Rosenkildeshah7321

BACKGROUND Low dose computed tomography (LDCT) screening can reduce lung cancer deaths in high risk individuals yet current Australian guidelines do not recommend screening. Little is known about current screening practices in Australia. METHODS A survey was distributed to a nationally-representative sample of 4000 Australian general practitioners (GPs). The questionnaire included respondent demographics, self-reported screening practices, knowledge of screening recommendations, recent screening education, preference for recruitment methodologies for potential screening programs and potential factors influencing GPs' screening practice. Two logistic regression models identified factors associated with self-reported Chest X-Ray (CXR) and LDCT screening within the last 12 months. RESULTS A total of 323 GPs attempted the survey (participation rate 8.1%). Participants were mostly females (50.6%), from collective/group (79.1%) and metropolitan-based practices (73.5%). Despite the majority of responders understanding that screening is not recommended by Australian professional societies (71.2%) a substantial proportion of participants requested a CXR or LDCT screening (46.4% and 20.8% respectively). A variety of shared (GP reassurance, affordability of screening, believing screening is funded) and unique practice, educational and cognitive factors were associated with self-reported LDCT and CXR screening, with the strongest association being recent education about screening from radiology practices (aOR for LDCT screening 10.4, p less then  0.001). CONCLUSION In Australia, lung cancer screening is occurring outside a coordinated programme and there is discordance between practice and national recommendations. This highlights an urgent need for clearer guidance from national and professional bodies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Cough is a common symptom in interstitial lung disease (ILD) often with treatment dissatisfaction for patients and physicians. AIM The objective of this study was to identify the prevalence and subjective adequacy of control of cough in patients with ILD. METHODS A cross-sectional study of patients with ILD attending a tertiary ILD clinic in Perth was undertaken by a pre-designed questionnaire that patients were invited to complete when attending clinic. Cough severity and impact on quality of life was assessed using a visual analogue scale and validated Leicester cough questionnaire. Participants were asked to list triggers to their cough and strategies or medications trialled to control cough. RESULTS Of 164 respondents, 118 (72%) had cough with prevalence common in all ILD subtypes. A lower FVC was found in the cough versus non-cough group (74.6 ± 18.7 vs 87.0 ± 15.9, p-value less then 0.0001). selleck Common reported triggers were lung irritants, exertion and doing routine daily activities. Avoidance of triggers was a common strategy to control cough. A high prevalence of non-ILD causes of cough was recorded in both groups. A variety of medications had been trialled, including anti-fibrotics, immunosuppression drugs, inhalers and proton pump inhibitors, with moderate benefit reported by 18% of participants. CONCLUSIONS Cough is prevalent in ILD but is not adequately suppressed. Cough has significant impact on quality of life leading patients to adopt their own strategies to control their cough. More study is needed to understand cough mechanisms in ILD and the interplay of other potential co-pathologies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Masculinising hormone therapy with testosterone is used to align an individual's physical characteristics with their gender identity. Testosterone therapy is typically administered via intramuscular or transdermal routes and polycythaemia is the most common adverse event. AIMS To compare the risk of polycythaemia with different formulations of testosterone therapy in transmasculine individuals. METHODS A retrospective cross-sectional analysis was undertaken of transmasculine individuals at a primary and secondary care clinic in Melbourne, Australia. 180 individuals who were on testosterone therapy for >6 months were included. Groups included those receiving (1) intramuscular testosterone undecanoate (n = 125), (2) intramuscular testosterone enantate (n = 31), or (3) transdermal testosterone (n = 24). Outcome was prevalence of polycythaemia (defined as haematocrit >0.5). RESULTS Mean age was 28.4 (8.8) years with a median duration of testosterone therapy 37.7 (24.2) months. 27% were smokers. There wd by copyright. All rights reserved.Gold-catalysis has enabled new synthetic opportunities in the chemistry of vinyldiazo compounds. Herein, we report the gold-catalyzed reaction of stabilized vinyldiazo compounds with pinacol alkenylboronates to provide boryl-functionalized cyclopentene derivatives through a formal [3+2] carbocycloaddition reaction, a very unusual pathway in alkenylboronate chemistry. This reaction proceeds with high regio- and stereoselectivity. The synthetic usefulness of the resulting borylated cyclopentene derivatives toward the synthesis of densely functionalized cyclopentanoids is also demonstrated. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Starting from readily available o-diazoacyl-substituted arene carboxylates, scaffolds with the 5,9-epoxycyclohepta[b]pyran-2(3H)-one core were obtained by cooperative Rh(II), Lewis and Brønsted acid catalysis. Four new bonds, three functional groups (lactone, ketal, and alcohol) and four contiguous stereocenters are formed during this regio- and diastereoselective process in a single synthetic step. Intensive optimization and mechanistic studies, including the isolation and trapping of reaction intermediates, led to a plausible mechanistic scenario. The reaction is proposed to involve carbonyl ylides but also transient species of the ketocarbene equilibrium that undergo a cascade of cycloaddition and skeletal rearrangements. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.