Angshu Bhowmik

Angshu Bhowmik
Homerton University Hospital NHS Foundation Trust · Department of Respiratory Medicine

MD

About

110
Publications
9,079
Reads
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8,368
Citations
Citations since 2016
47 Research Items
2894 Citations
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
Introduction
I am a Consultant Respiratory Physician at Homerton University Hospital. My interests are COPD, Lung Cancer and pleural disease as well as bronchoscopy and EBUS.
Additional affiliations
March 2016 - present
Queen Mary, University of London
Position
  • Lecturer
October 2003 - February 2016
Homerton University Hospital NHS Foundation Trust
Position
  • Consultant and Associate Medical Director
October 2003 - October 2016
Homerton University Hospital NHS Foundation Trust
Position
  • Consultant Physician

Publications

Publications (110)
Article
We present the case of a 38-year-old man, with congenital bullous emphysema, who presented with unilateral pleuritic chest pain, rigors and a non-productive cough. A chest X-ray on admission demonstrated extensive bilateral bullous lung disease with left-sided lung collapse. There were fluid levels present within several bullae, with the largest bu...
Article
Full-text available
The Lung Screen Uptake Trial tested a novel invitation strategy to improve uptake and reduce socioeconomic and smoking-related inequalities in lung cancer screening (LCS) participation. It provides one of the first UK-based ‘real-world’ LCS cohorts. Of 2012 invited, 1058 (52.6%) attended a ‘lung health check’. 768/996 (77.1%) in the present analysi...
Article
Rationale: Individuals eligible for lung cancer screening (LCS) by low-dose computed tomography (LDCT) are also at risk of Chronic Obstructive Pulmonary Disease (COPD) due to age and smoking exposure. Whether the LCS episode is useful for early detection of COPD is not well established. Objectives: To explore associations between symptoms, comor...
Chapter
This article describes the initial evaluation of a patient with new onset respiratory problem. A thorough medical history and physical examination are key to making a specific diagnosis or narrowing the differential diagnosis of most respiratory disorders. The common symptoms of respiratory problems include dyspnea, cough, sputum, hemoptysis, wheez...
Article
Full-text available
Rationale: Low uptake of low-dose CT (LDCT) lung cancer screening, particularly by current smokers of a low socioeconomic position, compromises effectiveness and equity. Objectives: To compare the effect of a 'targeted, low burden and stepped' invitation strategy versus control, on uptake of hospital-based 'Lung Health Check' appointments offeri...
Conference Paper
Introduction and objectives The success of lung cancer screening (LCS) with low-dose CT (LDCT) depends critically on delivering timely, accurate radiology reports. Its anticipated widespread introduction will place a significant burden on current thoracic radiologist capacity, mandating innovative solutions. We explored the role that trained radiog...
Article
Full-text available
Aim: To evaluate the association between the image quality of cancer staging whole-body magnetic resonance imaging (WB-MRI) and patient demographics, distress, and perceived scan burden. Materials and methods: A sample of patients recruited prospectively to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal c...
Article
Full-text available
Introduction Lung cancer screening (LCS) by low-dose computed tomography (LDCT) offers an opportunity to impact both lung cancer and coronary heart disease mortality through detection of coronary artery calcification (CAC). Here, we explore the value of CAC and cardiovascular disease (CVD) risk assessment in LCS participants in the Lung Screen Upta...
Article
Full-text available
Objectives To determine the importance placed by patients on attributes associated with whole-body MRI (WB-MRI) and standard cancer staging pathways and ascertain drivers of preference. Methods Patients recruited to two multi-centre diagnostic accuracy trials comparing WB-MRI with standard staging pathways in lung and colorectal cancer were invited...
Article
Rationale: Lung cancer screening has the potential to save lives, but it also carries a risk of potential harms. Explaining the benefits and harms of screening in a way that is balanced and comprehensible to individuals with various levels of education is essential. Although a shared decision-making approach is mandated by the Centers for Medicare...
Article
Full-text available
Background Whole-body magnetic resonance imaging (WB-MRI) could be an alternative to multi-modality staging of non-small-cell lung cancer (NSCLC), but its diagnostic accuracy, effect on staging times, number of tests needed, cost, and effect on treatment decisions are unknown. We aimed to prospectively compare the diagnostic accuracy and efficiency...
Article
Full-text available
Background Whole-body MRI (WB-MRI) could be an alternative to multimodality staging of colorectal cancer, but its diagnostic accuracy, effect on staging times, number of tests needed, cost, and effect on treatment decisions are unknown. We aimed to prospectively compare the diagnostic accuracy and efficiency of WB-MRI-based staging pathways with st...
Article
Lung and pleural malignancies remain common in the UK with poor survival rates due, at least in part, to late stage diagnosis. Diagnostic pathways aim to reduce the time taken for patients to reach a diagnosis and treatment, with the use of positron emission tomography and endobronchial ultrasound to provide staging information alongside diagnostic...
Article
Full-text available
Background: Whole-body magnetic resonance imaging (WB-MRI) is advocated as an alternative to multi-modality staging of non-small cell lung cancer but its relative diagnostic accuracy, effect on staging times, test number, cost, and impact on treatment decisions are unknown. We undertook a prospective multicentre cohort study to address this (ISRCTN...
Article
Full-text available
BACKGROUND: Whole-body magnetic resonance imaging (WB-MRI) could be an alternative to multi-modality staging of non-small-cell lung cancer (NSCLC), but its diagnostic accuracy, effect on staging times, number of tests needed, cost, and effect on treatment decisions are unknown. We aimed to prospectively compare the diagnostic accuracy and efficienc...
Data
Appendix S1. Evaluation questions – novel radiographer chest X‐ray training.
Article
Full-text available
Introduction Diagnostic capacity and time to diagnosis are frequently identified as a barrier to improving cancer patient outcomes. Maximising the contribution of the medical imaging workforce, including reporting radiographers, is one way to improve service delivery. Methods An efficient and effective centralised model of workplace training suppo...
Conference Paper
Introduction Lung Cancer screening by Low-Dose CT (LDCT) has been shown to reduce mortality, though exactly how best to implement this is unclear. Uptake to screening trials has generally been low, particularly in those at highest risk of lung cancer. The Lung Screen Uptake Trial is a UK based dual centre LDCT randomised controlled screening trial...
Conference Paper
Introduction Lung cancer screening by Low-Dose CT (LDCT) has been shown to reduce mortality, and the harm-benefit balance of screening is optimised by screening those at higher risk. The Lung Screen Uptake Trial is a UK based randomised controlled trial of standard versus enhanced invitation methods for LDCT screening in more deprived communities....
Article
Full-text available
Aim: To investigate the feasibility of radiographer-led immediate reporting of chest radiographs (CXRs) referred from general practice. Materials and methods: This 4-month feasibility study (November 2016 to March 2017) was carried out in a single radiology department at an acute general hospital. Comparison was made between CXRs that received a...
Article
Full-text available
Background Diagnostic capacity and suboptimal logistics are consistently identified as barriers to timely diagnosis of cancer, especially lung cancer. Immediate chest X-ray (CXR) reporting for patients referred from general practice is advocated in the National Optimal Lung Cancer Pathway to improve time to diagnosis of lung cancer and to reduce in...
Article
Full-text available
Anna Garner,1 Matthew Hodson,2 Georgios Ketsetzis,3 Laurence Pulle,3 Janelle Yorke,4,5 Angshu Bhowmik2 1NHS City and Hackney Clinical Commissioning Group, 2Respiratory Medicine, Homerton University Hospital NHS Foundation Trust, 3North East London Commissioning Support Unit, London, 4School of Health Sciences, University of Manchester, 5The Christi...
Article
Vitamin D deficiency is common in patients with chronic obstructive pulmonary disease (COPD), yet a comprehensive analysis of environmental and genetic determinants of serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with this condition is lacking. We conducted a multi-centre cross-sectional study in 278 COPD patients aged 41-92 years...
Article
Introduction and objectives Chronic obstructive pulmonary disease (COPD) and emphysema are considerably under-diagnosed conditions. Low dose CT (LDCT) for lung cancer screening, if implemented, may provide an opportunity for earlier diagnosis of smoking-related conditions, in addition to lung cancer. Data gathered in a lung cancer screening demonst...
Article
Vitamin D deficiency is common in children with asthma, and it associates with poor asthma control, reduced forced expiratory volume in one second (FEV1) and increased requirement for inhaled corticosteroids (ICS). Cross-sectional studies investigating the prevalence, determinants and clinical correlates of vitamin D deficiency in adults with asthm...
Conference Paper
Full-text available
Background It has been noted that patients with COPD may be inappropriately prescribed long acting β2 agonist/inhaled corticosteroid combinations (ICS/LABA). Aims The GOLD guideline recommends that patients with an FEV1 of < 50% predicted or a high risk of exacerbations should be prescribed ICS/LABA. Our objective was to audit the prescription of I...
Article
Introduction: Despite having national guidelines for the management of SP, there appears to be wide variation in clinical practice in UK hospitals. Aims and objectives: The audit aims to study the initial management of primary (PSP) and secondary (SSP) pneumothorax in a UK Hospital against the current BTS guideline. Methods: Data collection was mad...
Article
Background: It has been noted that patients with COPD may be inappropriately prescribed long acting β2 agonist/inhaled corticosteroid combinations (ICS/LABA). Aims: The GOLD guideline recommends that patients with an FEV1 of < 50% predicted or a high risk of exacerbations should be prescribed ICS/LABA. Our objective was to audit the prescription of...
Chapter
Pulmonary function abnormalities are quite common in obesity. Consequently, in this population, a number of respiratory comorbidities are seen, which have to be identified and treated prior to bariatric surgery. The most commonly occurring conditions are obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS), pulmonary hypertension a...
Article
In response to high mortality rates, high numbers of COPD admissions, poor quality of care and a lack of integration of services for people with COPD, City and Hackney Primary Care Trust tendered the provision of an acute- and community-based COPD service from Homerton University Hospital in 2009 (the Acute COPD Early Response Service: ACERS). We s...
Article
Background: New treatments for asthma & COPD may require evaluation in sub-groups with lower airway eosinophilia or neutrophilia. A non-invasive test to identify these phenotypes may reduce unnecessary sputum induction at screening. Aim: To establish whether eosinophil and neutrophil counts correlate with those in the lower airway in asthma and CO...
Article
Full-text available
Endobronchial ultrasound (EBUS) guided biopsy is the mainstay for investigation of mediastinal lymphadenopathy for laboratory diagnosis of malignancy, sarcoidosis or tuberculosis. However, improved methods for discriminating between tuberculosis and sarcoidosis and excluding malignancy are still needed. We sought to evaluate the role of genome-wide...
Article
Asthma exacerbations are commonly precipitated by viral upper respiratory infections (URIs). Vitamin D insufficiency associates with susceptibility to URI in patients with asthma. Trials of vitamin D in adults with asthma with incidence of exacerbation and URI as primary outcome are lacking. To conduct a randomised controlled trial of vitamin D3 su...
Article
Full-text available
Background: Patients with chronic obstructive pulmonary disease (COPD) often have vitamin D deficiency, which is associated with increased susceptibility to upper respiratory infection-a major precipitant of exacerbation. Multicentre trials of vitamin D supplementation for prevention of exacerbation and upper respiratory infection in patients with...
Article
Introduction and objectives Inadequate vitamin D status is common in patients with COPD, and it associates with susceptibility to upper respiratory infection (URI) – a major precipitant of exacerbation. Multi-centre trials of vitamin D supplementation for prevention of exacerbation and URI in COPD are lacking. We therefore conducted a multi-centre...
Article
Introduction and objectives Asthma exacerbations are commonly precipitated by viral upper respiratory infections (URI). Vitamin D insufficiency associates with susceptibility to URI in patients with asthma. A recent vitamin D trial in adults with asthma reported a trend towards reduced exacerbation risk in the intervention arm as a secondary outcom...
Conference Paper
Introduction. Coughing hinders EBUS and aerosolises secretions. Predictors of cough in bronchoscopy and methods of quantifying it are poorly described. Method. Successive patients wore an audio recorder and microphone immediately before, during and after EBUS. Each recording was analysed by one of three authors; half were re-analysed by the main a...
Article
Background Obstructive Sleep Apnoea (OSA) is prevalent in obese patients and has substantial impact on health and society1. We undertook this analysis to examine changes in Sleep Apnoea severity by studying the Apnoea-Hypopnoea Index (AHI) pre and post bariatric surgery in a London District General Hospital. Methods We retrospectively reviewed pati...
Conference Paper
Full-text available
The UK NHS recommends that hospitals take responsibility for patients readmitted within 30 days of discharge. We explored the impact on readmission rates of our "acute COPD early response service" (ACERS), comprising specialist nurses and physiotherapists with medical input from a respiratory physician. The ACERS provided daily hospital-at-home the...
Conference Paper
Full-text available
Identification of factors leading to prolonged hospital stay may help to find patients who need targeted approaches to management. Appropriate resource allocation would help to reduce the time spent in hospital. Co-morbidities are common in COPD and may lead to prolonged admissions. We performed a retrospective case note analysis of patients with C...
Article
Mediastinal lymphadenopathy may indicate diseases such as tuberculosis or sarcoidosis, and it is often difficult to establish a diagnosis when standard medical work-up is inconclusive. In this study we investigated the diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the differentiation between tuberculosis and s...
Article
Full-text available
Hyperammonaemia is often seen in the context of decompensated liver disease. It may also be triggered by stressful medical conditions in adults with partial enzyme deficiencies of the urea cycle. Occasionally, non-hepatic causes can result in hyperammonaemia severe enough to cause symptoms. The authors report the case of a 52-year-old Turkish woman...
Article
Full-text available
Lung Alerts were introduced by Wisia Wedzicha, Editor-in-Chief in 2003 to increase the educational content of the journal. The aim was to commission brief summaries of papers on respiratory topics published in non-respiratory journals, thereby attracting a broader interest particularly among doctors in training. It was also intended to allow reader...
Article
Fever with generalised lymphadenopathy is a common presentation in clinical practice. A degree of lymphadenopathy is frequently a characteristic of established systemic lupus erythematosus (SLE), but it is rarely the primary presenting feature. A 25-year-old man presented with night sweats, weight loss and generalised lymphadenopathy. A chest compu...
Article
Patients with COPD usually experience mucus hypersecretion as a result of airway inflammation and response to noxious stimuli. These in turn lead to worsening airway resistance, impaired airflow, increased work of breathing, dyspnoea and exercise intolerance. Mucus hypersecretion may also lead to increased exacerbations and poor health related qual...
Article
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterised by both an accelerated decline in lung function and periods of acute deterioration in symptoms termed exacerbations. The aim of this study was to investigate whether these are related. METHODS: Over 4 years, peak expiratory flow (PEF) and symptoms were measured at home daily...
Article
Full-text available
To determine the proportion of adult medical patients who have chronic obstructive pulmonary disease (COPD), using the Global initiative for Chronic Obstructive Lung Disease guidelines (GOLD), and its relation to vascular disease. This is a prospective cross-sectional study of adult patients admitted to acute medical wards. Interviewer administered...
Article
Study objectives Patients with COPD experience lower airway and systemic inflammation, and an accelerated decline in FEV1. There is no evidence on whether this inflammation changes over time, or if it is associated with a faster decline in FEV1. Patients and design A cohort of 148 COPD patients (100 men) was monitored daily for a median of 2.91 ye...
Article
Full-text available
Exhaled nitric oxide (eNO) appears to be associated with airway inflammation seen in chronic obstructive pulmonary disease (COPD). The present authors studied the effects of exacerbation, season, temperature and pollution on eNO. eNO was measured seasonally and at exacerbations in 79 outpatients suffering from COPD (mean forced expiratory volume in...
Article
Patients with COPD experience lower airway and systemic inflammation, and an accelerated decline in FEV1. There is no evidence on whether this inflammation changes over time, or if it is associated with a faster decline in FEV1. A cohort of 148 COPD patients (100 men) was monitored daily for a median of 2.91 years (interquartile range [IQR], 2.1 to...
Article
Full-text available
Irreversible airflow obstruction in Chronic Obstructive Pulmonary Disease (COPD) is thought to result from airway remodelling associated with aberrant inflammation. Patients who experience frequent episodes of acute deterioration in symptoms and lung function, termed exacerbations, experience a faster decline in their lung function, and thus over t...
Article
Full-text available
▴ Calverley P, Pauwels R, Vestbo J, et al . Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet2003;361:449–56 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] This randomised, double blind, parallel group, placebo controlled study funded by GlaxoSmithKline as...
Article
Full-text available
An opportunity to contribute to the new Lung Alert feature in Thorax.