W. Piotrowski, M. Martusewicz-Boros, A. Białas, A. Barczyk, B. Batko, K. Błasińska, P. Boros, K. Górska, P. Grzanka, E. Jassem, D. Jastrzębski, Janina Kaczyńska, O. Kowal-Bielecka, E. Kucharz, J. Kuś, B. Kuźnar-Kamińska, B. Kwiatkowska, R. Langfort, K. Lewandowska, B. Maćkiewicz, S. Majewski, J. Makowska, J. Miłkowska-Dymanowska, E. Puścińska, A. Siemińska, M. Sobiecka, Renata Soroka-Dąda, M. Szołkowska, E. Wiatr, D. Ziora, P. Śliwiński
Highlights The working group of the Polish Respiratory Society (PTChP) developed guidelines for diagnosis and treatment of PF-ILD. What are the main findings? A multidisciplinary team should be involved in the diagnosis and treatment of progressive pulmonary fibrosis. Nintedanib alone or in combination with immunomodulatory drugs is recommended for the treatment of PF-ILD, especially when an earlier solely immunomodulatory treatment was ineffective. What are the implications of the main finding? This document is a guide for Polish medical personnel involved in the diagnosis and treatment of PF-ILD. The guidelines will serve as an aid for healthcare organizers in Poland on how to optimize the diagnostic and therapeutic processes for ILD and improve the access of patients to modern therapy. Abstract The recommendations were developed as answers to previously formulated questions concerning everyday diagnostic and therapeutic challenges. They were developed based on a review of the current literature using the GRADE methodology. The experts suggest that PF-ILD be diagnosed based on a combination of different criteria, such as the aggravation of symptoms, progression of radiological lesions, and worsening of lung function test parameters. The experts recommend a precise diagnosis of an underlying disease, with serological testing for an autoimmune disease always being included. The final diagnosis should be worked out by a multidisciplinary team (MDT). Patients with an interstitial lung disease other than IPF who do not meet the criteria for the progressive fibrosis phenotype should be monitored for progression, and those with systemic autoimmune diseases should be regularly monitored for signs of interstitial lung disease. In managing patients with interstitial lung disease associated with autoimmune diseases, an opinion of an MDT should be considered. Nintedanib rather than pirfenidon should be introduced in the event of the ineffectiveness of the therapy recommended for the treatment of the underlying disease, but in some instances, it is possible to start antifibrotic treatment without earlier immunomodulatory therapy. It is also admissible to use immunomodulatory and antifibrotic drugs simultaneously. No recommendations were made for or against termination of anti-fibrotic therapy in the case of noted progression during treatment of a PF-ILD other than IPF. The experts recommend that the same principles of non-pharmacological and palliative treatment and eligibility for lung transplantation should be applied to patients with an interstitial lung disease other than IPF with progressive fibrosis as in patients with IPF.
{"title":"Guidelines of the Polish Respiratory Society on the Diagnosis and Treatment of Progressive Fibrosing Interstitial Lung Diseases Other than Idiopathic Pulmonary Fibrosis","authors":"W. Piotrowski, M. Martusewicz-Boros, A. Białas, A. Barczyk, B. Batko, K. Błasińska, P. Boros, K. Górska, P. Grzanka, E. Jassem, D. Jastrzębski, Janina Kaczyńska, O. Kowal-Bielecka, E. Kucharz, J. Kuś, B. Kuźnar-Kamińska, B. Kwiatkowska, R. Langfort, K. Lewandowska, B. Maćkiewicz, S. Majewski, J. Makowska, J. Miłkowska-Dymanowska, E. Puścińska, A. Siemińska, M. Sobiecka, Renata Soroka-Dąda, M. Szołkowska, E. Wiatr, D. Ziora, P. Śliwiński","doi":"10.3390/arm90050052","DOIUrl":"https://doi.org/10.3390/arm90050052","url":null,"abstract":"Highlights The working group of the Polish Respiratory Society (PTChP) developed guidelines for diagnosis and treatment of PF-ILD. What are the main findings? A multidisciplinary team should be involved in the diagnosis and treatment of progressive pulmonary fibrosis. Nintedanib alone or in combination with immunomodulatory drugs is recommended for the treatment of PF-ILD, especially when an earlier solely immunomodulatory treatment was ineffective. What are the implications of the main finding? This document is a guide for Polish medical personnel involved in the diagnosis and treatment of PF-ILD. The guidelines will serve as an aid for healthcare organizers in Poland on how to optimize the diagnostic and therapeutic processes for ILD and improve the access of patients to modern therapy. Abstract The recommendations were developed as answers to previously formulated questions concerning everyday diagnostic and therapeutic challenges. They were developed based on a review of the current literature using the GRADE methodology. The experts suggest that PF-ILD be diagnosed based on a combination of different criteria, such as the aggravation of symptoms, progression of radiological lesions, and worsening of lung function test parameters. The experts recommend a precise diagnosis of an underlying disease, with serological testing for an autoimmune disease always being included. The final diagnosis should be worked out by a multidisciplinary team (MDT). Patients with an interstitial lung disease other than IPF who do not meet the criteria for the progressive fibrosis phenotype should be monitored for progression, and those with systemic autoimmune diseases should be regularly monitored for signs of interstitial lung disease. In managing patients with interstitial lung disease associated with autoimmune diseases, an opinion of an MDT should be considered. Nintedanib rather than pirfenidon should be introduced in the event of the ineffectiveness of the therapy recommended for the treatment of the underlying disease, but in some instances, it is possible to start antifibrotic treatment without earlier immunomodulatory therapy. It is also admissible to use immunomodulatory and antifibrotic drugs simultaneously. No recommendations were made for or against termination of anti-fibrotic therapy in the case of noted progression during treatment of a PF-ILD other than IPF. The experts recommend that the same principles of non-pharmacological and palliative treatment and eligibility for lung transplantation should be applied to patients with an interstitial lung disease other than IPF with progressive fibrosis as in patients with IPF.","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47873170","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}
R. Dhar, D. Talwar, P. James, A. Mishra, Judo Vachaparambil, Saiprasad Patil, Nishtha Khatri, S. Bhagat, H. Barkate
Highlights What are the main findings? FF/Vi is an effective choice for patients who are uncontrolled on their current Asthma treatment and also for controlled Asthma patients. SABA or ICS/SABA can be a viable reliever option when personalizing treatment for appropriate sets of patients with FF/Vi. What is the implication of the main finding? FF/Vi offers a definitive advantage in terms of treatment adherence and compliance benefit as compared to the conventional ICS/LABAs. Adding LAMA to FF/Vi (100/25 μg) in GOLD group D and B COPD patients can be an optimized strategy. Abstract Inhaled corticosteroid and ultra-long-acting beta-agonist (ICS/uLABA) combination is a recent advancement in the armamentarium against obstructive airways diseases (OADs). The combination of ICS/uLABA has several advantages, creating a favorable landscape for its utilization. Fluticasone furoate/vilanterol trifenatate (FF/Vi) is one such example of an ICS/uLABA. It offers several benefits from both drugs, such as a convenient once daily dosing schedule; high lipophilicity; high receptor affinity of fluticasone furoate along with high functional selectivity and a quick onset of action of vilanterol. However, the Global Initiative for Asthma (GINA) as well as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines do not clearly define the positioning of ICS/uLABA compared to conventional ICS/LABAs. There are a few areas of uncertainty especially around the appropriate reliever strategy with ICS/uLABA in Asthma. The current consensus was planned with a group of Indian pulmonology experts to provide more clarity on the potential use of FF/Vi in Asthma and COPD. The clinical statements highlighted in this consensus manuscript address crucial clinical questions revolving around the efficacy and safety of FF/Vi as compared to conventional ICS/LABAs and identify the ideal patient profile for its use. This consensus paper also sheds light upon the appropriate reliever to be used along with FF/Vi in Asthma and the utilization of FF/Vi-based triple therapy in OADs. Expert recommendations mentioned in this paper will serve as guidance to pulmonologists as well as consultant physicians who are involved in providing care to OAD patients and will help them weigh the various factors that need to be taken into account while prescribing ICS/uLABA combination.
{"title":"ICS/Ultra LABA in the Treatment of Obstructive Airway Diseases: A Consensus of Indian Experts","authors":"R. Dhar, D. Talwar, P. James, A. Mishra, Judo Vachaparambil, Saiprasad Patil, Nishtha Khatri, S. Bhagat, H. Barkate","doi":"10.3390/arm90050051","DOIUrl":"https://doi.org/10.3390/arm90050051","url":null,"abstract":"Highlights What are the main findings? FF/Vi is an effective choice for patients who are uncontrolled on their current Asthma treatment and also for controlled Asthma patients. SABA or ICS/SABA can be a viable reliever option when personalizing treatment for appropriate sets of patients with FF/Vi. What is the implication of the main finding? FF/Vi offers a definitive advantage in terms of treatment adherence and compliance benefit as compared to the conventional ICS/LABAs. Adding LAMA to FF/Vi (100/25 μg) in GOLD group D and B COPD patients can be an optimized strategy. Abstract Inhaled corticosteroid and ultra-long-acting beta-agonist (ICS/uLABA) combination is a recent advancement in the armamentarium against obstructive airways diseases (OADs). The combination of ICS/uLABA has several advantages, creating a favorable landscape for its utilization. Fluticasone furoate/vilanterol trifenatate (FF/Vi) is one such example of an ICS/uLABA. It offers several benefits from both drugs, such as a convenient once daily dosing schedule; high lipophilicity; high receptor affinity of fluticasone furoate along with high functional selectivity and a quick onset of action of vilanterol. However, the Global Initiative for Asthma (GINA) as well as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines do not clearly define the positioning of ICS/uLABA compared to conventional ICS/LABAs. There are a few areas of uncertainty especially around the appropriate reliever strategy with ICS/uLABA in Asthma. The current consensus was planned with a group of Indian pulmonology experts to provide more clarity on the potential use of FF/Vi in Asthma and COPD. The clinical statements highlighted in this consensus manuscript address crucial clinical questions revolving around the efficacy and safety of FF/Vi as compared to conventional ICS/LABAs and identify the ideal patient profile for its use. This consensus paper also sheds light upon the appropriate reliever to be used along with FF/Vi in Asthma and the utilization of FF/Vi-based triple therapy in OADs. Expert recommendations mentioned in this paper will serve as guidance to pulmonologists as well as consultant physicians who are involved in providing care to OAD patients and will help them weigh the various factors that need to be taken into account while prescribing ICS/uLABA combination.","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46388781","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}
Wilfredo De Jesús-Rojas, Francisco Alvarado-Huerta, Jesús M Meléndez-Montañez, José Muñiz-Hernández, Arnaldo Santos-López, Ricardo A Mosquera
Primary Ciliary Dyskinesia (PCD) is a rare genetic disease characterized by motile cilia dysfunction with a prevalence of 1 in 16,309 individuals in Hispanic populations. In Puerto Rico, the prevalence of PCD is unknown. Diagnosis of PCD in Puerto Rico is challenging due to the lack of diagnostic technology. Algorithms for PCD diagnosis include clinical history, genetic testing, ciliary biopsy, and nasal Nitric Oxide (nNO) levels. For the first time, this study successfully implemented and measured the nNO levels in subjects with the RSPH4A (c.921+3_921+6del (intronic)) as a diagnostic tool to complement the current algorithm for PCD diagnosis on the island. The nNO level differentiated homozygous subjects with PCD due to the RSPH4A (c.921+3_921+6del (intronic)) founder mutation compared to healthy gender-age matched controls and subjects with VUS or negative genetic testing for PCD. The acquisition of state-of-the-art diagnostic tools such as nNO positively impacted and expanded our current PCD diagnostic capabilities in Puerto Rico for our founder genetic mutation. The addition of nNO technology promotes earlier disease screening and recognition for patients with PCD on the island. The access to nNO helped us to properly characterize the PCD diagnosis for patients with the RSPH4A (c.921+3_921+6del (intronic)). As a result, our findings will allow us to be part of the national PCD foundation registry and represent Puerto Rican Hispanics in future PCD multicentric clinical trials.
{"title":"Nasal Nitric Oxide Levels: Improving the Diagnosis of Primary Ciliary Dyskinesia in Puerto Rico.","authors":"Wilfredo De Jesús-Rojas, Francisco Alvarado-Huerta, Jesús M Meléndez-Montañez, José Muñiz-Hernández, Arnaldo Santos-López, Ricardo A Mosquera","doi":"10.3390/arm90050050","DOIUrl":"10.3390/arm90050050","url":null,"abstract":"<p><p>Primary Ciliary Dyskinesia (PCD) is a rare genetic disease characterized by motile cilia dysfunction with a prevalence of 1 in 16,309 individuals in Hispanic populations. In Puerto Rico, the prevalence of PCD is unknown. Diagnosis of PCD in Puerto Rico is challenging due to the lack of diagnostic technology. Algorithms for PCD diagnosis include clinical history, genetic testing, ciliary biopsy, and nasal Nitric Oxide (nNO) levels. For the first time, this study successfully implemented and measured the nNO levels in subjects with the <i>RSPH4A</i> (c.921+3_921+6del (intronic)) as a diagnostic tool to complement the current algorithm for PCD diagnosis on the island. The nNO level differentiated homozygous subjects with PCD due to the <i>RSPH4A</i> (c.921+3_921+6del (intronic)) founder mutation compared to healthy gender-age matched controls and subjects with VUS or negative genetic testing for PCD. The acquisition of state-of-the-art diagnostic tools such as nNO positively impacted and expanded our current PCD diagnostic capabilities in Puerto Rico for our founder genetic mutation. The addition of nNO technology promotes earlier disease screening and recognition for patients with PCD on the island. The access to nNO helped us to properly characterize the PCD diagnosis for patients with the <i>RSPH4A</i> (c.921+3_921+6del (intronic)). As a result, our findings will allow us to be part of the national PCD foundation registry and represent Puerto Rican Hispanics in future PCD multicentric clinical trials.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Reza Aslani, Mojtaba Amani, Faranak Moghadas, Hassan Ghobadi
Objective(s): One of the adipokines that have insulin-sensitizing properties is adipolin, whose reduced levels have been reported in obesity, oxidative stress, and inflammation. The present study investigated serum interleukin-6 (IL-6) and adipolin levels in chronic obstructive pulmonary disease (COPD) patients. Method: A control case study included 60 COPD patients and 30 healthy subjects in the research and measured adipolin and IL-6 serum levels. In addition, serum adipolin levels in COPD patients were assessed according to the GOLD grade. The relationship between serum adipolin levels and study variables were also analyzed. Results: The results showed reduced adipolin levels in COPD patients compared with healthy individuals (p < 0.001). Furthermore, increased levels of IL-6 were evident in the COPD group compared to the control group (p < 0.001). Adipolin serum levels were positively correlated with PFTs and negatively correlated with IL-6 levels. Conclusion: Decreased adipolin levels enhanced disease severity in COPD patients. It seems that the existence of a significant relationship between adipolin and IL-6 may indicate the role of adipolin in the pathophysiology of COPD.
{"title":"Adipolin and IL-6 Serum Levels in Chronic Obstructive Pulmonary Disease.","authors":"Mohammad Reza Aslani, Mojtaba Amani, Faranak Moghadas, Hassan Ghobadi","doi":"10.3390/arm90050049","DOIUrl":"https://doi.org/10.3390/arm90050049","url":null,"abstract":"<p><p>Objective(s): One of the adipokines that have insulin-sensitizing properties is adipolin, whose reduced levels have been reported in obesity, oxidative stress, and inflammation. The present study investigated serum interleukin-6 (IL-6) and adipolin levels in chronic obstructive pulmonary disease (COPD) patients. Method: A control case study included 60 COPD patients and 30 healthy subjects in the research and measured adipolin and IL-6 serum levels. In addition, serum adipolin levels in COPD patients were assessed according to the GOLD grade. The relationship between serum adipolin levels and study variables were also analyzed. Results: The results showed reduced adipolin levels in COPD patients compared with healthy individuals (p < 0.001). Furthermore, increased levels of IL-6 were evident in the COPD group compared to the control group (p < 0.001). Adipolin serum levels were positively correlated with PFTs and negatively correlated with IL-6 levels. Conclusion: Decreased adipolin levels enhanced disease severity in COPD patients. It seems that the existence of a significant relationship between adipolin and IL-6 may indicate the role of adipolin in the pathophysiology of COPD.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9077577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Climate change affects human health, and severe acute respiratory syndrome (SARS) incidence is one of the health impacts of climate change. This study is a retrospective cohort study. Data have been collected from the Iranian Ministry of Health and Medical Education between 17 February 2016 and17 February 2018. The Neural Network Model has been used to predict SARS infection. Based on the results of the multivariate Poisson regression and the analysis of the coexistence of the variables, the minimum daily temperature was positively associated with the risk of SARS in men and women. The risk of SARS has increased in women and men with increasing daily rainfall. According to the result, by changes in bioclimatic parameters, the number of SARS patients will be increased in cities of Iran. Our study has shown a significant relationship between SARS and the climatic variables by the type of climate and gender. The estimates suggest that hospital admissions for climate-related respiratory diseases in Iran will increase by 36% from 2020 to 2050. This study demonstrates one of the health impacts of climate change. Policymakers can control the risks of climate change by mitigation and adaptation strategists.
{"title":"Climate Change and Respiratory Diseases: Relationship between SARS and Climatic Parameters and Impact of Climate Change on the Geographical Distribution of SARS in Iran.","authors":"Giti Bahrami, Hassan Rafiey, Alireza Shakiba, Mehdi Noroozi, Homeira Sajjadi, Hamed Seddighi","doi":"10.3390/arm90050048","DOIUrl":"https://doi.org/10.3390/arm90050048","url":null,"abstract":"<p><p>Climate change affects human health, and severe acute respiratory syndrome (SARS) incidence is one of the health impacts of climate change. This study is a retrospective cohort study. Data have been collected from the Iranian Ministry of Health and Medical Education between 17 February 2016 and17 February 2018. The Neural Network Model has been used to predict SARS infection. Based on the results of the multivariate Poisson regression and the analysis of the coexistence of the variables, the minimum daily temperature was positively associated with the risk of SARS in men and women. The risk of SARS has increased in women and men with increasing daily rainfall. According to the result, by changes in bioclimatic parameters, the number of SARS patients will be increased in cities of Iran. Our study has shown a significant relationship between SARS and the climatic variables by the type of climate and gender. The estimates suggest that hospital admissions for climate-related respiratory diseases in Iran will increase by 36% from 2020 to 2050. This study demonstrates one of the health impacts of climate change. Policymakers can control the risks of climate change by mitigation and adaptation strategists.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33469686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 65-year-old woman presented to the Pulmonary Clinic for evaluation after Positron Emission Tomography/Computed Tomography (PET/CT), which was obtained for assessment of a 12 mm right middle lobe solitary pulmonary nodule [...].
{"title":"Increased FluoroDeoxyGlucose (FDG) Avidity Following COVID-19 Vaccination.","authors":"Mo'ath Nassar, Ayman Soubani","doi":"10.3390/arm90050047","DOIUrl":"https://doi.org/10.3390/arm90050047","url":null,"abstract":"<p><p>A 65-year-old woman presented to the Pulmonary Clinic for evaluation after Positron Emission Tomography/Computed Tomography (PET/CT), which was obtained for assessment of a 12 mm right middle lobe solitary pulmonary nodule [...].</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10326754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We have read with great interest the recent paper published by Barroso et al. [...].
我们饶有兴趣地阅读了Barroso等人最近发表的论文[…]。
{"title":"Adherence to Auto-CPAP and Age: A Stable Condition? Comment on Barroso et al. Influence of Age on Adherence to Auto-CPAP: Experience from a Sleep Center in Portugal. <i>Adv. Respir. Med.</i> 2022, <i>90</i>, 143-147.","authors":"Ahmet Cemal Pazarlı, Antonio M Esquinas","doi":"10.3390/arm90040045","DOIUrl":"https://doi.org/10.3390/arm90040045","url":null,"abstract":"<p><p>We have read with great interest the recent paper published by Barroso et al. [...].</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10321257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Patients with corona virus disease-19 (COVID-19)-induced acute hypoxemic respiratory failure (AHRF) are often on non-invasive ventilation (NIV) and use of awake prone positioning (PP) may pose concern in terms of feasibility, efficacy and side effects. This systematic review was undertaken to evaluate the feasibility and efficacy of awake PP along with NIV in them.
Materials and methods: A systematic literature search was conducted from the inception of COVID-19 until 15 August 2021. Various factors including feasibility, interface used, outcome, efficacy, side effects and limitations in both intensive care unit (ICU) and Non-ICU setups were noted.
Results: A total of 12 original articles and six case series including 359 patients were involved. Out of it, 40% (n = 122) of patients were in ICU and 60% (n = 237) in Non-ICU areas. Four clinical studies and four case series including 114 patients had evaluated PP along with helmet continuous positive airway pressure (CPAP). All had found PP with helmet CPAP to be feasible and efficacious; however, only one study documented the sustained improvement in oxygenation i.e., 12 h after PP.
Conclusions: The present systematic review observed moderate to serious risk of bias amongst the included studies along with heterogeneity in terms of varied respiratory support amongst patients. However, the use of awake PP in patients on NIV has been found to be feasible and efficacious with no adverse events.
{"title":"Awake Prone-Positioning in Patients on Non-Invasive Ventilation for Management of SARS-CoV-2 Pneumonia: A Systematic Review.","authors":"Geetanjali Tolia Chilkoti, Medha Mohta, Zainab Ahmad, Ashok Kumar Saxena","doi":"10.3390/arm90040046","DOIUrl":"10.3390/arm90040046","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with corona virus disease-19 (COVID-19)-induced acute hypoxemic respiratory failure (AHRF) are often on non-invasive ventilation (NIV) and use of awake prone positioning (PP) may pose concern in terms of feasibility, efficacy and side effects. This systematic review was undertaken to evaluate the feasibility and efficacy of awake PP along with NIV in them.</p><p><strong>Materials and methods: </strong>A systematic literature search was conducted from the inception of COVID-19 until 15 August 2021. Various factors including feasibility, interface used, outcome, efficacy, side effects and limitations in both intensive care unit (ICU) and Non-ICU setups were noted.</p><p><strong>Results: </strong>A total of 12 original articles and six case series including 359 patients were involved. Out of it, 40% (n = 122) of patients were in ICU and 60% (n = 237) in Non-ICU areas. Four clinical studies and four case series including 114 patients had evaluated PP along with helmet continuous positive airway pressure (CPAP). All had found PP with helmet CPAP to be feasible and efficacious; however, only one study documented the sustained improvement in oxygenation i.e., 12 h after PP.</p><p><strong>Conclusions: </strong>The present systematic review observed moderate to serious risk of bias amongst the included studies along with heterogeneity in terms of varied respiratory support amongst patients. However, the use of awake PP in patients on NIV has been found to be feasible and efficacious with no adverse events.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40440553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Ventilator associated pneumonia is a common type of sepsis that occurs to about 9-27% of all mechanically ventilated patients and 20-50% of them develop septic shock. Several clinical, laboratory, and radiological methods have been used for diagnosing VAP. Adrenomedullin (ADM) has been found to be elevated in the plasma of septic patients. The study aim was to explore the prognostic role of ADM in the VAP patients.
Design: A prospective observational study.
Setting: Intensive Care Department of Alexandria University Hospitals.
Patients: A total of 140 patients with proven VAP after medical ICU admission were consecutively enrolled.
Methods: APACHE II score, SOFA score, CRP, lactate, and serum ADM were measured at day 0 of VAP diagnosis and 5 days later. The results were correlated with the outcomes of patients.
Results: APACHE II, lactate, and serum ADM on day 0 could predict an unfavorable outcome. ADM prediction power was significantly higher than APACHE II and lactate. Day 5 readings of all tested parameters could predict occurrence of the unfavorable outcome. ADM on day 0 showed the highest sensitivity (96.25%).
Conclusions: Serum adrenomedullin when measured at days 0 and 5 of VAP diagnosis may serve as an early predictor of unfavorable outcome.
{"title":"Prognostic Role of Serum Adrenomedullin in Patients with Ventilator Associated Pneumonia.","authors":"Tamer Abdallah Helmy, Haitham Hamdy Tammam, Michael Ebrahim Leuis, Bassem Nashaat Beshey","doi":"10.3390/arm90040044","DOIUrl":"https://doi.org/10.3390/arm90040044","url":null,"abstract":"<p><strong>Objective: </strong>Ventilator associated pneumonia is a common type of sepsis that occurs to about 9-27% of all mechanically ventilated patients and 20-50% of them develop septic shock. Several clinical, laboratory, and radiological methods have been used for diagnosing VAP. Adrenomedullin (ADM) has been found to be elevated in the plasma of septic patients. The study aim was to explore the prognostic role of ADM in the VAP patients.</p><p><strong>Design: </strong>A prospective observational study.</p><p><strong>Setting: </strong>Intensive Care Department of Alexandria University Hospitals.</p><p><strong>Patients: </strong>A total of 140 patients with proven VAP after medical ICU admission were consecutively enrolled.</p><p><strong>Methods: </strong>APACHE II score, SOFA score, CRP, lactate, and serum ADM were measured at day 0 of VAP diagnosis and 5 days later. The results were correlated with the outcomes of patients.</p><p><strong>Results: </strong>APACHE II, lactate, and serum ADM on day 0 could predict an unfavorable outcome. ADM prediction power was significantly higher than APACHE II and lactate. Day 5 readings of all tested parameters could predict occurrence of the unfavorable outcome. ADM on day 0 showed the highest sensitivity (96.25%).</p><p><strong>Conclusions: </strong>Serum adrenomedullin when measured at days 0 and 5 of VAP diagnosis may serve as an early predictor of unfavorable outcome.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40440552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a lot of evidence to suggest that patients infected with the COVID-19 and influenza viruses are at risk of atherosclerosis. Additionally, there are heterogeneous studies on the risk of arthrosclerosis in patients infected with the influenza and COVID-19 viruses. We conducted a case−control and cross-sectional study and examined the association between the risk of atherosclerosis, and influenza virus (IV-A and IV-B) and COVID-19 infections in this study. We searched for keywords such as influenza virus, COVID-19 and atherosclerosis in English and Persian in well-known databases such as PubMed, SID, Magiran and Google Scholar. In this study, we analyzed the information using a meta-analysis, the random effect model, the I2 index and STAT (version 11.2). The results from the analysis of ten studies on influenza virus and nine studies on COVID-19 reviewed individually (totaling 6428 samples for influenza virus infections and 10,785 samples for COVID-19 infections) demonstrated a risk of arthrosclerosis in patients with influenza and COVID-19 infections, with an OR (odds ratio) = 0.45 ((95% CI): 0.25 to 0.64) and an OR (odds ratio) = 1.04 ((95% CI): 0.82 to 1.26), respectively. The present study provides new insights into the risk of atherosclerosis in patients infected with the COVID-19 and influenza viruses. Therefore, it seems necessary to consider different strategies for managing and eradicating viral infections among individuals.
{"title":"Association between Influenza and COVID-19 Viruses and the Risk of Atherosclerosis: Meta-Analysis Study and Systematic Review.","authors":"Mahsa Jalili, Kourosh Sayehmiri, Nastaran Ansari, Behzad Pourhossein, Maryam Fazeli, Farid Azizi Jalilian","doi":"10.3390/arm90040043","DOIUrl":"https://doi.org/10.3390/arm90040043","url":null,"abstract":"<p><p>There is a lot of evidence to suggest that patients infected with the COVID-19 and influenza viruses are at risk of atherosclerosis. Additionally, there are heterogeneous studies on the risk of arthrosclerosis in patients infected with the influenza and COVID-19 viruses. We conducted a case−control and cross-sectional study and examined the association between the risk of atherosclerosis, and influenza virus (IV-A and IV-B) and COVID-19 infections in this study. We searched for keywords such as influenza virus, COVID-19 and atherosclerosis in English and Persian in well-known databases such as PubMed, SID, Magiran and Google Scholar. In this study, we analyzed the information using a meta-analysis, the random effect model, the I2 index and STAT (version 11.2). The results from the analysis of ten studies on influenza virus and nine studies on COVID-19 reviewed individually (totaling 6428 samples for influenza virus infections and 10,785 samples for COVID-19 infections) demonstrated a risk of arthrosclerosis in patients with influenza and COVID-19 infections, with an OR (odds ratio) = 0.45 ((95% CI): 0.25 to 0.64) and an OR (odds ratio) = 1.04 ((95% CI): 0.82 to 1.26), respectively. The present study provides new insights into the risk of atherosclerosis in patients infected with the COVID-19 and influenza viruses. Therefore, it seems necessary to consider different strategies for managing and eradicating viral infections among individuals.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9122269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}