Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 199
Filter
1.
Journal of Clinical Medicine ; 11(17):5214, 2022.
Article in English | ProQuest Central | ID: covidwho-2023805

ABSTRACT

In older adults, community-acquired pneumonia (CAP) is often aspiration-related. However, as aspiration pneumonia (AP) lacks clear diagnostic criteria, the reported prevalence and clinical management vary greatly. We investigated what clinical factors appeared to influence the diagnosis of AP and non-AP in a clinical setting and reconsidered a more clinically relevant approach. Medical records of patients aged ≥75 years admitted with CAP were reviewed retrospectively. A total of 803 patients (134 APs and 669 non-APs) were included. The AP group had significantly higher rates of frailty, had higher SARC-F scores, resided in institutions, had neurologic conditions, previous pneumonia diagnoses, known dysphagia, and were more likely to present with vomiting or coughing on food. Nil by mouth orders, speech therapist referrals, and broad-spectrum antibiotics were significantly more common, while computed tomography scans and blood cultures were rarely performed;alternative diagnoses, such as cancer and pulmonary embolism, were detected significantly less. AP is diagnosed more commonly in frail patients, while aspiration is the underlying aetiology in most types of pneumonia. A presumptive diagnosis of AP may deny patients necessary investigation and management. We suggest a paradigm shift in the way we approach older patients with CAP;rather than trying to differentiate AP and non-AP, it would be more clinically relevant to recognise all pneumonia as just pneumonia, and assess their swallowing functions, causative organisms, and investigate alternative diagnoses or underlying causes of dysphagia. This will enable appropriate clinical management.

2.
International Journal of Molecular Sciences ; 23(16):9413, 2022.
Article in English | ProQuest Central | ID: covidwho-2023741

ABSTRACT

[...]although some novel characteristics of HDLs in the kidney diseases has been unraveled, more research is needed to fully understand the role of dysfunctional HDLs in the increased inflammation and risk of cardiovascular disease experienced in these diseases. [...]some studies associate high levels of HDL with compromised respiratory function [24], whereas others associate low levels with the severity of the disease [26]. [...]the uncovered data are likely to identify HDLs as promising targets for their beneficial effects in addressing this global health emergency. [...]the administration of HDLs reduced the infarct size in control mice but not in animals in which SR-BI was deleted.

3.
Healthcare ; 10(8):1524, 2022.
Article in English | ProQuest Central | ID: covidwho-2023396

ABSTRACT

Background: Vaccinations have the potential to significantly lower the burden of disease for many major infections in the high-risk population of hematological and oncological patients. In this regard Shingrix®, an inactivated Varicella Zoster Virus vaccine, received market approval in the European Union in March 2018, after prior US approval in October 2017, and recommendations specifically state immunocompromised, including oncological, patients. As vaccination rates are considered to be poor in oncological patients, determining the current vaccination rates for Shingrix® two years after market approval is important in defining the need for intervention to bring this potentially high-impact vaccine to the patients. Methods: We analyzed data of the EVO Study to provide data for Herpes zoster vaccination rates in oncological patients. The EVO Study was an interventional study evaluating the potential of increasing vaccination rates of specified must-have vaccinations by an instructional card in the oncological setting. Numbers presented in this publication merged baseline data and follow-up data of the control group;hence data not affected by the intervention. Results: Data of 370 patients were analyzed;21.1% with hematological malignancies and 78.9% with solid cancer. Only 3.0% were vaccinated with Shingrix®. Patients with hematological malignancy were more likely to be vaccinated than those with solid cancer (7.7 vs. 1.7%). Conclusion: Despite clear recommendations and a pressing need in the high-risk population of hematological and oncological patients, the vast majority of patients are still left without vaccine protection against Herpes zoster by Shingrix®.

4.
Applied Sciences ; 12(16):8213, 2022.
Article in English | ProQuest Central | ID: covidwho-2023099

ABSTRACT

In particular, the bi-directional communication network, also known as the gut lung axis connecting the intestinal and pulmonary microbiota, is considered responsible for the massively increased bacterial load in the cecum after acute lung injury, causing alterations in airway microbiota and its transitory translocation into the bloodstream toward the bowel [7,8]. [...]subjects with chronic obstructive pulmonary disease often show intestinal hyper-permeability and a high prevalence of IBD [9]. Both mechanisms would underlie the association between periodontitis and inflammatory and degenerative diseases, such as atherosclerosis, Alzheimer’s disease, age-related macular degeneration [22], chronic inflammatory bowel disease [23], and solid neoplasms, such as colorectal carcinoma [24]. [...]intestinal microbes could, due to mucosal barrier impairment, translocate to the liver through the biliary tract and the portal vein, and oral dysbiosis could exacerbate chronic liver diseases, likely modulating the gut ecosystem through the oral–gut axis, on the one side, and may reflect the intestinal dysbiotic ecosystem, affected in turn by hepatic diseases, on the other side [12,25]. Furthermore, mainly the upper but also the lower airways of healthy individuals frequently harbor oral anaerobes, including Prevotella and Veillonella species, probably secondary to continuing microaspiration by contiguity. [...]detecting oral bacterial DNA in the lower airways in healthy subjects could represent the traces of aspirated oral bacteria either not eliminated through physiological clearance or living in dynamic equilibrium with host defensive responses by promoting mucosal immunity of the Th17/neutrophilic phenotype and suppressing innate immunity. Whether bacteria from the oral microbiome regulate responses to pulmonary pathogens and whether they interfere in inflammatory lung disease pathogenesis [26] is still under study. [...]a growing body of evidence highlights that gut and oral dysbioses, interconnected with the local microbial and inflammatory environment of the lung, liver, and other organs, are crucially implied in a multitude of diseases also involving distant organs.

5.
Journal of Medical Internet Research ; 2022.
Article in English | ProQuest Central | ID: covidwho-2022362

ABSTRACT

Background: Extensive literature support telehealth as a supplement or adjunct to in-person care for the management of chronic conditions such as congestive heart failure (CHF) and type 2 diabetes mellitus (T2DM). Evidence is needed to support the use of telehealth as an equivalent and equitable replacement for in-person care and to assess potential adverse effects. Objective: We conducted a systematic review to address the following question: among adults, what is the effect of synchronous telehealth (real-time response among individuals via phone or phone and video) compared with in-person care (or compared with phone, if synchronous video care) for chronic management of CHF, chronic obstructive pulmonary disease, and T2DM on key disease-specific clinical outcomes and health care use? Methods: We followed systematic review methodologies and searched two databases (MEDLINE and Embase). We included randomized or quasi-experimental studies that evaluated the effect of synchronously delivered telehealth for relevant chronic conditions that occurred over ≥2 encounters and in which some or all in-person care was supplanted by care delivered via phone or video. We assessed the bias using the Cochrane Effective Practice and Organization of Care risk of bias (ROB) tool and the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation. We described the findings narratively and did not conduct meta-analysis owing to the small number of studies and the conceptual heterogeneity of the identified interventions. Results: We identified 8662 studies, and 129 (1.49%) were reviewed at the full-text stage. In total, 3.9% (5/129) of the articles were retained for data extraction, all of which (5/5, 100%) were randomized controlled trials. The CHF study (1/5, 20%) was found to have high ROB and randomized patients (n=210) to receive quarterly automated asynchronous web-based review and follow-up of telemetry data versus synchronous personal follow-up (in-person vs phone-based) for 1 year. A 3-way comparison across study arms found no significant differences in clinical outcomes. Overall, 80% (4/5) of the studies (n=466) evaluated synchronous care for patients with T2DM (ROB was judged to be low for 2, 50% of studies and high for 2, 50% of studies). In total, 20% (1/5) of the studies were adequately powered to assess the difference in glycosylated hemoglobin level between groups;however, no significant difference was found. Intervention design varied greatly from remote monitoring of blood glucose combined with video versus in-person visits to an endocrinology clinic to a brief, 3-week remote intervention to stabilize uncontrolled diabetes. No articles were identified for chronic obstructive pulmonary disease. Conclusions: This review found few studies with a variety of designs and interventions that used telehealth as a replacement for in-person care. Future research should consider including observational studies and studies on additional highly prevalent chronic diseases.

6.
Evidence - Based Complementary and Alternative Medicine ; 2022, 2022.
Article in English | ProQuest Central | ID: covidwho-2020470

ABSTRACT

Bufei decoction (BFD) has been applied to treat chronic obstructive pulmonary disease (COPD) for centuries as a recognized traditional Chinese herbal formula. However, mechanisms of BFD on COPD are unclear. This study conducts an inquiry into the underlying mechanisms of the therapeutic effect of BFD on COPD. A COPD rat model with qi deficiency in lungs was established through induction using cigarette and sawdust smoking combined with intratracheal instillation of lipopolysaccharide following BFD treatment for 28 days. Changes in Th17/Treg cells of COPD rats with the syndrome of lung qi deficiency after BFD administration were verified using pulmonary function, ELISA, flow cytometry, histopathology, and Western blotting assays. The findings showed that BFD protected COPD rats from decreased lung function and lung injury. BFD administration reduced proinflammatory cytokines IL-6 and IL-17 secretion, promoted inhibitory cytokines IL-10 and TGF-β secretion, decreased Th17/Treg cell ratio, markedly downregulated the Th17 cell transcription factor ROR-γt expression, and upregulated transcription factor Foxp3 expression in Treg cells. We speculate that lung tonic soup improved pulmonary qi deficiency in rats with COPD by regulating the balance of Th17/Treg cells.

7.
Thorax ; 2022.
Article in English | ProQuest Central | ID: covidwho-2020316

ABSTRACT

Correspondence to Dr Mark E Howard, Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, Victoria, Australia;mark.howard@austin.org.au Models of care that minimise the use of acute hospital beds have become increasingly important during the COVID-19 pandemic, not only to optimise capacity for acute care, but also to minimise infection transmission risks and meet the needs of patients who avoid care due to concerns regarding attending healthcare facilities. An important contribution to designing models for NIV initiation, Murphy and colleagues1 demonstrate that initiating ventilation using auto-titrating NIV at home combined with oximetry monitoring was clinically effective and safe in comparison with in-hospital titration of fixed pressure NIV in patients with stable OHS.1 Interestingly, the healthcare costs over 3 months were similar in both models, with higher set-up costs for the inpatient model, but higher healthcare utilisation costs post set-up in the home-based implementation, including more outpatient and emergency department visits. In addition to cost savings, home implementation reduces the potential risk of infection transmission given the aerosol-generating properties of NIV and enhances capacity for high-dependency acute hospital beds which are critical in the current environment.

8.
Journal of Epidemiology and Community Health ; 2022.
Article in English | ProQuest Central | ID: covidwho-2020144

ABSTRACT

BackgroundTo estimate prevalence and incidence of diseases through self-reports in observational studies, it is important to understand the accuracy of participant reports. We aimed to quantify the agreement of self-reported and general practitioner-reported diseases in an old-aged population and to identify socio-demographic determinants of agreement.MethodsThis analysis was conducted as part of the AugUR study (n=2449), a prospective population-based cohort study in individuals aged 70–95 years, including 2321 participants with consent to contact physicians. Self-reported chronic diseases of participants were compared with medical data provided by their respective general practitioners (n=589, response rate=25.4%). We derived overall agreement, over-reporting/under-reporting, and Cohen’s kappa and used logistic regression to evaluate the dependency of agreement on participants’ sociodemographic characteristics.ResultsAmong the 589 participants (53.1% women), 96.9% reported at least one of the evaluated chronic diseases. Overall agreement was >80% for hypertension, diabetes, myocardial infarction, stroke, cancer, asthma, bronchitis/chronic obstructive pulmonary disease and rheumatoid arthritis, but lower for heart failure, kidney disease and arthrosis. Cohen’s kappa was highest for diabetes and cancer and lowest for heart failure, musculoskeletal, kidney and lung diseases. Sex was the primary determinant of agreement on stroke, kidney disease, cancer and rheumatoid arthritis. Agreement for myocardial infarction and stroke was most compromised by older age and for cancer by lower educational level.ConclusionSelf-reports may be an effective tool to assess diabetes and cancer in observational studies in the old and very old aged. In contrast, self-reports on heart failure, musculoskeletal, kidney or lung diseases may be substantially imprecise.

9.
BMJ Open ; 12(8), 2022.
Article in English | ProQuest Central | ID: covidwho-2020034

ABSTRACT

IntroductionIncreasing numbers of patients with non-haematological diseases are infected with invasive pulmonary aspergillosis (IPA), with a high mortality reported which is mainly due to delayed diagnosis. The diagnostic capability of mycological tests for IPA including galactomannan test, (1,3)-β-D-glucan test, lateral flow assay, lateral flow device and PCR for the non-haematological patients remains unknown. This protocol aims to conduct a systematic review and meta-analysis of the diagnostic performance of mycological tests to facilitate the early diagnosis and treatments of IPA in non-haematological diseases.Methods and analysisDatabase including PubMed, CENTRAL and EMBASE will be searched from 2002 until the publication of results. Cohort or cross-sectional studies that assessing the diagnostic capability of mycological tests for IPA in patients with non-haematological diseases will be included. The true-positive, false-positive, true-negative and false-negative of each test will be extracted and pooled in bivariate random-effects model, by which the sensitivity and specificity will be calculated with 95% CI. The second outcomes will include positive (negative) likelihood ratio, area under the receiver operating characteristic curve and diagnostic OR will also be computed in the bivariate model. When applicable, subgroup analysis will be performed with several prespecified covariates to explore potential sources of heterogeneity. Factors that may impact the diagnostic effects of mycological tests will be examined by sensitivity analysis. The risk of bias will be appraised by the Quality Assessment tool for Diagnostic Accuracy Studies (QUADAS-2).Ethics and disseminationThis protocol is not involved with ethics approval, and the results will be peer-reviewed and disseminated on a recognised journal.PROSPERO registration numberCRD42021241820.

10.
BMJ Case Reports ; 15(9), 2022.
Article in English | ProQuest Central | ID: covidwho-2019954

ABSTRACT

Deep neck space infections (DNSIs) are challenging to diagnose and manage. A female ex-smoker presented with difficulty breathing and chest pain. She was initially treated for exacerbation of emphysema with intravenous antibiotics. The ear, nose and throat team were later asked to review the patient for left submandibular swelling and odynophagia. CT of the neck was performed 10 days later, due to limited availability during COVID-19. It showed an extensive retropharyngeal collection from the level of the vallecula to just above the carina. Normally, a DNSI extending to the mediastinum would require prompt surgical management. However, the patient was clinically well once imaged, so the abscess was managed conservatively with intravenous antibiotics.

11.
7th International Conference on Communication and Electronics Systems, ICCES 2022 ; : 484-489, 2022.
Article in English | Scopus | ID: covidwho-2018799

ABSTRACT

Air pollution causes several diseases like suffocation, chronic obstructive pulmonary disease (COPD), lung cancer, throat infection, and so forth. So, there is a need to monitor indoor air quality for the safety of human life. Indoor air pollution is even more dangerous than outdoor air pollution. Even, after the COVID-19 pandemic, humans are spending most of their time in indoor houses. In addition to this, air pollution is increasing day by day due to varying climate changes. In view of this fact, this research wor has designed and developed a novel system based on the latest IoT technology that monitors indoor air quality and provides a web portal for data visualization. The proposed system consists of several gas sensors integrated on a single PCB that helps in reading seven pollutants like CO2, CO, O3, NO2, VOC, and Particulate Matter along with humidity and temperature. In our work, Raspberry Pi acts as a processor as well as the communicating node to the cloud. The experimental setup is deployed in several indoor places like closed labs, classrooms, homes, etc., where humans spend more time. Raspberry Pi is having an inbuilt wi-fi functionality and the real-time data is sent to Google Firebase with help of a Jio Fi router. After visualizing the data, Indoor Air Quality Index (IAQI) is measured and generates an alarm for the safety of humans when air standard crosses a marginal value. © 2022 IEEE.

12.
Chinese Journal of Nosocomiology ; 32(10):1468-1472, 2022.
Article in English, Chinese | CAB Abstracts | ID: covidwho-2011846

ABSTRACT

OBJECTIVE: To systematically describe the outcomes of patients with COVID-19-associated pulmonary aspergillosis (CAPA). METHODS: All of the researches covering the clinical outcomes of CAPA were retrieved from databases such as ScienceDirect, PubMed, CNKI and MEDLINE (OVID) from Dec 31, 2019 to Dec 1, 2021. The literatures were screened out based on inclusion and exclusion criteria by 2 writers, the data were extracted, the quality of the literatures was evaluated, and meta-analysis was performed. RESULTS: Totally 14 cohort studies were included in this study, with 2 056 severe COVID-19 patients involved, including 338 CAPA patients and 1 718 non-CAPA patients. The incidence rate of CAPA was 16.4% among the ICU patients. As compared with the non-CAPA patients, the mortality rate of the CAPA patients was increased by 21% [risk difference (RD)]=0.21, 95% CI:0.15-0.27, (I-2=0%). No heterogeneity or publication bias was detected (t=1.98, P=0.069). Among the patients with underlying diseases, the patients with chronic obstructive pulmonary disease (COPD) were 2.37 times the risk of CAPA as high as the patients of the non-CAPA group (95% CI: 1.15-4.88, P=0.020). The creatinine level of the CAPA patients was higher than that of the non-CAPA patients (33.32 micro mol/L, 95% CI: 6.81-59.83, P=0.014). As compared with the non-CAPA patients, the patients who received renal replacement therapy were 2.33 times the risk of CAPA (95% CI: 1.43-3.80, P=0.001). CONCLUSION: 16.4% of the severe COVID-19 patients have CAPA, the mortality rate is high. COPD, serum creatinine and renal replacement therapy may remarkably increase the risk of CAPA, and it is suggested that a prospective screening of CAPA should be carried out for the severe COVID-19 patients.

13.
Chinese Journal of Nosocomiology ; 32(6):875-879, 2022.
Article in English, Chinese | GIM | ID: covidwho-2011588

ABSTRACT

OBJECTIVE: To explore the expression of tumor necrosis factor-a (TNF-a), interferon-? (IFN-?), soluble interleukin-2 receptor (sIL-2 R) and C-reactive protein (CRP) in chronic obstructive pulmonary disease (COPD) patients complicated with pulmonary tuberculosis (PTB). METHODS: From Mar 2016 to Mar 2019, the acute stage of COPD patients complicated with active stage of PTB who were treated in the department of respiratory and critical care medicine of the People's Hospital of Liangping District, Chongqing were assigned as the group, the acute stage of COPD patients complicated with recovery stage of PTB were assigned as the group B, the stable stage of COPD patients complicated with active stage of PTB were assigned as the group C, and the stable stage of COPD patients complicated with recovery stage of PTB were assigned as the group D. 25 patients with simple stable stage of COPD, 25 patients with simple recovery stage of PTB, 25 patients with simple acute stage of COPD, 25 patients with simple active stage of PTB and 25 people who received physical examination were chosen as the control group. The serum TNF-a, IFN-?, sIL-2 R and CRP were observed and compared among the groups, and the data were statistically analyzed. RESULTS: The levels of TNF-a, IFN-?, sIL-2 R and CRP of the case groups were significantly higher than those of the control group (P < 0.05). The levels of serum TNF-a, IFN-?, sIL-2 R and CRP of the simple stable stage of COPD group, the simple acute stage of COPD group, the simple recovery stage of PTB group, the simple active stage of PTB group, the group D, the group B, the group C and the group A were elevated successively (P < 0.05). The levels of serum TNF-a, IFN-?, sIL-2 R and CRP of the patients with improved illness condition were reduced after treatment. The AUCs of the TNF-a, IFN-?, sIL-2 R and CRP were respectively 0.706, 0.718, 0.768 and 0.807 in prediction of deterioration of disease. CONCLUSION: The PTB patients complicated with COPD show abnormal expression of serum TNF-a, IFN-?, sIL-2 R and CRP. The TNF-a, IFN-?, sIL-2 R and CRP are associated with the severity of disease and have high value in prediction of the deterioration of disease.

14.
Respir Res ; 23(1): 208, 2022 Aug 16.
Article in English | MEDLINE | ID: covidwho-2002180

ABSTRACT

BACKGROUND: Chronic obstructive pulmonary disease (COPD) and interstital lung disease (ILD) are incurable conditions characterised by airflow limitation, persisting respiratory symptoms, and progressive respiratory failure. People living with COPD or ILD often suffer from chronic and severe breathlessness, with limited treatment options and low engagement rates with current therapies. Group singing represents a potential community-based therapy to improve quality of life for patients with COPD or ILD and breathlessness. METHODS: This protocol papers describes SINFONIA, a parallel, double-arm, randomised, blinded-analysis, mixed-methods phase II/III trial of guided, online group singing that will be conducted over 24 months. Adults with confirmed COPD or ILD, on stable treatment for at least four weeks at time of recruitment, with a modified Medical Research Council (mMRC) dyspnoea score of two or greater, who are capable and willing to give consent, and not currently participating in pulmonary rehabilitation will be eligible to participate. Carers may optionally enrol in the trial. Data will be collected on quality of life, anxiety and depression, breathlessness, mastery of breathing, exercise tolerance, loneliness, healthcare utilisation, and carer quality of life (optional). Participants will be randomised 1:1 to intervention or control arms with intervention arm attending one 90 min, guided, online, group singing session per week for 12 weeks and control arm continuing routine care. Phase II of the trial aims to determine the feasibility and acceptability of guided, online group singing and will collect preliminary data on effectiveness. Phase III aims to determine whether guided, online group singing has an effect on quality of life with the primary outcome being a between arm difference in quality of life (36-item Short Form Survey) measured at 12 weeks. DISCUSSION: SINFONIA is the first study is the first of its kind in Australia and to our knowledge, the first to deliver the singing intervention program entirely online. Determining the feasibility, acceptability, and effectiveness of guided, online group singing is an important step towards improving low-cost, low-risk, community-based therapeutic options for patients living with COPD or ILD and breathlessness. TRIAL REGISTRATION: Phase II- ACTRN12621001274864 , registered 20th September 2021; Phase III- ACTRN12621001280897 , registered 22nd September 2021.


Subject(s)
Lung Diseases, Interstitial , Pulmonary Disease, Chronic Obstructive , Singing , Adult , Caregivers , Clinical Trials, Phase II as Topic , Dyspnea , Humans , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Life , Randomized Controlled Trials as Topic
15.
Health Science Journal ; 16(7):1-5, 2022.
Article in English | ProQuest Central | ID: covidwho-2002882

ABSTRACT

Keywords: Core Muscles;Functional Capacity;Peak Cough Flow;Hospitalized Patients;Case Report Introduction The "core" has been used to refer a three-dimensional space, the lumbopelvic-hip complex, which involves deeper muscles, such as the internal oblique, transverses abdominals, transversospinalis (multifidus, rotators, semispinalis), quadratus lumborum, and psoas major and minor, and superficial muscles, such as the rectus abdominis, external oblique, erector spinae (iliocostalis, spinalis, longissimus) latissimus dorsi, gluteus maximus and medius, hamstrings, and rectus femoris [1, 2]. At the beginning of the session HR, respiratory rate (RR), SpO2, Blood pressure (BP), dyspnea (using the MBS) was monitored for all patients and for those who have diabetes was also monitored glucose levels. Personal history (PH) of SARS-CoV2 pneumonia in March 2021 (hospitalized for 1 month in the Intensive Care Unit (ICU) using mechanically invasive ventilation), type 2 diabetes mellitus (DM) treated with premixed insulin, polyneuropathy for more than 10 years, arterial hypertension (AH), chronic kidney disease (CKD), coronary heart disease (placement stent in 2010), dyslipidaemia, chronic gastritis, lithiasis and renal cysts.

16.
NPJ Primary Care Respiratory Medicine ; 32(1), 2022.
Article in English | ProQuest Central | ID: covidwho-2000892

ABSTRACT

COPD is increasingly common in China but is poorly understood by patients, medications are not used as prescribed and there is no access to recommended non-pharmacological treatment. We explored COPD patients’ and general practitioners’ (GPs) knowledge of COPD, views on its management and the acceptability of a flexible lung health service (LHS) offering health education, exercise, self-management, smoking cessation and mental health support. Using a convergent mixed methods design, data were collected from patients and GPs using focus groups (FGs) in four Chinese cities, questionnaires were also used to collect data from patients. FGs were audio-recorded and transcribed. Quantitative data were analysed descriptively, thematic framework analysis was used for the qualitative data. Two-hundred fifty-one patients completed the questionnaire;39 patients and 30 GPs participated in ten separate FGs. Three overarching themes were identified: patients’ lack of knowledge/understanding of COPD, current management of COPD not meeting patients’ needs and LHS design, which was well received by patients and GPs. Participants wanted COPD education, TaiChi, psychological support and WeChat for social support. 39% of survey responders did not know what to do when their breathing worsened and 24% did not know how to use their inhalers. 36% of survey respondents requested guided relaxation. Overall, participants did not fully understand the implications of COPD and current treatment was sub-optimal. There was support for developing a culturally appropriate intervention meeting Chinese patients’ needs, health beliefs, and local healthcare delivery. Further research should explore the feasibility of such a service.

17.
Journal of Asthma and Allergy ; 15:1065-1068, 2022.
Article in English | ProQuest Central | ID: covidwho-1993633

ABSTRACT

Kyoung-Hee Sohn,1 Myung-Nam Lee,2 Da Woon Sim,3 Sujeong Kim,4 You Sook Cho,5 Hyouk-Soo Kwon,5 Sang-Heon Kim6 1Division of Pulmonology and Allergy, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, South Korea;2Department of Nursing, College of Health Science, Kangwon National University Samcheok, Samcheok-si, Gangwon-do, South Korea;3Department of Allergy and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea;4Division of Allergy and Clinical Immunology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea;5Department of Allergy and Clinical Immunology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea;6Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea Correspondence: Hyouk-Soo Kwon, Department of Allergy and Clinical Immunology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea, Email [email protected] Sang-Heon Kim, Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea, Email [email protected]

18.
The International Journal of Cardiovascular Imaging ; 38(8):1733-1739, 2022.
Article in English | ProQuest Central | ID: covidwho-1990682

ABSTRACT

BackgroundCOVID-19 has caused a global pandemic unprecedented in a century. Though primarily a respiratory illness, cardiovascular risk factors predict adverse outcomes. We aimed to investigate the role of baseline echocardiographic abnormalities in further refining risk in addition to clinical risk factors.MethodsAdults with COVID-19 positive RT-PCR test across St Luke’s University Health Network between March 1st 2020-October 31st 2020 were identified. Those with trans-thoracic echocardiography (TTE) within 15–180 days preceding COVID-19 positivity were selected, excluding severe valvular disease, acute cardiac event between TTE and COVID-19, or asymptomatic patients positive on screening. Demographic, clinical, and echocardiographic variables were manually extracted from patients’ EHR and compared between groups stratified by disease severity. Logistic regression was used to identify independent predictors of hospitalization.Results192 patients met inclusion criteria. 87 (45.3%) required hospitalization, 34 (17.7%) suffered severe disease (need for ICU care/mechanical ventilation/in-hospital death). Age, co-morbidities, and several echocardiographic abnormalities were more prevalent in those with moderate-severe disease than in mild disease, with notable exceptions of systolic/diastolic dysfunction. On multivariate analysis, age (OR 1.039, 95% CI 1.011–1.067), coronary artery disease (OR 4.184, 95% CI 1.451–12.063), COPD (OR 6.886, 95% CI 1.396–33.959) and left atrial diameter ≥ 4.0 cm (OR 2.379, 95% CI 1.031–5.493) predicted need for hospitalization. Model showed excellent discrimination (ROC AUC 0.809, 95% CI 0.746–0.873).ConclusionsBaseline left atrial enlargement is an independent risk factor for risk of hospitalization among patients with COVID-19. When available, baseline LA enlargement may identify patients for (1) closer outpatient follow up, and (2) counseling vaccine-hesitancy.

19.
Journal of Applied Biology and Biotechnology ; 10(5):52-58, 2022.
Article in English | Scopus | ID: covidwho-1988421

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is one of the most commonly identified co-morbidities with high morbidity and mortality risk in patients with Coronavirus Disease-19 (COVID-19) infection. The objective of the current study is to review the primary risk factors involved in the development of COVID-19 infections in COPD patients along with an insight on the effect of COPD medications in the development of this disease. The systematic search was performed on electronic databases such as PubMed, LitCovid, COVID-evidence, clinical trials, and Science Direct. ICU intervention and the use of invasive ventilators on the worsening of symptoms were the main inclusion parameters for the current review. Key findings indicate that the occurrence of COVID-2019 in COPD patients was low due to less availability of data. However, the risk of severity (66%) and mortality (58.62%) was high, suggesting that COPD patients with confirmed COVID-19 were at higher risk of disease. In regards to COVID-19, Angiotensin-converting enzyme-2 (ACE-2), one of the identified target receptors of the COVID-19 responsible for the infection, was observed to increase in COPD patients. COPD is thus a risk factor for developing extreme and critical forms of COVID-19 compared with the other groups, which further leads to requiring admission to an ICU and the use of invasive ventilators on the worsening of symptoms with high mortality rates. This systematic review, which together with ACE-2, will explain the severity and rate of mortality along with the risk factors of COVID-19 in COPD patients, the use of nebulizers with mesh to prevent transmission, and adherence to medication in the world’s current pandemic situation. © 2022 Meenakshi, et al.

20.
Lancet Reg Health Eur ; 21: 100473, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1977612

ABSTRACT

Background: The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail. Methods: We conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020 to November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis. Findings: 12,557 adult aLRTD hospitalisations occurred: 10,087 were associated with infection (pneumonia or non-pneumonic lower respiratory tract infection [NP-LRTI]), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% (3178/10,087) of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714.1, 264.2, and 449.9, and NP-LRTI were 346.2, 43.8, and 302.4 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (median 6.5 [IQR 0.7-10.2] admissions per 100,000 adults per week), while other infective aLRTD events were more stable (median 14.3 [IQR 12.8-16.4] admissions per 100,000 adults per week) as were non-infective aLRTD events (median 4.4 [IQR 3.5-5.5] admissions per 100,000 adults per week). Interpretation: While COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations. COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high. Funding: AvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer.

SELECTION OF CITATIONS
SEARCH DETAIL