Chronic Respiratory Disease最新文献

{"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}

{"title":"Palliation, end of life care and ventilation withdrawal in neuromuscular disorders.","authors":"Joanna Elverson,&nbsp;Hayley Evans,&nbsp;Felicity Dewhurst","doi":"10.1177/14799731231175911","DOIUrl":"https://doi.org/10.1177/14799731231175911","url":null,"abstract":"<p><strong>Background/objectives: </strong>The role of palliative care in the support of patients with neuromuscular disorders (NMDs) is generally recognised in spite of the scarcity of condition-specific evidence in the literature.</p><p><strong>Methods: </strong>We have focussed specifically on palliative and end-of-life care for patients whose neuromuscular disease has an impact on their respiratory function. Reviewing the literature, we have examined where existing palliative care knowledge can be applied to the specific challenges faced by patients with NMDs, identifying where lessons learnt during the management of one condition may need to be judiciously applied to others.</p><p><strong>Results: </strong>We highlight lessons for clinical practice centring on six themes: management of complex symptoms; crisis support; relief of caregiver strain; coordination of care; advance care planning; and end of life care.</p><p><strong>Conclusions: </strong>The principles of palliative care are well suited to addressing the complex needs of patients with NMDs and should be considered early in the course of illness rather than limited to care at the end of life. Embedding relationships with specialist palliative care services as part of the wider neuromuscular multidisciplinary team can facilitate staff education and ensure timely referral when more complex palliative care problems arise.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231175911"},"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/18/50/10.1177_14799731231175911.PMC10201157.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9580625","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":"Changes in lung cancer staging and emergency presentations during the first year of the COVID-19 pandemic.","authors":"Claire Vella,&nbsp;Wadood Parvez,&nbsp;Asif Ashraf,&nbsp;Syed Ajmal,&nbsp;Rajini Sudhir,&nbsp;Sanjay Agrawal,&nbsp;Jonathan Bennett,&nbsp;Muhammad Tufail","doi":"10.1177/14799731231157770","DOIUrl":"10.1177/14799731231157770","url":null,"abstract":"<p><p><b>Aim</b>: This study retrospectively analyses the impact of the 1^st year of the COVID-19 pandemic on route of presentation and staging in lung cancer compared to the 2 years before and after implementation of the Leicester Optimal Lung Cancer Pathway (LOLCP) in Leicester, United Kingdom. <b>Method</b>: Electronic databases and hospital records were used to identify all patients diagnosed with lung cancer in 2018 (pre-LOLCP), 2019 (post-LOLCP), and March 2020-2021 (post-COVID-19 lockdown). Information regarding patient characteristics, performance status, stage, and route of diagnosis was documented and analysed. Emergency presentation was defined as diagnosis of new lung cancer being made after unscheduled attendance to urgent or emergency care facility. <b>Results</b>: Following implementation of the LOLCP pathway, there was a significant decrease in emergency presentations from 26.8 to 19.6% (<i>p</i> = 0.002) with a stage shift from 33.9% early stage disease to 40.3%. These improved outcomes were annulled during the COVID-19 pandemic, with emergency presentations increasing to 38.9% (<i>p</i> < 0.001) and a reduction in early-stage lung cancer diagnoses to 31.5%. There was a 61% decline in 2 week wait referrals but no significant decline in the LOLCP direct-to-CT referrals. <b>Conclusion</b>: We have demonstrated a significant increase in late-stage lung cancer diagnoses and emergency presentations during the first year of the COVID-19 pandemic. The causes for these changes are likely to be multifactorial. The long-term effect on lung cancer mortality remains to be seen and is an important focus of future study.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231157770"},"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/00/80/10.1177_14799731231157770.PMC10422907.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9997433","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":"Characterising hospitalisation risk for chronic obstructive pulmonary disease exacerbations: Bedside and outpatient clinic assessments of easily measured variables.","authors":"Joshua Heerema, Sarah Hug, Natasha Bear, Kylie Hill","doi":"10.1177/14799731231211852","DOIUrl":"10.1177/14799731231211852","url":null,"abstract":"<p><strong>Objective: </strong>To identify the characteristics of people with chronic obstructive pulmonary disease (COPD) who require hospitalisation for exacerbations.</p><p><strong>Methods: </strong>People with COPD were recruited either during hospitalisation or from out-patient respiratory medicine clinics. Hospital admissions were tracked throughout the 5-months recruitment period. For participants who were admitted, hospital readmissions were tracked for at least 30 days following discharge. Participants were grouped as either needing; (i) no hospital admission during the study period (no admission; ø-A), (ii) one or more hospital admissions during the study period but no readmission within 30 days of discharge (no rapid readmission; ø-RR) or (iii) one or more hospital admissions with a readmission within 30 days of discharge (rapid readmission; RR).</p><p><strong>Results: </strong>Compared with the ø-A group (<i>n</i>=211), factors that independently increased the risk of ø-RR (<i>n</i>=146) and/or RR (<i>n</i>=57) group membership were being aged >60 years, identifying as an Indigenous person (relative risk ratio, 95% confidence interval 7.8 [1.8 to 34.0]) and the use of a support person or community service for activities of daily living (1.5 [1.0 to 2.4]. A body mass index ≥25 kg/m² was protective.</p><p><strong>Conclusions: </strong>Variables recorded at the bedside or in clinic provided information on hospitalisation risk.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231211852"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478662","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":"Translation, cross-cultural adaptation, reliability, and construct validity of the Brazilian Portuguese version of the Basic Psychological Needs in Exercise Scale.","authors":"Manuela Karloh, Simone G Gavenda, Juliana Araújo, Hellen F Alexandre, Isabela Jcs Silva, Aline A Gulart, Anelise B Munari, Symeon P Vlachopoulos, Thiago S Matias, Anamaria F Mayer","doi":"10.1177/14799731231183445","DOIUrl":"10.1177/14799731231183445","url":null,"abstract":"<p><strong>Results: </strong>59 patients were included (61% with COPD and 39% with ILD). BPNES factor scores were not significantly different between raters' assessments (<i>p</i> > 0.05). The internal consistency was 0.70 for autonomy, 0.76 for competence, and 0.80 for relatedness. Inter-rater and test-retest reliability were good to very good for autonomy (ICC = 0.78, 95%CI 0.62-0.87; ICC = 0.75, 95%CI 0.57-0.86, respectively), competence (ICC = 0.81, 95%CI 0.68-0.89; ICC = 0.65, 95%CI 0.43-0.80, respectively), and relatedness (ICC = 0.79, 95%CI 0.65-0.88; ICC = 0.70, 95%CI 0.50-0.83, respectively). Significant correlations were observed between BPNES factors and quality of life, anxiety, depression, and functional status. In conclusion, this study confirmed the reliability and construct validity of the Brazilian Portuguese version of the BPNES in patients with COPD and ILD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231183445"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71478663","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":"Comparison of health-related quality of life measures in asthma-COPD overlap.","authors":"Meishan Liu, Xuwen Yang, Ying Wang, Yong Lu, Lirong Liang, Hong Zhang, Kewu Huang","doi":"10.1177/14799731231215093","DOIUrl":"10.1177/14799731231215093","url":null,"abstract":"<p><strong>Objective: </strong>The Asthma Quality of Life Questionnaire (AQLQ) and COPD assessment test (CAT) are used to assess the health status of asthma and chronic obstructive pulmonary disease (COPD), respectively. However, whether these questionnaires are appropriate in patients with asthma-COPD overlap (ACO) has not been reported. This study aimed to evaluate the performance of the AQLQ and CAT in subjects with ACO.</p><p><strong>Methods: </strong>Subjects were enrolled from two previously described observational studies in Beijing, China. ACO was defined by a consensus definition from a roundtable discussion. All subjects completed the AQLQ, CAT, St George's Respiratory Questionnaire (SGRQ), pulmonary function tests, and the Asthma Control Questionnaire (ACQ)-5. Cross-sectional construct validity was evaluated by correlating the AQLQ and CAT with SGRQ score and other measures of asthma and COPD severity.</p><p><strong>Results: </strong>147 subjects with ACO were recruited. There were floor effects on non-respiratory components of the CAT, and ceiling effects on emotion domains of the AQLQ. Both questionnaires were significantly correlated with ACQ-5 score but were not correlated with FEV₁% predicted or FVC% predicted. The AQLQ and CAT were strongly correlated with SGRQ score (r = -0.657 and r = 0.623, respectively). Multivariable linear regression analysis showed that the AQLQ (standardized β-coefficient = -0.449, <i>p</i> < .001) had a stronger association with SGRQ score compared with CAT (standardized β-coefficient = 0.211, <i>p</i> = .023).</p><p><strong>Discussion: </strong>The AQLQ and CAT were both valid for assessing the health-related quality of life in subjects with ACO, but the AQLQ performed better than CAT.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231215093"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10640801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72208635","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}