Current Respiratory Medicine Reviews - Current Issue

This review examines COPD pathogenesis, biomarkers, and treatment. COPD, a progressive respiratory illness that blocks airflow, causes high morbidity and death. The complicated pathophysiology of COPD involves genetic predisposition, environmental variables (particularly tobacco smoke), and inflammatory pathways. COPD diagnosis, prognosis, and monitoring depend on biomarkers in clinical and preclinical investigations. COPD care should include pharmaceutical and non-pharmacological therapies to improve symptoms, lung function, and outcomes.

This review examines COPD pathogenesis, cytokines, and risk factors. This review article discusses how immune system signalling molecules called cytokines contribute to COPD's persistent inflammation. Smoking and environmental contaminants are also examined as COPD risk factors. The analysis also covers biomarkers needed to diagnose and track the condition.

The review paper on COPD highlights the critical role of cytokines in the disease's pathophysiology, emphasizing their contribution to chronic inflammation. Various cytokines, particularly interleukins, are implicated in driving the inflammatory processes within the airways and lungs, resulting in tissue damage and airflow limitation, which are hallmark features of COPD. The paper also identifies smoking and exposure to environmental pollutants as major risk factors for the development of COPD.

This review illuminates COPD's complex pathogenesis, highlighting cytokines' involvement in chronic inflammation. To create targeted therapeutics, cytokine-mediated pathways must be understood. The review emphasizes biomarkers' use in preclinical and clinical investigations to diagnose and monitor COPD and provide disease progression insights.

Given the high prevalence of Long COVID, sleep problems have emerged as a significant issue for individuals after COVID-19 infection, potentially impacting their quality of life.

Our study aims to identify effective strategies for improving sleep quality and offers recommendations for future research.

The present systematic review study investigated ways to improve sleep quality in Long COVID patients. The study was conducted according to the updated PRISMA guidelines. The risk of bias was assessed using ROB 2.0.

Finally, six articles were included in the present study to identify strategies for improving and enhancing sleep quality in Long COVID. The results of the present study indicate that various interventions have been carried out to improve sleep quality, including psychological, cognitive, and physical factors related to long-term COVID-19 conditions.

Based on existing evidence, interventions such as mind meditation, yoga, and hyperbaric oxygen therapy have demonstrated efficacy in enhancing sleep quality among Long COVID patients.

Tracheobronchopathia osteochondroplastica (TBOCP) is a rare, benign condition characterised by the presence of multiple bony and cartilaginous nodules in the tracheal and bronchial submucosa. Its etiology remains unknown, and clinical presentations and management vary.

We conducted a scoping review to evaluate clinical and radiological characteristics, diagnostic investigations and prognostic outcomes of TBOCP in adults by exploring Pubmed and SCOPUS databases.

From the search results of 675 studies, 98 were included in this scoping review. TBOCP has a myriad of presenting symptoms and clinical severity but is notably an asthma mimic, displaying an obstructive pattern on spirometry. Bronchoscopic tools were the most common interventional diagnostic or management tool.

While the etiology of TBOCP remains unknown, clinicians are alerted to its varied presentations and classical histopathological and gross morphological appearance.

The world changed in December 2019 due to respiratory tract infection cases, initially of unknown etiology, later known as COVID-19.

This study aimed to determine the factors and comorbidities associated with mortality from COVID-19 in Mexico.

It was a cross-sectional and observational prospective study of patients treated at an IMSS (Mexican Institute of Social Security) Hospital in Morelos with a confirmed diagnosis of COVID-19. Logistic regression models and survival analyses were developed to identify factors associated with mortality risk.

3,965 patients were analyzed, with most deaths occurring in men. The mortality risks were higher in men who were older than 50 years. The most significant associations were: age older than 80 years (HR:3.17), endotracheal intubation (HR:1.54), dyspnea (HR: 13.55), and polypnea (HR:1.54).

The risk of death in this population was high, considering the absence of primary protective measures at the beginning of the pandemic and the lack of consistency in using personal protection elements.

This study aimed to demonstrate the accuracy of a portable device for measuring nasal and bronchial fractional exhaled nitric oxide (nFeNO and FeNO) as an alternative method to replace a high-cost multiple flow device in subjects with allergic rhinitis (AR).

It was a descriptive and comparative study. The healthy subjects (control group), subjects with AR (AR group) and those with AR and asthma (AR-A group) were enrolled in this study. They underwent nasal and bronchial FeNO measurements by both fixed flow NObreath^® connected to nasal mask (for nFeNO) and without mask (for FeNO) and multiple flows HypAir FeNO^®.

There were 153 subjects recruited during the study period, including 63 healthy subjects and 90 subjects with AR and AR-A. There were no statistically significant differences in anthropometric characteristics between study groups. The concentrations of nasal FeNO and bronchial FeNO measured by a portable device in subjects with AR were higher than in healthy subjects: 76.0 ± 50.7 ppb vs 36.0 ± 28.1 ppb (P  < 0.01), and 32.3 ± 15.4 ppb vs 9.2 ± 5.6 ppb (P  < 0.001). There was a weak correlation between nasal FeNO measured by portable devices and multiple flow devices.

The portable device is useful in measuring nasal FeNO in subjects with AR. The advantages of a low-cost and accurate portable device may help it be used in primary care in the management of subjects with allergic rhinitis and asthma.

An inflammatory lung condition that lasts a long time is called chronic obstructive pulmonary disease (COPD), it results from exposure to noxious substances, abnormalities in the bronchi, and obstruction of lung airflow owing to alveoli.

This study compares the safety and efficacy of LABA-LAMA combination therapy administered at varied frequencies to individuals with stable chronic obstructive pulmonary disease. The purpose of the study is to ascertain which of the two combinations performs better when considering both subjective and objective criteria.

Patients with Group B Stable COPD in the outpatient department were assigned into two random groups of 50 and given a different medication combination. Those in Group 1 received a single daily dose of Indacaterol + Glycopyrrolate, while those in Group 2 received two daily doses of Formoterol + Glycopyrrolate. Every four weeks, patients were checked on individually. Spirometric data (FEV1 (% Pred), Trough FEV1 (L), FEV1/FVC), and symptoms (cough, shortness of breath, sputum production, sleep disturbance) were recorded for each patient.

After the therapy, both groups showed a decrease in symptomatic indicators. There was a notable improvement in trough FEV1 (L) and spirometric measurements. Moreover, no noticeable differences in subjective and objective criteria were observed between groups 1 and 2.

This study's conclusions are limited to patient populations with comparable features. To further elucidate the risk factors and potential genetic foundation of the disease conditions, more multi-centric studies including diverse ethnic groups must be conducted.

The descriptive study was conducted to determine the relationship between health literacy levels related to smoking, the frequency of exacerbations, and sleep quality in individuals with Chronic Obstructive Pulmonary Disease.

The study data were collected from 217 patients who were hospitalized in the pulmonology service of a university hospital between October 1, 2022, and January 31, 2023, who applied to the outpatient clinic between October 1, 2022, and January 31, 2023, by face-to-face interview method and by obtaining verbal and written informed consent. The data collection tools used in the study were the patient information form, chronic obstructive pulmonary disease assessment test, pittsburgh sleep quality scale, and smoking literacy scale.

It was determined that 24% of the individuals were 60 years old or younger, 42.9% were 61-70, and 33.2% were over 70. It was determined that 25.8% of the individuals were still smoking, 49.3% of the individuals had never been hospitalized due to an exacerbation in the last year, 32.3% had been hospitalized once, and 18.4% had been hospitalized twice or more. General views about smoking increased the level of sleep quality (β = -0.152). The total change in sleep quality level was explained by smoking literacy at a rate of 7.2% (R2 = 0.072). Smoking literacy increases the improvement of sleep quality levels (β = -0.275). Smoking literacy increases the improvement in COPD assessment level (β = -0.238). It was determined that the smoking literacy levels of the individuals were high, the severity of Chronic Obstructive Pulmonary Disease was at a poor level, and sleep quality was at a moderate level.

In the study, it was determined that the severity of chronic obstructive pulmonary disease decreased as the smoking literacy level of individuals increased, sleep quality level increased as the smoking literacy level increased, and chronic obstructive pulmonary disease staging worsened as smoking literacy total scores decreased.

Around 10-20% of hospitalized COVID-19 patients require readmission within 30-90 days, posing heightened risks of morbidity, mortality, and economic burden. Research on factors influencing post-COVID-19 readmission and hospital stay duration is limited.

This study describes clinical characteristics and identifies risk factors for prolonged hospital stays in readmitted post-COVID-19 patients.

A cross-sectional study included 52 patients readmitted between January and June 2022.

Patients had a mean age of 63.5 years. Severe and critical COVID-19 histories were reported in 27% and 11.5% of cases, respectively. Common symptoms leading to readmission included dyspnea, cough, fever, and chest pain. Respiratory support was required for 67.3% of patients (SpO2 < 90%), with 38.5% needing mechanical ventilation. Elevated D-Dimer (2029.07 ± 406.61) and CRP (50.97 ± 8.95) levels were common, and lung consolidation was the predominant chest image finding. The median hospital stay was 24.5 days, with 71.2% of patients staying longer than 14 days. Upon discharge, 96.1% were stable; 1 patient died, and 1 was transferred. Longer hospital stays were positively correlated with severe COVID-19 history, mechanical ventilation, CRP, Urea, and lung consolidation, while Hb and LDH were negatively correlated. Severe COVID-19 and lung consolidation were independent risk factors for extended stays.

Readmitted post-COVID-19 patients often experience respiratory complications requiring prolonged hospital stays. Key risk factors include a history of severe COVID-19 and lung consolidation at admission.