Jörg Leuppi

• Head of Department at Kantonsspital Liestal

Recently this international task force reported the general considerations for bronchial challenge testing and the performance of the methacholine challenge test, a "direct" airway challenge test. Here the task force provides an updated description of the pathophysiology and the methods to conduct indirect challenge tests. Because indirect challeng...

Entscheidungsträger haben Mühe, die Rationale einer «Allgemeinen» Inneren Medizin (AIM) am hochspezialisierten Universitätsspital zu verstehen und monieren deren «Profilunschärfe». Zudem konzentrieren sich auf der AIM multimorbide, oft unrentable Patienten. Folgen sind die Benachteiligung in Bezug auf Priorisierung und Ressourcen. Daraus wiederum r...

Background and objective: Daily physical activity (PA) and exercise capacity are reduced in patients with COPD. Whether the natural longitudinal course of both appears synchronically or one precedes the other is currently unclear. The aim was to assess the longitudinal relationship between exercise capacity and physical activity and their changes...

Background Some sleep disorders are known risk factors for occupational injuries (OIs). This study aimed to compare the prevalence of obstructive sleep apnea syndrome (OSAS) in a population of patients with OIs admitted to the emergency room (ER) with hospital outpatients as controls. Methods Seventy-nine patients with OIs and 56 controls were rec...

Background Obstructive sleep apnea syndrome (OSAS) is common in adults. People with OSAS have a higher risk of experiencing traffic accidents and occupational injuries (OIs). We aimed to clarify the diagnostic performance of a three-channel screening device (ApneaLinkTM) compared with the gold standard of full-night attended polysomnography (PSG) a...

The Global Initiative for Asthma (GINA) is a network of individuals, organizations, and public health officials that was established to disseminate information about the care of patients with asthma and to improve asthma care. The GINA ("Global Strategy for Asthma Management and Prevention") report has been updated annually since 2002. Due to new k...

Question under study: The aim of this study was to assess the feasibility, acceptability and effectiveness of a pilot COPD integrated care programme implemented in Valais, Switzerland. Methods: The programme was adapted from the self-management programme Living Well with COPD, and included the following elements: self-management patient-educatio...

Background: Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting cut-points for Global initi...

Background: Despite progress in pharmacological and non-pharmacological treatment in recent years, the burden of disease among patients with asthma and chronic obstructive pulmonary disease (COPD) is high and patients are frequently hospitalized due to exacerbations. Reasons for uncontrolled diseases are manifold, but are often associated with poo...

Introduction: Whether clinical prediction rules for pulmonary embolism are accepted and used among general internal medicine residents remains uncertain. We therefore evaluated the frequency of use and acceptability of the Revised Geneva Score (RGS) and the Pulmonary Embolism Severity Index (PESI), and explored which factors were associated with r...

Purpose The aim of this study was to evaluate the validity of a new pictorial form of a screening test for obstructive sleep apnea syndrome (OSAS) – the pictorial Sleepiness and Sleep Apnoea Scale (pSSAS). Validation was performed in a sample of patients admitted to sleep clinics in the UK and Switzerland. Patients and methods All study participan...

Background: Despite great efforts in establishing optimal asthma management, asthma may remain uncontrolled. To effectively manage chronic diseases, such as asthma, it is important to train patients in self-management skills. Objectives: The aim of this study was to assess the potential benefit of standardised asthma education in Switzerland for...

Real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has earned its place as a standard of care in the evaluation of mediastinal and hilar lymphadenopathy. It is a minimally invasive and a safe procedure with high diagnostic accuracy and efficacy. The increased usage of EBUS-TBNA worldwide has thrown light on its p...

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) compromise physical activity and quality of life and contribute significantly to health care costs. Systemic glucocorticoids benefit clinical outcome in AECOPD, and the REDUCE trial demonstrated noninferiority of a 5-day treatment course with prednisone compared with...

This international task force report updates general considerations for bronchial challenge testing and the performance of the methacholine challenge test. There are notable changes from prior recommendations in order to accommodate newer delivery devices. Rather than basing the test result upon a methacholine concentration (provocative concentrati...

Background and objective Physical activity (PA) is an important outcome parameter in patients with COPD regarding hospitalizations and mortality. Both objective assessment by accelerometers and self-evaluation by questionnaires were used in studies investigating PA in COPD. Whether self-reported questionnaires can adequately reflect PA and its chan...

Background Individualised treatment regimens for drug resistant tuberculosis have improved outcomes. This retrospective observational study examined potential factors that affect individualised treatment in an endemic region, and highlighted predictors of a successful outcome. Methods We examined records of proven MDR, pre-XDR and XDR TB patients...

Objective Obstructive sleep apnoea (OSA) is a risk factor for vascular disease and other adverse outcomes. These associations may be at least partly due to early endothelin-1 (ET-1)-mediated endothelial dysfunction (ED). Therefore, we assessed the relationships between subclinical sleep apnoea and plasma levels of ET-1. Methods We performed a popu...

We described physical activity measures and hourly patterns in patients with chronic obstructive pulmonary disease (COPD) after stratification for generic and COPD-specific characteristics and, based on multiple physical activity measures, we identified clusters of patients. In total, 1001 patients with COPD (65% men; age, 67 years; forced expirato...

Background Sleep disturbances are common in patients with chronic obstructive pulmonary disease (COPD) with a considerable negative impact on their quality of life. However, factors associated with measures of sleep in daily life have not been investigated before nor has the association between sleep and the ability to engage in physical activity o...

Introduction Objective data on the association of maximal aerobic capacity (VO2max) with work related physical activity are sparse. Thus, it is not clear whether occupational physical activity (OPA) contributes to an increase of VO2max. This study examined the association of VO2max with work and non-work related physical activity in a Swiss working...

Excel file of personal an job-related factors. (XLSX)

Excel file of body measurements and 20-meter shuttle run. (XLSX)

Professions of study subjects, stratified according to occupational group and category. (DOCX)

Excel file of SenseWear Mini Armband activity parameters. (XLSX)

Study protocol approved by the local ethics committee. (DOC)

Aim: The aim of this study is to investigate the effects of an acoustic reminder on medication adherence in lung patients. Methods: In this on-going prospective single-blind randomized controlled trial, in- and outpatients from several hospitals around Basel diagnosed with asthma or COPD and with prescribed inhalative medication were recruited. The...

Zusammenfassung. Die allergische Rhinitis und das allergische Asthma werden im Volksmund unter dem Begriff «Heuschnupfen» zusammengefasst und sind in der Schweizer Bevölkerung sehr prävalent. Die Behandlung mit «over the counter» Medikamenten ist sehr verbreitet und oft nicht nachhaltig. Die sich saisonal oft häufenden Hausarzt-Konsultationen belas...

Zusammenfassung. Die chronisch obstruktive Lungenerkrankung (COPD) ist vor allem unter Rauchern eine weit verbreitete Krankheit in der Schweiz. Der Verlauf ist oft progredient und die chronisch kranken und oft polymorbiden Patienten sind auf funktionierende Behandlungsnetzwerke angewiesen. Gesundheitspolitisch und auch medizinisch ist mehr Netzwerk...

Background: Acute exacerbations are key events in COPD, associated with a decline in lung function, lower quality of life and increased mortality. Aims and objectives: The Swiss COPD cohort was established to collect spirometric and other data of patients treated in primary care. Our objective was to evaluate different potentially predictive factor...

Introduction Nocturnal Non-invasive Positive Pressure Ventilation (NPPV) is the treatment of choice in patients with chronic hypercapnic respiratory failure due to hypoventilation. Continuous oxygen saturation measured with a pulse oximeter provides a surrogate measure of arterial oxygen saturation but does not completely reflect ventilation. Curre...

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the initial modality of choice in sampling mediastinal lymphadenopathy. It is possible to obtain both cytological and histological samples using both 21-gauge and 22-gauge EBUS-TBNA needles. The current study was undertaken to compare the diagnostic yield...

Obstructive sleep apnea seems to have an important influence on the autonomic nervous system. In this study, we assessed the relationships of sleep apnea related parameters with 24-hour (h) heart rate variability (HRV) in a large population of young and healthy adults. Participants aged 25-41 years with a body mass index <35kg/m2 and without known...

This study aimed to determine physical performance criteria of different occupational groups by investigating physical activity and energy expenditure in healthy Swiss employees in real-life workplaces on workdays and non-working days in relation to their aerobic capacity (VO2max). In this cross-sectional study, 337 healthy and full-time employed a...

Aerobic capacity and SenseWear activity data across occupational groups in women (n = 113). (DOCX)

Excel file of International Physical Activity Questionnaire variables. (XLSX)

Study protocol approved by the local ethics committee. (DOC)

Personal and job-related factors across occupational groups. (DOCX)

Aerobic capacity and SenseWear activity data across occupational groups in men (n = 190). (DOCX)

Excel file of personal and job-related factors. (XLSX)

Excel file of body measurements and 20-meter shuttle run. (XLSX)

Excel file of SenseWear Mini armband activity parameters. (XLSX)

Objective: For successful long-term asthma care, self-management education is a cornerstone. Little is known about associations between patients' interest in education, asthma control and care delivery. We compared patients' characteristics, asthma control and patients' perspective about asthma care in subjects with and without interest in asthma...

Parasite infections are increasing worldwide due to increasing migration and traveling. Parasitic infections can affect lungs and present as a focal or diffuse lung diseases. High index of suspicion and detailed history are most important. We present a case of interstitial pneumonitis caused by parasite infestation, which was diagnosed on transbron...

Background . Patients with Chronic Obstructive Pulmonary Disease (COPD) suffer from increased daytime sleepiness. The aim of this study was to identify potential predictors of subjective daytime sleepiness with special regard to sleep-related breathing disorder and nocturnal activity. Methods . COPD patients were recruited at the University Hospita...

Background: The influence of sleep related breathing disorders on heart rate variability (HRV), a measure of autonomic nervous function, is not well studied. We therefore assessed the relationship of the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI) with 24-hour HRV in a large population of young and healthy adults. Methods: In...

Introduction: Asthma and chronic obstructive pulmonary disease (COPD) are common lung diseases that require daily and mostly lifelong use of drugs. Poor adherence to inhaled medication represents an avoidable risk factor. Aim: The aim of this study was to investigate whether long-term medication was inhaled as prescribed in patients with asthma an...

Introduction: Excessive daytime sleepiness (EDS) with and without obstructive sleep apnea syndrome (OSAS) has been shown to be associated with road traffic accidents (RTAs). EDS and OSA are potential amenable risk factors where lifestyle changes and/or medical treatment offer the potential to lower the risk for future RTAs. Objectives: To report th...

Background: COPD is known to be a progressive disease and a major burden in health system. Our objective was to analyze the progression of the disease and disease management under primary care setting over long term period. Methods: COPD patients were screened by GPS and enrolled into our cohort. Demographic data was collected; medical treatment, s...

Background: To effectively manage chronic diseases such as asthma, it is important to provide the patients with education and self-management skills. Aims and objectives: The aim of this study was to find out whether participation in a patient education seminar has an effect on asthma control. We hypothesized that asthma patients achieved better as...

Therapy-resistant hypertension is a frequent finding in clinical practice. It is associated with a significantly increased risk for cardiovascular and renal events. Causes include but are not limited to erroneous blood pressure measurements, compliance issues, blood pressure increasing co-medication, and secondary hypertension. During the last year...

Arterial hypertension remains the most important risk factor for cardiovascular and renal diseases. In view of an increasing prevalence with older age and an increasingly aging population, the treatment of elderly patients with arterial hypertension will become increasingly important in daily practice. Arterial hypertension in the elderly differs i...

European and North-American guidelines for the diagnosis and therapy of arterial hypertension refer to hypertensive crisis as an acute and critical increase of blood pressure>180/120 mmHg. Presence of acute hypertensive target organ damage, such as stroke, myocardial infarction or heart failure, in this situation defines a “hypertensive emergency”....

With the growing amount of physical activity (PA) measures, the need for methods and algorithms that automatically analyse and interpret unannotated data increases. In this paper PA is seen as a combination of multi-modal constructs that can co-occur in different ways and proportions during the day. The design of a methodology able to integrate and...

To analyze prospectively the hypothalamic-pituitary-adrenal (HPA) axis and clinical outcome in patients treated with prednisone for exacerbated chronic obstructive pulmonary disease (COPD). Prospective observational study. Patients presenting to the emergency department were randomized to receive 40 mg prednisone daily for 5 or 14 days in a placebo...

Background and objectiveBoth comorbidities and physical inactivity have been shown to impair quality of life and contribute to hospital admissions and mortality in chronic obstructive pulmonary disease (COPD) patients. We hypothesized that the comorbid status predicts the level of daily physical activity (PA) in COPD.Methods In 228 patients with CO...

PURPOSE: Acute exacerbations (AE) in patients with COPD are associated with a decline in lung function, increased risk of hospitalization, and mortality. In this cross-sectional study we tested whether the level of objectively measured daily physical activity and exercise capacity are associated with the number of COPD exacerbations. METHODS: In 21...

Psychological morbidity is common in chronic respiratory diseases. The diagnostic accuracy of the Hospital Anxiety and Depression Scale (HADS) and risk factors for comorbid depression in chronic obstructive pulmonary disease (COPD) are addressed. Consecutive COPD patients (GOLD stage I–IV, 40–75 years old) were enrolled in a multicentre, cross-sect...

Background: The occurrence of both chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) in an individual patient has been described as 'overlap syndrome', which has been associated with poor prognosis. Little is known about the possible predictors of the overlap syndrome and its association with comorbidities contributing...

Objective: With respect to the overweight epidemic, this study aimed to investigate the association between domain-specific physical activity and body composition measures in Swiss male employees. Methods: A total of 192 healthy male adults in full-time employment were investigated. Height, weight, and waist circumference were measured and body...

Background The Global Initiative for Chronic Obstructive Lung Disease proposed in 2011 a new system to classify chronic obstructive pulmonary disease (COPD) patients into risk groups A-D, which considers symptoms and future exacerbation risk to grade disease severity. The aim of this study was to investigate the agreement between COPD risk group cl...

BACKGROUND: Existing prediction models for mortality in chronic obstructive pulmonary disease (COPD) patients have not yet been validated in primary care, which is where the majority of patients receive care. OBJECTIVES: Our aim was to validate the ADO (age, dyspnoea, airflow obstruction) index as a predictor of 2-year mortality in 2 general practi...

Background Mannitol- and exercise bronchial provocation tests are both used to diagnose exercise-induced bronchoconstriction. The study aim was to compare the short-term treatment response to budesonide and montelukast on airway hyperresponsiveness to mannitol challenge test and to exercise challenge test in children and adolescents with exercise-i...

Introduction: In the therapy of chronic obstructive pulmonary disease (COPD), it is a major goal to improve health-related quality of life (HRQOL). Patients with COPD often suffer from exertional dyspnea and adopt a sedentary lifestyle, which could be associated with poorer HRQOL. The aim of this study was to investigate the independent associatio...

Sleep problems are a well-known risk factor for work injuries, but less is known about which vulnerable populations are most at risk. The aims of this study were to investigate the association between sleep quality and the risk of work injury and to identify factors that may modify the association. A case-control study including 180 cases and 551 c...

Asthma and chronic obstructive airways disease are chronic pulmonary diseases which have a high prevalence world-wide. Both conditions can deteriorate acutely and potentially put patients into life-threatening situations. Management of an acute exacerbation starts in the emergency consultation-setting and ends only once the longterm management has...