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Adv. Respir. Med., Volume 92, Issue 2 (April 2024) – 5 articles

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17 pages, 3184 KiB  
Systematic Review
How to Enhance the Diagnosis of Early Stages of Chronic Obstructive Pulmonary Disease (COPD)? The Role of Mobile Spirometry in COPD Screening and Diagnosis—A Systematic Review
by Piotr Jankowski, Katarzyna Mycroft, Katarzyna Górska, Piotr Korczyński and Rafał Krenke
Adv. Respir. Med. 2024, 92(2), 158-174; https://0-doi-org.brum.beds.ac.uk/10.3390/arm92020018 - 27 Mar 2024
Viewed by 982
Abstract
COPD is the third leading cause of death worldwide. Its diagnosis can be made with spirometry, which is underused due to its limited accessibility. Portable spirometry holds promise for enhancing the efficacy of COPD diagnoses. The study aimed to estimate COPD prevalence diagnosed [...] Read more.
COPD is the third leading cause of death worldwide. Its diagnosis can be made with spirometry, which is underused due to its limited accessibility. Portable spirometry holds promise for enhancing the efficacy of COPD diagnoses. The study aimed to estimate COPD prevalence diagnosed with a portable spirometer in high-risk patients and compare it with COPD prevalence based on data from conventional, on-site spirometry. We also evaluated the strategy of a proactive approach to identify COPD in high-risk individuals. We conducted a systematic review of original studies on COPD targeted screening and diagnosis with portable and conventional spirometers selected from 8496 publications initially found in three databases: Cochrane, PubMed, and Embase. The inclusion criteria were met by 28 studies. COPD prevalence evaluated with the use of portable spirometers reached 20.27% and was lower compared to that estimated with the use of conventional spirometers (24.67%). In 11 included studies, postbronchodilator tests were performed with portable spirometers, which enabled a bedside COPD diagnosis. Portable spirometers can be successfully used in COPD targeted screening and diagnosis and thus enhance the detection of COPD at early stages. Full article
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2 pages, 174 KiB  
Editorial
Advances in Respiratory Medicine—Aims and Scopes Update
by Krzysztof Kuziemski, Monika Franczuk, Sebastian Majewski, Tadeusz M. Zielonka and Adam Barczyk
Adv. Respir. Med. 2024, 92(2), 156-157; https://0-doi-org.brum.beds.ac.uk/10.3390/arm92020017 - 19 Mar 2024
Viewed by 706
Abstract
Advances in Respiratory Medicine, which has been published by MDPI since 2022, serves as a platform for hosting pneumological studies [...] Full article
11 pages, 648 KiB  
Article
Outcomes and Functional Deterioration in Hospital Admissions with Acute Hypoxemia
by Susanne Simon, Jens Gottlieb, Ina Burchert, René Abu Isneineh and Thomas Fuehner
Adv. Respir. Med. 2024, 92(2), 145-155; https://0-doi-org.brum.beds.ac.uk/10.3390/arm92020016 - 6 Mar 2024
Viewed by 825
Abstract
Background: Many hospitalized patients decline in functional status after discharge, but functional decline in emergency admissions with hypoxemia is unknown. The primary aim of this study was to study functional outcomes as a clinical endpoint in a cohort of patients with acute hypoxemia. [...] Read more.
Background: Many hospitalized patients decline in functional status after discharge, but functional decline in emergency admissions with hypoxemia is unknown. The primary aim of this study was to study functional outcomes as a clinical endpoint in a cohort of patients with acute hypoxemia. Methods: A multicenter prospective observational study was conducted in patients with new-onset hypoxemia emergently admitted to two respiratory departments at a university hospital and an academic teaching hospital. Using the WHO scale, the patients’ functional status 4 weeks before admission and at hospital discharge was assessed. The type and duration of oxygen therapy, hospital length of stay and survival and risk of hypercapnic failure were recorded. Results: A total of 151 patients with a median age of 74 were included. Two-thirds declined in functional status by at least one grade at discharge. A good functional status (OR 4.849 (95% CI 2.209–10.647)) and progressive cancer (OR 6.079 (1.197–30.881)) were more associated with functional decline. Most patients were treated with conventional oxygen therapy (n = 95, 62%). The rates of in-hospital mortality and need for intubation were both 8%. Conclusions: Patients with acute hypoxemia in the emergency room have a poorer functional status after hospital discharge. This decline may be of multifactorial origin. Full article
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22 pages, 1729 KiB  
Article
Association between the Static and Dynamic Lung Function and CT-Derived Thoracic Skeletal Muscle Measurements–A Retrospective Analysis of a 12-Month Observational Follow-Up Pilot Study
by Mia Solholt Godthaab Brath, Sisse Dyrman Alsted, Marina Sahakyan, Esben Bolvig Mark, Jens Brøndum Frøkjær, Henrik Højgaard Rasmussen, Lasse Riis Østergaard, Rasmus Brath Christensen and Ulla Møller Weinreich
Adv. Respir. Med. 2024, 92(2), 123-144; https://0-doi-org.brum.beds.ac.uk/10.3390/arm92020015 - 6 Mar 2024
Viewed by 912
Abstract
Background: Patients with chronic obstructive pulmonary disease (COPD) with low skeletal muscle mass and severe airway obstruction have higher mortality risks. However, the relationship between dynamic/static lung function (LF) and thoracic skeletal muscle measurements (SMM) remains unclear. This study explored patient characteristics (weight, [...] Read more.
Background: Patients with chronic obstructive pulmonary disease (COPD) with low skeletal muscle mass and severe airway obstruction have higher mortality risks. However, the relationship between dynamic/static lung function (LF) and thoracic skeletal muscle measurements (SMM) remains unclear. This study explored patient characteristics (weight, BMI, exacerbations, dynamic/static LF, sex differences in LF and SMM, and the link between LF and SMM changes. Methods: A retrospective analysis of a 12-month prospective follow-up study patients with stable COPD undergoing standardized treatment, covering mild to severe stages, was conducted. The baseline and follow-up assessments included computed tomography and body plethysmography. Results: This study included 35 patients (17 females and 18 males). This study revealed that females had more stable LF but tended to have greater declines in SMM areas and indices than males (−5.4% vs. −1.9%, respectively), despite the fact that females were younger and had higher LF and less exacerbation than males. A multivariate linear regression showed a negative association between the inspiratory capacity/total lung capacity ratio (IC/TLC) and muscle fat area. Conclusions: The findings suggest distinct LF and BC progression patterns between male and female patients with COPD. A low IC/TLC ratio may predict increased muscle fat. Further studies are necessary to understand these relationships better. Full article
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13 pages, 708 KiB  
Review
Advancing Care in Severe Asthma: The Art of Switching Biologics
by Silvano Dragonieri, Andrea Portacci, Vitaliano Nicola Quaranta and Giovanna Elisiana Carpagnano
Adv. Respir. Med. 2024, 92(2), 110-122; https://0-doi-org.brum.beds.ac.uk/10.3390/arm92020014 - 21 Feb 2024
Viewed by 1373
Abstract
Biologics targeting IgE, IL-5, IL-4/IL-13, and TSLP are crucial in severe asthma treatment. Research, including randomized controlled trials and real-world studies, has been conducted to assess their efficacy and identify patient characteristics that may predict positive responses. The effectiveness of switching biologics, especially [...] Read more.
Biologics targeting IgE, IL-5, IL-4/IL-13, and TSLP are crucial in severe asthma treatment. Research, including randomized controlled trials and real-world studies, has been conducted to assess their efficacy and identify patient characteristics that may predict positive responses. The effectiveness of switching biologics, especially given overlaps in treatment eligibility, and the clinical outcomes post-cessation are critical areas of investigation. This work reviews the effects of switching between these biologics and the indicators of treatment success or failure. Insights are primarily derived from real-world experiences, focusing on patients transitioning from one monoclonal antibody to another. Moreover, this review aims to provide insights into the effectiveness, safety, and broader implications of switching biologics, enhancing understanding for clinicians to optimize severe asthma management. The article underlines the importance of a patient-centered approach, biomarker assessment, and the evolving nature of asthma treatment in making informed decisions about biologic therapy. Full article
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