High sustained virologic response rates, regardless of race or socioeconomic class, in patients treated with chronic hepatitis C in community practice using a specialized pharmacy team.

Approved direct-acting antiviral (DAA) regimens against hepatitis C virus (HCV) can cure nearly all patients; however, socioeconomic disparities may impact access and outcome. This study assesses socioeconomic factors, differences in insurance coverage and the drug prior authorization process in HCV-infected patients managed in community practices partnered with a dedicated pharmacy team with expertise in liver disease. This Institutional Review Board-approved, ongoing study captures data on a cohort of 2480 patients from community practices.

Uptake of internet-delivered UK adult hearing assessment.

Objective: To evaluate uptake of the internet-based hearing test, with respect to the 11% of UK adults that have hearing loss but do not use hearing aids.

Design: Feasibility study in a primary care practice in the North of England.

Study Sample: Adults aged 50-74 years were sent postal invitations to complete an internet hearing test ( = 600).

Real-world observational experience with direct-acting antivirals for hepatitis C: baseline resistance, efficacy, and need for long-term surveillance.

The aim of this study was to obtain real-world, US, observational data on the effect of baseline resistance-associated substitutions (RASs) on achieving sustained virologic response (SVR) in hepatitis C (HCV) patients treated with direct-acting antiviral (DAA) regimens; the need for long-term follow-up in post-SVR patients.It is uncertain if the presence of RASs limits efficacy to DAAs. Once SVR is achieved, society guidelines recommend long-term surveillance for hepatocellular carcinoma in certain patients.

Transesterification of propylene glycol methyl ether in chromatographic reactors using anion exchange resin as a catalyst.

Reactive chromatography using an anion exchange resin is proposed for a transesterification reaction of propylene glycol methyl ether (DOWANOL™ PM) with ethyl acetate to produce propylene glycol methyl ether acetate (DOWANOL™ PMA). This reaction is studied in batch and chromatographic reactors catalyzed by an anion exchange resin. Several anion exchange resins are tested and compared based on the performance of resin as an adsorbent and a catalyst.

Optimization of reactive simulated moving bed systems with modulation of feed concentration for production of glycol ether ester.

In this article, we extend the simulated moving bed reactor (SMBR) mode of operation to the production of propylene glycol methyl ether acetate (DOWANOL™ PMA glycol ether) through the esterification of 1-methoxy-2-propanol (DOWANOL™ PM glycol ether) and acetic acid using AMBERLYST™ 15 as a catalyst and adsorbent. In addition, for the first time, we integrate the concept of modulation of the feed concentration (ModiCon) to SMBR operation. The performance of the conventional (constant feed) and ModiCon operation modes of SMBR are analyzed and compared.

Making audit actionable: an example algorithm for blood pressure management in chronic kidney disease.

Despite widespread use of clinical guidelines, actual care often falls short of ideal standards. Electronic health records (EHR) can be analyzed to provide information on how to improve care, but this is seldom done in sufficient detail to guide specific action. We developed an algorithm to provide practical, actionable information for care quality improvement using blood pressure (BP) management in chronic kidney disease (CKD) as an exemplar.

Does BCG vaccination protect against childhood asthma? Final results from the Manchester Community Asthma Study retrospective cohort study and updated systematic review and meta-analysis.

Background: The Manchester Community Asthma Study (MANCAS) found a protective effect against the risk of wheeze at age 6 to 11 years for children given neonatal BCG vaccination. Our subsequent systematic review and meta-analysis suggested that BCG vaccination did not protect against allergic sensitization but might have exerted a protective effect against nonatopic asthma.

Objectives: We sought to assess whether the protective effect of BCG vaccination on wheeze observed in the MANCAS cohort was maintained at age 13 to 17 years and to incorporate the findings from this final MANCAS analysis into an updated systematic review and meta-analysis.

Prevalence of respiratory symptoms at two time points in a population of children in Manchester--a cohort study.

Objective: Although the prevalence of asthma and atopy has been noted to have increased in recent decades, patterns of asthma prevalence have, traditionally, been difficult to track. Most reports on trends in childhood asthma have been cross-sectional measuring the prevalence in cohorts of similar aged children at different time points. The aim of this paper is to report on the prevalence of symptoms in the same cohort at two separate time points.

Standards of care for occupational asthma: an update.

Background: The British Thoracic Society (BTS) Standards of Care (SoC) Committee produced a standard of care for occupational asthma (OA) in 2008, based on a systematic evidence review performed in 2004 by the British Occupational Health Research Foundation (BOHRF).

Methods: BOHRF updated the evidence base from 2004-2009 in 2010.

Results: This article summarises the changes in evidence and is aimed at physicians, nurses and other healthcare professionals in primary and secondary care, occupational health and public health and at employers, workers and their health, safety and other representatives.

Temporal change in health-related quality of life: a longitudinal study in general practice 1999-2004.

Background: In order to assess and plan for changing healthcare needs, the lack of available information regarding temporal changes in the health-related quality of life of a population must be addressed.

Aim: This paper aims to describe such changes over 5 years in a general population.

Design Of Study: Longitudinal postal questionnaire study.

How do common chronic conditions affect health-related quality of life?

Background: Comorbidity is common. National Institute for Health and Clinical Excellence (NICE) guidelines have been created to make best use of resources to improve patients' quality of life but do not currently take account of comorbidity. The effect of multiple chronic conditions with regard to health-related quality of life (HRQoL) is poorly researched.

Prevalence of airflow obstruction in patients attending a rapid access chest pain clinic.

Background: Many UK hospitals have set-up specialised chest pain clinics to deal promptly and efficiently with cases of possible cardiac chest pain. It is possible that a proportion of patients attending these clinics will have a respiratory cause for their chest pain, or respiratory disease in addition to their cardiac pain. This study aimed to determine the prevalence of airflow obstruction, ischaemic heart disease and dual pathology in such patients.

Factors influencing the response to postal questionnaire surveys about respiratory symptoms.

Background: Response rates to postal questionnaires have been falling in recent years.

Aim: To examine factors affecting the response to five postal respiratory questionnaire surveys.

Design: Cross sectional study.

Prevalence of respiratory symptoms, features of asthma, and characteristics associated with respiratory disease, in 6-11 year olds in Manchester.

Aims: This paper describes the prevalence of respiratory symptoms, features of asthma, and characteristics associated with respiratory disease in 6-11 year old children in an historical cohort study.

Methods: The study included 5086 children, all born in the same maternity unit in the north west of England over a four-year period. The prevalence of respiratory symptoms, features of asthma, and characteristics associated with respiratory disease were determined by the use of parent-completed questionnaires.

Long term prognosis in preschool children with wheeze: longitudinal postal questionnaire study 1993-2004.

Objectives: To follow a population of preschool children with and without parent reported wheeze over a period of 6-11 years to determine prognosis and its important predictive factors.

Design: Longitudinal series of five postal surveys based on the international study of asthma and allergies in childhood questionnaire carried out between 1993 and 2004.

Setting: Two general practice populations, south Manchester.

Dynamic response to heat--a novel physical characteristic of breast cancer.

We report a novel observation about breast cancer. We imaged 6 fresh pathological specimens of breast cancer (1 mastectomy and 5 lumpectomies) with a sensitive infrared camera. We found that, following exposure to hot air for 1min, the cancers warmed up much less than the surrounding normal breast with a difference ranging from 12 to 20 degrees C.

Retraction by surface ferromagnetisation of target tissues: preliminary studies on feasibility of magnetic retraction for endoscopic surgery.

Background: Magnetic retraction has potential advantages over existing direct physical retraction means (e.g., forceps) in terms of providing complete atraumatic retraction, avoiding tumour cell exfoliation as well as offering the possibility of noncontact retraction.

National survey on the roles and training of primary care respiratory nurses in the UK in 2006: are we making progress?

Objectives: To describe nurse-led UK general practice asthma and chronic obstructive pulmonary disease (COPD) care, and the training undertaken to support it.

Methods: Questionnaires were sent to 500 randomly-selected UK asthma and COPD practice nurses.

Results: 382 nurses (76%) completed the practice characteristics section, 389 (78%) described their asthma roles and training, and 368 (74%) described their COPD roles and training.

Use of glycol ethers for selective release of periplasmic proteins from Gram-negative bacteria.

Genetic modification of Gram-negative bacteria to express a desired protein within the cell's periplasmic space, located between the inner cytoplasmic membrane and the outer cell wall, can offer an attractive strategy for commercial production of therapeutic proteins and industrial enzymes. In certain applications, the product expression rate is high, and the ability to isolate the product from the cell mass is greatly enhanced because of the product's compartmentalized location within the cell. Protein release methods that increase the permeability of the outer cell wall for primary recovery, but avoid rupturing the inner cell membrane, reduce contamination of the recovered product with other host cell components and simplify final purification.

The estimated prevalence of chronic obstructive pulmonary disease in a general practice population.

Objective: To estimate the prevalence of chronic obstructive pulmonary disease (COPD) in a general practice population in the UK.

Method: Four postal respiratory questionnaire surveys were carried out between 1993 and 2001. Subjects from the 2001 study were invited for spirometry if they were aged 30 years or more, had indicated that they were 'ever smokers' in any of the surveys, and/or had been considered to have likely obstructive airways disease on the basis of their replies to the 2001 questionnaire.

Is the prevalence of wheeze in children altered by neonatal BCG vaccination?

Background: The prevalence of asthma and atopic disease has increased in recent decades, but precise reasons for this increase are unknown. BCG vaccination is thought to be among a group of vaccines capable of manipulating the immune system toward T(H)1 dominance and therefore reducing the likelihood of atopic disease.

Objective: The aim of this study was to determine the influence of neonatal BCG vaccination on the prevalence of wheeze in a large community population of children.

The diagnostic accuracies of chronic obstructive pulmonary disease (COPD) in general practice: The results of the MAGIC (Manchester Airways Group Identifying COPD) study.

Background: Although it is generally accepted that chronic obstructive pulmonary disease (COPD) is underdiagnosed, there is little objective information concerning the size of the problem in the UK.

Method: Patients from two general practices were offered spirometry if they were aged 30 or older, had reported ever smoking in one of four postal respiratory surveys (1993-2001), and/or reported four or more symptoms or risk factors in 2001 indicating likely obstructive airways disease.

Results: Of 2646 subjects invited, 871 attended and 825 had adequate spirometry results for analysis.

Smoking, respiratory symptoms and likely asthma in young people: evidence from postal questionnaire surveys in the Wythenshawe Community Asthma Project (WYCAP).

Background: Although it is recognised that smoking is a major risk factor for subjects with chronic obstructive pulmonary disease and is associated with respiratory symptoms, there is less agreement concerning the relationship between asthma and smoking. This study aims to examine the relationship between cigarette smoking and asthma prevalence.

Method: Data were used from two postal questionnaire surveys (1999 and 2001) in two general practice populations, using a respiratory questionnaire based on the ECRHQ and a generic quality of life questionnaire (EQ-5D).

IPEADAM study: indoor endotoxin exposure, family status, and some housing characteristics in English children.

Background: Many environmental factors have been investigated to determine their involvement in the asthma epidemic.

Objective: We sought to investigate the indoor environment of English children.

Method: The Indoor Pollutants, Endotoxin, Allergens, Damp and Asthma in Manchester (IPEADAM) study recruited 200 asthmatic and age-, sex-, and sibship size-matched nonasthmatic children after a questionnaire-based community screening epidemiology survey.