Respirology (Carlton, Vic.)最新文献

{"title":"Prognosis assessment model based on low serum calcium in patients with acute pulmonary thromboembolism","authors":"Yuqing Yang, Xin Wang, Yun-Jian Zhang, Yanfang Chen, Ling Wang, Xiao-Wen Hu, Ling Niu, Hong-Mei Pu, Xin Zhang, Zhen Zhang, Lan Wang, Fang Chen, Juhong Shi, Ying-qun Ji","doi":"10.1111/resp.14243","DOIUrl":"https://doi.org/10.1111/resp.14243","url":null,"abstract":"The pulmonary embolism severity index (PESI) and simplified PESI (sPESI) are recommended to recognize patients with acute pulmonary thromboembolism (PTE) with low prognosis risk, which is of great significance for treatment. This study aims to verify the influence of hypocalcaemia on the prognosis of patients with PTE and to establish a new prognosis assessment model.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"153 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127368206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth of the airway smooth muscle layer from late gestation to childhood is mediated initially by hypertrophy and subsequently hyperplasia","authors":"Kimberley C. W. Wang, G. Donovan, S. Saglani, T. Mauad, A. James, J. Elliot, P. Noble","doi":"10.1111/resp.14240","DOIUrl":"https://doi.org/10.1111/resp.14240","url":null,"abstract":"The airway smooth muscle (ASM) layer thickens during development. Identifying the mechanism(s) for normal structural maturation of the ASM reveals pathways susceptible to disease processes. This study characterized thickening of the ASM layer from foetal life to childhood and elucidated the underlying mechanism in terms of hypertrophy, hyperplasia and extracellular matrix (ECM) deposition.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132912701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID‐19 vaccine‐induced immunity: Head‐to‐head comparison of mRNA (BNT162b2) versus inactivated (CoronaVac) vaccines","authors":"Benjamin M Kagina, C. Dochez","doi":"10.1111/resp.14236","DOIUrl":"https://doi.org/10.1111/resp.14236","url":null,"abstract":"See related article","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123987749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct and indirect costs of systemic sclerosis and associated interstitial lung disease: A nationwide population‐based cohort study","authors":"M. Knarborg, A. Løkke, O. Hilberg, R. Ibsen, M. Sikjaer","doi":"10.1111/resp.14234","DOIUrl":"https://doi.org/10.1111/resp.14234","url":null,"abstract":"The study aimed to evaluate the direct and indirect costs of systemic sclerosis (SSc) in cases with and without interstitial lung disease (ILD).","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127717189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of mortality in subjects with progressive fibrosing interstitial lung diseases","authors":"K. Brown, Y. Inoue, K. Flaherty, F. Martinez, V. Cottin, F. Bonella, S. Cerri, S. Danoff, S. Jouneau, R. Goeldner, Martin Schmidt, S. Stowasser, R. Schlenker‐Herceg, A. Wells","doi":"10.1111/resp.14231","DOIUrl":"https://doi.org/10.1111/resp.14231","url":null,"abstract":"Demographic and clinical variables, measured at baseline or over time, have been associated with mortality in subjects with progressive fibrosing interstitial lung diseases (ILDs). We used data from the INPULSIS trials in subjects with idiopathic pulmonary fibrosis (IPF) and the INBUILD trial in subjects with other progressive fibrosing ILDs to assess relationships between demographic/clinical variables and mortality.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129032567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and critical care capacity: Can we mitigate demand?","authors":"Matthew Byrne, Timothy E Scott, Jonathan Sinclair, Nachiappan Chockalingam","doi":"10.1111/resp.14193","DOIUrl":"https://doi.org/10.1111/resp.14193","url":null,"abstract":"The COVID-19 pandemic has placed unprecedented demand on modern healthcare resources. As such, there has been much research and debate on how to best manage patients with COVID-19. Previous studies have shown the benefits of neuromuscular blockade and prone positioning in the management of acute respiratory distress syndrome (ARDS), as seen in COVID-19 pneumonitis, while more recent studies have explored the benefits of different medical treatments. These have included dexamethasone, sarilumab and tocilizumab as demonstrated by the RECOVERY and REMAP-CAP trials. None of these therapies have mitigated the demand for intensive care capacity which remains, at best, extremely limited or more usually overwhelmed. In such circumstances, there is a need to predict which patients with a significant oxygen dependency will avoid the need for mechanical ventilation. Such patients could safely be cared for in other parts of the hospital thereby preserving intensive care unit capacity for mechanically ventilated patients. With a view to optimizing our intensive care capacity prior to surging into other areas of the hospital, we describe our experience identifying which patients will avoid the need for mechanical ventilation despite currently requiring advanced respiratory support (high-flow nasal oxygen [HFNO] or continuous positive airway pressure [CPAP]). With concerns around the timing of intubation and duration of non-invasive ventilation (NIV), we were also interested in whether early intubation and increasing dexamethasone dose reduce critical care unit length of stay (LOS). What we report here is based on a retrospective audit which was registered with and approved by the Research and Innovation Directorate at the local NHS trust and our approach met all relevant research governance regulations. The Respiratory rate and OXygenation (ROX) index is the ratio of pulse oximetry/fraction of inspired oxygen (SpO2/FiO2) to respiratory rate, measured 12 h after the instigation of HFNO. A value greater than 4.88 predicts that a patient with non-COVID-19 pneumonia will not require mechanical ventilation with a positive predictive value approaching 90%. More recent work suggests that this predictive value may extend to patients with COVID-19 pneumonitis. Within our intensive care unit, patients alternate between HFNO and CPAP as tolerability and oral intake allow. Hence, we pragmatically applied the ROX index to this cohort of patients as a whole. Doing so on day 1 (once established on HFNO or CPAP) and day 5 (at midday) of admission to our unit allowed us to correctly predict success of NIV in 64% and 87% of cases, respectively. We felt that a positive predictive value of 64% was inadequate to influence a patient’s care pathway, but in our experience, patients can be located in non-critical care areas based on their day 5 ROX score. We have, on an ad hoc and empirical basis, increased the dose of dexamethasone in our patients with increased body mass index (BMI)","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"107-108"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39691936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPAP telemonitoring can track Cheyne-Stokes respiration and detect serious cardiac events: The AlertApnée Study.","authors":"Arnaud Prigent,&nbsp;Claude Pellen,&nbsp;Joëlle Texereau,&nbsp;Sébastien Bailly,&nbsp;Nicolas Coquerel,&nbsp;Renaud Gervais,&nbsp;Jean-Marc Liegaux,&nbsp;Régis Luraine,&nbsp;Jean-Christophe Renaud,&nbsp;Anne-Laure Serandour,&nbsp;Jean Louis Pépin","doi":"10.1111/resp.14192","DOIUrl":"https://doi.org/10.1111/resp.14192","url":null,"abstract":"<p><strong>Background and objective: </strong>Case reports have suggested that continuous positive airway pressure (CPAP) telemonitoring can detect the onset of acute cardiac events such as decompensated heart failure (HF) or atrial fibrillation through an increase in the apnoea-hypopnoea index (AHI) and onset of Cheyne-Stokes Respiration (CSR). This study addressed whether long-term remote CPAP treatment telemonitoring revealing CSR can help detect serious cardiac events (SCEs) in obstructive sleep apnoea (OSA) patients.</p><p><strong>Methods: </strong>This monocentric prospective cohort study included adults receiving CPAP therapy for OSA with daily telemonitoring. Any sudden increase in AHI generated an alert for the home healthcare provider to download CPAP data to identify CSR. A medical consultation was scheduled if CSR was detected.</p><p><strong>Results: </strong>We included 555 adults (412 men; 57% with known cardiovascular comorbidities). During the 1-year follow-up, 78 CSR episodes were detected in 74 patients (CSR+). The main conditions associated with incident CSR were HF (24 patients [30.8%]), ventilatory instability (21, 26.9%), leaks (13, 16.7%), medications inducing central apnoeas (baclofen, ticagrelor, opioids) (7, 9.0%), arrhythmias (6, 7.7%) and renal failure (2, 2.6%). Fifteen (20.3%) CSR+ patients had a confirmed SCE. In univariable analysis, a CSR episode increased the risk of an SCE by 13.8-fold (5.7-35.6) (p < 0.0001), with an adjusted OR of 5.7 (2.0-16.8) in multivariable analysis.</p><p><strong>Conclusion: </strong>Long-term telemonitoring of patients on CPAP treatment can alert CSR episodes and allows early detection of SCEs in patients with or without known cardiac comorbidities.</p>","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"161-169"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39788116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes to clinical education during the COVID-19 pandemic: Challenges and opportunities.","authors":"Mark Lavercombe","doi":"10.1111/resp.14201","DOIUrl":"https://doi.org/10.1111/resp.14201","url":null,"abstract":"The COVID-19 pandemic has caused widespread disruption to communities worldwide, and it is not surprising that health professions education was also affected. Changes have occurred at all levels of medical education: from undergraduates and doctors-in-training through to continuing professional development for established professionals. Educators had considered some of these changes for a long time, and the pandemic gave the final impetus to act. Other alterations were made simply to manage the crisis. With the shift to remote learning and the removal of students from clinical placements, we are only likely to fully understand the impact on training for the next generation of health practitioners in the years to come. In my workplace, our clinical students were unable to attend the hospital for months at a time during 2020 and faced significant limitations to patient access in 2021. Our response included casebased discussions to make didactic learning more clinically oriented, ‘meet the expert’ sessions run via videoconference and pre-recorded lectures for students to watch in their own time. Given the need to transform teaching programmes to virtual delivery as quickly as possible, it is unclear whether the change decisions were made based on educational merit rather than necessity. It is incumbent on educators to reconsider those choices in light of best practice learning theory and curriculum design principles to ensure that suitable modalities are chosen to match the intended learning outcomes. Any teaching that might best be delivered in-person should return to that form of delivery as soon as the pandemic allows. One method likely to become more prominent is the ‘flipped classroom’ model. This form of teaching requires learners to access learning materials before the scheduled session with the teacher. The in-person session becomes an opportunity to clarify misunderstandings and extend knowledge using active learning strategies such as case studies, simulation or debate. Materials developed for virtual or asynchronous use during the pandemic could be utilized as the ‘pre-reading’ for the classroom session. A novel strategy is virtual patient encounters, whereby the educator brings a videoconferencing device to the patient, and learners access the session remotely. This mitigates potential infection risks while still allowing students some semblance of real patient interaction. The literature supporting this technology-enhanced learning technique is still evolving. As many of the students most affected by the restrictions to clinical teaching are still to complete their studies, we cannot yet know whether their preparedness for practice has been affected. New graduates face a variety of learning and professional development challenges, some of which are difficult to measure before they begin their careers. We might only discover some deficiencies once they start work on our teams. Later stage doctors in specialist training programmes have al","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"112-113"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39786211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of high-flow nasal cannula oxygen therapy on exercise tolerance in patients with idiopathic pulmonary fibrosis: A randomized crossover trial.","authors":"Jumpei Harada,&nbsp;Kazuma Nagata,&nbsp;Takeshi Morimoto,&nbsp;Kentaro Iwata,&nbsp;Atsushi Matsunashi,&nbsp;Yuki Sato,&nbsp;Ryo Tachikawa,&nbsp;Akira Ishikawa,&nbsp;Keisuke Tomii","doi":"10.1111/resp.14176","DOIUrl":"https://doi.org/10.1111/resp.14176","url":null,"abstract":"<p><strong>Background and objective: </strong>Exercise capacity in idiopathic pulmonary fibrosis (IPF) is limited by exercise-induced hypoxaemia. This study aimed to examine the effect of high-flow nasal cannula oxygen therapy (HFNC) on exercise tolerance in patients with IPF.</p><p><strong>Methods: </strong>We conducted a single-centre, open-label, randomized crossover trial to compare HFNC and Venturi mask (VM) therapy in terms of exercise tolerance. Patients underwent constant-load symptom-limited exercise testing at 80% peak work rate with HFNC or a VM in a randomized order. The settings were 60 L/min and a 50% fraction of inspired oxygen (FiO₂ ) for HFNC and 12 L/min and 50% FiO₂ for VM. The primary outcome was endurance time, and the secondary outcomes were heart rate (HR), percutaneous oxygen saturation (SpO₂ ), dyspnoea and leg fatigue, as determined by the modified Borg Scale at the isotime and endpoint, and the level of comfort while using the devices.</p><p><strong>Results: </strong>Twenty-four participants (75.0% men; age, median [interquartile range]: 77.5 [68.8-83.0] years) were enrolled. Compared with VM, HFNC significantly improved the endurance time (647.5 s [454.0-1014.8] vs. 577.5 s [338.0-861.5]), minimum SpO₂ (96.0% [95.0-98.0] vs. 94.0% [92.8-96.0]) and leg fatigue at the isotime (3.0 [1.6-4.0] vs. 5.0 [3.0-6.3]) and endpoint (4.0 [2.8-5.0] vs. 5.0 [3.8-6.3]). Differences in maximum HR, dyspnoea at the isotime and endpoint and comfort were non-significant between HFNC and VM therapy.</p><p><strong>Conclusion: </strong>HFNC increased exercise tolerance in patients with stable IPF experiencing exercise-induced hypoxaemia.</p>","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"144-151"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39852564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decline in mortality due to respiratory diseases in Japan during the coronavirus disease 2019 pandemic.","authors":"Nobuyuki Horita,&nbsp;Hideaki Kato,&nbsp;Keisuke Watanabe,&nbsp;Yu Hara,&nbsp;Nobuaki Kobayashi,&nbsp;Takeshi Kaneko","doi":"10.1111/resp.14186","DOIUrl":"https://doi.org/10.1111/resp.14186","url":null,"abstract":"See related article","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"175-176"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9011564/pdf/RESP-27-175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39645879","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}