Canadian respiratory journal最新文献

{"title":"Blood Eosinophil Count as a Predictive Biomarker of Chronic Obstructive Pulmonary Disease Exacerbation in a Real-World Setting.","authors":"Moegi Komura,&nbsp;Tadashi Sato,&nbsp;Yohei Suzuki,&nbsp;Hitomi Yoshikawa,&nbsp;Naoko Arano Nitta,&nbsp;Mika Hayashi,&nbsp;Eriko Kuwasaki,&nbsp;Kimiko Horikoshi,&nbsp;Toshihiko Nishioki,&nbsp;Mikiko Mori,&nbsp;Yuzo Kodama,&nbsp;Shinichi Sasaki,&nbsp;Kazuhisa Takahashi","doi":"10.1155/2023/3302405","DOIUrl":"https://doi.org/10.1155/2023/3302405","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, and COPD exacerbation worsens the prognosis. Eosinophilic airway inflammation is a COPD phenotype that causes COPD exacerbation and is correlated with peripheral blood eosinophil count. We analyzed real-world data of COPD patients to assess the risk factors of COPD exacerbation focusing on blood eosinophils.</p><p><strong>Materials and methods: </strong>Patients with COPD who visited our hospital between January 1, 2018, and December 31, 2018, were recruited, and their background information, spirometry data, laboratory test results, and moderate-to-severe exacerbation events during the one-year follow-up period were collected from the electronic medical records and analyzed. The COPD exacerbation risk factors were assessed using univariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Twenty-two of 271 (8.1%) patients experienced moderate-to-severe exacerbation. Patients with exacerbation showed worse pulmonary function, and we found that a high blood eosinophil count (≥350 cells/<i>μ</i>L; <i>p</i>=0.014), low % FEV1 (<50%; <i>p</i>=0.002), increase in white blood cell (≥9000 cells/<i>μ</i>L; <i>p</i>=0.039), and use of home oxygen therapy (<i>p</i>=0.005) were risk factors for future exacerbations. We also found a strong correlation between eosinophil count cut-offs and exacerbation risk (<i>r</i> = 0.89, <i>p</i> < 0.001). On the other hand, there was no relation between exacerbation risk and inhalation therapy for COPD.</p><p><strong>Conclusion: </strong>In a real-world setting, peripheral blood eosinophil count could be a predictor of future COPD exacerbation.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"3302405"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation.","authors":"José Manuel Álvarez-Dobaño,&nbsp;Malena Toubes,&nbsp;José Ángel Novo-Platas,&nbsp;Francisco Reyes-Santías,&nbsp;Gerardo Atienza,&nbsp;Manuel Portela,&nbsp;Carlos Rábade,&nbsp;Tamara Lourido,&nbsp;Ana Casal,&nbsp;Carlota Rodríguez-García,&nbsp;Vanessa Riveiro,&nbsp;Romina Abelleira,&nbsp;Jorge Ricoy,&nbsp;Nuria Rodríguez-Núñez,&nbsp;Carlos Zamarrón,&nbsp;Felipe Calle,&nbsp;Francisco Gude,&nbsp;Luis Valdés","doi":"10.1155/2022/2423272","DOIUrl":"10.1155/2022/2423272","url":null,"abstract":"<p><strong>Introduction: </strong>This study assesses the impact of an electronic physician-to-physician consultation program on the waiting list and the costs of a Pulmonology Unit.</p><p><strong>Materials and methods: </strong>A prepost intervention study was conducted after a new ambulatory pulmonary care protocol was implemented and the capacity of the unit was adopted. In the new model, physicians at all levels of healthcare send electronic consultations to specialists.</p><p><strong>Results: </strong>In the preintervention year (2019), the Unit of Pulmonology attended 7,055 consultations (466 e-consultations and 6,589 first face-to-face visits), which decreased to 6,157 (3,934 e-consultations and 2,223 first face-to-face visits; 12.7% reduction) in the postintervention year (all were e-consultations). The mean wait time for the first appointment was 25.7 days in 2019 versus 3.2 days in 2021 (<i>p</i> < 0.001). In total, 43.5% of cases were solved via physician-to-physiciane-consultation. A total of 2,223 patients needed a face-to-face visit, with a mean wait time of 7.5 days. The mean of patients in the waiting listing decreased from 450.8 in 2019 to 44.8 in 2021 (90% reduction). The annual time devoted to e-consultations and first face-to-face visits following an e-consultation diminished significantly after the intervention (1,724 hours versus 2,312.8; 25.4% reduction). Each query solved via e-consultation represented a saving of €652.8, resulting in a total annual saving of €827,062.</p><p><strong>Conclusions: </strong>Physician-to-physiciane-consultations reduce waiting times, improve access of complex patients to specialty care, and ensure that cases are managed at the appropriate level. E-consultation reduces costs, which benefits both, society and the healthcare system.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"2423272"},"PeriodicalIF":2.2,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10378452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Eosinophil Endotypes across Asthma and Chronic Obstructive Pulmonary Disease (COPD).","authors":"Jia-Ying Luo,&nbsp;Hui-An Chen,&nbsp;Yuan-Yu Feng,&nbsp;Ye-Peng Chen,&nbsp;Xiang-Cheng Lei,&nbsp;Shuang-Lin Guo,&nbsp;Xiao-Bin Huang,&nbsp;Zhi-Man Liang,&nbsp;Ning Li,&nbsp;Bao-Qing Sun","doi":"10.1155/2022/9656278","DOIUrl":"https://doi.org/10.1155/2022/9656278","url":null,"abstract":"<p><strong>Background: </strong>Eosinophils were common inflammatory cells involved in the occurrence and development of various inflammatory diseases. Multiple recent studies have pointed to the increasingly important role of eosinophils in respiratory diseases. This article aims to compare the expression differences of blood eosinophil counts between asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO).</p><p><strong>Methods: </strong>Patients with asthma, COPD, and ACO who were seen in the First Affiliated Hospital of Guangzhou Medical University from January 2012 to June 2019 were included. We collected information such as age, gender, diagnosis, the eosinophil counts from the medical records. Moreover, the levels of 10 cytokines in the plasma of each group were detected by using the Meso Scale Discovery method.</p><p><strong>Results: </strong>We included 9787 patients with asthma, 15806 patients with COPD, and 831 ACO patients. From our results, it can be first found that eosinophil levels were age-related in the three diseases (asthma and ACO: <i>p</i> < 0.001; COPD: <i>P</i> = 0.001); in asthma and COPD, the number of eosinophils in males was more significant than that in females (asthma: <i>p</i> < 0.001; COPD: <i>p</i> = 0.012). Second, asthma patients had higher blood eosinophil counts than those with COPD and ACO (<i>p</i> < 0.001). Moreover, we found out that eosinophil levels were highly expressed in the stable group of all three diseases. Finally, we found that most cytokines in ACO patients showed a downward trend when the level of eosinophils was low, whereas the results were reversed in asthma patients; 7 cytokines had similar trends in COPD and ACO patients.</p><p><strong>Conclusions: </strong>In conclusion, eosinophils have their own unique endotypes in asthma, COPD, and ACO patients, which were reflected in the fluctuation of their levels and changes in cytokine secretion.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"9656278"},"PeriodicalIF":2.2,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40443808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Using High-Resolution Computed Tomography Features for Invasiveness Differentiation of Malignant Nodules Manifesting as Ground-Glass Nodules.","authors":"Xinyue Chen,&nbsp;Benbo Yao,&nbsp;Juan Li,&nbsp;Chunxiao Liang,&nbsp;Rui Qi,&nbsp;Jianqun Yu","doi":"10.1155/2022/2671772","DOIUrl":"https://doi.org/10.1155/2022/2671772","url":null,"abstract":"<p><p>Ground-glass nodule (GGN)-like adenocarcinoma is a special subtype of lung cancer. The invasiveness of the nodule correlates well with the patient's prognosis. This study aimed to establish a radiomic model for invasiveness differentiation of malignant nodules manifesting as ground glass on high-resolution computed tomography (HRCT). Between January 2014 and July 2019, 276 pulmonary nodules manifesting as GGNs on preoperative HRCTs, whose histological results were available, were collected. The nodules were randomly classified into training (<i>n</i> = 221) and independent testing (<i>n</i> = 55) cohorts. Three logistic models using features derived from HRCT were fit in the training cohort and validated in both aforementioned cohorts for invasive adenocarcinoma and preinvasive-minimally invasive adenocarcinoma (MIA) differentiation. The model with the best performance was presented as a nomogram and was validated using a calibration curve before performing a decision curve analysis. The benefit of using the proposed model was also shown by groups of management strategies recommended by The Fleischner Society. The combined model showed the best differentiation performance (area under the curve (AUC), training set = 0.89, and testing set = 0.92). The quantitative texture model showed better performance (AUC, training set = 0.87, and testing set = 0.91) than the semantic model (AUC, training set = 0.83, and testing set = 0.79). Of the 94 type 2 nodules that were IACs, 66 were identified by this model. Models using features derived from imaging are effective for differentiating between preinvasive-MIA and IACs among lung adenocarcinomas appearing as GGNs on CT images.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"2671772"},"PeriodicalIF":2.2,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40650235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Nutritional Status of Chronic Obstructive Pulmonary Disease Exacerbators.","authors":"Carina Rôlo Silvestre,&nbsp;Tiago Dias Domingues,&nbsp;Luís Mateus,&nbsp;Maria Cavaco,&nbsp;André Nunes,&nbsp;Ricardo Cordeiro,&nbsp;Teresa Silva Santos,&nbsp;Teresa Falcão,&nbsp;António Domingos","doi":"10.1155/2022/3101486","DOIUrl":"https://doi.org/10.1155/2022/3101486","url":null,"abstract":"<p><strong>Introduction: </strong>Malnutrition is underdiagnosed in chronic obstructive pulmonary disease.</p><p><strong>Objectives: </strong>This study aimed to evaluate the nutritional status of COPD patients and the link between dyspnea and nutritional status.</p><p><strong>Methods: </strong>This longitudinal observational study included patients hospitalized with exacerbated COPD. Nutritional status was assessed using Nutrition Risk Screening 2002, anthropometric, and biochemical assessments, in the first 48 hours of hospitalization.</p><p><strong>Results: </strong>Thirty patients were evaluated. According to the Nutrition Risk Screening 2002, half of the patients were at increased risk of malnutrition. 36.7% were classified as malnourished if we only considered the body mass index. From the evaluation of the tricipital skin fold, 69.0% were classified as malnourished, with 48.3% having severe malnutrition. According to the serum albumin level, 29.6% had malnutrition criteria. A significant association between dyspnea and increasing age (<i>p</i>=0.037) was found. There was a strong association between the fold classification and the degrees of severity of dyspnea (Fisher exact test: 13.60, <i>p</i>=0.001, <i>V</i> Cramer = 0.826). Most patients were malnourished and had higher grades of dyspnea. Tricipital skinfold reflects subcutaneous adipose tissue; this anthropometric measurement seems to be a good method to classify the nutritional status of COPD patients. It classified the biggest portion of patients as malnourished.</p><p><strong>Conclusion: </strong>The number of patients classified as malnourished changed with the method under analysis. The tricipital skin fold parameter was strongly associated with the dyspnea score. Most patients had adipose tissue and muscular mass depletion.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"3101486"},"PeriodicalIF":2.2,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40653054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on Cough Sensitivity and Airway Inflammation in Patients with Sinobronchial Syndrome.","authors":"Shengyuan Wang,&nbsp;Shanshan Niu,&nbsp;Siwan Wen,&nbsp;Mengru Zhang,&nbsp;Cuiqin Shi,&nbsp;Zhongmin Qiu,&nbsp;Li Yu,&nbsp;Xianghuai Xu","doi":"10.1155/2022/2726261","DOIUrl":"https://doi.org/10.1155/2022/2726261","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to clarify the characteristics of cough-reflex sensitivity and airway inflammation in patients with sinobronchial syndrome (SBS).</p><p><strong>Methods: </strong>39 patients with SBS, 53 patients with upper airway cough syndrome (UACS) induced by rhinitis, 33 patients with chronic sinusitis without cough, and 39 healthy controls (HCs) were enrolled between January 2013 and December 2018. All participants underwent a capsaicin cough-sensitivity test and cytology of induced sputum. The concentration of calcitonin-gene-related peptide (CGPR), histamine, prostaglandin (PG) E2, and eosinophil cationic protein (ECP) in induced sputum were measured using enzyme-linked immunosorbent assays (ELISAs).</p><p><strong>Results: </strong>The lowest concentration of capsaicin solution that induced ≥5 coughs (<i>C</i>5) was decreased markedly in patients with UACS induced by rhinitis compared with SBS patients (1.95 ± 2.92 <i>vs</i>. 31.2 ± 58.6 mol/L, <i>P</i> < 0.001), indicating higher cough-reflex sensitivity among UACS patients induced by rhinitis. However, there was no difference of these threshold between SBS patients and patients with sinusitis without cough and HCs. The percentage of neutrophils in sputum was increased remarkably in patients with SBS compared with HCs (40.0 ± 48.5% <i>vs</i>. 5.5 ± 9.0%, <i>P</i> < 0.001). A higher concentration of CGPR, histamine, and PGE2 was observed in induced sputum from patients with UACS induced by rhinitis than that in controls, and the ECP level was increased significantly in UACS induced by rhinitis compared with that in the other three groups.</p><p><strong>Conclusions: </strong>Cough-reflex sensitivity and airway inflammation in patients with SBS were different in patients with UACS induced by rhinitis. Thus, the mechanism of cough in those two patient populations might differ. Our study is registered in the Chinese Clinical Trials Register (https://www.chictr.org.cn/) as ChiCTR-TRC-00000152.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"2726261"},"PeriodicalIF":2.2,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40654996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition of MAD2L1 Mediates Pulmonary Fibrosis through Impairment of Mitochondrial Function and Induction of Cell Senescence.","authors":"Lan Wang,&nbsp;Ruyan Wan,&nbsp;Xinyu Chen,&nbsp;Xiaoshu Guo,&nbsp;Zhongzheng Li,&nbsp;Weiming Zhao,&nbsp;Peishuo Yan,&nbsp;Guoying Yu","doi":"10.1155/2022/9663354","DOIUrl":"https://doi.org/10.1155/2022/9663354","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a chronic, irreversible, and progressive interstitial lung disease characterized by recurrent alveolar epithelial cell injury, fibroblast hyperproliferation, and cumulative deposition of extracellular matrix leading to alveolar destruction in the lungs. Mitotic arrest deficient 2 like 1 (MAD2L1) is a component of the mitotic spindle assembly checkpoint that prevents the onset of anaphase until all chromosomes are properly aligned at metaphase and is a potential therapeutic target in cancers. However, the role of MAD2L1 in pulmonary fibrosis has not been explored. We analyzed the expression of MAD2L1 in lung tissues from control subjects, IPF patients, and mice with bleomycin-induced fibrosis via IHC, qRT-PCR, and Western blot analysis. We examined the roles of MAD2L1 in ROS production, mitochondrial function, cell senescence, and the establishment of a profibrotic microenvironment. We found that MAD2L1 was highly upregulated in alveolar epithelial cells in fibrotic lung tissues from both patients with IPF and mice with bleomycin-induced fibrosis. Loss of MAD2L1 expression or activity led to decreases of cell viability and proliferation in A549 cells. Subsequent mechanistic investigation demonstrated that inhibition of MAD2L1 damaged mitochondria, which led to augmented ROS production and cellular senescence, and thus promoted the establishment of a profibrotic microenvironment. Taken together, these results reveal that alleviation of alveolar epithelial cell mitochondrial damage arising from augmentation of MAD2L1 may be a novel therapeutic strategy for mitigating pulmonary fibrosis.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"9663354"},"PeriodicalIF":2.2,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33515958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasopharyngeal Wash with Normal Saline Decreases SARS-CoV-2 Viral Load: A Randomized Pilot Controlled Trial.","authors":"I Pantazopoulos,&nbsp;A Chalkias,&nbsp;G Mavrovounis,&nbsp;I Dimeas,&nbsp;S Sinis,&nbsp;A Miziou,&nbsp;E Rouka,&nbsp;K Poulas,&nbsp;K Gourgoulianis","doi":"10.1155/2022/8794127","DOIUrl":"https://doi.org/10.1155/2022/8794127","url":null,"abstract":"<p><strong>Background: </strong>Although great progress has been made over the past 2 years in the scientific understanding of the biology, epidemiology, and pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), case morbidity and fatality rates remain a great concern and continue to challenge the healthcare resources worldwide as novel variants emerge. There is therefore an urgent need for affordable and readily available strategies to reduce viral transmission. Previous studies in non-COVID-19 patients have demonstrated that administration of low-salt (isotonic but 0.0375% Na) and isotonic saline (0.9% Na) solutions has been associated with an immediate, significant reduction in the microbial antigens and a related decline of microbial burden. The aim of the present study was to determine the effect of nasal washes with normal saline 0.9% on nasopharyngeal viral load and outcome in hospitalized patients with COVID-19 pneumonia.</p><p><strong>Methods: </strong>We performed a prospective, randomized, pilot, controlled trial in 50 patients with confirmed COVID-19 disease. Patients were randomized into two groups, the normal saline group (received normal saline 0.9% solution for nasopharyngeal wash) and the control group (no treatment). In the normal saline group, nasopharyngeal wash was performed every 4 hours for a 16-hour period. Twenty-four hours after the baseline nasopharyngeal swab (and 8 hours after the last wash in the normal saline group), a second nasopharyngeal swab was collected for the semiquantitative estimation of the SARS-CoV-2 viral load as determined by cycle threshold (Ct) values.</p><p><strong>Results: </strong>In the normal saline group, mean N gene Ct values increased significantly 24 hours after the baseline measurement [ΔCt_day2-day1 = 1.87 ± 3.11 cycles, <i>p</i> = 0.007 (95% CI: 0.55 to 3.18)], indicating a decline in SARS-CoV-2 nasopharyngeal viral load by 8.9%. A significant decrease in mean N gene Ct values was observed in the control group, indicating an increase in viral load [ΔCt_day2-day1 = -2.12 ± 2.66, <i>p</i> < 0.001 (95% CI: -3.20 to -1.05)] by 9.7%. The difference between the two groups 24 hours after admission and nasopharyngeal wash was 3.09 cycles (<i>p</i> = 0.005, 95% CI: 0.97 to 5.20).</p><p><strong>Conclusion: </strong>Nasal washes with normal saline effectively decreased the viral load during hospitalization and at follow-up.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"8794127"},"PeriodicalIF":2.2,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9556252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33514403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Approaches in COVID-19 Patients: The Role of the Renin-Angiotensin System.","authors":"Farzaneh Ketabchi,&nbsp;Sina Jamzad","doi":"10.1155/2022/8698825","DOIUrl":"https://doi.org/10.1155/2022/8698825","url":null,"abstract":"<p><p>Two and a half years after COVID-19 was first reported in China, thousands of people are still dying from the disease every day around the world. The condition is forcing physicians to adopt new treatment strategies while emphasizing continuation of vaccination programs. The renin-angiotensin system plays an important role in the development and progression of COVID-19 patients. Nonetheless, administration of recombinant angiotensin-converting enzyme 2 has been proposed for the treatment of the disease. The catalytic activity of cellular ACE2 (cACE2) and soluble ACE2 (sACE2) prevents angiotensin II and Des-Arg-bradykinin from accumulating in the body. On the other hand, SARS-CoV-2 mainly enters cells via cACE2. Thus, inhibition of ACE2 can prevent viral entry and reduce viral replication in host cells. The benefits of bradykinin inhibitors (BKs) have been reported in some COVID-19 clinical trials. Furthermore, the effects of cyclooxygenase (COX) inhibitors on ACE2 cleavage and prevention of viral entry into host cells have been reported in COVID-19 patients. However, the administration of COX inhibitors can reduce innate immune responses and have the opposite effect. A few studies suggest benefits of low-dose radiation therapy (LDR) in treating acute respiratory distress syndrome in COVID-19 patients. Nonetheless, radiation therapy can stimulate inflammatory pathways, resulting in adverse effects on lung injury in these patients. Overall, progress is being made in treating COVID-19 patients, but questions remain about which drugs will work and when. This review summarizes studies on the effects of a recombinant ACE2, BK and COX inhibitor, and LDR in patients with COVID-19.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"8698825"},"PeriodicalIF":2.2,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33490413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of High-Flow Nasal Cannula versus Conventional Oxygen Therapy in Obese Patients during the Perioperative Period: A Systematic Review and Meta-Analysis.","authors":"Rong Zhou,&nbsp;Hao-Tian Wang,&nbsp;Wei Gu","doi":"10.1155/2022/4415313","DOIUrl":"https://doi.org/10.1155/2022/4415313","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a risk factor for severe airway obstruction and hypoxemia. High-flow nasal cannula (HFNC) is considered as a novel method for oxygen therapy, but the efficacy of HFNC for obese patients is controversial. This meta-analysis aimed to assess the efficacy of HFNC compared with conventional oxygen therapy (COT) in obese patients during the perioperative period.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, Web of Science, the Cochrane Library, and Google scholar databases for randomized controlled trials (RCTs) that compared the efficacy of HFNC with COT in obese patients during the perioperative period. The primary outcome was the incidence of hypoxemia, while the secondary outcomes included the lowest SpO₂, the need for additional respiratory support, and the hospital length of stay (LOS).</p><p><strong>Results: </strong>Twelve trials with 798 obese patients during the perioperative period were included. Compared with COT, HFNC reduced the incidence of hypoxemia (RR, 0.60; 95% CI, 0.43 to 0.83; <i>P</i>=0.002; <i>I</i> ² = 24%; 8 RCTs; <i>n</i> = 458), increased the lowest SpO₂ (MD, 2.88; 95% CI, 1.53 to 4.22; <i>P</i> < 0.0001; <i>I</i> ² = 32%; 5 RCTs; <i>n</i> = 264), decreased the need for additional respiratory support (RR, 0.43; 95% CI, 0.21 to 0.88; <i>P</i>=0.02; <i>I</i> ^<i>2</i>  = 0%; 3 RCTs; <i>n</i> = 305), and shortened the hospital LOS (MD, -0.31; 95% CI, -0.57 to -0.04; <i>P</i>=0.02; <i>I</i> ² = 0%; 3 RCTs; <i>n</i> = 214).</p><p><strong>Conclusions: </strong>This meta-analysis showed that compared with COT, the use of HFNC was able to reduce the incidence of hypoxemia, increase the lowest SpO₂, decrease the need for additional respiratory support, and shorten the hospital LOS in obese patients during the perioperative period. Well-organized trials with large sample size should be conducted to support our findings.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":"4415313"},"PeriodicalIF":2.2,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33515957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}