In fixed-dose inhaled corticosteroids (ICS) combined with long-acting beta-agonist (LABA) bronchodilators, the airway deposition patterns of the component drugs in various sections of the airway can vary widely. This was among results of a study recently published in the European Journal of Pharmaceutical Sciences.

Combination ICS-LABA drugs form the basis of current treatment for asthma and COPD. But the airway distribution of the receptors for each drug is unique, making delivery to the right receptor hit and miss. To better fine tune drug-receptor delivery, researchers based in Budapest, Hungary, attempted to compare the co-deposition patterns of 2 ICS-LABA medications with the distribution patterns of their corresponding airway receptors using numerical modelling.

The researchers chose 2 widely used combination drugs for their analysis. The first,  Symbicort Turbuhaler, contained budesonide as the ICS and formoterol fumarate dehydrate as the LABA; the second, Relvar Ellipta, contained the fluticasone furoate as the ICS combined with vilanterol (trifenatate) as the LABA. Both combination drugs offered a ready availability of data on their aerodynamic properties.

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A total of 49 patients with chronic obstructive pulmonary disease (COPD) underwent Turbuhaler testing, and 59 patients with COPD were selected for Ellipta. “The amount and size distribution of the particles emitted by [dry powder inhalers] depend on the inhalation profile of the patient,” the authors wrote. They elicited 50% inhalation profiles from airflow measurements taken as each patient inhaled the assigned medication. 

Using a stochastic lung model, the investigators calculated the deposition amount of each component drug in patient airways. They found that the ICS and LABA portions of Symbicort Turbuhaler reached their target receptors uniformly throughout the entire respiratory tract. However, the corticosteroid in Relvar Ellipta delivered its contents up to 25% better than its partner component in the large bronchi but nearly 40% worse in the deeper airways

“Better co-deposition would enhance the synergistic effects between the components, while selective deposition based on receptor distribution would lower it,” wrote the authors. But a perfect match is not an option, and only large clinical trials can uncover the most optimal resolution to the problem, the researchers said.

A key limitation of the study was variability in predicting where in the airway the drugs would be deposited, depending on the model used. To ensure that their conclusions were generalizable, the investigators repeated the simulations using another reliable model, the Multiple-Path Particle Dosimetry Model, which confirmed the trends seen in the original modelling.

“Present results highlight the need for extensive research to elucidate whether each drug component should deposit according to its receptor distribution or similar deposition distribution patterns of the components should be attained to benefit from the synergistic effects documented in the open literature,” the authors explained. “Once this aspect [is] clarified, the next step will be to tailor the aerodynamic properties of each component of combination drugs to yield the desired deposition distribution in the lungs,” they added.


Farkas Á, Horváth A, Tomisa G, et al. Do we really target the receptors? Deposition and co-deposition of ICS-LABA fixed combination drugs. Eur J Pharm Sci. Published online April 12, 2022. doi:10.1016/j.ejps.2022.106186

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Traditional Dance In Kyrgyzstan Used To Treat This Lung Disease

Kara Jorgo is Kyrgyzstan's national dance

In the country of Kyrgyzstan there is a traditional dance called Kara Jorgo which is also the country's national dance. The interesting thing about this dance is that it is used to treat people with Chronic Obstructive Pulmonary Disease, better known as COPD. COPD is a common, preventable and treatable lung disease.

The dance involve a range of body movements that help the patients with their COPD. According to The Guardian, in the beginning most patients complain of shortness of breath. Speaking to the news outlet Aidai Temiraly Kyzy, a 24 year old nurse says “Almost all patients, before doing this, complain of shortness of breath, a cough and say they have no physical aptitude…But, even on the second or third day, the improvement is noticeable. Physically, they can do more.”

She goes on to add “I've seen patients with really low mood transform and, by the end, they smile and are so grateful.”

Kyrgyzstan's health ministry has officially adopted this treatment and it is already being done in 3 hospitals. The sessions run for six weeks, with a couple of two hour sessions every week.

Prof Talant Sooronbaev who is the director of the National Centre of Cardiology and Internal Medicine, speaking to The Guardian said “When we give patients with COPD medicine and drugs, this is not a real medical service,” he says. “Pulmonary rehabilitation is an important part of treatment. This is why we have plans to extend, and why we will share our experience with neighbouring countries – Tajikistan, Uzbekistan, Kazakhstan and Turkmenistan.”

COPD often develops in one's midlife, with symptoms such as breathlessness, cough and fatigue. It can be caused by smoking, or being exposed to polluted air. If detected early it can be treated and managed.

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Adherence to guidelines for COPD in an ED setting can help patients avoid compromising their health-related quality of life.

Evidence suggests that adherence to COPD guidelines in the ED can help avoid compromising a patient’s HRQOL.

However, “challenges in the acute clinical setting include a lack of a single integrated platform, supporting infrastructure, interdisciplinary staff capacity, lack of clinician training and support for underconfident clinicians to use digital devices, and a lack of critical information at point of care,” write Hancy Issac, PhD-candidate and colleagues in the International Journal of Chronic Obstructive Pulmonary Disease.

Cultivating Consensus on COPD Management

Given these obstacles to adherence, the study team sought to cultivate a consensus of information necessary to develop an electronic integrated COPD proforma (E-ICP) that improves COPD management in the ED. This digital resource would provide staff with consistent information based on up-to-date guidelines, the ability to make referrals with ease, patient resources, and staff training opportunities.

Issac and colleagues used a modified Delphi study method that allowed targeted experts (eg, ED and respiratory clinicians) to share their opinions and experiences in order to develop an actionable consensus that could be used in the E-ICP. The process began with an extensive literature review, and then the investigators applied a mixed-method design using electronic surveys that kept participants semi-anonymous. This first convened a panel to identify interventions that should be included in the proforma. The next portion of the study aimed to find consensus among the experts regarding the interventions they identified, which required three rounds of a quantitative survey that was scored to narrow in on agreement among the experts.

The results were analyzed and consensus on a topic was “considered reached if at least 70% of the panel strongly agreed that an item should be included or excluded from the proforma,” explain Issac and team.

Agreement among the expert participants was highest (more than 80%) when it came to addressing barriers to care. General concern existed over lack of resources, lack of sufficient time to provide care, and lack of clear direction regarding the referral process. There was also a positive response to the development of the electronic proforma. Participants believed that this type of standardized digital tool could help with efficiencies and the distribution of information.

Providing Consistent COPD Guideline Adherence

The iteration of surveys also revealed that although ED and respiratory staff did not initially agree on the application of referrals when a patient presented with COPD symptoms in the ED, they did eventually agree that a respiratory nurse serving as a single point of contact would be the ideal advocate to provide consistent guideline adherence potentially avoiding readmission or compromised care.

Issac and colleagues explained that an E-ICP based on the information gleaned from their modified Delphi study has the potential to ease the referral process, reduce hospital admissions rates and lengths of stay, provide a more complete approach to care, and increase utilization of, and adherence to, up-to-date COPD guidelines (Table). “This proforma will aid to resolve major barriers of knowledge, environmental resources, and professional role clarity in the management of COPD patients in the ED,” they wrote.

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New York, May 27, 2022 (GLOBE NEWSWIRE) -- announces the release of the report "Respiratory Devices And Equipment (Diagnostic) Global Market Report 2022" -

The global respiratory devices and equipment (diagnostic) market is expected to grow from $6.36 billion in 2021 to $6.93 billion in 2022 at a compound annual growth rate (CAGR) of 9.0%. The market is expected to grow to $9.35 billion in 2026 at a compound annual growth rate (CAGR) of 7.8%.

The respiratory devices and equipment (diagnostic) market consists of sales of diagnostic respiratory devices and equipment and related services by entities (organizations, sole traders, and partnerships) that manufacture respiratory devices and equipment.Respiratory devices and equipment are used in the diagnosis of respiratory disorders such as asthma, cystic fibrosis, and chronic obstructive pulmonary disease.

Only goods and services traded between entities or sold to end consumers are included.

The main products of the respiratory devices and equipment (diagnostic) market are instruments and devices, assays, and reagents.The respiratory instruments and devices are used to diagnose respiratory disorders.

The test type included is traditional diagnostic tests, mechanical tests, imaging tests, and molecular diagnostic tests that are used to diagnose chronic obstructive pulmonary disease, lung cancer, asthma, tuberculosis, and other diseases. These are used in hospital/clinical laboratories, physician offices, reference laboratories, and other end users.

Asia Pacific was the largest region in the respiratory devices and equipment (diagnostic) market in 2021.North America was the second largest region in the respiratory devices and equipment (diagnostic) market.

Eastern Europe was the smallest region in the respiratory devices and equipment (diagnostic) market. The regions covered in this report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, and Africa.

The increasing prevalence of various respiratory diseases contributed to the global respiratory devices and equipment market growth by increasing the use of diagnostic devices and equipment for diagnosis and treatment.Diseases such as chronic obstructive pulmonary disease (COPD) are more prevalent in the geriatric population.

COPD is a type of obstructive lung disease that results in long-term breathing problems.For instance, in June 2021, according to the world health organization data, chronic obstructive pulmonary disease (COPD) is the third disease on the list of causing death in the world.

There are about 3.23 million deaths that are caused by chronic obstructive pulmonary disease (COPD) in 2019. . Thus, the increased number of such cases has surged the demand for diagnostic devices and equipment, therefore driving the market’s growth.

Stringent regulatory practices are expected to negatively impact the growth of diagnostic respiratory devices in the forecast period.In the USA, respiratory devices undergo a strict approval process as they come under Class III devices (that pose a significant risk to patients) as per the Food and Drug Administration (FDA) classification of medical devices.

These devices require clinical evidence that supports their intended use unlike, Class I and II devices, to receive marketing approval.In countries such as China, the approval process for medical devices, especially for devices used for support or sustenance, is strict and time-consuming.

Such a process has slowed the entry of medical devices into the market, thus restraining the growth.

Companies in the market are increasingly investing in portable and wireless diagnostic respiratory devices.The trend is being driven by the ease of handling, cost-effectiveness, advanced features of these devices, and their suitability for use at home care organizations.

Innovative technology-enabled portable respiratory devices are being launched into the market, which, unlike traditional devices, can be used for immediate diagnosis of vital signs, for example, the patients’ respiratory rate and the pulse rate. For instance, in 2019, the US Food and Drug Administration approved MediPines Corporation’s non-invasive portable medical device, which provides clinicians with real-time pulmonary parameters and insights to support rapid triage and treatment decisions for respiratory conditions.

In June 2020, AireHealth acquired BreathResearch for an undisclosed amount.The deal comprises the acquisition of IP, research, and patents, which include work on machine learning analytics for respiratory condition tracking.

BreathResearch is a US-based company engaged in converting the airwaves of breathing into sound waves producing new respiratory analytics which improve health, fitness, and performance.

The countries covered in the respiratory devices and equipment (diagnostic) market are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, and USA.

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Pinch-lip or pursed-lip breathing exercises, mouth breathing can help you improve breathing difficulties . Pursed-lip breathing helps you get more air in without over-breathing. Some of the effects of pursed-lip breathing are:
Releases large amounts of air trapped in your lungs; Clearing the airways makes it easier for you to breathe; Improve respiratory function; Evens out breathing due to deeper, longer breathing; Help you relax; Helps circulate air in the lungs; Reduce shortness of breath.

Pursed-lip breathing has many benefits for patients with chronic obstructive pulmonary disease (COPD). COPD causes a patient's airway to collapse. By prolonging expiration, pursed-lip breathing creates a small amount of backpressure, known as positive end-expiratory pressure (PEEP). Elastic pressure is generated by elastic contraction of the lung, chest wall (elastance) and volume of air delivered. For a given volume, elastic pressure is increased either by increased pulmonary stiffness (eg, pulmonary fibrosis) or restricted by the chest wall or diaphragm (eg, due to severe ascites or obesity).
Some studies show that pursed-lip breathing improves exercise tolerance in people with COPD. It also improves their ventilation system and increases the amount of oxygen in the blood.
Pursed-lip breathing also gives you a sense of control over your breathing. This can help prevent shortness of breath or anxiety and restlessness caused by shortness of breath.


#pursedlipbreathing #breathingexercise

Oxygen Conserving Devices Market: Overview

According to the report, the global oxygen conserving devices market was valued at ~US$ 164 Mn in 2018. It is projected to expand at a moderate CAGR during the forecast period. Oxygen therapy is considered to be a highly important tool to help save lives of patients suffering from hypoxemia and other health conditions. Oxygen conservers are used to regulate the supply of oxygen, thus saving the overuse of oxygen by offering precise amount of oxygen. Oxygen conservers are prescribed with ambulatory cylinders, which optimizes the supply for a long duration of up to three days. Pneumatic, electronic, liquid oxygen, and disposable are the various oxygen conserver devices available in the market.

Significant expansion of the oxygen conserving devices market can be attributed to investments in technology, strong product portfolio, and rise in patient pool suffering from pulmonary or non-pulmonary condition. Moreover, increase in geriatric population is another factor fueling the oxygen conserving devices market.

North America dominated the oxygen conserving devices market in 2018, and the trend is anticipated to continue during the forecast period. This can be ascribed to the rise in awareness about hypoxemia that is caused by COPD and other respiratory diseases, presence of key players, increase in patient pool, favorable reimbursement policies, and availability of new oxygen conservers for pediatric patients in the region. However, misdiagnosis or underdiagnoses and high product pricing of certain oxygen conservers are likely to hamper the oxygen conserving devices market in North America during the forecast period.

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Rise in Incidences of COPD and Other Chronic Respiratory Diseases to Drive Market

Rising incidences of chronic obstructive pulmonary disease (COPD) and other respiratory diseases globally is likely to prompt key players to develop oxygen conservers as a supplemental oxygen therapy and subsequently, save wastage of oxygen. COPD is considered to be the third-leading cause of death in the U.S., and fourth-leading cause of death across the world. According to an article published on Verywell Health, COPD affects around 11 million people in the U.S. and commonly occurs in people over the age of 40. This indication drives the need for supplemental oxygen, which is managed by the use of oxygen conserving devices.

According to the Global Burden of Disease Study, in 2016251 million cases of COPD were identified, and 3.17 million deaths were recorded due to this disease, globally. Mostly 90% of deaths by COPD occur in middle or low income countries. A major cause for COPD disease is the increase in incidence of smoking among adults across the globe. Moreover, long-term asthma is also responsible for causing the COPD disease. According to research published in Science Daily, in April 2018, China was home to a significantly large population of adult COPD patients, which is estimated to be 100 million. This number represents around 8.6% of the population of China, which indicates that the prevalence of COPD is considerably high in China.

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Increasing Geriatric Population Fuels Demand for Continuous Innovation in Oxygen Therapy

Rising geriatric population, globally, is fueling the demand for oxygen conserving devices to carry out their daily activities. The geriatric population often suffers from certain chronic respiratory diseases that hamper their mobility; hence, their dependence on oxygen therapy helps improve the quality of their life. For instance, pneumatic, electronic, and disposable oxygen conservers are available for geriatric patients and thus, fulfill the need for devices offering supplemental oxygen. Rise in the geriatric population demands better treatment options, which in turn is likely to provide opportunities to companies that operate in the oxygen conserving devices market. According to the United Nations, the geriatric population, or people above the age of 60, is expected to double by 2050, and triple by 2100. It is projected to rise from 962 million in 2017 to 2.1 billion by 2050 and reach 3.1 billion by 2100. Globally, the geriatric population is the rising at a rapid pace, as compared to the population growth rate of the younger age group.

Rising Prevalence of Chronic Bronchitis Drives Demand for Oxygen Conserving Devices

In terms of indication, the oxygen conserving devices market has been segmented into chronic bronchitis, emphysema, sleep apnea, and others. Chronic bronchitis and emphysema are two major COPD diseases that accounted for considerable deaths and these conditions drive the need for oxygen therapy across globe. Patients suffering from severe COPD require continuous supply of oxygen. According to WHO, COPD is the fourth-leading cause of death in the world, with approximately 2.75 million deaths per annum. The WHO predicts that COPD would be the third-leading cause of death by 2030. According to the CDC, over 16 million people in the U.S. are living with respiratory disorders such as lung cancer, COPD, and heart diseases, caused due to smoking.

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Oxygen Conserving Devices Market: Prominent Regions

In terms of region, the oxygen conserving devices market has been segmented into five major regions: North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. North America dominated the oxygen conserving devices market in 2018, followed by Europe. North America accounted for a major share of the oxygen conserving devices market in 2018, owing to a rise in incidence of COPD and supportive government policies. Moreover, aging baby boomers are estimated to fuel the demand for oxygen therapy, including oxygen conservers, to help them lead a comfortable life.

According to the U.S. Census Bureau, all baby boomers are expected to be older than the age of 65 by the year 2030. Technological advancements and reliable reimbursement policies in the U.S. for oxygen therapy devices helps patients to access these devices. Moreover, presence of key players in the region and a strong product portfolio of supplemental oxygen therapy are projected to drive the market in the region.

The oxygen conserving devices market in Asia Pacific is projected to expand at a notable CAGR from 2019 to 2027. This can be attributed to an increase in healthcare expenditure, rapid increase in rate of adoption of devices used for oxygen therapy, and growing prevalence of chronic respiratory diseases among patient population in developing countries. Moreover, rising geriatric population in countries such as Japan, India, and China is estimated to positively impact the development of innovative oxygen conserver devices in these countries. Furthermore, strong medical devices supply chain in countries such as India, Japan, and China is driving the oxygen conserving devices market in the region.

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Development of Innovative Disposable Oxygen Conservers Offers Significant Growth Opportunities

The oxygen conserving devices market is fragmented, in terms of number of players. Key as well as local players have been offering various oxygen conserving devices, including pneumatic, liquid oxygen, and disposable types in the market for the past few years. Key players operating in the oxygen conserving devices market include Inogen Inc., GCE Group, Precision Medical Inc., Drive DeVilbiss International, Medline Industries, Inc., GF health Products, Inc., Inovo, Inc., Essex Industries, and Krober Medizintechnik. These players have adopted various strategies, such as investments toward the development of oxygen conserving devices, which include disposable oxygen conservers, electronic oxygen conservers, and strengthening their distribution network and product portfolio.

Companies such as Drive Devilbliss Healthcare have introduced disposable oxygen conservers, such as Oxymizer disposable oxygen conserver, which provides and saves oxygen in 4:1 ratio, as compared to that offered by other continuous flow oxygen therapy devices.

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We identified 11 RCTs (10 double-blind and 1 single-blind) with a total 762 participants. The mean age of participants ranged from 62 to 76 years. Trials were single- or two-centre trials conducted in Iran, New Zealand, Nepal, Turkey, the UK, Tunisia and the USA between 2004 and 2018. We judged studies to be at low or unclear risk of bias for most of the domains. Three studies were at high risk for blinding and other biases. 

Intravenous magnesium sulfate versus placebo

Seven studies (24 to 77 participants) were included. Fewer people may require hospital admission with magnesium infusion compared to placebo (odds ratio (OR) 0.45, 95% CI 0.23 to 0.88; number needed to treat for an additional beneficial outcome (NNTB) = 7; 3 studies, 170 participants; low-certainty evidence). Intravenous magnesium may result in little to no difference in the requirement for non-invasive ventilation (OR 0.74, 95% CI 0.31 to 1.75; very low-certainty evidence). There were no reported cases of endotracheal intubation (2 studies, 107 participants) or serious adverse events (1 study, 77 participants) in either group. Included studies did not report intensive care unit (ICU) admission or deaths. Magnesium infusion may reduce the length of hospital stay by a mean difference (MD) of 2.7 days (95% CI 4.73 days to 0.66 days; 2 studies, 54 participants; low-certainty evidence) and improve dyspnoea score by a standardised mean difference of -1.40 (95% CI -1.83 to -0.96; 2 studies, 101 participants; low-certainty evidence). We were uncertain about the effect of magnesium infusion on improving lung function or oxygen saturation. For all adverse events, the Peto OR was 0.14 (95% CI 0.02 to 1.00; 102 participants); however, the event rate was too low to reach a robust conclusion. 

Nebulised magnesium sulfate versus placebo

Three studies (20 to 172 participants) were included. Magnesium inhalation may have little to no impact on hospital admission (OR 0.77, 95% CI 0.21 to 2.82; very low-certainty evidence) or need for ventilatory support (NIV or mechanical ventilation) (OR 0.33, 95% CI 0.01 to 8.20; very low-certainty evidence). It may result in fewer ICU admissions compared to placebo (OR 0.39, 95% CI 0.15 to 1.00; very low-certainty evidence) and improvement in dyspnoea (MD -14.37, 95% CI -26.00 to -2.74; 1 study, 20 participants; very low-certainty evidence). There were no serious adverse events reported in either group. There was one reported death in the placebo arm in one trial, but the number of participants was too small for a conclusion. There was limited evidence about the effect of magnesium inhalation on length of hospital stay, lung function outcomes or oxygen saturation. Included studies did not report adverse events. 

Magnesium sulfate versus ipratropium bromide 

A single study with 124 participants assessed nebulised magnesium sulfate plus intravenous magnesium infusion versus nebulised ipratropium plus intravenous normal saline. There was little to no difference between these groups in terms of hospital admission (OR 1.62, 95% CI 0.78 to 3.37), endotracheal intubation (OR 1.69, 95% CI 0.61 to 4.71) and length of hospital stay (MD 1.10 days, 95% CI -0.22 to 2.42), all with very low-certainty evidence. There were no data available for non-invasive ventilation, ICU admission and serious adverse events. Adverse events were not reported. 

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Liquid Clenbuterol is a powerful and effective weight loss supplement that has been used by bodybuilders and athletes to help them lose weight. It is also used to treat breathing disorders such as asthma and chronic obstructive pulmonary disease. Clenbuterol has been used by many bodybuilders and athletes to help them lose weight. You can clenbuterol buy in online stores. It is also used to treat breathing disorders such as asthma and chronic obstructive pulmonary disease.

Clenbuterol is manufactured in the form of a tablet that is taken orally, often before exercise. The main ingredient found in Clenbuterol is called clenbuterol hydrochloride. This substance activates the cells in your body that are responsible for burning fat, which leads to weight loss. In addition, it can help with breathing problems by relaxing the muscles in your airways and opening up airways passages. Liquid Clenbuterol is not a steroid or anabolic agent. Instead, it is a thermogenic blend that burns body fat in order to generate heat and energy.

What is Liquid Clenbuterol and How is it Used?

Liquid Clenbuterol is a dietary supplement that has been designed to help people lose weight and get in shape. It is also called liquid clean, liquid clenbuterol, or clean. Liquid clenbuterol comes in the form of a liquid that is taken orally. It is an alternative to the pill form of this supplement that can be hard to swallow for some people.

Liquid Clenbuterol has been used by athletes and bodybuilders for many years to improve their performance and appearance, but it has also become popular among those who are looking for a way to lose weight quickly. You can buy the best clenbuterol from an online store. You can also consult a trainer or a doctor to decide on what can be your regular dose.

What are the Benefits of Liquid Clen?

Liquid Clen is a natural supplement that aids in weight loss by boosting the metabolism and suppressing appetite. Liquid Clen is a natural supplement that aids in weight loss by boosting the metabolism and suppressing appetite. It helps to reduce body fat, maintain muscle mass, and improve general health. Liquid Clen helps to reduce body fat, maintain muscle mass, and improve general health. It also contains ingredients that are proven to help with weight loss such as green tea extract and CLA (conjugated linoleic acid).  Liquid Clen is a natural supplement that aids in weight loss by boosting the metabolism and suppressing appetite. It helps to reduce body fat, maintain muscle mass, and improve general health.

 It helps to reduce body fat, maintain muscle mass, and improve general health. It also contains ingredients that are proven to help with weight loss such as green tea extract and CLA (conjugated linoleic acid).

Some of the effects of liquid clenbuterol include:

  • Increased calorie burning rates to help people lose weight 
  • Improved energy levels due to increased metabolism and improved fat oxidation. rates 
  • Increase in oxygen transport and use within the body
  • Enhanced muscle building, Clenbuterol can be administered via inhalation or intravenously. Inhalation is thought to be more effective, due to the drug being able to be absorbed into the bloodstream faster. 
  • Increased endurance and reduced muscle fatigue
  • Improved recovery time 
  • Reduced performance anxiety
  • Enhanced focus, concentration, and alertness

Conclusion: Final Thoughts on the Best Way to Use Liquid Clen Buterol In The Future

Some people have been using liquid clenbuterol for weight loss purposes. It can be hard to lose weight because of the lack of time and motivation, but this supplement can help you with both of these things. Liquid clenbuterol can also help you build muscle mass and reduce fat deposits in your body. The best way to use liquid clenbuterol is by taking one or two doses per day with breakfast or lunch, and then before you work out at night.

There are many ways that you can use Liquid Clenbuterol in the future. It’s important to take care of what you put into your body and make sure that you are using it responsibly. 

The best way to use liquid clenbuterol in the future is to use it as a supplement for weight loss. It will help you get rid of the excess fat and tone your body. The only downside is that it can’t be used for long periods of time because it can cause side effects. 

Liquid clenbuterol will give you some of the same benefits as the injectable and pills. It might be best to use it when you don’t have time to do a lot of exercise. It sounds like liquid clenbuterol is a good option for you! Based on your symptoms, you should use liquid clenbuterol to help your breathing. It will also help you burn more fat and have a happier overall life.

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What Is Trelegy Ellipta?

Trelegy Ellipta (fluticasone, umeclidinium, and vilanterol) is an inhaled prescription drug used for the maintenance treatment of adults with asthma or chronic obstructive pulmonary disease (COPD). Maintenance treatment helps to prevent and control symptoms. COPD is a chronic lung disease that includes chronic bronchitis, emphysema, or both.

Trelegy Ellipta contains three drugs. Fluticasone is an inhaled corticosteroid. Umeclidinium is in a drug class called anticholinergics. Vilanterol is in a drug class called long-acting beta-agonists (LABAs). These three ingredients in Trelegy Ellipta work together to relax and open air passages in the lungs, making it easier to breathe.

Trelegy Ellipta is available as an inhaler. 

Drug Facts

Generic Name: Fluticasone, umeclidinium, and vilanterol

Brand Name: Trelegy Ellipta

Drug Availability: Prescription

Therapeutic Classification: Corticosteroid; anticholinergic; LABA

Available Generically: No

Controlled Substance: N/A

Administration Route: Inhalation

Active Ingredient: Fluticasone, umeclidinium, and vilanterol

Dosage Form: Powder for inhalation

What Is Trelegy Ellipta Used For?

The Food and Drug Administration (FDA) approved Trelegy Ellipta for adults (18 years and older) for the maintenance treatment of:

Trelegy Ellipta is not approved for children and does not treat acute bronchospasm (narrowing of the airways, which can cause wheezing and difficulty breathing).

How to Take Trelegy Ellipta

While using this medication, read the prescription label and information leaflet that comes with it. Trelegy Ellipta is administered with an inhaler. Consult your healthcare provider if you have any questions about using the inhaler.

If you are prescribed Trelegy Ellipta, remember the following:

  • Take your medication once a day, at the same time every day. 
  • Rinse with water and spit (do not swallow the water) after using Trelegy Ellipta to help prevent yeast infection in the mouth.
  • Do not take Trelegy Ellipta more than once in 24 hours. 
  • Discard Trelegy Ellipta six weeks after removing it from the foil pouch or if the dose indicator reaches zero (whichever comes first). Write the day you opened the pouch on the label on the inhaler.

It is important to take this medication exactly as prescribed. Trelegy Ellipta is not a rescue inhaler. Use your rescue inhaler for asthma or bronchospasm attacks. 

Call your healthcare provider if you are sick, feeling stressed, or are planning to have surgery. Get medical help if your breathing problems worsen or if it seems like your medicines are not working as well as before. Your healthcare provider will tell you what tests you need, such as vision and bone mineral density. 

Ask your healthcare provider if you have any questions or concerns.


Store Trelegy Ellipta at room temperature (between 68 and 77 degrees Fahrenheit) and away from heat, direct light, and moisture. Keep this medication in its sealed foil package until ready to use. Throw away the inhaler device six weeks after taking it out of the foil pouch or when the dose indicator is zero, whichever comes first.

Keep this medication out of reach and out of sight of children and pets.

How Long Does Trelegy Ellipta Take to Work?

Trelegy Ellipta may start working after the first dose, but it is essential to take it daily to prevent and control symptoms. It may take a few weeks to feel the full effect of Trelegy Ellipta.

What Are the Side Effects of Trelegy Ellipta?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at or 800-FDA-1088.

Common Side Effects

The most common side effects of Trelegy Ellipta are:

  • Yeast (fungal) infection of the mouth, throat, and/or esophagus
  • Upper respiratory infection (URI) symptoms (e.g., runny or stuffy nose, sore throat, cough)
  • Headache
  • Back or joint pain
  • Altered taste 
  • Mouth sores 
  • Hoarse voice
  • Stomach problems (e.g., nausea, vomiting, constipation, diarrhea)
  • Urinary tract infection (UTI)

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Pneumonia (when Trelegy Ellipta is used for COPD): Call your provider if you have a fever, chills, cough with mucus, or shortness of breath
  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing, and require emergency medical attention. 
  • Weakened immune system and increased chance of getting infections
  • Osteoporosis (bone thinning or weakness, which can lead to fractures)
  • Nervous system reactions, including tremors and nervousness
  • Changes in blood test values
  • Urinary retention
  • Effects on the heart, including chest pain, increased blood pressure, arrhythmia (irregular heartbeat), cardiac arrest (sudden loss of heart function, breathing, and consciousness)
  • Paradoxical bronchospasm (unexpected airway tightening after using the inhaler)
  • Worsening of asthma
  • Low levels of potassium in the blood (call your provider if you have leg cramps, constipation, chest fluttering, muscle weakness, irregular heartbeat, or numbness and tingling)
  • High levels of blood sugar (call your provider if you have increased thirst and urination)
  • Eosinophilia (high levels of eosinophils, a type of white blood cell)
  • Churg-Strauss syndrome (blood vessel inflammation)
  • Eye problems (including glaucoma and cataracts in COPD patients)

Long-Term Side Effects

While many people tolerate Trelegy Ellipta well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:

  • Back pain 
  • Taste disorder
  • Reflux
  • Muscle cramps
  • Anxiety 
  • Mouth pain

Moderate long-term side effects can include:

Severe long-term side effects may include: 

  • Bone fractures
  • Heart attack
  • Asthma-related death
  • Churg-Strauss syndrome
  • Vasculitis (blood vessel inflammation)
  • Increased pressure in the eye

Report Side Effects

Trelegy Ellipta may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Trelegy Ellipta Should I Take?

Drug Content Provided and Reviewed by

IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For inhalation dosage form (powder):

    • For treatment of asthma:

      • Adults—One inhalation once a day. Each inhalation contains 100 or 200 micrograms (mcg) of fluticasone, 62.5 mcg of umeclidinium, and 25 mcg of vilanterol.
      • Children—Use is not recommended.
    • For treatment and prevention of worsening attacks of COPD:

      • Adults—One inhalation once a day. Each inhalation contains 100 micrograms (mcg) of fluticasone, 62.5 mcg of umeclidinium, and 25 mcg of vilanterol.
      • Children—Use is not recommended.


You may need to use caution when taking Trelegy Ellipta if you are 65 years or older or have moderate to severe liver problems. Consult your healthcare provider.

If you are pregnant, planning to become pregnant, or are breastfeeding, consult your healthcare provider.

Missed Dose

Use Trelegy Ellipta as your provider directs, and do not skip doses. Misusing Trelegy Ellipta may cause serious heart problems or death.

If you do miss a dose, take it as soon as possible. Skip the missed dose if it is almost time for the next dose. Do not take two doses together. Do not take more than one inhalation of Trelegy Ellipta in 24 hours.

Overdose: What Happens If I Take Too Much Trelegy Ellipta?

Taking too much Trelegy Ellipta can cause shakiness, chest pain, a fast heart rate, and shortness of breath.

What Happens If I Overdose on Trelegy Ellipta?

If you think you or someone else may have overdosed on Trelegy Ellipta, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Trelegy Ellipta, call 911 immediately.


Drug Content Provided and Reviewed by

IBM Micromedex®

If you will be using this medicine for a long time, it is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to check for any unwanted effects.

Tell your doctor about other medicines you are using for your asthma or COPD. Follow your doctor's instructions on how you should take your medicine.

This medicine should not be used if you are having an asthma or COPD attack, or if symptoms of an asthma or COPD attack has already started. Your doctor will prescribe another medicine for you to use in case of an acute attack. If the other medicine does not work as well, tell your doctor right away.

This medicine may increase the chance of asthma-related problems. Be sure to read about these risks in the Medication Guide and talk to your doctor or pharmacist about any questions or concerns that you have.

This medicine may increase the risk of worsening asthma, which may lead to hospitalization, intubation, and death in patients with asthma. Talk to your doctor if you have concerns about this.

This medicine should not be used together with similar inhaled medicines such as arformoterol (Brovana®), formoterol (Foradil®, Perforomist®), indacaterol (Onbrez®), or salmeterol (Serevent®).

Your doctor may want you to carry a medical identification (ID) card stating that you are using this medicine. The card will say that you may need additional medicine during an emergency, a severe asthma or COPD attack or other illness, or unusual stress.

This medicine may weaken your immune system and increase your risk for infections. Tell your doctor about any immune system problems or infections, including tuberculosis or herpes infection in your eye. Tell your doctor right away if you have been exposed to chickenpox or measles.

This medicine may cause a fungus infection of the mouth or throat (thrush). Tell your doctor right away if you have white patches in the mouth or throat, or pain when eating or swallowing.

This medicine may increase your risk of having pneumonia. Call your doctor if you start having increased sputum (spit) production, change in sputum color, fever, chills, increased cough, or an increase in breathing problems.

Using too much of this medicine or using it for a long time may cause may increase your risk of having adrenal gland problems. Talk to your doctor if you have darkening of the skin, diarrhea, lightheadedness, dizziness, or fainting, loss of appetite, mental depression, muscle pain or weakness, nausea, skin rash, unusual tiredness or weakness, or vomiting.

This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. This may be life-threatening. Check with your doctor right away if you have coughing, or difficulty breathing after using this medicine.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

This medicine may increase your risk for heart and blood vessel problems, including changes in heart rhythm. Check with your doctor right away if you have dizziness, fainting spells, severe tiredness, chest pain, trouble with breathing, sudden or severe headache, or fast or irregular heartbeat.

This medicine may decrease bone mineral density when used for a long time. A low bone mineral density can cause weak bones or osteoporosis. If you have any questions about this, ask your doctor.

Check with your doctor right away if blurred vision, difficulty in reading, or any other change in vision occurs during or after treatment. Your doctor may want your eyes be checked by an ophthalmologist (eye doctor).

This medicine may affect blood sugar and potassium levels. If you have heart disease or diabetes and notice a change in the results of your blood or urine sugar or potassium tests, check with your doctor.

This medicine may cause a slowed growth in children. Talk with your doctor if you have any concerns about this.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Trelegy Ellipta?

Trelegy Ellipta is not appropriate for everyone.

There are certain reasons that you should not take this medication, such as:

  • If you are allergic to fluticasone, umeclidinium, vilanterol, or any of the inactive ingredients in Trelegy Ellipta
  • If you are allergic to milk protein
  • To attempt to treat an acute attack or a worsening of asthma or COPD
  • If you are taking any other drug that contains an anticholinergic or a LABA

Trelegy Ellipta may be prescribed with caution in some people only if the healthcare provider determines it is safe, including in people who have taken a drug called a monoamine oxidase inhibitor (MAOI) or tricyclic antidepressant within 14 days. This also includes people with:

What Other Medications May Interact With Trelegy Ellipta?

Tell your healthcare provider about the medications you take, including prescription and over-the-counter (OTC) drugs and vitamins or supplements.

Drug interaction studies have not been explicitly done with Trelegy Ellipta, so the available information is for each component—fluticasone, umeclidinium, and vilanterol.

Monoamine oxidase inhibitors should never be taken with Trelegy Ellipta. An MAOI combined with Trelegy Ellipta can cause high blood pressure and heart problems. Examples of MAOIs are:

  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Parnate (tranylcypromine)

Tricyclic antidepressants combined with Trelegy Ellipta can also increase blood pressure and cause heart problems. Examples of TCAs include:

  • Elavil (amitriptyline)
  • Pamelor (nortriptyline)

Beta-blockers should generally not be taken with Trelegy Ellipta (or may be used with caution in some instances) because the combination can lower the efficacy of both drugs. Examples of beta-blockers include:

  • Coreg (carvedilol)
  • Inderal (propranolol)
  • Lopressor, Toprol XL (metoprolol)
  • Tenormin (atenolol)

Other drug interactions may occur with Trelegy Ellipta. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Trelegy Ellipta contains three drugs: a steroid, an anticholinergic drug, and a LABA. It can be used for the maintenance treatment of COPD or asthma.

Breztri Aerosphere is an inhaler that also contains a drug from each of these categories. It contains budesonide (a steroid), glycopyrrolate (an anticholinergic), and formoterol fumarate (a LABA). Breztri Aerosphere is approved for the maintenance treatment of COPD, but it is not approved for asthma.

There are other combination inhaled drugs that contain a steroid and a LABA. Some examples include:

  • Advair Diskus (fluticasone and salmeterol)
  • Breo (fluticasone and vilanterol)
  • Dulera (mometasone and formoterol)
  • Symbicort (budesonide and formoterol)

Inhaled corticosteroid inhalers are available as single-ingredient products as well. Some examples include:

  • Alvesco (ciclesonide)
  • Asmanex (mometasone)
  • Flovent HFA (fluticasone)
  • Pulmicort Flexhaler (budesonide)
  • Qvar RediHaler (beclomethasone-diproprionate HFA)

LABAs are also available as single-ingredient products but should never be taken alone. LABAs should always be taken with an inhaled steroid, as taking them without a steroid can increase the risk of death. This can be done as two individual products or as a combination product. Serevent (salmeterol) is an example of a LABA. 

There are also a variety of other drugs that may be prescribed for asthma or COPD maintenance, such as oral medications like Singulair (montelukast). Biologics, which are injected, are sometimes used in patients with difficult-to-control asthma.

This is a list of drugs also prescribed for asthma and COPD. It is not a list of drugs recommended to take with Trelegy Ellipta. Ask your pharmacist or a healthcare practitioner if you have questions.

Frequently Asked Questions

  • What is Trelegy Ellipta used for?

    Trelegy Ellipta is used in adults 18 years and older for maintenance treatment of COPD or asthma. Trelegy Ellipta does not treat an acute attack.

  • How does Trelegy Ellipta work?

    Trelegy Ellipta contains three drugs: fluticasone (a steroid), umeclidinium (an anticholinergic), and vilanterol (a long-acting beta-agonist). These ingredients help to relax and open the lungs, making it easier to breathe. 

  • What drugs should not be taken with Trelegy Ellipta?

    Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants are some examples of drug classes that should not be mixed with Trelegy Ellipta. Beta-blockers generally should not be prescribed with Trelegy Ellipta, but in some cases, a beta-blocker may be used with caution if needed. There are other potential drug interactions as well. Tell your healthcare provider about all of the medications you take before taking Trelegy Ellipta. This includes prescription and OTC drugs as well as vitamins and supplements.

  • How long does it take for Trelegy Ellipta to work?

    Trelegy Ellipta may start to work after the first dose. However, it is important to take Trelegy Ellipta every day to prevent and control symptoms. The full effect may take a few weeks of treatment to be seen.

  • What are the side effects of Trelegy Ellipta?

    The most common side effects of Trelegy Ellipta are cold and flu symptoms, headache, back pain, joint pain, altered taste, mouth sores, hoarseness, urinary tract infection, nausea, vomiting, constipation, diarrhea, and yeast infection of the mouth, throat, and/or esophagus. Other side effects can occur.

  • How do I stop taking Trelegy Ellipta?

    Your healthcare provider will advise you on how long to take Trelegy Ellipta. Do not stop taking the medication without guidance from your provider. Trelegy Ellipta should not be stopped abruptly.

How Can I Stay Healthy While Taking Trelegy Ellipta?

Before taking Trelegy Ellipta, discuss your medical history and all medication you take with your healthcare provider. When taking Trelegy, follow your healthcare provider’s instructions for use. Read the patient information leaflet that comes with your prescription and ask your provider if you have any questions about the drug or how to use the inhaler.

Trelegy Ellipta must be taken once daily, every day, to help prevent and control symptoms. Each time you use Trelegy Ellipta, rinse your mouth with water and spit it out. This will help prevent a fungal infection of the mouth. 

Trelegy Ellipta cannot be used to treat an acute attack. Your rescue inhaler is fast-acting and should be used to treat symptoms of an acute asthma attack or bronchospasm. Common rescue inhalers include ProAir HFA (albuterol), Proventil HFA (albuterol), Ventolin HFA (albuterol), and Xopenex HFA (levalbuterol). If you notice you are using your rescue inhaler more frequently than usual, or feel like it is not working as well as it used to, contact your healthcare provider. 

Always carry your rescue inhaler with you. It can be helpful to have an extra rescue inhaler for work or school. Check the dose counter frequently to make sure your inhaler has enough remaining doses, and always call in your refills a few days early. This will allow extra time in case the pharmacy staff needs to contact your provider for refills, or if the inhaler has to be ordered. Check expiration dates periodically, to make sure your rescue inhaler is not expired.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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COVID-19 is a respiratory infection. It can cause difficulty breathing and can lead to low levels of oxygen in your bloodstream. Low levels of oxygen make it impossible for your body to function normally and can be life threatening.

Monitoring blood oxygen levels at home is one way to keep an eye on your COVID-19 infection and recovery. You can measure your blood oxygen levels with an inexpensive and easy-to-use device called a pulse oximeter.

A pulse oximeter gives you your blood oxygen level as a simple percentage. Any pulse oximeter reading of lower than 90 percent is a sign you need to seek urgent medical care.

Your blood oxygen level is a measure of the amount of oxygen in your blood.

Your body gets oxygen when you breathe in. As air passes through your lungs, oxygen moves into your bloodstream. When your lungs are inflamed due to a severe infection like COVID-19, you may take in less oxygen with each breath.

You need the right level of oxygen in your bloodstream for your body to perform essential functions, like keeping your heart beating. The oxygen in your blood also helps your cells create energy. That energy enables you to think, move, and carry out other daily tasks.

Blood oxygen levels are measured as a percentage. Levels that are closer to 100 percent are best and mean that your body has enough oxygen.

For most people, an oxygen level of 95 percent or higher is ‌standard and healthy.

Some people with chronic lung conditions like chronic obstructive pulmonary disease (COPD) live with lower-than-average blood oxygen levels.

If you have a lung condition, you should call your doctor as soon as you test positive for COVID-19. Your doctor can advise you on how to monitor and treat your condition during the infection.

If you’re monitoring your blood oxygen at home with a pulse oximeter, follow these general guidelines:

  • Contact a doctor if your blood oxygen level falls below 95 percent
  • Seek emergency medical care if your blood oxygen level falls below 90 percent.

A pulse oximeter (pulse ox) is a device that can measure your blood oxygen level quickly and noninvasively. They’re regularly used in doctor’s offices and hospitals, so you’ve most likely had one clipped on your finger before.

During a respiratory illness like COVID-19, your doctor might recommend that you use a pulse oximeter at home to keep track of your blood oxygen levels.

Blood oxygen levels can sometimes drop dangerously low without causing symptoms like shortness of breath. In these instances, a pulse oximeter can help detect low oxygen levels early on, when they can be treated with supplemental oxygen.

Overall, pulse oximeters can be a helpful tool for people with COVID-19. You can buy a pulse oximeter at most drug and grocery stores without a prescription.

Pulse ox readings in people with darker skin

Pulse oximeter readings aren’t perfect. Readings can sometimes be inaccurate, especially in people with darker skin. Because they work by passing a beam of light through your finger, skin tone can affect the results.

Studies have found that in people who self-identify as Black, pulse ox readings are often several points higher than their true values, which can be measured with a blood test called an arterial blood gas.

One study found that Black people were more than three times more likely than white people to have a pulse oximetry reading higher than the true value.

To get more reliable data on blood oxygen levels in people with darker skin, it’s best to take regular readings throughout the day and to keep a record. That way, you’ll notice any downward trends.

Low blood oxygen can affect how your body functions. It can cause severe symptoms, but sometimes it causes no symptoms at all. Either way, it can be life threatening.

Symptoms of a low blood oxygen level include:

The primary treatment for low oxygen levels is oxygen therapy. Oxygen therapy gets oxygen into your bloodstream and helps take the pressure off your lungs so that you recover from COVID-19.

There are a few ways to receive oxygen therapy. In most cases, you’ll receive extra oxygen through a nasal cannula.

A nasal cannula is plastic tubing that sits in your nose. Oxygen from a tank goes into the tubing and then into your body. Doctors and respiratory therapists can adjust the amount of oxygen you receive until your blood oxygen levels return to normal.

As you start to recover, they can slowly reduce the amount of oxygen you receive through the tubing.

If you need more support, you might receive oxygen therapy through a process called intubation. This involves putting plastic tubing directly into your trachea, or windpipe.

Intubation helps keep your airways open so that oxygen can get to your body. The tubing can then be connected to an oxygen supply. As you recover, you’ll transition from intubation to a nasal cannula and tank oxygen.

In some cases, you might be discharged from the hospital with portable oxygen, home oxygen tanks, and a nasal cannula.

In other cases, your treatment team might want you to be breathing entirely on your own and achieving healthy blood oxygen levels before discharge. Your goals will depend on factors such as:

  • your overall health
  • your age
  • any existing lung conditions
  • whether COVID-19 has damaged your lungs

You can take steps at home to help keep your oxygen levels up.

Your treatment team might have given you specific instructions, especially if you were sent home with oxygen. It’s important to follow any instructions you were given by your doctor or respiratory therapist.

Steps you can take on your own include:

  • Stop smoking, if you smoke. Smoking reduces the amount of oxygen circulating in your body.
  • Adjust your sleeping position. It’s best to avoid sleeping flat on your back. Instead, try sleeping on your side. You can also sleep on your stomach with pillows propped under your neck, chest, thighs, and chin.
  • Try pursed-lip breathing. Pursing your lips like you’re about to whistle and breathing deeply is a great way to reduce shortness of breath and increase blood oxygen levels.
  • Adjust how you sit. Try sitting up straight with a pillow behind your back when you’re on a couch or chair to help your lungs get more oxygen.
  • Get plenty of fresh air. Spend time outdoors or keep your windows open to ensure you’re getting fresh air.
  • Go for a walk. Short walks can increase your circulation and blood oxygen level.

COVID-19 is a respiratory infection that can lead to dangerously low blood oxygen levels. This is a medical emergency that requires immediate care. A pulse oximeter can help you monitor your blood oxygen levels at home.

The best use of a pulse oximeter as an indicator of when to call a doctor or seek emergency care. For most people, any reading of lower than 95 percent is a sign to call a doctor.

However, it’s important for everyone to seek urgent care if their blood oxygen level drops below 90 percent.

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ATLANTA--()--Altesa BioSciences, Inc. (Altesa), a clinical-stage biopharmaceutical company developing and commercializing novel antiviral drugs against common respiratory viruses and global viral threats, has U.S. Food & Drug Administration approval to proceed with a clinical study of a promising antiviral treatment, vapendavir. Accordingly, Altesa will initiate this trial and a series of others later this year and early next year, respectively.

Brett P. Giroir, MD, Altesa Chief Executive Officer and former United States Assistant Secretary for Health, announced the news today at the 2022 AdvanSE Life Science Conference in Atlanta.

“The green light from the FDA in response to our investigational new drug application (IND) is a significant step forward as we continue the clinical development of vapendavir, a Phase 2 oral antiviral drug,” Dr. Giroir said. “We believe vapendavir is well poised to mitigate the serious consequences resulting from viral respiratory infections in vulnerable populations. We are committed to evaluating its safety and effectiveness for patients in need.”

The broad spectrum viral capsid inhibitor, vapendavir, is Altesa’s lead clinical stage antiviral drug, which was in-licensed in 2021. Based on prior evaluations in nearly 700 trial participants and patients, vapendavir was well tolerated and showed clear evidence of an antiviral response.

Andrea True Kelly, PhD, Altesa’s Vice President of Clinical Development and Medical Affairs (formerly with Trimeris and Istari), said Altesa will initiate a clinical study this year to evaluate a new formulation of vapendavir. The study will be rapidly followed by Phase 2b clinical trials in 2023 to treat viral infections in vulnerable patients living with chronic obstructive pulmonary disease (COPD).

“Our goal at Altesa is to provide simple, safe, and effective treatments, especially for those at greatest risk from the most common viral respiratory infections,” Dr. Kelly said. “We look forward to finalizing our development partners and initiating trials for this promising therapy in the coming months.”

Over 16 million Americans suffer from COPD, the 4th leading cause of mortality in the U.S., which is anticipated to account for over $800 billion in direct medical expenditures from 2019 through 2038. Rhinoviruses, typically responsible for the common cold, are one of the viruses most commonly associated with serious disease exacerbation in patients suffering from COPD. In healthy individuals, rhinoviruses generally cause self-limiting upper respiratory tract infections, but in people with COPD, infection is readily associated with persistent lung inflammation, airflow obstruction and frequently with secondary bacterial infections, all of which can be life-threatening. By targeting rhinovirus, vapendavir holds great promise to reduce the severity of – or possibly prevent – exacerbations in infected patients with COPD.

About Altesa

Altesa BioSciences, Inc., is a biopharmaceutical company based in Atlanta, GA focused on developing antivirals to addresses diseases of global importance. Altesa has a preferred partnership with Emory DRIVE, a wholly-owned, not-for-profit drug discovery entity within Emory University. That collaboration includes a license to ALT-2023, a broadly active nucleoside analogue that is IND-enabled, as well as options to additional compounds targeting RNA viruses. In 2021, Altesa in-licensed vapendavir, a Phase 2 antiviral, broadly active against enteroviruses, including rhinovirus, from Vaxart. Altesa intends to progress vapendavir into a Phase 2b trial in the coming months for treatment of rhinoviral infection in vulnerable people suffering from chronic obstructive pulmonary disease (COPD).

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One of the UK’s leading clinical trials organisations, MAC Clinical Research, is searching for paid volunteers to take part in a trial testing a new, potentially life-changing treatment for those with COPD.

In the UK it’s estimated that an astounding three million people have Chronic Obstructive Pulmonary Disease (COPD), two million of which don’t even realise they have it – living with recurring, undiagnosed symptoms.

Dr Abimbola Babajide, Primary Investigator at MAC Clinical Research said: “It’s essential we raise awareness of COPD and potential new treatments, to support both those living with diagnosed and undiagnosed COPD.

For those living with COPD, day-to-day life can be tough. The disease causes swelling and destruction of the lungs, resulting in intolerable symptoms such as a persistent chesty cough, shortness of breath, and sputum production.

Even more, COPD is generally a progressive disease that gets worse over time and is associated with flare-ups or exacerbations. That’s why MAC Clinical Research are trialling a new study drug that may treat moderate to very severe COPD associated with elevated blood eosinophils and history of frequent exacerbation.”

The new potential treatment being trialled by MAC Clinical Research is being developed as an ad-on maintenance treatment for the prevention of exacerbations in patients with COPD– assisting the primary COPD medication already taken (triple therapy inhalers).

To be eligible to take part, volunteers must:

  • Be aged between 40 – 85 years
  • Be a current smoker or ex-smoker with a tobacco history of at least 20 cigarettes smoked per day for 10 years
  • History of moderate to very severe COPD
  • Documented history of more than 2 COPD flare-ups requiring treatment with strong steroids and/or hospitalization within the last 12 months
  • Use of triple therapy inhalers for COPD for at least 3 months immediately prior to enrolment

Volunteers will receive up to £850 in total over a 56-week period, and £50 per visit thereafter, plus travel expenses. Participants will also receive a full health screening, with all results being sent to their physician or GP.

To find out more, and help discover potentially life-changing new treatments, visit:

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MISSION, KS / ACCESSWIRE / May 26, 2022 / (Family Features) Chances are you know someone who takes care of a sick parent or spouse. You may even know someone who cares for a person with COPD, or chronic obstructive pulmonary disease. COPD is a lung disease that makes it hard to breathe and gets worse over time. Like other diseases, it often affects more than the person living with it. COPD can affect the whole family.

Family Features, Thursday, May 26, 2022, Press release picture

Joel Africk found this out firsthand.

“I watched my mother serve as the main caregiver for my father with COPD,” said Africk, president of Respiratory Health Association (RHA). “The follow-up appointments, the coordination of his care with his care team, the supervised exercise – my mother juggled it all. She was the driving force in my dad’s care.”

Luckily, because of the work he does, Africk said, “I was able to put our kitchen table conversations in front of a dedicated team of patients, caregivers and providers, and ‘The COPD Caregiver’s Toolkit’ was created. We worked to simplify some of the most complicated parts of being a COPD caregiver and provide resources to help.”

Caregivers who feel confident about what to do often provide better care for their loved ones. “The COPD Caregiver’s Toolkit” offers advice on a variety of topics for patients and caregivers, including how to prepare for doctors’ appointments, navigate changes in home life, provide help after a COPD flare-up or hospital stay and stay mentally and physically healthy through it all.

The National Heart, Lung, and Blood Institute’s (NHLBI) Learn More Breathe Better® program recently partnered with RHA to update and make the toolkit more broadly available online. Learn More Breathe Better works to improve the lives of the millions of people living with COPD and other lung conditions. Through its educational efforts, NHLBI reaches patients, providers, researchers and now, caregivers.

According to Jim Kiley, M.D., director of NHLBI’s Division of Lung Diseases, “COPD is a complex disease that over time can become debilitating. That’s why early diagnosis, treatment and disease management are so important. It can be overwhelming for many patients and their families.”

To help with disease management challenges, “The COPD Caregiver’s Toolkit” comes with medication and vaccination tracking sheets and a list of questions to ask doctors. It also features information caregivers can use to support their own health and well-being, such as how to find support groups and backup care.

The right tools can make all the difference.

“‘The COPD Caregiver’s Toolkit’ is a valuable resource that will help clarify what caregivers need to know to help themselves and their loved ones,” Kiley said.

Find and share this free resource at

Photo courtesy of Getty Images


Michael French
[email protected]

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A leading source for high-quality food, lifestyle and home and garden content, Family Features provides readers with topically and seasonally relevant tips, takeaways, information, recipes, videos, infographics and more. Find additional articles and information at and

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New study shows associations between air pollution and respiratory health in Canada

RI-MUHC researchers demonstrate that exposure to relatively low levels of air pollution in Canada is associated with lower lung function and COPD.

Montreal, May 26, 2022 – Long-term exposure to air pollution is linked to an increased prevalence of chronic obstructive pulmonary disease (COPD), which lowers lung function and makes breathing difficult for over 2 million people in Canada, and hundreds of millions worldwide. While most studies have looked at areas with high levels of pollution, a collaborative Canadian research network led by scientists from the Research Institute of the McGill University Health Centre (RI-MUHC) decided to examine the situation in Canada. According to their research work, even exposure to low concentrations of outdoor air pollution is associated with lower lung function in adults, i.e. the ability of the lungs to exchange oxygen and carbon dioxide through breathing. Their findings also show that individuals with dysanaptic lungs – a developmental mismatch between airway and lung size – could be more susceptible to the long-term effects of air pollution on lung function and COPD. Published in the American Journal of Respiratory and Critical Care Medicinetheir study is the first to scrutinize these associations in the Canadian population.

Dr. Jean Bourbeau
Dr. Jean Bourbeau

“Few studies have examined the relationship between air pollution and the lung health of adults in areas where air pollution concentrations are low, such as in Canada,” says Dr. Jean Bourbeau senior scientist in the Translational Research in Respiratory Diseases Program (RESP) at the RI-MUHC, professor in the Department of Medicine at McGill University and senior author on this publication. “Our study shows that even in this setting, long-term exposure to outdoor air pollution has significant negative impacts on lung function. We saw that small increases in fine particulate matter and nitrogen dioxide air pollution led to clinically relevant decreases in lung function.”

Lung structure, air pollution and COPD

Dany Doiron, PhD
Dany Doiron, PhD

The team of researchers did not stop at examining how air pollution affects lung health in the Canadian population. They also assessed how an individual’s susceptibility to lung problems may be impacted by the structure of their lungs. They found that individuals with smaller airways had lower lung function and were 87 per cent more likely to develop COPD compared to people with larger airways with similar exposure to air pollution.

“For the first time, common differences in lung structure that arise early in life were shown to increase susceptibility to the harmful effects of air pollution later in life,” says study author Dany Doiron, PhD, a Research Associate at the RI-MUHC.

Dr. Benjamin Smith
Dr. Benjamin Smith

“Our results suggest that a relatively important proportion of the Canadian population is particularly susceptible to inhaled air pollutants,” adds co-author of the study Dr. Benjamin Smith, a scientist in the Translational Research in Respiratory Diseases Program (RESP) at the RI-MUHC and an associate professor in the Department of Medicine at McGill University. “While exposure to air pollution during childhood has been shown to adversely affect lung function and lung development, our study suggests that early-life lung development could in turn play a key role in protecting from, or increasing susceptibility to, air pollution-induced reductions in lung function and COPD in adulthood.”

Understanding risk factors for COPD

Chronic obstructive pulmonary disease (COPD) is a major cause of hospitalizations in Canada and a leading cause of death. It is characterized by an inflammation and partial blockage of the airways in the lungs, making breathing difficult.

While tobacco smoke is the best-known risk factor for COPD, up to half of COPD cases worldwide are due to non-tobacco-related risk factors including occupational exposures, infectious diseases, early life events and air pollution, notably, fine particulate matter and nitrogen dioxide. Fine particulate matter is made up of small inhalable particles thirty times smaller than the width of a human hair, and it can travel deep into the respiratory tract. Key sources for fine particulate matter are industrial emissions, wildfire smoke, residential wood heating, cooking, agriculture and vehicle traffic. Nitrogen dioxide is a result of fossil fuel burning and an indicator of traffic-related air pollution. In September 2021, considering the damage air pollution inflicts on human health, the World Health Organization released new air quality guidelines, recommending significant reductions in these two kinds of pollutants.

Other recent studies have also shown that smaller airways relative to lung size are another major risk factor for COPD, even among individuals who have never smoked. However, until now, the interaction between air pollution and this condition called dysanapsis was unknown.

A cross-sectional study based on the CanCOLD study data

To perform their analysis, the study team used health data from the Canadian Cohort of Obstructive Lung Disease (CanCOLD) study co-lead by Dr. Bourbeau at the RI-MUHC and McGill University, and Dr. Wan-Cheng Tan at the University of British Columbia. CanCOLD includes 1,500 individuals aged 40 years and older from nine different Canadian cities. Ambient air pollution data was provided by the Canadian Urban Environmental Health Research Consortium (CANUE).

To measure lung function, participants in the CanCOLD study completed spirometry tests, a simple test that measures how much air can be expressed in one forced breath. CT Scans were used to determine the size of an individual’s airways relative to size of their lungs. Lifestyle and behavioural risk factors were assessed using questionnaires, and validated methods were used to estimate air pollution concentrations at each participant’s residential location. Researchers also accounted for individual factors such as age, sex, body size, socioeconomic status, tobacco use and intensity, environmental tobacco smoke and biomass smoke exposure, and respiratory medication intake.

“Our study can help inform clinical management of chronic respiratory disease by identifying individuals with increased susceptibility to air pollutants,” says Dr. Bourbeau, “Our findings emphasize that even low levels of air pollution should not be considered safe.”



About the study

Read the publication in the American Journal of Respiratory and Critical Care Medicine

The authors gratefully acknowledge support from the Canadian Institutes of Health Research (CIHR, grant # 453225) and GlaxoSmithKline (study # 213021).

The authors thank CanCOLD study participants and individuals in the CanCOLD Collaborative Research Group and the Canadian Respiratory Research Network. The authors also acknowledge the Canadian Urban Environmental Health Research Consortium (CANUE) for providing ambient air pollution data used in their study.


About the RI-MUHC

The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) – an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 450 researchers and around 1,200 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec – Santé (FRQS).

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Every day on the respiratory ward at one of Kyrgyzstan’s biggest hospitals, Aidai Temiraly Kyzy, a 24-year-old nurse, puts on the music and leads her patients in the Kara Jorgo, the national dance of the central Asian country.

This involves a range of body movements and leaves everyone smiling – but Kyzy is not doing it for fun. The session is part of a treatment programme offered to people with severe chronic obstructive pulmonary disease (COPD) – a common, preventable and treatable lung condition.

“Almost all patients, before doing this, complain of shortness of breath, a cough and say they have no physical aptitude,” she says. “But, even on the second or third day, the improvement is noticeable. Physically, they can do more.

The Kara Jorgo on stage. COPD patients dance a version of it in a Kyrgyzstan hospital.

“I’ve seen patients with really low mood transform and, by the end, they smile and are so grateful,” says Kyzy.

COPD develops from midlife onwards; symptoms include breathlessness, a chronic cough, often with phlegm, and tiredness. It is usually caused by smoking, but also by air pollution. There is no cure, and if left untreated it can lead to premature death. If detected early, it can be treated and managed.

It is one of the top three causes of death worldwide, and 90% of deaths occur in low- and middle-income countries. Globally, there are 3 million deaths a year from COPD but this number is expected to rise to 5.4 million by 2060, according to the latest report from the Global Initiative for Chronic Obstructive Lung Disease.

The National Center of Cardiology and Internal Medicine in Bishkek, Kyrgyzstan.
The National Center of Cardiology and Internal Medicine in Bishkek, Kyrgyzstan

“In Kyrgyzstan, COPD is a very serious problem,” says Prof Talant Sooronbaev, director of the National Centre of Cardiology and Internal Medicine, located in Bishkek, the capital city. Although official figures put the prevalence at between 30,000 and 40,000 cases, he cites research that suggests up to 200,000 people, out of a population of about 6.5 million, have the disease.

Quick Guide

A common condition


The human toll of non-communicable diseases (NCDs) is huge and rising. These illnesses end the lives of approximately 41 million of the 56 million people who die every year – and three quarters of them are in the developing world.

NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.

NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.

Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.

In low income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the traditional disease threats, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/ Aids combined.

A common condition is a new Guardian series reporting on NCDs in the developing world; their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.

Tracy McVeigh, editor

Thank you for your feedback.

Prof Talant Sooronbaev
Prof Talant Sooronbaev

“We have patients who don’t understand why they have a cough, or problems with breathlessness. They don’t visit health services and remain undiagnosed,” he says.

The number of sufferers is expected to rise. Sooronbaev says the country has more than 500,000 smokers, and there is widespread indoor pollution caused by people in mountainous and remote regions heating their homes with wood, dung or coal during long and harsh winters.

Sooronbaev decided to act. Treatment for COPD in many countries involves prescribing oxygen, inhalers and antibiotics, which patients have to buy. In Kyrgyzstan this can cost more than a monthly salary. Sooronbaev and his team started experimenting with pulmonary rehabilitation, a physical exercise programme designed in 2016 for people with lung conditions, as part of an EU-funded research project called Fresh Air.

Over the years, the programme has evolved, and incorporated patient feedback. Now it is being adopted by Kyrgyzstan’s health ministry, and is already in place in three hospitals and two GP surgeries. It runs for six weeks, with a couple of two-hour sessions a week. Added to lectures, dietary information and patient support groups is a regime of physical exercise incorporating elements of volleyball – which is popular in Kyrgyzstan – walking, cycling on exercise bikes, and dance. The idea is that patients can continue with what they are taught afterwards at home.

Dr Azamat Akylbekov, a pulmonologist in Bishkek, has seen the transformative effect. “I remember one woman who was 63,” he says. “She cried because she had severe shortness of breath, coughed all the time, was dependent on oxygen, and took a lot of strong antibiotics and inhalers. She was really depressed.”

She was invited to take part in the programme and the results surprised him. “Afterwards, she was like a flower – she smiled and her body language was more active. That sticks in my mind.”

Pulmonary specialist Ayzhan Taalaybekova gives a lecture as part of the patient programme.
Pulmonary specialist Ayzhan Taalaybekova gives a lecture as part of the patient programme

Tokhorbek Makeshov, 48, works at an animal market and lives in a village in the Naryn region, 190 miles (300km) from Bishkek. He noticed his health deteriorating in 2015 but thought it was just a smoker’s cough. By 2016, he was coughing up phlegm and becoming increasingly breathless. His GP referred him to hospital in Bishkek where he stayed for 10 days and was diagnosed with COPD.

The hospital later invited him to take part in the pulmonary rehabilitation programme, which at that time was still part of a research project. He says: “I didn’t believe it would work; I thought only inhalers or injections could help. But it was something new – I had nothing to lose.

“It had a massive impact. The rehab didn’t cure me; I still cough and have flare-ups [of COPD] but I’m more active. I can walk more and do more around the house. I was surprised to see that such simple exercises could improve my respiratory health. My whole outlook changed.”

Nurse Aidai Temiraly Kyzy dances the Kara Jorgo with patients
Nurse Aidai Temiraly Kyzy dances the Kara Jorgo with patients

Sooronbaev wants pulmonary rehabilitation to be available throughout the country from this year. Patients who have undergone the programme are being trained to teach others, and Sooronbaev and colleagues are due to speak at medical conferences to inform other healthcare professionals about their progress with the programme.

“When we give patients with COPD medicine and drugs, this is not a real medical service,” he says. “Pulmonary rehabilitation is an important part of treatment. This is why we have plans to extend, and why we will share our experience with neighbouring countries – Tajikistan, Uzbekistan, Kazakhstan and Turkmenistan.”

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Major players in the positive airway pressure devices market are ResMed Inc, Koninklijke Philips N. V, 3B Medical Inc, Fisher & Paykel Healthcare Limited, Drive DeVilbiss Healthcare LLC, Somnetics International Inc, Heyer Medical, Genstar Technologies, BMC Medical, and Apex Medical.

New York, May 25, 2022 (GLOBE NEWSWIRE) -- announces the release of the report "Positive Airway Pressure Devices Global Market Report 2022" -

The global positive airway pressure devices market is expected to grow from $3.23 billion in 2021 to $3.48 billion in 2022 at a compound annual growth rate (CAGR) of 7.9%. The market is expected to grow to $4.89 billion in 2026 at a compound annual growth rate (CAGR) of 8.9%.

The positive airway pressure devices market consists of sales of positive airway pressure devices by entities (organizations, sole traders, and partnerships) that manufacture positive airway pressure (PAP) devices that are used to trap air under pressure into the airway of the lungs.It is widely used in the treatment of obstructive sleep apnea (OSA), snoring, and others.

PAP devices include bands to position the mask, a pipe or tube to connect the mask to a device, and an air filter to purify the air entering the nostrils.

The main types of positive airway pressure devices are continuous positive airway pressure (CPAP), auto-titrating positive airway pressure (APAP), and bilevel positive airway pressure (BiPAP).Continuous positive airway pressure devices use mild air pressure to keep the airways open and are used for the treatment of patients who have breathing problems during sleep.

Auto-titrating positive airway pressure devices are used for the determination of an optimal fixed level of continuous positive airway pressure (CPAP) for long-term treatment with a conventional CPAP device and help in maintaining the least amount of pressure integrity of the airway.Bilevel positive airway pressure devices are used to push air through the lungs using two different machines, one for higher pressure when breathing in and the other with a lower pressure when breathing out.

These devices are used for the treatment of sleep apnea, COPD, and other disorders. The user of positive airway pressure devices includes hospitals & sleep labs, home care settings, and others.

The increasing geriatric population is expected to contribute to the growth of the positive airway pressure (PAP) devices market in the forecast period.The geriatric population is more prone to sleep apnea diseases.

The higher prevalence of obstructive sleep apnea (OSA) is related to the decrease in the size of the upper airway lumen because of the increasing age. According to the UN World Ageing Population 2020 report, there were 727 million persons aged 65 years or over in 2020, accounting for 9.3% of the total population. It is estimated that the aging population will reach over 1.5 billion, accounting for 16% in 2050. Thus, the rising geriatric population as the existence of apnea is more prevalent in the geriatric population, and this is likely to drive the market.

The launch of innovative and technologically advanced products by the industry players is gaining popularity in the positive airway devices market. For instance, in September 2020, keepMED, a start-up company developing disruptive solutions for the medication of obstructive sleep apnea (OSA) has designed and developed keePAP. keePAP will help in maintaining airway pressure to keep the upper airway open, this will support the user’s respiratory system to deliver just the amount of PAP needed intermittently and with minimal airflow. Thus, companies operating in the market are continuously focusing on introducing new technologies to survive in the positive airway pressure devices market.

The limited affordability of positive airway pressure devices due to the high cost associated with positive airway pressure machines proved to be a restraint for the positive airway pressure devices market in the forecast period.The prices of these machines depend on the type of functions offered by the machines.

For instance, according to the article published in January 2021, the average price of non-insured continuous positive airway pressure (CPAP) devices can range anywhere from $250 to $1,000, whereas, bilevel positive airway pressure (BiPAP) devices can cost around $1,000 to $6,000, due to their complexity. High prices of positive airway pressure devices hindered the growth of the market during the period.

Potable positive airway pressure devices are a growing trend in the positive airway pressure devices market.Positive airway pressure devices device manufacturing companies are increasingly investing in portable and easy-to-use continuous positive airway pressure devices to provide effective and fast breathing support.

For instance, in April 2019, InnAccel Technologies Pvt Ltd., an India-based medical devices company launched the first infrastructure-independent, portable neonatal CPAP device, called SAANS, to treat critically ill infants with Respiratory Distress Syndrome (RDS). The device has multiple power options, including a patented manual mode.

In March 2019, Resmed, a USA-based medical equipment company, announced the acquisition of HB Healthcare (HBH), for an undisclosed amount.With this deal, Resmed plans to reach out to Korean people with the help of HB Healthcare and its network of trusted distributor partners to deliver CPAP and respiratory care to millions of South Koreans living with sleep apnea, chronic obstructive pulmonary disease (COPD), and other respiratory conditions.

HB Healthcare is a South Korea-based medical equipment company providing sleep and respiratory disease solutions and home care services for local patients.

The regions covered in this report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, the Middle East, Africa.

The countries covered in the positive airway pressure devices market are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, the UK, and the USA.

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Grand opening

HRN's white paper reported some really incredible scores, maybe having us rethink and relearn why Pulmonary and Cardiac rehabilitation is necessary.

Over 99% of our patients report improvements in their breathing post-rehabilitation. Hospital readmission rates dropped by 2.4%”

— Alexander Grichuhin

OWINGS MILLS, MARYLAND, UNITED STATES, May 24, 2022 / -- The Home Rehab Network is Maryland-based Telehealth rehabilitation company founded in 2017 with the goal of making rehabilitation more accessible and improving health outcomes in patients with pulmonary disease from the comfort of their own home. Guided by practitioners that are well known in their field of practice, no other program offered in the United States can compete with HRN’s experience and success rates in the industry.

HRN is composed of physicians, respiratory/occupational therapists, clinical care coordinators, personal trainer, dietician, telehealth IT specialists, account manager, data

manager, and external programs/ consultants to enhance program.

Multidisciplinary Team

Program Success: Health Quality Measures


A total 100 stable COPD patients (GOLD stages II-IV, and <4L/min oxygen) between the age of 50-85 were randomly selected from chart review. COPD health quality metrics including COPD assessment test (CAT), 6-minute walk test (6MWT), incentive spirometry, and BORG scale were analyzed prior to, during, and at the completion of the program.

Measures were compared using paired t-test and Chi-squared test with p<0.05 considered a statistically significant. "Over 99% of our patients report improvement in their breathing post-rehabilitation "

Comparison of 30-day Hospital Readmission Rates (%) for AECOPD

Thirty-day readmission rates were compared between out-patient PR programs and health system, statewide, nationwide, and country-based readmission data (19-22). Telehealth- based PR resulted in a drastic reduction in rehospitalization with HRN demonstrating the lowest rates at 2.4%. The impact of a comprehensive telehealth PR program has also resulted in a readmission reduction up to 3-months. However, future research including randomized trials and registries will be required to further validate program success for hospital wide adoption.


Telehealth Based-6.2%

Home Respiratory therapy-12.2%

LifeBridgeHealth System-16.4%

State (MD)-19.9%



It is estimated that 15.7 million Americans (6.4%) have been diagnosed with COPD with prevalence varying considerably by state and country.

The potential cost savings is enormous saving over a billion dollars nationwide just accounting for hospital costs. In addition, each state and hospital could save

millions per 1000 index visits for COPD and bronchiectasis. The same savings could be applied to other chronic conditions that HRN manages such as heart failure.

There is critical need for more research and data analytics demonstrating the cost effectiveness of HRN's program by region, and payment models. Given the improvement in accessibility, health outcomes, patient satisfaction, and cost reduction it only makes sense for hospitals to provide this proven and one-of-a-kind program to all their patients that meet the criteria.

For a full White Paper review please use the link provided.

Home Rehab Network, LLC
Home Rehab Network, LLC
+1 410-714-1587
email us here

COVID Patient Recovery

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Wa Xian and Frank McKeon in the Department of Biology and Biochemistry and Stem Cell Center at University of Houston

image: Wa Xian and Frank McKeon in the Department of Biology and Biochemistry and the Stem Cell Center at University of Houston, are examining pro-inflammatory stem cell variants in cystic fibrosis and developing therapeutic combinations that selectively target them in the CF lung, while sparing the normal cells needed for regenerative repair.
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Credit: University of Houston

Two nationally recognized experts in cloning and stem cell science from the University of Houston are taking the first step toward limiting the consequences of chronic inflammation in cystic fibrosis (CF) by identifying the source of this persistent and enigmatic inflammation in CF lungs.  

Frank McKeon and Wa Xian in the Department of Biology and Biochemistry and the Stem Cell Center at UH have received a $2.7 million grant from the National Heart, Lung, and Blood Institute to examine pro-inflammatory stem cell variants in cystic fibrosis.  

Cystic fibrosis is an inherited and progressive disease that causes long-lasting lung infections and limits the ability to breathe. It is caused by a defect in a gene called the cystic fibrosis transmembrane conductance regulator (CFTR) and affects more than 30,000 people in the United States. That defect instructs the body to produce abnormally sticky and thick mucus that clogs organs, particularly lungs, causing chronic lung disease marked by infections and inflammation.  

While inflammation in the CF lung was always assumed to be a normal response to bacterial infections, recent studies have cast doubt on that link and rendered the source of this inflammation a mystery.  

“That raised the possibility that inflammation, and perhaps other pathogenic features of CF, are maintained by elements that emerge in the disease that are entirely independent of CFTR activity,” said McKeon.  

Interestingly, the same situation may be operating in chronic obstructive pulmonary disease (COPD), where inflammation and disease progression continues despite smoking cessation. In COPD, recent studies reported from the Xian-McKeon lab have shown a strong correlation between the emergence of pro-inflammatory stem cell variants and the disease itself. 

Using technology that clones stem cells from normal lungs, the Xian-McKeon lab found that the COPD lung was dominated by three stem cell variants that drive all the pathology of COPD including inflammation, fibrosis and mucin hypersecretion.    

“Given the known pathological similarities between COPD and cystic fibrosis, we asked whether the cystic fibrosis lung is also dominated by pathogenic stem cells,” said Xian.   “We generated stem cell libraries from four CF lungs that showed not only the three variants seen in COPD but two additional, proinflammatory variants.” 

The team hypothesizes that these CF stem cell variants play key roles in the progression of CF and represent pathogenic elements of this disease triggered by, and yet independent of, the CFTR gene.  

To identify key inflammatory drivers in the three variants, McKeon and Xian will use CRISPR-Cas9 gene editing, which allows them to quickly create cell models.  

“CRISPR-Cas9 genome editing, coupled with our xenograft models, offers a powerful and feasible means of assessing the hierarchy of factors secreted by these three pro-inflammatory stem cell variants found in the CF lung,” said Xian. 

The Xian-McKeon studies come on the cusp of a new class of cystic fibrosis drugs that restore CFTR activity in these patients.   

"The clinical studies suggest the early application of the CFTR modulators will be game-changers for CF, though their impact on advanced lung disease may be more modest,” noted McKeon. 

Foreseeing the need for companion drugs for advanced CF, the Xian-McKeon laboratory is developing small molecule combinations that selectively target the pathogenic stem cell variants in the CF lung, while sparing the normal cells needed for regenerative repair.  

"This is a race against time for patients with CF and other chronic lung diseases, and the targets are now clear," said Xian. 

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Among patients who are hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), use of an evidence-based COPD transition bundle with a care-coordinator is associated with mixed results — decreasing 7-day and 30-day hospital readmissions, but increasing length of stay (LOS) in the hospital and emergency department (ED) revisits. These were among the results of a multicenter cohort study  published in the journal Chest.

The researchers’ primary objective was to explore the effectiveness of a COPD transition bundle with or without a care-coordinator, on rates of rehospitalizations and ED revisits. This bundle included: demonstration of proper inhaler technique; discharge plan and discharge summary sent to family physician; optimization of respiratory prescriptions; referral to pulmonary rehabilitation; screening for comorbid conditions; and smoking cessation referral as appropriate. A secondary study objective was to examine the impact of the transition bundle on care continuity following hospital discharge. The investigators therefore conducted a clinical trial ( identifier: NCT03358771) with a nested randomized controlled trial (RCT) from February 2017 to June 2019 at 5 participating hospitals in Alberta, Canada. 

The study enrolled 2 patient cohorts: (1) those offered the transition bundle group (ie, EXPLAIN); and (2) those who received usual care (ie, with no bundle offered). Patients in the transition bundle group were randomized to a care-coordinator. An AECOPD transition bundle was implemented in each of the participating hospitals, with all patients who were randomized to the care-coordinator contacted within at least 72 hours postdischarge. 

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Overall, 4140 patients who were admitted with clinical characteristics of an AECOPD were discharged from 1 of 5 of the implementation hospitals between February 2017 and June 2019. A total of 604 participants from 5 Alberta, Canada, hospitals in 3 cities who met eligibility criteria were enrolled in the current study — 320 with a care-coordinator arm and 284 not randomized to a care-coordinator and receiving routine care — whereas 3106 patients who were discharged from the same hospitals received usual care. The primary study outcomes were 7-day, 30-day, and 90-day hospital readmissions; median LOS; and 30-day ED revisits.

Individuals in the transition bundle cohort were 83% (relative risk [RR], 0.17; 95% CI, 0.07-0.35) less likely to be readmitted to the hospital within 7 days of discharge and were 26% (RR, 0.74; 95% CI, 0.60 to 0.91) less likely to be readmitted to the hospital within 30 days of discharge. Readmissions at 90 days, however, remained unchanged (RR, 1.05; 95% CI, 0.93-1.18).

Use of the transition bundle was associated with a 7.3% (RR, 1.07; 95% CI, 1.00 -1.15) relative increase in LOS and a 76% (RR, 1.76; 95% CI, 1.53-2.02) increased risk for experiencing a 30-day ED revisit. Use of a care-coordinator did not affect rates of readmissions or ED revisits.

Limitations of the current study include the fact that as a clinical trial conducted within a real-world setting, a true RCT was impossible to perform. A cohort with a nested RCT design was utilized, which led to unbalanced comparisons and an RCT that was underpowered. 

The investigators concluded that future research should include an assessment of the intensity of care-coordinator/patient interaction needed for change, the reticence of health care providers to use the bundle, and the dependability of implementation of the elements of the bundle. 


Atwood CE, Bhutani M, Ospina MB, et al. Optimizing COPD acute care patient outcomes using a standardized transition bundle and care-coordinator: a randomized clinical trial. Chest. Published online April 8, 2022. doi:10.1016/j.chest.2022.03.047

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Report ocean published a new report on the Montelukast Intermediate market. The research report consists of thorough information about demand, growth, opportunities, challenges, and restraints. In addition, it delivers an in-depth analysis of the structure and possibility of global and regional industries.

The Centers for Medicare and Medicaid Services data estimates that the U.S. national healthcare expenditure surpassed US$ 4.1 trillion in 2020 and is forecast to reach US$ 6.2 trillion by 2028. According to the Commonwealth Fund, the U.S. expended nearly 17% of gross domestic product (GDP) on healthcare in 2018. Switzerland was the second-highest-ranking country, expending 12.2%. In addition, New Zealand and Australia devote only 9.3%.

According to the U.S. Bureau of Labor Statistics, employment in healthcare fields is forecast to grow 16% from 2020 to 2030, much quicker than the standard for all occupations, counting about 2.6 million new jobs. This estimated growth is mainly due to an elder population, showing to greater demand for healthcare services. The median annual wage for healthcare practitioners and technical fields (such as registered nurses, physicians and surgeons, and dental hygienists) was US$ 75,040 in May 2021, which was greater than the median annual wage for all occupations in the economy of US$ 45,760.

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Market analysis
The Global Montelukast Intermediate Market has been used to prevent wheezing, difficulty in breathing, chest tightness, and coughing caused by asthma by Montelukast which is a leukotriene receptor antagonist (LTRA)The collective presence of generics and the opposing part of the presence of stringent regulatory policies and the tall prices of manufacturing building blocks for active pharmaceutical ingredients which are likely to hamper the market development during the forecast period. Additionally, montelukast is designated for the handling of periodic and recurrent allergic rhinitis. The important aspects pouring the market evolution are worldwide rising commonness of allergic rhinitis, urticaria, asthma, bronchospasm, burgeoning pharmaceutical industry attached with the rising call from active pharmaceutical ingredients (APIs) manufacturers, and montelukast patent expiration.

Market segmentation
The segmentation for Global Montelukast Intermediate Market is given by the influences describing the market progress which are worldwide increasing frequency of allergic rhinitis, and urticaria asthma, bronchospasm mushrooming pharmaceutical industry coupled with the cumulative demand from API manufacturers, and montelukast patent termination along with the snowballing presence of generics. The global montelukast transitional Market is also provided by application which can thus be classified into three types, viz; bronchospasm, and urticaria. asthma and allergic rhinitis.

The World Health Organization (WHO) has estimated that 15 million disability-adjusted life-years are gone and 250,000 asthma deaths are informed worldwide every year. In the year 2016, asthma ranked twenty third (global) and thirty-first (in low- and middle-income countries ? LMICs) among the foremost causes of premature mortality (YLL). The market development in the European region is mostly due to the existence of huge pharmaceutical companies and sophisticated healthcare substructure and the rising frequency of asthma and allergic rhinitis in the US and Canada. About six million children under the age of 18 have asthma being more mutual in children than adults. Also, one in 13 people is living with asthma and is more common in adult women than adult men. Hence, the swelling burden of asthma is powering the demand for montelukast and is supporting in the market growth.

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Regional analysis
Geographically, The Global Montelukast Intermediate Market is segmented and targeted into global regions like Americas, Asia-Pacific, Middle East and Africa along with the European market.
Additionally, North America is expected to lead the market. Furthermore, The Global Montelukast Intermediate Market in the Americas is segmented into North America and Latin America.
It is forecasted that Europe currently holds a substantial share in the global Montelukast Intermediate market. The reasons responsible for the market progress in this region are poor air quality due to high fuel release and is growing the occurrence of chronic obstructive pulmonary disease (COPD), asthma, allergy and in the UK, Germany, and France. The Middle East and Africa market are predictable to hold the minimum share in the global Montelukast Intermediate market.

In this region, the Middle East is expected to control due to the presence of countries such as Egypt, Saudi Arabia, and others. Asia-Pacific is likely to characterize a hopeful outlook over the forecast period due to the mounting geriatric population along with the increasing prevalence of respiratory diseases. In Australia, one child out of six under the age of 16 is affected by asthma, while, India has an projected 15 to 20 Million. According to the WHO, presently, there are about 3 Million asthmatics in Japan of whom 7%have severe, and 30% have moderate asthma. The European Respiratory Society stated that, currently, about 30 Million children and adults less than 45 years old have asthma within the UK and Ireland have some of the maximum rates of asthma in the world. In Germany, there are an estimated 4 Million asthmatics. In addition, an article published in the NCBI journal specified that the commonness of allergic diseases in Europe is high.

Major players
Companies like P.G. Shah & Co., Manus Aktteva Biopharma LLP, VIVAN Life Sciences, P.G. Shah & Co. and Ortin Laboratories Limited., etc. are some of the major players in the global Montelukast Intermediate market.

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Table of Content:

  • Market Definition and Overview
  • Research Method and Logic
  • Market Competition Analysis
  • Product and Service Analysis
  • Strategies for Company to Deal with the Impact of COVID-19
  • Market Segment by Type, Historical Data and Market Forecasts
  • Market Segment by Application, Historical Data and Market Forecasts
  • Market by by Region, Historical Data and Market Forecasts
  • Market Dynamic Analysis and Development Suggestions

Available Customization

The following customization options are available for this report:
> Trends for other verticals including retail’ travel’ and hospitality
> Country-specific trends and market analysis
> Rest of the World (RoW) Region-specific market analysis
> Additional company profiles
Apart from the existing market analysis’ Reportocean can also offer a wide array of custom-tailored studies as per the company’s specific needs.

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