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Nurses' Role in the Control and Treatment of Asthma in Adults: A Systematic Literature Review. 护士在控制和治疗成人哮喘中的作用:系统性文献综述。
IF 1.8 Q3 Medicine Pub Date : 2024-04-25 DOI: 10.3390/arm92030019
Pedro Alexandre-Sousa, Nuno Sousa, Joana Bento, Filipa Azevedo, Maíra Assis, José Mendes

Bronchial asthma is a chronic pathology and a global public health problem. However, asthma can be controlled and treated for the most part by patients, so the Portuguese General Directorate of Health recommends shared medical appointments in primary health care (PHC). The present study aims to identify the role of PHC nurses in the control and treatment of asthma in adults. Using the MeSH platform, the following descriptors were validated: asthma, nurses, adults. An individual search was carried out in the following databases: CINAHL (ESBSCO host), MEDLINE (Pubmed host), Web of Science, and Scopus. Out of a total of 280 publications, 79 of which were duplicates and 185 publications which did not meet the inclusion criteria, 16 publications remained readable. Of the eligible articles, there were 13 specialist reports, one mixed study, one quasi-experimental study, and one randomized trial. Education was the intervention most identified in the scientific evidence analyzed, and patient assessment, application of an asthma control questionnaire, verification and training of inhalation technique, empowerment for self-management of the disease, support, promotion of seasonal influenza vaccination, and use of written action plans were also identified. The results reveal that, although the scientific evidence on the intervention of these professionals is poorly developed, nurses play a crucial role in the control and treatment of asthma. The scientific evidence analyzed allowed the identification of interventions that can help the organization of a nursing health appointment, providing nurses with a crucial role in the control and treatment of asthma in adults in the context of PHC.

支气管哮喘是一种慢性病,也是一个全球性的公共卫生问题。然而,哮喘在很大程度上可以由患者自己控制和治疗,因此葡萄牙卫生总局建议在初级卫生保健(PHC)中实行共同就诊。本研究旨在确定初级卫生保健护士在成人哮喘控制和治疗中的作用。利用 MeSH 平台,对以下描述符进行了验证:哮喘、护士、成人。在以下数据库中进行了单独检索:CINAHL(ESBSCO 主机)、MEDLINE(Pubmed 主机)、Web of Science 和 Scopus。在总共 280 篇出版物(其中 79 篇为重复出版物)和 185 篇不符合纳入标准的出版物中,仍有 16 篇可读。在符合条件的文章中,有 13 篇专家报告、1 篇混合研究、1 篇准实验研究和 1 篇随机试验。教育是科学证据分析中发现最多的干预措施,此外还发现了患者评估、哮喘控制问卷的应用、吸入技术的验证和培训、增强自我管理疾病的能力、支持、季节性流感疫苗接种的推广以及书面行动计划的使用。研究结果表明,尽管有关这些专业人员干预措施的科学证据并不充分,但护士在哮喘的控制和治疗中发挥着至关重要的作用。通过对科学证据的分析,可以确定有助于组织护理健康预约的干预措施,从而使护士在初级保健中控制和治疗成人哮喘方面发挥关键作用。
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引用次数: 0
How to Enhance the Diagnosis of Early Stages of Chronic Obstructive Pulmonary Disease (COPD)? The Role of Mobile Spirometry in COPD Screening and Diagnosis—A Systematic Review 如何加强慢性阻塞性肺病(COPD)早期诊断?移动肺活量计在慢性阻塞性肺病筛查和诊断中的作用--系统综述
IF 1.8 Q3 Medicine Pub Date : 2024-03-27 DOI: 10.3390/arm92020018
Piotr Jankowski, K. Mycroft, K. Górska, P. Korczyński, R. Krenke
COPD is the third leading cause of death worldwide. Its diagnosis can be made with spirometry, which is underused due to its limited accessibility. Portable spirometry holds promise for enhancing the efficacy of COPD diagnoses. The study aimed to estimate COPD prevalence diagnosed with a portable spirometer in high-risk patients and compare it with COPD prevalence based on data from conventional, on-site spirometry. We also evaluated the strategy of a proactive approach to identify COPD in high-risk individuals. We conducted a systematic review of original studies on COPD targeted screening and diagnosis with portable and conventional spirometers selected from 8496 publications initially found in three databases: Cochrane, PubMed, and Embase. The inclusion criteria were met by 28 studies. COPD prevalence evaluated with the use of portable spirometers reached 20.27% and was lower compared to that estimated with the use of conventional spirometers (24.67%). In 11 included studies, postbronchodilator tests were performed with portable spirometers, which enabled a bedside COPD diagnosis. Portable spirometers can be successfully used in COPD targeted screening and diagnosis and thus enhance the detection of COPD at early stages.
慢性阻塞性肺病是全球第三大死亡原因。慢性阻塞性肺气肿的诊断可通过肺活量测定法进行,但由于其可及性有限,因此未得到充分利用。便携式肺活量计有望提高慢性阻塞性肺病的诊断效率。这项研究旨在估算高危患者中使用便携式肺活量计诊断出的慢性阻塞性肺病患病率,并将其与基于传统现场肺活量计数据的慢性阻塞性肺病患病率进行比较。我们还评估了在高危人群中主动识别慢性阻塞性肺病的策略。我们对使用便携式和传统肺活量计进行慢性阻塞性肺病定向筛查和诊断的原始研究进行了系统性回顾,这些研究选自三个数据库中最初发现的 8496 篇出版物:Cochrane、PubMed 和 Embase。有 28 项研究符合纳入标准。使用便携式肺活量计评估的慢性阻塞性肺病发病率为 20.27%,低于使用传统肺活量计的估计值(24.67%)。在纳入的 11 项研究中,使用便携式肺活量计进行了支气管扩张后测试,从而实现了床旁慢性阻塞性肺病诊断。便携式肺活量计可成功用于慢性阻塞性肺病的定向筛查和诊断,从而提高慢性阻塞性肺病的早期发现率。
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引用次数: 0
Advances in Respiratory Medicine-Aims and Scopes Update. 呼吸系统医学的进展--目标和范围最新进展》。
IF 1.8 Q3 Medicine Pub Date : 2024-03-19 DOI: 10.3390/arm92020017
Krzysztof Kuziemski, Monika Franczuk, Sebastian Majewski, Tadeusz M Zielonka, Adam Barczyk

Advances in Respiratory Medicine, which has been published by MDPI since 2022, serves as a platform for hosting pneumological studies [...].

呼吸医学进展》(Advances in Respiratory Medicine)自 2022 年以来一直由 MDPI 出版,它是一个刊登呼吸学研究 [...] 的平台。
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引用次数: 0
Outcomes and Functional Deterioration in Hospital Admissions with Acute Hypoxemia. 急性低氧血症入院患者的预后和功能恶化。
IF 1.8 Q3 Medicine Pub Date : 2024-03-06 DOI: 10.3390/arm92020016
Susanne Simon, Jens Gottlieb, Ina Burchert, René Abu Isneineh, Thomas Fuehner

Background: Many hospitalized patients decline in functional status after discharge, but functional decline in emergency admissions with hypoxemia is unknown. The primary aim of this study was to study functional outcomes as a clinical endpoint in a cohort of patients with acute hypoxemia.

Methods: A multicenter prospective observational study was conducted in patients with new-onset hypoxemia emergently admitted to two respiratory departments at a university hospital and an academic teaching hospital. Using the WHO scale, the patients' functional status 4 weeks before admission and at hospital discharge was assessed. The type and duration of oxygen therapy, hospital length of stay and survival and risk of hypercapnic failure were recorded.

Results: A total of 151 patients with a median age of 74 were included. Two-thirds declined in functional status by at least one grade at discharge. A good functional status (OR 4.849 (95% CI 2.209-10.647)) and progressive cancer (OR 6.079 (1.197-30.881)) were more associated with functional decline. Most patients were treated with conventional oxygen therapy (n = 95, 62%). The rates of in-hospital mortality and need for intubation were both 8%.

Conclusions: Patients with acute hypoxemia in the emergency room have a poorer functional status after hospital discharge. This decline may be of multifactorial origin.

背景:许多住院病人出院后功能状态都会下降,但低氧血症急诊入院病人的功能下降情况尚不清楚。本研究的主要目的是研究急性低氧血症患者队列中作为临床终点的功能结果:一项多中心前瞻性观察研究针对一家大学医院和一家学术教学医院的两个呼吸科紧急收治的新发低氧血症患者。采用世界卫生组织的量表对患者入院前 4 周和出院时的功能状态进行了评估。记录了氧疗的类型和持续时间、住院时间、存活率以及高碳酸血症衰竭的风险:共纳入 151 名患者,中位年龄为 74 岁。三分之二的患者在出院时功能状态下降了至少一个等级。功能状态良好(OR 4.849(95% CI 2.209-10.647))和癌症进展(OR 6.079(1.197-30.881))与功能下降的关系更大。大多数患者接受了常规氧疗(95 人,62%)。院内死亡率和插管率均为8%:结论:急诊室急性低氧血症患者出院后功能状况较差。结论:急诊室急性低氧血症患者出院后功能状况较差,这种下降可能是多因素造成的。
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引用次数: 0
Association between the Static and Dynamic Lung Function and CT-Derived Thoracic Skeletal Muscle Measurements-A Retrospective Analysis of a 12-Month Observational Follow-Up Pilot Study. 静态和动态肺功能与 CT 导出的胸廓骨骼肌测量值之间的关联--一项为期 12 个月的观察性随访试点研究的回顾性分析。
IF 1.8 Q3 Medicine Pub Date : 2024-03-06 DOI: 10.3390/arm92020015
Mia Solholt Godthaab Brath, Sisse Dyrman Alsted, Marina Sahakyan, Esben Bolvig Mark, Jens Brøndum Frøkjær, Henrik Højgaard Rasmussen, Lasse Riis Østergaard, Rasmus Brath Christensen, Ulla Møller Weinreich

Background: Patients with chronic obstructive pulmonary disease (COPD) with low skeletal muscle mass and severe airway obstruction have higher mortality risks. However, the relationship between dynamic/static lung function (LF) and thoracic skeletal muscle measurements (SMM) remains unclear. This study explored patient characteristics (weight, BMI, exacerbations, dynamic/static LF, sex differences in LF and SMM, and the link between LF and SMM changes.

Methods: A retrospective analysis of a 12-month prospective follow-up study patients with stable COPD undergoing standardized treatment, covering mild to severe stages, was conducted. The baseline and follow-up assessments included computed tomography and body plethysmography.

Results: This study included 35 patients (17 females and 18 males). This study revealed that females had more stable LF but tended to have greater declines in SMM areas and indices than males (-5.4% vs. -1.9%, respectively), despite the fact that females were younger and had higher LF and less exacerbation than males. A multivariate linear regression showed a negative association between the inspiratory capacity/total lung capacity ratio (IC/TLC) and muscle fat area.

Conclusions: The findings suggest distinct LF and BC progression patterns between male and female patients with COPD. A low IC/TLC ratio may predict increased muscle fat. Further studies are necessary to understand these relationships better.

背景:骨骼肌质量低且气道阻塞严重的慢性阻塞性肺病(COPD)患者死亡率较高。然而,动态/静态肺功能(LF)与胸廓骨骼肌测量值(SMM)之间的关系仍不清楚。本研究探讨了患者特征(体重、体重指数、病情加重、动态/静态肺功能、肺功能和骨骼肌质量的性别差异以及肺功能和骨骼肌质量变化之间的联系:对接受标准化治疗、病情稳定的慢性阻塞性肺疾病患者进行了为期 12 个月的前瞻性随访研究,研究涵盖了轻度至重度阶段,并进行了回顾性分析。基线和随访评估包括计算机断层扫描和体胸膜成像:这项研究包括 35 名患者(17 名女性和 18 名男性)。研究显示,尽管女性比男性更年轻、低密度脂蛋白血症程度更高且病情加重程度更轻,但女性的低密度脂蛋白血症更稳定,但与男性相比,女性的低密度脂蛋白血症面积和指数下降幅度更大(分别为-5.4%和-1.9%)。多变量线性回归显示,吸气容量/总肺活量比值(IC/TLC)与肌肉脂肪面积呈负相关:研究结果表明,男性和女性慢性阻塞性肺疾病患者的 LF 和 BC 进展模式截然不同。低 IC/TLC 比值可能预示着肌肉脂肪的增加。要更好地了解这些关系,还需要进一步的研究。
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引用次数: 0
Advancing Care in Severe Asthma: The Art of Switching Biologics. 推进严重哮喘的治疗:切换生物制剂的艺术。
IF 1.8 Q3 Medicine Pub Date : 2024-02-21 DOI: 10.3390/arm92020014
Silvano Dragonieri, Andrea Portacci, Vitaliano Nicola Quaranta, Giovanna Elisiana Carpagnano

Biologics targeting IgE, IL-5, IL-4/IL-13, and TSLP are crucial in severe asthma treatment. Research, including randomized controlled trials and real-world studies, has been conducted to assess their efficacy and identify patient characteristics that may predict positive responses. The effectiveness of switching biologics, especially given overlaps in treatment eligibility, and the clinical outcomes post-cessation are critical areas of investigation. This work reviews the effects of switching between these biologics and the indicators of treatment success or failure. Insights are primarily derived from real-world experiences, focusing on patients transitioning from one monoclonal antibody to another. Moreover, this review aims to provide insights into the effectiveness, safety, and broader implications of switching biologics, enhancing understanding for clinicians to optimize severe asthma management. The article underlines the importance of a patient-centered approach, biomarker assessment, and the evolving nature of asthma treatment in making informed decisions about biologic therapy.

针对 IgE、IL-5、IL-4/IL-13 和 TSLP 的生物制剂对重症哮喘的治疗至关重要。目前已开展了包括随机对照试验和真实世界研究在内的多项研究,以评估这些药物的疗效,并确定可预测阳性反应的患者特征。切换生物制剂的有效性(尤其是在治疗资格重叠的情况下)以及停药后的临床疗效是研究的关键领域。本研究回顾了这些生物制剂之间的转换效果以及治疗成功或失败的指标。这些见解主要来自真实世界的经验,重点关注从一种单克隆抗体过渡到另一种单克隆抗体的患者。此外,这篇综述旨在深入探讨切换生物制剂的有效性、安全性和更广泛的影响,从而加深临床医生对优化重症哮喘治疗的理解。文章强调了以患者为中心的方法、生物标志物评估以及哮喘治疗不断发展的性质对做出生物制剂治疗知情决策的重要性。
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引用次数: 0
The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review 对垂体在长 COVID-19 综合征发病机制中的作用的认识不断加深:叙述性综述
IF 1.8 Q3 Medicine Pub Date : 2024-02-14 DOI: 10.3390/arm92010013
Ach Taieb, Ben Haj Slama Nassim, Gorchane Asma, Methnani Jabeur, S. Ghada, B. A. Asma
Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection, is a condition where individuals who have recovered from the acute phase of COVID-19 continue to experience a range of symptoms for weeks or even months afterward. While it was initially thought to primarily affect the respiratory system, it has become clear that Long COVID-19 can involve various organs and systems, including the endocrine system, which includes the pituitary gland. In the context of Long COVID-19, there is a growing understanding of the potential implications for the pituitary gland. The virus can directly affect the pituitary gland, leading to abnormalities in hormone production and regulation. This can result in symptoms such as fatigue, changes in appetite, and mood disturbances. Long COVID-19, the persistent and often debilitating condition following acute COVID-19 infection, may be explained by deficiencies in ACTH and Growth hormone production from the pituitary gland. Corticotropin insufficiency can result in the dysregulation of the body’s stress response and can lead to prolonged feelings of stress, fatigue, and mood disturbances in Long COVID-19 patients. Simultaneously, somatotropin insufficiency can affect growth, muscle function, and energy metabolism, potentially causing symptoms such as muscle weakness, exercise intolerance, and changes in body composition. Recently, some authors have suggested the involvement of the pituitary gland in Post COVID-19 Syndrome. The exact mechanisms of viral action on infected cells remain under discussion, but inflammatory and autoimmune mechanisms are primarily implicated. The aim of our study will be to review the main pituitary complications following COVID-19 infection. Moreover, we will explain the possible involvement of the pituitary gland in the persistence of Post COVID-19 Syndrome.
长COVID-19又称SARS-CoV-2感染急性后遗症,是指从COVID-19急性期痊愈的患者在数周甚至数月后继续出现一系列症状。虽然最初认为长 COVID-19 主要影响呼吸系统,但现在已经清楚,长 COVID-19 可累及多个器官和系统,包括内分泌系统,其中包括脑垂体。就长 COVID-19 而言,人们越来越了解它对脑垂体的潜在影响。病毒可直接影响脑垂体,导致激素分泌和调节异常。这会导致疲劳、食欲改变和情绪紊乱等症状。长COVID-19,即急性COVID-19感染后出现的持续且经常使人衰弱的症状,可解释为脑垂体促肾上腺皮质激素和生长激素分泌不足。促肾上腺皮质激素分泌不足会导致机体应激反应失调,并可能导致长 COVID-19 患者长期感到压力、疲劳和情绪紊乱。同时,体促素不足会影响生长、肌肉功能和能量代谢,可能导致肌无力、运动不耐受和身体成分变化等症状。最近,一些学者认为 COVID-19 后综合征与垂体有关。病毒作用于受感染细胞的确切机制仍在讨论中,但主要涉及炎症和自身免疫机制。我们的研究旨在回顾 COVID-19 感染后垂体的主要并发症。此外,我们还将解释垂体可能参与 COVID-19 后综合征的持续存在。
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引用次数: 0
The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review 对垂体在长 COVID-19 综合征发病机制中的作用的认识不断加深:叙述性综述
IF 1.8 Q3 Medicine Pub Date : 2024-02-14 DOI: 10.3390/arm92010013
Ach Taieb, Ben Haj Slama Nassim, Gorchane Asma, Methnani Jabeur, S. Ghada, B. A. Asma
Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection, is a condition where individuals who have recovered from the acute phase of COVID-19 continue to experience a range of symptoms for weeks or even months afterward. While it was initially thought to primarily affect the respiratory system, it has become clear that Long COVID-19 can involve various organs and systems, including the endocrine system, which includes the pituitary gland. In the context of Long COVID-19, there is a growing understanding of the potential implications for the pituitary gland. The virus can directly affect the pituitary gland, leading to abnormalities in hormone production and regulation. This can result in symptoms such as fatigue, changes in appetite, and mood disturbances. Long COVID-19, the persistent and often debilitating condition following acute COVID-19 infection, may be explained by deficiencies in ACTH and Growth hormone production from the pituitary gland. Corticotropin insufficiency can result in the dysregulation of the body’s stress response and can lead to prolonged feelings of stress, fatigue, and mood disturbances in Long COVID-19 patients. Simultaneously, somatotropin insufficiency can affect growth, muscle function, and energy metabolism, potentially causing symptoms such as muscle weakness, exercise intolerance, and changes in body composition. Recently, some authors have suggested the involvement of the pituitary gland in Post COVID-19 Syndrome. The exact mechanisms of viral action on infected cells remain under discussion, but inflammatory and autoimmune mechanisms are primarily implicated. The aim of our study will be to review the main pituitary complications following COVID-19 infection. Moreover, we will explain the possible involvement of the pituitary gland in the persistence of Post COVID-19 Syndrome.
长COVID-19又称SARS-CoV-2感染急性后遗症,是指从COVID-19急性期痊愈的患者在数周甚至数月后继续出现一系列症状。虽然最初认为长 COVID-19 主要影响呼吸系统,但现在已经清楚,长 COVID-19 可累及多个器官和系统,包括内分泌系统,其中包括脑垂体。就长 COVID-19 而言,人们越来越了解它对脑垂体的潜在影响。病毒可直接影响脑垂体,导致激素分泌和调节异常。这会导致疲劳、食欲改变和情绪紊乱等症状。长COVID-19,即急性COVID-19感染后出现的持续且经常使人衰弱的症状,可解释为脑垂体促肾上腺皮质激素和生长激素分泌不足。促肾上腺皮质激素分泌不足会导致机体应激反应失调,并可能导致长 COVID-19 患者长期感到压力、疲劳和情绪紊乱。同时,体促素不足会影响生长、肌肉功能和能量代谢,可能导致肌无力、运动不耐受和身体成分变化等症状。最近,一些学者认为 COVID-19 后综合征与垂体有关。病毒作用于受感染细胞的确切机制仍在讨论中,但主要涉及炎症和自身免疫机制。我们的研究旨在回顾 COVID-19 感染后垂体的主要并发症。此外,我们还将解释垂体可能参与 COVID-19 后综合征的持续存在。
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引用次数: 0
Administering Nitric Oxide (NO) with High Flow Nasal Cannulas: A Simple Method 使用高流量鼻导管施用一氧化氮(NO):一种简单的方法
IF 1.8 Q3 Medicine Pub Date : 2024-02-08 DOI: 10.3390/arm92010012
Vladimir L Cousin, R. Joye, Angelo Polito
Inhaled nitric oxide (iNO) is a pulmonary vasodilator that plays an important clinical ICU role. The administration of iNO is usually performed through an endotracheal tube, but spontaneously breathing patients might also benefit from iNO administration. The use of the non-invasive administration of iNO through high-flow nasal cannula (HFNC) allows for NO delivery in spontaneously breathing patients who still need supplemental oxygen and positive airway pressure. A simple method to administer NO through HFNC is described here using standard commercially available NO administration and HFNC.
吸入一氧化氮(iNO)是一种肺血管扩张剂,在重症监护病房的临床治疗中发挥着重要作用。一氧化氮通常通过气管插管给药,但自主呼吸的患者也可从一氧化氮给药中获益。通过高流量鼻插管(HFNC)以无创方式给药 iNO,可为仍需要补充氧气和气道正压的自主呼吸患者输送 NO。本文介绍了一种通过 HFNC 给药 NO 的简单方法,使用的是标准的市售 NO 给药器和 HFNC。
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引用次数: 0
Administering Nitric Oxide (NO) with High Flow Nasal Cannulas: A Simple Method 使用高流量鼻导管施用一氧化氮(NO):一种简单的方法
IF 1.8 Q3 Medicine Pub Date : 2024-02-08 DOI: 10.3390/arm92010012
Vladimir L Cousin, R. Joye, Angelo Polito
Inhaled nitric oxide (iNO) is a pulmonary vasodilator that plays an important clinical ICU role. The administration of iNO is usually performed through an endotracheal tube, but spontaneously breathing patients might also benefit from iNO administration. The use of the non-invasive administration of iNO through high-flow nasal cannula (HFNC) allows for NO delivery in spontaneously breathing patients who still need supplemental oxygen and positive airway pressure. A simple method to administer NO through HFNC is described here using standard commercially available NO administration and HFNC.
吸入一氧化氮(iNO)是一种肺血管扩张剂,在重症监护病房的临床治疗中发挥着重要作用。一氧化氮通常通过气管插管给药,但自主呼吸的患者也可从一氧化氮给药中获益。通过高流量鼻插管(HFNC)以无创方式给药 iNO,可为仍需要补充氧气和气道正压的自主呼吸患者输送 NO。本文介绍了一种通过 HFNC 给药 NO 的简单方法,使用的是标准的市售 NO 给药器和 HFNC。
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引用次数: 0
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Advances in respiratory medicine
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