THU0616-HPR EXPIRATORY FLOW ACCELERATOR (EFA) IN SYSTEMIC SCLEROSIS PATIENTS WITH MUCUS HYPERSECRETION, PRODUCTIVE COUGH AND DYSPNOEA: PRELIMINARY RESULTS FROM A HOME-BASED AIRWAY CLEARANCE TECHNIQUE DAILY PROGRAM

Background:Systemic sclerosis (SSc) is a chronic disease with frequent lung involvement. As mucociliary clearance is impaired, mucus retention and frequent pulmonary infections, increase morbidity and mortality (1).Airway clearance techniques (ACT) enhance removal of mucus from the airways. Expiratory flow accelerator (EFA) is a new technology that promotes deep and gentle drainage of the bronchial secretions, through the Venturi effect. No respiratory effort is required and no negative pressure is generated, avoiding risk of bronchial collapse (2).Objectives:The aim of this study was to describe the effectiveness of EFA in improving pulmonary symptoms in SSc patients.Methods:SSc patients with daily productive cough, frequent pulmonary exacerbations, exertional dyspnea and/or reduced physical activity were selected. All of them underwent a home-based ACT program with EFA. A Respiratory Physiotherapist (RT) trained each patient to use the device 3 times a day, 15 minutes each session. Every subject compiled the Saint George’s Respiratory Questionnaire (SGRQ) and scleroderma Health Assessment Questionnaire (SHAQ) at baseline, 30, 90 and 180 days from the beginning. Statistical analysis has been carried out with General linear model for repeated measures. A value of p<0.05 was considered statistically significant.Results:8 patients were enrolled (M:F=1:7), median age 54 (IC95% 46-69) years. Interstitial lung disease affected the majority of them (7/8). SGRQ total score and SHAQ domain for respiratory symptoms decreased over time (p= 0.003 and p= 0.005). In particular, there was an improvement in two SGRQ domains: activities (p= 0.013) and symptoms (p= 0.005) (fig.1).Figure 1Conclusion:This is the first study to investigate the effect of EFA technology on airway clearance in SSc patients. The observations suggest the importance of a daily ACT program with EFA in improving respiratory symptoms. This technology appear to be extremely promising in SS patient management as it is well tolerated and it has the potential to slow down the pulmonary disease progression by limiting bronchial infections.References:[1]Tyndall AJ et al. Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis 2010;69:1809–15.[2]Zampogna E, et al. Expiratory Flow Accelerator (EFA) technique on mucus hypersecretion of COPD patients with reduced cough efficiency after a severe exacerbation. Int Clin Med 2019;3:1-6.Disclosure of Interests:Silvia faverzani: None declared, Andrea Becciolini Speakers bureau: Sanofi-Genzyme, UCB and AbbVie, ernesto crisafulli: None declared, filippo nocera: None declared, eleonora di donato: None declared, Flavio Mozzani: None declared, michele riva: None declared, Daniele Santilli: None declared, lorenza monica: None declared, annalisa barbieri: None declared, lissette barone: None declared, maurizio marvisi: None declared, veronica alfieri: None declared, annalisa frizzelli: None declared, Alfredo Chetta: None declared, ALARICO ARIANI: None declared

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Expiratory Flow Accelerator (EFA) technique on mucus hypersecretion of COPD patients with reduced cough efficiency after a severe exacerbation

Integrative Clinical Medicine ◽

10.15761/icm.1000168 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Elisabetta Zampogna ◽

Ernesto Crisafulli ◽

Michele D’Andria ◽

Cristina Gregorini ◽

Giorgio Bellelli ◽

...

Keyword(s):

Severe Exacerbation ◽

Mucus Hypersecretion ◽

Copd Patients ◽

Expiratory Flow

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Alemtuzumab-associated diffuse alveolar damage – a case report

BMC Neurology ◽

10.1186/s12883-020-01934-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Antonios Bayas ◽

Martina Menacher ◽

Martin Schwaiblmair ◽

Bruno Märkl ◽

Markus Naumann

Keyword(s):

Lung Biopsy ◽

Respiratory Symptoms ◽

Diffuse Alveolar Damage ◽

Productive Cough ◽

Exertional Dyspnea ◽

Case Presentation ◽

Rare Side Effect ◽

Diagnostic Work ◽

Work Up ◽

Diagnostic Work Up

Abstract Background Identifying causes of alemtuzumab induced respiratory symptoms in Multiple Sclerosis (MS) patients is crucial. Case presentation We report a case of diffuse alveolar damage (DAD) in a patient with MS after the first course of alemtuzumab treatment. A 42-year-old female developed progressive non-productive cough and exertional dyspnea 2 months after alemtuzumab treatment. DAD was diagnosed histopathologically by lung biopsy. The patient recovered completely, alemtuzumab was not continued. Conclusions Our case highlights another pathomechanism for non-infective lung-disorders in alemtuzumab treated MS patients. DAD is a potential, albeit rare side effect of alemtuzumab, broadening the spectrum of non-infective lung disorders that should be considered in the diagnostic work-up.

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Feasibility study of the Home-based Exercises for Responsible Sex (HERS) intervention to promote correct and consistent condom use among young women

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00885-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Nicola Knights ◽

Nicole Stone ◽

Tom Nadarzynski ◽

Katherine Brown ◽

Katie Newby ◽

...

Keyword(s):

Condom Use ◽

Feasibility Study ◽

Young Women ◽

Self Efficacy ◽

Repeated Measures ◽

Recruitment Strategy ◽

Consistent Condom ◽

Post Intervention ◽

Study Objective ◽

Home Based

Abstract Background Male condoms are effective in preventing common sexually transmitted infections (STIs) and unintended pregnancy, if used correctly and consistently. However, condom use errors and problems are common and young people report negative experiences, such as reduced pleasure. The Kinsey Institute Home-Based Exercises for Responsible Sex (KIHERS) is a novel condom promotion intervention for young women, which aims to reduce condom errors and problems, increase self-efficacy and improve attitudes towards condoms, using a pleasure-focussed approach. The study objective was to test the operability, viability and acceptability of an adapted version of the KIHERS intervention with young women aged 16–25 years in the United Kingdom (UK) (Home-Based Exercises for Responsible Sex-UK (HERS-UK). Methods A repeated-measures single-arm design was used, with a baseline (T1) and two follow-up assessments (T2 and T3), conducted 4 weeks and 8 weeks post intervention over a 3-month period. Participants were provided a condom kit containing different condoms and lubricants and were asked to experiment with condoms alone using a dildo and/or with a sexual partner. Ten process evaluation interviews were conducted post intervention. Results Fifty-five young women received the intervention; 36 (65%) completed T2 and 33 (60%) completed T3. Condom use errors and problems decreased, self-efficacy increased and attitudes towards condoms improved significantly. The proportion of participants who reported using a condom for intercourse in the past 4 weeks increased from T1 (20; 47%) to T2 (27; 87%) and T3 (23; 77%) and using lubricant with a condom for intercourse increased from T1 (6; 30%) to T2 (13; 48%)) and T3 (16; 70%). However, motivation to use condoms did not change. Cronbach’s alpha scores indicated good internal consistency of measures used. Qualitative data provided strong evidence for the acceptability of the intervention. Conclusions HERS-UK was implemented as intended and the recruitment strategy was successful within a college/university setting. This feasibility study provided an early indication of the potential effectiveness and acceptability of the intervention, and the benefits of using a pleasure-focussed approach with young women. Measures used captured change in outcome variables and were deemed fit for purpose. Future research should explore cost-effectiveness of this intervention, in a large-scale controlled trial using a diverse sample and targeting young women most at risk of STIs.

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Impact of air pollution on pulmonary function and respiratory symptoms in children. Longitudinal repeated-measures study

BMC Pulmonary Medicine ◽

10.1186/1471-2466-10-62 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 32

Author(s):

Benigno Linares ◽

Juan M Guizar ◽

Norma Amador ◽

Alfonso Garcia ◽

Victor Miranda ◽

...

Keyword(s):

Air Pollution ◽

Pulmonary Function ◽

Repeated Measures ◽

Respiratory Symptoms

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The Efficacy of a Home-Based, Self-Administered Hand Exercise Program for Patients With Systemic Sclerosis

JCR Journal of Clinical Rheumatology ◽

10.1097/rhu.0000000000001752 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Neslihan Gokcen ◽

Suade Ozlem Badak ◽

Tunay Sarpel ◽

Yasar Sertdemir ◽

Eren Erken

Keyword(s):

Systemic Sclerosis ◽

Exercise Program ◽

Home Based

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The impact of a heat and moisture exchange mask on respiratory symptoms and airway response to exercise in asthma

ERJ Open Research ◽

10.1183/23120541.00271-2019 ◽

2020 ◽

Vol 6 (2) ◽

pp. 00271-2019

Author(s):

Anna R. Jackson ◽

J.H. Hull ◽

James G. Hopker ◽

Hannah Fletcher ◽

William Gowers ◽

...

Keyword(s):

Repeated Measures ◽

Respiratory Symptoms ◽

Face Mask ◽

Forced Expiratory Volume ◽

Peak Power Output ◽

Post Exercise ◽

Before And After ◽

Exercise Induced ◽

Heat And Moisture ◽

The Impact

Respiratory symptoms, including cough, are prevalent in individuals with asthma when exercising. This study investigates whether a heat and moisture exchanger (HME) face mask is effective in modulating exercise-induced bronchoconstriction (EIB) and post-exercise cough in a cold, dry environment in individuals with asthma.Twenty-six participants diagnosed with asthma (20 males, 6 females) completed three cycling exercise challenges at 8°C and 24% relative humidity in a randomised order. Participants wore either an HME mask (MASK), sham mask (SHAM), or no mask (CONT). Following a 3-min warm-up, participants completed 6-min cycling at 80% peak power output. Before and after exercise, maximal flow-volume loops were recorded. Post-exercise cough was monitored with a Leicester Cough Monitor (LCM) for 24 h. Results were analysed using repeated-measures ANOVA and Friedman's tests and data were presented as the mean±sd or median (interquartile range (IQR)).Eleven participants failed to demonstrate EIB (i.e. >10% fall in forced expiratory volume in 1 s after exercise) and were removed from analysis. The percentage fall in forced expiratory volume in 1 s following exercise in CONT was greater than MASK (MASK: −6% (7%), SHAM: −11% (11%), CONT: −13% (9%); p<0.01). No difference was found between exercise in cough count per hour over the 24-h monitoring period or the number of coughs in the first hour after exercise.HME masks can attenuate EIB when exercising in cold, dry environments. The SHAM mask may not have been entirely inert, demonstrating the challenges of running randomised control trials utilising control and sham conditions.

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