\n BMJ Open, 12(1): e048537. January 2022.\n \n\n\n\n
\n\n\n\n \n \n \"PerspectivesPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@article{foster_perspectives_2022,\n\ttitle = {Perspectives of mild asthma patients on maintenance versus as-needed preventer treatment regimens: a qualitative study},\n\tvolume = {12},\n\tissn = {2044-6055, 2044-6055},\n\tshorttitle = {Perspectives of mild asthma patients on maintenance versus as-needed preventer treatment regimens},\n\turl = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2020-048537},\n\tdoi = {10.1136/bmjopen-2020-048537},\n\tabstract = {Objectives\n              As-needed low-dose combination budesonide-formoterol is recommended by asthma guidelines in many countries as an alternative to maintenance inhaled corticosteroids (ICS) for treatment of mild asthma, but there are few data on patient attitudes toward these regimens. This study explored the comparative implementation experiences and future treatment preferences of mild asthma patients who had experienced these two treatment regimens.\n            \n            \n              Setting\n              A subgroup of adults randomised to maintenance ICS or as-needed ICS-formoterol in a multinational, 52-week open-label randomised controlled trial (NovelSTART) in mild asthma patients were interviewed to explore their motivations for treatment use during the study and their preferences for future treatment.\n            \n            \n              Participants\n              Semistructured interviews were conducted with 74 participants (Maintenance group: n=39, As-needed group n=35, mean age 38 (range 19–69)) and thematically analysed from transcribed audiorecordings.\n            \n            \n              Results\n              Emergent themes from analysis comprised: ‘How much my asthma affects me’ (how their asthma’s impact affected their self-management motivation); ‘What I know about asthma’ (limited knowledge impeded appropriate self-management decision making); ‘How much effort this treatment regimen involves for me’ (treatment complexity and/or difficulty establishing a medication routine impeded implementation, particularly in the Maintenance group); and ‘My beliefs about the benefits and risks of this treatment’ (patients who considered their treatment as ineffective, eg, limited difference in symptoms relative to salbutamol (both groups) or slower onset of relief (As-needed group) had poor motivation to use the treatment). Due to the simplicity of the as-needed combination strategy, this was the preferred future regimen, even by patients who had not yet tried it.\n            \n            \n              Conclusions\n              Key patient perspectives on the implementation of preventer treatments for mild asthma included factors relating to perceived asthma burden, disease knowledge, treatment complexity and treatment usefulness or safety. The as-needed budesonide-formoterol regimen was preferred to maintenance ICS treatment in mild asthma though patient education is urgently needed to address implementation motivation.\n            \n            \n              Trial registration number\n              ACTRN12615000999538.},\n\tlanguage = {en},\n\tnumber = {1},\n\turldate = {2022-03-27},\n\tjournal = {BMJ Open},\n\tauthor = {Foster, Juliet and Beasley, Richard and Braithwaite, Irene and Harrison, Tim and Holliday, Mark and Pavord, Ian and Reddel, Helen},\n\tmonth = jan,\n\tyear = {2022},\n\tpages = {e048537},\n}\n\n
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\n Objectives As-needed low-dose combination budesonide-formoterol is recommended by asthma guidelines in many countries as an alternative to maintenance inhaled corticosteroids (ICS) for treatment of mild asthma, but there are few data on patient attitudes toward these regimens. This study explored the comparative implementation experiences and future treatment preferences of mild asthma patients who had experienced these two treatment regimens. Setting A subgroup of adults randomised to maintenance ICS or as-needed ICS-formoterol in a multinational, 52-week open-label randomised controlled trial (NovelSTART) in mild asthma patients were interviewed to explore their motivations for treatment use during the study and their preferences for future treatment. Participants Semistructured interviews were conducted with 74 participants (Maintenance group: n=39, As-needed group n=35, mean age 38 (range 19–69)) and thematically analysed from transcribed audiorecordings. Results Emergent themes from analysis comprised: ‘How much my asthma affects me’ (how their asthma’s impact affected their self-management motivation); ‘What I know about asthma’ (limited knowledge impeded appropriate self-management decision making); ‘How much effort this treatment regimen involves for me’ (treatment complexity and/or difficulty establishing a medication routine impeded implementation, particularly in the Maintenance group); and ‘My beliefs about the benefits and risks of this treatment’ (patients who considered their treatment as ineffective, eg, limited difference in symptoms relative to salbutamol (both groups) or slower onset of relief (As-needed group) had poor motivation to use the treatment). Due to the simplicity of the as-needed combination strategy, this was the preferred future regimen, even by patients who had not yet tried it. Conclusions Key patient perspectives on the implementation of preventer treatments for mild asthma included factors relating to perceived asthma burden, disease knowledge, treatment complexity and treatment usefulness or safety. The as-needed budesonide-formoterol regimen was preferred to maintenance ICS treatment in mild asthma though patient education is urgently needed to address implementation motivation. Trial registration number ACTRN12615000999538.\n
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\n \n\n \n \n \n \n \n \n Predicting the benefits of type-2 targeted anti-inflammatory treatment with the prototype Oxford Asthma Attack Risk Scale (ORACLE).\n \n \n \n \n\n\n \n Couillard, S.; Do, W. I. H.; Beasley, R.; Hinks, T. S.; and Pavord, I. D.\n\n\n \n\n\n\n ERJ Open Research, 8(1): 00570–2021. January 2022.\n \n\n\n\n
\n\n\n\n \n \n \"PredictingPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@article{couillard_predicting_2022,\n\ttitle = {Predicting the benefits of type-2 targeted anti-inflammatory treatment with the prototype {Oxford} {Asthma} {Attack} {Risk} {Scale} ({ORACLE})},\n\tvolume = {8},\n\tissn = {2312-0541},\n\turl = {http://openres.ersjournals.com/lookup/doi/10.1183/23120541.00570-2021},\n\tdoi = {10.1183/23120541.00570-2021},\n\tlanguage = {en},\n\tnumber = {1},\n\turldate = {2022-03-27},\n\tjournal = {ERJ Open Research},\n\tauthor = {Couillard, Simon and Do, William Il Hoon and Beasley, Richard and Hinks, Timothy S.C. and Pavord, Ian D.},\n\tmonth = jan,\n\tyear = {2022},\n\tpages = {00570--2021},\n}\n\n
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\n \n\n \n \n \n \n \n \n Thoracic Society of Australia and New Zealand Position Statement on Acute Oxygen Use in Adults: ‘Swimming between the flags’.\n \n \n \n \n\n\n \n Barnett, A.; Beasley, R.; Buchan, C.; Chien, J.; Farah, C. S.; King, G.; McDonald, C. F.; Miller, B.; Munsif, M.; Psirides, A.; Reid, L.; Roberts, M.; Smallwood, N.; and Smith, S.\n\n\n \n\n\n\n Respirology, 27(4): 262–276. April 2022.\n \n\n\n\n
\n\n\n\n \n \n \"ThoracicPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n\n \n  \n \n 1 download\n \n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@article{barnett_thoracic_2022,\n\ttitle = {Thoracic {Society} of {Australia} and {New} {Zealand} {Position} {Statement} on {Acute} {Oxygen} {Use} in {Adults}: ‘{Swimming} between the flags’},\n\tvolume = {27},\n\tissn = {1323-7799, 1440-1843},\n\tshorttitle = {Thoracic {Society} of {Australia} and {New} {Zealand} {Position} {Statement} on {Acute} {Oxygen} {Use} in {Adults}},\n\turl = {https://onlinelibrary.wiley.com/doi/10.1111/resp.14218},\n\tdoi = {10.1111/resp.14218},\n\tlanguage = {en},\n\tnumber = {4},\n\turldate = {2022-03-27},\n\tjournal = {Respirology},\n\tauthor = {Barnett, Adrian and Beasley, Richard and Buchan, Catherine and Chien, Jimmy and Farah, Claude S. and King, Gregory and McDonald, Christine F. and Miller, Belinda and Munsif, Maitri and Psirides, Alex and Reid, Lynette and Roberts, Mary and Smallwood, Natasha and Smith, Sheree},\n\tmonth = apr,\n\tyear = {2022},\n\tpages = {262--276},\n}\n\n
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\n \n\n \n \n \n \n \n \n Evaluation of Budesonide-Formoterol for Maintenance and Reliever Therapy Among Patients With Poorly Controlled Asthma: A Systematic Review and Meta-analysis.\n \n \n \n \n\n\n \n Beasley, R.; Harrison, T.; Peterson, S.; Gustafson, P.; Hamblin, A.; Bengtsson, T.; and Fagerås, M.\n\n\n \n\n\n\n JAMA Network Open, 5(3): e220615. March 2022.\n \n\n\n\n
\n\n\n\n \n \n \"EvaluationPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@article{beasley_evaluation_2022,\n\ttitle = {Evaluation of {Budesonide}-{Formoterol} for {Maintenance} and {Reliever} {Therapy} {Among} {Patients} {With} {Poorly} {Controlled} {Asthma}: {A} {Systematic} {Review} and {Meta}-analysis},\n\tvolume = {5},\n\tissn = {2574-3805},\n\tshorttitle = {Evaluation of {Budesonide}-{Formoterol} for {Maintenance} and {Reliever} {Therapy} {Among} {Patients} {With} {Poorly} {Controlled} {Asthma}},\n\turl = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789512},\n\tdoi = {10.1001/jamanetworkopen.2022.0615},\n\tlanguage = {en},\n\tnumber = {3},\n\turldate = {2022-03-04},\n\tjournal = {JAMA Network Open},\n\tauthor = {Beasley, Richard and Harrison, Tim and Peterson, Stefan and Gustafson, Per and Hamblin, Angus and Bengtsson, Thomas and Fagerås, Malin},\n\tmonth = mar,\n\tyear = {2022},\n\tpages = {e220615},\n}\n\n
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\n \n\n \n \n \n \n \n \n Repeated dose budesonide/formoterol compared to salbutamol in adult asthma: A randomised cross-over trial.\n \n \n \n \n\n\n \n Kearns, N.; Bruce, P.; Williams, M.; Doppen, M.; Black, M.; Weatherall, M.; and Beasley, R.\n\n\n \n\n\n\n European Respiratory Journal,2102309. February 2022.\n \n\n\n\n
\n\n\n\n \n \n \"RepeatedPaper\n  \n \n\n \n \n doi\n  \n \n\n \n link\n  \n \n\n bibtex\n \n\n \n  \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n  \n \n \n\n\n\n
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@article{kearns_repeated_2022,\n\ttitle = {Repeated dose budesonide/formoterol compared to salbutamol in adult asthma: {A} randomised cross-over trial},\n\tissn = {0903-1936, 1399-3003},\n\tshorttitle = {Repeated dose budesonide/formoterol compared to salbutamol in adult asthma},\n\turl = {http://erj.ersjournals.com/lookup/doi/10.1183/13993003.02309-2021},\n\tdoi = {10.1183/13993003.02309-2021},\n\tabstract = {Objective\n              \n                To determine the comparative bronchodilator, systemic beta\n                2\n                -agonist, cardiovascular and adverse effects of salbutamol 200 µg and budesonide/formoterol 200/6 µg when taken repeatedly in stable asthma.\n              \n            \n            \n              Methods\n              \n                This open-label, cross-over, single-centre, controlled trial, randomised adults with asthma to different orders of two treatment regimens: salbutamol 200 µg\n                via\n                MDI at t=0, 30, 60, 90 min, then salbutamol 2.5 mg\n                via\n                nebuliser at t=120, 140, 160 and 420 min; or budesonide/formoterol 200/6 µg one actuation\n                via\n                Turbuhaler at t=0, 30, 60, 90 min, two actuations at t=120, 140, 160 and 420 min. The primary outcome measure was FEV\n                1\n                after 180 min. Secondary outcomes included repeat measures of FEV\n                1\n                , serum potassium, heart rate, and adverse events\n              \n            \n            \n              Results\n              \n                Of 39 patients randomised, two withdrew due to adverse events (QT\n                CF\n                prolongation and T wave abnormalities) after the first intervention with salbutamol. The mean (\n                sd\n                ) change from baseline FEV\n                1\n                180 min after randomisation for salbutamol and budesonide/formoterol regimens was 0.71 (0.46) L, N=38, and 0.58 (0.45) L, N=37, respectively; with a mean (\n                sd\n                ) paired difference of −0.10 (0.40) L, N=37, and a model-based estimated difference (95\\% CI) −0.12 (−0.25 to 0.02) L, p=0.088. In the main secondary analysis, salbutamol resulted in significantly greater FEV\n                1\n                from 30 to 240 min, but lesser FEV\n                1\n                at 360 and 420 min. Salbutamol resulted in a significantly lower serum potassium, and a higher heart rate and number of adverse events.\n              \n            \n            \n              Conclusion\n              \n                The comparative bronchodilator responses of repeated administration of salbutamol 200 µg dose\n                −1\n                and budesonide/formoterol 200/6 µg differed depending on the time of measurement. Salbutamol caused greater systemic beta\n                2\n                -agonist and cardiovascular effects and more adverse events.},\n\tlanguage = {en},\n\turldate = {2022-03-04},\n\tjournal = {European Respiratory Journal},\n\tauthor = {Kearns, Nethmi and Bruce, Pepa and Williams, Mathew and Doppen, Marjan and Black, Melissa and Weatherall, Mark and Beasley, Richard},\n\tmonth = feb,\n\tyear = {2022},\n\tpages = {2102309},\n}\n
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\n Objective To determine the comparative bronchodilator, systemic beta 2 -agonist, cardiovascular and adverse effects of salbutamol 200 µg and budesonide/formoterol 200/6 µg when taken repeatedly in stable asthma. Methods This open-label, cross-over, single-centre, controlled trial, randomised adults with asthma to different orders of two treatment regimens: salbutamol 200 µg via MDI at t=0, 30, 60, 90 min, then salbutamol 2.5 mg via nebuliser at t=120, 140, 160 and 420 min; or budesonide/formoterol 200/6 µg one actuation via Turbuhaler at t=0, 30, 60, 90 min, two actuations at t=120, 140, 160 and 420 min. The primary outcome measure was FEV 1 after 180 min. Secondary outcomes included repeat measures of FEV 1 , serum potassium, heart rate, and adverse events Results Of 39 patients randomised, two withdrew due to adverse events (QT CF prolongation and T wave abnormalities) after the first intervention with salbutamol. The mean ( sd ) change from baseline FEV 1 180 min after randomisation for salbutamol and budesonide/formoterol regimens was 0.71 (0.46) L, N=38, and 0.58 (0.45) L, N=37, respectively; with a mean ( sd ) paired difference of −0.10 (0.40) L, N=37, and a model-based estimated difference (95% CI) −0.12 (−0.25 to 0.02) L, p=0.088. In the main secondary analysis, salbutamol resulted in significantly greater FEV 1 from 30 to 240 min, but lesser FEV 1 at 360 and 420 min. Salbutamol resulted in a significantly lower serum potassium, and a higher heart rate and number of adverse events. Conclusion The comparative bronchodilator responses of repeated administration of salbutamol 200 µg dose −1 and budesonide/formoterol 200/6 µg differed depending on the time of measurement. Salbutamol caused greater systemic beta 2 -agonist and cardiovascular effects and more adverse events.\n
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