Awareness of Long-Term Prednisolone Use Among Patients Attending a Respiratory Clinic in Sri Lanka: A Clinical Audit

2020 ◽  
Author(s):  
Mohamed Osman Elamin Busharads
Keyword(s):  
Adverse Effects ◽  
Clinical Audit ◽  
Extrapulmonary Tuberculosis ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Airway Disease ◽  
Potential Method ◽  
Interstitial Lung Diseases ◽  
Chronic Obstructive ◽  
Chest Clinic

Background: Prednisolone is recognized as one of the most commonly used, highly effective anti-inflammatory agent. It plays a pivotal role in the management of various disease conditions in pulmonology, such as interstitial lung diseases, sarcoidosis, bronchial asthma, chronic obstructive airway disease, allergic bronchopulmonary aspergillosis and even in some forms of extrapulmonary tuberculosis. However, this medication with great therapeutic importance is not free of risks. Long-term use and use in higher doses are known to cause various systemic adverse effects. Therefore, complying with recommended precautionary strategies is of paramount importance. Objectives: To assess awareness of correct use of prednisolone particularly among long-term, outpatient users. Methodology: A structured interviewer-based questionnaire was used to assess awareness of prednisolone usage in patients attending Central chest clinic, Colombo. Forty-one consecutive patients on long term prednisolone were selected from the clinic. The questionnaire was prepared based on recommendations and guidelines related to proper use of corticosteroids. Data were collected by the principal investigator. Results: This clinical audit highlighted the inadequacy of awareness about side effects and safety practices among patients on prolonged courses of prednisolone. Conclusion: Patients need to be educated more on adverse effects, safety measures and correct use to improve risk/ benefit ratio. Designing a steroid treatment card was identified as a potential method to optimize patient education, monitoring and adverse outcome prevention in long-term steroid therapy. Intended quality improvement will be evaluated by re-auditing the implemented protocol.

scholarly journals Awareness of Long-Term Prednisolone Use Among Patients Attending a Respiratory Clinic in Sri Lanka: A Clinical Audit

2020 ◽  
Vol 3 (4) ◽  
Author(s):  
Menaka Thilakarathna ◽  
Keyword(s):  
Adverse Effects ◽  
Clinical Audit ◽  
Extrapulmonary Tuberculosis ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Airway Disease ◽  
Potential Method ◽  
Interstitial Lung Diseases ◽  
Chronic Obstructive ◽  
Chest Clinic

Background: Prednisolone is recognized as one of the most commonly used, highly effective anti-inflammatory agent. It plays a pivotal role in the management of various disease conditions in pulmonology, such as interstitial lung diseases, sarcoidosis, bronchial asthma, chronic obstructive airway disease, allergic bronchopulmonary aspergillosis and even in some forms of extrapulmonary tuberculosis. However, this medication with great therapeutic importance is not free of risks. Long-term use and use in higher doses are known to cause various systemic adverse effects. Therefore, complying with recommended precautionary strategies is of paramount importance. Objectives: To assess awareness of correct use of prednisolone particularly among long-term, outpatient users. Methodology: A structured interviewer-based questionnaire was used to assess awareness of prednisolone usage in patients attending Central chest clinic, Colombo. Forty-one consecutive patients on long term prednisolone were selected from the clinic. The questionnaire was prepared based on recommendations and guidelines related to proper use of corticosteroids. Data were collected by the principal investigator. Results: This clinical audit highlighted the inadequacy of awareness about side effects and safety practices among patients on prolonged courses of prednisolone. Conclusion: Patients need to be educated more on adverse effects, safety measures and correct use to improve risk/ benefit ratio. Designing a steroid treatment card was identified as a potential method to optimize patient education, monitoring and adverse outcome prevention in long-term steroid therapy. Intended quality improvement will be evaluated by re-auditing the implemented protocol.

scholarly journals Awareness of Long-Term Prednisolone Use Among Patients Attending a Respiratory Clinic in Sri Lanka: A Clinical Audit

2020 ◽  
Author(s):  
Richmond Sam Quarm
Keyword(s):  
Adverse Effects ◽  
Clinical Audit ◽  
Extrapulmonary Tuberculosis ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Airway Disease ◽  
Potential Method ◽  
Interstitial Lung Diseases ◽  
Chronic Obstructive ◽  
Chest Clinic

Background: Prednisolone is recognized as one of the most commonly used, highly effective anti-inflammatory agent. It plays a pivotal role in the management of various disease conditions in pulmonology, such as interstitial lung diseases, sarcoidosis, bronchial asthma, chronic obstructive airway disease, allergic bronchopulmonary aspergillosis and even in some forms of extrapulmonary tuberculosis. However, this medication with great therapeutic importance is not free of risks. Long-term use and use in higher doses are known to cause various systemic adverse effects. Therefore, complying with recommended precautionary strategies is of paramount importance. Objectives: To assess awareness of correct use of prednisolone particularly among long-term, outpatient users. Methodology: A structured interviewer-based questionnaire was used to assess awareness of prednisolone usage in patients attending Central chest clinic, Colombo. Forty-one consecutive patients on long term prednisolone were selected from the clinic. The questionnaire was prepared based on recommendations and guidelines related to proper use of corticosteroids. Data were collected by the principal investigator. Results: This clinical audit highlighted the inadequacy of awareness about side effects and safety practices among patients on prolonged courses of prednisolone. Conclusion: Patients need to be educated more on adverse effects, safety measures and correct use to improve risk/ benefit ratio. Designing a steroid treatment card was identified as a potential method to optimize patient education, monitoring and adverse outcome prevention in long-term steroid therapy. Intended quality improvement will be evaluated by re-auditing the implemented protocol.

scholarly journals Improving home oxygen therapy in patients with interstitial lung diseases: application of a noninvasive ventilation device

2020 ◽  
Vol 14 ◽  
pp. 175346662096302
Author(s):  
Sandra Cuerpo ◽  
Maria Palomo ◽  
Fernanda Hernández-González ◽  
Joel Francesqui ◽  
Nuria Albacar ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Noninvasive Ventilation ◽  
Exercise Tolerance ◽  
Oxygen Therapy ◽  
Arterial Oxygen Saturation ◽  
Interstitial Lung Diseases ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Long Term Oxygen Therapy

Background: Proper adjustment of arterial oxygen saturation (SaO2) during daily activities in patients with interstitial lung disease (ILD) requiring long-term oxygen therapy is challenging. Given the multifactorial nature of the limited exercise tolerance in patients with ILDs, the isolated use of oxygen therapy may not be enough. As demonstrated previously in patients with chronic obstructive pulmonary disease, the use of a noninvasive ventilation (NIV) device combined with oxygen therapy may prevent the falling of oxygen saturation during exercise, due to an improvement of the ventilation–perfusion ratio and a reduction of the respiratory work, thus enhancing exercise tolerance. We sought to assess in patients diagnosed with ILD who are in need of oxygen therapy, the effect of associating an NIV to improve oxygen parameters and the distance covered during the 6 min walking test (6MWT). Methods: We conducted a prospective observational study in patients with ILDs. After a clinical characterization, we performed a 6MWT in two different situations: using a portable oxygen concentrator with the regular flow used by the patient during their daily life activities and afterwards adding the additional support of a NIV. The oxygen saturation parameters were registered with a portable oximeter. Results: We included 16 patients with different ILDs who have oxygen therapy prescribed. The use of NIV associated with oxygen therapy in comparison with the use of oxygen therapy alone showed an increase of the average SaO2 [91% (88–93) versus 88% (86–90%); p = 0.0005] and a decrease in the percentage of time with oxygen saturation <90%: 36% (6–56%) versus 58% (36–77%); p < 0.0001. There were no changes in the 6MWT distance: 307 m (222–419 m) versus 316 m (228–425 m); p = 0.10. Conclusions: In our study the use of a NIV system associated with long-term oxygen therapy during exercise showed beneficial effects, especially improvement of oxygen saturation. The reviews of this paper are available via the supplemental material section.

Oil pollution and fisheries

1982 ◽  
Vol 297 (1087) ◽  
pp. 401-411 ◽  
Keyword(s):  
Water Quality ◽  
Adverse Effects ◽  
Oil Pollution ◽  
Coastal Areas ◽  
Short Term ◽  
Fish Stocks ◽  
Local Impacts ◽  
Reduced Water ◽  
Long Term Adverse Effects

The term ‘pollution’ is taken in its broadest sense and effects are recognized to be due to interference, tainting and toxicity. Each of these types of impact is discussed and assessed. It is concluded that no long-term adverse effects on fish stocks can be attributed to oil but that local impacts can be extremely damaging in the short term and that produce from specific localities can be tainted and unmarketable for long periods. In some coastal areas oil can be one among several contributors to reduced water quality, and the implications of this are discussed.

scholarly journals Allergic Diseases Caused by Aspergillus Species in Patients with Cystic Fibrosis

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 357
Author(s):  
Aidan K. Curran ◽  
David L. Hava
Keyword(s):  
Cystic Fibrosis ◽  
Fungal Infections ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Hyphal Growth ◽  
Allergic Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Th2 Immune Response ◽  
Difficulty Breathing ◽  
Oral Corticosteroids

Aspergillus spp. are spore forming molds; a subset of which are clinically relevant to humans and can cause significant morbidity and mortality. A. fumigatus causes chronic infection in patients with chronic lung disease such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). In patients with CF, A. fumigatus infection can lead to allergic disease, such as allergic bronchopulmonary aspergillosis (ABPA) which is associated with high rates of hospitalizations for acute exacerbations and lower lung function. ABPA results from TH2 immune response to Aspergillus antigens produced during hyphal growth, marked by high levels of IgE and eosinophil activation. Clinically, patients with ABPA experience difficulty breathing; exacerbations of disease and are at high risk for bronchiectasis and lung fibrosis. Oral corticosteroids are used to manage aspects of the inflammatory response and antifungal agents are used to reduce fungal burden and lower the exposure to fungal antigens. As the appreciation for the severity of fungal infections has grown, new therapies have emerged that aim to improve treatment and outcomes for patients with CF.

scholarly journals Partial Decellularization for Segmental Tracheal Scaffold Tissue Engineering: A Preliminary Study in Rabbits

Biomolecules ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 866
Author(s):  
Luong Huu Dang ◽  
Yuan Tseng ◽  
How Tseng ◽  
Shih-Han Hung
Keyword(s):  
Mechanical Stability ◽  
Vital Staining ◽  
Potential Method ◽  
Term Survival ◽  
Long Term Survival ◽  
Cartilage Cells ◽  
Preliminary Study ◽  
Epithelial Layers

In this study, we developed a new procedure for the rapid partial decellularization of the harvested trachea. Partial decellularization was performed using a combination of detergent and sonication to completely remove the epithelial layers outside of the cartilage ring. The post-decellularized tracheal segments were assessed with vital staining, which showed that the core cartilage cells remarkably remained intact while the cells outside of the cartilage were no longer viable. The ability of the decellularized tracheal segments to evade immune rejection was evaluated through heterotopic implantation of the segments into the chest muscle of rabbits without any immunosuppressive therapy, which demonstrated no evidence of severe rejection or tissue necrosis under H&E staining, as well as the mechanical stability under stress-pressure testing. Finally, orthotopic transplantation of partially decellularized trachea with no immunosuppression treatment resulted in 2 months of survival in two rabbits and one long-term survival (2 years) in one rabbit. Through evaluations of posttransplantation histology and endoscopy, we confirmed that our partial decellularization method could be a potential method of producing low-immunogenic cartilage scaffolds with viable, functional core cartilage cells that can achieve long-term survival after in vivo transplantation.

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