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- Ferrara, Francesco, et al.
(author)
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The Right Heart International Network (RIGHT-NET) : Rationale, Objectives, Methodology, and Clinical Implications
- 2018
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In: Heart Failure Clinics. - : Elsevier BV. - 1551-7136. ; 14:3, s. 443-465
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Research review (peer-reviewed)abstract
- The Right Heart International Network is a multicenter international study aiming to prospectively collect exercise Doppler echocardiography tests of the right heart pulmonary circulation unit (RHPCU) in large cohorts of healthy subjects, elite athletes, and individuals at risk of or with overt pulmonary hypertension. It is going to provide standardization of exercise stress echocardiography of RHPCU and explore the full physiopathologic response.
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| 2. |
- Ferrara, Giovanni, et al.
(author)
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Epidemiology of Pulmonary Fibrosis : A Cohort Study Using Healthcare Data in Sweden
- 2019
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In: Pulm Ther. - : Springer Nature. - 2364-1754 .- 2364-1746. ; 5:1, s. 55-68
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Journal article (peer-reviewed)abstract
- Introduction: Data on the epidemiology of idiopathic pulmonary fibrosis (IPF) in Sweden are lacking. This study estimates the incidence and prevalence of IPF in Sweden, and describes the demographic and clinical characteristics and the overall survival of patients with IPF.Methods: Two cohorts were studied: a national cohort of 17,247 patients with pulmonary fibrosis (ICD-10 code J84.1 with no competing diagnosis) from the Swedish National Patient Register (cohort 1 [C1]); and an electronic medical record-based regional subset of C1 comprising 1755 patients having pulmonary fibrosis and a radiology procedure (C2). Results: The incidence of pulmonary fibrosis in C1 ranged from 10.4 to 15.4 cases per 100,000 population per year between 2001 and 2015. The prevalence increased from 15.4 to 68.0 cases per 100,000 population per year. Patients C 70 years and men had a higher incidence and prevalence of pulmonary fibrosis. Common comorbidities included respiratory infections and cardiovascular disorders. Approximately one-third of patients in each cohort were hospitalised with pulmonary fibrosis within a year of diagnosis. The median survival time from disease diagnosis was 2.6 years in C1 and 5.2 years in C2. Older patients had a higher risk of hospitalisation and mortality. Women had a better prognosis than men.Conclusion: This study underscores the importance of pulmonary fibrosis as a cause of respiratory-related morbidity and mortality in Sweden. The stable incidence and increasing prevalence over time suggests longer survival. The higher morbidity and mortality in older patients highlights the importance of early case detection, diagnosis and management for better prognosis.
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| 3. |
- Ferrara, Giovanni, et al.
(author)
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Idiopathic pulmonary fibrosis in Sweden : report from the first year of activity of the Swedish IPF-Registry.
- 2016
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In: European Clinical Respiratory Journal. - : Informa UK Limited. - 2001-8525. ; 3
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Journal article (peer-reviewed)abstract
- BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is an emerging problem in the western world, being related to increasing age and implying significant costs for the diagnosis and management of affected patients. The epidemiology of IPF is not well understood.METHODS: To allow estimates of the problem and eventually to evaluate quality of the care of IPF patients in Sweden, a national IPF Registry was started in the autumn of 2014. Data on criteria used to diagnose IPF, demographics, lung function, and quality of life (measured with the King's Brief Interstitial Lung Disease Questionnaire, K-BILD) were reported directly to the registry, based at the coordinating centre (Karolinska University Hospital, Stockholm, Sweden) via a web-based platform.RESULTS: During the first year, the registry was implemented in 11 (33%) of the 33 respiratory units in the country. Seventy-one patients were registered between October 2014 and October 2015, 50 (70.4%) males and 21 (29.6%) females. Median age was 70 (range 47-86). The mean K-BILD score at the first inclusion in the registry was 54.3+9.5.CONCLUSIONS: The main features of IPF patients in this first Swedish cohort were consistent with data published in the literature in main multinational randomized controlled trials. The K-BILD questionnaire showed that quality of life of patients with IPF and their perception of the disease are quite poor at the time of inclusion in the registry.
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| 5. |
- Nguyen, Minh-Thao, et al.
(author)
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Evaluation of the unsteady aerodynamic forces acting on a vertical-axis turbine by means of numerical simulations and open site experiments
- 2020
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In: Journal of Wind Engineering and Industrial Aerodynamics. - : ELSEVIER. - 0167-6105 .- 1872-8197. ; 198
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Journal article (peer-reviewed)abstract
- An increasing number of vertical-axis wind turbine prototypes have reached the step in which the theoretically predicted performance needs to be validated in order to move to the next steps of a real commercial project. This step often faces the significant challenges posed by their airfoil aerodynamics that are more complex than those of conventional horizontal-axis wind turbines, and it has also to deal with the lack of fundamental experimental data for robust validation. In this context, an accurate prediction of the real turbine operation is important and the use of computational fluid dynamics (CFD) is imposing itself as the most suitable tool to characterize the unsteady phenomena that are difficult to detect by means of experimental measurements. In the current work, two-dimensional numerical simulations of an H-type three-blade Darrieus turbine have been performed in a wide range of tip-speed ratios (TSRs) from TSR = 1.8 to TSR = 5.0. Unsteady CFD simulations were compared with unique experimental data collected in the field in terms of normal aerodynamic forces acing on the blades during the revolution. Generally, nice agreement was found between simulations and experiments, especially at medium-high tip-speed ratios. The influence of operating conditions on the performance prediction capability of the numerical model was also discussed. This is one of the key points of study since the lack of detailed experimental data often makes numerical analyses doubtful or scarcely effective. Finally, the simulation results were exploited in order to analyze the phenomena occurring during the revolution and to correlate them with the experimental findings.
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| 8. |
- Sköld, C. Magnus, et al.
(author)
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Patient journey and treatment patterns in adults with IPF based on health care data in Sweden from 2001 to 2015
- 2019
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In: Respiratory Medicine. - : W B SAUNDERS CO LTD. - 0954-6111 .- 1532-3064. ; 155, s. 72-78
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Journal article (peer-reviewed)abstract
- Background: For patients with idiopathic pulmonary fibrosis (IPF), there is limited real-world data on patient journey and treatment patterns.Aim: To explore predictors of early diagnosis and treatment initiation, and treatment patterns in IPF patients using linked data from Swedish registers and electronic medical records (EMRs).Population: A national cohort (C1) of 17,247 pulmonary fibrosis patients (ICD-10 code J84.1; no competing diagnosis) diagnosed between 2001 and 2015, and an EMR-based regional subset (C2) comprising 1755 IPF patients diagnosed between 2004 and 2017. The time from early disease symptoms to diagnosis, use of anti-fibrotic medications, time from diagnosis to initiation of anti-fibrotic treatment, and adherence, persistence and treatment length with pirfenidone were explored in these patients.Results: In C1, the median time to diagnosis from the first symptoms dyspnoea, cough and fatigue were 307, 563 and 639 days, respectively. Glucocorticoids were the most frequently prescribed medication. Less than 10% of patients undergoing or initiating treatment, used pirfenidone or nintedanib. Males had a higher probability of initiating anti-fibrotic treatment than females within a year of diagnosis. One-year persistence in pirfenidone patients was 42% in C1 and 25% in C2.Conclusion: Diagnosis of pulmonary fibrosis was delayed in patients with cough and fatigue, which are early symptoms of IPF. This, and lower than expected utilisation of anti-fibrotic medications, suggests missed opportunities for early disease diagnosis and treatment. The high rate of treatment discontinuation underscores the importance of supporting and guiding patients to persist with their medications to ensure an accrual benefit of treatment.
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| 9. |
- Um-Bergström, Petra, et al.
(author)
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Lung function development after preterm birth in relation to severity of Bronchopulmonary dysplasia
- 2017
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In: BMC Pulmonary Medicine. - : BIOMED CENTRAL LTD. - 1471-2466. ; 17
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Journal article (peer-reviewed)abstract
- Background: Bronchopulmonary dysplasia (BPD) is a strong risk factor for respiratory morbidity in children born preterm. Our aims were to evaluate lung function in adolescents born preterm with and without a history of BPD, and to assess lung function change over time from school age.Methods: Fifty-one individuals born in Stockholm, Sweden between gestational ages 24 to 31 weeks (23 neonatally diagnosed with respiratory distress syndrome (RDS) but not BPD, and 28 graded as mild (n = 17), moderate (n = 7) or severe (n = 4) BPD) were examined in adolescence (13-17 years of age) using spirometry, impulse oscillometry (IOS), plethysmography, and ergospirometry. Comparison with lung function data from school age (6-8 years of age) was also performed.Results: Adolescents with a history of BPD had lower forced expiratory volume in 1 s (FEV1) compared to those without BPD (-0.61 vs.-0.02 z-scores, P < 0.05), with lower FEV1 values significantly associated with BPD severity (P for trend 0.002). Subjects with severe BPD had higher frequency dependence of resistance, R5-20, (P < 0.001 vs. non-BPD subjects) which is an IOS indicator of peripheral airway involvement. Between school age and adolescence, FEV1/FVC z-scores decreased in all groups and particularly in the severe BPD group (from -1.68 z-scores at 6-8 years to -2.74 z-scores at 13-17 years, p < 0.05 compared to the non-BPD group).Conclusions: Our results of spirometry and IOS measures in the BPD groups compared to the non-BPD group suggest airway obstruction including involvement of peripheral airways. The longitudinal result of a decrease in FEV1/FVC in the group with severe BPD might implicate a route towards chronic airway obstruction in adulthood.
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