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Kobayashi T, Murakami T, Ono H, Takahashi T. Phase angle as an indicator of physical activity in patients with stable chronic obstructive pulmonary disease. Nutrition 2024; 120:112330. [PMID: 38262195 DOI: 10.1016/j.nut.2023.112330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Phase angle (PhA) reflects cell membrane integrity and vitality and is an indicator of sarcopenia. PhA is associated with physical function in patients with stable chronic obstructive pulmonary disease (COPD). To our knowledge, the association between PhA and physical activity (PA) has not been investigated. Therefore, the aim of this study was to investigate whether PhA reflects PA in patients with COPD. METHODS This single-center, cross-sectional, observational study included 103 patients with stable COPD (87 men; mean age, 74.7 ± 8.1 y; mean forced expiratory volume in 1s %predicted value, 58.9 ± 20.4%). PhA was measured by bioelectrical impedance analysis. Patients were stratified into low (n = 54) and high (n = 49) PhA groups based on median values (4.3° ± 0.6° and 5.4° ± 0.5°, respectively). PA was calculated as the average daily duration of high-intensity light PA (HLPA; 2.0-2.9 metabolic equivalents [METs] of PA) and moderate- to vigorous-intensity PA (MVPA; >3 METs). Correlation and multivariate analyses using multiple regression analysis were performed to confirm the association between PhA and PA. RESULTS The high-PhA group demonstrated greater HLPA (104.4 [16.5-332.5] versus 131.3 [61.1-328.7] min, P = 0.005) and MVPA (19.5 [4.7-96.0] versus 46.6 [8.9-139.3] min, P < 0.001) than the low-PhA group. PhA was positively correlated with HLPA (r = 0.32, P < 0.001) and MVPA (r = 0.49, P < 0.001). MVPA (β = 0.178, P = 0.029) and HLPA (β = 0.158, P = 0.026) were associated with PhA independent of age, sex, body mass index, respiratory function, muscle strength, skeletal muscle mass index, and 6-min walking distance. CONCLUSION In patients with COPD, PhA may reflect PA as well as muscle function.
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Affiliation(s)
- Takeshi Kobayashi
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan.
| | - Tomoyuki Murakami
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
| | - Hiroto Ono
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
| | - Tsuneyuki Takahashi
- Department of Internal Medicine, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
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Verweel L, Packham T, Goldstein R, Brooks D, MacKay C. Implementation of virtual pulmonary rehabilitation during the COVID-19 pandemic: Experiences and perceptions of patients and healthcare providers. Respir Med 2024; 225:107588. [PMID: 38460709 DOI: 10.1016/j.rmed.2024.107588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Pulmonary rehabilitation (PR) plays an important role in the management of symptomatic patients with chronic respiratory diseases (CRD). While studies have investigated the feasibility and efficacy of virtual PR (VPR), it is important to understand the experiences of patients and healthcare providers (HCPs) during the rapid digital health transformation that occurred in the COVID-19 pandemic. OBJECTIVES To explore the experiences and perspectives of patients and HCPs who participated in VPR during the pandemic. METHODS Semi-structured interviews were conducted with CRD patients and HCPs. This study used a qualitative descriptive approach and a team-based inductive thematic analysis. RESULTS Participants included 11 HCPs (7 female; 29-55 years) and 19 CRD patients (11 male; 62-83 years; 15 COPD, 4 COPD/ILD). Three major themes and 10 subthemes were identified: i) the pandemic response: a 'trial by fire' (navigating uncertainty, emotional impact of change, shifting practice amid complexity); ii) beyond the emergency: navigating a 'new normal' (eligibility and assessment for VPR, virtual exercise, virtual education and resources, clinical supervision and patient safety); and iii) care beyond boundaries: the implications of using technology for PR (benefits and limitations of technology, psychosocial implications, VPR in the future). CONCLUSION The pivot to VPR was acknowledged as positive by both patients and HCPs although both groups were mindful of the implementation challenges. These findings provide insight into the experience of HCPs and patients in introducing VPR in response to the pandemic and will inform future implementation of VPR for individuals with CRD.
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Affiliation(s)
- L Verweel
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada.
| | - T Packham
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - R Goldstein
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada; Departments of Medicine and Physical Therapy, University of Toronto, Toronto, Canada
| | - D Brooks
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada; West Park Healthcare Centre, Toronto, Canada
| | - C MacKay
- West Park Healthcare Centre, Toronto, Canada; Departments of Medicine and Physical Therapy, University of Toronto, Toronto, Canada
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Mountain R, Knight J, Heys K, Giorgi E, Gatheral T. Spatio-temporal modelling of referrals to outpatient respiratory clinics in the integrated care system of the Morecambe Bay area, England. BMC Health Serv Res 2024; 24:229. [PMID: 38388919 PMCID: PMC10882730 DOI: 10.1186/s12913-024-10716-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Promoting integrated care is a key goal of the NHS Long Term Plan to improve population respiratory health, yet there is limited data-driven evidence of its effectiveness. The Morecambe Bay Respiratory Network is an integrated care initiative operating in the North-West of England since 2017. A key target area has been reducing referrals to outpatient respiratory clinics by upskilling primary care teams. This study aims to explore space-time patterns in referrals from general practice in the Morecambe Bay area to evaluate the impact of the initiative. METHODS Data on referrals to outpatient clinics and chronic respiratory disease patient counts between 2012-2020 were obtained from the Morecambe Bay Community Data Warehouse, a large store of routinely collected healthcare data. For analysis, the data is aggregated by year and small area geography. The methodology comprises of two parts. The first explores the issues that can arise when using routinely collected primary care data for space-time analysis and applies spatio-temporal conditional autoregressive modelling to adjust for data complexities. The second part models the rate of outpatient referral via a Poisson generalised linear mixed model that adjusts for changes in demographic factors and number of respiratory disease patients. RESULTS The first year of the Morecambe Bay Respiratory Network was not associated with a significant difference in referral rate. However, the second and third years saw significant reductions in areas that had received intervention, with full intervention associated with a 31.8% (95% CI 17.0-43.9) and 40.5% (95% CI 27.5-50.9) decrease in referral rate in 2018 and 2019, respectively. CONCLUSIONS Routinely collected data can be used to robustly evaluate key outcome measures of integrated care. The results demonstrate that effective integrated care has real potential to ease the burden on respiratory outpatient services by reducing the need for an onward referral. This is of great relevance given the current pressure on outpatient services globally, particularly long waiting lists following the COVID-19 pandemic and the need for more innovative models of care.
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Affiliation(s)
| | - Jo Knight
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Kelly Heys
- University Hospitals of Morecambe Bay NHS Foundation Trust, Westmorland General Hospital, Kendal, UK
| | - Emanuele Giorgi
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Timothy Gatheral
- Lancaster Medical School, Lancaster University, Lancaster, UK
- University Hospitals of Morecambe Bay NHS Foundation Trust, Westmorland General Hospital, Kendal, UK
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Al-Noshokaty TM, Fathi D, Abulsoud AI, Moustafa YM, Abdel Mageed SS, Mohammed OA, Abdel-Reheim MA, Abdelmaksoud NM, Doghish AS. Harnessing the power of miRNAs: The molecular architects of asthma pathogenesis and potential targets for therapeutic innovation. Pathol Res Pract 2024; 253:155054. [PMID: 38142525 DOI: 10.1016/j.prp.2023.155054] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023]
Abstract
Asthma is a chronic non-communicable respiratory disease that is characterized by airway inflammation and hyperreactivity. Defective functions of airway smooth muscle and dysregulated signaling pathways play a crucial role in the pathogenesis of asthma. Anti-inflammatories and targeted therapy are mainly used for the treatment of asthma. Recent studies have investigated the role of non-coding RNAs, especially microRNAs (miRNAs; miR) in regulating gene expression and their involvement in the dysfunctional signaling pathways. In immune-mediated diseases, including asthma, miRNAs govern the actions of cells that form the airway structure and those responsible for the defense mechanisms in the bronchi and lungs. miRNAs control cell survival, proliferation, and growth, as well as the cells' capacity to produce and release chemokines and immune mediators. Moreover, miRNAs have an important role in the response to therapeutic interventions. Collectively, this review highlights the regulatory roles of miRNAs in modulating the different signaling pathways and therapeutic responses in asthma. Patients who suffer from asthma, particularly those with severe disease characteristics, may benefit from the prospective treatment options that include targeting miRNAs in order to reduce airway inflammation, hyperreactivity, and mucus production.
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Affiliation(s)
- Tohada M Al-Noshokaty
- Biochemistry Department, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Doaa Fathi
- Biochemistry Department, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt
| | - Ahmed I Abulsoud
- Biochemistry Department, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt; Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt.
| | - Yasser M Moustafa
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Sherif S Abdel Mageed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt
| | - Osama A Mohammed
- Department of Pharmacology, College of Medicine, University of Bisha, Bisha 61922, Saudi Arabia
| | - Mustafa Ahmed Abdel-Reheim
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Shaqra 11961, Saudi Arabia; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef University, Beni Suef 62521, Egypt.
| | | | - Ahmed S Doghish
- Department of Biochemistry, Faculty of Pharmacy, Badr University in Cairo (BUC), Badr City, Cairo 11829, Egypt; Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo 11231, Egypt.
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5
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Fathi M, Moradi N, Yousefi N, Peiravian F, Shobeiri N. Evaluating the affordability of asthma, chronic obstructive pulmonary disease, and cystic fibrosis medicines in a middle-income country. BMC Pulm Med 2023; 23:429. [PMID: 37925396 PMCID: PMC10625700 DOI: 10.1186/s12890-023-02737-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND A heavy financial burden is imposed on patients suffering from chronic diseases due to medicine out-of-pocket payments. OBJECTIVES This study focuses on assessing the affordability of medications used for chronic respiratory diseases (CRDs) such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) in Iran, specifically on the category R medicines listed in the 2017 Iran drug list (IDL) that are used for the treatment of these diseases, based on the anatomical therapeutic chemical (ATC) drug code. METHODS The affordability of medicines in mono and combination therapy approaches was assessed in CRDs using the World Health Organization/Health Action International (WHO/HAI) methodology. Accordingly, if out-of-pocket payment for 30-days of pharmacotherapy exceeds one day for the lowest-paid unskilled government worker (LPGW), it's considered non-affordable. RESULTS Based on the monotherapy approach, our finding demonstrates that all generic medicines of category R were affordable. However, branded drugs such as Symbicort®, Pulmicort Respules®, Flusalmex®, Seretide®, Fluticort Plus®, Seroflo®, and Salmeflo® cost between 1.2 and 2.5 days' wage of LPGW and considered unaffordable despite 70% insurance coverage. Moreover, based on the affordability ratio in the combination therapy approach, all medicines used in asthma, COPD, and CF patients with mild respiratory problems are affordable except omalizumab (inj), which is non-affordable due to its high price and no insurance coverage. CONCLUSION Results showed that the existing insurance coverage does not protect households from hardship, so more considerations are needed such as different insurance schedules and patient support programs.
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Affiliation(s)
- Mahdieh Fathi
- Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Najmeh Moradi
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nazila Yousefi
- Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Peiravian
- Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nikta Shobeiri
- Department of Pharmaceutical Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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Tappan RS, Ettinger JR, Mahon D, Mroz SE, Hall W, Maajid E, Stratton C, Zynda DT, Conroy DE, Danilovich M. Development of a physical activity counseling intervention for people with chronic respiratory disease based on the health action process approach. Pilot Feasibility Stud 2023; 9:173. [PMID: 37828614 PMCID: PMC10568913 DOI: 10.1186/s40814-023-01397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Physical activity (PA) counseling holds promise for increasing PA levels in people with chronic respiratory disease, though little long-term change has been shown to date. Here, we describe the development of a Health Action Process Approach-based PA counseling intervention that aims to promote PA and exercise in people with chronic respiratory disease who are enrolled in pulmonary rehabilitation. METHODS To collaborate in defining and refining the intervention, we convened a varied team of authors that included a panel of five stakeholder partners: three patients, one clinician, and one health behavior change researcher. We completed three steps in the intervention development process: (1) initial intervention creation, (2) iterative intervention refinement, and (3) assessment of intervention acceptability. In step 1, we created an initial draft of the PA counseling intervention based on the HAPA theoretical framework, previous evidence in people with chronic respiratory disease, and clinical experience. In step 2, we used qualitative methods of focus groups and interviews to further develop and refine the intervention. Fifteen meetings occurred with the five-member stakeholder partner panel (six focus groups with the three patient partners, four interviews with the clinician partner, and five interviews with the researcher partner) over 5 months to systematically elicit input and incorporate it into the intervention. In step 3, we measured the intervention acceptability using five-point Likert scale ratings. RESULTS Intervention materials included the eligibility screen, participant workbook, and leader guide. We identified key themes in the input from the stakeholder partners and incorporated this input into the intervention content and methods. Ratings of the intervention by the stakeholder partners (n=5) were high with mean ratings ranging 4.0-5.0 on a five-point scale. CONCLUSIONS This development process successfully engaged an intervention development team with diverse perspectives and resulted in a PA counseling intervention for people with chronic respiratory disease. The intervention's strong theoretical underpinning, person-centeredness, and the contributions from varied perspectives during intervention development position it well for future evaluations of feasibility, efficacy, and effectiveness.
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Affiliation(s)
- Rachel S Tappan
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
- Department of Medicine (Pulmonary and Critical Care), Feinberg School of Medicine, Northwestern University, 645 N. Michigan Avenue, Suite 1100, Chicago, Illinois, 60611, USA.
| | - Jennifer R Ettinger
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Delaney Mahon
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Sarah E Mroz
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Walter Hall
- , 933 Garden Lane, Homewood, Illinois, 60430, USA
| | - Estelle Maajid
- , 536 East 32nd Street Unit E, Chicago, Illinois, 60616, USA
| | - Chelsea Stratton
- Department of Physical Therapy, Marquette University, Schroeder Complex, Room 346, P.O. Box 1881, Milwaukee, Wisconsin, 53210, USA
| | | | - David E Conroy
- Department of Kinesiology, Human Development & Family Studies and Public Health Sciences, The Pennsylvania State University, 268U Recreation Building, University Park, Pennsylvania, 16802, USA
| | - Margaret Danilovich
- Leonard Schanfield Research Institute, CJE SeniorLife, 3003 W. Touhy Avenue, Chicago, Illinois, 60645, USA
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Hohn RE, Kopec JA, Sawatzky R, Poureslami I, FitzGerald JM. Measuring skill-based health literacy in chronic airway disease patients: the development and psychometric evaluation of the Vancouver airways health literacy tool (VAHLT). Qual Life Res 2023; 32:2875-2886. [PMID: 37428406 DOI: 10.1007/s11136-023-03447-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE This article describes the development of the Vancouver airways health literacy tool (VAHLT), a novel measure of skill-based health literacy specific to chronic airway diseases (CADs). Across several phases, psychometric characteristics of the VAHLT were examined and used to guide its development. METHODS An initial pool of 46 items was developed using input from patients, clinicians, researchers, and policy-makers. An initial patient sample (N = 532) was evaluated and used to inform item revisions. A revised 44-item pool was then evaluated using a second sample, the results of which aided in the selection of a final set of 30 items. The finalized 30-item VAHLT was then psychometrically evaluated using the second sample (N = 318). An item response theory approach was utilized to evaluate the VAHLT by assessing model fit, item parameter estimates, test and item information curves, and item characteristic curves. Reliability was assessed using ordinal coefficient alpha. We additionally assessed differential item functioning between asthma and COPD diagnoses. RESULTS The VAHLT demonstrated a unidimensional structure and reasonably discriminated patients in the lower range of health literacy estimates. The tool demonstrated strong reliability (α = .920). Two of the 30 items were found to exhibit non-negligible differential item functioning. CONCLUSIONS This study presents compelling evidence of validity in several areas for the VAHLT, including content and structural validity. Further external validation studies are needed and forthcoming. Overall, this work represents a strong first step towards a novel, skill-based, and disease-specific measure of CAD-related health literacy.
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Affiliation(s)
- Richard E Hohn
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada.
| | - Jacek A Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Richard Sawatzky
- School of Nursing, Trinity Western University, Langley, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, BC, Canada
| | - Iraj Poureslami
- Faculty of Medicine, Respiratory Medicine Division, University of British Columbia, Vancouver, BC, Canada
- Canadian Multicultural Health Promotion Society (CMHPS), Burnaby, BC, Canada
- Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - J Mark FitzGerald
- Faculty of Medicine, Respiratory Medicine Division, University of British Columbia, Vancouver, BC, Canada
- Division of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
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Stolbrink M, Streicher C, Mcimeli K, Allwood B, Mortimer K, Chinouya M. "Asthma is a very bully disease" - patient experiences of living with chronic respiratory diseases in Cape Town, South Africa. Int J Equity Health 2023; 22:190. [PMID: 37710307 PMCID: PMC10500759 DOI: 10.1186/s12939-023-02002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Chronic respiratory diseases are common in Cape Town, South Africa. Yet the experiences of how adults with these conditions, such as asthma or COPD (chronic obstructive pulmonary disease), negotiate the health system are poorly understood. Qualitative methodology lends itself to investigate this question. AIM OF STUDY To explore the "emic" experiences of adults with CRDs in Cape Town when they were negotiating the health system using semi-structured interviews. METHODS Interviews were conducted following informed consent with purposively sampled adults who had attended public hospitals in Cape Town with chronic respiratory disease flare-ups. This work was nested in the quantitative "Diagnosing Airways Disease" study. The topic guide explored patients' experiences of accessing healthcare including receiving and interpretations of the diagnosis and management, and impacts on daily life. Interviews were conducted in Afrikaans, isiXhosa, or English; transcribed, and translated into English and thematically analysed until saturation. RESULTS Thirty-two interviews (16 in Afrikaans, 8 in isiXhosa, 8 in English) were completed in 2022. 17 women and 15 men participated. Most participants were older than 50 years (25/32), and most were unemployed (13/32) or retired (11/32). The identified themes were: Perceived causes of illness; experiences of healthcare; perceived risks and barriers when accessing healthcare; and impact on earnings. The perceived causes of their illness and risks were structural, and included air pollution, poor quality housing, occupational exposures, limited healthcare services, and fear of violence. These factors led to self-treatment, sharing of medicines, and delay in receiving a diagnosis. Many paid privately for treatments or services to overcome identified shortcomings of the public healthcare system, and many reported additional significant indirect costs. Being ill had a profound impact on income. The identified themes were explored through the lens of "structural violence", where "social structures stop individuals … from reaching their full potential" (Galtung, 1969). CONCLUSION In Cape Town structural elements such as stretched healthcare professionals, insufficiently enforced policies on e.g., housing or work-place exposures, poverty and crime made it difficult for participants to successfully navigate their illness experience. It forced some to pay out of pocket to receive perceived better healthcare privately.
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Affiliation(s)
- Marie Stolbrink
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- Division of Pulmonology, Department of Medicine, Stellenbosch University, Cape Town, South Africa.
| | - Chantel Streicher
- Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Khanyisa Mcimeli
- Faculty of Arts and Social Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Brian Allwood
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Kevin Mortimer
- Cambridge Africa, University of Cambridge, Cambridge, UK
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Martha Chinouya
- Faculty of Education, Liverpool School of Tropical Medicine, Liverpool, UK
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9
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Kadam S, Prem V, Ughreja RA. Effect of breathing re-training on end-tidal carbon-di-oxide in patients with asthma: a systematic review and meta-analysis. J Asthma 2023; 60:1493-1502. [PMID: 36562757 DOI: 10.1080/02770903.2022.2162413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The review aims to determine the effect of breathing re-training on End-tidal carbon-di-oxide (ETCO2) in patients with asthma. DATA SOURCES A systematic search of articles was performed in PubMed, Cochrane, PEDro, Scopus, and Ovid databases from their inception till May 2022. STUDY SELECTIONS Studies were included if the patients were clinically diagnosed with mild-moderate asthma. Randomized controlled trials that monitored ETCO2 as a primary or secondary outcome were included. Studies were examined for potential risk of bias using the Revised Cochrane risk of bias tool by two independent reviewers. RESULTS Eight articles were included. The trials used various techniques like Buteyko, Papworth, Biofeedback, and holistic approach. Quantitative analysis was conducted to examine the effects on ETCO2 at various time points. A significant large effect was seen on ETCO2 following breathing re-training post-treatment, 3 and 6 months post-intervention. CONCLUSION There is moderate evidence for a significant effect of breathing re-training on ETCO2 in the short and long term in patients with asthma. However, high-quality randomized controlled trials using standardized measurement of ETCO2 are required to evaluate the effects of different breathing re-training techniques.
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Affiliation(s)
- Shruti Kadam
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Venkatesan Prem
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Reepa Avichal Ughreja
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Dupin I, Eyraud E, Maurat É, Sac-Épée JM, Vallois P. Probabilistic cellular automata modelling of intercellular interactions in airways: complex pattern formation in patients with chronic obstructive pulmonary disease. J Theor Biol 2023; 564:111448. [PMID: 36878400 DOI: 10.1016/j.jtbi.2023.111448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/07/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a highly prevalent lung disease characterized by chronic inflammation and tissue remodeling possibly induced by unusual interactions between fibrocytes and CD8+ T lymphocytes in the peribronchial area. To investigate this phenomenon, we developed a probabilistic cellular automata type model where the two types of cells follow simple local interaction rules taking into account cell death, proliferation, migration and infiltration. We conducted a rigorous mathematical analysis using multiscale experimental data obtained in control and disease conditions to estimate the model's parameters accurately. The simulation of the model is straightforward to implement, and two distinct patterns emerged that we can analyse quantitatively. In particular, we show that the change in fibrocyte density in the COPD condition is mainly the consequence of their infiltration into the lung during exacerbations, suggesting possible explanations for experimental observations in normal and COPD tissue. Our integrated approach that combines a probabilistic cellular automata model and experimental findings will provide further insights into COPD in future studies.
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Affiliation(s)
- Isabelle Dupin
- Univ-Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, U1045, F-33000 Bordeaux, France; INSERM, Centre de Recherche Cardio-thoracique de Bordeaux, U1045, F-33000 Bordeaux, France.
| | - Edmée Eyraud
- Univ-Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, U1045, F-33000 Bordeaux, France; INSERM, Centre de Recherche Cardio-thoracique de Bordeaux, U1045, F-33000 Bordeaux, France
| | - Élise Maurat
- Univ-Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, U1045, F-33000 Bordeaux, France; INSERM, Centre de Recherche Cardio-thoracique de Bordeaux, U1045, F-33000 Bordeaux, France
| | | | - Pierre Vallois
- Université de Lorraine, CNRS, Inria, IECL., F-54000 Nancy, France
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11
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Ahmed U, Lin JCW, Srivastava G. Multivariate time-series sensor vital sign forecasting of cardiovascular and chronic respiratory diseases. Sustain Comput 2023; 38:100868. [PMID: 37168459 PMCID: PMC10076073 DOI: 10.1016/j.suscom.2023.100868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 11/27/2022] [Accepted: 04/02/2023] [Indexed: 05/13/2023]
Abstract
Approximately 19 million people die each year from cardiovascular and chronic respiratory diseases. As a result of the recent Covid-19 epidemic, blood pressure, cholesterol, and blood sugar levels have risen. Not only do healthcare institutions benefit from studying physiological vital signs, but individuals also benefit from being alerted to health problems in a timely manner. This study uses machine learning to categorize and predict cardiovascular and chronic respiratory diseases. By predicting a patient's health status, caregivers and medical professionals can be alerted when needed. We predicted vital signs for 180 seconds using real-world vital sign data. A person's life can be saved if caregivers react quickly and anticipate emergencies. The tree-based pipeline optimization method (TPOT) is used instead of manually adjusting machine learning classifiers. This paper focuses on optimizing classification accuracy by combining feature pre-processors and machine learning models with TPOT genetic programming making use of linear and Prophet models to predict important indicators. The TPOT tuning parameter combines predicted values with classical classification models such as Naïve Bayes, Support Vector Machines, and Random Forests. As a result of this study, we show the importance of categorizing and increasing the accuracy of predictions. The proposed model achieves its adaptive behavior by conceptually incorporating different machine learning classifiers. We compare the proposed model with several state-of-the-art algorithms using a large amount of training data. Test results at the University of Queensland using 32 patient's data showed that the proposed model outperformed existing algorithms, improving the classification of cardiovascular disease from 0.58 to 0.71 and chronic respiratory disease from 0.49 to 0.70, respectively, while minimizing the mean percent error in vital signs. Our results suggest that the Facebook Prophet prediction model in conjunction with the TPOT classification model can correctly diagnose a patient's health status based on abnormal vital signs and enables patients to receive prompt medical attention.
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Affiliation(s)
- Usman Ahmed
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, 5063, Bergen, Norway
| | - Jerry Chun-Wei Lin
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, 5063, Bergen, Norway
| | - Gautam Srivastava
- Department of Mathematics & Computer Science, Brandon University, Brandon, Canada
- Research Centre of Interneural Computing, Taichung, Taiwan
- Department of Computer Science & Math, Lebanese American University, Beirut, Lebanon
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12
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Li J, Chen W, Liu H, Liu H, Xiang S, You F, Jiang Y, Lin J, Zhang D, Zheng C. Pharmacologic effects approach of essential oils and their components on respiratory diseases. J Ethnopharmacol 2023; 304:115962. [PMID: 36529244 DOI: 10.1016/j.jep.2022.115962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Essential oils (EOs) are concentrated hydrophobic liquids with volatility and a unique aroma. Formed by aromatic plants as secondary metabolites, EOs have been used as traditional medicines to treat various health problems worldwide. Historical records show that herbs rich in EOs have been widely used to treat respiratory diseases in China, Europe, and many other regions. AIM OF THE REVIEW This review summarizes the traditional applications and modern pharmacological mechanisms of EOs derived from aromatic herbs and their active ingredients in respiratory diseases in preclinical and clinical trials through multitarget synergy. MATERIALS AND METHODS Information about EOs and respiratory diseases was collected from electronic databases, such as ScienceDirect, Web of Science, PubMed, Google Scholar, Baidu Scholar, and the China National Knowledge Infrastructure (CNKI). RESULTS This review presents the preventive and therapeutic effects of EOs on respiratory diseases, including chronic obstructive pulmonary disease, bronchial asthma, acute lung injury, pulmonary infection, and pulmonary fibrosis. The molecular mechanisms of EOs in treating different lung diseases are summarized, including anti-inflammation, anti-oxidation, mucolytic, and immune regulatory mechanisms. CONCLUSIONS EOs show potential as supplements or substitutes for treating lung diseases.
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Affiliation(s)
- Jia Li
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
| | - Wu Chen
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
| | - Huimin Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, No. 1066 Avenue Liutai, Chengdu, 611137, China.
| | - Hong Liu
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
| | - Sirui Xiang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
| | - Fengming You
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
| | - Yifang Jiang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
| | - Junzhi Lin
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
| | - Dingkun Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, No. 1066 Avenue Liutai, Chengdu, 611137, China.
| | - Chuan Zheng
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan Province, China.
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Egere U, Shayo EH, Chinouya M, Taegtmeyer M, Ardrey J, Mpagama S, Ntinginya NE, Ahmed R, Hussein EH, Sony AE, Wingfield T, Obasi A, Tolhurst R. "Honestly, this problem has affected me a lot": a qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania. BMC Public Health 2023; 23:485. [PMID: 36915117 PMCID: PMC10010645 DOI: 10.1186/s12889-023-15368-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/02/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Over 500 million people live with chronic respiratory diseases globally and approximately 4 million of these, mostly from the low- and middle-income countries including sub-Saharan Africa, die prematurely every year. Despite high CRD morbidity and mortality, only very few studies describe CRDs and little is known about the economic, social and psychological dimensions of living with CRDs in sub-Saharan Africa. We aimed to gain an in-depth understanding of the social, livelihood and psychological dimensions of living with CRD to inform management of CRDs in Sudan and Tanzania. METHOD We conducted 12 in-depth interviews in 2019 with people with known or suspected CRD and 14 focus group discussions with community members in Gezira state, Sudan and Dodoma region, Tanzania, to share their understanding and experience with CRD. The data was analysed using thematic framework analysis. RESULTS People with CRD in both contexts reported experiences under two broad themes: impact on economic wellbeing and impact on social and psychological wellbeing. Capacity to do hard physical work was significantly diminished, resulting in direct and indirect economic impacts for them and their families. Direct costs were incurred while seeking healthcare, including expenditures on transportation to health facility and procurement of diagnostic tests and treatments, whilst loss of working hours and jobs resulted in substantial indirect costs. Enacted and internalised stigma leading to withdrawal and social exclusion was described by participants and resulted partly from association of chronic cough with tuberculosis and HIV/AIDS. In Sudan, asthma was described as having negative impact on marital prospects for young women and non-disclosure related to stigma was a particular issue for young people. Impaired community participation and restrictions on social activity led to psychological stress for both people with CRD and their families. CONCLUSION Chronic respiratory diseases have substantial social and economic impacts among people with CRD and their families in Sudan and Tanzania. Stigma is particularly strong and appears to be driven partly by association of chronic cough with infectiousness. Context-appropriate measures to address economic impacts and chronic cough stigma are urgently needed as part of interventions for chronic respiratory diseases in these sub-Saharan African contexts.
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Affiliation(s)
- Uzochukwu Egere
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK.
| | - Elizabeth H Shayo
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Martha Chinouya
- Faculty of Education, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Miriam Taegtmeyer
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- Tropical Infectious Diseases Unit, Royal Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool, UK
| | - Jane Ardrey
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
| | - Stellah Mpagama
- Kibong'oto Infectious Diseases Hospital, Mae Street, Kilimanjaro, Tanzania
- Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | | | - Rana Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
| | | | | | - Tom Wingfield
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- Tropical Infectious Diseases Unit, Royal Liverpool University Hospitals NHS Foundation Trust, Prescot Street, Liverpool, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Department of Global Public Health, WHO Collaborating Centre on Tuberculosis and Social Medicine, Karolinska Institute, Stockholm, Sweden
| | - Angela Obasi
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
- Honorary Consultant in HIV and Genitourinary Medicine, AXESS Clinic, The Royal Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Rachel Tolhurst
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK
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14
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Heidari-Foroozan M, Aryan A, Esfahani Z, Shahrbaf MA, Moghaddam SS, Keykhaei M, Ghasemi E, Rashidi MM, Rezaei N, Ghamari SH, Abbasi-Kangevari M, Fateh SM, Farzi Y, Rezaei N, Larijani B. National, subnational and risk attributed burden of chronic respiratory diseases in Iran from 1990 to 2019. Respir Res 2023; 24:74. [PMID: 36906596 PMCID: PMC10006557 DOI: 10.1186/s12931-023-02353-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/28/2023] [Indexed: 03/13/2023] Open
Abstract
INTRODUCTION Data on the distribution of the burden of diseases is vital for policymakers for the appropriate allocation of resources. In this study, we report the geographical and time trends of chronic respiratory diseases (CRDs) in Iran from 1990 to 2019 based on the Global burden of the Disease (GBD) study 2019. METHODS Data were extracted from the GBD 2019 study to report the burden of CRDs through disability-adjusted life years (DALYs), mortality, incidence, prevalence, Years of Life lost (YLL), and Years Lost to Disability (YLD). Moreover, we reported the burden attributed to the risk factors with evidence of causation at national and subnational levels. We also performed a decomposition analysis to determine the roots of incidence changes. All data were measured as counts and age-standardized rates (ASR) divided by sex and age group. RESULTS In 2019, the ASR of deaths, incidence, prevalence, and DALYs attributed to CRDs in Iran were 26.9 (23.2 to 29.1), 932.1 (799.7 to 1091.5), 5155.4 (4567.2 to 5859.6) and 587,911 (521,418 to 661,392) respectively. All burden measures were higher in males than females, but in older age groups, CRDs were more incident in females than males. While all crude numbers increased, all ASRs except for YLDs decreased over the studied period. Population growth was the main contributor to the changes in incidence at a national and subnational levels. The ASR of mortality in the province (Kerman) with the highest death rate (58.54 (29.42 to 68.73) was four times more than the province (Tehran) with the lowest death rate (14.52 (11.94 to 17.64)). The risk factors which imposed the most DALYs were smoking (216 (189.9 to 240.8)), ambient particulate matter pollution (117.9 (88.1 to 149.4)), and high body mass index (BMI) (57 (36.3 to 81.8)). Smoking was also the main risk factor in all provinces. CONCLUSION Despite the overall decrease in ASR of burden measures, the crude counts are rising. Moreover, the ASIR of all CRDs except asthma is increasing. This suggests that the overall incidence of CRDs will continue to grow in the future, which calls for immediate action to reduce exposure to the known risk factors. Therefore, expanded national plans by policymakers are essential to prevent the economic and human burden of CRDs.
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Affiliation(s)
- Mahsa Heidari-Foroozan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran.,Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alisam Aryan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran.,Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | | | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran.,Kiel Institute for the World Economy, Kiel, Germany
| | - Mohammad Keykhaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran.,Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | - Yousef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersectionsection, Tehran, 1411713137, Iran. .,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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15
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Ganta S, Komaravalli PL, Ahmad S, Gaddam SL. Influence of genetic variants and mRNA expression of interleukin IL17A gene in asthma susceptibility. Gene 2023; 854:147119. [PMID: 36529350 DOI: 10.1016/j.gene.2022.147119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Asthma is a chronic respiratory disease characterized by coughing, wheezing, shortness of breath, chest tightness, overproduction of mucus, and expiratory airflow limitation, which affects >300 million people worldwide. It is triggered by the dynamic interplay of genetic factors and environmental exposure. Th17 cells are an emerging subset of CD4+ T cells, which secrete IL-17A. This proinflammatory cytokine has recently been associated with asthma, autoimmune diseases, and inflammatory disorders. The present case-control study was focused on identifying the involvement of the IL-17A gene in asthma pathogenesis among 150 clinically diagnosed asthma patients and 150 healthy controls (HCs) of South Indian origin. To carry out the study, we aimed to screen the genetic variants of rs2275913G/A and rs8193036C/T and also estimated the serum cytokine levels of the IL-17A cytokine of recruited subjects. Further, we evaluated mRNA expression in selected subjects to correlate with the genetic variants. The results revealed that the mean IL-17A serum levels (161.6 ± 380.1 pg/ml vs. 86.75 ± 90.01 pg/ml) and IgE levels (257.7 ± 133.3 pg/ml vs. 311.2 ± 160.5 pg/ml) in asthma patients were significantly high as compared to healthy controls (p < 0.05). The ROC curves were constructed to compare the cytokine levels of asthma patients and HC, and the area under the curve (AUC) for IL-17A cytokine was 0.64, indicating that the test was satisfactory and significant (95 % CI: 0.575-0.709; p < 0.001). Genotyping of rs2275913G/A polymorphism indicated a 1.6-fold risk (95 % CI-1.02-2.56; p = 0.04) for asthma patients compared to healthy controls, whereas no significant association was observed for rs8193036C/T polymorphism with asthma susceptibility. Under genetic models, GA and AA models showed a protective effect against the disease for rs2275913G/A. In contrast, no statistically significant result was observed among the models of rs8193036C/T when adjusted with age and sex. The mRNA expression levels of the gene were statistically high in patients compared to the HCs, with a 1.8-fold change (p < 0.0001). We conclude that the results indicate IL-17A rs2275913G/A is likely to contribute to protection against the disease, while IL-17A rs8193036C/T shows no association with the disease. However, no correlation was identified in serum cytokine levels concerning genotypes. This comprehensive information in the present study might contribute to developing novel therapeutic strategies for treating inflammatory diseases like asthma. Further studies are warranted to understand the diverse functions of IL-17A concerning its longitudinal stability and its response to clinical interventions with large sample sizes in various ethnicities.
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Affiliation(s)
- Soujanya Ganta
- Department of Genetics, Osmania University, Hyderabad, India
| | - Prasanna Latha Komaravalli
- Department of Genetics, Osmania University, Hyderabad, India; Global Medical Education and Research Foundation, Lakdi-ka-pool, Hyderabad, India
| | - Shazia Ahmad
- Bhagwan Mahavir Medical Research Centre, Hyderabad, India
| | - Suman Latha Gaddam
- Department of Genetics, Osmania University, Hyderabad, India; Bhagwan Mahavir Medical Research Centre, Hyderabad, India.
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Maddocks S, Camp P, Tang C. Engaging Ethnically Diverse Populations in Self-Management Interventions for Chronic Respiratory Diseases: A Narrative Review. Pulm Ther 2023; 9:195-206. [PMID: 36773131 PMCID: PMC9922039 DOI: 10.1007/s41030-023-00218-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/30/2023] [Indexed: 02/12/2023] Open
Abstract
The burden of chronic respiratory diseases continues to rise globally. Comprehensive management relies on a combination of treatment approaches including patient self-management, where health professionals are required to educate and support patients to take control of their disease. When self-management interventions are suitably directed and effectively executed, outcomes point to increases in quality of life and a reduction in unscheduled or emergency consultations for people living with chronic respiratory disease. However, despite these positive gains, the literature reveals poor trends of engagement with this management approach and reduced access to appropriately designed programs for people from ethnically diverse populations, including migrants and refugees. The purpose of this review article is to discuss factors influencing engagement in chronic respiratory disease self-management among people from ethnically diverse backgrounds and to propose strategies to improve the participation of this population in these interventions in the future.
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Affiliation(s)
- Stacy Maddocks
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada ,Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada ,Physiotherapy University of KwaZulu-Natal, Durban, South Africa
| | - Pat Camp
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada ,Physiotherapy University of KwaZulu-Natal, Durban, South Africa
| | - Clarice Tang
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Allied Health, South Western Sydney Local Health District, Sydney, Australia.
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Pierucci P. Tele-consultation: A new promised land? Pulmonology 2023; 29:2-3. [PMID: 36182660 PMCID: PMC9805545 DOI: 10.1016/j.pulmoe.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 01/28/2023] Open
Affiliation(s)
- P Pierucci
- Cardiothoracic Department, Respiratory and Critical care Unit Bari Policlinic University Hospital, Italy; Section of Respiratory Diseases, Dept. of Basic Medical Science Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Italy.
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18
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Shi Y, Habibi P, Haq ANU, Saeed M, Gulghutay Amjad N, Khan I. Seed-Based System for Cost-Effective Production of Vaccine Against Chronic Respiratory Disease in Chickens. Mol Biotechnol 2023; 65:570-580. [PMID: 36087216 PMCID: PMC9463513 DOI: 10.1007/s12033-022-00554-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 08/22/2022] [Indexed: 11/29/2022]
Abstract
The production of vaccines in plant cells, termed plant-made pharmaceuticals or molecular farming, is a promising technology for scalable production. Compared to mammalian cell lines, like Chinese Hamster Ovary (CHO) or bacterial cells, plants can be grown with less cost on a large scale to make vaccines antigens and therapeutics affordable and accessible worldwide. An innovative application of this alternative system is the production of vaccines in edible tissues that can be consumed orally to deliver protein antigen without any further processing. In this project, we report stable expression of amino acid sequences corresponding to the TM-1 gene of Mycoplasma gallisepticum as a candidate vaccine antigen against Chronic Respiratory Disease (CRD) in chickens using wheat seed's tissues as a production host. Molecular and immunoblotting analysis confirmed the ubiquitous expression of a recombinant 41.8-kDa protein with an expression level of 1.03 mg/g dry weight in the endosperm tissues. When orally delivered, the plant-made vaccine was effective in terms of developing antibody response in animal model i.e., chicken without any detectable weight loss. Two doses of orally delivered plant-made TM-1 vaccine candidate elicited the immune response and protective effect against MG virus challenge at the level comparable to commercially available inactivated vaccine against CRD. Our study demonstrates that plant-made vaccines are not only safe but also scalable and cost-effective with prolonged stability at room temperature.
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Affiliation(s)
- Yao Shi
- Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Peyman Habibi
- Department of Pathology and Laboratory Medicine and Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Ayesha Naveed Ul Haq
- SA-Center for Interdisciplinary Research in Basic Sciences, International Islamic University, Islamabad, Pakistan
| | - Madiha Saeed
- SA-Center for Interdisciplinary Research in Basic Sciences, International Islamic University, Islamabad, Pakistan
| | - Namra Gulghutay Amjad
- Department of Community Medicine and Public Health, Khyber Girls Medical College, KPK, Peshawar, Pakistan
| | - Imran Khan
- Department of Chemical Engineering, School of Engineering, University of California, Davis, Davis, CA, USA.
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19
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Jouneau S, Chapron A, Ropars C, Marette S, Robert AM, Gouyet T, Belleguic C, Rochefort-Morel C, Guillot S, Mailloux C, Desrues B, Viel JF. Prevalence and risk factors of asthma in dairy farmers: Ancillary analysis of AIRBAg. Environ Res 2022; 214:114145. [PMID: 35998695 DOI: 10.1016/j.envres.2022.114145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/07/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Prolonged occupational agricultural exposure is associated with an increase in asthma diagnosis. This study aimed to identify the prevalence and risk factors for asthma in dairy farmers. METHODS AIRBAg was a cross-sectional study including 1203 representative dairy farmers. They completed a self-administered questionnaire and underwent a health respiratory check-up. Referral to a pulmonologist was made for any participant with wheezing, dyspnoea, chronic bronchitis, a chronic cough or a FEV1/FEV6 ratio<80%. They underwent further examinations such as spirometry with a reversibility test. Controls (non-asthmatic dairy farmers and non-farm employees) were matched to each asthma case for sex and age (±5 years). The odds ratios (OR) between asthma and different risk factors were estimated using conditional multivariate logistic regression models. RESULTS Active asthma was diagnosed in 107 (8.9%) farmers. Compared with control dairy farmers, there was a positive association with family history of allergy (OR = 8.68; 95% CI [4.26-17.69]), personal history of eczema (OR = 3.39; 95% CI [1.61-7.13]), hay manipulation (OR = 5.36, 95% CI [1.59-18.01]), and a negative association with farm area (OR = 0.92; 95% CI [0.85-0.99]) and handling treated seeds (OR = 0.47; 95% CI [0.23-0.95]). Compared with control non-farm employees, there was a positive association between asthma and family history of allergy (OR = 95.82, 95% CI [12.55-731.47]). CONCLUSIONS The prevalence of active asthma in dairy farmers was somewhat higher than the rate observed in the general population but may be controlled by reducing exposure to airborne organic contaminants through occupational adaptions on farms.
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Affiliation(s)
- Stéphane Jouneau
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Anthony Chapron
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France; Univ Rennes, CHU Rennes, Department of General Practice, F-35000, Rennes, France; INSERM, CIC-1414, Primary Care Research Team, F-35000, Rennes, France.
| | - Cécile Ropars
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France
| | - Solenne Marette
- Univ Rennes, CHU Rennes, Department of Occupational Pathology, University Hospital, F-35033, Rennes, France
| | - Ange-Marie Robert
- Univ Rennes, CHU Rennes, Department of Clinical Research, F-35033, Rennes, France
| | - Thomas Gouyet
- Univ Rennes, CHU Rennes, Department of Occupational Pathology, University Hospital, F-35033, Rennes, France
| | - Chantal Belleguic
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France
| | | | - Stéphanie Guillot
- Univ Rennes, CHU Rennes, Department of Pulmonary Function Tests, F-35033, Rennes, France
| | - Carole Mailloux
- Mutualité Sociale Agricole des Portes de Bretagne, F-35170, Bruz, France
| | - Benoît Desrues
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France; INSERM, U1242-COSS, CLCC Eugène Marquis, Rennes 1 University, F-35000, Rennes, France
| | - Jean-François Viel
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France; Univ Rennes, CHU Rennes, Department of Epidemiology and Public Health, F-35033, Rennes, France
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20
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İlhan B, Bozdereli Berikol G, Doğan H. The predictive value of modified risk scores in patients with acute exacerbation of COPD: a retrospective cohort study. Intern Emerg Med 2022; 17:2119-2127. [PMID: 35854207 PMCID: PMC9296366 DOI: 10.1007/s11739-022-03048-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/30/2022] [Indexed: 11/26/2022]
Abstract
This study aims to evaluate the performance of CREWS (Chronic Respiratory Early Warning Score), S-NEWS (Salford-National Early Warning Score), qNEWS (Quick National Early Warning Score), NEWS (National Early Warning Score), and qSOFA (Quick Sequential Organ Failure Assessment) scores in predicting mortality, intensive care unit (ICU) admission and the need for mechanical ventilation (MV) of patients presented with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This retrospective cohort study was conducted in the emergency department of a tertiary hospital between January 1 and December 31, 2019. The patients with AECOPD and aged ≥ 18 were included. Patients who were transferred from another center and whose data could not be reached were excluded. Demographic information, comorbid diseases, variables of the scores, laboratory results, and outcomes were recorded. A total of 575 consecutive patients were included. The 30-day mortality, ICU admission, and MV need rate were 5.7% (n = 33), 9.6% (n = 55), and 13.7% (n = 79), respectively. Each score had moderate-to-excellent performance in predicting MV need and ICU admission, while their performance in predicting mortality was poor. CREWS is the most successful score in predicting 30-day mortality (AUC 0.695), ICU admission (AUC 0.841), and MV need (AUC 0.924). ICU admission, age, and creatinine levels were associated with mortality (p < 0.05). All scores have better performance in predicting ICU admission and MV need than mortality. ICU admission, age, and creatinine levels may be the predictors of mortality among AECOPD patients.
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Affiliation(s)
- Buğra İlhan
- Department of Emergency Medicine, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
| | - Göksu Bozdereli Berikol
- Department of Emergency Medicine, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Halil Doğan
- Department of Emergency Medicine, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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21
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Fallahzadeh A, Sharifnejad Tehrani Y, Sheikhy A, Ghamari SH, Mohammadi E, Saeedi Moghaddam S, Esfahani Z, Nasserinejad M, Shobeiri P, Rashidi MM, Rezaei N, Heidari-Foroozan M, Rezaei N, Larijani B, Farzadfar F. The burden of chronic respiratory disease and attributable risk factors in North Africa and Middle East: findings from global burden of disease study (GBD) 2019. Respir Res 2022; 23:268. [PMID: 36175873 PMCID: PMC9521864 DOI: 10.1186/s12931-022-02187-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND North Africa and Middle East (NAME) has an increasing burden of chronic respiratory diseases (CRDs); however, a systematic understanding of the distribution and trends is not available. We aimed to report the trends of CRDs and attributable risk factors in this region between 1990 and 2019. METHODS Using data from the Global Burden of Diseases Study (GBD) 2019, cause specific mortality served as the basis for estimating incidence and disability-adjusted life years (DALYs). The burden attributable to risk factors was calculated by a comparative risk assessment and contribution of population ageing and growth was determined by decomposition analysis. RESULTS The number of deaths due to CRD in 2019 were 128,513 (110,781 to 114,351). In 2019, the age-standardized incidence rate (ASIR) of CRDs was 1052.8 (924.3 to 1209.4) per 100,000 population and had a 10.3% increase and the age-standardized death rate (ASDR) was 36.1 (30.9 to 40.3) with a 32.9% decrease compared to 1990. In 2019, United Arab Emirates had the highest ASIR (1412.7 [1237.3 to 1622.2]) and Afghanistan had the highest ASDR (67.8 [52.0 to 81.3]). CRDs were responsible for 2.91% of total DALYs in 2019 (1.69% due to chronic obstructive pulmonary disease [COPD] and 1.02% due to asthma). With regard to the components of DALYs, the age-standardized rate of years of life lost (YLL) had a - 39.0% (- 47.1 to - 30.3) decrease; while the age-standardized rate of years lived with disability (YLD) had a 13.4% (9.5 to 17.7) increase. Of total ASDRs of CRDs, 31.6% were attributable to smoking and 14.4% to ambient particulate matter pollution. CONCLUSION CRDs remain a leading cause of death and disability in NAME, with growth in absolute numbers. COPD and asthma were the most common CRDs and smoking was the leading risk factor especially in men. More attention is needed in order to reduce CRDs' burden through appropriate interventions and policies.
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Affiliation(s)
- Aida Fallahzadeh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yeganeh Sharifnejad Tehrani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheikhy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Heidari-Foroozan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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22
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Kawaji T, Hasegawa T, Uchiyama Y. Dyspnea and outcome expectations are associated with physical activity in persons with pneumoconiosis: a cross-sectional study. BMC Pulm Med 2022; 22:335. [PMID: 36056341 PMCID: PMC9440502 DOI: 10.1186/s12890-022-02128-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background There are various reports on factors associated with physical activity in patients with chronic respiratory diseases. However, there are no studies on the relationship between physical activity and psychological or environmental factors. In this study, we investigated the relationship between physical activity and psychological and environmental factors using questionnaires for patients with pneumoconiosis. Methods This cross-sectional study included patients with pneumoconiosis who underwent a pneumoconiosis health examination in 2019. A self-administered questionnaire was used to conduct the study. Physical activity was evaluated using the International Physical Activity Questionnaire, and subjective symptoms [dyspnea and quality of life (QOL)], environmental factors (environment around home and life space), psychological factors (depression, stage of change, self-efficacy, decisional balance, and outcome expectations), and others (e.g., experience with pulmonary rehabilitation) were investigated. Results The number of respondents in the study was 185 (men: 171, women: 14). Age, dyspnea, stage of change, self-efficacy, outcome expectations, QOL, depression, decisional balance, and life space were significantly correlated with physical activity. In the multivariate analysis, outcome expectations and dyspnea were extracted as independent factors. In the path analysis, outcome expectations and dyspnea had a direct influence on physical activity. Dyspnea directly impacted not only physical activity but also outcome expectations, stage of change, QOL, life space, and depression. Conclusions Dyspnea and outcome expectations were associated with physical activity in patients with pneumoconiosis. To improve physical activity in pneumoconiosis patients, it was suggested that it may be necessary to improve dyspnea and promote an understanding of physical activity.
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Affiliation(s)
- Tomohiro Kawaji
- Department of Rehabilitation, Asahi Rosai Hospital, 61 Hirakocho Kita, Owariasshi, Aichi, Japan.,Division of Creative Physical Therapy, Field of Prevention and Rehabilitation Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, Aichi, Japan
| | - Takashi Hasegawa
- Division of Creative Physical Therapy, Field of Prevention and Rehabilitation Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, Aichi, Japan
| | - Yasushi Uchiyama
- Division of Creative Physical Therapy, Field of Prevention and Rehabilitation Sciences, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, Aichi, Japan.
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23
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Chen Z, Zhu J, Zhou H, Jia Y, Ruan H, Diao Q, Li M, Zheng L, Yao S, Guo Y, Zhou Y, Jiang Y. The involvement of copper, circular RNAs, and inflammatory cytokines in chronic respiratory disease. Chemosphere 2022; 303:135005. [PMID: 35605724 DOI: 10.1016/j.chemosphere.2022.135005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/23/2022] [Accepted: 05/15/2022] [Indexed: 06/15/2023]
Abstract
Exposure to high concentrations of copper is associated with pulmonary inflammation and chronic respiratory disease (CRD). Epigenetic modulation of noncoding RNAs contributes to the development of several CRDs. It is unknown whether epigenetic modulation is involved in copper mediated pulmonary inflammation and CRD. We conducted a case-control study of 101 CRD cases and 161 control subjects in Shijiazhuang, China, and evaluated circRNAs and cytokine levels (IL-6 and IL-8) by qPCR and ELISA. Urinary copper concentration was determined by inductively coupled plasma mass spectrometry. Linear mixed models and generalized linear mixed models were used to assess the associations of circRNAs with CRD, urinary copper, and cytokines. We exposed the human bronchial epithelial cell line, 16HBE, to copper and assessed the functional role of a circRNA, circ_0008882, by RNA overexpression. Cellular location of circ_0008882 was assessed by separation of nuclear and cytoplasmic RNAs. Nine circRNAs were associated with an increased risk for CRDs, while the relative expression of circ_0008882 was decreased after copper exposure in vitro and in vivo. Copper exposure stimulated 16HBE cells to release proinflammatory IL-6 and IL-8. The release of the cytokines was inhibited by overexpression of circ_0008882. These results suggest a role for circ_0008882 in the regulation of CRD associated inflammation following copper exposure.
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Affiliation(s)
- Zehao Chen
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China; Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jialu Zhu
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China; Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Hanyu Zhou
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yangyang Jia
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Honglian Ruan
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Qinqin Diao
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Meizhen Li
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Liting Zheng
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Shuwei Yao
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yaozheng Guo
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yun Zhou
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China; Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China.
| | - Yiguo Jiang
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China; Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, 511436, China.
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24
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Molinier V, Alexandre F, Heraud N. Effectiveness comparison of inpatient vs. outpatient pulmonary rehabilitation: a systematic review. BMC Health Serv Res 2022; 22:1028. [PMID: 35962341 PMCID: PMC9373520 DOI: 10.1186/s12913-022-08345-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background Pulmonary rehabilitation (PR) is the cornerstone of nonpharmacological treatments in chronic respiratory disease (CRD) management. PR can be performed in different settings, the most frequent of which are inpatient (inPR) and outpatient (outPR) management. In the literature, these two distinct modalities are generally considered to be the same intervention. Yet, they differ in terms of the length of stay, social support, and the time the patient is not in their normal environment, and the presumed absence of differences in terms of efficacy has never been established. Purpose To identify studies that directly compared the effects of inPR and outPR on patients with all types of CRDs through a systematic review and to synthesize the evidence regarding the effectiveness comparison of both modalities. Methods A literature search was performed on PubMed, Web of Science, and Cochrane Library on 24 March 2022. The inclusion criteria were: articles with adults with chronic respiratory disease and comparing inPR versus outPR in at least one PR outcome. Results Seven hundred thirty-six articles were retrieved from the databases. Six retrospective articles met the inclusion criteria. A best-evidence synthesis (BES) was carried out. Eight outcomes could be found in the included papers. For healthcare burden and refusals, no data could be extracted, and thus no BES was performed. For the eight remaining outcomes, two results were in favor of inPR with moderate evidence (HRQoL and psychological status), three were in favor of no difference between inPR and outPR with moderate or limited evidence (muscle strength, dropouts/adherence, and survival status), and three led to conflicting results (exercise tolerance, dyspnea, and economic costs). Conclusion With the current state of knowledge, the majority of the studies converge towards an absence of differences between inPR and outPR or in favor of inPR for seven out of eight outcomes, albeit with moderate, limited, or conflicting evidence. The greater effectiveness of inPR for some outcomes will have to be confirmed in a well-designed RCT in order to orient public health policies in terms of the development of PR with the best evidence-based medicine approach. Trial registration PROSPERO: CRD42020166546. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08345-z.
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Affiliation(s)
- Virginie Molinier
- Les Cliniques du Souffle - Groupe KORIAN, 800 Avenue Joseph Vallot, 34700, LODEVE, France. .,Direction de la recherche et de l'innovation en santé - Groupe KORIAN, 800 Avenue Joseph Vallot, 34700, LODEVE, France.
| | - François Alexandre
- Les Cliniques du Souffle - Groupe KORIAN, 800 Avenue Joseph Vallot, 34700, LODEVE, France.,Direction de la recherche et de l'innovation en santé - Groupe KORIAN, 800 Avenue Joseph Vallot, 34700, LODEVE, France
| | - Nelly Heraud
- Les Cliniques du Souffle - Groupe KORIAN, 800 Avenue Joseph Vallot, 34700, LODEVE, France.,Direction de la recherche et de l'innovation en santé - Groupe KORIAN, 800 Avenue Joseph Vallot, 34700, LODEVE, France
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25
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Ditha BA, Sutikno B. Extraction of sphenochoanal polyp with functional endoscopic sinus surgery approach: A rare case and review article. Int J Surg Case Rep 2022; 97:107429. [PMID: 35905676 DOI: 10.1016/j.ijscr.2022.107429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/12/2022] [Accepted: 07/17/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sphenochoanal polyp, a rare case of nasal polyp, is a benign mass that originates in the sphenoid sinus and develops into a choanal polyp. CASE PRESENTATION A 36-year-old Indonesian male complained of irregular right nasal obstruction and runny nose for one year. Physical examination showed soft tissue mass in the right nasal cavity, cyst retention in the right maxillary sinus, right sphenoid sinus, and cervical spondylosis. Diagnosis of sphenochoanal polyp was supported by nasoendoscopy and CT-Scan of paranasal sinuses. The patient got medical care and underwent functional endoscopic sinus surgery (FESS) and rinsed the nose with normal saline and topical steroids. Evaluation at six months after the surgery, the patient came without complaint and showed no sign of polyp mass or cysts recurrence, so the patient was declared to have a full recovery. DISCUSSION FESS is proven effective for managing sphenochoanal polyp and minimizes complications post-surgery and repetition of the polyp. CONCLUSION FESS is recommended for management of sphenochoanal polyp in term of minimizing recurrency.
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26
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Hua Y, Yuan X, Wang J, Zeng K, Zhi S, Liu L. Association between air pollution and hospital admissions for chronic respiratory disease in people aged over 65 years: a time series analysis in Ningbo, China, 2015-2017. Int Arch Occup Environ Health 2022; 95:1293-1304. [PMID: 35661917 DOI: 10.1007/s00420-022-01887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To provide essential information of environmental triggers leading to CRD. METHODS We investigated the short-term effects of ambient air pollutants on CRD-related hospitalizations in people aged ≥ 65 years in Ningbo. Data on 23,610 cases of CRD requiring hospitalization were collected from January 2015 to August 2017. After adjusting for temporal trends, seasonality, meteorological conditions, day of week (DOW), and public holidays, we used generalized additive Poisson distribution models to calculate the excess risks (ERs) and 95% confidence intervals (95% CIs) of CRD related hospitalizations. RESULTS Our results showed that fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were associated with CRD-related hospitalizations in people aged ≥ 65 years. We observed that each 10 μg/m3 increase (except for each 0.1 mg/m3 increase in CO) in the concentration of air pollutants, the percentage of CRD-related hospitalizations due to PM2.5, PM10, and SO2 exposure at lag 07, NO2 exposure at lag 03, and CO exposure at lag 0 increased by 2.13% (95% CI: 0.55%, 3.74%), 1.76% (95% CI: 0.70%, 2.83%), 8.24% (95% CI: 0.92%, 16.09%), 2.16% (95% CI: 0.26%, 4.05%), and 1.19% (95% CI: 0.26%, 2.12%), respectively. In addition, we found stronger effects of particulate matter in 75-84 years age group, on warmer days, and in asthmatics. CONCLUSION In conclusion, air pollution may have adverse effects on CRD-related hospitalizations among people aged ≥ 65 years in Ningbo. Therefore, public health measures should be taken to improve air quality.
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Affiliation(s)
- Yuzhe Hua
- School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoqi Yuan
- Ningbo Women and Children Hospital, Ningbo, China
| | - Jichao Wang
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Ke Zeng
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Shuai Zhi
- School of Medicine, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Medicine, Ningbo University, Ningbo, China.
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27
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Gan H, Hou X, Zhu Z, Xue M, Zhang T, Huang Z, Cheng ZJ, Sun B. Smoking: a leading factor for the death of chronic respiratory diseases derived from Global Burden of Disease Study 2019. BMC Pulm Med 2022; 22:149. [PMID: 35443660 PMCID: PMC9019969 DOI: 10.1186/s12890-022-01944-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/08/2022] [Indexed: 01/04/2023] Open
Abstract
Background Smoking is believed as one of the major risk factors resulting in a variety of non-communicable diseases, such as lung cancer and chronic respiratory diseases (CRDs). However, the global burden of CRDs attributed to smoking has not been systematically studied, particularly across different temporal and spatial scales. Methods We conducted a systematic analysis of the Global Burden of CRDs and related risk factors using data from the Global Burden of Disease Study 2019. Incidence, death, risk factors, and other parameters such as estimated annual percentage change have been analyzed. We also compared various risk factors across regions, countries, and genders. Results Globally, the incidence of CRDs and deaths cases have increased in the last 30 years, while the corresponding age-standardized incidence rate (ASIR) and death rate (ASDR) have declined. Smoking was the leading risk factor for the death of CRDs all over the world. However, in low and low-middle Socio-demographic Index (SDI) areas, particulate matter pollution was the main risk factor leading to death from CRDs, while smoking was ranked first among the major risk factors in areas with middle, middle-high, or high SDI. Globally, gender differences in morbidity and mortality from CRDs were observed. Males had slightly more cases and ASIR of chronic respiratory diseases than females over the last 30 years. However, the mortality cases and ASDR in males were significantly higher than that of females. Furthermore, the ASDR of all major risk factors, specially smoking, was higher in men than in women. Conclusions CRDs were still major threats human health. The current study highlights the dominating roles of smoking for death risks resulting from CRDs, followed by PM pollution. Therefore, tobacco control and improving air quality are key to reducing deaths from CRDs. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01944-w.
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Affiliation(s)
- Hui Gan
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Xiangqing Hou
- Faculty of Health Sciences, University of Macau, Macau, 999078, China
| | - Zheng Zhu
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Mingshan Xue
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.,Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, 510060, China
| | - Teng Zhang
- Faculty of Health Sciences, University of Macau, Macau, 999078, China
| | - Zhifeng Huang
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Zhangkai Jason Cheng
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.
| | - Baoqing Sun
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.
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28
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Purghè B, Manfredi M, Ragnoli B, Baldanzi G, Malerba M. Exosomes in chronic respiratory diseases. Biomed Pharmacother 2021; 144:112270. [PMID: 34678722 DOI: 10.1016/j.biopha.2021.112270] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/12/2021] [Accepted: 09/27/2021] [Indexed: 12/12/2022] Open
Abstract
Exosomes are nano-sized vesicles released by almost all cell types, with a central role as mediators of intercellular communication. In addition to physiological conditions, these extracellular vesicles seem to play a pivotal role in inflammatory processes. This assumption offers the opportunity to study exosomes as promising biomarkers and therapeutic tools for chronic respiratory disorders. Indeed, although it is well-known that at the basis of conditions like asthma, chronic obstructive pulmonary disease, alpha-1 antitrypsin deficiency and idiopathic pulmonary fibrosis there is a dysregulated inflammatory process, an unequivocal correlation between different phenotypes and their pathophysiological mechanisms has not been established yet. In this review, we report and discuss some of the most significant studies on exosomes from body fluids of subjects affected by airway diseases. Furthermore, the most widespread techniques for exosome isolation and characterization are described. Further studies are needed to answer the unresolved questions about the functional link between exosomes and chronic respiratory diseases.
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Affiliation(s)
- Beatrice Purghè
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), University of Piemonte Orientale, 28100 Novara, Italy
| | - Marcello Manfredi
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), University of Piemonte Orientale, 28100 Novara, Italy.
| | | | - Gianluca Baldanzi
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), University of Piemonte Orientale, 28100 Novara, Italy
| | - Mario Malerba
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
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Laffey KG, Nelson AD, Laffey MJ, Nguyen Q, Sheets LR, Schrum AG. Chronic respiratory disease disparity between American Indian/Alaska Native and white populations, 2011-2018. BMC Public Health 2021; 21:1466. [PMID: 34320979 PMCID: PMC8317382 DOI: 10.1186/s12889-021-11528-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/21/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND American Indian/Alaska Native (AI/AN) populations have been disproportionately affected by chronic respiratory diseases for reasons incompletely understood. Past research into disease disparity using population-based surveys mostly focused on state-specific factors. The present study investigates the independent contributions of AI/AN racial status and other socioeconomic/demographic variables to chronic respiratory disease disparity in an 11-state region with historically high AI/AN representation. Using data from the Behavioral Risk Factor Surveillance System (BRFSS) spanning years 2011-2018, this work provides an updated assessment of disease disparity and potential determinants of respiratory health in AI/AN populations. METHODS This cross-sectional study used data from the BRFSS survey, 2011-2018. The study population included AI/AN and non-Hispanic white individuals resident in 11 states with increased proportion of AI/AN individuals. The yearly number of respondents averaged 75,029 (62878-87,350) which included approximately 5% AI/AN respondents (4.5-6.3%). We compared the yearly adjusted prevalence for chronic respiratory disease, where disease status was defined by self-reported history of having asthma and/or chronic obstructive pulmonary disease (COPD). Multivariable logistic regression was performed to determine if being AI/AN was independently associated with chronic respiratory disease. Covariates included demographic (age, sex), socioeconomic (marital status, education level, annual household income), and behavioral (smoking, weight morbidity) variables. RESULTS The AI/AN population consistently displayed higher adjusted prevalence of chronic respiratory disease compared to the non-Hispanic white population. However, the AI/AN race/ethnicity characteristic was not independently associated with chronic respiratory disease (OR, 0.93; 95% CI, 0.79-1.10 in 2017). In contrast, indicators of low socioeconomic status such as annual household income of <$10,000 (OR, 2.02; 95% CI, 1.64-2.49 in 2017) and having less than high school education (OR, 1.37; 95% CI, 1.16-1.63 in 2017) were positively associated with disease. These trends persisted for all years analyzed. CONCLUSIONS This study highlighted that AI/AN socioeconomic burdens are key determinants of chronic respiratory disease, in addition to well-established risk factors such as smoking and weight morbidity. Disease disparity experienced by the AI/AN population is therefore likely a symptom of disproportionate socioeconomic challenges they face. Further promotion of public health and social service efforts may be able to improve AI/AN health and decrease this disease disparity.
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Affiliation(s)
- Kimberly G Laffey
- Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO, USA.
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO, USA.
| | - Alfreda D Nelson
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Matthew J Laffey
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO, USA
| | - Quynh Nguyen
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO, USA
- Department of Pathology and Anatomical Sciences, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Lincoln R Sheets
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Adam G Schrum
- Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO, USA
- Department of Surgery, School of Medicine, University of Missouri, Columbia, MO, USA
- Department of Biomedical, Biological, and Chemical Engineering, College of Engineering, University of Missouri, Columbia, MO, USA
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Perumal SD. Renewed vision on pulmonary rehabilitation service delivery for chronic obstructive pulmonary disease management beyond COVID-19. Chronic Dis Transl Med 2021; 7:107-116. [PMID: 34136770 PMCID: PMC8180444 DOI: 10.1016/j.cdtm.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Indexed: 12/22/2022] Open
Abstract
Pulmonary rehabilitation (PR) is a cornerstone management for chronic obstructive pulmonary disease (COPD). International respiratory societies defined PR is more than "just an exercise program"; it is a comprehensive care delivered by a team of dedicated healthcare professionals with a strong emphasis on long-term health-enhancing Behaviors. However, "Uncertainty" exists with varied reasons for the political and geographical barriers of referral, uptake, attendance, and completion of PR in both primary and secondary care. Besides, COVID-19 pandemic has sparked many global controversies and challenges on pulmonary rehabilitation service delivery. Post-COVID-19 guidelines emphasize on integrated care rehabilitation for patients with COPD. Thus, this concise review intends to understand the gaps in United Kingdom healthcare policies, practices, and PR services resources. To date, there is no clear consensus on PR integrated care model pathway to address the unmet needs, measure the health and social care disparities; adds to the disease burden of COPD. Based on the culmination of evidence, this perspective offers a theoretical framework of PR integrated service model, a pathway to deliver high-value personalized care to patients with COPD.
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Masuda T, Nakatani E, Shirai T, Akamatsu T, Tamura K, Takahashi S, Tanaka Y, Watanabe H, Endo Y, Suzuki T, Saigusa M, Yamamoto A, Morita S, Sato Y, Asada K. Effectiveness of a 23-valent pneumococcal polysaccharide vaccine for the prevention of pneumococcal pneumonia in the elderly with chronic respiratory diseases: a case-control study of a single center. BMC Pulm Med 2021; 21:123. [PMID: 33863300 PMCID: PMC8051051 DOI: 10.1186/s12890-021-01491-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/08/2021] [Indexed: 11/21/2022] Open
Abstract
Background The effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in preventing pneumococcal pneumonia has been controversial. Methods To evaluate the effectiveness of the PPSV23 in elderly outpatients with chronic respiratory diseases, we carried out a case–control study, including 4128 outpatients aged ≥ 65 years, in the respiratory department. Results There were 320 vaccinated patients, of which 164 were diagnosed with pneumococcal pneumonia. The adjusted odds ratio was 0.39 (95% confidence interval (CI), 0.17 to 0.89). In the subsets consisting of age groups ≥ 70 and ≥ 75 years, the adjusted odds ratio (95% CI) was respectively 0.16 (0.04 to 0.67) and 0.15 (0.02 to 1.12). Conclusion This real-world study suggests that PPSV23 can be useful in preventing pneumococcal pneumonia in the elderly with chronic respiratory diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01491-w.
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Affiliation(s)
- Toshihiro Masuda
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Eiji Nakatani
- Division of Clinical Biostatistics, Research Support Center, Shizuoka General Hospital, 4-27-1, Kita-ando, Aoi, Shizuoka, 420-8527, Japan. .,Graduate School of Public Health, Shizuoka Graduate University of Public Health, 4-27-2 Kitaando, Aoi-ku, Shizuoka, 420-0881, Japan.
| | - Toshihiro Shirai
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Taisuke Akamatsu
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Kanami Tamura
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Shingo Takahashi
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Yuko Tanaka
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Hirofumi Watanabe
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Yoshinari Endo
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Takahito Suzuki
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Mika Saigusa
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Akito Yamamoto
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Satoru Morita
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
| | - Yoko Sato
- Division of Clinical Biostatistics, Research Support Center, Shizuoka General Hospital, 4-27-1, Kita-ando, Aoi, Shizuoka, 420-8527, Japan
| | - Kazuhiro Asada
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1, Shizuoka, Japan
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de Cosio FG, Diaz-Apodaca B, Baker A, Cifuentes MP, Ojeda-Casares H, Constandce D, Becerra F. US Obesity Mortality Trends and Associated Noncommunicable Diseases Contributing Conditions Among White, Black, and Hispanic Individuals by Age from 1999 to 2017. ACTA ACUST UNITED AC 2021;:1-10. [PMID: 33842841 DOI: 10.1007/s42399-021-00850-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 12/11/2022]
Abstract
This study aims to assess the effect of obesity as an underlying cause of death in association with four main noncommunicable diseases (NCDs) as contributing causes of mortality on the age of death in White, Black, and Hispanic individuals in the USA. To estimate mortality hazard ratios, we ran a Cox regression on the US National Center for Health Statistics mortality integrated datasets from 1999 to 2017, which included almost 48 million cases. The variable in the model was the age of death in years as a proxy for time to death. The cause-of-death variable allowed for the derivation of predictor variables of obesity and the four main NCDs. The overall highest obesity mortality HR when associated with NCD contributing conditions for the year 1999-2017 was diabetes (2.15; 95% CI: 2.11-2.18), while Whites had the highest HR (2.46; 95% CI: 2.41-2.51) when compared with Black (1.32; 95% CI: 1.27-1.38) and Hispanics (1.25; 95% CI: 1.18-1.33). Hispanics had lower mortality HR for CVD (1.21; 95% CI: 1.15-1.27) and diabetes (1.25; 95% CI: 1.18-1.33) of the three studied groups. The obesity death mean was 57.3 years for all groups. People who die from obesity are, on average, 15.4 years younger than those without obesity. Although Hispanics in the USA have a higher prevalence of diabetes and cardiovascular disease (CVD), they also have the lowest mortality HR for obesity as an underlying cause of death when associated with CVD and cancer. While there is no obvious solution for obesity and its complications, continued efforts to address obesity are needed.
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Ekezie W, Jenkins AR, Hall IP, Evans C, Koju R, Kurmi OP, Bolton CE. The burden of chronic respiratory diseases in adults in Nepal: A systematic review. Chron Respir Dis 2021; 18:1479973121994572. [PMID: 34227410 PMCID: PMC8264743 DOI: 10.1177/1479973121994572] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/07/2021] [Accepted: 01/23/2021] [Indexed: 12/11/2022] Open
Abstract
While chronic lung disease causes substantial global morbidity and mortality, global estimates have primarily been based on broad assumptions. Specific country data from low-income countries such as Nepal are limited. This review assessed primary evidence on chronic respiratory disease burden among adults in Nepal. A systematic search was performed in June 2019 (updated May 2020) for studies through nine databases. High levels of heterogeneity deemed a narrative synthesis appropriate. Among 27 eligible studies identified, most were low-moderate quality with cross-sectional and retrospective study design. Chronic lung diseases identified were chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and restrictive lung diseases. Studies were categorised as: (i) community-based, (ii) hospital-based and (iii) comorbidity-related and disease burden. Reported disease prevalence varied widely (COPD, 1.67-14.3%; asthma, 4.2-8.9%). The prevalence of airflow obstruction was higher among rural dwellers (15.8%) and those exposed to household air pollution from domestic biomass burning as opposed to liquid petroleum gas users (Odds Ratio: 2.06). Several comorbidities, including hypertension and diabetes mellitus added to the disease burden. The review shows limited literature on lung disease burden in Nepal. Publications varied in terms of overall quality. Good quality research studies with prospective cohorts related to respiratory conditions are required.
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Affiliation(s)
- Winifred Ekezie
- NIHR Nottingham BRC Respiratory Theme, School of Medicine, University of Nottingham, Nottingham, UK
- Division of Epidemiology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Alex Robert Jenkins
- NIHR Nottingham BRC Respiratory Theme, School of Medicine, University of Nottingham, Nottingham, UK
| | - Ian Philip Hall
- NIHR Nottingham BRC Respiratory Theme, School of Medicine, University of Nottingham, Nottingham, UK
| | - Catrin Evans
- Nottingham Centre for Evidence Based Healthcare, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Rajendra Koju
- Department of Medicine, Dhulikhel Hospital, Dhulikhel, Nepal
| | - Om Prakash Kurmi
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Charlotte Emma Bolton
- NIHR Nottingham BRC Respiratory Theme, School of Medicine, University of Nottingham, Nottingham, UK
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Banes GL, Fountain ED, Karklus A, Huang HM, Jang-Liaw NH, Burgess DL, Wendt J, Moehlenkamp C, Mayhew GF. Genomic targets for high-resolution inference of kinship, ancestry and disease susceptibility in orang-utans (genus: Pongo). BMC Genomics 2020; 21:873. [PMID: 33287706 PMCID: PMC7720378 DOI: 10.1186/s12864-020-07278-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Orang-utans comprise three critically endangered species endemic to the islands of Borneo and Sumatra. Though whole-genome sequencing has recently accelerated our understanding of their evolutionary history, the costs of implementing routine genome screening and diagnostics remain prohibitive. Capitalizing on a tri-fold locus discovery approach, combining data from published whole-genome sequences, novel whole-exome sequencing, and microarray-derived genotype data, we aimed to develop a highly informative gene-focused panel of targets that can be used to address a broad range of research questions. RESULTS We identified and present genomic co-ordinates for 175,186 SNPs and 2315 Y-chromosomal targets, plus 185 genes either known or presumed to be pathogenic in cardiovascular (N = 109) or respiratory (N = 43) diseases in humans - the primary and secondary causes of captive orang-utan mortality - or a majority of other human diseases (N = 33). As proof of concept, we designed and synthesized 'SeqCap' hybrid capture probes for these targets, demonstrating cost-effective target enrichment and reduced-representation sequencing. CONCLUSIONS Our targets are of broad utility in studies of orang-utan ancestry, admixture and disease susceptibility and aetiology, and thus are of value in addressing questions key to the survival of these species. To facilitate comparative analyses, these targets could now be standardized for future orang-utan population genomic studies. The targets are broadly compatible with commercial target enrichment platforms and can be utilized as published here to synthesize applicable probes.
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Affiliation(s)
- Graham L Banes
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, 1220 Capitol Court, Madison, WI, 53715, USA.
| | - Emily D Fountain
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, 1220 Capitol Court, Madison, WI, 53715, USA
| | - Alyssa Karklus
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI, 53706, USA
| | - Hao-Ming Huang
- Conservation Genetics Laboratory, Conservation and Research Center, Taipei Zoo, No. 30, Section 2, Xinguang Road, Wenshan District, Taipei City, Taiwan, 11656
| | - Nian-Hong Jang-Liaw
- Conservation Genetics Laboratory, Conservation and Research Center, Taipei Zoo, No. 30, Section 2, Xinguang Road, Wenshan District, Taipei City, Taiwan, 11656
| | - Daniel L Burgess
- Roche Sequencing Solutions, 500 S Rosa Road, Madison, WI, 53719, USA.,Polymer Forge, Inc., 504 S Rosa Rd Ste 200, Madison, WI, 53719, USA
| | - Jennifer Wendt
- Roche Sequencing Solutions, 500 S Rosa Road, Madison, WI, 53719, USA.,Promega Corporation, 2800 Woods Hollow Rd, Fitchburg, WI, 53711, USA
| | - Cynthia Moehlenkamp
- Roche Sequencing Solutions, 500 S Rosa Road, Madison, WI, 53719, USA.,Exact Sciences, 441 Charmany Dr, Madison, WI, 53719, USA
| | - George F Mayhew
- Roche Sequencing Solutions, 500 S Rosa Road, Madison, WI, 53719, USA
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Tabernero Huguet E, Ortiz de Urbina Antia B, González Quero B, Garay Llorente E, Andia Iturrate J, Pérez Fernández S, Gómez Larrauri A, Iriberri Pascual M. Prevalence and Mortality of Patients with Palliative Needs in an Acute Respiratory Setting. Arch Bronconeumol 2020; 57:345-350. [PMID: 33069460 DOI: 10.1016/j.arbres.2020.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION NECPAL is a tool for identification of patients with advanced chronic disease in need of palliative care. The main objective of the study is to know the prevalence of patients with palliative needs in an acute respiratory ward in a Spanish tertiary hospital using NECPAL. A second objective of the study is to know the annual mortality rate of these patients. MATERIALS AND METHODS Cross sectional study and prospective monitoring of a cohort identified as palliative patients with the NECPAL tool for 12 months. Patient identification was performed in patients admitted to the respiratory ward of our hospital for longer than 3 days. We have assessed the annual vital status (deceased or not deceased) of patients and have recorded demographics, clinical and functional data, as well as the use of healthcare resources. RESULTS We monitored a cohort of 363 patients. Of them, 87 patients (24.3%) (IC 95% 19-30) were identified as NECPAL positive. 60% of patients (n = 64) died within 12 months of their admission. There was no significant difference in the mortality ratio of oncologic versus non oncologic patients. In a multivariable analysis, mortality was associated with demand by patients or relatives for palliative care and with the presence of specific disease progression markers or indicators. CONCLUSIONS prevalence of patients with palliative needs in acute respiratory wards is high (one out of four patients). 60% of the patients identified as NECPAL positive in our cohort died in the first 12 months. Training of healthcare professionals as well as availability of appropriate resources are indispensable factors to improve care of this population.
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Abstract
The review covers select disease conditions most frequently described in aging rodents (rats, mice, hamsters, guinea pigs), rabbits, and ferrets. The conditions are categorized by general organ systems, infectious diseases, and neoplasms. Two data systems, the Veterinary Medical Teaching Hospital and Comparative Pathology Laboratory at the University of California, Davis and Zoo/Exotic Pathology Service, Citrus Heights, California were used in the determining disease conditions to describe.
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Affiliation(s)
- Drury R Reavill
- ZNLabs Veterinary Diagnostics, 7647 Wachtel Way, Citrus Heights, CA 95610, USA.
| | - Denise M Imai
- Comparative Pathology Laboratory, University of California, 1000 Old Davis Road, Building R1, Davis, CA 95616, USA
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Nikolaou V, Massaro S, Fakhimi M, Stergioulas L, Price D. COPD phenotypes and machine learning cluster analysis: A systematic review and future research agenda. Respir Med 2020; 171:106093. [PMID: 32745966 DOI: 10.1016/j.rmed.2020.106093] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 12/21/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a highly heterogeneous condition projected to become the third leading cause of death worldwide by 2030. To better characterize this condition, clinicians have classified patients sharing certain symptomatic characteristics, such as symptom intensity and history of exacerbations, into distinct phenotypes. In recent years, the growing use of machine learning algorithms, and cluster analysis in particular, has promised to advance this classification through the integration of additional patient characteristics, including comorbidities, biomarkers, and genomic information. This combination would allow researchers to more reliably identify new COPD phenotypes, as well as better characterize existing ones, with the aim of improving diagnosis and developing novel treatments. Here, we systematically review the last decade of research progress, which uses cluster analysis to identify COPD phenotypes. Collectively, we provide a systematized account of the extant evidence, describe the strengths and weaknesses of the main methods used, identify gaps in the literature, and suggest recommendations for future research.
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Affiliation(s)
- Vasilis Nikolaou
- Surrey Business School, University of Surrey, Guildford, GU2 7HX, UK.
| | - Sebastiano Massaro
- Surrey Business School, University of Surrey, Guildford, GU2 7HX, UK; The Organizational Neuroscience Laboratory, London, WC1N 3AX, UK
| | - Masoud Fakhimi
- Surrey Business School, University of Surrey, Guildford, GU2 7HX, UK
| | | | - David Price
- Observational and Pragmatic Research Institute, Singapore, Singapore; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Ghimire U, Shrestha N, Adhikari B, Mehata S, Pokharel Y, Mishra SR. Health system's readiness to provide cardiovascular, diabetes and chronic respiratory disease related services in Nepal: analysis using 2015 health facility survey. BMC Public Health 2020; 20:1163. [PMID: 32711487 PMCID: PMC7382840 DOI: 10.1186/s12889-020-09279-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/20/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The burgeoning rise of non-communicable diseases (NCDs) is posing serious challenges in resource constrained health facilities of Nepal. The main objective of this study was to assess the readiness of health facilities for cardiovascular diseases (CVDs), diabetes and chronic respiratory diseases (CRDs) services in Nepal. METHODS This study utilized data from the Nepal Health Facility Survey 2015. General readiness of 940 health facilities along with disease specific readiness for CVDs, diabetes, and CRDs were assessed using the Service Availability and Readiness Assessment manual of the World Health Organization. Health facilities were categorized into public and private facilities. RESULTS Out of a total of 940 health facilities assessed, private facilities showed higher availability of items of general service readiness except for standard precautions for infection prevention, compared to public facilities. The multivariable adjusted regression coefficients for CVDs (β = 2.87, 95%CI: 2.42-3.39), diabetes (β =3.02, 95%CI: 2.03-4.49), and CRDs (β = 15.95, 95%CI: 4.61-55.13) at private facilities were higher than the public facilities. Health facilities located in the hills had a higher readiness index for CVDs (β = 1.99, 95%CI: 1.02-1.39). Service readiness for CVDs (β = 1.13, 95%CI: 1.04-1.23) and diabetes (β = 1.78, 95%CI: 1.23-2.59) were higher in the urban municipalities than in rural municipalities. Finally, disease-related services readiness index was sub-optimal with some degree of variation at the province level in Nepal. Compared to province 1, province 2 (β = 0.83, 95%CI: 0.73-0.95) had lower, and province 4 (β =1.24, 95%CI: 1.07-1.43) and province 5 (β =1.17, 95%CI: 1.02-1.34) had higher readiness index for CVDs. CONCLUSION This study found sub-optimal readiness of services related to three NCDs at the public facilities in Nepal. Compared to public facilities, private facilities showed higher readiness scores for CVDs, diabetes, and CRDs. There is an urgent need for policy reform to improve the health services for NCDs, particularly in public facilities.
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Affiliation(s)
- Umesh Ghimire
- Kalopul, Rudramati Marga, Kathmandu, 44600, Bagmati, Nepal
| | - Nipun Shrestha
- Institute for Health and Sport (IHeS), Victoria University, Melbourne, Australia
| | - Bipin Adhikari
- Nepal Community Health and Development Centre, Kathmandu, Nepal.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK.
| | | | - Yashashwi Pokharel
- Health Foundation Nepal, America Nepal Medical Foundation, Kathmandu, Nepal
- University of Missouri, Kansas City, USA
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Poureslami I, Shum J, Goldstein R, Gupta S, Aaron SD, Lavoie KL, Poirier C, Kassay S, Starnes K, Akhtar A, FitzGerald JM. Asthma and COPD patients' perceived link between health literacy core domains and self-management of their condition. Patient Educ Couns 2020; 103:1415-1421. [PMID: 32087989 DOI: 10.1016/j.pec.2020.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/23/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Health literacy (HL) is a person's ability to practically apply a wide range of cognitive and non-cognitive skills, to make health-related decisions. Currently, no tool applies all HL core domains to capture necessary data to measures HL in adult asthma and COPD patients. We endeavored to develop a comprehensive, function-based tool that adequately and accurately measures HL skills of this patient population. We explored the perspectives of patients related to each core HL domain, with an emphasis on self-management practices. METHODS Sixteen focus groups were conducted (n = 93; 40 asthma and 53 COPD) across Canada. Data was analyzed using NVivo12. RESULTS Thirteen subthemes were identified within five HL domains: (a) access: active access; passive access; lack of access; (b) understanding: how to improve understanding; (c) trustworthiness; relevancy and validity of information: pre- and post- application of information; (d) communication: barriers to proper communication; (e) application of information: making health decisions. CONCLUSIONS Participants provided valuable insight in terms of disease management topics and corresponding items to include in our HL tool. PRACTICE IMPLICATIONS Involvement of patients from initial stage allowed us to develop a tool that will serve as a first ever developed HL tool for asthma and COPD patient group.
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Affiliation(s)
- Iraj Poureslami
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, The University of British Columbia, Vancouver, BC, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Jessica Shum
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, The University of British Columbia, Vancouver, BC, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Roger Goldstein
- West Park's Respiratory Rehabilitation Service Toronto, West Park Hospital, University of Toronto, Toronto, ON, Canada
| | - Samir Gupta
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Shawn D Aaron
- Division of Respirology in Department of Medicine U-Ottawa, Ottawa, ON, Canada
| | - Kim L Lavoie
- Department of Psychology, University of Quebec at Montreal (UQAM), Montreal, QC, Canada
| | - Claude Poirier
- Centre Hospital, University of Montreal (CHUM), Montreal, QC, Canada
| | - Saron Kassay
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, The University of British Columbia, Vancouver, BC, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Kassie Starnes
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, The University of British Columbia, Vancouver, BC, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Alizeh Akhtar
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - J Mark FitzGerald
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, The University of British Columbia, Vancouver, BC, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, Vancouver, BC, Canada.
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Gardner LE, Horton KL, Shoemark A, Lucas JS, Nielsen KG, Kobbernagel H, Rubbo B, Hirst RA, Kouis P, Ullmann N, Reula A, Rumman N, Mitchison HM, Pinto A, Richardson C, Schmidt A, Thompson J, Gaupmann R, Dabrowski M, Mill P, Carr SB, Norris DP, Kuehni CE, Goutaki M, Hogg C. Proceedings of the 4 th BEAT-PCD Conference and 5 th PCD Training School. BMC Proc 2020; 14:7. [PMID: 32577127 PMCID: PMC7304082 DOI: 10.1186/s12919-020-00191-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Primary ciliary dyskinesia (PCD) is an inherited ciliopathy leading to chronic suppurative lung disease, chronic rhinosinusitis, middle ear disease, sub-fertility and situs abnormalities. As PCD is rare, it is important that scientists and clinicians foster international collaborations to share expertise in order to provide the best possible diagnostic and management strategies. 'Better Experimental Approaches to Treat Primary Ciliary Dyskinesia' (BEAT-PCD) is a multidisciplinary network funded by EU COST Action (BM1407) to coordinate innovative basic science and clinical research from across the world to drive advances in the field. The fourth and final BEAT-PCD Conference and fifth PCD Training School were held jointly in March 2019 in Poznan, Poland. The varied program of plenaries, workshops, break-out sessions, oral and poster presentations were aimed to enhance the knowledge and skills of delegates, whilst also providing a collaborative platform to exchange ideas. In this final BEAT-PCD conference we were able to build upon programmes developed throughout the lifetime of the COST Action. These proceedings report on the conference, highlighting some of the successes of the BEAT-PCD programme.
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Affiliation(s)
- Laura E Gardner
- Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, Sydney Street, London, UK
| | - Katie L Horton
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,University of Southampton Faculty of Medicine, Academic Unit of Clinical and Experimental Medicine, Southampton, UK
| | - Amelia Shoemark
- Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, Sydney Street, London, UK.,Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,University of Southampton Faculty of Medicine, Academic Unit of Clinical and Experimental Medicine, Southampton, UK
| | - Kim G Nielsen
- Danish PCD & Child Centre, CF Centre Copenhagen, Paediatric Pulmonary Service, ERN Accredited, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Helene Kobbernagel
- Danish PCD & Child Centre, CF Centre Copenhagen, Paediatric Pulmonary Service, ERN Accredited, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Bruna Rubbo
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,University of Southampton Faculty of Medicine, Academic Unit of Clinical and Experimental Medicine, Southampton, UK
| | - Robert A Hirst
- Department of Respiratory Sciences, Centre for PCD Diagnosis and Research, University of Leicester, RKCSB, Leicester, LE2 7LX UK
| | - Panayiotis Kouis
- Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Nicola Ullmann
- Paediatric Pulmonology and Respiratory Intermediate Care Unit, Sleep and Long-term Ventilation Unit, Department of Pediatrics, Bambino Gesù Children's Hospital, Rome, Italy
| | - Ana Reula
- Pathology Department, University of Valencia, Valencia, Spain.,Molecular, Cellular and Genomic Biomedicine Group, IIS La Fe, Valencia, Spain
| | - Nisreen Rumman
- Department of Pediatrics, Makassed Hospital, East Jerusalem, Palestine
| | - Hannah M Mitchison
- Genetics and Genomic Medicine Programme, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Andreia Pinto
- Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, Sydney Street, London, UK
| | - Charlotte Richardson
- Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, Sydney Street, London, UK
| | - Anne Schmidt
- Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, Sydney Street, London, UK
| | - James Thompson
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,University of Southampton Faculty of Medicine, Academic Unit of Clinical and Experimental Medicine, Southampton, UK
| | - René Gaupmann
- Department of Paediatrics, Division of Paediatric Allergy, Pulmology, and Endocrinology, Medical University of Vienna, Vienna, Austria
| | - Maciej Dabrowski
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Pleasantine Mill
- MRC Human Genetics Unit, MRC Institute of Genetics & Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, EH4 2XU UK
| | - Siobhan B Carr
- Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, Sydney Street, London, UK
| | | | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, University Children's Hospital, University of Bern, Bern, Switzerland
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, University Children's Hospital, University of Bern, Bern, Switzerland
| | - Claire Hogg
- Primary Ciliary Dyskinesia Centre, Royal Brompton Hospital, Sydney Street, London, UK
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Veeranki SP, Downer B, Jupiter D, Kuo YF, Raji M, Calhoun W, Wong R. Chronic Respiratory Disease and Cognitive Impairment in Older Mexican Adults. Neurol India 2020; 67:1539-1542. [PMID: 31857556 DOI: 10.4103/0028-3886.273646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Cognitive impairment has emerged as an important concern in clinical practice in aging population. Several comorbid factors contribute to etiopathogenesis; one disease of interest is chronic respiratory disease. Aim The aim of this study is to investigate the association of chronic respiratory disease with risk of cognitive impairment in older Mexicans. Materials and Methods Data were obtained from 2782 Mexicans, aged ≥60 years, enrolled in waves I (2001) and III (2012) of the Mexican Health and Aging Study, a prospective cohort of nationally representative sample of older Mexicans. Participants' self-reported responses were used to categorize them into having respiratory disease or not. Study outcome included participants categorized into "cognitively impaired" or "cognitively normal" groups. Multivariable logistic regression models were used to investigate the relationship. Results Overall, 16% of cohort participants reported cognitively impaired at Wave III. Compared with older Mexicans without chronic respiratory disease diagnosis, those diagnosed were not significantly associated with risk of cognitive impairment [adjusted odds ratio (OR): 0.94, 95% confidence interval (CI): 0.58-1.58]. Conclusion Chronic respiratory disease is not significantly associated with risk of cognitive impairment in older Mexican adults.
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Affiliation(s)
- Sreenivas P Veeranki
- Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Brian Downer
- Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas, USA
| | - Daniel Jupiter
- Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Yong-Fang Kuo
- Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Mukaila Raji
- Division of Geriatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - William Calhoun
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Rebeca Wong
- Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA
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Abstract
Chronic respiratory diseases are progressive and often life-limiting illnesses. Patients experience debilitating and troubling symptoms that impact on their quality of life. Despite this, there is under-recognition of patients who may be entering the final year of their life and require palliative care services. The Royal Wolverhampton NHS Trust in partnership with Compton Care has established chronic respiratory disease multidisciplinary team meetings and a combined respiratory and palliative care outpatient clinic to address these issues. This article presents the impact of this service, now in to its fourth year, of delivering palliative care services to patients with chronic respiratory disease.
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Affiliation(s)
| | | | - Helen Ward
- Consultant Respiratory Physician, Royal Wolverhampton NHS Trust
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Collaro AJ, Chang AB, Marchant JM, Masters IB, Rodwell LT, Takken AJ, McElrea MS. Culturally Appropriate Outreach Specialist Respiratory Medical Care Improves the Lung Function of Children in Regional and Remote Queensland. Lung 2020; 198:361-9. [PMID: 32078041 DOI: 10.1007/s00408-020-00332-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/20/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Indigenous Respiratory Outreach Care (IROC) is a culturally appropriate specialist respiratory service established to deliver multidisciplinary respiratory care to regional and remote Queensland communities. Our objective was to evaluate the impact of an outreach specialist respiratory service on the spirometry of children attending IROC clinics, particularly Indigenous children with asthma and bronchiectasis. METHODS Retrospective single-arm cohort study of 189 children who performed spirometry at twelve sites across regional and remote Queensland between October 2010 and December 2017. Each child's baseline spirometry was compared to their best spirometry at follow-up visit occurring within (1) 12 months of their most recent visit with at least 12 months of specialist care and; (2) each year of their first 3 years of care. RESULTS Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) z-scores improved significantly across the whole group from baseline to follow-up (change in z-scores (Δz) of FEV1 = 0.38, 95% CI 0.22, 0.53; ΔzFVC = 0.36, 95% CI 0.21, 0.51). In subgroup analyses, lung function significantly improved in Indigenous children (n = 141, ΔzFEV1 = 0.37, 95% CI 0.17, 0.57; ΔzFVC = 0.36, 95% CI 0.17, 0.55) including those with asthma (n = 117, ΔzFEV1 = 0.41, 95% CI 0.19, 0.64; ΔzFVC = 0.46, 95% CI 0.24, 0.68) and bronchiectasis (n = 38, ΔzFEV1 = 0.33, 95% CI 0.07, 0.59; ΔzFVC = 0.26, 95% CI - 0.03, 0.53). Significant improvements in FEV1 and FVC were observed within the first and second year of follow-up for Indigenous children, but not for non-Indigenous children. CONCLUSION The IROC model of care in regional and remote settings leads to significant lung function improvement in Indigenous children with asthma and bronchiectasis.
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Brakema EA, Tabyshova A, van der Kleij RMJJ, Sooronbaev T, Lionis C, Anastasaki M, An PL, Nguyen LT, Kirenga B, Walusimbi S, Postma MJ, Chavannes NH, van Boven JFM. The socioeconomic burden of chronic lung disease in low-resource settings across the globe - an observational FRESH AIR study. Respir Res 2019; 20:291. [PMID: 31864411 PMCID: PMC6925865 DOI: 10.1186/s12931-019-1255-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/05/2019] [Indexed: 01/01/2023] Open
Abstract
Background Low-resource settings are disproportionally burdened by chronic lung disease due to early childhood disadvantages and indoor/outdoor air pollution. However, data on the socioeconomic impact of respiratory diseases in these settings are largely lacking. Therefore, we aimed to estimate the chronic lung disease-related socioeconomic burden in diverse low-resource settings across the globe. To inform governmental and health policy, we focused on work productivity and activity impairment and its modifiable clinical and environmental risk factors. Methods We performed a cross-sectional, observational FRESH AIR study in Uganda, Vietnam, Kyrgyzstan, and Greece. We assessed the chronic lung disease-related socioeconomic burden using validated questionnaires among spirometry-diagnosed COPD and/or asthma patients (total N = 1040). Predictors for a higher burden were studied using multivariable linear regression models including demographics (e.g. age, gender), health parameters (breathlessness, comorbidities), and risk factors for chronic lung disease (smoking, solid fuel use). We applied identical models per country, which we subsequently meta-analyzed. Results Employed patients reported a median [IQR] overall work impairment due to chronic lung disease of 30% [1.8–51.7] and decreased productivity (presenteeism) of 20.0% [0.0–40.0]. Remarkably, work time missed (absenteeism) was 0.0% [0.0–16.7]. The total population reported 40.0% [20.0–60.0] impairment in daily activities. Breathlessness severity (MRC-scale) (B = 8.92, 95%CI = 7.47–10.36), smoking (B = 5.97, 95%CI = 1.73–10.22), and solid fuel use (B = 3.94, 95%CI = 0.56–7.31) were potentially modifiable risk factors for impairment. Conclusions In low-resource settings, chronic lung disease-related absenteeism is relatively low compared to the substantial presenteeism and activity impairment. Possibly, given the lack of social security systems, relatively few people take days off work at the expense of decreased productivity. Breathlessness (MRC-score), smoking, and solid fuel use are potentially modifiable predictors for higher impairment. Results warrant increased awareness, preventive actions and clinical management of lung diseases in low-resource settings from health policymakers and healthcare workers.
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Affiliation(s)
- Evelyn A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands.
| | - Aizhamal Tabyshova
- Pulmonary Department, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan.,Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rianne M J J van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Talant Sooronbaev
- Pulmonary Department, National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Marilena Anastasaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Pham Le An
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | - Bruce Kirenga
- Department of Medicine and Makerere Lung Institute, Makerere University, Kampala, Uganda
| | - Simon Walusimbi
- Department of Medicine and Makerere Lung Institute, Makerere University, Kampala, Uganda
| | - Maarten J Postma
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Postzone V0-P, Postbus 9600, 2300 RC, Leiden, The Netherlands
| | - Job F M van Boven
- Department of General Practice & Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
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Singh SS, Bhat A, Mohapatra AK, Manu MK, Vaishali K. Comparison of reaction time and functional balance in chronic obstructive pulmonary disease and healthy participants. Heart Lung 2019; 48:570-573. [PMID: 31607410 DOI: 10.1016/j.hrtlng.2019.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Reaction time is one of the components of functional balance and could contribute to balance impairment. Information regarding this relationship is scant among Chronic Obstructive Pulmonary Disease (COPD) participants. OBJECTIVES To compare stepping reaction time between participants with COPD and age; gender-matched healthy individuals to find out whether reaction time in COPD population is affected. METHODS This cross-sectional study included 41 COPD participants and 41 age and gender-matched healthy individuals. All the participants underwent measurements of stepping reaction time (SRT) and timed up and go test (TUG). RESULTS SRT was significantly higher in COPD participants compared to healthy individuals [median of difference- 350 milliseconds (110, 830), p < 0.001]. TUG was significantly higher in COPD participants compared to healthy individuals [median of difference = 2.82 seconds (0.34 and 4.5), p < 0.001]. CONCLUSIONS Participants with COPD exhibit marked increase in SRT and demonstrate a deficiency in functional balance compared to the healthy participants.
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Affiliation(s)
- Shashank Shekar Singh
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anup Bhat
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Aswini Kumar Mohapatra
- Department of Respiratory Medicine, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka
| | - Mohan K Manu
- Department of Respiratory Medicine, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka
| | - K Vaishali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Valero-Moreno S, Castillo-Corullón S, Prado-Gascó VJ, Pérez-Marín M, Montoya-Castilla I. Chronic Respiratory Disease Questionnaire (CRQ-SAS): Analysis of psychometric properties. ARCH ARGENT PEDIATR 2019; 117:149-156. [PMID: 31063298 DOI: 10.5546/aap.2019.eng.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/17/2018] [Indexed: 11/12/2022]
Abstract
Introduction The Chronic Respiratory Disease Questionnaire Self-Administered Standardized (CRQ-SAS) format is used to assess health-related quality of life in different languages and adult populations, but it has not been validated in adolescents. This study analyzes the psychometric properties of the CRQ-SAS in a sample of adolescent patients with chronic respiratory disease and correlates them to anxiety and depression. Method In relation to the CRQ-SAS psychometric properties, exploratory and confirmatory factor analyses were done to assess the instrument's reliability and validity. Correlations and multiple linear regressions with the Hospital Anxiety and Depression Scale were done to assess the relation with anxiety and depression. The mean difference was estimated based on sociodemographic outcome measures. Results The CRQ-SAS was administered to 280 children and adolescents with chronic respiratory disease aged 9-18 years (mean=12.02), with a similar male-female distribution. The original 4-factor structure was maintained; 3 items were removed from the original scale and a new 17-item version was obtained. This showed adequate psychometric properties and discriminant validity. The dyspnea and emotional functioning domains better predicted anxiety and depression. Lastly, scales were obtained for the interpretation of health-related quality of life scores. Conclusions This questionnaire, which has been previously used in the adult population, may be an adequate instrument to assess health-related quality of life in adolescent patients with chronic respiratory disease.
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Affiliation(s)
- Selene Valero-Moreno
- Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamientos Psicológicos
| | - Silvia Castillo-Corullón
- Unidad de Neumología Infantil y Fibrosis Quística del Hospital Clínico y Universitario de Valencia
| | - Vicente J Prado-Gascó
- Departamento de Psicología Social, Facultad de Psicología, Universidad de Valencia, Valencia, España
| | - Marián Pérez-Marín
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Valencia, Valencia, España
| | - Inmaculada Montoya-Castilla
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Valencia, Valencia, España.
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Homma T, Kawahara T, Mikuni H, Uno T, Sato H, Fujiwara A, Uchida Y, Fukuda Y, Manabe R, Ida H, Kuwahara N, Kimura T, Hirai K, Miyata Y, Jinno M, Yamaguchi M, Kishino Y, Murata Y, Ohta S, Yamamoto M, Watanabe Y, Yamaguchi H, Kusumoto S, Suzuki S, Tanaka A, Yokoe T, Ohnishi T, Sagara H. Beneficial Effect of Early Intervention with Garenoxacin for Bacterial Infection-Induced Acute Exacerbation of Bronchial Asthma and Chronic Obstructive Pulmonary Disease. Int Arch Allergy Immunol 2019; 178:355-362. [PMID: 30759444 DOI: 10.1159/000495761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 11/23/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and asthma have similar clinical features and are both exacerbated by airway infection. OBJECTIVE To determine whether garenoxacin mesylate hydrate (GRNX) added to the standard care for bacterial infection-induced acute exacerbation of asthma or COPD in adults has clinical benefits. METHOD This single-arm clinical trial was conducted from January 2015 to March 2016. Adults with a history of asthma or COPD for more than 12 months were recruited within 48 h of presentation with fever and acute deterioration of asthma or COPD requiring additional intervention. Participants were administered 400 mg GRNX daily for 7 days without additional systemic corticosteroids or other antibiotics. The primary outcome was efficacy of GRNX based on clinical symptoms and blood test results after 7 days of treatment. Secondary outcomes were: (1) comparison of the blood test results, radiograph findings, and bacterial culture surveillance before and after treatment; (2) effectiveness of GRNX after 3 days of administration; (3) analyzation of patient symptoms based on patient diary; and (4) continued effectiveness of GRNX on 14th day after the treatment (visit 3). RESULTS The study included 44 febrile patients (34 asthma and 10 COPD). Frequently isolated bacteria included Moraxella catarrhalis (n = 6) and Klebsiella pneumoniae (n = 4). On visit 2, 40 patients responded, and no severe adverse events were observed. All secondary outcomes showed favorable results. CONCLUSION GRNX effectively treated asthma and COPD patients with acute bacterial infection without severe adverse events. Further research with a larger study population is needed.
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Affiliation(s)
- Tetsuya Homma
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan,
| | - Tomoko Kawahara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hatsuko Mikuni
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Uno
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Haruna Sato
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akiko Fujiwara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshitaka Uchida
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yosuke Fukuda
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Ryo Manabe
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hitomi Ida
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Naota Kuwahara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tomoyuki Kimura
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kuniaki Hirai
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshito Miyata
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Megumi Jinno
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Munehiro Yamaguchi
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yasunari Kishino
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yasunori Murata
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Mayumi Yamamoto
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshio Watanabe
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hirofumi Yamaguchi
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Sojiro Kusumoto
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shintaro Suzuki
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Tanaka
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takuya Yokoe
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tsukasa Ohnishi
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hironori Sagara
- Division of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
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Farley H, Rubbo B, Bukowy-Bieryllo Z, Fassad M, Goutaki M, Harman K, Hogg C, Kuehni CE, Lopes S, Nielsen KG, Norris DP, Reula A, Rumman N, Shoemark A, Wilkins H, Wisse A, Lucas JS, Marthin JK. Proceedings of the 3rd BEAT-PCD Conference and 4th PCD Training School. BMC Proc 2018; 12:64. [PMID: 30807620 PMCID: PMC6297936 DOI: 10.1186/s12919-018-0161-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Primary ciliary dyskinesia (PCD) is a chronic suppurative airways disease that is usually recessively inherited and has marked clinical phenotypic heterogeneity. Classic symptoms include neonatal respiratory distress, chronic rhinitis since early childhood, chronic otitis media, recurrent airway infections leading to bronchiectasis, chronic sinusitis, laterality defects with and without congenital heart disease including abnormal situs in approximately 50% of the cases, and male infertility. Lung function deteriorates progressively from childhood throughout life. 'Better Experimental Approaches to Treat Primary Ciliary Dyskinesia' (BEAT-PCD) is a network of scientists and clinicians coordinating research from basic science through to clinical care with the intention of developing treatments and diagnostics that lead to improved long-term outcomes for patients. BEAT-PCD activities are supported by EU funded COST Action (BM1407). The third BEAT-PCD conference and fourth PCD training school were held jointly in February 2018 in Lisbon, Portugal. Presentations and workshops focussed on advancing the knowledge and skills relating to PCD in: basic science, epidemiology, diagnostic testing, clinical management and clinical trials. The multidisciplinary conference provided an interactive platform for exchanging ideas through a program of lectures, poster presentations, breakout sessions and workshops. Three working groups met to plan consensus statements. Progress with BEAT-PCD projects was shared and new collaborations were fostered. In this report, we summarize the meeting, highlighting developments made during the meeting.
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Affiliation(s)
- Hannah Farley
- MRC Harwell Institute, Harwell Campus, Oxfordshire, UK
- Department of Physiology, Anatomy and Genetics, Parks Road, Oxford, Oxfordshire, UK
| | - Bruna Rubbo
- Primary Ciliary Dyskinesia Centre, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Mahmoud Fassad
- Genetics and Genomic Medicine Programme, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
- Department of Human Genetics, Medical Research Institute, Alexandria University, 165 El-Horreya Avenue El- Hadra, Alexandria, 21561 Egypt
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Paediatric Respiratory Medicine, University Children’s Hospital, University of Bern, Bern, Switzerland
| | | | - Claire Hogg
- Paediatric Respiratory Medicine, Imperial College, London, UK
- Department of Paediatrics, Royal Brompton Hospital, Sydney Street, London, UK
| | - Claudia E. Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Paediatric Respiratory Medicine, University Children’s Hospital, University of Bern, Bern, Switzerland
| | - Susana Lopes
- CEDOC, Chronic Diseases Research Centre, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
| | - Kim G. Nielsen
- Danish PCD & Child Centre, CF Centre Copenhagen, Paediatric Pulmonary Service, ERN Accredited, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Ana Reula
- Department of Physiology, University of Valencia, Valencia, Spain
- UCIM Departament, Instituto de Investigación Sanitaria Incliva, Valencia, Spain
| | - Nisreen Rumman
- Department of Pediatrics, Makassed Hospital, East Jerusalem, Palestine
| | - Amelia Shoemark
- Royal Brompton Hospital, Sydney Street, London, UK
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Hannah Wilkins
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Agatha Wisse
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Jane S. Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - June K. Marthin
- Danish PCD & Child Centre, CF Centre Copenhagen, Paediatric Pulmonary Service, ERN Accredited, Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Denmark
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Sørensen JK, Buchvald F, Berg AK, Robinson PD, Nielsen KG. Ventilation inhomogeneity and NO and CO diffusing capacity in ex-premature school children. Respir Med 2018; 140:94-100. [PMID: 29957288 DOI: 10.1016/j.rmed.2018.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/03/2018] [Accepted: 06/04/2018] [Indexed: 11/18/2022]
Abstract
AIM Ex-premature school children show mild-to-moderate airway obstruction and decreased CO diffusing capacity. Multiple breath nitrogen washout (N2MBW) and NO diffusing capacity (DLNO) measurements may provide new insight into long-term pulmonary and vascular impairment in bronchopulmonary dysplasia (BPD). METHODS We examined a randomly selected group of 70 ex-premature children (gestational age <28 weeks or birth weight <1500 g; 42 with and 28 without BPD) and 38 term-born healthy controls of 8-13 years of age. Subjects performed N2MBW (lung clearance index, LCI; Sacin, and Scond), DLNO (membrane related diffusing capacity, Dm and pulmonary capillary volume, Vc), Fractional exhaled NO, CO diffusing capacity, conventional spirometry (FEV1, FVC, FEF25-75) and plethysmography (RV, TLC). Respiratory symptoms were assessed by questionnaire. RESULTS Compared to healthy controls, the BPD group had higher z-scores for lung clearance index (P = 0.003), Sacin (P = 0.005), lower CO diffusing capacity (P = 0.025), DLNO (P = 0.022), DLNO/VA z-scores (P = 0.025) and a significant larger proportion had respiratory complaints. Amongst ex-premature children, the BPD group did not differ from the non-BPD group except for a decreased Dm (P = 0.023). Ex-premature with BPD showed predominantly airway obstruction (FEV1/FVC; P < 0.0001), signs of hyperinflation (RV/TLC-ratio; P = 0.028), and 25% had a positive bronchodilator response (>12% in FEV1). CONCLUSION Ex-premature school children exhibited relatively mild but significant long-term respiratory symptoms and pulmonary peripheral impairment judged by N2MBW and DLNO measurements along with well-known airway obstruction. Larger longitudinal studies are needed to assess the clinical use of these advanced methods of assessing ventilation inhomogeneity and DLNO.
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Affiliation(s)
- Jesper Kiehn Sørensen
- Danish Pediatric Pulmonary Service, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Frederik Buchvald
- Danish Pediatric Pulmonary Service, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Anna Korsgaard Berg
- Danish Pediatric Pulmonary Service, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Paul D Robinson
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Pediatrics and Child Health, Sydney Medical School, University of Sydney, Australia
| | - Kim Gjerum Nielsen
- Danish Pediatric Pulmonary Service, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Trompeter G, Grigsby MR, Miele CH, Wise RA, Gilman RH, Miranda JJ, Bernabe-Ortiz A, Checkley W. Patterns of Body Composition Relating to Chronic Respiratory Diseases Among Adults in Four Resource-Poor Settings in Peru. Lung 2018; 196:277-284. [PMID: 29556728 DOI: 10.1007/s00408-018-0109-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 03/10/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Body composition is known to influence the development and progression of chronic respiratory diseases (CRDs). We sought to characterize the unique anthropometric phenotypes that present with asthma, chronic obstructive pulmonary disease (COPD), and chronic bronchitis across four distinct settings in Peru. METHODS We collected sociodemographic, clinical history, and spirometry data from 2959 participants from Lima, Tumbes, and rural and urban Puno. We compared the prevalence of CRDs among different study sites and described disease phenotypes. We used single and multivariable linear regression to model the influence of CRD status on various descriptors of body composition. RESULTS Overall prevalence of CRDs varied across sites with the highest prevalence of asthma in Lima (14.5%) and the highest prevalence of COPD in rural Puno (9.9%). Measures of body composition also varied across sites, with highest mean body mass index (BMI) in Lima (28.4 kg/m2) and the lowest mean BMI in rural Puno (25.2 kg/m2). Participants with COPD had the lowest mean fat mass index (FMI) (10.5 kg/m2) and waist circumference (88.3 cm), whereas participants with asthma had the highest mean FMI (14.5 kg/m2), and waist circumference (94.8 cm). In multivariable analysis, participants with COPD had a lower waist circumference (adjusted mean - 2.97 cm, 95% CI 4.62 to - 1.32 cm) when compared to non-CRD participants. CONCLUSIONS Our findings provide evidence that asthma and chronic bronchitis are more likely to be associated with obesity and higher fat mass, while COPD is associated with being underweight and having less lean mass.
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Affiliation(s)
- Grace Trompeter
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, 1830 E. Monument St. Room 555, Baltimore, MD, 21287, USA
| | - Matthew R Grigsby
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, 1830 E. Monument St. Room 555, Baltimore, MD, 21287, USA
| | - Catherine H Miele
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, 1830 E. Monument St. Room 555, Baltimore, MD, 21287, USA
| | - Robert A Wise
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, 1830 E. Monument St. Room 555, Baltimore, MD, 21287, USA
| | - Robert H Gilman
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - William Checkley
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, 1830 E. Monument St. Room 555, Baltimore, MD, 21287, USA.
- Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
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