Adam T Hill

Adam T Hill
The University of Edinburgh | UoE · College of Medicine and Veterinary Medicine

MBChB commendation, MD, FRCPEd

About

343
Publications
48,502
Reads
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14,753
Citations
Citations since 2016
95 Research Items
8424 Citations
201620172018201920202021202202004006008001,0001,2001,400
201620172018201920202021202202004006008001,0001,2001,400
201620172018201920202021202202004006008001,0001,2001,400
201620172018201920202021202202004006008001,0001,2001,400
Additional affiliations
May 2001 - present
The University of Edinburgh
Position
  • Professor

Publications

Publications (343)
Article
Full-text available
The global burden of bronchiectasis in children and adolescents is being recognised increasingly. However, marked inequity exists between, and within, settings and countries for resources and standards of care afforded to children and adolescents with bronchiectasis compared with those with other chronic lung diseases. The European Respiratory Soci...
Article
Full-text available
This British Thoracic Society Quality Standard for Clinically Significant Bronchiectasis in Adults 2022 aims to encourage good practice by setting standards of high-quality respiratory care that services should follow.
Article
Bronchiectasis is being diagnosed increasingly in children and adolescents. Recurrent respiratory exacerbations are common in children and adolescents with this chronic pulmonary disorder. Respiratory exacerbations are associated with an impaired quality-of-life, poorer long-term clinical outcomes and substantial costs to the family and health syst...
Article
Rationale: Lung Clearance index (LCI) has good intra-visit repeatability with better sensitivity in detecting lung disease on CT scan compared to Forced Expiratory Volume in 1 second (FEV1) in adults with bronchiectasis. Alternative multiple breath washout (MBW) parameters have not been systematically studied in bronchiectasis. Objectives: To de...
Article
Full-text available
Introduction Bronchiectasis is characterised by excessive neutrophilic inflammation. Lipid mediators such as prostaglandins and leukotrienes have crucial roles in the inflammatory response. Further characterisation of these lipids and understanding the interplay of anti-inflammatory and proinflammatory lipid mediators could lead to the development...
Conference Paper
Introduction: We investigated (i) changes in total bacterial density in sputum during clinical stability and PEx and (ii) the relationship between total bacterial density, inflammation and FEV1. Methods: Two subgroups from the BRONCH-UK cohort study (n=74) were analysed; A) clinically stable patients (n=54) who provided sputum at baseline and one...
Article
Bronchiectasis refers to both a clinical disease and a radiological appearance that has multiple causes and can be associated with a range of conditions. Disease heterogeneity and the absence of standardised definitions have hampered clinical trials of treatments for bronchiectasis and are important challenges in clinical practice. In view of the n...
Article
Introduction There is lack of evidence to guide duration of intravenous antibiotics for bronchiectasis exacerbations. Aims To assess whether it is feasible based on bacterial load to shorten intravenous antibiotics during exacerbations and whether 14 days treatment is superior. Method We recruited participants requiring intravenous antibiotics fo...
Article
Full-text available
Background Immunoglobulin G (IgG) subclass 2 deficiency is the most frequent IgG subclass deficiency identified in patients with bronchiectasis, but its clinical significance is not known. Aim To analyse if bronchiectasis patients with isolated IgG2 deficiency at risk of recurrent exacerbations and/or hospitalisation? Do patients with IgG2 deficie...
Article
There is increasing awareness of bronchiectasis in children and adolescents, a chronic pulmonary disorder associated with poor quality-of-life for the child/adolescent and their parents, recurrent exacerbations and costs to the family and health systems. Optimal treatment improves clinical outcomes. Several national guidelines exist, but there are...
Article
Full-text available
Bronchiectasis has been a largely overlooked disease area in respiratory medicine. This is reflected by a shortage of large-scale studies and lack of approved therapies, in turn leading to a variation of treatment across centres. BronchUK (Bronchiectasis observational cohort and biobank UK) is a multicentre, prospective, observational cohort study...
Article
Bronchiectasis is a long-term respiratory disease in which there is permanent bronchial dilatation, and it is associated with recurrent cough, sputum production and respiratory tract infections. The incidence and prevalence of bronchiectasis is rising, but it can be challenging to identify and manage this disease. The British Thoracic Society publi...
Article
Full-text available
Neutrophil activation is an integral process to acute inflammation and is associated with adverse clinical sequelae. Identification of neutrophil activation in real time in the lungs of patients may permit biological stratification of patients in otherwise heterogenous cohorts typically defined by clinical criteria. No methods for identifying neutr...
Article
Full-text available
Aim: Patients on anti-tuberculosis (anti-TB) therapy are at risk of drug-induced liver injury (DILI). MicroRNA-122 (miR-122) and cytokeratin-18 (K18) are DILI biomarkers. To explore their utility in this global context, circulating miR-122 and K18 were measured in UK and Ugandan populations on anti-TB therapy for mycobacterial infection. Methods:...
Presentation
Background/Aim: Patients with bronchiectasis suffer from recurrent infective exacerbations (PEx) with associated increase in morbidity and mortality. The aim of this study was to compare total bacterial load and bacterial load of respiratory pathogens (Haemophilus influenzae and Pseudomonas aeruginosa) in sputum samples, collected longitudinally fr...
Article
Full-text available
Background Evaluation of multiple breath washout (MBW) set-up including staff training, certification and central “over-reading” for data quality control is essential to determine the feasibility of MBW in future bronchiectasis studies. Aims To assess the outcomes of a MBW training, certification and central over-reading programme. Methods MBW tr...
Article
Purpose: Coronary artery calcification (CAC) on thoracic computed tomography (CT) can identify patients at risk of coronary artery disease (CAD) mortality. However, the overlap between bronchiectasis and CAC severity for predicting subsequent outcomes is unknown. Materials and methods: CT images from 362 patients (mean age 66±14 y, 38% male) wit...
Article
Introduction The study aimed to determine the efficacy of a safe and well-tolerated dose and regimen of tobramycin inhalation powder (TIP) on Pseudomonas aeruginosa ( Pa ) sputum density in patients with bronchiectasis (BE). Methods This is a phase II, double-blind, randomised study in BE patients aged ≥18 years with chronic Pa infection. Patients...
Preprint
Full-text available
Patients on anti-tuberculosis (anti-TB) therapy are at risk of developing drug-induced liver injury (DILI). Cytokeratin-18 (K18) is an exploratory DILI biomarker that has been developed predominately in Caucasian populations and not African populations in whom TB is common. Our aim was to determine the K18 concentration in different populations wit...
Article
Background: The evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guideline Cough due to Acute Bronchitis. Methods: Acute bronchitis was defined as an acute lower respira...
Article
Full-text available
Background: Current guidelines for the management of bronchiectasis (BE) highlight the lack of evidence to recommend mucoactive agents, such as hypertonic saline (HTS) and carbocisteine, to aid sputum removal as part of standard care. We hypothesise that mucoactive agents (HTS or carbocisteine, or a combination) are effective in reducing exacerbat...
Conference Paper
Bronchiectasis is increasingly recognised but poorly described. There is variability in aetiology, management and outcomes. We have adapted the EMBARC platform and created a multisite UK based registry with affiliated biobank. The BronchUK partnership (www.bronch.ac.uk) aimed to recruit 1500 adult patients with annual follow up over 3–5 years. We r...
Conference Paper
Introduction Two quality of life instruments are widely used in bronchiectasis clinical trials, the Quality of Life bronchiectasis questionnaire and the St Georges Respiratory Questionnaire with few large scale multi-centre direct comparisons. Convergent validity represents an assessment of the instrument against other measures that are considered...
Preprint
Background Current guidelines for the management of bronchiectasis (BE) highlight the lack of evidence to recommend mucoactive agents, such as hypertonic saline (HTS) and carbocisteine, to aid sputum-removal as part of standard care. We hypothesise that mucoactive agents (HTS or cabocisteine, or a combination) are effective in reducing exacerbation...
Article
In patients with bronchiectasis (BE), infection with Pseudomonas aeruginosa (Pa) results in disease progression, frequent pulmonary exacerbations and lung function decline. However, at present, no inhaled antibiotics have been approved for the treatment of these patients. Tobramycin inhalation powder (TIP), approved for treatment of Pa infection in...
Article
Full-text available
The British Thoracic Society (BTS) Guidelines for Bronchiectasis in adults were published in January 2019, and comprise recommendations for treatment from primary to tertiary care. Here, we outline the practical implications of these guidelines for primary care practitioners. A diagnosis of bronchiectasis should be considered when a patient present...
Preprint
Background: Current guidelines for the management of bronchiectasis (BE) highlight the lack of evidence to recommend mucoactive agents, such as hypertonic saline (HTS) and carbocisteine, to aid sputum-removal as part of standard care. We hypothesise that mucoactive agents (HTS or cabocisteine, or a combination) are effective in reducing exacerbatio...
Article
The new British Thoracic Society (BTS) Guideline for Bronchiectasis in Adults has been published. This article provides a summary of key highlights of the new BTS Guideline and covers who to investigate, what investigations should be carried out and a management strategy.
Article
Full-text available
The full British Thoracic Society Guideline for Bronchiectasis in Adults is published in Thorax . The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline. The appendices are available in the full guideline.
Article
Full-text available
Respiratory infections in mechanically ventilated patients caused by Gram-negative bacteria are a major cause of morbidity. Rapid and unequivocal determination of the presence, localization, and abundance of bacteria is critical for positive resolution of the infections and could be used for patient stratification and for monitoring treatment effic...
Article
Background: Patients commonly present to primary care services with upper and lower respiratory tract infections, and guidelines to help physicians investigate and treat acute cough due to suspected pneumonia and influenza are needed. Methods: A systematic search was carried out with eight patient, intervention, comparison, outcome questions rel...
Article
Background: A validated clinical end point is needed to assess response to therapies in bronchiectasis. Objectives: The goal of this study was to assess the reliability, validity, and responsiveness of the incremental shuttle walk test (ISWT) as a clinical end point in bronchiectasis. Methods: In clinically stable patients (n = 30), the ISWT w...
Article
Rationale Improved therapeutic options are needed for patients with treatment-refractory nontuberculous mycobacterial lung disease caused by Mycobacterium avium complex (MAC). Objectives To evaluate the efficacy and safety of daily amikacin liposome inhalation suspension (ALIS) added to standard guideline-based therapy (GBT) in patients with refrac...
Article
Full-text available
Tom M Quinn, Adam T Hill Respiratory Department, Royal Infirmary of Edinburgh, Edinburgh, UK Abstract: Bronchiectasis is a chronic lung disease with permanently damaged airways predisposing to recurrent respiratory tract infections. There is an increasing prevalence of bronchiectasis in the elderly, affecting approximately 10 patients per 1,000 pop...
Article
In bronchiectasis, exacerbations are believed to be triggered by infectious agents, but often no pathogen can be identified. We hypothesised that acute air pollution exposure may be associated with bronchiectasis exacerbations. We combined a case-crossover design with distributed lag models in an observational record linkage study. Patients were re...
Article
Rationale: Excessive neutrophilic airway inflammation is the central feature of bronchiectasis, but little is known about neutrophils in bronchiectasis. Objectives: To assess blood neutrophil phenotype in patients with bronchiectasis while stable and during exacerbations. Methods: In the clinically stable arm of this study, there were eight he...
Article
Pseudomonas aeruginosa is responsible for chronic infection in many bronchiectasis patients but it is not known whether it is associated with worse clinical outcomes independent of the underlying severity of disease. This study analysed data from 2596 bronchiectasis patients included from 10 different bronchiectasis clinical centres across Europe a...
Article
Rationale: Exacerbations are key events in the natural history of bronchiectasis, but clinical predictors and outcomes of frequently exacerbating patients are not well described. Objectives: To establish if there is a "frequent exacerbator phenotype" in bronchiectasis and the impact of exacerbations on long-term clinical outcomes. Methods: We...
Article
Background: In bronchiectasis, due to cystic fibrosis (CF) and other causes, airways clearance is one of the mainstays of management. We conducted a systematic review on airways clearance using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on coug...
Chapter
Bronchiectasis is a chronic respiratory condition that for many patients results in daily symptoms, frequent exacerbations in the form of chest infections and a detrimental impact on quality of life. The cornerstone of bronchiectasis is abnormal dilation of the bronchi and this is visible on CT scanning of the thorax; however radiological assessmen...
Article
Objectives: The aim of our study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. Methods: The BRICS (Bronchiectasis Radiologically Indexed CT Score) was devised based on multivariable analysis of the Bhalla score and their ability in predicting clinical parameters of severity. The sco...
Article
Full-text available
Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines. The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a...