European Clinical Respiratory Journal最新文献

{"title":"Defined daily dose definition in medication adherence assessment in asthma.","authors":"Päivi Saukkosalmi,&nbsp;Hannu Kankaanranta,&nbsp;Iida Vähätalo,&nbsp;Lauri Sillanmäki,&nbsp;Markku Sumanen","doi":"10.1080/20018525.2023.2207335","DOIUrl":"https://doi.org/10.1080/20018525.2023.2207335","url":null,"abstract":"<p><p>Adherence to inhaled corticosteroids (ICS) has been described as poor. In adherence studies, if the actual prescribed dosing is not available, generic defined daily doses (DDD) are applied instead when assessing adherence. We evaluated asthma patients' adherence in a large prospective follow-up survey. We also analysed whether World Health Organization (WHO) and Global Initiative for Asthma (GINA) reference doses give different results. The current study was cross-sectional and included respondents attending to HeSSup follow-up questionnaire in 2012. Altogether 1,141 of 12,854 adult participants answered positively to the question about having asthma. According to the Finnish Social Insurance Institutions' medication register, 686 of them had purchased ICS medication during 2011. DDDs for ICS by WHO as well as medium doses from GINA report were used as reference doses to evaluate adherence. To estimate adherence to ICS, the proportion of days covered (PDC) over one year was calculated for every patient. If the lower limit of GINA medium ICS dose was used as a reference, 65% of the patients were adherent (PDC ≥ 80%). Use of WHO's DDD as reference halved the proportion of adherent patients. Adherence was higher among those using a combination inhaler of corticosteroid and long-acting β₂-agonist compared to those using steroid only inhalers. Use of WHO's daily defined doses as reference values may lead to underestimation of adherence to inhaled corticosteroids. Thus, attention should be paid when choosing the reference doses for the evaluation of adherence to inhaled corticosteroids in asthma.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"10 1","pages":"2207335"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/c3/ZECR_10_2207335.PMC10150619.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9416794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-genome sequencing of the clinical isolate of <i>Legionella pneumophila</i> ALAW1 from the West Bank allows high-resolution typing and determination of pathogenicity mechanisms.","authors":"Ashraf R Zayed,&nbsp;Boyke Bunk,&nbsp;Lina Jaber,&nbsp;Hadeel Abu-Teer,&nbsp;Mousa Ali,&nbsp;Michael Steinert,&nbsp;Manfred G Höfle,&nbsp;Ingrid Brettar,&nbsp;Dina M Bitar","doi":"10.1080/20018525.2023.2168346","DOIUrl":"https://doi.org/10.1080/20018525.2023.2168346","url":null,"abstract":"<p><strong>Background: </strong><i>Legionella pneumophila</i> is water-based bacterium causing Legionnaires' disease (LD). We describe the first documented case of nosocomial LD caused by <i>L. pneumophila</i> sequence type (ST) 461 and serogroup 6. The etiology of LD was confirmed by culturing the bronchoalveolar lavage sample retrieving <i>L. pneumophila</i> strain ALAW1. A 7-days treatment of the LD patient with Azithromycin and Levofloxacin allowed complete recovery.</p><p><strong>Methods: </strong>In details, we sequenced the whole genome of the <i>L. pneumophila</i> ALAW1 using Illumina HiSeq platform. The sequence of ALAW1 was aligned with the genome sequence from the closely related reference strain Alcoy 2300/99 and a whole-genome phylogeny based on single nucleotide polymorphisms (SNPs) was created using Parsnp software. Also, the TYGS web-server was used in order to compare the genome with type strain.</p><p><strong>Results: </strong>An analysis of the population structure by SNP and TYGS comparison clustered ALAW1 with the reference genome Alcoy 2300/99. Blastp analysis of the type IV secretion Dot/Icm system genes showed that these genes were highly conserved with (≤25%) structural differences at the protein level.</p><p><strong>Conclusions: </strong>Overall, this study provides insights into detailed genome structure and demonstrated the value of whole-genome sequencing as the ultimate typing tool for <i>Legionella.</i></p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"10 1","pages":"2168346"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/9d/ZECR_10_2168346.PMC9869991.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10622342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 in athletes (COVA) study: a national study on cardio-pulmonary involvement of SARS-CoV-2 infection among elite athletes.","authors":"Hanne Kruuse Rasmusen, Mikkel Aarøe, Christoffer Valdorff Madsen, Helga Lillian Gudmundsdottir, Kenneth Hudlebusch Mertz, Astrid Duus Mikkelsen, Christian Have Dall, Christoffer Brushøj, Jesper Løvind Andersen, Maria Helena Dominguez Vall-Lamora, Ann Bovin, S Peter Magnusson, Jens Jakob Thune, Redi Pecini, Lars Pedersen","doi":"10.1080/20018525.2022.2149919","DOIUrl":"10.1080/20018525.2022.2149919","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 can cause cardiopulmonary involvement. Physical activity and cardiac complications can worsen prognosis, while pulmonary complications can reduce performance.</p><p><strong>Aims: </strong>To determine the prevalence and clinical implications of SARS-CoV-2 cardiopulmonary involvement in elite athletes.</p><p><strong>Methods: </strong>An observational study between 1 July 2020 and 30 June 2021 with the assessment of coronary biomarkers, electrocardiogram, echocardiography, Holter-monitoring, spirometry, and chest X-ray in Danish elite athletes showed that PCR-tested positive for SARS-CoV-2. The cohort consisted of male football players screened weekly (cohort I) and elite athletes on an international level only tested if they had symptoms, were near-contact, or participated in international competitions (cohort II). All athletes were categorized into two groups based on symptoms and duration of COVID-19: Group 1 had no cardiopulmonary symptoms and duration ≤7 days, and; Group 2 had cardiopulmonary symptoms or disease duration >7 days.</p><p><strong>Results: </strong>In total 121 athletes who tested positive for SARS-CoV-2 were investigated. Cardiac involvement was identified in 2/121 (2%) and pulmonary involvement in 15/121 (12%) participants. In group 1, 87 (72%), no athletes presented with signs of cardiac involvement, and 8 (7%) were diagnosed with radiological COVID-19-related findings or obstructive lung function. In group 2, 34 (28%), two had myocarditis (6%), and 8 (24%) were diagnosed with radiological COVID-19-related findings or obstructive lung function.</p><p><strong>Conclusions: </strong>These clinically-driven data show no signs of cardiac involvement among athletes who tested positive for SARS-CoV-2 infection without cardiopulmonary symptoms and duration <7 days. Athletes with cardiopulmonary symptoms or prolonged duration of COVID-19 display, exercise-limiting cardiopulmonary involvement.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"10 1","pages":"2149919"},"PeriodicalIF":1.8,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/17/ZECR_10_2149919.PMC9744211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10730541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to treatment guidelines and good asthma control in Finland.","authors":"Johanna Pakkasela,&nbsp;Petri Salmela,&nbsp;Pekka Juntunen,&nbsp;Jussi Karjalainen,&nbsp;Lauri Lehtimäki","doi":"10.1080/20018525.2022.2149918","DOIUrl":"https://doi.org/10.1080/20018525.2022.2149918","url":null,"abstract":"<p><strong>Background: </strong>Asthma program in Finland decreased asthma-related mortality and expenses of care on national level, but there is lack of data on adherence to treatment guidelines and disease control on individual level. We aimed to assess adherence to guidelines and disease control among Finnish adult asthmatics.</p><p><strong>Methods: </strong>Questionnaires were sent in Finland to 2000 randomly selected recipients aged 18-80 years, who had bought medication for obstructive airways disease during the previous 12 months. The questionnaire included questions on asthma medication, exacerbations, self-management and follow-up. Asthma symptom control was assessed by the Asthma Control Test (ACT).</p><p><strong>Results: </strong>A high proportion (82.4%) of the 541 responders with physician-diagnosed asthma reported regular use of asthma medication and 97.1% of them used inhaled corticosteroids. Almost all (97.0%) of the asthmatics were taught how to use their inhaler and 78.4% had an asthma self-management plan, but only 35.7% reported regular annual follow-up visits. According to symptoms, 60.0% had their asthma well-controlled (ACT score ≥20). On the other hand, 29.2% had a course of oral corticosteroid and 21.8% had an asthma-related unscheduled health care visit during the previous year, but only 2.6% reported a hospitalization. Asthma control was better in those not using regular asthma medication.</p><p><strong>Conclusions: </strong>The guidelines are well adopted in Finnish adult asthma care except for regular follow-up visits. Majority of patients had good symptom control and hospitalizations were rare. Better asthma control among those not using regular asthma medication implies they are not undertreated but have a mild disease.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":" ","pages":"2149918"},"PeriodicalIF":1.9,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/33/ZECR_10_2149918.PMC9707375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40456973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to inhaled corticosteroids in relation to quality of life and symptoms of anxiety and depression in asthma.","authors":"Martino Renzi-Lomholt,&nbsp;Kjell Erik Julius Håkansson,&nbsp;Charlotte Suppli Ulrik","doi":"10.1080/20018525.2022.2149920","DOIUrl":"https://doi.org/10.1080/20018525.2022.2149920","url":null,"abstract":"<p><strong>Background: </strong>Poor asthma control, often caused by non-adherence with controller medication, is a well-known risk factor for impaired quality of life (QoL) and major mood disorders (MMD). Previous studies have shown a relationship between non-adherence, lower QoL, and MMD across chronic diseases, but the relationship remains uncertain in asthma.</p><p><strong>Methods: </strong>All asthma patients followed at the respiratory outpatient clinic at Copenhagen University Hospital - Hvidovre were invited to fill-in the Hospital Anxiety and Depression Scale (HADS) and the Mini Asthma Quality of Life Questionnaire (miniAQLQ). Medication Possession Ratio (MPR) was calculated using pharmacy redemption data. Relationships between questionnaire scores, inhaled corticosteroid MPR and use of rescue medication were investigated using Pearson correlation and multivariable linear regression adjusted for age, sex, FEV₁, and GINA Step. Data from scheduled visits were collected from patients' medical records.</p><p><strong>Results: </strong>A total of 308 patients (73% females, median age 51 years (interquartile range (IQR) 37, 62)) completed the questionnaires and had 1-year medication data available. Median adherence to inhaled corticosteroids (ICS) was 57% (35%, 75%) with 18% of patients having adherence above 80%. Of the participating patients, 14% and 27% reported depressive and anxiety-related symptoms, respectively, and 72% reported impaired QoL. In correlation analyses, ICS adherence was not significantly associated with either prevalence of MMD symptoms or impaired QoL in asthma patients. However, a strong correlation was found between ACQ-6 and both MMD symptoms and impaired QoL, as well as between rescue medication use and impaired QoL. In adjusted analysis, however, the latter correlation was no longer statistically significant.</p><p><strong>Conclusion: </strong>Our results suggest that ICS adherence is not directly correlated with either impaired quality of life or major mood disorder symptoms in asthma patients. Self-reported asthma control, on the other hand, is strongly correlated with both QoL and MMD.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":" ","pages":"2149920"},"PeriodicalIF":1.9,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/5f/ZECR_10_2149920.PMC9704108.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40493343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical course of COVID-19 in hospitalized children of Ukraine in different pandemic periods.","authors":"Iryna Seriakova,&nbsp;Vitalii Yevtushenko,&nbsp;Sergiy Kramarov,&nbsp;Liudmyla Palatna,&nbsp;Iryna Shpak,&nbsp;Tatiana Kaminska","doi":"10.1080/20018525.2022.2139890","DOIUrl":"https://doi.org/10.1080/20018525.2022.2139890","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus infection (COVID-19) pandemic has seen a progressive increase in childhood morbidity worldwide. Continuous mutation of the SARS-CoV-2 virus causes the wave-like course of the COVID-19 pandemic, which is characterized by an undulating course and the predominance of different variants of the SARS-CoV-2 virus. There are many reports that the clinical picture may vary depending on the circulating strain of the virus [7-11, 13-16]. Based on this, we decided to analyze and evaluate the presence of a pattern between the clinical and epidemic COVID-19 characteristics and the strain of the SARS-CoV-2 virus prevailing locally.</p><p><strong>The aim of the work: </strong>To study the effects of various strains of SARS-CoV-2 on the clinical and epidemiological characteristics of pediatric patients; to determine the regularity between the severity of the disease and the circulating strain of SARS-CoV-2.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 945 case stories of COVID-19 disease in children who were hospitalized at the infectious diseases hospital (Kyiv, Ukraine) in the period from June 2020 to February 2022 (corresponding to a period of four waves of different SARS-CoV-2 strains). We investigated epidemiological and clinical features, as well as laboratory and instrumental parameters, comparing four waves of the disease.</p><p><strong>Results and conclusions: </strong>A regularity between the wave of COVID-19 and the severity of the disease was found. The third wave seemed to be the most severe, due to the increase in the frequency of complications, concomitant pathology, clinical symptoms and the level of mortality. The timing of this outbreak matched with the circulation of the SARS-CoV-2 delta-variant and correlated with an increase in hospitalization rates in Ukraine.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":" ","pages":"2139890"},"PeriodicalIF":1.9,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/13/f8/ZECR_9_2139890.PMC9621244.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity, physical capacity and sedentary behavior among asthma patients.","authors":"Nikolaj Brix Hansen,&nbsp;Marius Henriksen,&nbsp;Christian Have Dall,&nbsp;Susanne Vest,&nbsp;Lotte Larsen,&nbsp;Charlotte Suppli Ulrik,&nbsp;Vibeke Backer","doi":"10.1080/20018525.2022.2101599","DOIUrl":"https://doi.org/10.1080/20018525.2022.2101599","url":null,"abstract":"<p><p><b>BACKGROUND</b>: Although exercise and daily physical activity (PA) have long been known to benefit patients with chronic disorders, knowledge is limited regarding asthma. <b>OBJECTIVE</b>: In a Danish setting, our aim was to measure physical activity, sedentary behavior, and physical capacity among patients with asthma. We hypothesized that people with severe asthma would be less active and more sedentary than their mild-moderate counterparts. <b>METHODS</b>: Adults with asthma were recruited through respiratory outpatient clinics and subsequently examined twice, 4 weeks apart. At each visit, participants underwent a series of lung function tests, questionnaires, and maximum oxygen uptake testing (VO₂max). Between the visits, participants wore an accelerometer continuously for 4 weeks, measuring sedentary time and daily steps. Sixty patients, 27 with mild-moderate asthma (GINA 1-3) and 33 with severe asthma (GINA 4-5), completed both visits and had valid accelerometer measurements. <b>RESULTS</b>: No significant differences between the two groups were found in sedentary time, number of steps or VO₂max.   VO₂max was significantly correlated with FeNO (r = -0.30, p < 0.05), Short Form-12 Mental Health (r = 0.37, p < 0.05), Asthma Control Questionnaire (r = -0.35, p < 0.05), and Mini Asthma Quality of Life Questionnaire (r = 0.36, p < 0.05). <b>CONCLUSION</b>: No differences were observed between patients with mild-moderate and severe asthma regarding sedentary behavior, daily steps or level of cardiopulmonary fitness. Furthermore, patients with the highest VO₂max had the higher quality of life scores. <b>Abbreviations</b>: VO₂max: Maximal Oxygen Uptake; CPET: Cardiopulmonary Exercise Testing; BMI: Body Mass Index; FEV1: Forced Expired Volume in the First Second; FVC: Forced Vital Capacity; PEF: Peak Expiratory Flow; EIB: Exercise-Induced Bronchoconstriction; COPD: Chronic Obstructive Pulmonary Disease; ACQ: Asthma Control Questionnaire; Mini-AQLQ: Mini Asthma Quality of Life Questionnaire; SF-12: Short Form 12 Health Survey; SNOT-22: Sino-Nasal Outcome Test 22; GINA: The Global Initiative for Asthma; CRP: C-reactive Protein; Hgb:Hemoglobin count; EOS: Eosinophil count; EVH: Eucapnic Voluntary Hyperventilation; FeNO: Fractional Exhaled Nitric Oxide; PA: Physical Activity ERS: European Respiratory Society; ATS: American Thoracic Society; CRS: Chronic Rhinosinusitis; AHR: Airway Hyperresponsiveness.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":" ","pages":"2101599"},"PeriodicalIF":1.9,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/85/ZECR_9_2101599.PMC9467604.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a systematic multidisciplinary clinical and teaching model for the palliative approaches in patients with severe lung failure.","authors":"Kristoffer Marsaa,&nbsp;Janni Mendahl,&nbsp;Steen Nielsen,&nbsp;Lotte Mørk,&nbsp;Per Sjøgren,&nbsp;Geana Paula Kurita","doi":"10.1080/20018525.2022.2108195","DOIUrl":"https://doi.org/10.1080/20018525.2022.2108195","url":null,"abstract":"<p><p>Palliative medicine has traditionally focused on people affected by cancer with rapidly advancing disease progression. However, as more people live longer time with serious illnesses, including lung diseases, the need of palliative care for these patients if also increasing. There is a lack of research and clinical knowledge about what palliative care is for people affected by chronic obstructive pulmonary disease and interstitial lung disease. The aim of this paper is to describe the development process of an easy to use and clinically relevant model for the palliative care approach in people affected by severe illnesses. The developed model consists of four components, which originated the title\" 4,2,4,2 model\". Each number has a specific meaning: the first 4 = the four disease trajectories that patients may experience; 2 = the two forms of knowledge, objective, and intuitive that must be achieved by the health professionals to gain an understanding of the situation; 4 = the four dimensions of suffering physically, mentally, socially and existentially/spiritually; and 2 = the two roles that health-care professionals must be able to take in when treating patients with serious illnesses. The 4-2-4-2 model proposes an easy-to-use and clinically relevant model for palliative approach and integration of PC and pulmonary medicine. Another important purpose of this model is to provide HPs with different educational backgrounds and from different medical fields with a 'golden standard approach' to enhance the focus of the palliative approach in both the clinic and teaching. The effect and consequences of the use of the 4-2-4-2 model should be explored in future clinical trials. Furthermore, it should be investigated whether teaching the model creates a change in clinical approach to patients with serious illnesses as well as whether these changes are long-lasting.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":" ","pages":"2108195"},"PeriodicalIF":1.9,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/fc/ZECR_9_2108195.PMC9377267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40706584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma-related hospitalizations after implementing SABA-free asthma management with a maintenance and anti-inflammatory reliever regimen.","authors":"L J Nannini,&nbsp;N S Neumayer,&nbsp;N Brandan,&nbsp;O M Fernández,&nbsp;D M Flores","doi":"10.1080/20018525.2022.2110706","DOIUrl":"https://doi.org/10.1080/20018525.2022.2110706","url":null,"abstract":"<p><p>Overreliance on short-acting β₂-agonists (SABA) has been a common feature of asthma management globally for at least 30 years. However, given the evidence against the long-term use of SABA, including potentially increased risk of exacerbations, emergency room visits, overall healthcare resource utilization, and mortality, the latest Global Initiative for Asthma report no longer recommends SABA only therapy. Since 2014, we implemented an ICS-containing reliever strategy at our asthma center at the G Baigorria Hospital in Argentina; we only administered budesonide/formoterol via a single inhaler device across the spectrum of asthma severity and completely eliminated the use of SABA therapy. In this article, we compare hospitalization data from our center, previously reported in the EAGLE study (when inhaled corticosteroids plus as-needed SABA was administered) for the years 1999 and 2004 with data from 2017 to 2018 (when budesonide/formoterol in a single inhaler device was administered as maintenance and/or anti-inflammatory reliever therapy [MART/AIR] without any SABA) from our center, to assess the impact of two distinct asthma management strategies on asthma-related hospitalizations. MART/AIR regimens in our SABA-free center reduced asthma hospitalizations from 9 (1999 and 2004) to 1 (2017 and 2018) (Fisher's exact test, p = 0.031; odds ratio = 0.11; 95% confidence interval [CI] = 0.013-0.98); the hospitalization rate was reduced by 92% (1.47% in 1999 and 2004 to 0.12% in 2017 and 2018). Our data provide preliminary real-world evidence that MART/AIR with budesonide/formoterol simultaneously with SABA elimination across asthma severities is an effective asthma management strategy for reducing asthma-related hospitalizations.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":" ","pages":"2110706"},"PeriodicalIF":1.9,"publicationDate":"2022-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/1d/ZECR_9_2110706.PMC9361757.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40606229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Permanent indwelling catheter for the management of refractory malignant pericardial effusion.","authors":"Frederik Schultz Pustelnik,&nbsp;Christian B Laursen,&nbsp;Arman Arshad,&nbsp;Ahmed Aziz","doi":"10.1080/20018525.2022.2095720","DOIUrl":"https://doi.org/10.1080/20018525.2022.2095720","url":null,"abstract":"<p><p>In this case report, we describe the novel use of a permanent indwelling catheter (PiC) in the management of refractory malignant pericardial effusion (PE). The patient had disseminated lung cancer and was hospitalised repeatedly with circulatory collapse due to malignant PE despite treatments with pericardiocentesis (PCC) and a pericardial window (PW). The PiC was inserted as a last resort with no complications and was a mediator of pericardiodesis (PCD), resulting in the cease of PE. The PiC could subsequently be removed, and there was no relapse of PE.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":" ","pages":"2095720"},"PeriodicalIF":1.9,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/63/ZECR_9_2095720.PMC9291668.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40609052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}