Pub Date : 2022-06-03DOI: 10.2174/1573398x18666220603160215
Ahmad Mahdi Ahmad
Pulmonary rehabilitation is a multidisciplinary intervention recommended by international guidelines in the management of COVID-19 patients and/or post-COVID-19 conditions with mid- and long-term complications of the initial illness. Physiotherapy-based pulmonary rehabilitation has been receiving considerable attention since the COVID-19 pandemic, with supervised exercise training being probably the most important component. Current guidelines clearly encourage low- to moderate-intensity exercises to begin with for COVID-19 recovered patients, and discourage high-intensity/vigorous exercises. However, the ongoing interests in high-intensity interval training (HIIT) have extended to post-COVID-19 rehabilitation, based on its efficacy and safety in other patient populations. In this perspective, several reasons behind the possibility of the inappropriateness of the HIIT in post-COVID-19 conditions will be discussed, supported by evidence. In addition, the key points for safe exercise after COVID-19 illness will be listed.
{"title":"Why could High-intensity Interval Training be Inappropriate in Pulmonary Rehabilitation of COVID-19 Recovered Patients? Opinion Article","authors":"Ahmad Mahdi Ahmad","doi":"10.2174/1573398x18666220603160215","DOIUrl":"https://doi.org/10.2174/1573398x18666220603160215","url":null,"abstract":"\u0000\u0000Pulmonary rehabilitation is a multidisciplinary intervention recommended by international guidelines in the management of COVID-19 patients and/or post-COVID-19 conditions with mid- and long-term complications of the initial illness. Physiotherapy-based pulmonary rehabilitation has been receiving considerable attention since the COVID-19 pandemic, with supervised exercise training being probably the most important component. Current guidelines clearly encourage low- to moderate-intensity exercises to begin with for COVID-19 recovered patients, and discourage high-intensity/vigorous exercises. However, the ongoing interests in high-intensity interval training (HIIT) have extended to post-COVID-19 rehabilitation, based on its efficacy and safety in other patient populations. In this perspective, several reasons behind the possibility of the inappropriateness of the HIIT in post-COVID-19 conditions will be discussed, supported by evidence. In addition, the key points for safe exercise after COVID-19 illness will be listed.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47010704","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}
Pub Date : 2022-06-03DOI: 10.2174/1573398x18666220603160837
J. Betancourt-Peña, J. Rodríguez-Castro, Hamilton Rosero-Carvajal
Heart rate recovery (HRR) delay is a marker of cardiac autonomic dysfunction. In people with chronic obstructive pulmonary disease (COPD) attending pulmonary rehabilitation programs, assessing HRR could have prognostic utility, yielding valuable information for setting treatment goals and targets in therapeutic interventions. Therefore, this study aimed to establish the sociodemographic, pulmonary function, and functional aerobic capacity differences in people with COPD with normal and abnormal HRR during the 6-minute walk test (6MWT) and explore factors associated with abnormal HRR. Analytical cross-sectional study. Sociodemographic, anthropometric characteristics, pulmonary function, aerobic capacity, BODE index, and Hospital Anxiety and Depression Scale (HADS) were assessed in COPD patients. An HRR cut-off point of 14 beats or more was used to define HRR delay. Of 128 patients included, 89 (69.5%) showed abnormal HRR. Patients with abnormal HRR were classified with higher overweight/obesity, lower resting SpO2 and lower distance walked, predicted percentage, and estimated VO2 in the 6MWT, with more significant symptoms at one minute after the end of the test (dyspnea and fatigue). In the multivariate regression model adjusted for age, sex, resting heart rate, and FEV1, findings showed that distance walked in the 6MWT (OR 0.994, p-value=0.010), fatigue at 1 minute (OR 2.12, p-value=0.000), and HADS depression domain (OR 0.87, p-value=0.018) are factors associated with HRR. In outpatients with COPD, HRR relates to the distance walked in the 6MWT, fatigue, and depression measured with the HADS.
{"title":"Factors Associated With Heart Rate Recovery In People With Chronic Obstructive Pulmonary Disease. Analytical Cross-Sectional Study","authors":"J. Betancourt-Peña, J. Rodríguez-Castro, Hamilton Rosero-Carvajal","doi":"10.2174/1573398x18666220603160837","DOIUrl":"https://doi.org/10.2174/1573398x18666220603160837","url":null,"abstract":"\u0000\u0000Heart rate recovery (HRR) delay is a marker of cardiac autonomic dysfunction. In people with chronic obstructive pulmonary disease (COPD) attending pulmonary rehabilitation programs, assessing HRR could have prognostic utility, yielding valuable information for setting treatment goals and targets in therapeutic interventions. Therefore, this study aimed to establish the sociodemographic, pulmonary function, and functional aerobic capacity differences in people with COPD with normal and abnormal HRR during the 6-minute walk test (6MWT) and explore factors associated with abnormal HRR.\u0000\u0000\u0000\u0000Analytical cross-sectional study. Sociodemographic, anthropometric characteristics, pulmonary function, aerobic capacity, BODE index, and Hospital Anxiety and Depression Scale (HADS) were assessed in COPD patients. An HRR cut-off point of 14 beats or more was used to define HRR delay.\u0000\u0000\u0000\u0000Of 128 patients included, 89 (69.5%) showed abnormal HRR. Patients with abnormal HRR were classified with higher overweight/obesity, lower resting SpO2 and lower distance walked, predicted percentage, and estimated VO2 in the 6MWT, with more significant symptoms at one minute after the end of the test (dyspnea and fatigue). In the multivariate regression model adjusted for age, sex, resting heart rate, and FEV1, findings showed that distance walked in the 6MWT (OR 0.994, p-value=0.010), fatigue at 1 minute (OR 2.12, p-value=0.000), and HADS depression domain (OR 0.87, p-value=0.018) are factors associated with HRR.\u0000\u0000\u0000\u0000In outpatients with COPD, HRR relates to the distance walked in the 6MWT, fatigue, and depression measured with the HADS.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43485938","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}
Pub Date : 2022-05-26DOI: 10.2174/1573398x18666220526163255
N. Hashim, M. A. Ibrahim, F. Ahmedy, K. Ibrahim, W. Zohdi, Nor Faridah Ahmad Roslan
Exercise training is paramount in improving aerobic capacity, improving lung function, reducing the symptoms of dyspnea, and reconditioning the wasted skeletal muscles. Many literature and guidelines have advocated the importance of exercise intervention in addressing the secondary impairment to post covid-19 infection, including home-based therapy and telerehabilitation. Pulmonary hypertension (PH) was previously thought to be contraindicated for exercise training; however, exercise was later found to be beneficial and relatively safe in chronic PH. However, there is a lack of high-quality evidence on the safety and effectiveness of exercise training in post-Covid-19 infected individuals with PH. Pulmonary hypertension has been documented to be one of the post-Covid-19 complications. PH occurred due to Covid-19 infection should be given careful consideration before subjecting them to exercise training, especially in home-based therapy. This article aims to discuss the differing etiological factor, pathophysiological backgrounds, and the possible disease long-term outcomes that may compromise the safety of exercise training in post-Covid-19 patients complicated with PH. By understanding the risk of developing PH, risk assessment and stratification can be explicitly outlined for a safe exercise prescription through proper patient selections. Any possible complications can be anticipated; hence, proper preventive strategies can be instituted.
{"title":"Post-Covid -19 Pulmonary Hypertension: How it may physiologically affect exercise training","authors":"N. Hashim, M. A. Ibrahim, F. Ahmedy, K. Ibrahim, W. Zohdi, Nor Faridah Ahmad Roslan","doi":"10.2174/1573398x18666220526163255","DOIUrl":"https://doi.org/10.2174/1573398x18666220526163255","url":null,"abstract":"\u0000\u0000Exercise training is paramount in improving aerobic capacity, improving lung function, reducing the symptoms of dyspnea, and reconditioning the wasted skeletal muscles. Many literature and guidelines have advocated the importance of exercise intervention in addressing the secondary impairment to post covid-19 infection, including home-based therapy and telerehabilitation. Pulmonary hypertension (PH) was previously thought to be contraindicated for exercise training; however, exercise was later found to be beneficial and relatively safe in chronic PH. However, there is a lack of high-quality evidence on the safety and effectiveness of exercise training in post-Covid-19 infected individuals with PH. Pulmonary hypertension has been documented to be one of the post-Covid-19 complications. PH occurred due to Covid-19 infection should be given careful consideration before subjecting them to exercise training, especially in home-based therapy. This article aims to discuss the differing etiological factor, pathophysiological backgrounds, and the possible disease long-term outcomes that may compromise the safety of exercise training in post-Covid-19 patients complicated with PH. By understanding the risk of developing PH, risk assessment and stratification can be explicitly outlined for a safe exercise prescription through proper patient selections. Any possible complications can be anticipated; hence, proper preventive strategies can be instituted.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43285850","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}
Pub Date : 2022-05-26DOI: 10.2174/1573398x18666220526164329
R. Garg, Mona Piplani, Y. Singh, Yogesh Joshi
Asthma, a common respiratory disorder with frequent blowout following a characteristic spread pattern is vibrant in India. Respiratory disorders are the leading cause of death worldwide. `1 In India, asthma is more prominent especially in Delhi and Uttar Pradesh of the North India region. In this review, our main focus is to study the drug therapy for the asthma and its complications. The present paper illustrates the epidemiology, etiology, pathophysiology, mechanism of airway inflammation, classification, and diagnosis of asthma. We have also compiled the data of asthma in Northern India, state-wise for the last five years. Diagnosis and management of asthma are also described as per the guidelines of various agencies, i.e., NICE/BTS/SIGN and WHO.
{"title":"Epidemiology, Pathophysiology, and Pharmacological Status of Asthma","authors":"R. Garg, Mona Piplani, Y. Singh, Yogesh Joshi","doi":"10.2174/1573398x18666220526164329","DOIUrl":"https://doi.org/10.2174/1573398x18666220526164329","url":null,"abstract":"\u0000\u0000Asthma, a common respiratory disorder with frequent blowout following a characteristic spread pattern is vibrant in India. Respiratory disorders are the leading cause of death worldwide. `1 In India, asthma is more prominent especially in Delhi and Uttar Pradesh of the North India region. In this review, our main focus is to study the drug therapy for the asthma and its complications. The present paper illustrates the epidemiology, etiology, pathophysiology, mechanism of airway inflammation, classification, and diagnosis of asthma. We have also compiled the data of asthma in Northern India, state-wise for the last five years. Diagnosis and management of asthma are also described as per the guidelines of various agencies, i.e., NICE/BTS/SIGN and WHO.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48370561","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}
Pub Date : 2022-05-18DOI: 10.2174/1573398x18666220518144330
Diana Quintero Medina, V. Benavides-Córdoba, Esther Cecilia Wilches Luna
Electrical Impedance Tomography (EIT) has emerged as a non-invasive, radiation-free imaging modality that allows monitoring at the patient's bedside, providing real-time information on the regional distribution of pulmonary ventilation. Although there has been increasing research on EIT in Intensive Care Units (ICUs), few studies use this tool in spontaneously breathing patients. The objective is to provide a synthesis of current evidence regarding the outpatient use of EIT in patients with chronic obstructive pulmonary disease (COPD). A scoping review was developed, extensive research was conducted in seven health-based databases, Scopus, Medline, OVID, Scielo, PEDro, EBSCO, and VHL search portal. This scoping review used the checklist recommended by PRISMA. To assess the quality of the studies, the BEME protocol of "questions to ask about the evidence of an investigation or evaluation" was used. In this scoping review, 7 studies related to the outpatient use of EIT in COPD patients were identified, published between 2009 and 2019. The evidence reviewed allowed to identify that the largest use is related to the evaluation of the distribution of ventilation, the evaluation of regional respiratory mechanics, and the degree of pre-and post-bronchodilator obstruction. EIT is used on an outpatient basis in patients with COPD, as an evaluation tool that complements the information of the clinical results of pulmonary function tests, improving the monitoring of the course of the disease in real-time, non-invasively and without ionizing radiation.
{"title":"Outpatient use of electrical impedance tomography in patients with chronic obstructive pulmonary disease. Scoping review","authors":"Diana Quintero Medina, V. Benavides-Córdoba, Esther Cecilia Wilches Luna","doi":"10.2174/1573398x18666220518144330","DOIUrl":"https://doi.org/10.2174/1573398x18666220518144330","url":null,"abstract":"\u0000\u0000Electrical Impedance Tomography (EIT) has emerged as a non-invasive, radiation-free imaging modality that allows monitoring at the patient's bedside, providing real-time information on the regional distribution of pulmonary ventilation. Although there has been increasing research on EIT in Intensive Care Units (ICUs), few studies use this tool in spontaneously breathing patients. The objective is to provide a synthesis of current evidence regarding the outpatient use of EIT in patients with chronic obstructive pulmonary disease (COPD).\u0000\u0000\u0000\u0000A scoping review was developed, extensive research was conducted in seven health-based databases, Scopus, Medline, OVID, Scielo, PEDro, EBSCO, and VHL search portal. This scoping review used the checklist recommended by PRISMA. To assess the quality of the studies, the BEME protocol of \"questions to ask about the evidence of an investigation or evaluation\" was used.\u0000\u0000\u0000\u0000In this scoping review, 7 studies related to the outpatient use of EIT in COPD patients were identified, published between 2009 and 2019. The evidence reviewed allowed to identify that the largest use is related to the evaluation of the distribution of ventilation, the evaluation of regional respiratory mechanics, and the degree of pre-and post-bronchodilator obstruction.\u0000\u0000\u0000\u0000EIT is used on an outpatient basis in patients with COPD, as an evaluation tool that complements the information of the clinical results of pulmonary function tests, improving the monitoring of the course of the disease in real-time, non-invasively and without ionizing radiation.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42825022","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}
Pub Date : 2022-05-09DOI: 10.2174/1573398x18666220509153713
Salieva Rana Sherbaevna, Mamasaidov Abdumitalib Tashalievich, Azhimamatova Rakhima Momunovna, S. Alrefaee, Musaeva Begaiym Sovetbekovna, Mamatova Sabirakhan Mirzaevna, Mohd Faizan Siddiqui
Airway involvement results from long-standing rheumatoid arthritis leading to a severe pulmonary complication, correlated with increased mortality and socioeconomic costs. Different types of pulmonary lesions, including pulmonary rheumatoid nodule, pulmonary arteritis, diffuse interstitial fibrosis, and rheumatoid pneumoconiosis or Caplan's syndrome, are believed to be related to rheumatoid arthritis (R.A.). The above changes may indicate the increased susceptibility to the infection, toxins from a disease, or chronic immunity activation. The symptoms vary from asymptomatic to severe life-treating conditions, and the prognosis varies depending on the genre and severity of involvement. Our study aims to assess the prevalence and characteristics of airways association in rheumatoid arthritis as these data provide a brief insight into early diagnosis and treatment, which could be applied to minimize complications of airways diseases in rheumatoid arthritis.
{"title":"The spectrum of airway disease associated with rheumatoid arthritis","authors":"Salieva Rana Sherbaevna, Mamasaidov Abdumitalib Tashalievich, Azhimamatova Rakhima Momunovna, S. Alrefaee, Musaeva Begaiym Sovetbekovna, Mamatova Sabirakhan Mirzaevna, Mohd Faizan Siddiqui","doi":"10.2174/1573398x18666220509153713","DOIUrl":"https://doi.org/10.2174/1573398x18666220509153713","url":null,"abstract":"\u0000\u0000Airway involvement results from long-standing rheumatoid arthritis leading to a severe pulmonary complication, correlated with increased mortality and socioeconomic costs. Different types of pulmonary lesions, including pulmonary rheumatoid nodule, pulmonary arteritis, diffuse interstitial fibrosis, and rheumatoid pneumoconiosis or Caplan's syndrome, are believed to be related to rheumatoid arthritis (R.A.). The above changes may indicate the increased susceptibility to the infection, toxins from a disease, or chronic immunity activation. The symptoms vary from asymptomatic to severe life-treating conditions, and the prognosis varies depending on the genre and severity of involvement. Our study aims to assess the prevalence and characteristics of airways association in rheumatoid arthritis as these data provide a brief insight into early diagnosis and treatment, which could be applied to minimize complications of airways diseases in rheumatoid arthritis.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47447049","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}
Pub Date : 2022-05-09DOI: 10.2174/1573398x18666220509154612
P. Saberian, Behshad Pazooki, Zahra Shajari, Parisa Hasani-Sharamin, Mahnaz Jamshididana, S. Karimi, Alireza Baratloo
The present study aimed to assess the prevalence of persistent/late complications after recovery from the acute phase of COVID-19 in emergency medical technicians (EMTs). This is a cross-sectional case-series study performed during the last quarter of 2020 in Tehran, Iran. All EMTs who had been diagnosed with COVID-19 were eligible. The researcher contacted the EMTs via telephone to determine any complications following their recovery. Those who suffered from any complication were referred to an internal specialist physician for a detailed history and physical examination. Based on the physician’s opinion, some paraclinical or clinical evaluations were requested to be performed. Four hundred thirty-one confirmed cases and two deaths due to this disease were registered among the Tehran EMS center’s EMTs during the study period. Two hundred thirty-eight EMTs were contacted, and 22.7% of them had at least one persistent/late complication following recovery of the acute phase of COVID-19; of whom, 28 EMTs were visited by an internist and completed the tests. The final participants mentioned seventy-five persistent/late complications. Only one EMT had a residual lesion among those who underwent lung CT scans. There were also some pathological findings in the echocardiographic examination and spirometry. Our study showed that persistent/late-onset complications could likely accompany by COVID-19.
{"title":"Persistent/late complications of COVID-19 in affected emergency medical technicians; a case series and brief literature review","authors":"P. Saberian, Behshad Pazooki, Zahra Shajari, Parisa Hasani-Sharamin, Mahnaz Jamshididana, S. Karimi, Alireza Baratloo","doi":"10.2174/1573398x18666220509154612","DOIUrl":"https://doi.org/10.2174/1573398x18666220509154612","url":null,"abstract":"\u0000\u0000The present study aimed to assess the prevalence of persistent/late complications after recovery from the acute phase of COVID-19 in emergency medical technicians (EMTs).\u0000\u0000\u0000\u0000This is a cross-sectional case-series study performed during the last quarter of 2020 in Tehran, Iran. All EMTs who had been diagnosed with COVID-19 were eligible. The researcher contacted the EMTs via telephone to determine any complications following their recovery. Those who suffered from any complication were referred to an internal specialist physician for a detailed history and physical examination. Based on the physician’s opinion, some paraclinical or clinical evaluations were requested to be performed.\u0000\u0000\u0000\u0000Four hundred thirty-one confirmed cases and two deaths due to this disease were registered among the Tehran EMS center’s EMTs during the study period. Two hundred thirty-eight EMTs were contacted, and 22.7% of them had at least one persistent/late complication following recovery of the acute phase of COVID-19; of whom, 28 EMTs were visited by an internist and completed the tests. The final participants mentioned seventy-five persistent/late complications. Only one EMT had a residual lesion among those who underwent lung CT scans. There were also some pathological findings in the echocardiographic examination and spirometry.\u0000\u0000\u0000\u0000Our study showed that persistent/late-onset complications could likely accompany by COVID-19.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47827993","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}
Pub Date : 2022-05-03DOI: 10.2174/1573398x18666220503184459
Mukesh Masand, Pramod Kumar Sharma, Vishal M. Balaramnavar, Deepti Mathpal
The World Health Organization (WHO) considers tuberculosis to be the most dangerous chronic communicable disease in the world, infecting two billion people or one-third of the world’s population. Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a leading cause of mortality worldwide into the 21st century. Tuberculosis is second only to AIDS among other infectious diseases in causing deaths worldwide. The emergence of AIDS, multidrug-resistant TB (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB), the decline of socioeconomic standards, and a reduced emphasis on tuberculosis control programmers contribute to the disease’s resurgence in industrialized countries.
{"title":"Tuberculosis: Current Progress in Drug targets, Potential Drugs and Therapeutic Impact","authors":"Mukesh Masand, Pramod Kumar Sharma, Vishal M. Balaramnavar, Deepti Mathpal","doi":"10.2174/1573398x18666220503184459","DOIUrl":"https://doi.org/10.2174/1573398x18666220503184459","url":null,"abstract":"\u0000\u0000The World Health Organization (WHO) considers tuberculosis to be the most dangerous chronic communicable disease in the world, infecting two billion people or one-third of the world’s population. Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a leading cause of mortality worldwide into the 21st century. Tuberculosis is second only to AIDS among other infectious diseases in causing deaths worldwide. The emergence of AIDS, multidrug-resistant TB (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB), the decline of socioeconomic standards, and a reduced emphasis on tuberculosis control programmers contribute to the disease’s resurgence in industrialized countries.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45048529","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}
Pub Date : 2022-05-01DOI: 10.2174/1573398x18666220501124708
A. Parthasarathi, Sachith Srinivas, Jayaraj Biligere Siddaiah, Padukudru Anand Mahesh
Inhaled corticosteroids (ICS) have an essential and established role in the treatment of asthma. Both systemic and local adverse effects may accompany the long-term use of ICS. Systemic adverse drug reactions (ADRs) of ICS are well established. However, there is a paucity of information on local ADRs, especially in the Indian population. To determine the prevalence, severity, predictability, and preventability of local ADRs to ICS and their associated risk factors. Patients with asthma who need ICS were enrolled. Study patients were interviewed with open-ended questions to assess local ADRs to ICS at baseline and each follow-up visit, once a month for three months. Causality (Naranjo’s algorithm and WHO scale), severity (Hartwig SCf scale), predictability (based on the frequency of occurrence of ADR and history of drug exposure), and preventability (Schumock and Thornton criteria) of local ADRs were assessed. Bivariate analysis and subsequently multivariate logistic regression were used to identify the risk factors for local ADRs to ICS. A total of 243 patients (134 female) were included in the study. A total of 74 local ADRs were observed in 59 patients (prevalence 24.3%). The most common local ADRs were feeling of thirst (14.8%) followed by cough during inhalation (8.6%) and taste disturbance (4.5%). All ADRs were predictable and mild in severity. Preventability assessment found 85.1% of local ADRs as ‘probably preventable’. Two out of five patients who had ADR’s reduced or skipped doses because of the discomfort, despite their physician’s recommendation to continue their regular dose of ICS. Age >41 years, use of MDI without spacer, and use of budesonide were identified as the risk factors for developing ADRs to ICS. Local ADRs to ICS were observed in approximately one in four patients with asthma. Two out of five patients who had ADRs reduced or skipped doses because of it. Strategies to prevent local ADRs to ICS should focus on patients aged >41 years, receiving budesonide, using MDI without a spacer, and is dose-dependent. We need to establish standards on the best practices for preventing ADRs, such as identifying the most suited device or ICS that is best tolerated by the individual patient, identifying the least ICS dose that maintains ideal asthma control.
{"title":"Local Adverse Drug Reactions In Ambulatory Asthma Patients Treated With Inhaled Corticosteroids: An Experience From A South Indian Teaching Hospital","authors":"A. Parthasarathi, Sachith Srinivas, Jayaraj Biligere Siddaiah, Padukudru Anand Mahesh","doi":"10.2174/1573398x18666220501124708","DOIUrl":"https://doi.org/10.2174/1573398x18666220501124708","url":null,"abstract":"\u0000\u0000Inhaled corticosteroids (ICS) have an essential and established role in the treatment of asthma. Both systemic and local adverse effects may accompany the long-term use of ICS. Systemic adverse drug reactions (ADRs) of ICS are well established. However, there is a paucity of information on local ADRs, especially in the Indian population.\u0000\u0000\u0000\u0000To determine the prevalence, severity, predictability, and preventability of local ADRs to ICS and their associated risk factors.\u0000\u0000\u0000\u0000Patients with asthma who need ICS were enrolled. Study patients were interviewed with open-ended questions to assess local ADRs to ICS at baseline and each follow-up visit, once a month for three months. Causality (Naranjo’s algorithm and WHO scale), severity (Hartwig SCf scale), predictability (based on the frequency of occurrence of ADR and history of drug exposure), and preventability (Schumock and Thornton criteria) of local ADRs were assessed. Bivariate analysis and subsequently multivariate logistic regression were used to identify the risk factors for local ADRs to ICS.\u0000\u0000\u0000\u0000A total of 243 patients (134 female) were included in the study. A total of 74 local ADRs were observed in 59 patients (prevalence 24.3%). The most common local ADRs were feeling of thirst (14.8%) followed by cough during inhalation (8.6%) and taste disturbance (4.5%). All ADRs were predictable and mild in severity. Preventability assessment found 85.1% of local ADRs as ‘probably preventable’. Two out of five patients who had ADR’s reduced or skipped doses because of the discomfort, despite their physician’s recommendation to continue their regular dose of ICS. Age >41 years, use of MDI without spacer, and use of budesonide were identified as the risk factors for developing ADRs to ICS.\u0000\u0000\u0000\u0000Local ADRs to ICS were observed in approximately one in four patients with asthma. Two out of five patients who had ADRs reduced or skipped doses because of it. Strategies to prevent local ADRs to ICS should focus on patients aged >41 years, receiving budesonide, using MDI without a spacer, and is dose-dependent. We need to establish standards on the best practices for preventing ADRs, such as identifying the most suited device or ICS that is best tolerated by the individual patient, identifying the least ICS dose that maintains ideal asthma control.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46048097","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}
Pub Date : 2022-05-01DOI: 10.2174/1573398x18666220501133152
M. Dwivedi, M. Bhat, Aiswarya R.K.
Tuberculosis is one of the most common and oldest human afflictions caused by the deadly pathogen, Mycobacterium tuberculosis. Its infection drastically increasing worldwide with time despite the application of various antibiotics and live attenuated vaccines. The major risk factor associated with tuberculosis is the long-term malfunction of the respiratory system that increases the deaths whereas the continuous emergence of drug-resistant MTB strains (MDR/TDR/XDR) acts as a driving force to accelerate additional obstacles to humankind. Researchers are effortlessly involved in a systematic examination of tuberculosis and drug designing against it but still, we could not find a permanent cure for tuberculosis. Therefore, it is extremely necessary to analyse pathogenesis, epidemiology and associated risk factors to plan an overall strategy against this deadly disease. In the present study, we have gone through a comprehensive literature survey to provide all related information that may assist us understanding this disease and designing strategic planning. This study would fill the gap created due to lack of knowledge on MTB infection and molecular mechanism which is the biggest hurdle in finding out a therapeutic lead against tuberculosis.
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