Chronic Respiratory Disease最新文献

{"title":"The untapped potential of physical activity monitoring for quality assurance of field-based walking tests in clinical respiratory trials","authors":"M. Orme, Ilaria Pina, Sally J. Singh","doi":"10.1177/14799731221089318","DOIUrl":"https://doi.org/10.1177/14799731221089318","url":null,"abstract":"Field-based walking tests are well-established outcome measures in clinical research trials and in the evaluation of routine clinical services, including pulmonary rehabilitation. Despite widespread use, there has been little attention to, or reporting of, the quality assurance of these tests. Physical activity monitoring has become increasingly popular and data from activity monitors could be used for quality assurance of field-based walking tests. We provide examples in this article of data-driven insights possible with this approach, using data from waist-worn accelerometry, for the incremental shuttle walking test (ISWT), endurance shuttle walk test (ESWT) and six-minute walk test (6MWT). Given the multitude of devices to measure physical activity and the range metrics to describe physical activity, we also comment on some of the technical considerations to using activity monitors for walking test quality assurance. Data-driven approaches to quality assurance are already commonplace for other outcome measures in clinical respiratory trials, but little is known about this approach for field-based walking tests. The application of physical activity monitoring may be extended to other field-based exercise tests and additional rehabilitation services. This may be more challenging for self-paced walking tests such as the 6MWT. Future work should apply this approach to research trials and service evaluations to explore the impact of field-based walking test quality on performance (e.g. distance on the ISWT or time achieved for the ESWT), responsiveness to interventions (e.g. pulmonary rehabilitation) and effectiveness of training procedures (e.g. remote training for multi-site trials).","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45340584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"30 s sit-to-stand power is positively associated with chest muscle thickness in COVID-19 survivors.","authors":"Rodrigo Núñez-Cortés,&nbsp;Carlos Cruz-Montecinos,&nbsp;Francisco Martinez-Arnau,&nbsp;Rodrigo Torres-Castro,&nbsp;Esteban Zamora-Risco,&nbsp;Sofía Pérez-Alenda,&nbsp;Lars L Andersen,&nbsp;Joaquín Calatayud,&nbsp;Estanislao Arana","doi":"10.1177/14799731221114263","DOIUrl":"https://doi.org/10.1177/14799731221114263","url":null,"abstract":"<p><strong>Introduction: </strong>After hospitalization, early detection of musculoskeletal sequelae might help healthcare professionals to improve and individualize treatment, accelerating recovery after COVID-19. The objective was to determine the association between the 30s sit-to-stand muscle power (30s-STS) and cross-sectional area of the chest muscles (pectoralis) in COVID-19 survivors.</p><p><strong>Method: </strong>This cross-sectional study collected routine data from COVID-19 survivors one month after hospitalization: 1) a chest computed tomography (CT) scan and 2) a functional capacity test (30s-STS). The pectoralis muscle area (PMA) was measured from axial CT images. For each gender, patients were categorized into tertiles based on PMA. The 30s-STS was performed to determine the leg extension power. The allometric and relative STS power were calculated as absolute 30s-STS power normalized to height squared and body mass. The two-way ANOVA was used to compare the gender-stratified tertiles of 30s-STS power variants.</p><p><strong>Results: </strong>Fifty-eight COVID-19 survivors were included (mean age 61.2 ± 12.9 years, 30/28 (51.7%/48.3%) men/women). The two-way ANOVA showed significant differences between the PMA tertiles in absolute STS power (<i>p</i> = .002) and allometric STS power (<i>p</i> = .001). There were no significant gender x PMA tertile interactions (all variables <i>p</i> > .05). The high tertile of PMA showed a higher allometric STS power compared to the low and middle tertile, <i>p</i> = .002 and <i>p</i> = .004, respectively. Absolute STS power and allometric STS power had a moderate correlation with the PMA, r = 0.519 (<i>p</i> < .001) and r = 0.458 (<i>p</i> < .001) respectively.</p><p><strong>Conclusion: </strong>The 30s-STS power is associated with pectoralis muscle thickness in both male and female COVID-19 survivors. Thus, this test may indicate global muscle-wasting and may be used as a screening tool for lower extremity functional capacity in the early stages of rehabilitation planning in COVID-19 survivors.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/19/10.1177_14799731221114263.PMC9379968.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40715310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adiposity increases weight-bearing exercise-induced dyspnea despite favoring resting lung hyperinflation in COPD.","authors":"Zewari S,&nbsp;van den Borst B,&nbsp;van den Elshout Fj,&nbsp;Vercoulen Jh,&nbsp;Dekhuijzen Pn,&nbsp;Heijdra Yf,&nbsp;Vos Pj","doi":"10.1177/14799731211052305","DOIUrl":"https://doi.org/10.1177/14799731211052305","url":null,"abstract":"<p><strong>Objectives: </strong>Our aim was to study the associations between resting lung hyperinflation, weight-bearing exercise-induced dyspnea and adipose distribution in obese and normal-weight COPD patients.</p><p><strong>Methods: </strong>We performed a comparison between 80 obese COPD patients (COPD_OB) with 80 age- and FEV₁ matched normal-weight COPD patients (COPD_NW). Dyspnea was assessed by the mMRC scale and the Borg dyspnea score before and after a 6 min walk test. Further characterization included spirometry, body plethysmography and metronome paced tachypnea (MPT) to estimate dynamic hyperinflation. Body composition was assessed with bioelectrical impedance analysis. Associations between dyspnea scores and BMI and body composition groups were studied using logistic regression models.</p><p><strong>Results: </strong>COPD_OB patients had attenuated increases in TLC, FRC and RV compared to COPD_NW patients (<i>p</i> < 0.01). The groups had comparable 6 min walking distance and ΔFRC upon MPT (<i>p</i> > 0.05). Compared to COPD_NW, COPD_OB patients reported more often a mMRC ≥ 2 (65 vs 46%; <i>p</i> = 0.02; OR 3.0, 95% CI 1.4-6.2, <i>p</i> < 0.01) and had higher ΔBorg upon 6MWT: 2.0 (SEM 0.20) vs. 1.4 (SEM 0.16), <i>p</i> = 0.01; OR for ΔBorg ≥ 2: 2.4, 95% CI 1.1-5.2, <i>p</i> = 0.03. Additional logistic regression analyses on the associations between body composition and dyspnea indicated that increased body fat percentage, fat mass index and waist-to-hip ratio were associated with higher ORs for mMRC ≥ 2 and ΔBorg upon 6MWT ≥ 2.</p><p><strong>Conclusion: </strong>Despite its beneficial effect on resting lung hyperinflation, adiposity is associated with increased weight-bearing exercise-induced dyspnea in COPD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39596087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of pulmonary hypertension on exercise capacity and gas exchange in patients with chronic obstructive pulmonary disease living at high altitude","authors":"M. González-García, C. Aguirre-Franco, Leslie Vargas-Ramirez, M. Barrero, C. Torres-Duque","doi":"10.1177/14799731221104095","DOIUrl":"https://doi.org/10.1177/14799731221104095","url":null,"abstract":"Background: Pulmonary hypertension (PH) is associated with decreased exercise tolerance in chronic obstructive pulmonary disease (COPD) patients, but in the altitude the response to exercise in those patients is unknown. Our objective was to compare exercise capacity, gas exchange and ventilatory alterations between COPD patients with PH (COPD-PH) and without PH (COPD-nonPH) residents at high altitude (2640 m). Methods: One hundred thirty-two COPD-nonPH, 82 COPD-PH, and 47 controls were included. Dyspnea by Borg scale, oxygen consumption (VO2), work rate (WR), ventilatory equivalents (VE/VCO2), dead space to tidal volume ratio (VD/VT), alveolar-arterial oxygen tension gradient (AaPO2), and arterial-end-tidal carbon dioxide pressure gradient (Pa-ETCO2) were measurement during a cardiopulmonary exercise test. For comparison of variables between groups, Kruskal-Wallis or one-way ANOVA tests were used, and stepwise regression analysis to test the association between PH and exercise capacity. Results: All COPD patients had a lower exercise capacity and higher PaCO2, A-aPO2 and VD/VT than controls. The VO2 % predicted (61.3 ± 20.6 vs 75.3 ± 17.9; p < 0.001) and WR % predicted (65.3 ± 17.9 vs 75.3 ± 17.9; p < 0.001) were lower in COPD-PH than in COPD-nonPH. At peak exercise, dyspnea was higher in COPD-PH (p = 0.011). During exercise, in COPD-PH, the PaO2 was lower (p < 0.001), and AaPO2 (p < 0.001), Pa-ETCO2 (p = 0.033), VE/VCO2 (p = 0.019), and VD/VT (p = 0.007) were higher than in COPD-nonPH. In the multivariate analysis, PH was significantly associated with lower peak VO2 and WR (p < 0.001). Conclusion: In COPD patients residing at high altitude, the presence of PH was an independent factor related to the exercise capacity. Also, in COPD-PH patients there were more dyspnea and alterations in gas exchange during the exercise than in those without PH.","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42004281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of quadriceps muscle size and quality in adults with cystic fibrosis with different severities of cystic fibrosis transmembrane conductance regulator protein dysfunction.","authors":"Kenneth Wu,&nbsp;Anna Michalski,&nbsp;Jenna Sykes,&nbsp;Jane Batt,&nbsp;Anne L Stephenson,&nbsp;Sunita Mathur","doi":"10.1177/14799731221131330","DOIUrl":"https://doi.org/10.1177/14799731221131330","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) is characterized by CF transmembrane conductance regulator (CFTR) dysfunction. CFTR protein is expressed in human skeletal muscle; however, its impact on skeletal muscle is unknown. The objectives of this study were to compare quadriceps muscle size and quality between adults with various severities of CFTR protein dysfunction.</p><p><strong>Methods: </strong>We conducted a prospective, cross-sectional study comparing 34 adults with severe versus 18 with mild CFTR protein dysfunction, recruited from a specialized CF centre. Ultrasound images of rectus femoris cross-sectional area (RF-CSA) and quadriceps layer thickness for muscle size, and rectus femoris echogenicity (RF-ECHO) (muscle quality) were obtained. Multivariable linear regression models were developed using purposeful selection technique.</p><p><strong>Results: </strong>People with severe CFTR protein dysfunction had larger RF-CSA by 3.22 cm², 95% CI (1.03, 5.41) cm², <i>p</i>=.0049], after adjusting for oral corticosteroid use and <i>Pseudomonas aeruginosa</i> colonization. However, a sensitivity analysis indicated that the result was influenced by the specific confounders being adjusted for in the model. We did not find any significant differences in quadriceps layer thickness or RF-ECHO between the two groups.</p><p><strong>Conclusion: </strong>We found no differential impact of the extent of diminished CFTR protein activity on quadriceps muscle size or quality in our study cohort. Based on these findings, CFTR mutation status cannot be used differentiate leg muscle size or quality in people with CF.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9669672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10417944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of a physical activity behavioural modification tele-coaching intervention in lung transplant recipients.","authors":"Emily Hume,&nbsp;Hazel Muse,&nbsp;Kirstie Wallace,&nbsp;Mick Wilkinson,&nbsp;Karen Heslop Marshall,&nbsp;Arun Nair,&nbsp;Stephen Clark,&nbsp;Ioannis Vogiatzis","doi":"10.1177/14799731221116588","DOIUrl":"https://doi.org/10.1177/14799731221116588","url":null,"abstract":"<p><strong>Background: </strong>Despite improvements in pulmonary function following lung transplantation (LTx), physical activity levels remain significantly lower than the general population. To date, there is little research investigating interventions to improve daily physical activity in LTx recipients. This study assessed the feasibility and acceptability of a novel, 12-weeks physical activity tele-coaching (TC) intervention in LTx recipients.</p><p><strong>Methods: </strong>Lung transplant recipients within 2 months of hospital discharge were recruited and randomised (1:1) to TC or usual care (UC). TC consists of a pedometer and smartphone app, allowing transmission of activity data to a platform that provides feedback, activity goals, education, and contact with the researcher as required. Recruitment and retention, occurrence of adverse events, intervention acceptability and usage were used to assess feasibility.</p><p><strong>Results: </strong>Key criteria for progressing to a larger study were met. Of the 15 patients eligible, 14 were recruited and randomised to TC or UC and 12 completed (67% male; mean ± SD age; 58 ± 7 years; COPD <i>n</i> = 4, ILD <i>n</i> = 6, CF <i>n</i> = 1, PH <i>n</i> = 1): TC (<i>n</i> = 7) and UC (<i>n</i> = 5). TC was well accepted by patients, with 86% indicating that they enjoyed taking part. Usage of the pedometer was excellent, with all patients wearing it for over 90% of days and rating the pedometer and telephone contact as the most vital aspects. There were no adverse events related to the intervention. After 12 weeks, only TC displayed improvements in accelerometry steps/day (by 3475 ± 3422; <i>p</i> = .036) and movement intensity (by 153 ± 166 VMU; <i>p</i> = .019), whereas both TC and UC groups exhibited clinically important changes in physical SF-36 scores (by 11 ± 14 and 7 ± 9 points, respectively).</p><p><strong>Conclusion: </strong>TC appears to be a feasible, safe, and well-accepted intervention in LTx.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9619269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10778547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to “A review of respiratory manifestations and their management in Ehlers-Danlos syndromes and hypermobility spectrum disorders”","authors":"","doi":"10.1177/14799731211049699","DOIUrl":"https://doi.org/10.1177/14799731211049699","url":null,"abstract":"Chohan K, Mittal N, McGillis L et al. A review of respiratory manifestations and their management in EhlersDanlos syndromes and hypermobility spectrum disorders. Chronic Respiratory Disease. 2021; 18: 1-14. doi: 10.1177/ 14799731211025313 The correct list of references for this article can be found below: 1. Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet 2017; 175:8-26 2. Callewaert B, Malfait F, Loeys B, et al. Ehlers-Danlos syndromes and Marfan syndrome. Best Pract Res Clin Rheumatol 2008; 22:165-189 3. Demmler JC, AtkinsonMD,Reinhold EJ, et al. Diagnosed prevalence of Ehlers-Danlos syndrome and hypermobility spectrum disorder in Wales, UK: a national electronic cohort study and case-control comparison. BMJOpen 2019; 9:e031365 4. Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 2000; 27:1777-1779 5. Castori M, Tinkle B, Levy H, et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet 2017; 175: 148-157 6. Cederlof M, Larsson H, Lichtenstein P, et al. Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome and their siblings. BMCPsychiatry 2016; 16: 207 7. Ayres JG, Pope FM, Reidy JF, et al. Abnormalities of the lungs and thoracic cage in the Ehlers-Danlos syndrome. Thorax 1985; 40:300-305 8. Shields LB, Rolf CM, Davis GJ, et al. Sudden and unexpected death in three cases of Ehlers-Danlos syndrome type IV. J Forensic Sci 2010; 55:1641-1645 9. Morgan AW, Pearson SB, Davies S, et al. Asthma and airways collapse in two heritable disorders of connective tissue. Ann Rheum Dis 2007; 66:1369-1373 10. Castori M, Hakim A. Contemporary approach to joint hypermobility and related disorders. Curr Opin Pediatr 2017; 29:640-649 11. Yost BA, Vogelsang JP, Lie JT. Fatal hemoptysis in Ehlers-Danlos syndrome. Old malady with a new curse. Chest 1995; 107:1465-1467 12. Herman TE, McAlister WH. Cavitary pulmonary lesions in type IV Ehlers-Danlos syndrome. Pediatr Radiol 1994; 24:263-265 13. Park MA, Shin SY, Kim YJ, et al. Vascular EhlersDanlos syndrome with cryptorchidism, recurrent pneumothorax, and pulmonary capillary hemangiomatosis-like foci: A case report. Medicine (Baltimore) 2017; 96:e8853 14. Reychler G, Liistro G, Pierard GE, et al. Inspiratory muscle strength training improves lung function in patients with the hypermobile Ehlers-Danlos syndrome: A randomized controlled trial. Am J Med Genet A 2019; 179: 356-364 15. Castori M, Camerota F, Celletti C, et al. Natural history and manifestations of the hypermobility type EhlersDanlos syndrome: a pilot study on 21 patients. Am J Med Genet A 2010; 152A:556-564 16. Gazit Y, Nahir AM, Grahame R, et al. Dysautonomia in the joint hypermobility syndrome. Am J Med 2003; 115: 33-40 17. Sim","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41861834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognosis of pre-frail chronic obstructive pulmonary disease patients for hospitalizations and mortality depends on their level of functional physical performance.","authors":"Francesc Medina-Mirapeix,&nbsp;Roberto Bernabeu-Mora,&nbsp;Mariano Gacto-Sánchez,&nbsp;Joaquina Montilla-Herrador,&nbsp;Pilar Escolar-Reina,&nbsp;María Piedad Sánchez-Martínez","doi":"10.1177/14799731221119810","DOIUrl":"https://doi.org/10.1177/14799731221119810","url":null,"abstract":"<p><strong>Objective: </strong>To determine if pre-frail Chronic obstructive pulmonary disease (COPD) patients with poor and non-poor performance in the five-repetition sit-to-stand test (5-STS) had a worse prognosis for hospitalization and mortality at 2 years and for mortality at 5 years than non-frail patients.</p><p><strong>Methods: </strong>We prospectively included patients with stable COPD, between 40 and 80 years, from a hospital in Spain. Patients were classified according their performance on the 5-STS test and level of frailty. Timing, number of hospitalizations, length of stay, and timing and rate of mortality were outcome measures. Patients were followed for 2 years for exacerbations and for 5 years for mortality. Kaplan-Meier curves and univariate and multivariate Cox proportional-hazard analyses, ANOVA tests and univariate and multivariate linear and logistic regression models were used.</p><p><strong>Results: </strong>Of the 125 patients included, 25.6% were pre-frail with poor performance, 57% pre-frail with non-poor performance, and 17.4% non-frail with non-poor performance. Pre-frail patients with poor performance had a higher number of hospitalizations (adjusted beta: 0.49; 95% CI: 0.01-0.96), mortality rates (odds ratio: 11.33; 95% CI: 1.15-110.81), and risk at 5 years (adjusted hazard ratio: 8.77; 95% CI: 1.02-75.51) than non-frail patients. Pre-frail patients with poor performance also had worse prognoses than non-frail patients with respect to length of hospital stays (increased by 4.16 days) and timing to first hospitalization (HR: 6.01) in unadjusted models, but not when adjusted.</p><p><strong>Conclusion: </strong>The COPD prognosis of pre-frail patients with respect to the number of exacerbations with hospitalization and the timing and rate of mortality is dependent of functional performance.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/76/10.1177_14799731221119810.PMC9459488.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The benefits of a home non-invasive ventilation retrieval service: Improved effectiveness and environmental sustainability in challenging times","authors":"A. Oakes, P. Antoine-Pitterson, Alastair Watson, B. Cooper, R. Mukherjee","doi":"10.1177/14799731221081857","DOIUrl":"https://doi.org/10.1177/14799731221081857","url":null,"abstract":"In the last 6 months, home non-invasive ventilation (NIV) services have faced several unanticipated challenges to their effectiveness and delivery as the result of a ‘perfect storm’ of the COVID-19 pandemic demands. We developed and delivered an innovative follow-up service, to support home NIV delivery, and improve cost-effectiveness and sustainability during COVID-19. Between Feb-2019 and Nov-2020, 92 post-acute patients were issued with home NIV; 25 (27%) out of the 92 patients had unused NIV machines successfully retrieved. The median (IQR) days of home NIV usage were 207 (98) for patients who had their machines returned. All the unused NIV machines retrieved were within the 5-year working life guaranteed by the manufacturer and were all redeployed after appropriate reconditioning and infection control measures. Without the home-visiting and recycling pilot, we would have relied on patients and families to return the unused machines. Given the expected disruption to NIV machine supply for at least the foreseeable 12–18 months, we feel it is important to get this important message out to other home NIV services urgently. Wider implementation of this novel approach could increase the availability of this vital resource and help meet the current demand on home NIV services.","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45936112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of the post-tuberculous phenotype of bronchiectasis: A real-world observational study.","authors":"Isaac Fong, Teck Boon Low, Anthony Yii","doi":"10.1177/14799731221098714","DOIUrl":"10.1177/14799731221098714","url":null,"abstract":"<p><strong>Objective: </strong>Bronchiectasis is a heterogeneous disease with distinct phenotypes. The post-tuberculosis (post-TB) bronchiectasis phenotype is prevalent in many countries but is under-studied. Our aim was to identify distinct phenotypic characteristics of post-TB bronchiectasis.</p><p><strong>Methods: </strong>We recruited adults admitted between Jan 2010-Oct 2017 at Changi General Hospital, Singapore for bronchiectasis exacerbation. We collected demographics, symptoms, lung function, microbiology and FACED scores. Participants were followed-up until the next hospitalized exacerbation or end of study, whichever was sooner. Participants diagnosed by their attending respiratory specialist to have post-TB bronchiectasis were compared to those with bronchiectasis from other aetiologies.</p><p><strong>Results: </strong>148 participants were included with mean±standard deviation age 63 ± 9 years; 46 (31.1%) had post-TB bronchiectasis and 102 (68.9%) other aetiologies. Compared to other aetiologies, participants with post-TB bronchiectasis had significantly lower body mass index (BMI), more frequent presentation with haemoptysis, lower forced expiratory volume in one second (FEV₁), more frequent isolation of nontuberculous mycobacteria (NTM), and higher FACED scores indicating greater disease severity. Over a median follow-up of 21 months, post-TB bronchiectasis was associated with shorter time to next hospitalized exacerbation (49 vs 76 months, Log-Rank <i>p</i> = .01).</p><p><strong>Conclusion: </strong>Post-TB bronchiectasis is a distinct entity with higher rates of haemoptysis and NTM isolation, more frequent exacerbations, and greater disease severity.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45047550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}