Gartnavel General Hospital

Background Chronic disease in young adults is associated with poor healthcare engagement, poor health-related outcomes, and high-risk behaviours. However, there is minimal data regarding the outcomes of young adults with severe asthma. In this study we aimed to assess asthma characteristics and outcomes in young adults aged 16–25 years compared to older age-groups. Methods Using the UK Severe Asthma Registry, we undertook a retrospective observational analysis, comparing baseline assessment and annual follow-up data in young adults against other age-groups. We investigated differences in medication use, healthcare utilisation, exacerbation rates, lung function, airway inflammation, quality of life and co-morbidities using univariate and multivariable analysis. Results Registry data from 2812 participants was included, including 236 (8.4%) young adults. This age-group had the lowest levels of adherence and highest fractional exhaled nitric oxide, highest rates of emergency department attendance and hospitalisation, the second highest rate of intubation, and most frequently reported anxiety and depression. Data from the first annual review confirmed this age-group still had the highest rate of emergency department attendance, hospitalisation and the smallest improvement in asthma control. Conclusion In this cohort, young adults with severe asthma were at a higher risk of poor clinical outcomes, when compared to other age-groups. The higher rates of emergency treatment, admission and higher levels of airway inflammation suggest that they may experience more severe exacerbations, the reasons for which require further investigation. If a causative link is supported by further work, these findings suggest that age-specific management strategies should be explored towards improving clinical outcomes.

<h3></h3> Introduction and objectives: REALITI-A study demonstrated mepolizumab effectiveness independent of immunoglobulin-E (IgE) and fractional exhaled nitric oxide (FeNO) levels in patients with severe asthma in preliminary 1-year analyses. However, additional longer-term real-world evidence on the effect of mepolizumab on asthma control and lung function may be useful to inform clinical decision making. <h3>Method</h3> REALITI-A, a 2-year, observational, prospective study enrolled patients (≥18 years) with severe asthma, newly prescribed mepolizumab (100-mg subcutaneously). Changes from baseline in asthma control (Asthma Control Questionnaire-5 [ACQ-5] scores, minimal clinically important difference: 0.5) and lung function (forced expiratory volume in 1 second [FEV₁]) were assessed for baseline FeNO subgroups (&lt;25, 25–50, ≥50 parts per billion [ppb]) and baseline IgE subgroups (&lt;60, 60–&lt;180, 180–&lt;500, ≥500 KU/L) at 1-year and 2-years post-mepolizumab exposure. <h3>Results</h3> ACQ-5 scores decreased across all FeNO subgroups 1-year post-mepolizumab exposure and were sustained at 2-years: &lt;25 ppb (least squares [LS] mean change from baseline [95% CI]: -1.21 [-1.58, -0.85]), 25–&lt;50 ppb ( -1.68 [-2.10, -1.25]), ≥50 ppb (-1.61 [-1.89, -1.34]; figure 1). ACQ-5 scores also decreased across all IgE subgroups at 1-year and were sustained at 2-years: &lt;60 KU/L (-1.53 [-1.82, -1.24]), 60–&lt;180 KU/L (-1.59 [-1.90, -1.27]), 180–&lt;500 KU/L (-1.64 [-1.96, -1.31]), ≥500 KU/L (-1.19 [-1.53, -0.84]). FEV₁ improved at Months 9–12 post-mepolizumab exposure for FeNO &lt;25 ppb and ≥50 ppb subgroups and was sustained at Months 21–24 (LS mean change from baseline [95% CI]: 133.1 [22.7, 243.6]; 220.6 [98.0, 343.2], respectively). FEV₁ also improved at Months 9–12 post-mepolizumab exposure for IgE &lt;60 KU/L, 60–&lt;180 KU/L and 180–&lt;500 KU/L, and was sustained at Months 21–24 (LS mean change from baseline [95% CI]: 167.6 [81.1, 254.1], 108.8 [-31.7, 249.3], 198.1 [107.7, 288.6], respectively). FEV₁ improvements were seen to a lesser extent in FeNO 25–&lt;50 ppb subgroup at 2-years (72.2 [-57.6, 202.1]) and IgE ≥500 KU/L subgroup at Months 21–24 (82.0 [-60.7, 224.8]). <h3>Conclusion</h3> Treatment with mepolizumab in a real-life setting improves asthma control and lung function after 1-year, with improvements sustained to 2-years, independent of baseline FeNO and IgE. <h3>Funding</h3> GSK (204710).

<bold>Introduction:</bold> Remission is now an aspiration for asthma patients on biologics, although there is no agreed definition. Predicting the likelihood of remission at an early stage on treatment would improve precision therapy. <bold>Aims:</bold> To identify the characteristics at 4 and 16 weeks on treatment associated with remission at 1 year in a real-world asthma cohort on benralizumab. <bold>Methods:</bold> BenRex is a multicentre study of exacerbations on benralizumab for severe eosinophilic asthma. We defined remission at 1 year as meeting all of: no OCS for asthma (for maintenance/exacerbation); ACQ <1.5 and FEV1 ≥ 80% predicted and/or ≥ 10% higher than baseline FEV1% predicted. Forest plots of associations between early changes at 4 and 16 weeks and remission at 1 year were derived from logistic regression models. <bold>Results:</bold> 36 of 136 subjects (26.5%) met remission criteria. Subjects achieving remission were older (p=0.04). Male and female participants achieved remission at similar rates (p=0.84). Fig 1 shows predictors of remission using changes from baseline at 4 and 16 weeks. FEV1 and SGRQ improvement are strongly associated with subsequent remission. <bold>Conclusion:</bold> An improvement in FEV1 of ≥100 ml and SGRQ change of double the MCID at 4 and 16 weeks on benralizumab are strongly associated with clinical remission at one year. <fig><object-id>erj;66/suppl_69/PA4619/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

ABSTRACT Background Ocular surface disorders (OSD) and glaucoma often co exist. Intraocular pressure lowering medications and preservatives used with them may lead to ocular surface toxicity and drug induced cicatrizing conjunctivitis (DICC). Surgical management of glaucoma helps in reducing the requirement of topical anti glaucoma drugs but, at the same time, may also disrupt the ocular surface. On the other hand, medical therapies and surgeries required for management of OSD often lead to secondary glaucoma, thereby inducing a vicious cycle. Methods Relevant articles (English only) up to January, 2025 were searched from PubMed and summarized. Results Our review discusses the epidemiology, various diagnostic, therapeutic and surgical aspects of this interlinked scenario in a comprehensive manner. Medical therapies (steroids) utilized for controlling inflammation in OSD and related steroid induced glaucoma, anti glaucoma medications (and their preservatives) causing OSD and their respective available alternatives have been discussed in individual sections. Similarly, glaucoma surgeries causing OSD, surgeries for OSD leading to secondary glaucoma and the surgical considerations with possible alternatives, including the novel therapies, have been reviewed. The future directions, along with the role of gut microbiome in ocular diseases and the various therapeutic agents/interventions under clinical investigations, are also explored. Conclusion A deeper understanding of the interplay of different factors in these co-morbid conditions will help in breaking the vicious cycle induced and therefore, in offering more effective treatment. Recommendations for clinicians have been suggested to help optimize the treatment provided to this specific patient cohort of ‘OSD and glaucoma’.

This chapter deals with normal and references ranges for the white cell count and differential count, haemoglobin concentration, red cell indices, platelet count and reticulocyte count. The effects of age, gender, ethnic origin, altitude, pregnancy and the method and circumstances of obtaining the blood specimen are considered.

This chapter deals with pre-analytical, analytical and post-analytical errors in blood counts. Consideration is given to the white cell count, haemoglobin concentration and red cell indices, platelet count, differential leucocyte count and reticulocyte count.

The International Radiation Protection Association established a task group (TG) in 2023 to collect data on knowledge and understanding of tissue reactions involving the eye lens, skin and cardiovascular system among radiation protection practitioners. The aim was to contribute to the sharing of experiences and raise awareness within the radiation protection community about tissue reactions. In 2024, the TG conducted a survey through a questionnaire and this paper provides an analysis and overview of the results.

To identify risk factors affecting the change in visual acuity in successfully re-attached macula-off rhegmatogenous retinal detachment (RD) surgery. A cohort study, using an online database, of visual outcomes for 2770 macula-off retinal detachments that were successfully re-attached by vitrectomy and internal tamponade. The database included detailed retinal diagrams of each detachment. The change in LogMAR visual acuity from pre-operatively to post-operatively. Male patients accounted for 64.6% of the sample and the median age was 63 years old. The median pre-operative VA was counting fingers (LogMAR 1.98); this improved to 0.30 LogMAR post-operatively. An improvement in VA of ≥0.30 LogMAR was achieved by 88.0% eyes. The change in VA model identified the preoperative VA, patient age, duration of central vision loss, lens status at follow up, extent of detachment, and the number of breaks in the detached retina, as factors influencing the change in VA. The model had an adjusted R2 of 0.749, and for 75.5% of eyes, the model prediction was within ±0.30 LogMAR of the recorded VA change. Greater post-operative visual acuity improvement was more likely in eyes that were pseudophakic at follow up, and had shorter durations of central vision loss. Non modifiable factors associated with greater vision improvement included worse presenting vision, younger age, less extensive detachment and less than three breaks in the detached retina. These results confirm that prompt surgery improves functional outcomes in successfully treated macula off retinal detachments irrespective of presenting visual acuity.