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Protocol, rationale and design of the PHOLLOWcross-sectional and retrospective chart reviewstudy to assess the prevalence and characterize thepatient profile, clinical features and disease burdenof type-2 low severe asthma in routine care settingsin Greece 希腊常规护理机构中2型低严重哮喘的患病率、患者概况、临床特征和疾病负担评估的横断面和回顾性图表回顾研究的方案、基本原理和设计
IF 0.7 Q4 Medicine Pub Date : 2022-12-07 DOI: 10.18332/pne/157014
P. Bakakos, E. Fouka, P. Galanakis, K. Katsoulis, K. Kostikas, S. Loukides, N. Mathioudakis, Konstantinos Porpodis, K. Samitas, P. Steiropoulos, E. Zervas
Type 2 (T2)-low severe asthma (SA) presents a distinct subpopulation for which, in lack of a consistent classification system, epidemiological and clinical outcome data remain unclear and therapeutic needs remain largely unmet. The aim of the PHOLLOW real-world study is to assess the prevalence and predictors of T2-low SA, and depict the patient profile, clinical features, treatment patterns and disease burden using clinical and patient-reported outcomes (PROs) in routine settings in Greece. This is a cross-sectional and retrospective chart review 2-part study that will enroll 600 adult outpatients with SA over a 1-year period by 20–30 asthma specialists. A new SA phenotype classification system and two different definitions proposed herein will be used to categorize patients into definite or possible T2-low (unlikely or least likely T2-high) SA, and definite/most likely or possible/likely T2-high SA, based on a composite measure of airway inflammation markers (blood eosinophil counts, fractional exhaled nitric oxide), allergic/atopic status and age-of-onset phenotype, taking into consideration the current receipt of biologic and/or maintenance oral corticosteroid treatment and response to it. Part A will collect top-level data for all participants to assess T2-low SA prevalence and predictors. T2-low SA patients will proceed to part B, where further data and PROs assessing asthma symptom control, quality of life, anxiety, depression, work productivity and activity impairment will be collected.
2型(T2)-低严重哮喘(SA)是一个独特的亚群,由于缺乏一致的分类系统,流行病学和临床结果数据仍不清楚,治疗需求仍未得到满足。PHOLLOW真实世界研究的目的是评估t2 -低SA的患病率和预测因素,并利用希腊常规环境中的临床和患者报告的结果(PROs)描述患者概况、临床特征、治疗模式和疾病负担。这是一项横断面和回顾性图表回顾两部分研究,将由20-30名哮喘专家在1年内招募600名成年SA门诊患者。本文提出了一种新的SA表型分类系统和两种不同的定义,将基于气道炎症标志物(血嗜酸性粒细胞计数、呼气一氧化氮分数)、过敏/特应性状态和发病年龄表型的综合测量,将患者分为明确或可能的t2 -低(不太可能或最不可能的t2 -高)SA和明确/最可能或可能的t2 -高SA。考虑到目前接受生物和/或维持口服皮质类固醇治疗和对它的反应。A部分将收集所有参与者的顶级数据,以评估t2 -低SA患病率和预测因素。t2 -低SA患者将进入B部分,进一步收集评估哮喘症状控制、生活质量、焦虑、抑郁、工作效率和活动障碍的数据和PROs。
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引用次数: 0
Inhalers and the Environment: Pollution, Plastics and Policy 吸入器和环境:污染、塑料和政策
IF 0.7 Q4 Medicine Pub Date : 2022-11-29 DOI: 10.18332/pne/154608
Monbi Chakma, O. Usmani
The effects of the climate crisis have been well established with the first global efforts to address the issue made over 30 years ago. The global healthcare sector is a large contributor to the total greenhouse gas (GHG) emissions, with the recent focus on the respiratory care sector. However, recent directives to address these emissions include ‘blanket unconsented switching’ of stable respiratory patients from pressurized metered dose inhalers (pMDIs) to dry powder inhalers (DPIs), which has the potential to cause a multitude of serious consequences for the patient. This article reviews the broad consequences and provides recommendations to encourage an environmentally friendly patient-centered approach without causing harm to the patient
气候危机的影响在30多年前全球首次努力解决这一问题时就已经得到了充分确认。全球医疗保健部门是温室气体(GHG)排放总量的主要贡献者,最近的重点是呼吸保健部门。然而,最近针对这些排放的指令包括将稳定呼吸系统患者从加压计量吸入器(pmdi)“未经同意地全面切换”到干粉吸入器(dpi),这可能会对患者造成多种严重后果。本文回顾了广泛的后果,并提供了建议,以鼓励一种环境友好的以患者为中心的方法,而不会对患者造成伤害
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引用次数: 0
Outcomes of hospitalized COVID-19 patients belonging to ethnic/racial minorities in Greece 希腊少数民族/种族住院COVID-19患者的结局
IF 0.7 Q4 Medicine Pub Date : 2022-11-04 DOI: 10.18332/pne/154601
Michaella Alexandrou, S. Daskalopoulou, Anna-Louiza Haliassou, E. Kranidioti, E. Margellou, A. Panagopoulos, E. Papageorgiou, Artemis Rodopoulou, G. Stavropoulou, Apostolos G. Pappas, I. Kalomenidis
INTRODUCTION Research suggests that racial minorities are overrepresented in the number of COVID-19 related deaths compared to people of White origin. This is the first study to assess racial differences in the clinical characteristics and outcomes of COVID-19 positive patients, hospitalized in Greece. METHODS This retrospective, cross-sectional study included 628 COVID-19 hospitalized patients, from 10 September to 31 December 2020. We compared data concerning gender, age, comorbidities and outcome, between patients of European and non-European origin. Moreover, we applied logistic regression in which the outcome, in our case in-hospital death, was assessed with race, age, sex, and Charlson Comorbidity Index (CCI) score. RESULTS In the first and unadjusted race-only logistic regression model, non-Europeans (OR=0.057;95% CI: 0.008-0.411, p=0.005) were less likely than European patients to die in the hospital. However, controlling for sex, age and CCI score resulted in non-significant differences. CONCLUSIONS There are a lot of statistically significant differences between European and non-European COVID-19 hospitalized patients regarding their clinical characteristics, with the second presenting a lower hospital mortality rate, but after adjusting for age, sex and CCI score, race seems to be not significant. Copyright © 2022 Alexandrou M. et al.
研究表明,与白人相比,少数民族在COVID-19相关死亡人数中所占比例过高。这是第一项评估在希腊住院的COVID-19阳性患者临床特征和结果的种族差异的研究。方法本回顾性横断面研究纳入了2020年9月10日至12月31日期间住院的628例COVID-19患者。我们比较了欧洲和非欧洲患者的性别、年龄、合并症和预后数据。此外,我们应用逻辑回归,在我们的病例中,用种族、年龄、性别和Charlson合并症指数(CCI)评分来评估结果。结果在第一个未经调整的纯种族logistic回归模型中,非欧洲患者(OR=0.057;95% CI: 0.008-0.411, p=0.005)在医院死亡的可能性低于欧洲患者。然而,在控制性别、年龄和CCI评分后,差异不显著。结论欧洲与非欧洲住院患者的临床特征有很多统计学意义上的差异,其中欧洲住院患者的医院死亡率较低,但在调整年龄、性别和CCI评分后,种族差异似乎不显著。版权所有©2022 Alexandrou M. et al。
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引用次数: 0
Capturing patient-centered outcomes using innovative technologies in adults with severe eosinophilic asthma on benralizumab: Τhe EMPOWAIR real-world study design 使用创新技术在使用benralizumab治疗的成人严重嗜酸性粒细胞哮喘患者中获取以患者为中心的结果:Τhe EMPOWAIR真实世界研究设计
IF 0.7 Q4 Medicine Pub Date : 2022-10-07 DOI: 10.18332/pne/154605
K. Kostikas, P. Bakakos, Petros A. Galanakis, G. Hillas, G. Konstantinou, M. Makris, N. Mathioudakis, Konstantinos Porpodis, N. Rovina, E. Zervas, S. Loukides
Severe eosinophilic asthma (SEA) is associated with poor disease control and compromised health-related quality of life (HRQoL), leading to a substantial psychosocial and economic disease burden. Benralizumab, an interleukin-5-alpha receptor monoclonal antibody, is approved as an add-on maintenance treatment for SEA, yet real-world evidence of its effectiveness is limited. EMPOWAIR is a non-interventional, multicenter, 48-week prospective cohort study aiming to evaluate the clinical effectiveness and the patient-perceived impact of benralizumab on HRQoL, sleep quality, depression, anxiety, work productivity and activity impairment among SEA patients treated in routine care settings in Greece. The study will also engage advanced remote patient monitoring technologies using portable spirometers and wearable activity trackers to collect data on lung function parameters and physical activity. The study plans to consecutively enroll 150 adult patients treated by lung specialists practicing in various healthcare settings across the country over an 18-month recruitment Eligible patients must be newly prescribed benralizumab per the approved label. Primary data will be collected at enrollment and 4, 16, 32, and 48 weeks after initiation through routine clinic or as the standard clinical assess the change from baseline in HRQoL, as measured by the St. George’s Respiratory Questionnaire (SGRQ), and to estimate the proportion of patients achieving a minimum clinically important improvement in respiratory health status, defined as ≥ 4-point reduction from baseline in SGRQ total score, after 16 weeks of benralizumab treatment. The study rationale, design and protocol, are described herein.
严重嗜酸性粒细胞性哮喘(SEA)与疾病控制不良和健康相关生活质量(HRQoL)受损相关,导致严重的社会心理和经济疾病负担。Benralizumab是一种白细胞介素-5- α受体单克隆抗体,已被批准作为SEA的附加维持治疗,但其有效性的实际证据有限。EMPOWAIR是一项非介入性、多中心、为期48周的前瞻性队列研究,旨在评估benralizumab在希腊常规护理机构治疗的SEA患者的HRQoL、睡眠质量、抑郁、焦虑、工作效率和活动障碍方面的临床有效性和患者感知的影响。该研究还将采用先进的远程患者监测技术,使用便携式肺活量计和可穿戴活动追踪器来收集肺功能参数和身体活动数据。该研究计划在18个月的招募期内连续招募150名成年患者,这些患者由全国不同医疗机构的肺病专家治疗,符合条件的患者必须根据批准的标签新开benralizumab。通过常规临床或标准临床评估HRQoL与基线相比的变化(通过圣乔治呼吸问卷(SGRQ)测量)收集入组时和开始后4周、16周、32周和48周的主要数据,并估计在贝纳利珠单抗治疗16周后,呼吸健康状况达到最低临床重要改善的患者比例,定义为SGRQ总分较基线降低≥4分。本文介绍了研究的基本原理、设计和方案。
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引用次数: 1
The role of private primary care pulmonologists network in Greece in the first year of COVID-19 pandemic 在2019冠状病毒病大流行的第一年,希腊私营初级保健肺病学家网络的作用
IF 0.7 Q4 Medicine Pub Date : 2022-09-16 DOI: 10.18332/pne/153021
Stylianos Vittorakis *, Vasiliki Georgakopoulou *, G. Apollonatos, S. Loukides, A. Liapikou
INTRODUCTION The COVID-19 pandemic has overwhelmed the capacities of healthcare systems. Primary care physicians had a pivotal role in reducing the unnecessary access of suspected and confirmed cases to hospitals, and they substantially contributed to the success of vaccination programs. In this study, we aim to determine the role of the Greek private primary care pulmonologists (PPCPs) network during the first year of the pandemic. METHODS An electronic questionnaire consisting of 28 simple questions was administered to PPCPs by e-mail or by sharing a link in private social networking groups. RESULTS A total of 150 PPCPs completed the study. According to their answers, they examined a significant portion of suspected and confirmed COVID-19 cases, and they offered to several patients blood testing and chest radiography. PPCPS maintained close contact with both patients that had faceto-face assessment and patients managed remotely with a great number of telephone contacts. The majority of PPCPs provided information for COVID-19 vaccination by telephone for more than 20 patients weekly. CONCLUSIONS PPCPs offered high quality and specialized support for COVID-19 patients. Besides, they supported the national vaccination program by informing a substantial number of patients.
2019冠状病毒病大流行已使卫生保健系统不堪重负。初级保健医生在减少不必要的疑似病例和确诊病例进入医院方面发挥了关键作用,他们为疫苗接种计划的成功做出了重大贡献。在这项研究中,我们的目标是确定希腊私人初级保健肺科医生(PPCPs)网络在大流行的第一年的作用。方法通过电子邮件或在私人社交网络群中分享链接的方式向PPCPs发放包含28个简单问题的电子问卷。结果共有150名PPCPs完成了研究。根据他们的回答,他们检查了很大一部分疑似和确诊的COVID-19病例,并为几名患者提供了血液检查和胸部x光检查。PPCPS与面对面评估的患者和通过大量电话联系人远程管理的患者保持密切联系。大多数PPCPs每周通过电话为20多名患者提供COVID-19疫苗接种信息。结论PPCPs为COVID-19患者提供了高质量的专业支持。此外,他们通过通知大量患者来支持国家疫苗接种计划。
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引用次数: 0
A life-threatening massive hemoptysis case in the course of dual antiplatelet therapy with ticagrelor 替格瑞洛双重抗血小板治疗过程中危及生命的大咯血病例
IF 0.7 Q4 Medicine Pub Date : 2022-09-15 DOI: 10.18332/pne/152774
Dimitrios Molyvas, M. Kipourou, S. Lampridis, K. Kipourou, P. Koutoukoglou, I. Tsanaktsidis, G. Spyropoulos, K. Katsoulis
A chest computed tomography (chest CT) revealed diffuse ground glass infiltrates in the apical and posterior segments of the right upper lobe and alveolar infiltrates in the remainder of the lungs, findings compatible with diffuse alveolar hemorrhage (images could not be retrieved due to technical reasons). Recent bleeding originating from the right bronchial tree was the finding of ABSTRACT Massive hemoptysis is a life-threatening medical condition which usually occurs in the course of parenchymal destructive diseases. We herein report the case of a 61-year-old male patient who presented with massive hemoptysis six months after commencement of dual antiplatelet therapy with acetylsalicylic acid and ticagrelor, for drug-eluting coronary stents. Control of bleeding with discontinuation of both antiplatelet agents, as well as negative imaging and laboratory studies for other pulmonary hemorrhage causes, indicate that either of the antiplatelet drugs or combination thereof was the cause of the pulmonary hemorrhage. In contrast to the previous limited case reports with pulmonary hemorrhage early during antiplatelet therapy with ticagrelor, this case highlights that it can even occur later in the course of antiplatelet therapy.
胸部计算机断层扫描(胸部CT)显示右上肺叶顶端和后段弥漫性磨玻璃浸润,肺其余部分肺泡浸润,表现符合弥漫性肺泡出血(由于技术原因无法检索图像)。摘要大咯血是一种危及生命的疾病,通常发生在实质破坏性疾病的过程中。我们在此报告一例61岁男性患者,在开始使用乙酰水杨酸和替格瑞洛双重抗血小板治疗药物洗脱冠状动脉支架6个月后出现大量咯血。停用两种抗血小板药物控制出血,以及其他肺出血原因的阴性影像学和实验室检查表明,抗血小板药物中的任何一种或其联合是肺出血的原因。与以往有限的在替格瑞洛抗血小板治疗期间早期出现肺出血的病例报道相反,本病例强调,肺出血甚至可以在抗血小板治疗过程的后期发生。
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引用次数: 1
Investigating the factors affecting hookah smoking during the COVID-19 pandemic: Application of Protection Motivation Theory 新冠肺炎大流行期间水烟吸烟影响因素研究:保护动机理论的应用
IF 0.7 Q4 Medicine Pub Date : 2022-08-04 DOI: 10.18332/pne/147970
S. Bashirian, Hossein Effatpanah, M. Barati, Salman Khazaee, A. Farhadinasab, Mojdeh Shokri, A. Poormohammadi, E. Ezati
INTRODUCTION In recent decades, hookah use has been considered a common method of smoking. Since hookah use is one of the factors exacerbating the coronavirus disease, COVID-19, the present study aimed to determine the factors affecting hookah smoking during the COVID-19 pandemic using protection motivation theory (PMT). METHODS This is a cross-sectional study and conducted on 560 people aged ≥13 years living in Hamedan. Data were collected electronically using a researcher-made questionnaire consisting of three parts. The first, second, and third parts included demographic information, questions about hookah use, and information about the constructs of PMT, respectively. Data were analyzed using SPSS 22 software. RESULTS The mean age of the participants was 28.8 ± 9.6 years. In the regression analysis of perceived reward structures (β=0.378), perception sensitivity (β=0.208), self-efficacy (β=0.0166) were respectively the important predictors for the intention of hookah use behavior. Overall, the constructs of the PMT explain 71% of the variance of the changes in the behavioral intention construct in the participants. No significant relationship was observed between self-efficacy constructs (r=0.039) and perceived cost. The prevalence of hookah use before the COVID-19 pandemic in participants was 41.8%, which decreased to 35% during the COVID-19 pandemic. CONCLUSIONS A greater correlation between the constructs of the PMT concerning protective behaviors against COVID-19 emphasizes designing educational programs based on this theory and the role of media to increase people’s knowledge in preventive behaviors.
近几十年来,水烟被认为是一种常见的吸烟方式。由于水烟使用是加剧冠状病毒病COVID-19的因素之一,本研究旨在利用保护动机理论(PMT)确定COVID-19大流行期间水烟吸烟的影响因素。方法:这是一项横断面研究,对居住在Hamedan的560名年龄≥13岁的人进行了研究。数据以电子方式收集,使用研究人员制作的由三部分组成的问卷。第一部分、第二部分和第三部分分别包括人口统计信息、关于水烟使用的问题和关于PMT结构的信息。数据分析采用SPSS 22软件。结果患者平均年龄28.8±9.6岁。在回归分析中,感知奖励结构(β=0.378)、感知敏感性(β=0.208)和自我效能感(β=0.0166)分别是水烟使用行为意向的重要预测因子。总的来说,PMT的构念解释了参与者行为意向构念变化的71%的方差。自我效能感构念与感知成本无显著相关(r=0.039)。在COVID-19大流行之前,参与者中水烟的使用率为41.8%,在COVID-19大流行期间降至35%。结论PMT的构建与COVID-19防护行为之间存在较大的相关性,强调设计基于该理论的教育方案和媒体的作用,以增加人们对预防行为的知识。
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引用次数: 1
Atypical presentation and progression of scleroderma associated interstitial lung disease 硬皮病相关间质性肺疾病的不典型表现和进展
IF 0.7 Q4 Medicine Pub Date : 2022-08-04 DOI: 10.18332/pne/149901
Mackenzie Skov, S. Anees
A known complication associated with scleroderma or systemic sclerosis (SSc) is the development of interstitial lung disease (ILD). It is occasional that symptoms of connective tissue diseases (CTDs) emerge in patients with ILD that have previously ruled out rheumatologic etiology. Presented here is a unique case of scleroderma associated interstitial lung disease (SSc-ILD) where the diagnosis of scleroderma was made over 5 years after the diagnosis of ILD. A 52-year-old female presented with dyspnea on exertion and chronic cough with a history of ILD dating back 5 years. Initial consultation revealed negative autoimmune serology and no symptoms or signs associated with scleroderma. When new rheumatologic features presented months later, serology was repeated and showed positive antinuclear antibody with nucleolar pattern suggestive of scleroderma. This case shows a potential importance of thoroughly monitoring rheumatologic signs and symptoms with patients already diagnosed with ILD, even with no initial suggestions of CTDs.
与硬皮病或系统性硬化症(SSc)相关的已知并发症是间质性肺疾病(ILD)的发展。结缔组织疾病(CTDs)的症状偶尔出现在以前已排除风湿病病因的ILD患者中。本文报告一个独特的硬皮病相关间质性肺疾病(SSc-ILD)病例,在诊断为ILD后5年多才诊断为硬皮病。52岁女性,以用力呼吸困难和慢性咳嗽为临床表现,有5年的ILD病史。初步咨询显示自身免疫血清学阴性,无硬皮病相关症状或体征。当几个月后出现新的风湿病特征时,重复血清学检查并显示抗核抗体阳性,核仁模式提示硬皮病。本病例显示了彻底监测已诊断为ILD的患者的风湿病体征和症状的潜在重要性,即使最初没有CTDs的迹象。
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引用次数: 1
Surgical approaches in obstructive sleep apnea syndrome: A review of techniques 阻塞性睡眠呼吸暂停综合征的手术入路:技术综述
IF 0.7 Q4 Medicine Pub Date : 2022-07-25 DOI: 10.18332/pne/147971
Agathi Spyropoulou, Vassilis Spiropoulos, Georgia Spiropoulou, Christos Tsilivigos, K. Spiropoulos, N. Mastronikolis
{"title":"Surgical approaches in obstructive sleep apnea syndrome: A review of techniques","authors":"Agathi Spyropoulou, Vassilis Spiropoulos, Georgia Spiropoulou, Christos Tsilivigos, K. Spiropoulos, N. Mastronikolis","doi":"10.18332/pne/147971","DOIUrl":"https://doi.org/10.18332/pne/147971","url":null,"abstract":"","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74231043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Urinothorax: A pleural effusion that might not alwaysbe like urine 尿胸:不像尿液的胸腔积液
IF 0.7 Q4 Medicine Pub Date : 2022-06-08 DOI: 10.18332/pne/148105
K. Psathakis, Theofani Rimpa, Angeliki Kokkini-Paschou, J. Koutsikos
{"title":"Urinothorax: A pleural effusion that might not always\u0000be like urine","authors":"K. Psathakis, Theofani Rimpa, Angeliki Kokkini-Paschou, J. Koutsikos","doi":"10.18332/pne/148105","DOIUrl":"https://doi.org/10.18332/pne/148105","url":null,"abstract":"","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90680194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Pneumon
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