scholarly journals Reduction in Hospitalizations for Respiratory Diseases during the First COVID-19 Wave in Greece

Respiration ◽  
2021 ◽  
pp. 1-6
Author(s):  
Christos Kyriakopoulos ◽  
Athena Gogali ◽  
Konstantinos Exarchos ◽  
Dimitrios Potonos ◽  
Konstantinos Tatsis ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Demographic Data ◽  
Sleep Apnoea ◽  
Medical Attention ◽  
Respiratory Morbidity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Number Of Patients

<b><i>Introduction:</i></b> During the first COVID-19 wave, a considerable decline in hospital admissions was observed worldwide. <b><i>Aim:</i></b> This retrospective cohort study aimed to assess if there were any changes in the number of patients hospitalized for respiratory diseases in Greece during the first CO­VID-19 wave. <b><i>Methods:</i></b> In the present study, we evaluated respiratory disease hospitalization rates across 9 tertiary hospitals in Greece during the study period (March–April 2020) and the corresponding period of the 2 previous years (2018–2019) that served as the control periods. Demographic data and discharge diagnosis were documented for every patient. <b><i>Results:</i></b> Of the 1,307 patients who were hospitalized during the study period, 444 (35.5%) were males with a mean (±SD) age of 66.1 ± 16.6 years. There was a 47 and 46% reduction in all-cause respiratory morbidity compared to the corresponding periods of 2018 and 2019, respectively. The mean incidence rate for respiratory diseases during the study period was 21.4 admissions per day, and this rate was significantly lower than the rate during the same period in 2018 (40.8 admissions per day; incidence rate ratio [IRR], 0.525; 95% confidence interval [CI], 0.491–0.562; <i>p</i> &#x3c; 0.001) or the rate during 2019 (39.9 admissions per day; IRR, 0.537; 95% CI, 0.502–0.574; <i>p</i> &#x3c; 0.001). The greatest reductions (%) in the number of daily admissions in 2020 were observed for sleep apnoea (87% vs. 2018 and 84% vs. 2019) followed by admissions for asthma (76% vs. 2018 and 79% vs. 2019) and chronic obstructive pulmonary disease (60% vs. 2018 and 51% vs. 2019), while the lowest reductions were detected in hospitalizations for pulmonary embolism (6% vs. 2018 and 23% vs. 2019) followed by tuberculosis (25% vs. both 2018 and 2019). <b><i>Discussion/Conclusion:</i></b> The significant reduction in respiratory admissions in 2020 raises the reasonable question of whether some patients may have avoided seeking medical attention during the COVID-19 pandemic and suggests an urgent need for transformation of healthcare systems during the pandemic to offer appropriate management of respiratory diseases other than COVID-19.

scholarly journals Profile of patients admitted in a pulmonology ward and developing Clostridium difficile enterocolitis

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 31-36
Author(s):  
Ioana Cojocaru ◽  
Livia Luculescu ◽  
Daniela Negoescu ◽  
Irina Strâmbu
Keyword(s):  
Clostridium Difficile ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Respiratory Infections ◽  
Demographic Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Male Predominance ◽  
Number Of Patients ◽  
Lower Intestine

Abstract Clostridium difficile is an anaerobic bacterium than can colonise the lower intestine and cause enterocolitis in susceptible patients. Clostridium difficile infection (CDI) is typically a nosocomial infection, favoured by treatment with antibiotics (especially with broad-spectrum drugs), proton pump inhibitors, but also comorbidities, old age and prolonged hospitalisation. Based on the observation that in the past years, the frequency of nosocomial CDI has increased in the Institute of Pulmonology, Bucharest, this retrospective observational study aimed to analyse the characteristics of admitted patients who develop CDI, in order to identify possible particular features and risk factors. Accordingly, medical files from 80 patients admitted from January 2015 to August 2017 were analysed for demographic data, respiratory diagnosis, comorbidities, blood tests, treatments prescribed, time of CDI onset, evolution and outcome. The number of patients studied was 29 in 2015, 16 in 2016 and 35 in 2017, with slight male predominance. Totally, 54 patients (67.5%) had tuberculosis (pulmonary or pleural), 12 had lung cancer, five had respiratory infections, two had chronic obstructive pulmonary disease and seven had other diseases. All patients but nine were receiving antibiotics: tuberculosis drugs, cephalosporins, fluoroquinolones and beta-lactams. About half of the patients received proton pump inhibitors. Most patients had several comorbidities. Mean time since admittance to onset of diarrhoea was 20 days. CDI was treated with metronidazole or vancomycin. The evolution was favourable in 90% of patients, but eight patients (10%) died This study highlights a high frequency of CDI in patients treated for tuberculosis. Due to insufficient data, no epidemiological consideration could be made. Further studies are needed to assess the relationship among tuberculosis, tuberculosis treatment and CDI.

Respiratory diseases and respiratory failure

2016 ◽  
Author(s):  
Professor Ann B Millar ◽  
Dr Richard Leach ◽  
Dr Rebecca Preston ◽  
Dr Richard Leach ◽  
Dr Richard Leach ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Lung Disease ◽  
Respiratory Diseases ◽  
Immunocompromised Host ◽  
Mycobacterial Infection ◽  
Sleep Apnoea ◽  
Disease Assessment ◽  
Chronic Obstructive ◽  
Diffuse Lung Disease ◽  
Obstructive Pulmonary Disease

Chapter 5 covers respiratory diseases and respiratory failure, including clinical presentations of respiratory disease, assessment of diffuse lung disease, hypoxaemia, respiratory failure, and oxygen therapy, pneumonia, mycobacterial infection, asthma, chronic obstructive pulmonary disease (COPD), lung cancer, mediastinal lesions, pneumothorax, pleural disease, asbestos-related lung disease, diffuse parenchymal (interstitial) lung disease, sarcoidosis, pulmonary hypertension, acute respiratory distress syndrome, bronchiectasis and cystic fibrosis, bronchiolitis, eosinophilic lung disease, airways obstruction, aspiration syndromes, and near-drowning, pulmonary vasculitis, the immunocompromised host, sleep apnoea, and rare pulmonary diseases.

scholarly journals The accuracy of the heat index to explain the excess of mortality and morbidity during heat waves – a case study in a mediterranean climate

2013 ◽  
Vol 20 (20) ◽  
pp. 71-84 ◽  
Author(s):  
Ana Monteiro ◽  
Vânia Carvalho ◽  
Sara Velho ◽  
Carlos Sousa
Keyword(s):  
Heat Wave ◽  
Respiratory Diseases ◽  
Heat Waves ◽  
Heat Index ◽  
Respiratory Morbidity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mortality And Morbidity ◽  
Comfort Index ◽  
T Distribution

Abstract The aim of this contribution was to evaluate the accuracy of a well known human comfort index, the heat index, to anticipate the effects of the July 2006 heat wave in mortality (all causes) and morbidity (all causes, respiratory and circulatory disease). Our assessment was done to all citizens, to people of the 75+ cohort and to each gender, in Porto. For further statistical analysis, we calculated an expected number of admissions by averaging the admissions recorded during the comparison period. The 95% confidence interval was calculated, using a standard method based on the t-distribution, for differences between independent means with different population variances, using the Leveane test to evaluate the variance’s homogeneity. During the 2006 heat wave, a 52% mortality excess was registered relatively to the expected mortality (p < 0.001), for all cohorts of the population. The admissions excess for all ages included the admissions due to respiratory diseases (p < 0.029), pneumonia (p < 0.001) and chronic obstructive pulmonary disease (p < 0.001). For the 75+ cohort, the admissions due to respiratory diseases (p < 0.017), pneumonia (p < 0.001) and heart failure (p < 0.610) were also statistically high. The obtained results confirm that the heat index is a truthful method to anticipate the negative impacts of heat waves in human health even in climate contexts adapted to hot summers like at Porto - a Mediterranean tempered climate. The impacts of July 2006’s heat wave in the increase of mortality (all causes) and in respiratory morbidity (all population and 75+cohort) was evident.

scholarly journals Association Between SGLT2is and Cardiovascular and Respiratory Diseases: A Meta-Analysis of Large Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Dao-Gen Yin ◽  
Mei Qiu ◽  
Xue-Yan Duan
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular Diseases ◽  
Pulmonary Disease ◽  
Respiratory Diseases ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Meta Analyses

The association between sodium-glucose cotransporter 2 inhibitors (SGLT2is) and various cardiovascular and respiratory diseases is unestablished. This meta-analysis aimed to explore whether use of SGLT2is is significantly associated with the occurrences of 80 types of cardiovascular diseases and 55 types of respiratory diseases. Large randomized trials of SGLT2is were included in analysis. Meta-analysis was conducted to synthesize risk ratio (RR) and 95% confidence interval (CI). Nine large trials were included in analysis. Compared to placebo, SGLT2is were associated with the reduced risks of 9 types of cardiovascular diseases (e.g., atrial fibrillation [RR 0.78, 95% CI 0.67-0.91], bradycardia [RR 0.60, 95% CI 0.40-0.89], and hypertensive emergency [RR 0.29, 95% CI 0.12-0.72]) and 11 types of respiratory diseases (e.g., chronic obstructive pulmonary disease [RR 0.77, 95% CI 0.61-0.97], asthma [RR 0.57, 95% CI 0.35-0.95], and sleep apnoea syndrome [RR 0.36, 95% CI 0.15-0.87]). The results of random-effects meta-analysis were similar with those of fixed-effects meta-analysis. No heterogeneity or only little heterogeneity was found in most meta-analyses. No publication bias was observed in most of the meta-analyses conducted in this study. SGLT2is were not significantly associated with the other 115 cardiovascular and respiratory diseases. SGLT2is are associated with the reduced risks of 9 types of cardiovascular diseases (e.g., atrial fibrillation, bradycardia, and hypertensive emergency) and 11 types of respiratory diseases (e.g., chronic obstructive pulmonary disease, asthma, and sleep apnoea syndrome). This proposes the potential of SGLT2is to be used for prevention of these cardiovascular and respiratory diseases.

scholarly journals Trends in hospitalizations for respiratory diseases in Salvador, Bahia State, Brazil, 1998-2009

2012 ◽  
Vol 28 (5) ◽  
pp. 869-877 ◽  
Author(s):  
Fernanda Pedro Antunes ◽  
Maria da Conceição Nascimento Costa ◽  
Jairnilson Silva Paim ◽  
Ligia Maria Vieira-da-Silva ◽  
Carlos Antonio de Souza Teles Santos ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Hospital Admissions ◽  
Chronic Obstructive ◽  
Age Group ◽  
Simple Linear Regression ◽  
Annual Average ◽  
Obstructive Pulmonary Disease ◽  
Hospitalization Rates ◽  
Pregnancy And Postpartum ◽  
The City

Respiratory diseases are the leading cause of hospitalizations in Brazil (excluding hospital admissions related to childbirth, pregnancy, and postpartum). To analyze the trend and seasonality of hospitalizations for respiratory diseases in Salvador, Bahia State, Brazil, 1998-2009, a time trend study was performed using simple linear regression. Hospitalization rates for all respiratory diseases and specifically for asthma, chronic obstructive pulmonary disease (COPD), and pneumonia were calculated by year and age group. Hospitalizations for all respiratory diseases decreased by 45.6% (β = -2.2; p < 0.001); those due to asthma showed the largest decline (annual average 1.2/10,000), pneumonia showed the largest reduction until 2002, subsequently tending to stabilize, and COPD remained unchanged. The under-5-year age group showed the largest decline in hospitalizations for all respiratory diseases. There was no seasonality in hospitalizations for COPD. There was a reduction in the burden of hospitalizations due to respiratory diseases in Salvador, mainly due to the drop in asthma and pneumonia in children < 5 years. However, the city still has hospitalization rates for respiratory diseases that are higher than in other large Brazilian cities.

scholarly journals MP08: The frequency of emergency departments visits for patients with end-of-life conditions: a call for action

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S44-S45
Author(s):  
S. Kirkland ◽  
M. Kruhlak ◽  
M. Garrido Clua ◽  
C. Villa-Roel ◽  
S. Couperthwaite ◽  
...  
Keyword(s):  
Palliative Care ◽  
Emergency Departments ◽  
Demographic Data ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Obstructive Pulmonary Disease ◽  
Index Visit ◽  
Number Of Patients ◽  
Ed Visits ◽  
End Stage

Introduction: An increasing number of patients with end-stage diseases present to emergency departments (EDs) for physical, spiritual, psychological and social care. The objective of this study was to identify patients with end-stage diseases with palliative care (PC) needs and document their frequency of ED visits. Methods: This prospective cohort study was conducted in two Canadian EDs. Using a modified palliative care screening tool, volunteer ED physicians were asked to identify adult patients with end-stage, chronic conditions including cancer, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), heart failure (HF), cirrhosis, dementia and/or progressive central nervous system (PCNS) disease. Demographic data were collected from these tools and data regarding patients’ visits in both the 6 months prior to and 30 days following their index visits were collected from the ED Information System. Bivariate analyses were completed using Student's t and chi-square test. Results: A total of 663 patients with end-stage illness were identified; 338 (51%) were female and the median age was 76 (IQR: 63, 85). Cancer was the most common presentation (41%), followed by dementia (23%), COPD (16%), HF (9%), CKD (9%), PCNS disease (9%) and cirrhosis (7%). These patients made a total of 1277 visits in the 6 months prior to and 288 in the 30 days following the index visit. Patients presenting to the EDs with cancer (p = 0.001), cirrhosis (p = 0.005) and CKD (p = 0.03) were more likely to visit an ED in the 6 months prior to their index visit. In contrast, patients presenting with dementia (p &lt; 0.0001) and PCNS disease (p = 0.02) were significantly less likely to present to an ED in the 6 months prior to their index visit. Patients presenting with cirrhosis or CKD had the highest average number of ED visits in the 6 months prior to their index visit (cirrhosis: 4.59 visits, SD: 3.8, p &lt; 0.0001; CKD: 4.39 visits, SD: 3.8, p = 0.0001). Of these patients, those presenting with end-stage cirrhosis were significantly more likely to make a return visit to an ED within 30 days after their index visit (p = 0.014). Conclusion: Cancer is the most common condition for patients with end-stage, chronic illnesses in these EDs. Those presenting with cirrhosis or CKD are at a significantly higher risk of repeat visits to the EDs. This study has identified potential deficits in care and can serve as a baseline for future intervention studies.

Evidence-Based Smoking Cessation Interventions for Patients With Acute Respiratory Disorders

2009 ◽  
Vol 27 (1) ◽  
pp. 273-296 ◽  
Author(s):  
Janie Heath ◽  
Sara Young ◽  
Sharon Bennett ◽  
Mary Beth Ginn ◽  
Geoffrey Cox
Keyword(s):  
Respiratory Diseases ◽  
Tobacco Cessation ◽  
Hospital Admissions ◽  
Models Of Care ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Evidence Based ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Illnesses ◽  
The One

Worldwide, tobacco use continues to be the most significant preventable cause of death and hospital admissions, particularly related to respiratory diseases. Acute respiratory illnesses requiring hospitalization provide an opportunity for nurses to intervene and help smokers quit. Of the three top hospital admissions related to respiratory diseases, chronic obstructive pulmonary disease (COPD) is the one that continues to have increased mortality whereas community acquired pneumonia and asthma have decreased over the past 5 years. The course of all three can be caused or exacerbated by continued smoking. This review describes the state of the science of nursing research focused on tobacco cessation interventions for hospitalized patients with COPD, asthma, or community acquired pneumonia. Additionally, we describe two evidence-based, nurse-driven, hospital protocols to treat tobacco dependence that can serve as models of care. Recommendations are made as to how to effectively promote nursing interventions for tobacco cessation in the acute care setting.

scholarly journals Comprehensive Analysis of Adverse Events Associated With SGLT2is: A Meta-Analysis Involving Nine Large Randomized Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Mei Qiu ◽  
Li-Min Zhao ◽  
Ze-Lin Zhan
Keyword(s):  
Adverse Events ◽  
Respiratory Diseases ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Comprehensive Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Randomized Controlled ◽  
Sodium Glucose Cotransporter

Recently, Lin and colleagues assessed the safety of sodium-glucose cotransporter 2 inhibitors (SGLT2is) by a meta-analysis [1], in which the authors assessed 16 kinds of adverse events (AE) reported in the published articles based on 10 randomized controlled trials. We conducted a further meta-analysis and targeted the association between use of SGLT2is and occurrences of various kinds of serious AE published in the Clinical Trials website (clinicaltrials.gov). Our meta-analysis revealed that use of SGLT2is was not significantly associated with occurrences of 980 kinds of serious AE but was significantly associated with lower risks of 29 kinds of serious AE, especially including several important respiratory diseases (e.g., asthma, chronic obstructive pulmonary disease, sleep apnoea syndrome, and pneumonia). These findings may cause more studies to evaluate the possibilities of gliflozins being used for prevention of these specific diseases.

scholarly journals Sensors for detecting pulmonary diseases from exhaled breath

2019 ◽  
Vol 28 (152) ◽  
pp. 190011 ◽  
Author(s):  
Dina Hashoul ◽  
Hossam Haick
Keyword(s):  
Respiratory Diseases ◽  
Sensor Arrays ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Chronic Obstructive ◽  
Exhaled Breath ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
New Frontier ◽  
Pulmonary Arterial

This review presents and discusses a new frontier for fast, risk-free and potentially inexpensive diagnostics of respiratory diseases by detecting volatile organic compounds (VOCs) present in exhaled breath. One part of the review is a didactic presentation of the overlaying concept and the chemistry of exhaled breath. The other part discusses diverse sensors that have been developed and used for the detection of respiratory diseases (e.g.chronic obstructive pulmonary disease, asthma, lung cancer, pulmonary arterial hypertension, tuberculosis, cystic fibrosis, obstructive sleep apnoea syndrome and pneumoconiosis) by analysis of VOCs in exhaled breath. The strengths and pitfalls are discussed and criticised, particularly in the perspective in disseminating information regarding these advances. Ideas regarding the improvement of sensors, sensor arrays, sensing devices and the further planning of workflow are also discussed.

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.

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