Pub Date : 2022-01-01DOI: 10.1177/14799731221105516
E. Hume
Dyspnea is a prominent symptom of Chronic Obstructive Pulmonary Disease (COPD), occurring as a result of expiratory flow limitation, which may lead to varying degrees of dynamic hyperinflation, hypoxemia, hypercapnia and neuromechanical dissociation. Although pain appears to be a prevalent symptom in COPD patients, it is rarely considered in clinical practice guidelines for the management of the disease, which could be due to pain being a complex and understudied factor in COPD. When compared to other disease entities (diabetes, heart disease and arthritis), COPD patients had an increased risk of pain prevalence and intensity, second only to those with arthritis. There are several underlying mechanisms that may contribute to higher pain prevalence in COPD compared to healthy individuals. These include increased and persistent respiratory muscle loading, along with systemic inflammation, musculoskeletal disorders and co-morbities. In patients with stable COPD, pain is a prevalent symptom which negatively impacts quality of life, and is associated with higher levels of lung hyperinflation and dyspnea. An acute exacerbation of COPD (AECOPD) occurs when there is an acute worsening of respiratory symptoms requiring additional treatment. Thus, given the relationship between the two perceptions, many factors linked to pain in the stable state tend to worsen during an AECOPD. The systematic review by Clarke et al. focused on the prevalence of pain and dyspnea experienced concurrently in people admitted to hospital with an AECOPD. A total of 1300 articles were identified from initial database searches, however only four studies met the inclusion criteria and were included in the review. Pain and dyspnea are both unpleasant sensations which share many clinical, physiological and psychological features. Brain imaging studies highlight that perceptions of pain and dyspnea activate similar cortical regions of the brain, and share common neural mechanisms. Due to these commonalities, the review aimed to further understand the interactions between pain and dyspnea, and their clinical implications during an AECOPD. Of the available data, pooled prevalence of pain and dyspnea was 44% and 91% respectively, demonstrating that both symptoms are prevalent in COPD patients during acute exacerbations. However, due to the small number of studies co-reporting pain and dyspnea, the scope of the review to draw clinical associations and implications of both symptoms during AECOPD was limited. As described by the authors in the review, management of COPD exacerbations primarily focuses on relieving dyspnea, reducing medication and oxygen requirements, returning to baseline function and follow up care. Discharge care bundles have been shown to reduce hospital readmissions following hospitalisation for an AECOPD, but did not improve survival or quality of life. The individual components of discharge bundles tend to vary and it is not clear whether pain is considered within the
{"title":"The concomitant assessment of pain and dyspnea in acute exacerbations of chronic obstructive pulmonary disease; is pain an understudied factor?","authors":"E. Hume","doi":"10.1177/14799731221105516","DOIUrl":"https://doi.org/10.1177/14799731221105516","url":null,"abstract":"Dyspnea is a prominent symptom of Chronic Obstructive Pulmonary Disease (COPD), occurring as a result of expiratory flow limitation, which may lead to varying degrees of dynamic hyperinflation, hypoxemia, hypercapnia and neuromechanical dissociation. Although pain appears to be a prevalent symptom in COPD patients, it is rarely considered in clinical practice guidelines for the management of the disease, which could be due to pain being a complex and understudied factor in COPD. When compared to other disease entities (diabetes, heart disease and arthritis), COPD patients had an increased risk of pain prevalence and intensity, second only to those with arthritis. There are several underlying mechanisms that may contribute to higher pain prevalence in COPD compared to healthy individuals. These include increased and persistent respiratory muscle loading, along with systemic inflammation, musculoskeletal disorders and co-morbities. In patients with stable COPD, pain is a prevalent symptom which negatively impacts quality of life, and is associated with higher levels of lung hyperinflation and dyspnea. An acute exacerbation of COPD (AECOPD) occurs when there is an acute worsening of respiratory symptoms requiring additional treatment. Thus, given the relationship between the two perceptions, many factors linked to pain in the stable state tend to worsen during an AECOPD. The systematic review by Clarke et al. focused on the prevalence of pain and dyspnea experienced concurrently in people admitted to hospital with an AECOPD. A total of 1300 articles were identified from initial database searches, however only four studies met the inclusion criteria and were included in the review. Pain and dyspnea are both unpleasant sensations which share many clinical, physiological and psychological features. Brain imaging studies highlight that perceptions of pain and dyspnea activate similar cortical regions of the brain, and share common neural mechanisms. Due to these commonalities, the review aimed to further understand the interactions between pain and dyspnea, and their clinical implications during an AECOPD. Of the available data, pooled prevalence of pain and dyspnea was 44% and 91% respectively, demonstrating that both symptoms are prevalent in COPD patients during acute exacerbations. However, due to the small number of studies co-reporting pain and dyspnea, the scope of the review to draw clinical associations and implications of both symptoms during AECOPD was limited. As described by the authors in the review, management of COPD exacerbations primarily focuses on relieving dyspnea, reducing medication and oxygen requirements, returning to baseline function and follow up care. Discharge care bundles have been shown to reduce hospital readmissions following hospitalisation for an AECOPD, but did not improve survival or quality of life. The individual components of discharge bundles tend to vary and it is not clear whether pain is considered within the","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46321530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731221098722
J. Domínguez-Ortega, V. Plaza, V. Li, E. Fonseca, L. cea-calvo, Ashley Martin, M. Sánchez-Jareño, Joanne E. Brady, J. Schelfhout
Background Chronic cough (CC) represents a significant health burden. This study assessed the prevalence of CC (defined as per international guidelines as cough duration >8 weeks) in Spanish adults and compared characteristics between CC and non-CC cohorts. Methods CC cohorts were compiled using data from adult respondents to the 2020 Spanish cross-sectional online National Health and Wellness Survey (NHWS). Using propensity scores, respondents experiencing CC during their lifetime and the previous 12 months were matched 3:1 to respondents without CC and their health characteristics were compared. The number of Spanish adults affected with CC was estimated using weighted CC prevalence. Results CC during their lifetime or the previous 12 months was experienced by 579 (8.2%) and 389 (5.5%) of 7074 NHWS respondents, of whom 233 (38.5%) and 171 (44.0%), respectively, had physician-diagnosed CC. Based on weighted prevalence rates, lifetime and 12-month CC were estimated to affect ≈3.3 million and ≈2.2 million Spanish adults, respectively. Relative to the non-CC cohort, the 12-month CC cohort consistently demonstrated poorer health status, poorer mental health, greater healthcare utilization, and lower productivity at work and home. Conclusion This study contributes novel data regarding the prevalence of CC in Spain, suggests that CC is underdiagnosed, and reflects that CC and related comorbidities inflict a significant health burden in the affected population.
{"title":"Prevalence of chronic cough and patient characteristics in adults in Spain: A population-based cross-sectional survey","authors":"J. Domínguez-Ortega, V. Plaza, V. Li, E. Fonseca, L. cea-calvo, Ashley Martin, M. Sánchez-Jareño, Joanne E. Brady, J. Schelfhout","doi":"10.1177/14799731221098722","DOIUrl":"https://doi.org/10.1177/14799731221098722","url":null,"abstract":"Background Chronic cough (CC) represents a significant health burden. This study assessed the prevalence of CC (defined as per international guidelines as cough duration >8 weeks) in Spanish adults and compared characteristics between CC and non-CC cohorts. Methods CC cohorts were compiled using data from adult respondents to the 2020 Spanish cross-sectional online National Health and Wellness Survey (NHWS). Using propensity scores, respondents experiencing CC during their lifetime and the previous 12 months were matched 3:1 to respondents without CC and their health characteristics were compared. The number of Spanish adults affected with CC was estimated using weighted CC prevalence. Results CC during their lifetime or the previous 12 months was experienced by 579 (8.2%) and 389 (5.5%) of 7074 NHWS respondents, of whom 233 (38.5%) and 171 (44.0%), respectively, had physician-diagnosed CC. Based on weighted prevalence rates, lifetime and 12-month CC were estimated to affect ≈3.3 million and ≈2.2 million Spanish adults, respectively. Relative to the non-CC cohort, the 12-month CC cohort consistently demonstrated poorer health status, poorer mental health, greater healthcare utilization, and lower productivity at work and home. Conclusion This study contributes novel data regarding the prevalence of CC in Spain, suggests that CC is underdiagnosed, and reflects that CC and related comorbidities inflict a significant health burden in the affected population.","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43657867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731221089318
M. Orme, Ilaria Pina, Sally J. Singh
Field-based walking tests are well-established outcome measures in clinical research trials and in the evaluation of routine clinical services, including pulmonary rehabilitation. Despite widespread use, there has been little attention to, or reporting of, the quality assurance of these tests. Physical activity monitoring has become increasingly popular and data from activity monitors could be used for quality assurance of field-based walking tests. We provide examples in this article of data-driven insights possible with this approach, using data from waist-worn accelerometry, for the incremental shuttle walking test (ISWT), endurance shuttle walk test (ESWT) and six-minute walk test (6MWT). Given the multitude of devices to measure physical activity and the range metrics to describe physical activity, we also comment on some of the technical considerations to using activity monitors for walking test quality assurance. Data-driven approaches to quality assurance are already commonplace for other outcome measures in clinical respiratory trials, but little is known about this approach for field-based walking tests. The application of physical activity monitoring may be extended to other field-based exercise tests and additional rehabilitation services. This may be more challenging for self-paced walking tests such as the 6MWT. Future work should apply this approach to research trials and service evaluations to explore the impact of field-based walking test quality on performance (e.g. distance on the ISWT or time achieved for the ESWT), responsiveness to interventions (e.g. pulmonary rehabilitation) and effectiveness of training procedures (e.g. remote training for multi-site trials).
{"title":"The untapped potential of physical activity monitoring for quality assurance of field-based walking tests in clinical respiratory trials","authors":"M. Orme, Ilaria Pina, Sally J. Singh","doi":"10.1177/14799731221089318","DOIUrl":"https://doi.org/10.1177/14799731221089318","url":null,"abstract":"Field-based walking tests are well-established outcome measures in clinical research trials and in the evaluation of routine clinical services, including pulmonary rehabilitation. Despite widespread use, there has been little attention to, or reporting of, the quality assurance of these tests. Physical activity monitoring has become increasingly popular and data from activity monitors could be used for quality assurance of field-based walking tests. We provide examples in this article of data-driven insights possible with this approach, using data from waist-worn accelerometry, for the incremental shuttle walking test (ISWT), endurance shuttle walk test (ESWT) and six-minute walk test (6MWT). Given the multitude of devices to measure physical activity and the range metrics to describe physical activity, we also comment on some of the technical considerations to using activity monitors for walking test quality assurance. Data-driven approaches to quality assurance are already commonplace for other outcome measures in clinical respiratory trials, but little is known about this approach for field-based walking tests. The application of physical activity monitoring may be extended to other field-based exercise tests and additional rehabilitation services. This may be more challenging for self-paced walking tests such as the 6MWT. Future work should apply this approach to research trials and service evaluations to explore the impact of field-based walking test quality on performance (e.g. distance on the ISWT or time achieved for the ESWT), responsiveness to interventions (e.g. pulmonary rehabilitation) and effectiveness of training procedures (e.g. remote training for multi-site trials).","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45340584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731221104095
M. González-García, C. Aguirre-Franco, Leslie Vargas-Ramirez, M. Barrero, C. Torres-Duque
Background: Pulmonary hypertension (PH) is associated with decreased exercise tolerance in chronic obstructive pulmonary disease (COPD) patients, but in the altitude the response to exercise in those patients is unknown. Our objective was to compare exercise capacity, gas exchange and ventilatory alterations between COPD patients with PH (COPD-PH) and without PH (COPD-nonPH) residents at high altitude (2640 m). Methods: One hundred thirty-two COPD-nonPH, 82 COPD-PH, and 47 controls were included. Dyspnea by Borg scale, oxygen consumption (VO2), work rate (WR), ventilatory equivalents (VE/VCO2), dead space to tidal volume ratio (VD/VT), alveolar-arterial oxygen tension gradient (AaPO2), and arterial-end-tidal carbon dioxide pressure gradient (Pa-ETCO2) were measurement during a cardiopulmonary exercise test. For comparison of variables between groups, Kruskal-Wallis or one-way ANOVA tests were used, and stepwise regression analysis to test the association between PH and exercise capacity. Results: All COPD patients had a lower exercise capacity and higher PaCO2, A-aPO2 and VD/VT than controls. The VO2 % predicted (61.3 ± 20.6 vs 75.3 ± 17.9; p < 0.001) and WR % predicted (65.3 ± 17.9 vs 75.3 ± 17.9; p < 0.001) were lower in COPD-PH than in COPD-nonPH. At peak exercise, dyspnea was higher in COPD-PH (p = 0.011). During exercise, in COPD-PH, the PaO2 was lower (p < 0.001), and AaPO2 (p < 0.001), Pa-ETCO2 (p = 0.033), VE/VCO2 (p = 0.019), and VD/VT (p = 0.007) were higher than in COPD-nonPH. In the multivariate analysis, PH was significantly associated with lower peak VO2 and WR (p < 0.001). Conclusion: In COPD patients residing at high altitude, the presence of PH was an independent factor related to the exercise capacity. Also, in COPD-PH patients there were more dyspnea and alterations in gas exchange during the exercise than in those without PH.
{"title":"Effect of pulmonary hypertension on exercise capacity and gas exchange in patients with chronic obstructive pulmonary disease living at high altitude","authors":"M. González-García, C. Aguirre-Franco, Leslie Vargas-Ramirez, M. Barrero, C. Torres-Duque","doi":"10.1177/14799731221104095","DOIUrl":"https://doi.org/10.1177/14799731221104095","url":null,"abstract":"Background: Pulmonary hypertension (PH) is associated with decreased exercise tolerance in chronic obstructive pulmonary disease (COPD) patients, but in the altitude the response to exercise in those patients is unknown. Our objective was to compare exercise capacity, gas exchange and ventilatory alterations between COPD patients with PH (COPD-PH) and without PH (COPD-nonPH) residents at high altitude (2640 m). Methods: One hundred thirty-two COPD-nonPH, 82 COPD-PH, and 47 controls were included. Dyspnea by Borg scale, oxygen consumption (VO2), work rate (WR), ventilatory equivalents (VE/VCO2), dead space to tidal volume ratio (VD/VT), alveolar-arterial oxygen tension gradient (AaPO2), and arterial-end-tidal carbon dioxide pressure gradient (Pa-ETCO2) were measurement during a cardiopulmonary exercise test. For comparison of variables between groups, Kruskal-Wallis or one-way ANOVA tests were used, and stepwise regression analysis to test the association between PH and exercise capacity. Results: All COPD patients had a lower exercise capacity and higher PaCO2, A-aPO2 and VD/VT than controls. The VO2 % predicted (61.3 ± 20.6 vs 75.3 ± 17.9; p < 0.001) and WR % predicted (65.3 ± 17.9 vs 75.3 ± 17.9; p < 0.001) were lower in COPD-PH than in COPD-nonPH. At peak exercise, dyspnea was higher in COPD-PH (p = 0.011). During exercise, in COPD-PH, the PaO2 was lower (p < 0.001), and AaPO2 (p < 0.001), Pa-ETCO2 (p = 0.033), VE/VCO2 (p = 0.019), and VD/VT (p = 0.007) were higher than in COPD-nonPH. In the multivariate analysis, PH was significantly associated with lower peak VO2 and WR (p < 0.001). Conclusion: In COPD patients residing at high altitude, the presence of PH was an independent factor related to the exercise capacity. Also, in COPD-PH patients there were more dyspnea and alterations in gas exchange during the exercise than in those without PH.","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42004281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731211049699
Chohan K, Mittal N, McGillis L et al. A review of respiratory manifestations and their management in EhlersDanlos syndromes and hypermobility spectrum disorders. Chronic Respiratory Disease. 2021; 18: 1-14. doi: 10.1177/ 14799731211025313 The correct list of references for this article can be found below: 1. Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet 2017; 175:8-26 2. Callewaert B, Malfait F, Loeys B, et al. Ehlers-Danlos syndromes and Marfan syndrome. Best Pract Res Clin Rheumatol 2008; 22:165-189 3. Demmler JC, AtkinsonMD,Reinhold EJ, et al. Diagnosed prevalence of Ehlers-Danlos syndrome and hypermobility spectrum disorder in Wales, UK: a national electronic cohort study and case-control comparison. BMJOpen 2019; 9:e031365 4. Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 2000; 27:1777-1779 5. Castori M, Tinkle B, Levy H, et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet 2017; 175: 148-157 6. Cederlof M, Larsson H, Lichtenstein P, et al. Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome and their siblings. BMCPsychiatry 2016; 16: 207 7. Ayres JG, Pope FM, Reidy JF, et al. Abnormalities of the lungs and thoracic cage in the Ehlers-Danlos syndrome. Thorax 1985; 40:300-305 8. Shields LB, Rolf CM, Davis GJ, et al. Sudden and unexpected death in three cases of Ehlers-Danlos syndrome type IV. J Forensic Sci 2010; 55:1641-1645 9. Morgan AW, Pearson SB, Davies S, et al. Asthma and airways collapse in two heritable disorders of connective tissue. Ann Rheum Dis 2007; 66:1369-1373 10. Castori M, Hakim A. Contemporary approach to joint hypermobility and related disorders. Curr Opin Pediatr 2017; 29:640-649 11. Yost BA, Vogelsang JP, Lie JT. Fatal hemoptysis in Ehlers-Danlos syndrome. Old malady with a new curse. Chest 1995; 107:1465-1467 12. Herman TE, McAlister WH. Cavitary pulmonary lesions in type IV Ehlers-Danlos syndrome. Pediatr Radiol 1994; 24:263-265 13. Park MA, Shin SY, Kim YJ, et al. Vascular EhlersDanlos syndrome with cryptorchidism, recurrent pneumothorax, and pulmonary capillary hemangiomatosis-like foci: A case report. Medicine (Baltimore) 2017; 96:e8853 14. Reychler G, Liistro G, Pierard GE, et al. Inspiratory muscle strength training improves lung function in patients with the hypermobile Ehlers-Danlos syndrome: A randomized controlled trial. Am J Med Genet A 2019; 179: 356-364 15. Castori M, Camerota F, Celletti C, et al. Natural history and manifestations of the hypermobility type EhlersDanlos syndrome: a pilot study on 21 patients. Am J Med Genet A 2010; 152A:556-564 16. Gazit Y, Nahir AM, Grahame R, et al. Dysautonomia in the joint hypermobility syndrome. Am J Med 2003; 115: 33-40 17. Sim
{"title":"Erratum to “A review of respiratory manifestations and their management in Ehlers-Danlos syndromes and hypermobility spectrum disorders”","authors":"","doi":"10.1177/14799731211049699","DOIUrl":"https://doi.org/10.1177/14799731211049699","url":null,"abstract":"Chohan K, Mittal N, McGillis L et al. A review of respiratory manifestations and their management in EhlersDanlos syndromes and hypermobility spectrum disorders. Chronic Respiratory Disease. 2021; 18: 1-14. doi: 10.1177/ 14799731211025313 The correct list of references for this article can be found below: 1. Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet 2017; 175:8-26 2. Callewaert B, Malfait F, Loeys B, et al. Ehlers-Danlos syndromes and Marfan syndrome. Best Pract Res Clin Rheumatol 2008; 22:165-189 3. Demmler JC, AtkinsonMD,Reinhold EJ, et al. Diagnosed prevalence of Ehlers-Danlos syndrome and hypermobility spectrum disorder in Wales, UK: a national electronic cohort study and case-control comparison. BMJOpen 2019; 9:e031365 4. Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 2000; 27:1777-1779 5. Castori M, Tinkle B, Levy H, et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet 2017; 175: 148-157 6. Cederlof M, Larsson H, Lichtenstein P, et al. Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome and their siblings. BMCPsychiatry 2016; 16: 207 7. Ayres JG, Pope FM, Reidy JF, et al. Abnormalities of the lungs and thoracic cage in the Ehlers-Danlos syndrome. Thorax 1985; 40:300-305 8. Shields LB, Rolf CM, Davis GJ, et al. Sudden and unexpected death in three cases of Ehlers-Danlos syndrome type IV. J Forensic Sci 2010; 55:1641-1645 9. Morgan AW, Pearson SB, Davies S, et al. Asthma and airways collapse in two heritable disorders of connective tissue. Ann Rheum Dis 2007; 66:1369-1373 10. Castori M, Hakim A. Contemporary approach to joint hypermobility and related disorders. Curr Opin Pediatr 2017; 29:640-649 11. Yost BA, Vogelsang JP, Lie JT. Fatal hemoptysis in Ehlers-Danlos syndrome. Old malady with a new curse. Chest 1995; 107:1465-1467 12. Herman TE, McAlister WH. Cavitary pulmonary lesions in type IV Ehlers-Danlos syndrome. Pediatr Radiol 1994; 24:263-265 13. Park MA, Shin SY, Kim YJ, et al. Vascular EhlersDanlos syndrome with cryptorchidism, recurrent pneumothorax, and pulmonary capillary hemangiomatosis-like foci: A case report. Medicine (Baltimore) 2017; 96:e8853 14. Reychler G, Liistro G, Pierard GE, et al. Inspiratory muscle strength training improves lung function in patients with the hypermobile Ehlers-Danlos syndrome: A randomized controlled trial. Am J Med Genet A 2019; 179: 356-364 15. Castori M, Camerota F, Celletti C, et al. Natural history and manifestations of the hypermobility type EhlersDanlos syndrome: a pilot study on 21 patients. Am J Med Genet A 2010; 152A:556-564 16. Gazit Y, Nahir AM, Grahame R, et al. Dysautonomia in the joint hypermobility syndrome. Am J Med 2003; 115: 33-40 17. Sim","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41861834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731221081857
A. Oakes, P. Antoine-Pitterson, Alastair Watson, B. Cooper, R. Mukherjee
In the last 6 months, home non-invasive ventilation (NIV) services have faced several unanticipated challenges to their effectiveness and delivery as the result of a ‘perfect storm’ of the COVID-19 pandemic demands. We developed and delivered an innovative follow-up service, to support home NIV delivery, and improve cost-effectiveness and sustainability during COVID-19. Between Feb-2019 and Nov-2020, 92 post-acute patients were issued with home NIV; 25 (27%) out of the 92 patients had unused NIV machines successfully retrieved. The median (IQR) days of home NIV usage were 207 (98) for patients who had their machines returned. All the unused NIV machines retrieved were within the 5-year working life guaranteed by the manufacturer and were all redeployed after appropriate reconditioning and infection control measures. Without the home-visiting and recycling pilot, we would have relied on patients and families to return the unused machines. Given the expected disruption to NIV machine supply for at least the foreseeable 12–18 months, we feel it is important to get this important message out to other home NIV services urgently. Wider implementation of this novel approach could increase the availability of this vital resource and help meet the current demand on home NIV services.
{"title":"The benefits of a home non-invasive ventilation retrieval service: Improved effectiveness and environmental sustainability in challenging times","authors":"A. Oakes, P. Antoine-Pitterson, Alastair Watson, B. Cooper, R. Mukherjee","doi":"10.1177/14799731221081857","DOIUrl":"https://doi.org/10.1177/14799731221081857","url":null,"abstract":"In the last 6 months, home non-invasive ventilation (NIV) services have faced several unanticipated challenges to their effectiveness and delivery as the result of a ‘perfect storm’ of the COVID-19 pandemic demands. We developed and delivered an innovative follow-up service, to support home NIV delivery, and improve cost-effectiveness and sustainability during COVID-19. Between Feb-2019 and Nov-2020, 92 post-acute patients were issued with home NIV; 25 (27%) out of the 92 patients had unused NIV machines successfully retrieved. The median (IQR) days of home NIV usage were 207 (98) for patients who had their machines returned. All the unused NIV machines retrieved were within the 5-year working life guaranteed by the manufacturer and were all redeployed after appropriate reconditioning and infection control measures. Without the home-visiting and recycling pilot, we would have relied on patients and families to return the unused machines. Given the expected disruption to NIV machine supply for at least the foreseeable 12–18 months, we feel it is important to get this important message out to other home NIV services urgently. Wider implementation of this novel approach could increase the availability of this vital resource and help meet the current demand on home NIV services.","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45936112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731221131330
Kenneth Wu, Anna Michalski, Jenna Sykes, Jane Batt, Anne L Stephenson, Sunita Mathur
Background: Cystic fibrosis (CF) is characterized by CF transmembrane conductance regulator (CFTR) dysfunction. CFTR protein is expressed in human skeletal muscle; however, its impact on skeletal muscle is unknown. The objectives of this study were to compare quadriceps muscle size and quality between adults with various severities of CFTR protein dysfunction.
Methods: We conducted a prospective, cross-sectional study comparing 34 adults with severe versus 18 with mild CFTR protein dysfunction, recruited from a specialized CF centre. Ultrasound images of rectus femoris cross-sectional area (RF-CSA) and quadriceps layer thickness for muscle size, and rectus femoris echogenicity (RF-ECHO) (muscle quality) were obtained. Multivariable linear regression models were developed using purposeful selection technique.
Results: People with severe CFTR protein dysfunction had larger RF-CSA by 3.22 cm2, 95% CI (1.03, 5.41) cm2, p=.0049], after adjusting for oral corticosteroid use and Pseudomonas aeruginosa colonization. However, a sensitivity analysis indicated that the result was influenced by the specific confounders being adjusted for in the model. We did not find any significant differences in quadriceps layer thickness or RF-ECHO between the two groups.
Conclusion: We found no differential impact of the extent of diminished CFTR protein activity on quadriceps muscle size or quality in our study cohort. Based on these findings, CFTR mutation status cannot be used differentiate leg muscle size or quality in people with CF.
背景:囊性纤维化(CF)以CF跨膜传导调节因子(CFTR)功能障碍为特征。CFTR蛋白在人骨骼肌中表达;然而，它对骨骼肌的影响尚不清楚。本研究的目的是比较不同程度CFTR蛋白功能障碍的成年人的股四头肌大小和质量。方法:我们进行了一项前瞻性横断面研究，比较了34名严重CFTR蛋白功能障碍的成年人和18名轻度CFTR蛋白功能障碍的成年人，这些患者来自一家专门的CF中心。获得股直肌横截面积(RF-CSA)和股四头肌层厚度的超声图像，以及股直肌回声度(RF-ECHO)的超声图像(肌肉质量)。采用有目的的选择技术建立了多变量线性回归模型。结果:CFTR蛋白功能严重的患者RF-CSA大3.22 cm2, 95% CI (1.03, 5.41) cm2, p=。[00:49]，在调整口服皮质类固醇使用和铜绿假单胞菌定植后。然而，敏感性分析表明，结果受到模型中调整的特定混杂因素的影响。我们没有发现两组之间股四头肌层厚度或RF-ECHO有任何显著差异。结论:在我们的研究队列中，我们没有发现CFTR蛋白活性降低程度对股四头肌大小或质量的差异影响。基于这些发现，CFTR突变状态不能用于区分CF患者的腿部肌肉大小或质量。
{"title":"Comparison of quadriceps muscle size and quality in adults with cystic fibrosis with different severities of cystic fibrosis transmembrane conductance regulator protein dysfunction.","authors":"Kenneth Wu, Anna Michalski, Jenna Sykes, Jane Batt, Anne L Stephenson, Sunita Mathur","doi":"10.1177/14799731221131330","DOIUrl":"https://doi.org/10.1177/14799731221131330","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) is characterized by CF transmembrane conductance regulator (CFTR) dysfunction. CFTR protein is expressed in human skeletal muscle; however, its impact on skeletal muscle is unknown. The objectives of this study were to compare quadriceps muscle size and quality between adults with various severities of CFTR protein dysfunction.</p><p><strong>Methods: </strong>We conducted a prospective, cross-sectional study comparing 34 adults with severe versus 18 with mild CFTR protein dysfunction, recruited from a specialized CF centre. Ultrasound images of rectus femoris cross-sectional area (RF-CSA) and quadriceps layer thickness for muscle size, and rectus femoris echogenicity (RF-ECHO) (muscle quality) were obtained. Multivariable linear regression models were developed using purposeful selection technique.</p><p><strong>Results: </strong>People with severe CFTR protein dysfunction had larger RF-CSA by 3.22 cm<sup>2</sup>, 95% CI (1.03, 5.41) cm<sup>2</sup>, <i>p</i>=.0049], after adjusting for oral corticosteroid use and <i>Pseudomonas aeruginosa</i> colonization. However, a sensitivity analysis indicated that the result was influenced by the specific confounders being adjusted for in the model. We did not find any significant differences in quadriceps layer thickness or RF-ECHO between the two groups.</p><p><strong>Conclusion: </strong>We found no differential impact of the extent of diminished CFTR protein activity on quadriceps muscle size or quality in our study cohort. Based on these findings, CFTR mutation status cannot be used differentiate leg muscle size or quality in people with CF.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"19 ","pages":"14799731221131330"},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9669672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10417944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731221116588
Emily Hume, Hazel Muse, Kirstie Wallace, Mick Wilkinson, Karen Heslop Marshall, Arun Nair, Stephen Clark, Ioannis Vogiatzis
Background: Despite improvements in pulmonary function following lung transplantation (LTx), physical activity levels remain significantly lower than the general population. To date, there is little research investigating interventions to improve daily physical activity in LTx recipients. This study assessed the feasibility and acceptability of a novel, 12-weeks physical activity tele-coaching (TC) intervention in LTx recipients.
Methods: Lung transplant recipients within 2 months of hospital discharge were recruited and randomised (1:1) to TC or usual care (UC). TC consists of a pedometer and smartphone app, allowing transmission of activity data to a platform that provides feedback, activity goals, education, and contact with the researcher as required. Recruitment and retention, occurrence of adverse events, intervention acceptability and usage were used to assess feasibility.
Results: Key criteria for progressing to a larger study were met. Of the 15 patients eligible, 14 were recruited and randomised to TC or UC and 12 completed (67% male; mean ± SD age; 58 ± 7 years; COPD n = 4, ILD n = 6, CF n = 1, PH n = 1): TC (n = 7) and UC (n = 5). TC was well accepted by patients, with 86% indicating that they enjoyed taking part. Usage of the pedometer was excellent, with all patients wearing it for over 90% of days and rating the pedometer and telephone contact as the most vital aspects. There were no adverse events related to the intervention. After 12 weeks, only TC displayed improvements in accelerometry steps/day (by 3475 ± 3422; p = .036) and movement intensity (by 153 ± 166 VMU; p = .019), whereas both TC and UC groups exhibited clinically important changes in physical SF-36 scores (by 11 ± 14 and 7 ± 9 points, respectively).
Conclusion: TC appears to be a feasible, safe, and well-accepted intervention in LTx.
背景:尽管肺移植(LTx)后肺功能有所改善，但体力活动水平仍明显低于普通人群。迄今为止，很少有研究调查干预措施，以改善LTx接受者的日常身体活动。本研究评估了一种新颖的、为期12周的远程体育活动指导(TC)干预LTx接受者的可行性和可接受性。方法:招募出院2个月内的肺移植受者，按1:1的比例随机分为TC组或常规护理组(UC)。TC由计步器和智能手机应用程序组成，可以将活动数据传输到平台，平台可以根据需要提供反馈、活动目标、教育和与研究人员的联系。采用招募和保留、不良事件的发生、干预措施的可接受性和使用情况来评估可行性。结果:符合进行更大规模研究的关键标准。在符合条件的15例患者中，14例被招募并随机分配到TC或UC, 12例完成(67%男性;平均±SD年龄;58±7岁;COPD n = 4, ILD n = 6, CF n = 1, PH n = 1): TC (n = 7)和UC (n = 5)。TC被患者很好地接受，86%的患者表示喜欢参加。计步器的使用情况非常好，所有患者都戴着它超过90%的天，并将计步器和电话联系评为最重要的方面。没有与干预相关的不良事件。12周后，只有TC显示加速度计步数/天的改善(增加3475±3422;p = 0.036)和运动强度(153±166 VMU;p = 0.019)，而TC组和UC组在SF-36物理评分方面均表现出临床重要的变化(分别为11±14分和7±9分)。结论:TC似乎是一种可行、安全且被广泛接受的LTx干预措施。
{"title":"Feasibility and acceptability of a physical activity behavioural modification tele-coaching intervention in lung transplant recipients.","authors":"Emily Hume, Hazel Muse, Kirstie Wallace, Mick Wilkinson, Karen Heslop Marshall, Arun Nair, Stephen Clark, Ioannis Vogiatzis","doi":"10.1177/14799731221116588","DOIUrl":"https://doi.org/10.1177/14799731221116588","url":null,"abstract":"<p><strong>Background: </strong>Despite improvements in pulmonary function following lung transplantation (LTx), physical activity levels remain significantly lower than the general population. To date, there is little research investigating interventions to improve daily physical activity in LTx recipients. This study assessed the feasibility and acceptability of a novel, 12-weeks physical activity tele-coaching (TC) intervention in LTx recipients.</p><p><strong>Methods: </strong>Lung transplant recipients within 2 months of hospital discharge were recruited and randomised (1:1) to TC or usual care (UC). TC consists of a pedometer and smartphone app, allowing transmission of activity data to a platform that provides feedback, activity goals, education, and contact with the researcher as required. Recruitment and retention, occurrence of adverse events, intervention acceptability and usage were used to assess feasibility.</p><p><strong>Results: </strong>Key criteria for progressing to a larger study were met. Of the 15 patients eligible, 14 were recruited and randomised to TC or UC and 12 completed (67% male; mean ± SD age; 58 ± 7 years; COPD <i>n</i> = 4, ILD <i>n</i> = 6, CF <i>n</i> = 1, PH <i>n</i> = 1): TC (<i>n</i> = 7) and UC (<i>n</i> = 5). TC was well accepted by patients, with 86% indicating that they enjoyed taking part. Usage of the pedometer was excellent, with all patients wearing it for over 90% of days and rating the pedometer and telephone contact as the most vital aspects. There were no adverse events related to the intervention. After 12 weeks, only TC displayed improvements in accelerometry steps/day (by 3475 ± 3422; <i>p</i> = .036) and movement intensity (by 153 ± 166 VMU; <i>p</i> = .019), whereas both TC and UC groups exhibited clinically important changes in physical SF-36 scores (by 11 ± 14 and 7 ± 9 points, respectively).</p><p><strong>Conclusion: </strong>TC appears to be a feasible, safe, and well-accepted intervention in LTx.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"19 ","pages":"14799731221116588"},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9619269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10778547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731221103274
L. Walsh, D. Murphy
Dear Editor, We would like to thank Dr Fiorentino and his colleagues for their interest in our publication and for the opportunity to clarify the issues which they have highlighted. Our study was a retrospective cohort analysis of motor neuron disease (MND) patients attending a service in the South of Ireland. The focus of the study was to determine whether or not we could establish a relationship between patient survival and non-invasive ventilation (NIV) usage in this cohort. We acknowledge that due to its observational and retrospective nature direct causation is more difficult to establish and certainly we agree that there may be a variety of factors contributing to the outcome observed. Despite these limitations we believe that the results and observations of this study are nevertheless valid. The preferred approach to NIV set-up in our institution is to set patients up and establish compliance where possible as early as possible. Hence, the majority of patients underwent elective set up either at home or as an inpatient rather than during an acute deterioration. The analysis of acute hospital admissions and how this may have affected respiratory functioning was beyond the scope of this study as was an evaluation of why patients may not have been compliant. The aetiology of non-compliance is multifactorial, and given the nature of this study, the vast majority of data was collected retrospectively. Unfortunately, given the natural history of MND, at the time of data analysis the majority of our patient cohort were not alive and so even prospective collection of this data would not have been feasible. In our institute we do not routinely perform Arterial Blood Gas (ABG) sampling once NIV usage has been established. Patients undergo assessment to commence NIV, only after the diagnosis of MND has been clearly established. Patients are usually admitted and undergo clinical assessment, ABG, overnight pulse oximetry and pulmonary function testing. It is known that the majority of patients with MND have evidence of respiratory muscle dysfunction at the time of diagnosis. As Dr Fiorentino and colleagues stated there is now a known benefit to early commencement of NIV. Therefore, if patients were willing to attend, they were commenced on NIV as early post diagnosis as possible, usually using a full mask interface. Titration of NIV settings wasn’t recorded during this study. We do comment on the measurement of pulmonary function testing with disease progression, but we note in our limitations section that this data set was incomplete and only available for 78 patients. We used the observation that if a patient was compliant at 3 months, they would remain compliant in order to simply the fact that we had low numbers in groups. We acknowledge again that compliance is variable and can vary over hours, days, and weeks. Indeed, we also mention that compliance data was not always available or if it was may not have been regularly recorded which reduced avai
{"title":"The benefit of non-invasive ventilation in motor neuron disease. Response to letter CRD-22-0013","authors":"L. Walsh, D. Murphy","doi":"10.1177/14799731221103274","DOIUrl":"https://doi.org/10.1177/14799731221103274","url":null,"abstract":"Dear Editor, We would like to thank Dr Fiorentino and his colleagues for their interest in our publication and for the opportunity to clarify the issues which they have highlighted. Our study was a retrospective cohort analysis of motor neuron disease (MND) patients attending a service in the South of Ireland. The focus of the study was to determine whether or not we could establish a relationship between patient survival and non-invasive ventilation (NIV) usage in this cohort. We acknowledge that due to its observational and retrospective nature direct causation is more difficult to establish and certainly we agree that there may be a variety of factors contributing to the outcome observed. Despite these limitations we believe that the results and observations of this study are nevertheless valid. The preferred approach to NIV set-up in our institution is to set patients up and establish compliance where possible as early as possible. Hence, the majority of patients underwent elective set up either at home or as an inpatient rather than during an acute deterioration. The analysis of acute hospital admissions and how this may have affected respiratory functioning was beyond the scope of this study as was an evaluation of why patients may not have been compliant. The aetiology of non-compliance is multifactorial, and given the nature of this study, the vast majority of data was collected retrospectively. Unfortunately, given the natural history of MND, at the time of data analysis the majority of our patient cohort were not alive and so even prospective collection of this data would not have been feasible. In our institute we do not routinely perform Arterial Blood Gas (ABG) sampling once NIV usage has been established. Patients undergo assessment to commence NIV, only after the diagnosis of MND has been clearly established. Patients are usually admitted and undergo clinical assessment, ABG, overnight pulse oximetry and pulmonary function testing. It is known that the majority of patients with MND have evidence of respiratory muscle dysfunction at the time of diagnosis. As Dr Fiorentino and colleagues stated there is now a known benefit to early commencement of NIV. Therefore, if patients were willing to attend, they were commenced on NIV as early post diagnosis as possible, usually using a full mask interface. Titration of NIV settings wasn’t recorded during this study. We do comment on the measurement of pulmonary function testing with disease progression, but we note in our limitations section that this data set was incomplete and only available for 78 patients. We used the observation that if a patient was compliant at 3 months, they would remain compliant in order to simply the fact that we had low numbers in groups. We acknowledge again that compliance is variable and can vary over hours, days, and weeks. Indeed, we also mention that compliance data was not always available or if it was may not have been regularly recorded which reduced avai","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46260138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/14799731211052301
H. Martynowicz, Tomasz Wieczorek, Piotr Macek, A. Wojakowska, R. Poręba, P. Gać, G. Mazur, R. Skomro, Joanna Smardz, M. Więckiewicz
We aimed to evaluate and compare the effects of continuous positive airway pressure (CPAP) and mandibular advancement device (MAD) in reducing the intensity of sleep bruxism (SB) in patients with obstructive sleep apnea (OSA). Forty-eight adults with OSA were subjected to single-night full polysomnography (PSG) in the Sleep Laboratory of the Wroclaw Medical University. The respiratory events and bruxism episodes were scored according to the standards of the American Academy of Sleep Medicine. The patients were assigned to the CPAP treatment or the MAD treatment in accordance to apnea–hypopnea index (AHI). The second PSG examination was conducted during the MAD or CPAP treatment to assess the effect of treatment on bruxism episode index (BEI) and AHI. The mean AHI and mean BEI in the study material were estimated to be 30.05 ± 15.39 and 5.10 ± 5.31, respectively. The bruxism parameters were significantly decreased in both the CPAP and MAD groups. Compared to the MAD, the CPAP treatment was more effective in reducing AHI; however, there was no significant difference in effectiveness of CPAP and MAD treatment in BEI reduction. Both CPAP and MAD treatments were effective against SB coexisting with OSA. Due to the application of these treatment options, the risk of OSA should be estimated in patients with SB.
{"title":"The effect of continuous positive airway pressure and mandibular advancement device on sleep bruxism intensity in obstructive sleep apnea patients","authors":"H. Martynowicz, Tomasz Wieczorek, Piotr Macek, A. Wojakowska, R. Poręba, P. Gać, G. Mazur, R. Skomro, Joanna Smardz, M. Więckiewicz","doi":"10.1177/14799731211052301","DOIUrl":"https://doi.org/10.1177/14799731211052301","url":null,"abstract":"We aimed to evaluate and compare the effects of continuous positive airway pressure (CPAP) and mandibular advancement device (MAD) in reducing the intensity of sleep bruxism (SB) in patients with obstructive sleep apnea (OSA). Forty-eight adults with OSA were subjected to single-night full polysomnography (PSG) in the Sleep Laboratory of the Wroclaw Medical University. The respiratory events and bruxism episodes were scored according to the standards of the American Academy of Sleep Medicine. The patients were assigned to the CPAP treatment or the MAD treatment in accordance to apnea–hypopnea index (AHI). The second PSG examination was conducted during the MAD or CPAP treatment to assess the effect of treatment on bruxism episode index (BEI) and AHI. The mean AHI and mean BEI in the study material were estimated to be 30.05 ± 15.39 and 5.10 ± 5.31, respectively. The bruxism parameters were significantly decreased in both the CPAP and MAD groups. Compared to the MAD, the CPAP treatment was more effective in reducing AHI; however, there was no significant difference in effectiveness of CPAP and MAD treatment in BEI reduction. Both CPAP and MAD treatments were effective against SB coexisting with OSA. Due to the application of these treatment options, the risk of OSA should be estimated in patients with SB.","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45791733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：