scholarly journals Distant Compliance with Treatment in Patients with Chronic Respiratory Diseases: Asthma, Copd and Asthma-Copd Overlap Syndrome. Prospective Study

2021 ◽  
Vol 18 (2) ◽  
pp. 15-47
Author(s):  
Simona Maria Ţîrcă ◽  
Marius Sorin Ciontea ◽  
Elena Vlad ◽  
Florin Dumitru Mihălţan
Keyword(s):  
Respiratory Diseases ◽  
Symptom Control ◽  
Chronic Obstructive ◽  
Asthma Control Test ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Material Resources ◽  
Copd Assessment Test ◽  
Adolescents And Adults

Abstract Medications prescribed for chronic diseases such as asthma, chronic obstructive pulmonary disease (COPD) or asthma-COPD overlap (ACO) syndrome should be administered in the long term and compliance becomes a health care concern. Noncompliance adversely affects the outcome of treatment and results in the consumption of human and material resources. The aim of our study was to identify the factors that cause non-compliance with treatment in children, adolescents, and adults with asthma/COPD/ACO in Romania, the methods by which these factors can be understood and corrected, and the evaluation of symptoms. To achieve the goal, regular visits were carried out with symptom control questionnaires (Asthma Control Test (ACT), COPD Assessment Test (CAT)) and FEV1 evaluation using spirometry. The results obtained indicate low long-term compliance (12.35%) due to patients’ abstinence from regular check-ups. In conclusion, we can say that the factors related to doctors have been successfully corrected, but it remains a challenge in correcting the factors related to patients and the health regime.

CRISPR/Cas9 Genome Editing Tool: A Promising Tool for Therapeutic Applications on Respiratory Diseases

2020 ◽  
Vol 20 (5) ◽  
pp. 333-346
Author(s):  
Sadiya Bi Shaikh ◽  
Yashodhar Prabhakar Bhandary
Keyword(s):  
Respiratory Diseases ◽  
Gene Editing ◽  
Epithelial Mesenchymal Transition ◽  
Respiratory Health ◽  
Chronic Obstructive ◽  
Therapeutic Tool ◽  
Obstructive Pulmonary Disease ◽  
Mesenchymal Transition ◽  
Chronic Respiratory Diseases ◽  
Promising Tool

Respiratory diseases are one of the prime topics of concern in the current era due to improper diagnostics tools. Gene-editing therapy, like Clustered regularly interspaced palindromic repeats- associated nuclease 9 (CRISPR/Cas9), is gaining popularity in pulmonary research, opening up doors to invaluable insights on underlying mechanisms. CRISPR/Cas9 can be considered as a potential gene-editing tool with a scientific community that is helping in the advancement of knowledge in respiratory health and therapy. As an appealing therapeutic tool, we hereby explore the advanced research on the application of CRISPR/Cas9 tools in chronic respiratory diseases such as lung cancer, Acute respiratory distress syndrome (ARDS) and cystic fibrosis (CF). We also address the urgent need to establish this gene-editing tool in various other lung diseases such as asthma, Chronic obstructive pulmonary disease (COPD) and Idiopathic pulmonary fibrosis (IPF). The present review introduces CRISPR/Cas9 as a worthy application in targeting epithelial-mesenchymal transition and fibrinolytic system via editing specific genes. Thereby, based on the efficiency of CRISPR/Cas9, it can be considered as a promising therapeutic tool in respiratory health research.

scholarly journals Chronic respiratory diseases at primary health care level in Georgia: the results of the pilot study

2016 ◽  
Vol 71 (4) ◽  
Author(s):  
I. Chkhaidze ◽  
T. Maglakelidze ◽  
N. Khaltaev
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Official Statistics ◽  
Global Alliance ◽  
Care Level ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Chronic Morbidity ◽  
Official Data

Background and aim. Millions of people suffer from chronic respiratory diseases (CRD). To address this serious global health problem WHO formed the Global Alliance against Chronic Respiratory Diseases (GARD). Chronic obstructive pulmonary disease (COPD) is a major priority of GARD due to high chronic morbidity and mortality; however, there is still little prevalence data available. The prevalence of COPD in Georgia, as well as other CRD, is suspected to be high. Methods. GARD Pilot Survey (GAPS) in Georgia had been carried out by the Georgian Respiratory Association. The survey was conducted in the Sagarejo and Mtskheta districts with total population of about 70.000. All subjects provided information on asthma, bronchitis, respiratory symptoms, smoking, allergic conditions, CRD comorbidity and lifestyle via an interviewer-administered questionnaire. A total of 3,646 questionnaires were analysed. Results. It was discovered that official data concerning allergic rhinitis, TB and asthma are almost equal, but readings in relation to CRD are about five times lower according to official data of the Ministry of Health of Georgia. The data results: for allergic rhinitis - 218 in GAPS vs. 177 in the official statistics (for 100.000 population); for TB -105 in GAPS vs. 147 in the official statistics; for asthma -250 in GAPS vs. 374 in the official statistics; the data about CRD according to our survey is almost five times higher - 365 in GAPS vs. 84 in the official statistics (for 100.000 population). Conclusions. It is necessary to expand the survey to the entire country population. Country results are likely to be useful and interesting for local doctors and managers, as well as for officials.

scholarly journals Evidence for pulmonary rehabilitation in chronic respiratory diseases in sub-Saharan Africa: a systematic review

2020 ◽  
Vol 24 (10) ◽  
pp. 991-999
Author(s):  
F. M. Bickton ◽  
C. Fombe ◽  
E. Chisati ◽  
J. Rylance
Keyword(s):  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Sub Saharan Africa ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Exercise Regimen ◽  
Home Based ◽  
Sub Saharan ◽  
Randomised Controlled

BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases.OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa.METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings.RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6–12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies.CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.

scholarly journals Bronchiectasis and increased mortality in patients with corticosteroid-dependent severe asthma: a nationwide population study

2020 ◽  
Vol 14 ◽  
pp. 175346662096303
Author(s):  
Hayoung Choi ◽  
Hyun Lee ◽  
Jiin Ryu ◽  
Sung Jun Chung ◽  
Dong Won Park ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Study Cohort ◽  
Limited Information ◽  
Term Survival ◽  
Obstructive Pulmonary Disease ◽  
All Cause Mortality ◽  
The Impact

Background: Long-term corticosteroid (CS) use is associated with increased mortality in patients with asthma, and comorbid bronchiectasis is also associated with frequent asthma exacerbation and increased healthcare use. However, there is limited information on whether bronchiectasis further increases mortality in patients with CS-dependent asthma. This study examined the impact of bronchiectasis on mortality in patients with CS-dependent asthma. Methods: A retrospective cohort of patients with CS-dependent asthma ⩾18 years old was established using records from the Korean National Health Insurance Service database from 2005 to 2015. Patients with CS-dependent asthma with and without bronchiectasis were matched by age, sex, type of insurance, and Charlson comorbidity index. We evaluated the hazard ratio (HR) for all-cause mortality in patients with bronchiectasis compared with those without bronchiectasis. Results: The study cohort included 754 patients with CS-dependent asthma with bronchiectasis and 3016 patients with CS-dependent asthma without bronchiectasis. Patients with CS-dependent asthma with bronchiectasis had a higher all-cause mortality than those without bronchiectasis (8429/100,000 versus 6962/100,000 person-years, p < 0.001). The adjusted HR for mortality in patients with CS-dependent asthma with bronchiectasis relative to those without bronchiectasis was 1.33 (95% confidence interval, 1.18–1.50), and the association was primarily significant for respiratory diseases (subdistribution HR = 1.65, 95% confidence interval, 1.42–1.92). Conclusions: Bronchiectasis further increases all-cause mortality in patients with CS-dependent asthma, a trend that was especially associated with respiratory diseases including chronic obstructive pulmonary disease. Strategies to improve treatment outcomes in patients with CS-dependent asthma with bronchiectasis are urgently needed to improve long-term survival. The reviews of this paper are available via the supplemental material section.

scholarly journals The microbiome in respiratory medicine: current challenges and future perspectives

2017 ◽  
Vol 49 (4) ◽  
pp. 1602086 ◽  
Author(s):  
Rosa Faner ◽  
Oriol Sibila ◽  
Alvar Agustí ◽  
Eric Bernasconi ◽  
James D. Chalmers ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Future Research ◽  
Chronic Obstructive ◽  
Gene Expressions ◽  
Obstructive Pulmonary Disease ◽  
Bacterial Gene ◽  
Chronic Respiratory Diseases ◽  
Culture Techniques ◽  
Negative Results ◽  
Cultivable Bacteria

The healthy lung has previously been considered to be a sterile organ because standard microbiological culture techniques consistently yield negative results. However, culture-independent techniques report that large numbers of microorganisms coexist in the lung. There are many unknown aspects in the field, but available reports show that the lower respiratory tract microbiota: 1) is similar in healthy subjects to the oropharyngeal microbiota and dominated by members of the Firmicutes, Bacteroidetes and Proteobacteria phyla; 2) shows changes in smokers and well-defined differences in chronic respiratory diseases, although the temporal and spatial kinetics of these changes are only partially known; and 3) shows relatively abundant non-cultivable bacteria in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis and bronchiectasis, with specific patterns for each disease. In all of these diseases, a loss of diversity, paralleled by an over-representation of Proteobacteria (dysbiosis), has been related to disease severity and exacerbations. However, it is unknown whether dysbiosis is a cause or a consequence of the damage to bronchoalveolar surfaces.Finally, little is known about bacterial functionality and the interactions between viruses, fungi and bacteria. It is expected that future research in bacterial gene expressions, metagenomics longitudinal analysis and host–microbiome animal models will help to move towards targeted microbiome interventions in respiratory diseases.

scholarly journals Tanimilast, A Novel Inhaled Pde4 Inhibitor for the Treatment of Asthma and Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Fabrizio Facchinetti ◽  
Maurizio Civelli ◽  
Dave Singh ◽  
Alberto Papi ◽  
Aida Emirova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Side Effects ◽  
Pulmonary Disease ◽  
Respiratory Diseases ◽  
Pde4 Inhibitor ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Copd Patients ◽  
Anti Inflammatory

Chronic respiratory diseases are the third leading cause of death, behind cardiovascular diseases and cancer, affecting approximately 550 million of people all over the world. Most of the chronic respiratory diseases are attributable to asthma and chronic obstructive pulmonary disease (COPD) with this latter being the major cause of deaths. Despite differences in etiology and symptoms, a common feature of asthma and COPD is an underlying degree of airways inflammation. The nature and severity of this inflammation might differ between and within different respiratory conditions and pharmacological anti-inflammatory treatments are unlikely to be effective in all patients. A precision medicine approach is needed to selectively target patients to increase the chance of therapeutic success. Inhibitors of the phosphodiesterase 4 (PDE4) enzyme like the oral PDE4 inhibitor roflumilast have shown a potential to reduce inflammatory-mediated processes and the frequency of exacerbations in certain groups of COPD patients with a chronic bronchitis phenotype. However, roflumilast use is dampened by class related side effects as nausea, diarrhea, weight loss and abdominal pain, resulting in both substantial treatment discontinuation in clinical practice and withdrawal from clinical trials. This has prompted the search for PDE4 inhibitors to be given by inhalation to reduce the systemic exposure (and thus optimize the systemic safety) and maximize the therapeutic effect in the lung. Tanimilast (international non-proprietary name of CHF6001) is a novel highly potent and selective inhaled PDE4 inhibitor with proven anti-inflammatory properties in various inflammatory cells, including leukocytes derived from asthma and COPD patients, as well as in experimental rodent models of pulmonary inflammation. Inhaled tanimilast has reached phase III clinical development by showing promising pharmacodynamic results associated with a good tolerability and safety profile, with no evidence of PDE4 inhibitors class-related side effects. In this review we will discuss the main outcomes of preclinical and clinical studies conducted during tanimilast development, with particular emphasis on the characterization of the pharmacodynamic profile that led to the identification of target populations with increased therapeutic potential in inflammatory respiratory diseases.

scholarly journals High Frequency of Viral Co-Detections in Acute Bronchiolitis

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 990
Author(s):  
Hortense Petat ◽  
Vincent Gajdos ◽  
François Angoulvant ◽  
Pierre-Olivier Vidalain ◽  
Sandrine Corbet ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Virus Detection ◽  
Public Health Issue ◽  
Chronic Obstructive ◽  
Acute Bronchiolitis ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Coronavirus Infection ◽  
Syncytial Virus

Over two years (2012–2014), 719 nasopharyngeal samples were collected from 6-week- to 12-month-old infants presenting at the emergency department with moderate to severe acute bronchiolitis. Viral testing was performed, and we found that 98% of samples were positive, including 90% for respiratory syncytial virus, 34% for human rhino virus, and 55% for viral co-detections, with a predominance of RSV/HRV co-infections (30%). Interestingly, we found that the risk of being infected by HRV is higher in the absence of RSV, suggesting interferences or exclusion mechanisms between these two viruses. Conversely, coronavirus infection had no impact on the likelihood of co-infection involving HRV and RSV. Bronchiolitis is the leading cause of hospitalizations in infants before 12 months of age, and many questions about its role in later chronic respiratory diseases (asthma and chronic obstructive pulmonary disease) exist. The role of virus detection and the burden of viral codetections need to be further explored, in order to understand the physiopathology of chronic respiratory diseases, a major public health issue.

scholarly journals Air pollution exposure—the (in)visible risk factor for respiratory diseases

2021 ◽  
Author(s):  
Gabriel-Petrică Bălă ◽  
Ruxandra-Mioara Râjnoveanu ◽  
Emanuela Tudorache ◽  
Radu Motișan ◽  
Cristian Oancea
Keyword(s):  
Air Pollution ◽  
Low Income ◽  
Air Pollutants ◽  
Respiratory Diseases ◽  
Respiratory Infections ◽  
Low Income Countries ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Pollution Exposure

AbstractThere is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.

scholarly journals Peak Outpatient and Emergency Department Visit Forecasting for Patients With Chronic Respiratory Diseases Using Machine Learning Methods: Retrospective Cohort Study (Preprint)

2018 ◽  
Author(s):  
Junfeng Peng ◽  
Chuan Chen ◽  
Mi Zhou ◽  
Xiaohua Xie ◽  
Yuqi Zhou ◽  
...  
Keyword(s):  
Machine Learning ◽  
Air Quality ◽  
Environmental Pollution ◽  
Respiratory Diseases ◽  
Area Under The Curve ◽  
Weather Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Adaptive Boosting ◽  
Chronic Respiratory Diseases

BACKGROUND The overcrowding of hospital outpatient and emergency departments (OEDs) due to chronic respiratory diseases in certain weather or under certain environmental pollution conditions results in the degradation in quality of medical care, and even limits its availability. OBJECTIVE To help OED managers to schedule medical resource allocation during times of excessive health care demands after short-term fluctuations in air pollution and weather, we employed machine learning (ML) methods to predict the peak OED arrivals of patients with chronic respiratory diseases. METHODS In this paper, we first identified 13,218 visits from patients with chronic respiratory diseases to OEDs in hospitals from January 1, 2016, to December 31, 2017. Then, we divided the data into three datasets: weather-based visits, air quality-based visits, and weather air quality-based visits. Finally, we developed ML methods to predict the peak event (peak demand days) of patients with chronic respiratory diseases (eg, asthma, respiratory infection, and chronic obstructive pulmonary disease) visiting OEDs on the three weather data and environmental pollution datasets in Guangzhou, China. RESULTS The adaptive boosting-based neural networks, tree bag, and random forest achieved the biggest receiver operating characteristic area under the curve, 0.698, 0.714, and 0.809, on the air quality dataset, the weather dataset, and weather air quality dataset, respectively. Overall, random forests reached the best classification prediction performance. CONCLUSIONS The proposed ML methods may act as a useful tool to adapt medical services in advance by predicting the peak of OED arrivals. Further, the developed ML methods are generic enough to cope with similar medical scenarios, provided that the data is available.

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