Chronic Respiratory Disease最新文献

{"title":"The efficacy and safety of additional treatment with short-acting muscarinic antagonist combined with long-acting beta-2 agonist in stable patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Kazuya Tanimura,&nbsp;Susumu Sato,&nbsp;Yukio Fujita,&nbsp;Yoshifumi Yamamoto,&nbsp;Takashi Hajiro,&nbsp;Nobuyuki Horita,&nbsp;Tomotaka Kawayama,&nbsp;Shigeo Muro","doi":"10.1177/14799731231166008","DOIUrl":"https://doi.org/10.1177/14799731231166008","url":null,"abstract":"<p><strong>Background: </strong>The rationale for additional treatment with short-acting bronchodilators combined with long-acting bronchodilators for patients with chronic obstructive pulmonary disease (COPD) is not adequately studied.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of a short-acting muscarinic antagonist (SAMA) therapy combined with a long-acting beta-2 agonist (LABA) in patients with stable COPD. Pulmonary function, dyspnea, health-related quality of life, exercise tolerance, physical activity, exacerbations of COPD, and adverse events during regular use were set as outcomes of interest.</p><p><strong>Results: </strong>We included five controlled trials including two sets of publicly available online data without article publications for the meta-analysis. Additional use of SAMA plus LABA showed a significant improvement in the peak response in FEV₁ (mean difference (MD) 98.70 mL, <i>p</i> < .00001), transitional dyspnea index score (MD .85, <i>p</i> = .02), and St George's Respiratory Questionnaire score (MD -2.00, <i>p</i> = .008) compared to LABA treatment. There was no significant difference in the risk of exacerbation of COPD (<i>p</i> = .20) and only a slight trend of increased severe adverse events (OR: 2.16, <i>p</i> = .08) and cardiovascular events (OR: 2.38, <i>p</i> = .06).</p><p><strong>Conclusion: </strong>Additional treatment with SAMA combined with LABA could be a feasible choice due to its efficacy and safety.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231166008"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0c/d6/10.1177_14799731231166008.PMC10052583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9210724","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":"Alterations in circulating mitochondrial signals at hospital admission for COPD exacerbation.","authors":"Carlos A Amado, Paula Martín-Audera, Juan Agüero, Diego Ferrer-Pargada, Begoña Josa Laorden, Daymara Boucle, Ana Berja, Bernardo A Lavín, Armando R Guerra, Cristina Ghadban, Pedro Muñoz, Mayte García-Unzueta","doi":"10.1177/14799731231220058","DOIUrl":"10.1177/14799731231220058","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) exacerbation (ECOPD) alters the natural course of the disease. To date, only C-reactive protein has been used as a biomarker in ECOPD, but it has important limitations. The mitochondria release peptides (Humanin (HN), FGF-21, GDF-15, MOTS-c and Romo1) under certain metabolic conditions. Here, we aimed to evaluate the pathophysiologic, diagnostic and prognostic value of measuring serum mitochondrial peptides at hospital admission in patients with ECOPD.</p><p><strong>Methods: </strong>A total of 51 consecutive patients admitted to our hospital for ECOPD were included and followed for 1 year; in addition, 160 participants with stable COPD from our out-patient clinic were recruited as controls.</p><p><strong>Results: </strong>Serum FGF-21 (<i>p</i> < .001), MOTS-c (<i>p</i> < .001) and Romo1 (<i>p</i> = .002) levels were lower, and GDF-15 (<i>p</i> < .001) levels were higher, in patients with ECOPD than stable COPD, but no differences were found in HN. In receiver operating characteristic analysis, MOTS-c (AUC 0.744, 95% CI 0.679-0.802, <i>p</i> < .001) and GDF-15 (AUC 0.735, 95% CI 0.670-0.793, <i>p</i> < .001) had the best diagnostic power for ECOPD, with a diagnostic accuracy similar to that of C-RP (AUC 0.796 95% IC 0.735-0.848, <i>p</i> < .001). FGF-21 (AUC 0.700, 95% CI 0.633-0.761, <i>p</i> < .001) and Romo1 (AUC 0.645 95% CI 0.573-0.712, <i>p</i> = .001) had lower diagnostic accuracy. HN levels did not differentiate patients with ECOPD versus stable COPD (<i>p</i> = .557). In Cox regression analysis, HN (HR 2.661, CI95% 1.009-7.016, <i>p</i> = .048) and MOTS-c (HR 3.441, CI95% 1.252-9.297, <i>p</i> = .016) levels exceeding mean levels were independent risk factors for re-admission.</p><p><strong>Conclusions: </strong>Most mitochondrial peptides are altered in ECOPD, as compared with stable COPD. MOTS-c and GDF15 levels have a diagnostic accuracy similar to C-RP for ECOPD. HN and MOTS-c independently predict future re-hospitalization.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231220058"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138799454","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":"Muscle oxygen utilization and ventilatory parameters during exercise in people with cystic fibrosis: Role of HbA_1c.","authors":"Brooke P Quertermous,&nbsp;Nichole Seigler,&nbsp;Jacob Looney,&nbsp;Reva Crandall,&nbsp;Abigayle B Simon,&nbsp;Marsha Blackburn,&nbsp;Cassandra C Derella,&nbsp;Anson Blanks,&nbsp;Kathleen T McKie,&nbsp;Caralee Forseen,&nbsp;Ryan A Harris","doi":"10.1177/14799731231174542","DOIUrl":"https://doi.org/10.1177/14799731231174542","url":null,"abstract":"<p><strong>Introduction: </strong>Glycated hemoglobin can interfere with oxygen delivery and CO₂ removal during exercise. Additionally, pancreatic insufficiency increases oxidative stress and exacerbates exercise intolerance in people with cystic fibrosis (PwCF). This investigation sought to test the hypotheses that elevated Hemoglobin A_1c (HbA_1c) can negatively affect exercise parameters in PwCF and that reductions in oxidative stress can improve tissue oxygenation in individuals with elevated HbA_1c.</p><p><strong>Methods: </strong>Twenty four PwCF were divided into two groups; normal HbA1c <5.7% (N-HbA_1c) and elevated HbA_1c >5.7% (E-HbA_1c). A maximal exercise test was conducted to obtain peak oxygen uptake (VO₂peak), VO₂ at ventilatory threshold (VT), ventilatory parameters (V_E/VCO₂ slope and end-tidal CO₂ (petCO₂)). Near-Infrared Spectroscopy (NIRS) was used to assess muscle oxygenated/deoxygenated hemoglobin during exercise. A subset of individuals with E-HbA_1cwere given an antioxidant cocktail (AOC) for 4 weeks to determine the effects on tissue oxygenation during exercise.</p><p><strong>Results: </strong>A negative relationship between HbA_1c and VO₂peak at VT was observed (r = -0.511; <i>p</i> = 0.018). In addition, a positive relationship between HbA_1c and V_E/VCO₂ slope (<i>r =</i> 0.587;<i>p</i> = 0.005) and a negative relationship between HbA_1c and petCO₂ at maximal exercise (<i>r</i> = -0.472<i>;p =</i> 0.031) was observed. N-HbA_1c had greater VO₂peak (<i>p</i> = 0.021), VO₂ at VT (<i>p</i> = 0.004), petCO₂ (<i>p =</i> 0.002), and lower V_E/VCO₂ slope (<i>p</i> = 0.004) compared with E-HbA_1c. Muscle deoxygenated hemoglobin at VT was higher in N-HbA_1c vs. E-HbA_1c and 4 weeks of AOC improved skeletal muscle utilization of oxygen.</p><p><strong>Conclusion: </strong>Findings demonstrate that glycated hemoglobin may lead to tissue oxygenation impairment and ventilation inefficiency during exercise in PwCF. In addition, antioxidant supplementation may lead to improved tissue oxygenation during exercise.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231174542"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/e3/10.1177_14799731231174542.PMC10184196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9562038","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":"Age of asthma onset does not impact the response to omalizumab.","authors":"Linda Rogers,&nbsp;Cecile Tj Holweg,&nbsp;Hooman Pazwash,&nbsp;Jinnie Ko,&nbsp;Samuel Louie","doi":"10.1177/14799731231159673","DOIUrl":"https://doi.org/10.1177/14799731231159673","url":null,"abstract":"<p><strong>Trial registration: </strong>These studies were conducted before clinical trial registration was required; therefore, clinical trial registration numbers are not available.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231159673"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/a9/10.1177_14799731231159673.PMC10071096.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9305679","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":"Thanks to reviewers.","authors":"","doi":"10.1177/14799731231158689","DOIUrl":"https://doi.org/10.1177/14799731231158689","url":null,"abstract":"","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231158689"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10765600","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":"Developments in respiratory self-management interventions over the last two decades.","authors":"Tanja W Effing","doi":"10.1177/14799731231221819","DOIUrl":"10.1177/14799731231221819","url":null,"abstract":"<p><p>This paper describes developments in the fields of asthma and COPD self-management interventions (SMIs) over the last two decades and discusses future directions. Evidence around SMIs has exponentially grown. Efficacy on group level is convincing and both asthma and COPD SMIs are currently recommended by respiratory guidelines. Core components of asthma SMIs are defined as education, action plans, and regular review, with some discussion about self-monitoring. Exacerbation action plans are defined as an integral part of COPD management. Patient's adherence to SMI's is however inadequate and significantly reducing the intervention's impact. Adherence could be improved by tailoring of SMIs to patients' needs, health beliefs, and capabilities; the use of shared decision making; and optimising the communication between patients and health care providers. Due to the COVID-19 pandemic, digital health innovations have rapidly been introduced and expanded. Digital technology use may increase efficiency, flexibility, and efficacy of SMIs. Furthermore, artificial intelligence can be used to e.g., predict exacerbations in action plans. Research around digital health innovations to ensure evidence-based practice is of utmost importance. Current implementation of respiratory SMIs is not satisfactory. Implementation research should be used to generate further insights, with cost-effectiveness, policy (makers), and funding being significant determinants.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231221819"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828439","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":"Rehabilitation pre- and post thoracic surgery: Progress and future opportunities.","authors":"Dmitry Rozenberg","doi":"10.1177/14799731231165305","DOIUrl":"https://doi.org/10.1177/14799731231165305","url":null,"abstract":"The rehabilitation needs of patients undergoing thoracic surgery are evolving over the last two decades. Surgical management is being undertaken for older patients and those with increased co-morbidities, which are established risk factors for functional limitations peri-operatively. Thus, there is a growing need to understand the implications of pre-operative function, peri-operative course and preand post-operative rehabilitation strategies. This special collection of articles highlights keys areas in preand postthoracic surgical rehabilitation focusing on principles of frailty, skeletal muscle function, gait, balance, physical activity levels, and surgical outcomes. A narrative review by Daniel Langer summarizes the landscape of rehabilitation in thoracic surgery focusing on interventions that aim to optimize physical function preoperatively and recovery in the post-operative period. This review highlights that the majority of the evidence is in the areas of thoracic oncology and lung transplantation. It also reinforces that rehabilitation programs can be beneficial in improving skeletal muscle function, exercise capacity, quality of life, and functional recovery, but there remains a lack of guidelines with respect to training regimens, duration and referral pathways. The review identifies gaps that could be addressed in the future including opportunities for tele-rehabilitation, web-based activity counselling, and rehabilitation strategies beyond the immediate post-operative period. An article by Hanada et al. extends our knowledge on the importance of pre-operative physical function. Hanada and colleagues demonstrate in a prospective multicentered study of 364 older adults (&gt; 65 years) undergoing elective surgical resection for lung cancer in Japan, that a reduced Short Physical Performance Battery (SPPB &lt; 10 out of 12) was associated with post-operative pulmonary complications. The SPPB captures three functional domains (balance, gait speed and chair stands), which have been shown to be important elements of physical and lower extremity function predictive of surgical outcomes in gastrointestinal and lung transplant populations. The premise is pre-operative physical fitness correlates with cardiorespiratory, musculoskeletal, and physiological reserve that can help mitigate surgical stressors. Pre-operative physical function can help with earlier post-operative mobilization, improved airway clearance and ventilatory mechanics that can help reduce postoperative pulmonary complications. Similarly, a study by Roy et al. highlights the importance of underlying chronic lung disease on post-surgical outcomes, given the high prevalence of chronic obstructive pulmonary disease (COPD) in patients undergoing surgical lung cancer resection. Of the 1126 patients included in their study cohort, 672 (60%) had COPD. The authors highlight that following surgical lung cancer resection, patients with COPD are at higher risk of all cause morbidity, including r","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231165305"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/b7/10.1177_14799731231165305.PMC10031604.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9204077","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":"Association between non-cystic fibrosis bronchiectasis and the risk of incident dementia: A nationwide cohort study.","authors":"Sang Hyuk Kim, Kyungdo Han, Jongkyu Park, Dong Won Park, Ji-Yong Moon, Yun Su Sim, Tae-Hyung Kim, Sang-Heon Kim, Jang Won Sohn, Ho Joo Yoon, Hyun Lee, Hayoung Choi","doi":"10.1177/14799731231222282","DOIUrl":"https://doi.org/10.1177/14799731231222282","url":null,"abstract":"<p><strong>Background: </strong>Chronic lung diseases, such as chronic obstructive pulmonary disease or asthma, are associated with an increased risk of dementia. However, few data are available regarding the risk of dementia in individuals with bronchiectasis.</p><p><strong>Objectives: </strong>To explore the association between bronchiectasis and the risk of incident dementia using a longitudinal population-based cohort.</p><p><strong>Methods: </strong>A total of 4,068,560 adults older than 50 years without previous dementia were enrolled from the Korean National Health Insurance Service database in 2009. They were followed up until the date of the diagnosis of dementia or December 31, 2020. The study exposure was the diagnosis of bronchiectasis, and the primary outcome was incident dementia comprising Alzheimer's disease and vascular dementia.</p><p><strong>Results: </strong>During the median follow-up duration of 9.3 years, the incidence of all-cause dementia was 1.6-fold higher in individuals with bronchiectasis than in those without bronchiectasis (15.0 vs. 9.3/1000 person-years, <i>p</i> < .001). In the multivariable Cox regression analysis, the risk of all dementia was significantly higher in individuals with bronchiectasis than in those without bronchiectasis (adjusted hazard ratio [aHR] 1.09, 95% confidence interval [CI] 1.04-1.14). In a subgroup analysis by dementia type, individuals with bronchiectasis had an increased risk of Alzheimer's disease compared to those without bronchiectasis (aHR 1.07, 95% CI 1.01-1.12); the risk of vascular dementia did not significantly differ between the two groups (aHR 1.05, 95% CI 0.90-1.21).</p><p><strong>Conclusion: </strong>Bronchiectasis was associated with an increased risk of dementia, especially Alzheimer's disease.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231222282"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10725102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138799457","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":"Respiratory therapies for Amyotrophic Lateral Sclerosis: A state of the art review.","authors":"Priscila Sales de Campos, Wendy L Olsen, James P Wymer, Barbara K Smith","doi":"10.1177/14799731231175915","DOIUrl":"10.1177/14799731231175915","url":null,"abstract":"<p><p>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative condition noteworthy for upper and lower motor neuron death. Involvement of respiratory motor neuron pools leads to progressive pathology. These impairments include decreases in neural activation and muscle coordination, progressive airway obstruction, weakened airway defenses, restrictive lung disease, increased risk of pulmonary infections, and weakness and atrophy of respiratory muscles. These neural, airway, pulmonary, and neuromuscular changes deteriorate integrated respiratory-related functions including sleep, cough, swallowing, and breathing. Ultimately, respiratory complications account for a large portion of morbidity and mortality in ALS. This state-of-the-art review highlights applications of respiratory therapies for ALS, including lung volume recruitment, mechanical insufflation-exsufflation, non-invasive ventilation, and respiratory strength training. Therapeutic acute intermittent hypoxia, an emerging therapeutic tool for inducing respiratory plasticity will also be introduced. A focus on emerging evidence and future work underscores the common goal to continue to improve survival for patients living with ALS.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231175915"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/04/10.1177_14799731231175915.PMC10214054.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9797252","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":"Long-term mechanical ventilation: State of the evidence and future directions.","authors":"Sunita Mathur,&nbsp;Michael Steiner","doi":"10.1177/14799731231199764","DOIUrl":"10.1177/14799731231199764","url":null,"abstract":"","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231199764"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10494530","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}