Rick Burd and his son, Justin, during this year’s Hustle Chicago. Burd is the captain of the High Steppers.
Palatine resident Rick Burd has been hustling for quite some time. Ten years ago, he was encouraged by one of his sons, Justin, to join him in a charity stair climb to raise money for the Respiratory Health Association (RHA). The annual event, then known as “Hustle Up the Hancock” and in recent years renamed “Hustle Chicago,” is the largest annual fundraiser for RHA whose mission is to support those struggling with breathing disorders (COPD, cystic fibrosis, asthma, other lung diseases, and now, long Covid) and to promote healthy lungs and fight lung disease through research, advocacy, and education.
The recent Hustle Chicago was Burd’s 10th climb up the 94-floor iconic Hancock building in Chicago as a way to give back and support RHA’s efforts. The team, known as the High Steppers, are friends and colleagues of Burd and his son who believe in this great cause and want to make this collective effort.
Team High Steppers dedicated their climb in honor of longtime Chicagoland theater leader, actor and director Frank Roberts, who passed away last fall after his battle with pancreatic cancer. Roberts was the theatrical magician for over 30 years bringing magic to the stage and entertaining audiences across Chicagoland. It was always his dream to one year join this climb to support RHA.
This year’s High Steppers team was made up of 26 members, ages 10 to 74, from: Palatine, Arlington Heights, Buffalo Grove, Rolling Meadows, Lake Zurich, Cary, Long Grove, Ingleside, Elk Grove Village, Frankfort, Bensenville, Naperville, Prospect Heights, and Chicago. Ten members were participating for the first time while others have climbed in previous years ranging from 2 to 10 years.
Training for this event ranged from workouts on stair-stepper machines and treadmills to fitness centers and other training facilities. Interval training focused on cardio preparation was especially beneficial.
Burd’s role as captain of the climb team included recruiting members to participate, promoting the importance of reaching out with fundraising efforts, and creating a sense of team enthusiasm for being part of this event. Through their collective efforts and Burd’s leadership, not only did they all complete the 94-floor climb, High Steppers is fifth out of 113 teams in funds raised bringing in over $13,000 to support RHA.
This year’s Hustle Chicago was surrounded by excitement as the event returned for the first time since 2020 to the (formerly Hancock) 94 floor building.
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Compared with individuals with normal spirometry findings, the prevalence of ischemic heart disease (IHD) and heart failure (HF) is higher among those with chronic obstructive pulmonary disease (COPD) and preserved ratio impaired spirometry (PRISm), according to one study.
“Individuals with impaired spirometry findings, especially those with moderate or worse COPD and PRISm findings, have increased comorbid cardiovascular disease (CVD) compared with their peers with normal spirometry findings, and having COPD increases the risk of CVD developing,” wrote the researchers of this study.
To the researchers’ knowledge, this is the first study to describe the risk of CVD among individuals with diagnosed or undiagnosed COPD and PRISm findings. The full results of this observational cohort study were published in Chest.
The study was part of the Canadian Cohort Obstructive Lung Disease (CanCOLD) longitudinal study, which included a cohort of individuals with COPD, spirometry-conformed diagnosis, and matched non-COPD peers from 9 different cities across Canada: Vancouver, Calgary, Saskatoon, Toronto, Kingston, Ottawa, Montreal, Quebec, and Halifax.
Participants were evaluated at 4 visits, an initial visit between 2005 to 2016, and 3 visits between 2009 to 2019 over the duration of 3 to 10 years. At each visit, lung function and questionnaires were evaluated, while CVD variables used to calculate risk scores were obtained during the initial visit.
In total, the study enrolled 1561 participants. Of these participants, 726 had normal spirometry findings, 739 had spirometry-confirmed COPD, and 96 had PRISm findings. Most participants were White (95%) in their mid-sixties. Furthermore, 58% of the participants with COPD with COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage ≤ 2 and 84% with GOLD stage 1 had not received a diagnosis from their physicians.
As a result, the prevalence of IHD, odds ratio (OR, 1.66; 95% CI, 1.13-2.43; P = .01) or HF (OR, 1.55; 95% CI, 1.04-2.31; P = .033) was significantly higher among individuals with COPD and PRISm findings compared to those with normal spirometry, respectively.
Additionally, the prevalence of CVD was significantly higher in participants with PRISm findings and COPD GOLD stage ≤ 2, but not GOLD stage 1.
The incidence of CVD was also significantly higher in the impaired spirometry group, with hazard ratios (HR, 2.07; 95% CI, 1.10-3.91; P = .024) and (HR, 2.09; 95% CI, 1.10-3.98; P = .024) in the COPD group. This difference was significantly higher in participants with COPD GOLD stage ≤ 2, but not GOLD stage 1.
Furthermore, when adding spirometry status in the discrimination for predicting global CVD, no statistically significant differences were observed.
The researchers acknowledged some limitations to the study, including relying on self-reported CVD and the potential underreporting, misclassification, and recall bias of HF. Additionally, 21% of participants did not follow up or had died, which may have caused some CVD events to have been missed.
Despite limitations, the researchers believe the study provides evidence that individuals with COPD and PRISm findings are at higher risk of CVD compared to those with normal spirometry findings.
“Because these individuals with impaired spirometry are at higher risk of CVD, spirometry could help physicians to identify which individuals are at greatest risk so they may be offered preventive care,” concluded the researchers. “Cardiovascular risk scores should be evaluated further for how well they perform and how they can be improved in predicting CVD in this group.”
Krishnan S, Tan WC, Farias R, et al. Impaired spirometry and COPD increase the risk of cardiovascular disease. Chest. March 2023. doi:10.1016/j.chest.2023.02.045
Research has not established a conclusive link between Agent Orange exposure and chronic obstructive pulmonary disease (COPD). Some data suggests people with exposure to the chemical are more likely to receive a COPD diagnosis.
However, it is unclear whether the herbicide itself causes COPD.
A 2018 study found that when doctors based a COPD diagnosis on spirometry testing, rather than a person’s symptoms, the association between Agent Orange and COPD disappeared.
In this article, we examine the potential link between Agent Orange and COPD, including whether there is a relationship and if veterans with the condition qualify for disability benefits.
Agent Orange is a chemical that kills plants. The U.S. military used it to destroy large areas of rainforest during the Vietnam War. It is also toxic to humans.
People can be exposed to Agent Orange by inhaling it, through physical touch, or by consuming contaminated food or water. One of its potential effects on the lungs and airways is cancer.
Agent Orange has strong links to many types of cancer, including cancer of the:
larynx, or voice box
trachea, or windpipe
bronchus, the large airways leading to the lungs
Research has not proven that Agent Orange can cause COPD.
A 2018 study with 3,193 U.S. Chemical Corps veterans aimed to determine whether there is an association between the herbicide and a higher risk of COPD.
Researchers found that there was a higher rate of COPD among people who self-reported having COPD symptoms, particularly those who had more exposure to Agent Orange.
However, when researchers based COPD diagnoses on spirometry testing alone, this association vanished. There was no significant link between COPD and Agent Orange exposure based on this testing method.
alpha-1 deficiency, which is a rare genetic condition
Smoking is much more common among people in the armed services than in the general population. They may also be more likely to encounter other sources of pollution that may raise the risk of COPD, such as:
oil well fires
sand and dust particles
The presumptive list includes conditions that the Department of Veterans Affairs (VA) presumes are from Agent Orange exposure. This means to get disability benefits, a person does not have to prove that one of these conditions is from Agent Orange if they served in an area where the U.S. military used it.
COPD is not on the presumptive list of conditions the VA believes Agent Orange can cause. However, this does not necessarily mean a person with COPD cannot receive benefits.
People with COPD may have other conditions that are on the presumptive list, such as:
The VA also gives benefits to people with conditions that are not on the presumptive list if the person can prove it is due to their time in service. For example, exposure to other types of air pollution during service could put someone at higher risk of COPD.
In some cases, people may be able to provide evidence of a “secondary service connection.” This means a primary condition, which was directly due to a person’s time in service, led to the development of another condition.
For example, a person who has post-traumatic stress disorder (PTSD) may be able to prove they started smoking to manage their symptoms, which later led to a secondary condition, such as COPD.
VA disability ratings affect how much compensation a person receives. The VA bases this rating on the severity of the disease and how it impacts a person.
Because COPD is a progressive illness, someone with early stage COPD may have a different rating than someone with more advanced disease. If a person has more than one condition, the VA assigns a combined disability rating.
The exact benefit a person receives also depends on whether they live alone or have dependents, such as a spouse, parents, or children.
As of December 2022, the VA disability ratings and compensation ranges are:
If a person has health concerns that could have links to Agent Orange exposure, they can speak with their local VA Environmental Health Coordinator or visit their nearest VA office. They can discuss what support is available.
If a person would like help filing a claim, they can speak with a claims agent, Veterans Service Officer, or attorney who specializes in this area. People can search for a representative to help with their claim at eBenefits.
There are also organizations that provide other types of support for people with COPD, such as:
A local VA office or doctor may be able to recommend other support groups in the local area.
It is uncertain whether there is a link between Agent Orange and COPD. While Agent Orange is toxic and known to cause cancers of the lungs and respiratory system, there is no conclusive evidence it directly causes COPD.
As a result, COPD is not on the list of presumptive conditions the VA assumes are the result of Agent Orange exposure during the Vietnam War.
However, veterans are more likely to develop COPD for other reasons, such as exposure to other types of pollution or smoking. As a result, a person with COPD may still be eligible for disability benefits and other forms of support.
“Blue bloater” and “pink puffer” are terms doctors once used to describe and distinguish types of people with chronic obstructive pulmonary disease (COPD). The terms described stereotypes of some physical symptoms of COPD.
Healthcare professionals use the term COPD to refer to two chronic lung conditions: emphysema and bronchitis. A person with COPD may experience one or both conditions, which cause breathing difficulties and airflow blockage.
COPD affects about 16 million people in the United States. Many more Americans may have COPD and be unaware of it. There is no cure for COPD, but a healthcare professional can recommend treatments to alleviate a person’s symptoms.
This article defines the outdated terms “pink puffer” and “blue bloater” and explains why healthcare professionals no longer use them. It also discusses what emphysema and bronchitis are and when someone should speak with a doctor.
In the 1950s, health experts used the terms “blue bloater” and “pink puffer” to refer to two classical phenotypes of individuals with severe COPD. A phenotype is a set of observable attributes or characteristics of an individual.
Doctors may have referred to people as “blue bloaters” because they experienced cyanosis, which is when a person’s skin, fingernail beds, and lips become a bluish color, usually due to hypoxia. Additionally, many of these individuals may have been overweight or living with obesity.
Doctors used to refer to people with emphysema as “pink puffers.” People with emphysema typically find it difficult to catch their breath, which means they may take short, fast breaths or gasp. This fast, labored breathing may cause their skin to appear red or pink temporarily.
As their COPD worsens, individuals with emphysema may also experience weight loss as a result of using more energy to breathe and systemic inflammation.
Medical professionals no longer use the terms “blue bloater” and “pink puffer” to refer to people with COPD for several reasons.
Firstly, the terms were based on stereotypes of how people with emphysema and bronchitis appeared physically. The terms did not refer to the underlying causes of the conditions and were therefore unhelpful to medical professionals and demeaning to people with the conditions.
Additionally, because the terms were based on the stereotypes of how these conditions physically looked, people with less typical or severe symptoms of COPD may have been overlooked or misdiagnosed by healthcare professionals.
Finally, an individual with COPD may display multiple phenotypes of the condition. This means someone with COPD may have both emphysema and chronic bronchitis, so the separation of “blue bloaters” and “pink puffers” was not helpful.
Emphysema is a form of COPD that occurs due to gradual damage to the air sacs in the lungs, which doctors call alveoli. Typically, these air sacs are elastic, inflating and deflating when a person breathes in and out.
When a person has emphysema, the walls between many of the alveoli are damaged, causing the alveoli themselves to lose their shape and become floppy. In some cases, the damage can destroy the alveoli walls, causing fewer and larger alveoli instead of many tiny alveoli.
The reduced surface area in the lungs makes gas exchange and breathing difficult. Gas exchange is when the lungs move oxygen in and carbon dioxide out of the body.
Symptoms may not appear until the disease gets worse. They may include:
frequent coughing and wheezing, which is a high pitched whistling sound while breathing
COPD has no cure, but it is often treatable and preventable. Identifying COPD early may help prevent lung function decline and reduce the burden of symptoms, significantly improving a person’s quality of life.
Millions of people in the United States have COPD, but many more may have the condition without knowing it. Therefore, a person should speak with a healthcare professional if they experience any symptoms of COPD, including chronic bronchitis and emphysema.
People with COPD should also speak with a healthcare professional if their symptoms worsen or do not improve with treatment.
“Pink puffer” and “blue bloater” were terms that doctors once used to describe two phenotypes of people with COPD. Healthcare professionals no longer use these terms due to their inaccuracy and because they are demeaning to people with COPD.
Emphysema and chronic bronchitis are obstructive lung conditions that fall under the umbrella of COPD. They are both preventable and treatable.
A person should speak with a healthcare professional if they recognize any symptoms of COPD. People with COPD should report any worsening symptoms to their doctor or discuss any treatments that are not helping with their symptoms.
Aevice Health has announced that its flagship medical device, a wearable stethoscope for respiratory health monitoring, has been approved by Singapore's Health Sciences Authority.
The AI-powered wearable stethoscope AeviceMD, which is worn on the chest, continuously detects and records abnormal breath sounds, such as wheezing, and monitors vital signs including heart rate and respiratory rate.
Based on a press statement, the monitoring device system has been approved for use in people aged three and above and in both clinical and home settings.
WHY IT MATTERS
Singapore has one of the highest asthma and COPD prevalences in the world. Asthma affects around 5% of adults and 20% of children in the country while COPD is one of the 10 major disease killers.
With its remote health monitoring technology, Aevice Health aims to help reduce ED presentations and readmissions among patients dealing with these chronic respiratory diseases. By providing health professionals with an overview of a patient's lung health, AeviceMD supports the early detection of potential exacerbations.
According to the company, it will use its HSA approval as a springboard to expand the reach of its technology to populations with high cases of respiratory diseases.
"We are excited to leverage Singapore's strategic presence in Asia as a medical hub to bring this novel technology into new markets where there is a high prevalence of respiratory diseases," Aevice Health CEO Adrian Ang shared.
THE LARGER TREND
The market approval comes two years since Aevice Health first conducted a clinical trial of AeviceMD with the National University Health System to investigate its use cases in paediatric patients with breathing difficulties.
Aside from Singapore, the device has also been introduced in Japan using the $2 million proceeds from its pre-Series A funding round in 2021.
This post was contributed by a community member. The views expressed here are the author's own.
Called Zephyr valves, the devices were approved in 2018 under the FDA’s breakthrough device status because of the need for new treatment options for patients with Chronic Obstructive Pulmonary Disease (COPD), the third leading cause of death worldwide. COPD can vary in severity, but for people with advanced disease every activity can leave them breathless.
The valves are the first less-invasive option for patients with one form of COPD: severe emphysema. These patients had few options before this treatment and often were waiting on lung transplant lists or oxygen-dependent with very poor quality of life.
Medical devices and equipment refer to a broad range of tools, instruments, machines, and devices that are used by healthcare professionals to diagnose, treat, or prevent diseases, injuries, or other medical conditions. These devices can be as simple as a stethoscope or as complex as a robotic surgical system.
Medical devices and equipment can be classified into various categories based on their function and level of invasiveness. Some common examples include:
Diagnostic devices: These devices are used to diagnose medical conditions and include tools like X-ray machines, CT scanners, and blood glucose monitors.
Therapeutic devices: These devices are used to treat medical conditions and include tools like pacemakers, insulin pumps, and nebulizers.
Surgical devices: These devices are used during surgical procedures and include tools like scalpels, forceps, and retractors.
Monitoring devices: These devices are used to monitor patients’ vital signs and include tools like blood pressure monitors, heart rate monitors, and pulse oximeters.
Medical devices and equipment play a crucial role in modern healthcare, enabling healthcare professionals to provide better and more effective care to patients. These devices are subject to strict regulations to ensure their safety and efficacy, and they must undergo rigorous testing and approval processes before they can be used in clinical settings.
List of some of the most commonly used medical devices and equipment in India:
Ultrasound machines consist of a transducer, which emits sound waves and receives the echoes that bounce back from the body, and a computer that processes the data to create images. The images produced by ultrasound machines can be used to examine a wide range of organs and tissues, including the heart, liver, kidneys, and reproductive organs.
Some of the common applications of ultrasound machines include:
Obstetrics and gynecology: Ultrasound machines are frequently used to monitor fetal development during pregnancy and to diagnose conditions such as ovarian cysts and uterine fibroids.
Cardiology: Ultrasound machines are used to evaluate the heart’s structure and function and to diagnose conditions such as heart valve abnormalities and congenital heart defects.
Abdominal imaging: Ultrasound machines are used to examine the liver, gallbladder, pancreas, and other abdominal organs to diagnose conditions such as liver disease and pancreatic cancer.
Musculoskeletal imaging: Ultrasound machines are used to diagnose conditions such as tendonitis, arthritis, and other musculoskeletal disorders.
ECG machines work by detecting the electrical signals that are generated by the heart’s contraction and relaxation. The machine consists of electrodes, which are placed on the patient’s chest, arms, and legs, and a computer that records and analyzes the signals. The resulting ECG waveform can be used to assess the heart’s rhythm, rate, and conduction system.
Some of the common applications of ECG machines include:
Diagnosing heart conditions: ECG machines are used to diagnose a wide range of heart conditions, such as atrial fibrillation, ventricular tachycardia, and myocardial infarction.
Monitoring cardiac health: ECG machines can be used to monitor patients with existing heart conditions to assess the effectiveness of treatments and to detect changes in heart function over time.
Evaluating risk for heart disease: ECG machines can be used as part of routine physical exams to evaluate a patient’s risk for developing heart disease.
Defibrillators are medical devices used to treat life-threatening conditions such as cardiac arrest, where the heart stops beating or beats in an irregular pattern. Defibrillators deliver an electric shock to the heart, which can help restore normal heart rhythm and save the patient’s life.
There are two main types of defibrillators: external and internal. External defibrillators are used outside the body, and include manual defibrillators, automated external defibrillators (AEDs), and wearable cardioverter defibrillators (WCDs). Internal defibrillators are surgically implanted devices that deliver shocks directly to the heart.
Some of the common applications of defibrillators include:
Cardiac arrest: Defibrillators are used to treat patients experiencing sudden cardiac arrest, where the heart stops beating or beats in an irregular pattern.
Arrhythmias: Defibrillators can also be used to treat arrhythmias, which are abnormal heart rhythms that can be life-threatening.
Heart failure: In some cases, defibrillators can be used as part of a treatment plan for patients with heart failure, a condition where the heart is unable to pump enough blood to meet the body’s needs.
Oxygen concentrators are medical devices that concentrate oxygen from ambient air and deliver it to patients with respiratory conditions who require supplemental oxygen. They are used in healthcare settings and also in home care settings to help patients with conditions such as COPD, asthma, and other respiratory diseases.
Oxygen concentrators work by filtering out nitrogen and other gases from ambient air, leaving behind highly concentrated oxygen. The device then delivers the concentrated oxygen through a nasal cannula or mask to the patient.
Some of the common applications of oxygen concentrators include:
COPD: Oxygen concentrators are commonly used to treat patients with COPD (chronic obstructive pulmonary disease), a chronic lung disease that makes it difficult to breathe.
Asthma: Oxygen concentrators can also be used to treat patients with severe asthma, a condition that causes inflammation and narrowing of the airways.
Sleep apnea: Oxygen concentrators are sometimes used to treat patients with sleep apnea, a condition that causes breathing to stop and start during sleep.
Ventilators are medical devices that support or replace the natural breathing process of patients who are unable to breathe on their own due to illness or injury. They are commonly used in hospitals, intensive care units (ICUs), and other healthcare settings to provide mechanical ventilation to patients who require respiratory assistance.
Ventilators work by delivering air to the patient’s lungs through a breathing tube that is inserted into the mouth, nose, or trachea. The machine delivers a predetermined amount of oxygen and air at a controlled rate and volume to assist with breathing. Some ventilators also have settings for controlling the timing and pressure of the air delivered to the patient.
Some of the common applications of ventilators include:
Respiratory failure: Ventilators are used to treat patients with respiratory failure, a condition where the lungs are unable to deliver enough oxygen to the body.
Trauma: Ventilators can also be used to treat patients who have suffered from trauma, such as spinal cord injuries or head injuries, that affect their ability to breathe on their own.
Surgery: Ventilators are commonly used during surgical procedures that require general anesthesia, which can temporarily depress the respiratory system.
Infusion pumps are medical devices that deliver fluids, medications, or nutrients directly into a patient’s bloodstream. They are commonly used in hospitals, clinics, and other healthcare settings to deliver intravenous (IV) therapy to patients who require precise and controlled doses of medication or fluids.
Infusion pumps work by delivering fluids or medications through a sterile tubing system that is connected to the patient’s vein through a catheter or needle. The pump controls the flow rate, volume, and dosage of the medication or fluid being delivered, ensuring accurate and consistent administration.
Some of the common applications of infusion pumps include:
Pain management: Infusion pumps are commonly used to deliver pain medication to patients who require continuous pain relief.
Chemotherapy: Infusion pumps can also be used to deliver chemotherapy drugs to cancer patients.
Nutrition: Infusion pumps are used to deliver parenteral nutrition, which is a method of providing nutrients to patients who are unable to eat or digest food through the digestive system.
Blood glucose monitors are medical devices that measure the level of glucose (sugar) in a person’s blood. They are commonly used by people with diabetes to monitor their blood glucose levels at home, and by healthcare professionals to diagnose and manage diabetes in patients.
Blood glucose monitors work by using a small lancet to prick the skin and draw a small drop of blood. The blood is then placed on a test strip, which is inserted into the monitor. The monitor then analyzes the blood and displays the glucose level on a digital screen.
Some of the common applications of blood glucose monitors include:
Diabetes management: Blood glucose monitors are essential for people with diabetes to monitor their blood sugar levels regularly and adjust their treatment accordingly.
Diagnosis of diabetes: Blood glucose monitors are also used by healthcare professionals to diagnose diabetes in patients who are at risk or have symptoms of the condition.
Gestational diabetes: Blood glucose monitors can also be used by pregnant women with gestational diabetes to monitor their blood sugar levels and ensure the health of the fetus.
Blood pressure monitors are medical devices used to measure the force of blood against the walls of arteries as it flows through them. They are commonly used by healthcare professionals to diagnose and monitor high blood pressure (hypertension) in patients, and by people with hypertension to monitor their blood pressure at home.
There are two types of blood pressure monitors: manual and automatic. Manual blood pressure monitors consist of a cuff that is inflated and deflated manually with a bulb and a stethoscope to listen to the blood flow. Automatic blood pressure monitors consist of a cuff that inflates and deflates automatically and displays the readings on a digital screen.
Some of the common applications of blood pressure monitors include:
Diagnosis of hypertension: Blood pressure monitors are used by healthcare professionals to diagnose hypertension in patients and to monitor their blood pressure over time.
Management of hypertension: Blood pressure monitors are used by people with hypertension to monitor their blood pressure at home and to make lifestyle changes or adjust their medications accordingly.
Screening for high blood pressure: Blood pressure monitors are used in health screenings to detect high blood pressure in people who may not be aware they have it.
Pulse oximeters are medical devices used to measure the oxygen saturation level in a person’s blood. They are commonly used in hospitals, clinics, and other healthcare settings to monitor patients’ oxygen levels and respiratory function, and by people with respiratory conditions to monitor their oxygen levels at home.
Pulse oximeters work by shining a light through a person’s fingertip or earlobe and measuring the amount of oxygenated and deoxygenated hemoglobin in the blood. The device then calculates the oxygen saturation level and displays it on a digital screen.
Some of the common applications of pulse oximeters include:
Monitoring respiratory function: Pulse oximeters are used by healthcare professionals to monitor the oxygen levels and respiratory function of patients with respiratory conditions, such as asthma, COPD, and pneumonia.
Monitoring during anesthesia: Pulse oximeters are used during surgery and other medical procedures to monitor the oxygen levels and respiratory function of patients who are under anesthesia.
Monitoring during exercise: Pulse oximeters are used by athletes and people who exercise regularly to monitor their oxygen levels and ensure they are getting enough oxygen during physical activity
Nebulizers are medical devices that convert liquid medication into a fine mist that can be inhaled through a mask or mouthpiece. They are commonly used by people with respiratory conditions, such as asthma, COPD, and cystic fibrosis, to deliver medication directly to the lungs and airways.
Nebulizers work by using compressed air or ultrasonic vibrations to break up the liquid medication into a fine mist, which is then inhaled through a mask or mouthpiece. The medication is delivered directly to the lungs, where it can quickly and effectively relieve respiratory symptoms.
Some of the common applications of nebulizers include:
Treatment of respiratory conditions: Nebulizers are commonly used to deliver medication to the lungs and airways to treat respiratory conditions, such as asthma, COPD, and cystic fibrosis.
Relief of respiratory symptoms: Nebulizers can quickly and effectively relieve respiratory symptoms, such as wheezing, coughing, and shortness of breath, by delivering medication directly to the lungs.
Delivery of antibiotics: Nebulizers can also be used to deliver antibiotics directly to the lungs to treat respiratory infections, such as pneumonia.
Surgical instruments are tools or devices that are used by healthcare professionals during surgical procedures to perform various tasks, such as cutting, dissecting, grasping, and suturing. These instruments are designed to be precise, durable, and easy to use, and are made from a variety of materials, such as stainless steel, titanium, and plastic.
Some of the most common surgical instruments include:
Scalpels: A scalpel is a small, sharp knife used for making incisions in tissue.
Forceps: Forceps are tweezers-like instruments used for grasping and holding tissue or objects during surgery.
Scissors: Scissors are used for cutting tissue or materials during surgery.
Retractors: Retractors are used to hold open an incision or wound to provide better access to the surgical site.
Sutures: Sutures are used to close incisions or wounds after surgery.
Surgical drills: Surgical drills are used to make holes in bone or to remove bone tissue during surgery.
Endoscopes: Endoscopes are thin, flexible tubes with a light and camera attached that are used to view and perform surgery inside the body.
CT (computed tomography) scanners are medical imaging devices that use X-rays and computer technology to create detailed cross-sectional images of the body. They are commonly used in hospitals and clinics to diagnose and monitor a wide range of medical conditions, such as cancer, heart disease, and neurological disorders.
CT scanners work by rotating an X-ray source and detector around the patient’s body, taking multiple X-ray images from different angles. These images are then processed by a computer to create detailed cross-sectional images of the body, which can be viewed on a computer screen or printed on film.
Some of the common applications of CT scanners include:
Diagnosis of medical conditions: CT scans are commonly used to diagnose medical conditions, such as cancer, heart disease, and neurological disorders.
Monitoring of medical conditions: CT scans can be used to monitor the progress of medical conditions and track the effectiveness of treatment.
Planning of medical procedures: CT scans can be used to plan medical procedures, such as surgery or radiation therapy.
X-ray machines are medical devices that use X-rays to produce images of the inside of the body. They are commonly used in hospitals and clinics to diagnose and monitor a wide range of medical conditions, such as broken bones, lung infections, and dental problems.
X-ray machines work by emitting a small amount of ionizing radiation through the body. The radiation passes through the body and is absorbed by different tissues and structures at different rates, depending on their density. The X-rays that pass through the body are detected by an X-ray detector, which produces an image of the internal structures.
Some of the common applications of X-ray machines include:
Diagnosis of medical conditions: X-rays are commonly used to diagnose medical conditions, such as broken bones, lung infections, and dental problems.
Monitoring of medical conditions: X-rays can be used to monitor the progress of medical conditions, such as osteoporosis.
Planning of medical procedures: X-rays can be used to plan medical procedures, such as surgery or the placement of medical devices.
MRI (magnetic resonance imaging) machines are medical imaging devices that use a strong magnetic field, radio waves, and computer technology to create detailed images of the inside of the body. They are commonly used in hospitals and clinics to diagnose and monitor a wide range of medical conditions, such as cancer, neurological disorders, and musculoskeletal injuries.
MRI machines work by generating a strong magnetic field around the patient’s body, which causes the hydrogen atoms in the body’s tissues to align in a particular way. Radio waves are then used to cause these atoms to produce a signal, which is detected by the MRI machine and used to create detailed images of the body’s internal structures.
Some of the common applications of MRI machines include:
Diagnosis of medical conditions: MRI scans are commonly used to diagnose medical conditions, such as cancer, neurological disorders, and musculoskeletal injuries.
Monitoring of medical conditions: MRI scans can be used to monitor the progress of medical conditions and track the effectiveness of treatment.
Planning of medical procedures: MRI scans can be used to plan medical procedures, such as surgery or radiation therapy.
Dialysis machines are medical devices that are used to filter waste and excess fluid from the blood of patients with kidney failure. They work by mimicking the function of the kidneys, which normally filter waste and excess fluid from the blood.
Dialysis machines work by circulating the patient’s blood through a filter, which removes waste and excess fluid from the blood. The filtered blood is then returned to the patient’s body. There are two main types of dialysis: hemodialysis and peritoneal dialysis.
Hemodialysis is the most common type of dialysis, and involves using an artificial kidney (dialyzer) and a dialysis machine to filter the blood. During hemodialysis, the patient’s blood is pumped through the dialyzer, which removes waste and excess fluid from the blood. The filtered blood is then returned to the patient’s body.
Peritoneal dialysis involves using the patient’s own abdominal lining (peritoneum) as a filter. During peritoneal dialysis, a special solution is introduced into the patient’s abdomen, where it remains for several hours. The solution draws waste and excess fluid from the blood into the peritoneum, where it can be drained out of the body.
Chronic diseases are a major health concern worldwide, affecting millions of people of all ages. They are defined as conditions that persist over a long period of time and are often difficult to manage.
Many chronic diseases are caused by lifestyle factors such as diet and lack of physical activity and can be managed or prevented through lifestyle changes and natural remedies.
In this complete guide, we will look at 100 common chronic diseases and the natural remedies that have been shown to help manage their symptoms and improve overall health and well-being.
A Comprehensive List of Chronic Diseases and Their Natural Treatments
Arthritis: Arthritis is a condition that affects the joints and causes pain, swelling, and stiffness. Natural remedies such as glucosamine and chondroitin, ginger, turmeric, and omega-3 fatty acids have been shown to help reduce inflammation and improve joint health.
Asthma: Asthma is a chronic respiratory condition that causes difficulty breathing and wheezing. Natural remedies such as magnesium, vitamin D, and probiotics have been shown to help improve lung function and reduce symptoms.
Cancer: Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells. Natural remedies such as turmeric, green tea, and vitamin D have been shown to help boost the immune system and reduce the risk of cancer.
Cardiovascular disease: Cardiovascular disease is a group of conditions that affect the heart and blood vessels, and is a leading cause of death worldwide. Natural remedies such as omega-3 fatty acids, garlic, and CoQ10 have been shown to help reduce the risk of heart disease and improve heart health.
Chronic Obstructive Pulmonary Disease (COPD): COPD is a progressive lung disease that causes difficulty breathing and increased susceptibility to lung infections. Natural remedies such as omega-3 fatty acids, vitamin D, and probiotics have been shown to help improve lung function and reduce symptoms.
Depression: Depression is a common mental health condition that affects mood, thoughts, and behavior. Natural remedies such as omega-3 fatty acids, St. John’s Wort, and exercise have been shown to help improve mood and reduce symptoms of depression.
Diabetes: Diabetes is a chronic condition that affects blood sugar levels and can lead to a range of serious health complications. Natural remedies such as magnesium, cinnamon, and alpha-lipoic acid have been shown to help improve insulin sensitivity and regulate blood sugar levels.
Fatigue: Fatigue is a common symptom of many chronic diseases and can affect energy levels and quality of life. Natural remedies such as magnesium, iron, and B-complex vitamins have been shown to help improve energy levels and reduce fatigue.
Headaches: Headaches are a common symptom of many chronic diseases and can cause pain and discomfort. Natural remedies such as magnesium, ginger, and feverfew have been shown to help reduce the frequency and intensity of headaches.
High Blood Pressure: High blood pressure is a chronic condition that can lead to a range of serious health complications, including heart disease and stroke. Natural remedies such as magnesium, omega-3 fatty acids, and potassium have been shown to help regulate blood pressure and reduce the risk of heart disease.
Chronic diseases are caused by a mix of things, such as genes, lifestyle choices, and the environment.Some of the common causes of chronic diseases include:
Unhealthy diet: A diet that is high in saturated and trans fats, sugar, and salt can increase the risk of chronic diseases such as heart disease, diabetes, and cancer.
Lack of physical activity: A sedentary lifestyle can increase the risk of chronic diseases such as heart disease, obesity, and type 2 diabetes.
Smoking: Smoking can increase the risk of chronic diseases such as heart disease, stroke, and cancer.
Pollutants in the environment: Being around air pollution, chemicals, and other toxic substances can make you more likely to get long-term diseases like cancer and lung problems.
Genetics: Some chronic diseases, such as cystic fibrosis and sickle cell anemia, are caused by genetic mutations that are passed down from generation to generation.
Symptoms of Chronic Diseases
Chronic diseases can have many different kinds of symptoms, but here are some of the most common ones:
Pain: Many chronic diseases, like arthritis, fibromyalgia, and neuropathic pain, cause pain that lasts for a long time.
Fatigue: Chronic fatigue is a common symptom of many chronic diseases, including fibromyalgia, chronic fatigue syndrome, and depression.
Difficulty breathing: Chronic difficulty breathing is a common symptom of chronic respiratory diseases such as asthma and Chronic Obstructive Pulmonary Disease (COPD).
Weight changes: Sudden weight changes can be a symptom of chronic diseases such as diabetes, thyroid disorders, and certain types of cancer.
Changes in mood: Chronic diseases can affect mood and behavior, leading to symptoms such as depression, anxiety, and irritability.
Traditional Medical Treatments for Chronic Diseases
Traditional medical treatments for chronic diseases typically involve the use of medications, surgery, and other medical procedures. Some common treatments include:
Medications: Chronic diseases are often treated with medications such as anti-inflammatory drugs, pain relievers, and antibiotics.
Surgery: Certain chronic diseases, such as joint disorders and certain types of cancer, may require surgery to correct the underlying problem.
Physical therapy: Physical therapy can help manage the symptoms of chronic diseases such as arthritis, back pain, and fibromyalgia.
Lifestyle changes: Lifestyle changes, such as losing weight, quitting smoking, and increasing physical activity, can help manage the symptoms of chronic diseases and improve overall health and well-being.
Herbs and supplements: Herbs and supplements such as ginger, turmeric, and omega-3 fatty acids have been shown to help reduce inflammation, improve joint health, and boost the immune system.
Diet: A diet that is high in fruits, vegetables, and whole grains, and low in saturated and trans fats, sugar, and salt can help manage the symptoms of chronic diseases such as heart disease, diabetes, and cancer.
Exercise: Regular physical activity can help improve the health of your heart, reduce inflammation, and make you healthier and happier overall.
Stress management: Mindfulness, meditation, and yoga can help you deal with stress and improve your mood. They can also help reduce the symptoms of long-term illnesses like depression and anxiety.
Explanation of Natural Remedies
Natural remedies are treatments that come from things you can find in nature, like plants, minerals, and other things.
They are often used to treat the symptoms of long-term diseases and as a supplement to traditional medical treatments. Natural remedies can include herbal supplements, dietary changes, exercise, and other lifestyle modifications.
How Natural Remedies Can Help Manage Symptoms of Chronic Diseases
Natural remedies can help manage the symptoms of chronic diseases in several ways, including:
Improving joint health: Herbs and supplements such as glucosamine and chondroitin can help improve joint health and reduce pain and stiffness in conditions such as arthritis.
Boosting the immune system: Natural remedies such as echinacea and garlic can help boost the immune system, reducing the risk of infection and improving overall health and well-being.
Improving cardiovascular health: Lifestyle modifications such as regular physical activity and a diet that is low in saturated and trans fats and high in fruits, vegetables, and whole grains can help improve cardiovascular health and reduce the risk of heart disease.
Mood improvement and stress reduction: Mindfulness, meditation, and yoga are all practices that can help improve mood and reduce stress. This can be helpful for managing the symptoms of long-term illnesses like depression and anxiety.
Evidence-Based Research on the Effectiveness of Natural Remedies for Chronic Diseases
There is a growing body of evidence-based research that supports the use of natural remedies for chronic diseases. Many natural remedies have been shown to help ease symptoms and improve health and well-being as a whole.
For example, studies have shown that ginger can help reduce inflammation and improve joint health, while omega-3 fatty acids can help improve cardiovascular health. Mindfulness and meditation have also been shown to help reduce stress and make people feel better.
It is very important to note that while natural remedies can be effective, they should not be used as a substitute for traditional medical treatments.
Instead, natural remedies should be used in addition to traditional medical treatments, under the supervision of a medical professional. This will help make sure that chronic diseases are managed in the best way possible.
The Importance of Understanding and Managing Chronic Diseases
Chronic diseases are a significant public health concern that require proper understanding and management. These conditions, such as diabetes, heart disease, and cancer, are long-lasting and can have a significant impact on an individual’s quality of life.
It is crucial to understand the risk factors, symptoms, and treatment options for chronic diseases to prevent their onset and manage them effectively. By taking a proactive approach to managing chronic diseases, individuals can improve their overall health and reduce the risk of complications.
With over 300 million people affected worldwide, chronic diseases have become a major health concern for many individuals. It is essential to comprehend the root causes, symptoms, and conventional medical remedies for chronic illnesses to effectively manage and enhance one’s overall health and well-being.
Importance of Natural Remedies as a Complementary Therapy to Traditional Medical Treatment
Natural remedies have gained popularity as a complementary therapy to traditional medical treatment. Many people are turning to natural remedies to supplement their medical treatments, and there is growing evidence to support their effectiveness.
Natural remedies can help alleviate symptoms, improve overall health, and reduce the side effects of traditional medical treatments. As such, they are becoming an important part of many people’s healthcare routines.
According to recent studies, natural remedies have demonstrated their efficacy in alleviating symptoms and enhancing the general health and wellness of individuals suffering from various chronic illnesses.
According to healthcare professionals, complementary therapies can be used in conjunction with traditional medical treatments under their guidance.
using natural remedies into a comprehensive management plan can potentially improve the health and well-being of individuals with chronic diseases while also reducing the risk of complications.
In conclusion, managing chronic diseases is a complex and ongoing process that requires a multifaceted approach. It is important for patients to work closely with their healthcare providers to develop a personalized treatment plan that addresses their specific needs and goals.
This may involve making lifestyle changes, taking medications as prescribed, and monitoring symptoms regularly.
Additionally, staying informed about the latest research and advancements in treatment options can help individuals make informed decisions about their care. With the right support and resources, individuals with chronic diseases can lead fulfilling and healthy lives.
Bronchodilators relax the muscles around the airways or breathing tubes which work to help open the airways. When the airways are more open, it helps you breathe easier.
Bronchodilators can be short-acting or long-acting.
Short-acting bronchodilators work quickly so that you get relief from symptoms fast, but they wear off in a few hours.
Long-acting bronchodilators provide relief for many hours, but the effect may be slower. Long-acting bronchodilators need to be taken every day, even when you feel well
Types of Bronchodilator Medications
Beta2-Agonists work to relax the tightened musclesaround your airways. This opens the airway and makes breathing easier. Short-acting beta-agonists (SABA) work within minutes but last only 4-6 hours. Long-acting beta-agonists (LABA) may be slow to start working but can last up to 12 to 24 hours so are used to maintain open airways throughout the day or the night. LABAs need to be taken every day.
Anticholinergics work to prevent the muscles around your airways from tightening so keep the airways open and help clear mucus from your lungs. This combination allows your cough to expel mucus more easily. There are short-acting anticholinergic (SAMA) and long-acting anticholinergics (LAMA).
Many individuals experience discomfort due to seasonal allergies. The severity of COPD is increased by the presence of any other ailment that makes breathing harder.
Research conducted in 2012 at the Johns Hopkins Allergy and Asthma Center found that the respiratory symptoms of persons with COPD and seasonal allergies, such as coughing and wheezing, were worse by combining the two conditions.
They also had a far higher propensity to seek medical care for their problems.
COPD is a collection of lung diseases that often includes chronic bronchitis and emphysema. Cigarette smoking is associated with a higher risk of developing COPD.
The illness causes mucus production and airway narrowing, which may make breathing very difficult. Some of the signs and symptoms are:
shortness of breath
feeling winded after activities that weren’t difficult in the past
Seasonal allergies affect millions of individuals yearly, making their eyes and noses wet and itchy.
When your body’s immune system responds to allergens in the air like dust, mold and animal dander, you may experience symptoms like:
Itchy eyes, nose and throat
Runny nose and eyes
Post nasal drip (drainage in the throat)
Certain cells in your body, including histamine-producing ones, are triggered into action by your immune system. These chemicals cause allergic reactions.
Individuals with chronic obstructive pulmonary disease seem to be more vulnerable to respiratory illnesses. Naturally, if you have COPD, you already have respiratory difficulties.
How Can I Avoid Serious Complications?
To minimize the risk of an allergic reaction, it’s better to steer clear of anything that can trigger one. There are allergens in the air, food, and even water, but if you know what makes you sensitive, you have a leg up. Now is the time to take action to
UC Davis Health will provide the Propeller remote monitoring program to eligible patients. It includes sensors, a mobile app, web portal, and personalized support. The sensors attach to a patient’s inhaler to capture unique signals that record events, such as medication usage or respiration. This data will be transmitted to UC Davis Health’s electronic health record system to support patient enrollment and remote patient monitoring via single sign-on. Eventually, the remote monitoring system may be expanded to patients in other University of California health systems.
“Digital health devices and platforms are helping improve care for patients with chronic conditions, like COPD, by providing clinicians a more expansive view of our patient’s disease management,” said Brooks Kuhn, assistant professor of medicine and co-director of the Comprehensive COPD Clinic. “This collaboration will help us improve the clinical outcomes of our COPD patients by identifying the need for interventions early so we can avoid serious exacerbations, preserve their lung function and improve their quality of life.”
This collaboration will help us improve the clinical outcomes of our COPD patients by identifying the need for interventions early so we can avoid serious exacerbations, preserve their lung function and improve their quality of life.” —Brooks Kuhn
Benefits of personalized care program
Through the EHR system integration, clinicians will be able to track a patient’s day-to-day use of their inhalers, allowing them to monitor the use of “everyday medications” that keep the lungs functioning optimally. They’ll also be able to track rescue medications, which are used when the patient is short of breath and needs more help.
“The rescue use will be key in alerting clinicians that the patient may be experiencing early signs of a COPD exacerbation,” explained Krystal Craddock, clinical operations manager for respiratory care. “We will then be able to reach out to these patients and treat them early, hopefully avoiding unnecessary emergency room visits or hospitalizations.”
COPD describes a group of diseases that include emphysema and chronic bronchitis. According to the Centers for Disease Control and Prevention, 16 million Americans suffer from COPD. The CDC also stated that this number is likely higher as many have yet to receive a diagnosis or treatment.
“There are so many patients in our community that could benefit from a program like this and improve their clinical outcomes,” Kuhn added. “I appreciate all the hard work of our UC Davis information technology team, who helped integrate the Propeller platform with our EHR system so we can streamline workflows and efficiently put real-time data, alerts, and messaging in front of our clinicians.”
The new collaboration is a project of the UC Davis Health Operations Center of Excellence, a partnership between Innovation Technology and Clinical Operations. The goal is large-scale transformation through digital monitoring, virtual care, AI automation, and the latest technologies.
“We are committed to advancing digital and data-driven models of care to continue to provide exceptional patient care and experiences,” said Kuhn. “Our collaboration with Propeller Health will help us empower our COPD patients with health technology tools to help remove barriers to care, emphasize preventive care, and reduce hospital readmissions.”
Propeller Health, a ResMed company, is a leader in digital health and therapeutics for asthma and COPD. In over 150 peer-reviewed studies and articles, Propeller’s FDA-cleared and CE-marked Digital Therapeutics Platform has demonstrated improved quality of life and clinical outcomes while lowering health care costs.
"Collaborating with UC Davis Health demonstrates our continued commitment to patients as well as physicians by providing care-connected journeys and actionable insights to better manage chronic conditions," said Susa Monacelli, general manager for Propeller Health.
Hospital admissions and medication prescriptions associated with chronic obstructive pulmonary disease (COPD) and asthma increased substantially from 1999 to 2020, according to study findings published in BMC Pulmonary Medicine.
Researchers conducted a cross-sectional ecological study assessing trends in asthma- and COPD-related hospital admissions and medication prescriptions in England and Wales between 1999 and 2020.
Data were obtained from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales from April 1999 to April 2020. Data regarding COPD and asthma medication prescriptions in England and Wales were collected from the Prescription Cost Analysis database for 2004 to 2020.
The total annual number of COPD and asthma hospital admissions for various causes increased by 82.2% (from 210,525 in 1999 to 383,652 in 2020), which was an increased hospital admission rate of 59.1% (403.77; 95% CI, 402.05-405.49 in 1999 to 642.42; 95% CI, 640.39-644.45 in 2020 per 100,000 persons, trend test, P <.05).
COPD with acute lower respiratory infection was the most common COPD and asthma hospital admissions cause, which accounted for 38.7% of admissions.
Throughout the study period, hospital admissions due to chronic obstructive pulmonary disease and asthma, as well as medication prescriptions, increased dramatically among all age groups.
Participants aged 75 years and older accounted for 34.7% of the total number of COPD and asthma hospital admissions, followed by those aged 60 to 74 years (33.0%). Conversely, hospital admission rates for COPD and asthma for patients younger than 15 years of age were reduced by 28.5% (from 278.84; 95% CI, 275.56-282.13 in 1999 to 199.34; 95% CI, 196.67-202.01 in 2020 per 100,000 persons).
During the study period, 6,068,837 COPD and asthma hospital admissions were reported in England and Wales. Female patients accounted for 53.8% of COPD and asthma hospital admissions.
The absolute number of COPD and asthma medication prescriptions that were dispensed annually increased by 42.2% (from 42,062,859 in 2004 to 59,819,658 in 2020). Bronchodilators and corticosteroids (respiratory) were the most common COPD and asthma medication prescriptions (59.1% and 37.3%, respectively).
The researchers noted that their findings are based on an ecological study on the population level, not individual level, which limited their ability to retrieve data for comorbidities, medication history and adherence, and laboratory history. In addition, the researchers were unable to estimate the age-adjusted rate of admissions, and systematic differences may exist across regions in tracking disease frequency and measuring exposures.
“Throughout the study period, hospital admissions due to chronic obstructive pulmonary disease and asthma, as well as medication prescriptions, increased dramatically among all age groups,” the study authors concluded. The notable exception to this was the finding that admissions among children under the age of 15 decreased during the study period.
New York, Global Homecare Oxygen Concentrators Market report from Global Insight Services is the single authoritative source of intelligence on Homecare Oxygen Concentrators Market. The report will provide you with analysis of impact of latest market disruptions such as Russia-Ukraine war and Covid-19 on the market. Report provides qualitative analysis of the market using various frameworks such as Porters’ and PESTLE analysis. Report includes in-depth segmentation and market size data by categories, product types, applications, and geographies. Report also includes comprehensive analysis of key issues, trends and drivers, restraints and challenges, competitive landscape, as well as recent events such as M&A activities in the market.
Homecare oxygen concentrators are devices that are used to provide oxygen therapy to people who have difficulty breathing. Concentrators work by taking in air from the surrounding environment and using a series of filters to remove impurities and concentrate the oxygen. The oxygen is then delivered to the patient through a nasal cannula or mask.
Precision Medical Inc.
Besco Medical Co.
Air Water Inc.
Longfian Scitech Co.
Market Trends and Drivers
Homecare oxygen concentrators market growth is driven by the increasing prevalence of chronic respiratory diseases, especially, in developed countries. Increasing prevalence rate is owing to several risk factors such as sedentary lifestyle, smoking habits and environmental exposure among others. The chronic obstructive pulmonary disease (COPD) and asthma are among the leading respiratory diseases across the world. For instance, as per the World Health Organization, nearly 3.23 million deaths were caused due to the COPD, globally, in 2019. Thus, increasing need for additional oxygen supply in COPD treatment will augment the market statistics. Furthermore, booming elderly population base highly prone to numerous chronic respiratory diseases across the developed regions will positively impact the demand for homecare oxygen concentrators in the future. All these factors are expected to positively impact the homecare oxygen concentrators demand during the forecast timeframe.
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COPD is a chronic inflammatory lung disease marked by airway blockage due to long-term exposure to lung irritants, particularly cigarette smoke.
Acute COPD exacerbations, or episodes of sudden symptom worsening, have a large effect on patients’ health as they’ve been associated with a higher risk of hospitalization and disease progression.
If identified and treated early, these episodes can be managed with medications, such as bronchodilators (medicines that help relax and open the airways), antibiotics, oral steroids, and other therapies such as oxygen therapy, pulmonary rehabilitation, and noninvasive ventilation.
Hospital admissions decrease with remote patient monitoring
In this study (NCT05518981), researchers studied whether sustained remote patient monitoring contributed to identifying exacerbations early, improved patients’ healthcare and lowered hospitalization rates.
They retrospectively analyzed data from 126 COPD patients (mean age, 73.8) from a large outpatient pulmonary practice in San Francisco between May 2019 and February 2022. The patients were monitored for two years — before initiating monitoring and after starting it.
The remote monitoring service, which was tailored to COPD patients, included three components — undergarment-adhered cardiorespiratory sensors, an in-home data transmission hub, and a web-based clinical dashboard.
Sensors communicated wirelessly with a data transmission hub at home, which sent the data to a cloud-based dashboard assessed by the medical team. The dashboard displayed notifications if respiratory and pulse rates increased by 10% and 20%, respectively, above each patient’s baseline, or when 35 breaths per minute or 135 beats a minute were exceeded.
When comparing the year before using the remote system with the year after, researchers found the total number of all-cause hospital admissions decreased from 137 to 48, a 65% reduction. Per patient, the total number of all-cause hospitalizations also dropped significantly from a mean of 1.09 to 0.38.
The total number of hospitalizations due to cardiopulmonary events, such as chest pain, shortness of breath, or pneumonia, also decreased significantly — from 88 before remote monitoring to 32 after — a 63.6% drop. Per patient, the mean number of cardiopulmonary hospitalizations also fell significantly from 0.7 to 0.25.
Although the length of hospital stays tended to be shorter in the year after remote monitoring, the differences weren’t considered statistically significant.
“We hypothesize that [remote patient monitoring] may have led to subjects being treated earlier for exacerbations than they may have otherwise, which has been shown to improve outcomes,” the researchers wrote, attributing them to “low patient burden, high adherence rates, and … benefits of continuous monitoring of parameters directly relevant to [acute COPD exacerbations] … which may allow for earlier detection of exacerbations.”
ER visits fall, outpatient visits rise
The number of all-cause emergency room (ER) visits also dropped from 61 to 34, corresponding to a significant 44% reduction, a drop from a mean of 0.48 to 0.27 per patient. Similarly, the number of cardiopulmonary-related ER visits decreased from 36 to 20, corresponding to a significant 44.4% drop (from a mean of 0.29 to 0.16 per patient).
The total number of outpatient care visits increased by 13.2% (from 532 to 602), corresponding to an increase from a mean of 4.22 to 4.78 visits per patient. The total number of prescribed steroids increased by 3.4% — from 116 to 120.
The adherence to using the sensors for remote monitoring was high, with patients adhering 88.6% of the days. Adherent days were defined as those when the sensors were worn for at least eight hours. Most of the patients were adherent 90% or more of the year after the remote monitoring was implemented. Adherence tended to decrease with time, however.
“The results from this study are preliminary evidence of improved clinical outcomes. The shift observed to less acute care also suggests support for earlier intervention as a proposed mechanism,” the researchers wrote, noting more research with a control group would help validate their findings.
The global COPD and asthma devices market size reached US$ 43.4 Billion in 2022. Looking forward, the publisher expects the market to reach US$ 60.4 Billion by 2028, exhibiting a CAGR of 5.66% during 2022-2028.
Chronic obstructive pulmonary disease (COPD) is an inflammatory disease that leads to obstructed airflow from the lungs. Its early symptoms include shortness of breath, wheezing, chest tightness, chronic cough with or without mucus, frequent cold, and throat soreness.
On the other hand, asthma, also known as bronchial asthma, is a respiratory disorder that affects the airways in the lungs. Its symptoms are shortness of breath, chest tightness, trouble sleeping, and coughing or wheezing attacks. These respiratory diseases are treated using various devices that help deliver inhaled medication. COPD and asthma devices, also known as pulmonary drug delivery devices, are used as permanent treatment or rescue therapy for respiratory diseases. As a result, they are gaining immense traction across the globe.
COPD and Asthma Devices Market Trends:
The growing global geriatric population, which is highly susceptible to chronic respiratory disorders, represents one of the key factors positively influencing the market. In addition, rising occurrences of respiratory diseases caused due to the rising smoking of cigarettes are increasing the sales of COPD and asthma devices.
Apart from this, the increasing expenditure on healthcare and continuous automation in the healthcare industry are contributing to the market growth.
The widespread adoption of advanced medical solutions is offering lucrative growth opportunities to manufacturers across the globe. At present, healthcare practitioners and pulmonary diseases specialists are preferring a combination of a drug and a device on account of their fast and effective outcome.
Furthermore, the expansion of chemical industries is resulting in the rising environmental pollution level and breathing problems, which, in turn, is driving the market. Additionally, the introduction of portable drug delivery devices is propelling the market growth.
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Between 10% and 20% of people attending for low-dose CT screening for lung cancer have unexplained symptomatic airflow obstruction and, thus, may have undiagnosed chronic obstructive pulmonary disease (COPD), but few studies have looked at what happens to people following this initial prebronchodilator spirometry.
WHAT THIS STUDY ADDS
This study describes downstream events for people found to have unexplained airflow obstruction at a Lung Health Check who were referred to a Community Respiratory Team for further assessment and treatment. About one-third of referred people declined assessment, and of those seen and undergoing postbronchodilator spirometry, 29% did not have airflow obstruction. Of all participants undergoing Lung Health Check spirometry, 2.3% commenced appropriate new pharmacotherapy as a result and 0.2% entered pulmonary rehabilitation.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
Measuring spirometry alongside lung cancer screening offers the possibility of diagnosing COPD earlier. However, this study demonstrates the importance of checking postbronchodilator spirometry in this population and illustrates some of the ‘real-world’ challenges in actioning these findings. Further research is needed to optimise investigation and management of this population and to measure eventual clinical outcomes.
Chronic obstructive pulmonary disease (COPD) is a worldwide health problem that causes significant morbidity and mortality1 2 and shares the common risk factor of smoking with lung cancer. It is widely recognised that COPD is underdiagnosed,3 4 but screening for the disease in asymptomatic adults is not recommended by either the United Kingdom National Screening Committee5 or the United States Preventive Service Task Force (USPSTF).6 In comparison, the most recent Global Obstructive Lung Disease (GOLD) guidelines advocate active case finding in individuals with symptoms and/or risk factors, alongside aggressive identification and management of coexisting comorbidities.7
In the United Kingdom, several programmes have offered low-dose CT (LDCT) screening for lung cancer as part of a Lung Health Check (LHC), whereby a number of interventions (screening, prebronchodilator spirometry, smoking cessation) are offered as a bundle to improve lung health. Studies have reported between 10% and 20% of screening attendees having symptomatic undiagnosed airflow obstruction (AO) picked up by these programmes.8–10 However, there is limited evidence of subsequent downstream events, such as the proportion of individuals who undergo postbronchodilator spirometry as a formal diagnostic test for COPD. Only one study has reported treatment outcomes in this context, with 11% of individuals commencing new pharmacotherapy and 2% entering a pulmonary rehabilitation programme.11 Here, we present the downstream clinical assessment and management as a result of spirometry offered as part of an LHC in the Yorkshire Lung Screening Trial (YLST).
YLST study design
The protocol of the YLST has previously been published.12 Briefly, people aged 55–80 in Leeds were invited to telephone-based risk assessment for lung cancer and, if eligible for screening, were invited for a face-to-face LHC. These were provided in mobile units in convenient community locations and comprised LDCT screening, prebronchodilator spirometry and, where appropriate, an immediate opt-out consultation with a colocated smoking cessation practitioner (including Nicotine Replacement Therapy/pharmacotherapy, ongoing behavioural support and 4-week carbon monoxide validation for quitters). YLST was approved by the Health Research Authority following review by Research Ethics Committee (reference 18/NW/0012) and is registered with the ISRCTN (reference ISRCTN42704678).
Data collection during the LHC
General practitioner (GP)-entered codes for a previous diagnosis of COPD were extracted from primary care electronic healthcare records; all other parameters were self-reported. Previous respiratory diagnoses, COPD assessment test scores (CAT), modified Medical Research Council dyspnoea score, WHO performance status and the presence of COPD-defining symptoms (exertional breathlessness, chronic cough, regular sputum production, wheeze, frequent winter bronchitis)13 were recorded for each participant. Measurements of prebronchodilator forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were performed with AO defined as an FEV1/FVC ratio of less than 0.7, and restrictive spirometry defined as an FEV1/FVC ratio of ≥0.7 and an FVC of <80% predicted.
Communication of results and referral to the Community Respiratory Team
Criteria for referral of participants with possible undiagnosed COPD to the Leeds Community Respiratory Team (CRT) were: no COPD code on primary care record; no self-reported asthma; AO on spirometry (FEV1/FVC <0.7) and any self-reported COPD-defining symptom. For the first 2 months of the programme (November and December 2018), participants were referred irrespective of their FEV1 per cent-predicted value. Following review of referral numbers, from January 2019 onwards, an additional criterion of FEV1 less than 80% predicted was added. Referrals to the CRT were made by secure email communication after each round of LHCs (approximately monthly). Spirometry results including reference to the presence or absence of prebronchodilator AO and referral to the CRT where appropriate were communicated to the participant’s GP by electronic letter. A separate letter was sent to appropriate participants explaining the rationale for referral to the CRT within 4 weeks of their LHC.
Community Respiratory Team review
Most referred participants were initially contacted by telephone by the CRT to invite them for a respiratory assessment. Those not contactable by phone were sent a letter asking them to contact the CRT to arrange an appointment; if there was no response within a month, they were discharged back to their GP. A questionnaire template was setup within the CRT electronic patient record (SystmOne, TPP) to record clinical information and outcomes from the assessment. Postbronchodilator spirometry was recorded for a proportion of participants referred to the service.
The baseline round of YLST ran from November 2018 until February 2021. YLST was paused between March and June 2020 due to the COVID-19 pandemic, and when the programme recommenced in July 2020, spirometry was omitted from ongoing LHCs. Similarly, the CRT assessment of participants referred from screening was paused in March 2020 and did not restart again after the pandemic, with all those who remained on the waiting list redirected to their GP. Due to the lag between LHC visit and CRT assessment, referrals from YLST to the CRT were significantly affected for all screening rounds from October 2019 onwards. This analysis is, therefore, limited to participants who were screened between November 2018 and September 2019.
Review of outcomes and analysis
Primary care records for people resident in Leeds are visible to secondary care users through the shared Leeds Care Record, except in instances where the patient has specifically asked for their record not to be available or where the patient is deceased. The primary care records of all participants referred to the CRT were reviewed from March to May 2021. The presence of a primary care code for COPD was determined, together with prescriptions for inhaled medications. Inhaled medications issued prior to the LHC visit were recorded, including whether the prescription was active at the time of the LHC visit (ie, recently issued) or had been previously discontinued. Similarly inhaled medication initiated since the LHC visit was recorded, including whether the prescription was active or not (defined as medication issued since January 2021). Appropriate statistical tests were used (Mann-Whitney U test and Fisher’s exact test) based on skewed data and categorical labels, and all statistical analyses were performed using GraphPad Prism V.5.00.
Between November 2018 and March 2020, 4510 participants attended for an LHC and underwent LDCT screening, of whom 3920 (87%) had prebronchodilator spirometry. Considering only those attending an LHC between November 2018 and September 2019 (ie, prior to the impact of COVID-19 on the referral pathway), 2786 participants underwent LDCT screening of whom 2391 (86%) had prebronchodilator spirometry measured on the mobile units. Of these, 505 had a COPD code recorded in their primary care record, and 145 self-reported a history of asthma.
Of the 1741 participants without a prior diagnosis of COPD or asthma, 1163 (67%) had no AO (1086 normal spirometry, 77 restrictive spirometry, mean [± SD] CAT score was 8.1±5.9 for this group as a whole) and 578 (33%) were found to have AO (185 asymptomatic, 393 symptomatic). The mean (±SD) CAT score was 4.5±3.3 for the asymptomatic AO group and 10.4±5.8 for the symptomatic AO group. Of the 393 with undiagnosed symptomatic AO, 192 were not referred to the CRT (170 because they did not fulfil the additional criteria of FEV11<80% predicted introduced from January 2019 onwards, and 22 for a variety of other reasons - the the most common being referral to the lung cancer pathway). The remaining 201 participants were referred to the CRT; a consort diagram is shown in figure 1.
Consort diagram for participants attending a Lung Health Check between November 2018 and September 2019. AO, airflow obstruction, CRT, community respiratory team; LHC, lung health heck; SCP, smoking cessation practitioner.
At the time of their LHC, all participants were asked whether they had a previous history of COPD, emphysema or bronchitis. Overall, 43 of the 201 people who fulfilled the referral criteria (21%) reported one or more of these conditions (bronchitis 34, COPD 9, emphysema 1), and 114 of the 201 (57%) were current smokers. All had been offered an immediate consultation with an on-site smoking cessation practitioner (SCP) at the time of their initial LHC. Seventy nine people were seen by the SCP at the time of their visit (69% of those offered) of whom 23 later reported a successful quit with 17 validated by carbon monoxide measurement (20% and 15% of eligible current smokers respectively).
Ninety seven participants were eventually seen by the CRT (48% of all those referred). Eight people were contacted by the CRT to arrange an appointment, but had already seen their GP since the LHC and had undergone assessment and management, so were not offered an appointment. Forty six people declined assessment, either refusing during the initial telephone call or failing to respond to written invitations. Fifty people were not contacted by the CRT or not seen for other reasons (44 due to logistical failure in the referral process, 4 were discharged having not been invited by the time the service closed due to COVID-19, 1 reported a diagnosis of asthma during his initial CRT telephone call, 1 was under investigation for lung cancer and was not contacted). Demographic and clinical characteristics of the cohort according to invitation/response are shown in table 1. There were no differences in demographic or clinical parameters between those who declined review and those seen (either by the CRT or their GP in advance of CRT contact).
Demographics and clinical information regarding participants eligible for Community Respiratory Team referral for possible new COPD
Outcomes for those seen and assessed by the CRT are shown in figure 2. Two thirds of those seen had post-bronchodilator spirometry checked with AO confirmed in 72%, but not shown in 28% of participants thereby excluding COPD. The 33 participants seen by the CRT who did not have repeat spirometry were managed on the basis of values measured during their LHC. Of the eight participants seen and assessed by their GP prior to CRT contact, 4 had post-bronchodilator spirometry by the GP confirming AO, 2 had normal post-bronchodilator spirometry and one had no record of spirometry in primary care record. One participant had died and thus their primary care record was not available for review. Thus of all 70 participants who had post-bronchodilator spirometry checked after the initial LHC for whom results are available, fifty (71%) had confirmed AO and 20 (29%) did not.
Outcomes for participants seen by the Community Respiratory Team. CRT, community respiratory team; ICS, inhaled corticosteroid; LABA, long acting beta agonist; LAMA, long acting muscarinic antagonist; LHC, lung ealth heck; PR, pulmonary rehabilitation; SABA, short acting beta agonist; SMP, self-management plan.
Outcomes for the 97 participants seen by the CRT are shown in figure 2. Forty six people had post-bronchodilator spirometry confirming AO, and 33 had no spirometry but were managed based on pre-bronchodilator spirometry measured at the LHC. Considering these two groups together, 34 people (43%) had record of a COPD self-management plan, and inhaled medication was recommended for 27 (34%), 22 (28%) short-acting beta agonist (SABA), 21 (27%) combination long acting beta-agonist/long acting antimuscarinic antagonist (LABA/LAMA). Nineteen participants underwent inhaler technique review or education, and 23 were offered pulmonary rehabilitation, but only 5 (22% of those offered) took up this referral.
The results of primary care record review for all 201 participants referred to the CRT are shown in table 2; the record was not accessible for 13 participants either because they had died, or because they had requested that this information not be available for secondary care review. Excluding those in whom subsequent post-bronchodilator spirometry ruled out COPD, 59 participants had a COPD code recorded in their primary care record in early 2021 (35% of all those with access to primary care records). The proportion of people with a COPD code was higher in those seen by the CRT (58%) than in those who refused assessment (17%) or those who were not contacted by the service (12%). Interestingly, reviewing those 20 participants where post-bronchodilator spirometry excluded COPD, 7 (35%) still had a GP COPD code present in their primary care record.
Primary care COPD code and inhaled medication pre- and post-Lung Health Check visit
Considering the whole cohort referred to the CRT (n=201), 53 (26%) participants had a record of an inhaler prescription at any time before their LHC. Excluding those participants with subsequent normal spirometry (n=20), 27 individuals were taking some form of inhaled medication at the time of their LHC (16% of all attendees for whom primary care records were accessible), most frequently a SABA. Fifty six participants commenced a new inhaled medication subsequent to the LHC (33% of those with accessible primary care records) with SABA (n=36, 21%) and LAMA/LABA (n=42, 25%) being the most commonly prescribed inhalers. Interestingly, 9 of the 20 participants (45%) where spirometry subsequently excluded COPD remained on inhaled medication at the time of primary care record review (25% SABA, 20% LAMA/LABA). The CAT score of those participants who commenced new inhaled medication subsequent to the LHC was slightly higher than those who did not (mean±SD was 12.9±5.9 vs 10.7±5.7 respectively, p=0.007).
Considering changes in coding and management across the whole population undergoing spirometry as part of their LHC during the study period (n=2391), 201 (8.4%) fulfilled criteria for referral to the CRT of whom 105 (4.4%) were seen (or reviewed earlier by their GP). Excluding those with subsequent normal spirometry, 59 participants had a new COPD code entered into their primary care record (35% of those fulfilling referral criteria, and 2.5% of all those undergoing LHC spirometry) and 56 commenced new inhaled medication (33% of those fulfilling referral criteria and 2.3% of all those undergoing LHC spirometry). Twenty three participants were offered pulmonary rehabilitation by the CRT, of whom five accepted the referral (6.3% of those seen by the CRT with COPD, and 0.2% of all participants undergoing LHC spirometry).
There is clear evidence of underdiagnosis of COPD in the general population,3 4 and previous studies have shown a high prevalence of undiagnosed AO in people undergoing LDCT screening.8 9 Given the recommendation from GOLD for active case finding in people with symptoms,7 the possible roll-out of LCS offers an opportunity to co-deliver spirometry for symptomatic patients with the aim of diagnosing COPD and thus allowing therapeutic interventions earlier in the natural history of the disease. However, a recent USPSTF targeted evidence update found no direct evidence that COPD active case finding improved COPD morbidity, mortality or health-related quality of life.6
Other LHC programmes8 9 have previously reported a high prevalence of undiagnosed symptomatic AO in people having pre-bronchodilator spirometry alongside LDCT screening. However, the analysis presented here demonstrates that 29% of those having subsequent post-bronchodilator spirometry were not found to have AO, thereby excluding COPD. Most people in our study did not have post-bronchodilator spirometry checked and yet many commenced inhaled treatments for COPD; for some these treatments might be unnecessary. Similarly, 45% of those with confirmed normal post-bronchodilator spirometry continued to receive inhaled medication many months after their assessment. While asthma might be a diagnostic possibility in this group, the majority of patients who remained on inhaled medication were on bronchodilators alone without inhaled corticosteroids, suggesting they may not be on appropriate therapy. Our findings therefore highlight that pre-bronchodilator spirometry alone should not be used to guide treatment, and emphasise the importance of instituting treatment for COPD only after post-bronchodilator spirometry has confirmed this diagnosis.
Of those referred to the CRT, nearly half were not seen either because their referral was not processed or because they declined assessment. For a small number, the referral was affected by the COVID-19 pandemic, but a large number (44) were not invited due to logistical failures in the referral process that pre-dated the pandemic. This highlights the importance of establishing robust referral pathways with regular audit to avoid the failures described here. Nearly a third of people who were invited declined assessment. Previous analysis from YLST has shown clear factors predicting failure to respond to LHC invitation (most notably increased deprivation and current smoking status). However, these factors did not predict refusal to CRT assessment, nor did any other analysed parameter. It may be that these participants have lower symptom burden when compared with people with known COPD and that in the absence of significant functional impairment, a proportion of screening participants are reluctant to engage in further respiratory assessment. This might also explain the low uptake for pulmonary rehabilitation, with only 22% of those offered referral to a pulmonary rehabilitation programme accepting. Although CAT scores did not differ between those who took up the invitation compared with those who did not, there was a significantly higher CAT score in those participants who commenced inhaled medication following their LHC compared with those who did not, although the difference was relatively small.
Comparison to other published literature
The only previous report of downstream impact of spirometry performed in the context of LCS described outcomes in 55 participants found to have unexplained symptomatic AO from 1542 undergoing screening in a West London pilot.11 In that study, participants were advised to see their GP for further assessment and treatment, and 28 (51% of those referred) attended a primary care appointment (four were lost to follow-up and 23 did not attend their GP appointment). Sixteen participants subsequently received a new respiratory diagnosis (14 COPD, 2 asthma, overall 29% of those referred and 1.0% of those screened); pharmacotherapy was commenced in six people (11% of those referred and 0.4% of those screened) and one participant commenced pulmonary rehabilitation (1.8% of those referred and 0.06% of those screened). The corresponding figures reported here (expressed as proportions of those referred and those screened) are: 59 participants with a new GP COPD code (35% and 2.5% respectively); 56 participants commenced appropriate pharmacotherapy (33% and 2.3% respectively) and five participants referred to pulmonary rehabilitation (2.5% and 0.2% respectively).
Strengths and limitations
A strength of this study is the comparison between pre-bronchodilator LHC spirometry and post-bronchodilator confirmatory spirometry for a proportion of participants (the first study in the context of lung screening to report this). Limitations include the logistical failures in the referral process which resulted in fewer participants benefiting from CRT review; however this service was not part of a clinical trial, and thus represented ‘real-world’ experience. Second, the referral criteria were mostly limited to those participants with an FEV1 of less than 80% predicted. This was a pragmatic, although arbitrary criterion to ensure the service was able to cope with demand, and to direct limited resource to those participants who might have the greatest need. However, there may have been people with AO above this threshold who might have benefited from CRT referral, although the spirometry results were communicated to the GP in all cases.
There are ways in which the assessment process and referral criteria might be amended in future programmes. In the current study, only symptomatic patients were referred for further assessment, with self-reporting of any COPD symptom being used to define this group.13 An alternative strategy could be to define an appropriate CAT score threshold. This could either be used to determine which patients with AO are referred for further assessment, or possibly could be used to target spirometry testing such that people below this threshold do not undergo this test.
Summary and implications for practice
This report describes the challenges involved in actioning potential cases of undiagnosed COPD detected by pre-bronchodilator spirometry delivered in the context of LCS. While some of the logistical issues described could easily be addressed (eg, ensuring a robust referral pathway), there are other important points which have implications for future programmes. First, a proportion of participants decline further respiratory assessment (30% here, 42% in West London.11 Furthermore some participants who were seen declined onward referral to other services (eg, to pulmonary rehabilitation programmes), perhaps reflecting the low symptom burden experienced by this patient population. Second, 29% of our participants fulfilling referral criteria to the CRT were subsequently found to have no AO following post-bronchodilator spirometry. This most likely reflects the effect of the bronchodilation itself although we cannot exclude a contribution from training/competency issues in measurement of spirometry. The evidence-base for pharmacotherapy is limited to those with post-bronchodilator AO, and thus some participants in the described analysis may be receiving unnecessary treatment (including those with proven normal post-bronchodilator spirometry). Third, many of these participants either self-reported COPD, emphysema or bronchitis (n=43), or had been previously issued with inhaled medication (n=53). In total, 78 (39% of the whole cohort) individuals fulfilled one or other criteria, suggesting possible previous opportunities for diagnosis in primary care.
Adding spirometry to LCS offers the opportunity of earlier diagnosis of COPD and therefore possibly improved outcomes. However, further research is needed to clarify the optimal way to investigate and manage people found to have unexplained symptomatic AO at LHC, and to measure eventual clinical outcomes to confirm overall patient benefit. In addition, there is a need to undertake qualitative research with this population to understand the barriers to patients attending for assessment and treatment of possible COPD, and strategies that might mitigate these to ensure maximum clinical benefit.
Data availability statement
All data relevant to the current manuscript are included in the article. The data sharing policy from the Yorkshire Lung Screening Trial itself are shown below. The Yorkshire Lung Screening Trial is a Clinical Trial (ISRCTN42704678). Data collected as part of this study are available on reasonable request according to the following data sharing policy. 'The YLST study is registered at the ISRCTN registry with identifier ISRCTN42704678. In order to meet our ethical obligation to responsibly share data generated by clinical trials, YLST operates a transparent data-sharing request process. Anonymous data will be available for request once the study has published the final proposed analyses. Researchers wishing to use the data will need to complete a request for data-sharing form describing a methodologically sound proposal. The form will need to include the objectives, what data are requested, timelines for use, intellectual property and publication rights, data release definition in the contract and participant informed consent, etc. A data-sharing agreement from the sponsor may be required'. The data presented here are mostly clinical data subsequent to trial participation, and so is not included in the above data sharing policy.
Patient consent for publication
This study involves human participants and was approved by North West—Greater Manchester West Research Ethics Committee REC reference:18/NW/0012. Participants gave informed consent to participate in the study before taking part.
PAJC is supported by the Manchester National Institute for Health Research Manchester Biomedical Research Centre (IS-BRC-1215-20007). We acknowledge the contribution of the whole YLST clinical team (Sayyorakhon Alieva, Carol Bisby, Cat Bruckner, Andy Cameron, Richard Cannon, Elly Charles, Suzette Colquhoun, Sam Curtis, Angie Dunne, Melanie Brear, Fazia Fazal, Helen Ford, Alice Forkin, Rita Haligah, Jade McAndrew, Sadia Moyudin, Joseph Peill, Angelika Pelka, Ellie Scott, Sophie Stevenson, Matt Ward).
Training your breathing muscles may provide longer-lasting benefits than previously believed, according to new research published in Experimental Physiology. The study revealed that the strength gains from five weeks of inspiratory muscle training, a specialized form of weight training focusing on the muscles used for breathing, persisted for an additional five weeks after the training had ceased.
These stronger breathing muscles can improve blood flow distribution during exercise, allowing cyclists to ride for more extended periods before fatigue and breathlessness set in. Improved breathing muscle function could potentially help individuals manage and slow down the progression of chronic obstructive pulmonary disease (COPD), a group of lung conditions including emphysema and bronchitis.
Researchers from the University of Waterloo, Canada, discovered that breathing muscles remained stronger after an equal amount of time without training. This finding indicates that respiratory muscles can be trained similarly to other skeletal muscles.
Paolo Dominelli, a researcher on the study, explained, “Inspiratory muscle training can be beneficial to people with breathing difficulties and can be part of pulmonary rehabilitation. Knowing the time frame before muscle function loss occurs could help inform treatment programs, determining how frequently an individual would need to train and the length of the program.”
The research also demonstrated positive changes to the respiratory muscle metaboreflex, a process that restricts blood flow to the limbs when breathing muscles tire. Inspiratory muscle training reduces the metaboreflex, lowering heart rate and blood pressure, thus improving a person’s endurance during exercise.
Dominelli added, “By showing that the strength of the breathing muscles persisted, along with the retained reductions in the respiratory metaboreflex after five weeks without training, suggests that the training itself may not need to be continuous. We would need to carry out subsequent clinical trials to test the appropriate frequency and length of training required to evaluate how long the health benefits persist.”
For cyclists interested in training and fitness, this research highlights the potential advantages of incorporating inspiratory muscle training into their exercise routine to improve overall endurance and performance. Believe it or not, there are actually many manufacturers making devices to strength train your breathing muscles!
Zafar reports being a co-owner of PEP Buddy, LLC. Please see the study for all other authors’ relevant financial disclosures.
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In more than 70% of patients with COPD, a positive expiratory pressure device improved exertional dyspnea.
The device mitigated desaturation in five of 14 patients with exertional desaturation.
Patients with COPD who experience breathlessness and exertional desaturation may see improvements with use of an oral positive expiratory device, according to study results published inRespiratory Care.
Muhammad Ahsan Zafar
“PEP buddy is an adjunct to current COPD therapies, such as inhalers and pulmonary rehabilitation,” Muhammad Ahsan Zafar, MD,co-creator of the device andassociate professor in the department of pulmonary critical care and sleep medicine at the University of Cincinnati College of Medicine, told Healio. “It provides a tool for self-management and breathing re-training, in addition to reducing dyspnea and improving quality of life.”
In this study, Zafar and colleagues analyzed 32 patients (mean age, 66.6 years; 43% women) with moderate to severe COPD who had an FEV1 less than 80% predicted and a prior 6-minute walk test (6MWT) that showed exertional dyspnea or desaturation to see if PEP Buddy, a small oral positive expiratory pressure (PEP) device that generates 4 cm H2O to 10 cm H2O of expiratory pressure, could improve exertional dyspnea, desaturation and quality of life.
Through the Shortness of Breath Questionnaire (SOBQ; score range 1 to 100, lower is better), researchers found out baseline dyspnea (52.8 ± 25), and through the St. George Respiratory Questionnaire (score range 1 to 100, lower is better), they found out baseline quality of life (50.1 ± 15).
To assess PEP Buddy, researchers conducted one 6MWT with PEP Buddy and one 6MWT without it, and asked patients to use the device in their daily lives for 2 weeks.
After 2 weeks, researchers obtained new dyspnea and quality of life scores, as well as the patients’ level of device use.
Following this short-term period, researchers found that seven patients had a meaningful improvement in end Borg score (a decrease of 1 or more points) on the 6MWT, 11 patients had a meaningful decline in SOBQ (a decrease of at least 5 points) and five patients had a reduction in both measures, for a total of 23 (71.8%) patients classified as “dyspnea responders.”
“While most people had meaningful improvement with PEP buddy use, there are some that did not benefit from it, so the response may be different in different people,” Zafar told Healio.
Researchers observed that those with a dyspnea response had worse FEV1 (40.4% vs. 56.5%; P = .009) and FVC (68.5% vs. 82%; P = .03) than dyspnea nonresponders, but they showed more improvement after using PEP Buddy in SOBQ (–7.37 vs. 13.55; P = .001) and quality of life scores (–4.69 vs. 1.77; P = .03) than nonresponders.
Researchers noted no differences in 6MWT distance with and without use of PEP Buddy.
In terms of exertional desaturation (nadir oxygen saturation < 88%), 14 patients had decreased oxygen levels during the 6MWT without PEP Buddy. During the 6MWT with PEP Buddy, five of these patients (35.7%) mitigated desaturation with oxygen levels close to normal levels throughout the 6MWT.
“I have never seen such a response to oxygen levels with anything other than supplemental oxygen,” Zafar told Healio.
Those who mitigated desaturation had higher nadir oxygen saturation with use of PEP Buddy than the nine nonresponders (91.2% vs. 82.5%; P = .002).
When assessing how often patients used the device, Zafar said some patients reported that the device led to a decreased use of other breathing aids.
“A few patients reported less use of rescue inhalers,” he said. “They would sit down and use this device when feeling out of breath first, before using inhalers.”
Other benefits of the device reported by patients included breathing training/regulation, ease of use, pre-exertional use, faster recovery after exertion and less anxiety.
However, patients did report some limitations, such as restrictive pressure on peak exertion, saliva buildup and difficulty getting comfortable with the device.
Future studies will cover more factors over a longer period of time, Zafar told Healio.
“In the next steps, we would like to explore the long-term effects of PEP buddy on symptoms and quality of life for people with COPD, and its impact on emergency room visit rates, use of rescue inhalers and health care cost,” he said. “PEP buddy also seems like an attractive addition to pulmonary rehabilitation programs to help enhance early outcomes and potentially sustain the benefits of pulmonary rehabilitation longer.”
Covina, March 27, 2023 (GLOBE NEWSWIRE) -- Breathing Circuits Market is expected to grow significantly in the coming years, driven by factors such as the increasing prevalence of respiratory diseases, the rising demand for critical care services, and the growing adoption of advanced anesthesia techniques. Breathing circuits are medical devices used to deliver respiratory gases from a mechanical ventilator or anesthesia machine to a patient's lungs. These circuits are essential in critical care, emergency care, and anesthesia procedures, as they provide a pathway for oxygen and anesthetic gases to reach the patient's airways. Breathing circuits typically consist of a series of flexible tubing, valves, connectors, and other components that are designed to deliver gas to the patient while also allowing for the removal of carbon dioxide. They may be disposable or reusable, depending on the specific application and medical setting.
Breathing Circuits Market Insights from the report:
Breathing Circuit Market accounted for US$ 1.3 billion in 2022 and is estimated to be US$ 2.0 billion by 2032 and is anticipated to register a CAGR of 4.3%. The Breathing CircuitMarket is segmented based on Type, Application, End-Users and Region.
Based on Type, Breathing Circuit Market is segmented into Closed Breathing Circuits, Semi-Open Breathing Circuits, and Semi-Closed Breathing Circuits.
Based on Application, Breathing Circuit Market is segmented into Respiratory Dysfunction, Anesthesia.
Based on End-Users, Breathing Circuit Market is segmented into Hospitals, Clinics, Ambulatory Surgical Centers, and others.
By Region, the Breathing Circuit Market is segmented into North America, Europe, Asia Pacific, Latin America, Middle East & Africa.
Analyst View: The key factor driving the growth of the breathing circuit market is increasing prevalence of pulmonary diseases, lung cancer due to rapid urbanization which has given rise in consumption of unhealthy food, use of alcohol, tobacco, cigarette smoking as a new lifestyle, lack of exercise, which has led to cause of respiratory and lung cancer diseases. Most urbanized areas are characterized by higher lung cancer mortality rate. Rising urbanization has become the major factor in growth of chronic diseases like cancer, heart disease, pulmonary disease, and others. Another factor projected to assist the target market's expansion during the forecast period is rising industrialization which cause air pollution that led to respiratory diseases like asthma, allergic rhinitis, etc. However, rising prevalence of pulmonary disease, lung cancer, rapid growth in urbanization has given rise in target market growth. Furthermore, number of new launched products, technological advancement in devices, and rising government initiatives is expected to boost the breathing circuit market growth during the forecast period. As a result, market competition is intensifying, and both big international corporations and start-ups are vying to establish position in the market.
Key players included:
C. R. Bard Inc.
Armstrong Medical Ltd.
Xplore Health Technologies Pvt. Ltd.
Fisher & Paykel Healthcare Ltd.
In November 2022, Xplore Health Technologies has launched ‘Airofit Pro’ the world’s first smart respiratory device which cost Rs. 34,990. Newly launched ‘Airofit Pro’ is the respiratory muscle training device. The new product helps in personalizing breathing training experience for users by making their respiratory muscles more efficient, stronger, and faster. The new product help in training inspiratory and expiratory muscles.
In January 2022, Armstrong Medical has launched new ‘AquaVENT VT’ state of art heated breathing technology in Middle East market. The Gulf region values new innovative clinically robust products which has given significant opportunity for Armstrong Medical to become a key player in critical care market.
The rising incidence of respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, and pneumonia is driving the demand for respiratory support devices such as breathing circuits.
The development of advanced breathing circuit technologies such as heated and humidified circuits, closed-loop systems, and integrated airway pressure sensors is driving the adoption of these devices in healthcare settings.
As healthcare providers seek to improve patient outcomes and reduce complications associated with anesthesia, there is a growing demand for advanced anesthesia techniques that require the use of breathing circuits.
COVID-19 pandemic has led to a surge in demand for respiratory support devices such as breathing circuits, particularly in the context of intensive care treatment for severe cases.
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Bicycling is one of the best ways to get fit and stay healthy. It’s a low-impact exercise that can be done by anyone at any age, and it’s not just for people who want to be professional cyclists! If you’ve ever thought about getting on your bike but weren’t sure if it was worth it, here are eight reasons why cycling is good for your health:
Although riding a bike is one of the simplest forms of exercise, it has many health benefits that can last a lifetime. Cycling is good for your respiration rate and lungs. It’s also great for burning calories, which helps to maintain or lose weight. Cycling is an excellent way to get regular physical activity without feeling like you’re exercising at all! The more active you are, the better chance you have at living a longer life with fewer diseases like diabetes or heart disease.” Cycling helps strengthen joints by increasing circulation around them so they don’t stiffen up as much when sitting still all day long (like most office jobs). Bicycling keeps bones strong by putting pressure on them while pedaling uphill–just like walking uphill does but faster! This pressure causes bone cells near surface areas where tendons attach themselves onto bone surfaces; this makes those attachments stronger so they can withstand more stress caused by running downhill later on in life when gravity takes its toll on us.”
Bike riding is good for your respiration rate and lungs. Riding a bike can help you breathe more easily. When the body is in motion, it requires more oxygen than when it’s at rest. A brisk ride on your bicycle will help increase your respiration rate and improve lung function over time. Cycling also reduces airway resistance, which means that the muscles surrounding your windpipe contract less to let air pass through them as you cycle along (1). This makes breathing easier for people who suffer from asthma or chronic obstructive pulmonary disease (COPD) because their respiratory systems are less obstructed by mucus or other debris within their bodies (2). In fact, some studies have shown that regular cycling may even prevent asthma attacks! There are many good reasons to go for a bike ride! Biking is great exercise. It can help you lose weight, reduce stress and anxiety, improve your cardiovascular health and bone density. You could also be breathing better if you regularly ride your bike instead of driving or taking public transportation. Biking has been shown to improve lung function in people with chronic obstructive pulmonary disease (COPD), according to research from the University of California San Diego School of Medicine published in the European Respiratory Journal in December 2017. Additionally, studies have shown that cycling at moderate intensity levels can improve lung capacity even further than brisk walking does–and it doesn’t require any special equipment beyond sneakers and shorts!