Respirology (Carlton, Vic.)最新文献

{"title":"Why we still need drugs for COVID-19 and can't just rely on vaccines.","authors":"Bruce W S Robinson, Anna Tai, Kyle Springer","doi":"10.1111/resp.14199","DOIUrl":"https://doi.org/10.1111/resp.14199","url":null,"abstract":"The COVID-19 pandemic has resulted in over 5 million deaths with an economic cost to the world estimated by the International Monetary Fund to be 28 trillion dollars. A number of COVID-19 vaccines have been developed which, contrary to much international misinformation, have proven to be some of the most effective and safest vaccines ever developed. Despite this, it would be unwise to rely upon these vaccines alone and it remains crucial to continue to focus on developing drugs that can be taken in the earliest stages of COVID-19 to halt progression. Why should we not simply rely upon these vaccines? First, the SARS-CoV-2 has continued to mutate and may become resistant to current vaccines. Rapid emergence and global dissemination of new virulent viral variants, such as the highly infectious ‘Delta’ variant and the B1.1.529, ‘Omicron’ variant, have highlighted the need for rapid drug and vaccine discovery. The Omicron variant harbours a large number of mutations in the spike protein compared to the Delta variant which might confer greater transmissibility, although its level of vaccine resistance is uncertain. Although the actual level of threat remains to be determined, it illustrates potential future challenges if a new variant-specific vaccine is required to deal with such strains. A significant percentage of any population will never accept COVID-19 vaccines and will remain vulnerable to severe COVID-19 complications. Drugs which control COVID-19 progression would be useful in these situations. Second, it is considered by the WHO to be inevitable that similar viral pandemics will occur in the future. They may be mild or may be severe such as avian flu. A key to future-proofing us from a repeat of the COVID-19 lockdown/mortality experience is to have drugs available which can restrain the disease, especially in the lung, turning the disease into a ‘mild flu’. If such therapies could be quickly mobilized to limit the severity of new outbreaks, it would reduce the need for lockdowns and ease healthcare burdens. Third, it is less wealthy nations that suffer most from such pandemics due to their population numbers and density, the impact of lockdowns on subsistence living, limitations on government economic support and less access to high level health care, including intensive care unit beds and expensive drugs. The official death tolls in India and Indonesia for example, at the time of writing, are over 477,000 and 144,000 thousand, respectively. The socio-economic impact of the pandemic in these countries has been severe. In India and Indonesia, millions of people have been pushed back into poverty. In addition, failure to control COVID-19 in these poorer countries provides an incubator for potential virus variants. Such nations would be vastly helped by the availability of cheap, effective, rapidly deployable drugs that can restrain the disease. The race to develop therapies for COVID-19 has mostly focused on anti-viral agents, two of the most ","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"109-111"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39652070","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 needs and well-being of severe asthma and COPD carers: A cross-sectional study.","authors":"Eleanor C Majellano,&nbsp;Vanessa L Clark,&nbsp;Peter G Gibson,&nbsp;Juliet M Foster,&nbsp;Vanessa M McDonald","doi":"10.1111/resp.14167","DOIUrl":"https://doi.org/10.1111/resp.14167","url":null,"abstract":"<p><strong>Background and objective: </strong>Caring for people with severe asthma and chronic obstructive pulmonary disease (COPD) can impair the quality of life (QoL) of the carer. We aimed to describe the QoL and needs of severe asthma and COPD carers.</p><p><strong>Methods: </strong>Carers of severe asthma (n = 89) and COPD (n = 48) completed an online cross-sectional survey assessing QoL and carer support needs using the Short Form Health Survey 12v2 (SF-12), the Hospital Anxiety and Depression Scale (HADS) and Carers Support Needs Assessment Tool (CSNAT) questionnaires.</p><p><strong>Results: </strong>Carers of people with severe asthma and COPD were similar in age (mean ± SD 57.78 ± 14.09 vs. 56.93 ± 12.91) and gender (65% female vs. 66%); however, they differed in caring duration (proportion caring for >10 years: 65% vs. 33%, p < 0.002). QoL was impaired in both groups, but there were no significant differences between severe asthma and COPD carers in either of the SF-12 component scores. The HADS scores revealed no difference between groups. Compared to severe asthma carers, COPD carers had significantly greater needs for: 'having time for self' (33% vs. 13%, p = 0.006), 'equipment to help care for relative' (33% vs. 13%, p = 0.006), 'practical help in the home' (35% vs. 18%, p = 0.006) and 'getting a break from caring overnight' (21% vs. 6%, p = 0.023).</p><p><strong>Conclusion: </strong>QoL is impaired in carers of people with severe asthma to a similar degree of COPD carers and other debilitating diseases like cancer. These novel data highlight the support needs of severe asthma carers and identifies areas where tailored support is needed to reduce their substantial carer burden.</p>","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"134-143"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39515600","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":"Letter from Chile.","authors":"María Fernanda Del Valle,&nbsp;Jorge Valenzuela,&nbsp;Loretto Godoy,&nbsp;Mariano Del Sol,&nbsp;Pablo A Lizana,&nbsp;Máximo Escobar-Cabello,&nbsp;Rodrigo Muñoz-Cofre","doi":"10.1111/resp.14196","DOIUrl":"https://doi.org/10.1111/resp.14196","url":null,"abstract":"In Chile prior to the COVID-19 pandemic, the prevalence of chronic non-transmissible diseases was high; for example, the obesity rate was 31.2%, hypertension was 26.7% and diabetes stood at 12.3%. Later in 2019, the WHO declared the first case of COVID-19, with ‘patient zero’ of the pandemic in Chile being diagnosed on 3 March 2020. From that date to the present, our country has seen two peaks: the first in mid-June 2020 with 6938 daily positives and 187 deaths, and the second in early April 2021 with 9171 positive cases and 135 deaths. In light of this, local health authorities adopted a series of measures based on social distancing and mobility restriction, a situation which has gradually been relaxed since September 2020. Together with this, vaccination and testing strategies have managed to decrease the daily infection rate. One of the main complications from COVID-19 is acute hypoxaemic respiratory failure requiring invasive mechanical ventilatory (IMV) support associated with prolonged hospitalization in an intensive care unit (ICU). To meet this need, Chilean health authorities raised the number of ICU beds, reaching 3000 during the first peak and 4500 during the second peak, with occupation rates of 94% and 96%, respectively. Network functioning was also implemented, so that bed availability was at the national level and not at the local level, allowing patients to move nationwide. While this rise in beds has been able to handle health needs, the clinical condition in which these patients are discharged must not be neglected. Around 72% of adult patients reported suffering dyspnoea, even 2 months after hospital discharge, which would be a side effect of a restrictive pattern moving backwards. Together with dyspnoea, patients also report decreased muscle strength connected with severe mobility restrictions due to prolonged bedrest. After more than a year and a half of the COVID-19 pandemic and two waves, patients in Chile who survived COVID19 have been observed to have movement-connected fatigue, similar to that observed in patients with severe acute respiratory syndrome, even in those patients who did not develop critical illness or severe respiratory failure. Therefore, strategies must be prepared for functional recovery among patients who came through the hospitalization stage of COVID-19. Muscle weakness in critical COVID-19 patients can rise as high as 27% of the population at the moment of hospital discharge. One risk factor is the immobilization associated with prolonged hospitalization, along with the use of corticoids, sedatives and neuromuscular blockers, typically applied to patients undergoing critical care. All of this lead to muscle mass reduction, which negatively impacts the ability to generate strength. However, there is still more to learn about the profile of respiratory, physical and functional limitations which these patients will present, a fundamental fact for individualizing rehabilitation programmes. On 2 November ","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"173-174"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39818337","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":"The importance of being apnoeic (on CPAP).","authors":"Matthew T Naughton","doi":"10.1111/resp.14200","DOIUrl":"https://doi.org/10.1111/resp.14200","url":null,"abstract":"See related article","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"105-106"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39789589","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":"Improving support of informal carers of respiratory patients.","authors":"Morag Farquhar","doi":"10.1111/resp.14175","DOIUrl":"https://doi.org/10.1111/resp.14175","url":null,"abstract":"See related article","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"103-104"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39565391","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":"EBUS versus EUS-B for diagnosing sarcoidosis: The International Sarcoidosis Assessment (ISA) randomized clinical trial.","authors":"Laurence M M Crombag,&nbsp;Kirsten Mooij-Kalverda,&nbsp;Artur Szlubowski,&nbsp;Maciej Gnass,&nbsp;Kurt G Tournoy,&nbsp;Jiayuan Sun,&nbsp;Masahide Oki,&nbsp;Maarten K Ninaber,&nbsp;Daniel P Steinfort,&nbsp;Barton R Jennings,&nbsp;Moishe Liberman,&nbsp;Semra Bilaceroglu,&nbsp;Peter I Bonta,&nbsp;Daniël A Korevaar,&nbsp;Rocco Trisolini,&nbsp;Jouke T Annema","doi":"10.1111/resp.14182","DOIUrl":"https://doi.org/10.1111/resp.14182","url":null,"abstract":"<p><strong>Background and objective: </strong>Endosonography with intrathoracic nodal sampling is proposed as the single test with the highest granuloma detection rate in suspected sarcoidosis stage I/II. However, most studies have been performed in limited geographical regions. Studies suggest that oesophageal endosonographic nodal sampling has higher diagnostic yield than endobronchial endosonographic nodal sampling, but a head-to-head comparison of both routes has never been performed.</p><p><strong>Methods: </strong>Global (14 hospitals, nine countries, four continents) randomized clinical trial was conducted in consecutive patients with suspected sarcoidosis stage I/II presenting between May 2015 and August 2017. Using an endobronchial ultrasound (EBUS) scope, patients were randomized to EBUS or endoscopic ultrasound (EUS)-B-guided nodal sampling, and to 22- or 25-G ProCore needle aspiration (2 × 2 factorial design). Granuloma detection rate was the primary study endpoint. Final diagnosis was based on cytology/pathology outcomes and clinical/radiological follow-up at 6 months.</p><p><strong>Results: </strong>A total of 358 patients were randomized: 185 patients to EBUS-transbronchial needle aspiration (EBUS-TBNA) and 173 to EUS-B-fine-needle aspiration (FNA). Final diagnosis was sarcoidosis in 306 patients (86%). Granuloma detection rate was 70% (130/185; 95% CI, 63-76) for EBUS-TBNA and 68% (118/173; 95% CI, 61-75) for EUS-B-FNA (p = 0.67). Sensitivity for diagnosing sarcoidosis was 78% (129/165; 95% CI, 71-84) for EBUS-TBNA and 82% (115/141; 95% CI, 74-87) for EUS-B-FNA (p = 0.46). There was no significant difference between the two needle types in granuloma detection rate or sensitivity.</p><p><strong>Conclusion: </strong>Granuloma detection rate of mediastinal/hilar nodes by endosonography in patients with suspected sarcoidosis stage I/II is high and similar for EBUS and EUS-B. These findings imply that both diagnostic tests can be safely and universally used in suspected sarcoidosis patients.</p>","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"152-160"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/b3/RESP-27-152.PMC9299594.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634980","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":"Letter from Nepal.","authors":"Achyut Bhakta Acharya,&nbsp;Narendra Bhatta,&nbsp;Deebya Raj Mishra,&nbsp;Prahlad Karki,&nbsp;Mukesh Kumar Gupta,&nbsp;Madhab Lamsal,&nbsp;Basuda Khanal","doi":"10.1111/resp.14198","DOIUrl":"https://doi.org/10.1111/resp.14198","url":null,"abstract":"The Federal Democratic Republic of Nepal is a beautiful and stunning country which is part of the Himalayan mountain ranges. Nepal has a population of 30 million spread over 147,516 km. The capital of Nepal is Kathmandu. Nepal is home to people from more than 100 ethnic groups, most of whom share the official Nepali language. As a small, landlocked country, Nepal’s topography, climate, religion and population are diverse. Nepal has eight of the world’s 10 tallest mountains and contains more than 240 peaks over 6096 m above sea level. Nepal is a low-middle income country; its per capita income was US $729 in 2016. In Nepal, health care is delivered by a hybrid system of public and private sectors with predominantly modern health care and some traditional Ayurveda health care and other alternative medicines. The public healthcare system is composed of hospitals, primary healthcare centres and outreach healthcare providers (the latter provides basic level of health care by paramedical staff targeting the rural population). Nepal used to have a high prevalence of communicable diseases (CDs); currently, the country has higher agestandardized death rates and disability-adjusted life years from non-CDs (NCDs) than CDs. NCDs account for 80% of outpatient visits and are the leading cause of death, with two thirds of deaths due to NCDs and an additional 9% due to injuries. The remaining 25% of deaths are due to communicable, maternal, neonatal and nutritional diseases. As a percentage of total deaths, the leading five causes in 2017 were ischaemic heart disease (16.4%), chronic obstructive pulmonary disease (COPD; 9.8%), diarrhoeal diseases (5.6%), lower respiratory infections (5.1%) and intracerebral haemorrhage (3.8%). The rising incidence of NCDs is partly due to changing age structure and lifestyles, such as increasing sedentary behaviour, tobacco use, modified eating habits and harmful use of alcohol. The increase in life expectancy as well as the burden of NCDs signals a demographic shift to an ageing population, which could have significant effects on resource distribution in the Nepalese health system. Bronchiectasis and COPD are the most common chronic respiratory diseases diagnosed in developing countries. Despite differing aetiology, pathophysiology and prognosis, bronchiectasis clearly overlaps with features of COPD in a subset of patients. Bronchiectasis–COPD overlap syndrome (BCOS) is a discrete, chronic clinical entity meeting the structural and diagnostic criteria of bronchiectasis, that is, the presence of ‘bronchiectatic’ airway wall changes and physiological criteria for the diagnosis of COPD. There are no data on the prevalence of BCOS among patients presenting with respiratory symptoms complex (i.e., cardinal chronic symptoms of the respiratory system occurring together) in Nepal. Within this context, we conducted a hospital-based cross-sectional study at the Department of Pulmonary, Critical Care and Sleep Medicine of the B. P. Koiral","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"170-172"},"PeriodicalIF":6.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39888127","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":"P5‐71: Rapidly progressive honeycombing in a spontaneously breathing patient with COVID‐19 pneumonia","authors":"H. Bandara, D. Dharmasena, Sampath Liyanage, S. Kularatne, Sagar S. Panchal, K. Venugopal, A. Vora, Anil Daxini, P. Dadhich, S. Bhagat, Saiprasad Patil, H. Barkate","doi":"10.1111/resp.14150_278","DOIUrl":"https://doi.org/10.1111/resp.14150_278","url":null,"abstract":"","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116678176","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":"P6‐12: The cruel dual; SARS‐CoV‐2 and tuberculosis co‐infection, the Sri Lankan experience","authors":"","doi":"10.1111/resp.14150_378","DOIUrl":"https://doi.org/10.1111/resp.14150_378","url":null,"abstract":"80% of patients were newly diagnosed tuberculosis patients while 20% had reinfection or reactivation with one Multi Drug Resistant tuberculosis patient. Tuberculosis, SARS-COV-2 co-infection, causing double burden to the lung is an emerging syndemic. 1 National Hospital for Respiratory Diseases-Welisara, Sri Lanka B Background and Aims b : Tuberculosis, the ancient infection of the lung should not be overlooked while the global health care systems struggle to control the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-COV-2) infection i.e., COVID-19. [Extracted from the article] Copyright of Respirology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all Abstracts.)","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123567504","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":"P5‐82: The correlation of cycle threshold value with severity of COVID‐19 at the isolation of new emerging and re‐emerging infectious diseases room Arifin Achmad General Hospital Riau Province Indonesia","authors":"T. Uruma, Y. Iwata, N. Shimizudani, S. Teramoto, Ana Aulia, Zarfiardy Aksa Fauzi, Indra Yovi, A. Syamsu, Zahtamal Tamal","doi":"10.1111/resp.14150_289","DOIUrl":"https://doi.org/10.1111/resp.14150_289","url":null,"abstract":"","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114946630","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}