This risk is high for indians after severe COVID-19 infection..!?

Indians face a higher risk of lung damage after severe Covid exposure, a new study reveals. A recent study revealed that people who recovered from severe coronavirus infection faced impaired lung function. It was also revealed that half of the participants in the study suffered from shortness of breath. A study was conducted by Vellore Christian Medical college to investigate the impact of corona infection on lung function. 207 people participated in this study. The lung function and exercise capacity of people who recovered from Corona were studied. The study found that among indians recovering from severe COVID-19 for more than two months, respiratory symptoms were more common, with 49.3% having shortness of breath and 27.1% having cough.
TJ Christopher, professor of Pulmonary Medicine at CMC Vellore, said, "The study clearly shows that lung function is more affected in the indian population compared to data from other countries at every level of disease severity." He said it could be due to a person having more than one disease or co-morbidity at the same time. Published in the journal PLOS Global Public Health, researchers compared data from europe and China.For example, a study based in italy found that 43% had shortness of breath or shortness of breath and less than 20% had a cough. Corresponding figures in the Chinese study were lower than those observed in the indian study. However, the Vellore Medical college study did not cite any specific data from china or european countries other than Italy. Although the exact cause of the poor condition among indians is unknown, co-morbidities are said to be a factor. The researchers concluded that post-coronavirus lung damage has a significant impact on lung function, quality of life, and exercise tolerance.



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The term “medical miracle” is sometimes used to describe any situation in which the patient’s outcome defies the odds. But 42-year-old Aaron Cengiz and the medical staff at UChicago Medicine AdventHealth Bolingbrook believe that he is alive today because of a real miracle.

In late June 2022, Cengiz, a father of six and an avid runner, was on a run with his dog when he rolled his ankle badly. A few weeks later, he thought he might have COVID-19 because of his incessant cough. He also began experiencing severe pain in the back of his knee. He made an appointment to take a COVID-19 test, but when he went to get tested, he felt dizzy and light-headed, and had difficulty breathing. He called his wife, Tami, but his breathing worsened. Then he called 911 and started to pray.  

After he was admitted to the hospital, Cengiz’s oxygen level was determined to be dangerously low at 79 percent despite being at 100 percent oxygen.   

“My breathing got worse, and I actually thought: This is it. I am going to die here,” Cengiz said. At that point, the staff sedated him and that is all he remembers for a long time. 

“Miracle Patient” Aaron Cengiz is back to running and cycling after suffering a pulmonary embolism that caused his heart to stop multiple times in July 2022. 
“Miracle Patient” Aaron Cengiz is back to running and cycling after suffering a pulmonary embolism that caused his heart to stop multiple times in July 2022. 

Cengiz’s lungs were full of clots that had developed after his ankle injury, and the clots were causing a massive pulmonary embolism. He was taken to the Interventional Radiology Lab where doctors used the Inari device, which removes clots from the bloodstream and then filters the blood and returns it to the patient. The device successfully removed the clots, but Cengiz’s heart stopped twice during the procedure. “There was significant improvement with no more clots present. But his heart had just had enough,” said Elizabeth Kraft, RN, manager of Cardiac Services at the hospital. 

After the procedure, Cengiz was moved to the Intensive Care Unit (ICU) for monitoring.  The doctors talked to Tami and explained to her that Cengiz’s heart was failing and even if he survived, he might suffer permanent brain damage because his brain had been deprived of oxygen. “We were not hopeful he was going to recover,” said Dr. Ali Bawamia, who noted that Cengiz nearly died again in the ICU.  

When the medical staffers who had worked with him on Friday night checked on him Saturday morning, they feared the worst. But the staff found that not only had Cengiz survived, but he had improved considerably. 

“We became hopeful,” Bawamia said. “I was very emotional. It is one of those cases I cannot forget. As human beings we do the best we can. But sometimes it takes intervention from above.” 

Aaron Cengiz (left) and Elizabeth Kraft, RN, (right) walked together in the 2023 American Heart Association Heart Walk at the DuPage County Fairgrounds in Wheaton, Illinois. 
Aaron Cengiz (left) and Elizabeth Kraft, RN, (right) walked together in the 2023 American Heart Association Heart Walk at the DuPage County Fairgrounds in Wheaton, Illinois. 

Cengiz’s progress continued. He woke up fully on Sunday evening, and by Monday morning he was off the ventilator. Amazingly, the medical team could not identify any lingering issues from his near-death experience. A week later, he was home.   

“Sometimes in health care, we need a miracle to keep us going, to remind us why we do what we do,” Kraft said. “This man walked out of the building because of our amazing work as a team and by the grace of God!” 

Cengiz also believes his recovery was miraculous. “I felt like God had used these professionals as instruments in His hands to perform this miracle,” he said.  


Julie Busch, associate vice president, marketing and communications for UChicago Medicine AdventHealth 

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Respiratory Inhaler Devices Market Characteristics

Respiratory Inhaler Devices Market Characteristics

The Business Research Company has updated its global market reports, featuring the latest data for 2024 and projections up to 2033

The Business Research Company offers in-depth market insights through Respiratory Inhaler Devices Global Market Report 2024, providing businesses with a competitive advantage by thoroughly analyzing the market structure, including estimates for numerous segments and sub-segments.

Market Size And Growth Forecast:

The respiratory inhaler devices market size has grown strongly in recent years. It will grow from $38.54 billion in 2023 to $41.35 billion in 2024 at a compound annual growth rate (CAGR) of 7.3%. The growth in the historic period can be attributed to smoking epidemic, allergic disorders, pharmaceutical innovation, aging population.

The respiratory inhaler devices market size is expected to see strong growth in the next few years. It will grow to $54.72 billion in 2028 at a compound annual growth rate (CAGR) of 7.3%. The growth in the forecast period can be attributed to air quality concerns, digital health integration, regulatory emphasis on inhaler safety, personalized treatment. Major trends in the forecast period include inhaler device miniaturization, sustainability and eco-friendly inhalers, home-based care, technological advancements.

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Market Segmentation:

The main products of respiratory inhaler devices are dry powder inhalers, metered dose inhalers and nebulizers. Dry powder inhalers (DPIs) are medical devices that deliver powdered medications directly to the lungs for respiratory conditions. The technologies involved include manually operated inhaler devices and digitally operated inhaler devices for the treatment of asthma, chronic obstructive pulmonary disease, pulmonary arterial hypertension and others. The end user are hospitals and clinics, respiratory care centers and others.

Major Driver - Rising Prevalence Of Respiratory Diseases Drives Growth Of Respiratory Inhaler Devices Market

The growing prevalence of respiratory diseases is expected to propel the growth of the respiratory inhaler devices market going forward. Respiratory diseases are disorders that affect the lungs and the respiratory system, leading to breathing difficulties and impaired lung function. Respiratory inhaler devices are used to deliver medications directly to the lungs, providing fast and targeted relief for respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), respiratory syncytial virus infection and other respiratory conditions. For instance, in March 2023, according to the Centers for Disease Control and Prevention, a US-based national public health organization, in the United States, 8,300 tuberculosis (TB) cases were reported in 2022, a rise from 7,874 cases in 2021. Therefore, the growing prevalence of respiratory diseases propels the growth of the respiratory inhaler devices market.

Competitive Landscape:

Major players in the respiratory inhaler devices market are Merck & Co. Inc., Novartis AG, AstraZeneca PLC, Gerresheimer AG, GlaxoSmithKline PLC, 3M, Boehringer Ingelheim International GmbH, Koninklijke Philips N.V., Viatris Inc., Teva Pharmaceutical Industries Ltd., Catalent Inc., Perrigo Company PLC, AptarGroup Inc., Recipharm AB, Chiesi Farmaceutici S.p.A., Cipla Limited, Hikma Pharmaceuticals PLC, Zydus Lifesciences Limited, Lupin Limited, Glenmark Pharmaceuticals Ltd., Orion Corporation, Sumitomo Pharma America Inc., Beximco Pharmaceuticals Ltd., Hovione Limited, Vectura Group Limited, H&T Presspart Manufacturing Ltd., Pari Medical Holding GmbH, OMRON Healthcare Europe B.V., Medisol Lifescience Pvt. Ltd., Consort Medical plc.

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Top Trend - Adoption Of Advanced Metered Dosage Inhaler (MDI) Technology By Market Leaders To Enhance Respiratory Inhaler Devices

Major companies operating in the respiratory inhaler devices market are adopting new technologies, such as metered dosage inhalers, to sustain their position in the market. A metered dosage inhaler (MDI) is a portable aerosol device that delivers a precise dose of medication to the lungs in the form of a mist or inhaled spray. For instance, in February 2022, AptarGroup Inc., a US-based consumer dispensing packaging and drug delivery device manufacturer, launched HeroTracker Sense. This advanced digital respiratory health solution converts a conventional metered dosage inhaler (pMDI) into a smart, connected medical apparatus. HeroTracker Sense is made to track patients' use of MDIs and facilitate better adherence to their recommended therapy to improve the lives of patients worldwide who suffer from chronic respiratory diseases like asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis and other respiratory conditions brought on by COVID-19. HeroTracker Sense provides valuable analytics and insights into patient training, onboarding and performance to healthcare providers (HCPs) through the Aptar Pharma Cohero Health BreatheSmart Connect portal.

The Table Of Content For The Market Report Include:

1. Executive Summary

2. Respiratory Inhaler Devices Market Characteristics

3. Respiratory Inhaler Devices Market Trends And Strategies

4. Respiratory Inhaler Devices Market - Macro Economic Scenario

5. Respiratory Inhaler Devices Market Size And Growth

…..

27. Respiratory Inhaler Devices Market Competitor Landscape And Company Profiles

28. Key Mergers And Acquisitions

29. Future Outlook and Potential Analysis

30. Appendix

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Research Nester

Research Nester

Key chronic obstructive pulmonary disease (COPD) treatment market players include GlaxoSmithKline plc, AstraZeneca plc, Boehringer Ingelheim International GmbH, Novartis International AG, Teva Pharmaceutical Industries Ltd., Mylan N.V. Merck 7 Co., Inc., Sunovion Pharmaceuticals Inc., Chiesi Farmaceutici S.p.A. and Circassia Pharmaceuticals plc,

New York, Feb. 29, 2024 (GLOBE NEWSWIRE) -- The global chronic obstructive pulmonary disease (COPD) treatment market size is estimated to attain at ~9% CAGR from 2024 to 2036. The market is expected to garner a revenue of USD 22 billion by the end of 2036, up from a revenue of ~USD 10 billion in the year 2023.The advancements in inhalation therapies are evaluated to drive the market size. The recent advancements in the respiratory therapy sector include the invention of inhaled corticosteroids and biologics and the development of new delivery systems such as breath-activated[MK1]  inhalers. Apart from this, AstraZeneca is working on HFO 1234ze pMDI[MK2]  (pressurized metered dose inhalers) which is in phase I clinical trial.

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Additionally, technological improvements in the development of user-friendly inhalation devices are likely to have a positive impact on the market size. The integration of a feedback mechanism in these devices ensures to administration of their medication at the right dose. The dry powder inhalers that provide feedback with the dose counter include Novolizer, Genuair, and NEXThaler[MK3]  through visual and voice signals to confirm the inhalation dose.

Government Support in Creating Awareness and Taking Actions is Driving the Growth of the Chronic Obstructive Pulmonary Disease (COPD) Market

The government's support in starting initiatives and awareness programs to promote health education regarding respiratory diseases is fueling the market size. The program is aimed to promote early diagnosis and enhance patient outcomes. Cancer Research UK developed the Improving Early Diagnosis of Cancer ‘Waterfall’ infographic to promote early diagnosis in England with an ambition to achieve a diagnosis[MK4]  of over 70% of cancer patients at stage I or II by the end of 2028.

Chronic Obstructive Pulmonary Disease (COPD) Treatment Market: Regional Overview

Investment in the COPD Research and Development by the Government is Strengthening the Market Growth in Asia Pacific Region

The chronic obstructive pulmonary disease (COPD) treatment market in the Asia Pacific region is anticipated to hold the largest revenue share of 39% by the end of 2036. The government investment in the research and development activities of COPD in the region to advance the treatment methods is fostering the market size. Also, the rising healthcare expenditure and prevalence of COPD are intensifying the market growth. The incidence of COPD in India was around 5% among[MK5]  adults as of 2023.

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Increasing Incidence of COPD Cases and Use of Tobacco is Propelling the Market Expansion in North America Region

The North American region market of chronic obstructive pulmonary disease (COPD) is estimated to garner the second largest market share in the coming years owing to the prevalence of COPD cases in the region. Further, the increasing number of tobacco consumers and the presence of air pollutants in the environment are drastically raising the COPD incidents in the region thereby boosting the market growth. As of 2021 reports, more than 45 million adults in the U.S. use[MK6]  tobacco or any other product.

Chronic Obstructive Pulmonary Disease (COPD) Treatment , Segmentation by Type

  • Bronchodilators

  • Antibiotics

The antibiotics segment of the chronic obstructive pulmonary disease (COPD) treatment market is projected to gain a significant revenue share of 60% during the forecast period. The market segment growth is attributed to the recognition of antibiotics application in the case of chronic obstructive pulmonary disease (COPD) by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). GOLD suggests that antibiotics for the exacerbations related to bacterial infections. Antibiotic usage in patients with stable COPD is observed to reduce exacerbation odds[MK7]  by over 40% as of 2023 reports.

Chronic Obstructive Pulmonary Disease (COPD) Treatment, Segmentation by End-User

  • Hospitals

  • Homecare

  • Research Institutes

The chronic obstructive pulmonary disease (COPD) treatment market from the hospitals segment is predicted to secure a noteworthy market share in the year 2036. The market segment growth is credited to the conducive environment of the hospitals that provide comprehensive COPD care such as rehabilitation programs and multidisciplinary care teams. The high incidence of COPD and the difficulty in management along with the requirement for special care in serious cases is propelling the market demand.  The percentage of COPD and asthma admissions in the hospital according to the ICD codes rose from 8o% i.e., 210,500 in[MK8]  1999 to 384,000 in 2020, and from 60% hospital admission rate with 400 in 1999 to 642 in 2020 for every 100,000 people across the world.

A few of the well-known industry leaders in the chronic obstructive pulmonary disease (COPD) treatment market that are profiled by Research Nester are GlaxoSmithKline plc, AstraZeneca plc, Boehringer Ingelheim International GmbH, Novartis International AG, Teva Pharmaceutical Industries Ltd., Mylan N.V. Merck 7 Co., Inc., Sunovion Pharmaceuticals Inc., Chiesi Farmaceutici S.p.A. Circassia Pharmaceuticals plc and others.

Recent Development in the Market

  • AstraZeneca declared the owing of Caelum Biosciences, a US biotech company developing new medicines for chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). The acquisition adds to the strength of AstraZeneca in the respiratory franchise and expands its pipeline with promising late-stage assets.

  • AstraZeneca and Merck revealed a partnership for a Phase 3 clinical trial evaluation done on Lynparza (olaparib), targeted therapy for metastatic pancreatic cancer patients with the combination of gemcitabine and nab-paclitaxel. The collaboration aids in extending the treatment options for this cancer with limited therapeutic options.

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  1. Non-invasive Imaging Technology

Know about noninvasive imaging technology harnessing advanced algorithms & sensors to deliver comprehensive imaging solutions. This blog uncovers the potential of the technology in enhancing diagnostic capabilities.

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  1. Medical Technology Business investing in Enhanced Technology

The case study summarises the integration of new technological advancements in the field of medicine. The detailed survey provides the examination of the right customer segmentation and customer retention.

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By Eve Glazier, M.D., and Elizabeth Ko, M.D.

Andrews McMeel Syndication

Dear Doctors: I work in a big shop where we make custom furniture. My wife thinks it puts me at risk of COPD and insists I should use a mask. Is she right? I thought COPD was something that happens to smokers. Plus, wearing a mask isn’t very comfortable.

Dear Reader: COPD is short for chronic obstructive pulmonary disease. It’s an umbrella term for a group of diseases in which damage to the tissues of the lungs, along with inflammation, obstruct the airways and make breathing difficult.

Symptoms include shortness of breath, a persistent cough, difficulty taking a deep breath, wheezing, excess mucus and a feeling of tightness in the lungs and chest. Because the airways of someone with COPD are obstructed, they can’t get enough oxygen. This causes an oxygen deficit in tissues throughout the body, which results in weakness, fatigue and a loss of stamina.

The two most common conditions associated with COPD are chronic bronchitis and emphysema. In chronic bronchitis, the lining of the bronchial tubes, which carry air to and from the tiny air sacs of the lungs, become inflamed. This causes excess mucus production and a chronic cough. It also puts the person at increased risk of having repeated respiratory infections. In emphysema, those tiny air sacs, known as alveoli, become permanently damaged. This leads to the oxygen deficit and resulting fatigue and breathing difficulties that we discussed earlier.

Smoking is a primary cause of COPD; The condition develops in response to repeated and long-term exposure to irritating gases and fine particulates, both of which smoking delivers in abundance. however, COPD can be an industrial hazard as well. People who work in occupations as varied as construction, mining, agriculture, welding, brick laying, stonemasonry, textiles, painting, and hair and nail care can all be at risk. When workers in these professions are also smokers, their chance of developing COPD goes up.

Occupational health data show that your own work in a carpentry shop, which exposes you to an environment that is not kind to the lungs, does put you at risk of developing COPD. The act of cutting, carving and sanding wood creates fine, airborne particulates that can damage the lungs and impair their ability to function. So can the fumes and gases emitted by the paints, stains, shellacs and solvents typically used in making furniture.

Even in a well-ventilated shop, particulates and gases will remain in the air. Long-term exposure to these can irritate, inflame and even damage delicate lung tissues, which can eventually lead to COPD.

COPD is a progressive disease. That means it gets worse with the passage of time. Although there is no known cure, it can be managed with medications and changes to behavior. Fortunately, you can significantly lower your own risk of developing this condition with one easy step: Always wear a high-quality, well-fitted mask while at work. It may be a bit uncomfortable, but to protect your lungs, it’s a small price to pay.

Send your questions to [email protected].

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Employment Type: Temporary Part Time (until 30 June 2025)
Position Classification: Physiotherapist - Level 3
Remuneration: $108,595.00 - $112,114.00 per annum, pro rata (+ super + 17.5% leave loading where applicable)
Hours per Week: up to 16
Requisition ID:  REQ471838

Applications Close: 22 March 2024
Vaccination Category: A

Outstanding Experience. Infinite Opportunities.

Here in the Riverina, we treasure your skills and experience and we’re ready to roll out the red carpet to welcome you to town.

We’ve prepared oodles of goodies to help you move and settle in, including:

  • Salary packaging up to $20,600 per annum tax free for living expenses! Take advantage of novated leasing a new car!
  • Subsidised gym and leisure centre membership for you and your family
  • Free confidential counselling services for you and your family
  • Genuine training and development opportunities plus a comprehensive online learning library
  • Flexible working arrangements, choose your own hours! 

Craving a fresh start somewhere new and actually interesting? Join the incredible team in the Murrumbidgee District. Jump in at a comfort level that suits you: from state-of-the-art hospital that will remind you of the city, to small multi-disciplinary health facility where you literally get to do it all. No matter where you choose, your learning will be nurtured and you’ll be well supported to operate at the top of your scope.

And don’t worry - there are already oodles of young people here to welcome you: at work, in local clubs, at the pub, and down at the river!

There’s heaps to show your family when they come to visit, which is a breeze - you’ll be central to Sydney, Melbourne and Canberra. (You can always pop home for the weekend on a quick flight if you find a break in your social calendar!)

Want to know more about the community of Wagga Wagga? Visit us here

About Your Role

Wagga Wagga Base Hospital is looking for a hardworking, experienced and team oriented Physiotherapist. The incumbent will work closely with the multidisciplinary team in providing care to patients with chronic conditions through support of the chronic respiratory clinic and various other methods. The position is primarily outpatient based and is run out of the rapid access clinic. 

Allied Health Professionals are an integral part of the multidisciplinary health care team, providing quality services to patients/clients of the Murrumbidgee Local Health District in order to meet their health and wellbeing needs. 

The Level 3 Physiotherapist will be responsible for providing a range of high-level assessment and therapeutic services for clients with chronic respiratory and cardiac conditions, within scope of practice, according to relevant models of care, frameworks and priorities. This Level 3 Physiotherapist will lead the development of initiatives and improvement activities to enhance clinical outcomes for people with respiratory and cardiac conditions. Advanced clinical reasoning skills and the ability to operate with minimal direct clinical supervision are requirements of the position.

The Level 3 Physiotherapist will support a multidisciplinary Chronic Respiratory and Cardiac care team across the Murrumbidgee Local Health District to implement evidence based practice for Physiotherapy in chronic pulmonary and cardiac rehabilitation, from diagnosis through to disease transition

Learn more about the role and requirements here.

Upgrade Your Career and Lifestyle at MLHD

Your application will require you to include a resume and cover letter outlining your skills and experience and why you are a good fit for this position.

Go on, you’ve earned a promotion, a world-class workplace, inspiring colleagues, award-winning staff and patient programs - all wrapped up in a rich tapestry of cultural treasures. Contact Carolyn Nixon, Clinical Support Officer on 02 5943 2429 or [email protected] now for a confidential chat.

New applicants must have completed the COVID-19 Primary vaccination course prior to commencement with NSW Health or provide an approved medical contraindication certificate. Should a medical contraindication certificate be provided, ongoing employment post certificate expiry is conditional to meeting COVID-19 vaccination requirements.

MLHD is an Equal Opportunity Employer and encourage all suitably qualified applicants to apply, including Aboriginal People and people from racial, ethnic, or ethno-religious minority groups and people with disability.

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Megan Lewis, a 33-year-old from Cardiff, has been navigating a challenging journey since being diagnosed with hypersensitive pneumonitis, a rare and incurable lung disease, in January 2022. Her path to diagnosis was fraught with numerous inconclusive tests over nine months, showcasing the complexities of diagnosing such a rare condition. Despite the adversity, Megan has found solace in her medical team and the support of her community online, sharing her story to raise awareness and help others.

Struggle for Diagnosis and Understanding

The journey to Megan's diagnosis was not straightforward. For months, she experienced debilitating symptoms such as severe fatigue, mood swings, rashes, hair loss, dizziness, weakness, and confusion, which baffled her doctors. It was only after a surgical biopsy that the diagnosis of hypersensitive pneumonitis was confirmed. This condition, characterized by inflammation of the lung tissue, is not only rare but also progressive and incurable, presenting a significant challenge for both patients and medical professionals. Megan's experience underscores the need for increased awareness and understanding of rare diseases, which often suffer from misdiagnosis and lack of effective treatments.

Pulmonary Rehabilitation: A Beacon of Hope

Despite the grim prognosis, Megan has taken strides towards managing her condition. Recently, she underwent her first round of pulmonary rehabilitation, an intervention that has significantly improved both her physical and mental health. Pulmonary rehab, a combination of exercise training, education, and support, is crucial for patients with chronic lung diseases but remains underutilized and inaccessible for many. Asthma + Lung UK Cymru has been vocal about the challenges individuals with interstitial lung diseases (ILD) face in accessing treatments like pulmonary rehab in Wales. The Welsh Government has recognized this gap and is working towards improving pulmonary rehabilitation services and coordinating care for rare diseases, aiming to ensure that patients like Megan have the support they need.

Raising Awareness and Advocating for Change

Megan's decision to share her story on Instagram has not only provided her with a platform to connect with others facing similar challenges but also serves as a powerful tool for raising awareness about hypersensitive pneumonitis and other rare lung diseases. By bringing her journey into the public eye, she hopes to shed light on the importance of early diagnosis, effective treatment options, and the need for a supportive community. Asthma + Lung UK's efforts to highlight the condition and advocate for improved access to treatments echo Megan's message, emphasizing the collective effort required to address the needs of those with rare diseases in Wales and beyond.

As Megan continues to navigate her condition, her story is a poignant reminder of the resilience required to face a rare disease. It also highlights the importance of awareness, proper diagnosis, and the availability of treatment options like pulmonary rehabilitation. With increased attention and support from both the medical community and the government, patients like Megan can hope for a better quality of life and a brighter future despite their diagnoses.



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In 2003, while covering the war in Iraq for NBC News, journalist David Bloom died of a blood clot that formed in his leg and traveled to his lungs.

In memory of Bloom, a U.S. Senate bill in 2005, sponsored by Arlen Specter (R-PA), declared March Deep Vein Thrombosis Awareness Month.

In 2009, Representatives Lois Capps (D-CA) and Cathy McMorris Rodgers (R-WA) came together in an bipartisan effort to reinforce March as a time to focus on blood clots. Capps’ husband Walter died of a pulmonary embolism (PE) in 2006, and a friend and mentor of McMorris Rodgers, Rep. Jennifer Dunn, died of a PE in 2007.



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Bacterial infections were found in 21.1% of patients with asthma exacerbations (AEs), and Chlamydia pneumoniae was associated with longer use of corticosteroids in patients with AEs without obesity. These were among study findings published in BMC Pulmonary Medicine.

Researchers compared clinical characteristics and pathogens associated with AEs in patients with and without obesity.

Adult patients with AEs from 24 secondary or tertiary medical institutes in the Republic of Korea were screened between January 2015 and December 2018. Eligible participants were diagnosed with asthma at least 6 months before the occurrence of an AE. Viruses and bacteria that were confirmed with microbiologic assessment at AE diagnosis were evaluated.

The analysis included 407 patients — 171 (42.0%) with obesity and 236 (58.0%) without. Their mean (SD) age was 66.4 (17.4) years, and 69.3% were women. The group with obesity had a significantly higher proportion of individuals who had never smoked vs the group without obesity (82.5% vs 73.9%, P =.026).

Although the reason for the higher incidence of C infection in nonobese patients is unclear, identification of C pneumoniae as an acute infectious pathogen as well as colonization might be important in uncontrolled asthma or AE.

Of the cohort, 27.8% of patients were not receiving maintenance treatment at the time of AE. No significant difference occurred in asthma control level between the 2 groups, although more patients with vs without obesity had uncontrolled asthma (41.4% vs 30.5%, P =.077).

Bacterial infection was identified in 21.1% of patients with AE. Overall, viral or bacterial infection was identified in 205 (50.4%) patients: 119 patients had viral infection only, 49 had bacterial only, and 37 had both infections. Influenza virus was the most frequently isolated virus (n=67), followed by human rhinovirus (n=37) and respiratory syncytial virus (RSV; n=17). No significant difference occurred in the incidence of viral infection between the 2 groups.

Streptococcus pneumoniae (n=25), Pseudomonas aeruginosa (n=17), and C pneumoniae (n=10) were the dominantly isolated bacteria. The patients with obesity had a lower incidence of C pneumoniae infection than patients without obesity (1.0% vs 7.6%, P =.024).

Systemic corticosteroids were used by 341 of 379 patients (90.0%) for treatment of AE. Patients with vs without obesity were significantly more likely to receive systemic corticosteroids (92.0% vs 88.4%, P =.048) and had a tendency for a greater duration of corticosteroid use (12.8 [12.6] vs 10.4 [10.5] days, P =.066).

Among those with obesity, no significant differences were found in treatment outcomes based on viral or bacterial infection. Among those without vs with obesity, bacterial infection was associated with a greater duration of corticosteroid use (13.6 [19.8] vs 9.7 [6.7] days, P =.049), and C pneumoniae infection was associated with a longer AE duration (22.7 [15.9] vs 9.9 [7.5] days, P <.001) and longer corticosteroid use (25.0 [39.2] vs 9.8 [6.7] days, P <.001).

Limitations include the relatively small number of participants. Additionally, patients with AE were not compared with those with stable asthma or with healthy individuals, it was not possible to assess the effects of the susceptibility test results on treatment outcomes, and researchers did not correct for differences among institutions.

“Although the reason for the higher incidence of C infection in nonobese patients is unclear, identification of C pneumoniae as an acute infectious pathogen as well as colonization might be important in uncontrolled asthma or AE,” the study authors stated.

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Transparency Market Research

Transparency Market Research

The increasing prevalence of asthma and COPD, and increasing demand for effective nebulizer inhalation tools drive market demand.

Wilmington, Delaware, United States, Feb. 29, 2024 (GLOBE NEWSWIRE) -- Transparency Market Research Inc. - The global soft mist inhalers market is projected to grow at a CAGR of 6.8% from 2022 to 2031. As per the report published by TMR, a valuation of US$ 4.4 billion is anticipated for the market in 2031. As of 2023, the demand for soft mist inhalers is expected to close at US$ 2.5 billion.

With an increasing incidence of respiratory conditions such as asthma, COPD (Chronic Obstructive Pulmonary Disease), and bronchitis globally, there's a growing demand for effective inhalation therapy, thus boosting the market for soft mist inhalers.

Many patients prefer inhalation therapy over traditional oral medications due to its convenience, faster onset of action, and targeted delivery to the lungs. Soft mist inhalers offer a user-friendly alternative, further fueling market growth.

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The global aging population is prone to respiratory ailments, which is driving the demand for respiratory care devices, including soft mist inhalers. As the elderly population grows, so does the market for respiratory devices, creating opportunities for market expansion.

Rising awareness about respiratory diseases and the importance of effective management, coupled with increased healthcare expenditure, particularly in emerging markets, is boosting the adoption of soft mist inhalers. Governments and healthcare organizations are also focusing on promoting inhalation therapy, further propelling market growth.

Soft mist inhalers are increasingly being used for a wide range of indications beyond asthma and COPD, including cystic fibrosis, pulmonary hypertension, and respiratory infections. This expansion of indications broadens the market base and drives demand for soft mist inhalers.

Key Takeaways from the Market Study

  • As of 2022, the soft mist inhalers market was valued at US$ 2.4 billion.

  • In terms of type, the reusable inhalers segment held a prominent share of the global soft mist inhalers market in 2021.

Soft Mist Inhalers Market: Key Trends and Opportunistic Frontiers

  • The rising incidence of respiratory conditions such as asthma, COPD, and bronchitis is driving demand for soft mist inhalers as effective treatment options.

  • Growing emphasis on patient-centered care in respiratory medicine, leading to increased adoption of soft mist inhalers due to their ease of use, improved compliance, and better patient outcomes.

  • Soft mist inhalers are being explored for a wider range of respiratory conditions beyond asthma and COPD, such as cystic fibrosis and respiratory infections, expanding the market potential.

  • Ongoing innovations in soft mist inhaler technology, including improvements in dose accuracy, breath-actuation synchronization, and portability, are enhancing patient convenience and driving market growth.

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Soft Mist Inhalers Market: Regional Analysis

  • North America dominates the soft mist inhalers market due to the high prevalence of respiratory diseases, well-established healthcare infrastructure, and favorable reimbursement policies. Additionally, the presence of key market players and ongoing technological advancements further bolster market growth in this region.

  • The Asia Pacific region is witnessing rapid growth in the soft mist inhalers market, propelled by factors such as the growing prevalence of respiratory disorders, rising healthcare awareness, and improving access to healthcare services. Increasing disposable income levels and expanding healthcare infrastructure also play a crucial role in driving market growth in countries like China, India, and Japan.

Competitive Landscape

The soft mist inhalers market is characterized by its fragmented nature, hosting numerous players vying for market dominance. These companies are strategically prioritizing investments in research and development as well as forging collaborations to bolster their market presence and enhance their competitive edge.

Key Players Profiled

Key Developments in the Market

  • Merxin Ltd. introduced MRX004 represents a soft mist inhaler device designed to offer an interchangeable AB rated opportunity for tiotropium/olodaterol, formulated similarly to the Respimat.
    MRX004 is versatile, serving as a soft mist inhaler suitable for various applications, including delivering new molecules to the lungs, repurposing existing ones, managing product life cycles, and reformulating compounds from nebulizers or pMDI/DPI devices.

  • In January 2024 - Recipharm, a prominent contract development and manufacturing organization (CDMO), is excited to unveil an exclusive license and collaboration agreement with Medspray and Resyca. Together, they will focus on the development of soft mist nasal delivery devices intended for both single and combination drug products.

Soft Mist Inhalers Market – Key Segments

Type

Application

Age Group

End User

  • Hospitals

  • Clinics

  • Others (Home Care, etc.)

Region

  • North America

  • Latin America

  • Europe

  • Asia Pacific

  • Middle East & Africa

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About Transparency Market Research

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By SÍLE MOLONEY

THE FIRST OUTPATIENT Pulmonary Rehabilitation Program in The Bronx opened at Montefiore Medical Center’s Wakefield campus on Monday, Feb. 26, 2024.
Photo courtesy of Montefiore Einstein

Montefiore has opened the borough’s first pulmonary rehabilitation program in Wakefield. A ribbon-cutting ceremony was held on Monday, Feb. 26 to mark the opening.

 

The new space at Montefiore Medical Center’s Wakefield campus, located at 600 East 233rd Street, will serve patients with a variety of chronic respiratory diseases, including COPD, emphysema, cystic fibrosis, and Long-COVID related lung disease, as well as patients in need of both pre and post-lung transplant care.

 

Montefiore officials said additionally, the new space will serve increased numbers of cardiac rehabilitation patients, including people with heart failure, ischemic heart disease, and those who need cardiac rehabilitation after heart surgeries and procedures, such as heart transplants, cardiac bypass surgery, and valve replacement or repair.

THE FIRST OUTPATIENT Pulmonary Rehabilitation Program in The Bronx opened at Montefiore’s Wakefield campus on Monday, Feb. 26, 2024.
Photo courtesy of Montefiore Einstein

As reported, February marks American Heart Month. Montefiore officials said one thousand new patients per year will now be able to receive supervised exercise training, disease-related education and group support, in their home borough.

 

According to Montefiore, cardiopulmonary rehabilitation care improves symptoms of disease, improves quality of life, and reduces hospital admissions, yet not enough patients have access to these specialized services.

 

Montefiore officials said with the expanded and enhanced facilities at Montefiore’s Wakefield campus, more patients will have access to exercise physiologists, physical therapists, occupational therapists, and rehabilitation medicine specialists.

THE FIRST OUTPATIENT Pulmonary Rehabilitation Program in The Bronx opened at Montefiore’s Wakefield campus on Monday, Feb. 26, 2024.
Photo courtesy of Montefiore Einstein

Read our latest story on the launch of American Heart Month at Montefiore Medical Center here, and click here to read our latest health check relating to heart disease prevention.

 

 

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Olympus Canada Inc. (OCI) has broadened its healthcare offerings by introducing the Spiration Valve System (SVS) to treat severe emphysema, marking a pivotal advancement in respiratory care. This innovative technology, previously utilized for addressing prolonged air leaks, now offers hope to Canadians suffering from severe emphysema, a form of chronic obstructive pulmonary disease (COPD) characterized by damaged lung air sacs. The device aims to improve lung function and quality of life by redirecting airflow within the lungs.

Expanding Treatment Horizons

The availability of the Spiration Valve System in Canada signifies a major step forward in the treatment of severe emphysema. By placing the umbrella-shaped device in the most diseased parts of the lung through a minimally invasive procedure, the treatment focuses on enhancing lung efficiency and patient comfort. Supported by the EMPROVE trial, which demonstrated sustained clinical benefits over 24 months, the SVS stands as the only endobronchial valve treatment available in Canada for this condition.

Rising COPD Hospital Admissions

Amidst an escalating number of COPD hospital admissions in Canada, which have surged over 68% from 2002 to 2017, the introduction of the SVS comes at a critical time. Contributing factors to this increase include air pollution, wildfire smoke, and stable smoking rates. These statistics highlight the urgent need for effective treatments like the Spiration Valve System. With COPD affecting a significant portion of the younger adult population (ages 40-64), the potential for SVS to mitigate hospital admissions and improve patient outcomes is substantial.

Potential Risks and Benefits

While the SVS presents a promising treatment option for severe emphysema, potential risks such as pneumothorax, worsening COPD symptoms, pneumonia, and dyspnea have been identified. Patients considering this treatment should consult with healthcare professionals to weigh the benefits against possible complications. Olympus Canada's commitment to enhancing respiratory care through innovative solutions like the Spiration Valve System offers new hope to those battling severe emphysema, aiming to improve their quality of life significantly.

The deployment of the Spiration Valve System in Canada not only showcases Olympus Canada's dedication to advancing medical technology but also represents a beacon of hope for severe emphysema sufferers. As the healthcare landscape continues to evolve, the introduction of such groundbreaking treatments underscores the importance of innovation in addressing complex health challenges, ultimately paving the way for better patient outcomes and a healthier future.



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Interstitial Lung Disease Market Size

Interstitial Lung Disease Market Size

The Business Research Company has updated its global market reports, featuring the latest data for 2024 and projections up to 2033

The Business Research Company offers in-depth market insights through Interstitial Lung Disease Global Market Report 2024, providing businesses with a competitive advantage by thoroughly analyzing the market structure, including estimates for numerous segments and sub-segments.

Market Size And Growth Forecast:

The interstitial lung disease market size has grown strongly in recent years. It will grow from $1.83 billion in 2023 to $1.97 billion in 2024 at a compound annual growth rate (CAGR) of 7.3%. The growth in the historic period can be attributed to awareness and diagnosis improvement, immune system modulation therapies, respiratory rehabilitation programs, multidisciplinary care teams.

The interstitial lung disease market size is expected to see strong growth in the next few years. It will grow to $2.62 billion in 2028 at a compound annual growth rate (CAGR) of 7.4%. The growth in the forecast period can be attributed to precision medicine, novel drug development, regenerative medicine, telehealth and remote monitoring. Major trends in the forecast period include advancements in imaging technology, ai in imaging, fibrosis subtype differentiation, supportive care services.

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Market Segmentation:

The main types of drugs used for interstitial lung disease are oral corticosteroids, immune-suppressing, anti-fibrotic medication and others. Interstitial pneumonia, also known as non-infectious interstitial pneumonia, is a type of interstitial lung disease (ILD) that affects the interstitium, which is the tissue that surrounds and supports the air sacs (alveoli) in the lungs. They are indicated for the treatment of interstitial pneumonia, idiopathic pulmonary fibrosis, nonspecific interstitial pneumonitis, hypersensitivity pneumonitis, cryptogenic organizing pneumonia (COP), sarcoidosis and acute interstitial pneumonitis for adults and children. It is distributed by various channels such as hospital pharmacies, retail pharmacies and online pharmacies.

Major Driver - Role Of Allergic Conditions In Driving Growth Of The Interstitial Lung Disease Market

The growing prevalence of allergic conditions is expected to propel the growth of the interstitial lung disease market going forward. An allergic condition is when the immune system overreacts to an allergen, often known as a harmless substance. Allergic reactions might result in interstitial lung disease (ILD), specifically hypersensitivity pneumonitis, which causes an allergic reaction in the body causes hypersensitivity pneumonitis. For instance, in January 2023, according to the Centers for Disease Control and Prevention (CDC), a US-based federal agency for public health, over one-third of American adults and more than one-fourth of American children had a seasonal allergy, eczema, or food allergy in 2021. Further, anaphylaxis (a severe allergic reaction to food) is estimated to cause 90,000 emergency room visits in the United States each year. Therefore, the growing prevalence of allergic conditions is driving the growth of the interstitial lung disease market.

Competitive Landscape:

Major players in the interstitial lung disease market are Roche Laboratories Inc., Merck & Co. Inc., Bayer AG, Novartis Pharmaceuticals Corporation, The Bristol-Myers Squibb Company, Amgen Inc., Boehringer Ingelheim, Siemens Healthineers, Koninklijke Philips N.V., Teva Pharmaceuticals USA Inc., AstraZeneca PLC, Horizon Pharma USA Inc., Genentech Inc., Amneal Pharmaceuticals LLC, Fujirebio Diagnostics Inc., Insmed Inc., VIDA Diagnostics Inc., EmphyCorp Inc., Verseau Therapeutics, Regend Therapeutics Co., LTT Bio-Pharma Co. Ltd., Galecto Biotech, Pulmatrix Inc., PureTech Health PLC, Pneuma Respiratory Inc., Bellerophon Therapeutics Inc., MediciNova Inc., Altavant Sciences Inc., Verona Pharma plc.

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Top Trend - Innovative Drug Development Initiatives To Improve Interstitial Lung Disease Treatment

Major Companies operating in the interstitial lung disease market are focusing on developing innovative drugs to treat their customers and sustain their position in the market. The development of new drugs can improve treatment outcomes for patients with lung-related diseases. For instance, in April 2021, United Therapeutics, a US-based biotechnology company, launched Tyvaso, a medication for treating patients with pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) to improve exercise ability. Tyvaso is a treatment for patients with Pulmonary Hypertension associated with Interstitial Lung Disease (PH-ILD). It is a sterile version of the prostacyclin-mimicking drug treprostinil that is meant to be inhaled orally utilizing the Tyvaso inhalation system.

The Table Of Content For The Market Report Include:

1. Executive Summary

2. Interstitial Lung Disease Market Characteristics

3. Interstitial Lung Disease Market Trends And Strategies

4. Interstitial Lung Disease Market - Macro Economic Scenario

5. Interstitial Lung Disease Market Size And Growth

…..

27. Interstitial Lung Disease Market Competitor Landscape And Company Profiles

28. Key Mergers And Acquisitions

29. Future Outlook and Potential Analysis

30. Appendix

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Acute Respiratory Distress Syndrome (ARDS) Market Characteristics

Acute Respiratory Distress Syndrome (ARDS) Market Characteristics

The Business Research Company has updated its global market reports, featuring the latest data for 2024 and projections up to 2033

The Business Research Company offers in-depth market insights through Acute Respiratory Distress Syndrome (ARDS) Global Market Report 2024, providing businesses with a competitive advantage by thoroughly analyzing the market structure, including estimates for numerous segments and sub-segments.

Market Size And Growth Forecast:

The acute respiratory distress syndrome (ards) market size has grown rapidly in recent years. It will grow from $1.17 billion in 2023 to $1.29 billion in 2024 at a compound annual growth rate (CAGR) of 10.6%. The growth in the historic period can be attributed to advancements in critical care medicine, aging population, pulmonary rehabilitation, multidisciplinary care teams.

The acute respiratory distress syndrome (ards) market size is expected to see rapid growth in the next few years. It will grow to $1.93 billion in 2028 at a compound annual growth rate (CAGR) of 10.7%. The growth in the forecast period can be attributed to global healthcare preparedness, vaccine development and infectious disease management, telemedicine and remote monitoring, patient-centered care models. Major trends in the forecast period include artificial lung devices, personalized ventilation strategies, lung protective ventilation, drug therapies for ards subtypes.

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Market Segmentation:

The main types of services involved in acute respiratory distress syndrome (ARDS) are diagnosis and treatment. Diagnosis is the process of separating a disease or disorder from other potential disorders and defining its nature. The diagnosis of acute respiratory distress syndrome (ARDS) is based on the physical exam, chest X-ray and oxygen levels. It can be caused by COVID-19 disease 2019 (COVID-19), sepsis, inhalation of harmful substances, severe pneumonia and others with severity ranging from mild, moderate and severe. The major end users are hospitals, clinics, ambulatory service centers and others.

Major Driver - Impact Of Increasing Pneumonia Prevalence On The Acute Respiratory Distress Syndrome (ARDS) Market

The growing prevalence of pneumonia is expected to propel the growth of the acute respiratory distress syndrome (ARDS) market going forward. Pneumonia is an infection that affects one or both lungs, causing the lungs' air sacs, or alveoli, to fill up with fluid or pus. Pneumonia causes an inflammatory reaction in the lungs, increasing blood vessel permeability and fluid leakage into the alveoli. This fluid buildup interferes with the exchange of oxygen and carbon dioxide, causing respiratory discomfort. For instance, according to the Centers for Disease Control and Prevention, a US-based government agency, in 2021, the number of deaths due to pneumonia in the United States was 41,309, with a mortality rate of 12.4 deaths per 100,000 population. Therefore, the growing prevalence of pneumonia drives the growth of the acute respiratory distress syndrome (ARDS) market.

Competitive Landscape:

Major players in the acute respiratory distress syndrome (ards) market are Johnson & Johnson Services Inc., Novartis AG, GlaxoSmithKline PLC, Medtronic PLC, Boehringer Ingelheim International GmbH, Gilead Sciences Inc., Amgen Inc., Fresenius SE & Co. KGaA, Koninklijke Philips N.V., Baxter International Inc., Teva Pharmaceutical Industries Ltd., CSL Behring, Terumo Corporation, ResMed Inc., Smiths Medical Inc., Dräger Safety AG & Co. KGaA., Getinge AB, Mallinckrodt PLC, Masimo Corporation, United Therapeutics Corporation, Fisher & Paykel Healthcare Corporation Limited, Hamilton Medical AG, Zuventus Healthcare Ltd., Windtree Therapeutics Inc., Faron Pharmaceuticals Oy, AcelRx Pharmaceuticals Inc.

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Top Trend - Innovative Drug Development Initiatives Transforming The Acute Respiratory Distress Syndrome (ARDS) Market

Major companies operating in the acute respiratory distress syndrome (ARDS) market are focusing on developing innovative drugs and supplements, such as Aviptadil, HSP90 inhibitors and others to sustain their position in the market. Aviptadil is a synthesized vasoactive intestinal peptide (VIP) that binds specifically to receptors on lung alveolar type II cells. For instance, in November 2022, Zuventus Healthcare Ltd., an India-based pharmaceutical manufacturing company, launched Aviptadil to treat acute respiratory distress syndrome. Aviptadil, a vasoactive intestinal peptide supplement, improves breathing and lowers mortality in ARDS patients. This is accomplished through Aviptadil's ability to protect and regenerate Type-2 Pneumocytes, restore Type-1 Pneumocytes, increase surfactant synthesis and suppress IL-6 (interleukin 6) and tumor necrosis factor (TNF)-alpha.

The Table Of Content For The Market Report Include:

1. Executive Summary

2. Acute Respiratory Distress Syndrome (ARDS) Market Characteristics

3. Acute Respiratory Distress Syndrome (ARDS) Market Trends And Strategies

4. Acute Respiratory Distress Syndrome (ARDS) Market - Macro Economic Scenario

5. Acute Respiratory Distress Syndrome (ARDS) Market Size And Growth

…..

27. Acute Respiratory Distress Syndrome (ARDS) Market Competitor Landscape And Company Profiles

28. Key Mergers And Acquisitions

29. Future Outlook and Potential Analysis

30. Appendix

Contact Us:

The Business Research Company

Europe: +44 207 1930 708

Asia: +91 88972 63534

Americas: +1 315 623 0293

Email: [email protected]

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LinkedIn: in.linkedin.com/company/the-business-research-company

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Global Market Model: www.thebusinessresearchcompany.com/global-market-model

About The Business Research Company

The Business Research Company (www.thebusinessresearchcompany.com) is a market intelligence firm that pioneers in company, market, and consumer research. Located globally, TBRC's consultants specialize in various industries including manufacturing, healthcare, financial services, chemicals, and technology. The firm has offices located in the UK, the US, and India, along with a network of proficient researchers in 28 countries.

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March is Blood Clot Awareness Month (BCAM), a time dedicated to spreading the word about blood clots and their potentially fatal complication, pulmonary embolism.  

Throughout the month, NBCA’s  awareness campaign, “Recognize the Signs, Save Lives,” promotes learning the signs and symptoms of blood clots. This is because knowing the signs and symptoms and acting quickly can be the difference between life and death.

What will be happening during Blood Clot Awareness Month?

  • NBCA is working to raise $100,000 and reach 100,000 people in honor of the 100,000 who die each year from preventable blood clots through the 100,000 Reasons Challenge.
  • To honor the 100,000 people who die every year as a result of a blood clot, NBCA is asking their loved ones to share their stories. These stories will be shared during March on our website and social platforms.
  • To build awareness of the signs and symptoms of blood clots, NBCA is asking blood clot survivors to create short videos describing the signs and symptoms they experienced, tagging @stoptheclot, and posting it to their social media platforms. NBCA will reshare this content throughout the month.
  • NBCA staff and volunteers are gathering in Washington, DC to meet with members of Congress to urge them to increase funding for blood clot education and awareness.

Why is it important to raise blood clot awareness?

  • Less than 6% of Americans know what blood clots are and how to prevent them, yet they affect as many as 900,000 Americans every year.
  • Every six minutes in the U.S., someone dies of a blood clot.
  • The overall incidence of venous blood clots is 30-60% higher in Black patients compared to white patients.
  • 274 people die every day in the U.S. from blood clots.
  • A blood clot in the lung is one of the most common causes of pregnancy-related death in the U.S.
  • Blood clots are the second leading cause of death in cancer patients, aside from cancer itself.

How can you get involved?

  • Sign up for the 100,000 Reasons Challenge. Ride, run, walk, or move your body during this 31-day virtual challenge in March. Help us raise $100,000 and reach 100,000 people in honor of the 100,000 who die each year from preventable blood clots.
  • Use our BCAM Social Media Toolkit and Action Guide to share resources about blood clots to your social platforms and learn about other ways to get involved.
  • Urge Congress to expand funding for blood clot awareness and education by sending a message to your representatives.
  • If you’ve experienced deep vein thrombosis or pulmonary embolism, post a short video on social media describing your blood clot signs and symptoms and use the hashtags #BCAM2024, #BCAM and #StopTheClot. Make sure to tag @StopTheClot.
  • If you’ve lost a loved one to a blood clot, we urge you to share their story. Doing so is a meaningful action you can take to help raise awareness, educate others about signs and symptoms, promote prevention, and foster a supportive community. We will share these stories on our website and social media platforms throughout the month.

Learn more about Blood Clot Awareness Month 2024.

 

 



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Introduction

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease that can be prevented and treated. It primarily involves various airway and/or alveolar abnormalities caused by excessive exposure to the toxic particles or gases, and can result in persistent and progressively worsening chronic respiratory symptoms and airflow limitations.1 It is estimated that COPD would become the fourth leading cause of premature death by 2040.2 Meanwhile, COPD is ranked as sixth leading cause of all-age mortality and years of life loss (YLLs) by 2019, and its rank was proportional to the age.3

The enormous financial burden of COPD is closely related to both itself and its multiple comorbidities.4 In 2011, the ‘comorbidities’ were included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and used for the comprehensive evaluation of COPD. In the 2023 GOLD guidelines, the concept of “heterogeneous lung condition” was proposed,1 emphasizing the diversity and individual differences in clinical manifestations of COPD patients. The reason for this is that various factors, such as hypoxia, oxidative stress (OS), systemic inflammation and other mechanisms, can lead to damage in multiple organs and tissues throughout the body. These include the cardiovascular, endocrine, hematological, locomotor, neuropsychiatric, and digestive system.5 The risk of comorbidities in COPD patients is also elevated by factors such as smoking history and advanced age.6 In addition, several extrapulmonary comorbidities of COPD have been found to considerably increase the risk of acute exacerbation, complicate the treatment, and impose a heavy medical burden on COPD patients.4,7

Therefore, a comprehensive understanding and early diagnosis of comorbidities are extremely important to optimize the treatment and prognosis of COPD. This review summarizes recent advances in the study of such above extrapulmonary comorbidities in COPD.

Method

We conducted a comprehensive search on Medline/PubMed and China national knowledge infrastructure (CNKI) up to December 2023 to identify studies relevant to this review. The combination of the following keywords was used as the potential search terms: “Comorbidities in COPD”, “Relationship”, “Prevalence”, “Risk factors”, “Treatment”, “Management”, “Survival and Quality of Life” and so on. In addition, the reference lists of the retrieved articles were further examined in order to determine their significance to the subject matter of this review.

COPD and Cardiovascular Diseases (CVD)

A meta-analysis of observational studies found that the probability of cardiovascular events was significantly increased in patients with COPD compared to patients without COPD [OR=2.46; 96% CI; 2.02–3.00; P<0.0001], and the risk of ischemic heart disease (IHD), cardiac dysrhythmia, heart failure, and arterial circulation diseases in COPD patients was two to five times higher than those in the non-COPD population.8

COPD and CVD have a significant overlap in risk factors, pathophysiological mechanisms, clinical characteristics, and symptoms, which in turn worsen the prognosis for individuals affected by both conditions.9,10 Although smoking is a common and significant risk factor for the two diseases mentioned above, an increasing number of studies have indicated that smoking is not the only link between COPD and CVD. Obesity, hypoxia, aging, lifestyle, and genetics may also be common risk factors.11 In addition, under the stimulation of different factors (eg, inflammation, hypoxia, and OS), in some COPD patients, cardiovascular damage may occur in the early stages.12 Here, hypoxia can induce stress responses in hemodynamics, leading to an increase in cardiac output index, leading to increased peripheral vascular contraction and OS.12 Furthermore, increased oxidative stress can further stimulate persistent systemic inflammation, which in turn can effectively alter the vascular structure.13 The systemic inflammatory response, in turn can significantly enhance cytokine activity, contributing to platelet aggregation and blood coagulation.14,15 Additionally, OS not only causes extensive damage to the airway epithelium, but can also adversely affect both the function and quantity of endothelial cells. The dysfunction of endothelial cells can disrupt the vascular homeostasis, while excessive endothelial cell apoptosis can effectively reduce their antioxidant, anti-inflammatory, and antithrombotic abilities.16 This series of reactions can significantly increase the possibility of cardiovascular events.

Clinically, patients with COPD and CVD may sometimes experience exertional dyspnea, and both can increase the patient’s fatigue, which can further limit their physical activity and continuously reduce their activity tolerance. Patients with both diseases develop severe symptoms. The most important drugs for COPD currently include bronchodilators (eg, β receptor agonists, anti-cholinergic drugs, and theophyllines), corticosteroids, and other symptomatic therapeutic drugs.4 It is important to emphasize that recent studies have indicated that the use of dual long-acting bronchodilators can significantly increase the risk of cardiovascular events.17 However, in the treatment of cardiovascular complications, treatment with β receptor agonist appears to violate the principles of COPD therapy. Interestingly, studies have reported that selective cardiac β receptor agonists exhibit more significant benefits than potential risks in mild to moderate reversible respiratory diseases or coronary artery disease with COPD.18,19 However, its use in COPD patients combined with heart failure remains controversial.20 Meanwhile, statins have shown numerous benefits such as antioxidant, anti-inflammatory, antithrombotic, and immunomodulatory properties.21 These effects prove effective in managing inflammation, reducing the severity of COPD, and lowering CVD-related mortality,22,23 in addition to reducing the risk of pulmonary hypertension.24 However, some studies have demonstrated that the beneficial effects of statins may depend on the patient’s age and corticosteroid use.25 Additionally, antiplatelet agents can significantly reduce the risk of ischemic events in patients with COPD.26 These agents can also contribute to delaying the progression of emphysema,27 improving dyspnea and quality of life in patients.28 Furthermore, angiotensin-converting enzyme inhibitor (ACEI) / angiotensin receptor block (ARB) have also been proposed to display a beneficial effect on the risk of cardiovascular events. These drugs may also potentially delay the progression of emphysema while improving the lung function,29,30 with dual cardiorespiratory protective properties. In addition, the imbalance between protease and antiproteinase is also a major pathogenic mechanism of COPD and CVD. Matrix metalloproteinases (MMPs) play an important role and antiproteinase inhibitors are expected to be employed as novel therapeutic targets.15 Although some MMP inhibitors were found to be safe in cancer trials, their success rate is relatively limited.31 Therefore, large-scale prospective studies are still needed to further evaluate the safety and effectiveness of MMP inhibitors in COPD patients affected with CVD. It is noteworthy that numerous studies have demonstrated that both COPD and CVD share common mechanisms such as oxidative stress and systemic inflammation. This suggests that antioxidant therapy could provide a novel and effective therapeutic direction for the treatment of COPD and its associated cardiovascular diseases. However, further extensive prospective studies are required to validate this potential therapeutic direction.

COPD and Endocrine Diseases

According to statistics, up to 40% of COPD cases are associated with one or more diseases related to metabolic syndrome (MetS), with diabetes being the most common.32,33 COPD is also regarded as a common comorbidity of diabetes, and they mutually increase the risk of disease and unfavorable prognostic factors.34,35 It is worth indicating that the severity of diabetes has been strongly related to the deterioration of lung function, which could be related to the limited activity and the reduced quality of life of COPD patients.36,37 In contrast, hyper glycaemia can also cause a decline in lung function and physical performance.38 For instance, in a 30-year follow-up study involving more than 27,000 non-smokers, low FEV1 was found to precede diabetes and has a significant predictive effect on diabetes incidence.39 Multiple shared risk factors and pathological changes play a vital role in their cooccurrence and interaction, including smoking, obesity, age, hypoxia, oxidative stress, inflammation, and so on.34

A sustained systemic inflammatory response and OS are considered as major factors in the progression of these two diseases.33 The inflammation of airways can cause harm to pancreatic beta cells and obstruct the signaling pathway of insulin, resulting in insulin resistance.40,41 At the same time, the hyperglycemic state can lead to inflammation and oxidative stress, resulting in damage to the pulmonary blood vessels.42 Additionally, the damage to the endothelial cells in the pulmonary blood vessels can lead to connective tissue proliferation and subsequently reduce pulmonary compliance.43 In addition, the advanced glycation end products (AGEs) associated with hyper glycaemia can trigger inflammation and attenuate alveolar retraction, thus exacerbating the patient’s ventilatory deficits.44 At the same time, diabetic autonomic neuropathy can also dysregulate airway diastolic function.45 Additionally, hypoxia has the potential to impact glucose metabolism and insulin sensitivity,29 leading to an increased risk of excessive oxidation and oxidative stress. Furthermore, it can disrupt the defense provided by antioxidants as well as antiproteases, and evolve into a potential risk factor for diabetes mellitus.33 Interestingly, although corticosteroids can also increase the risk of diabetes.46 For instance, corticosteroids, which are commonly used in COPD patients, some studies have reported that the risk of diabetes was only significantly increased upon treatment with high-doses of corticosteroids.47,48 However, other studies have suggested that the combined use of inhaled corticosteroids (ICS) and statins could increase the risk of developing new-onset diabetes.49 Therefore, more long-term observational studies and randomized controlled trials should be conducted in the future to assess the potential safety of drug combinations.

For the treatment of COPD cases combined with diabetes, blood sugar control is essential, as it has been linked to immune dysfunction.50 Recently, the hypoglycemic drug metformin has received significant attention because of its properties of anti-inflammatory and antioxidant. It effectively improves lung outcomes by reducing the production of pro-inflammatory factors through the activation of AMP-activated protein kinase (AMPK).51 Furthermore, it promotes the breakdown of inflammatory mediators by stimulating autophagy,52 with a primary focus on inhibiting the nuclear factor of kappa B (NF-κB) pathway, which is considered to play a crucial role in promoting inflammation.53,54 In addition, metformin can also attenuate oxidative stress-induced cytotoxicity and inhibit the inflammatory response in macrophages through an AMPK-dependent pathway.55 However, the use of metformin still remains controversial. Several large-scale cohort studies have demonstrated that metformin can significantly reduce the risk of exacerbation and all-cause mortality in COPD patients.56,57 However, another retrospective cohort study suggested that metformin failed to improve the blood glucose elevation caused by COPD in non-diabetic patients.58 Hence, additional clinical trials of metformin with stronger evidence are needed to validate its effectiveness in delaying progression. Among other oral hypoglycemic agents, thiazolidinedione drugs and dipeptidyl peptidase-4 (DPP-4) inhibitors can substantially attenuate the inflammatory reactions while lowering blood sugar, thereby protecting the lung tissues.59,60 Sulfonylureas can reduce risk of acute exacerbation of COPD, bacterial pneumonia and cardiovascular events.61 However, recently, there has been growing attention on glucagon-like peptide 1 (GLP-1) receptor agonist and sodium-glucose cotransporter 2 (SGLT-2) inhibitor. Research suggests that GLP-1 receptor agonists can enhance airway function and reduce the risk of exacerbation of COPD.62,63 Additionally, SGLT-2 inhibitors have shown a reduced risk of exacerbating obstructive airway disease when compared to DPP-4 inhibitors.64 In addition to medication, reducing sedentary time, increasing exercise, and implementing individual nutritional interventions can also effectively improve the quality of life and prognosis of COPD patients with diabetes.

COPD and Hematological Diseases

A number of previous studies have shown that high incidence of hypoxia in COPD patients could lead to a compensatory increase in erythropoietin (EPO), leading to secondary hyperhemoglobinemia. However, recent studies in China and abroad suggest that anemia was also one of the comorbidities of COPD and its incidence rate was even higher than that of hyperhemoglobinemia.65,66 It was found that compared to hyperhemoglobinemia, anemia has a greater impact on the disease severity and quality of life in COPD patients.67,68 As shown in a 9-year multicenter clinical study in Korea, anemia (WHO criteria) can serve as an independent risk factor for mortality in COPD.69 In addition, it has been observed that COPD patients affected with anemia had a higher comorbidity burden, especially CVD and MetS,70 which further increased their disease burden and risk of death.

Currently, COPD combined with anemia is considered to belong to the anemia of chronic disease (ACD), commonly known as “inflammatory anemia”, which is essentially an immune- driven inflammatory response.71,72 Prolonged chronic inflammation in COPD patients can significantly weaken the proliferative stimulation response of EPO and shorten the lifespan of red blood cells.73 In addition, some inflammatory factors can directly inhibit hypoxia-induced activation of EPO, which leads to an increase in OS. These factors also interfere with EPO receptor-mediated signaling pathways, thus inhibiting the production of EPO.74 During chronic inflammation, phagocytes have been found to inhibit inflammation by depleting iron and affect iron metabolism as well as transport. This is primarily caused by high levels of hepcidin, leading to iron deficiency in the body, which evolves into iron deficiency anemia (IDA).75,76 Thus, iron deficiency can affect lung function and disease progression in COPD,77,78 forming a vicious circle. Furthermore, since COPD is a chronic wasting disease with malnutrition, there may be a deficiency of hematopoietic raw materials,79 resulting in a decrease in red blood cells.

Hemoglobin can transport oxygen to the various tissues and organs. However, the decrease in hemoglobin in anemia patients leads to a reduction in oxygen supply capacity. Although the blood oxygen partial pressure is sometimes within the normal range, the patient may still be in a state of hypoxia. Therefore, patients with anemia are more likely to develop symptoms such as dyspnea, affecting the motor ability and quality of life.67 Therefore, it is important to actively improve the hemoglobin level. For clinical improvement of anemia, we generally choose direct blood transfusions, EPO injections, and supplementation with hematopoietic raw materials. However, it has been suggested that patients with COPD combined with anemia are resistant to EPO due to the inhibitory effect of inflammatory factors on erythroid progenitor cells.80 Furthermore, although iron supplementation has been found to be effective in reducing the levels of OS in COPD patients, recent studies have further shown that iron therapy could affect the composition of the microbiota as well as the distribution of fecal metabolites, to a certain extent, which has a potentially detrimental effect on the patients.81,82 It is worth noting that intravenous iron supplementation can be effective in increasing hemoglobin levels while reducing gastrointestinal adverse effects compared to oral iron supplementation. This is particularly significant as inflammation can impair iron absorption in the gut.83 In addition, the supplementation of essential nutrients like vitamins and amino acids plays a pivotal role in facilitating the production of hemoglobin and erythropoiesis, underscoring their potential importance. Vitamin C is recognized as a powerful antioxidant, while vitamin D has the potential to exhibit anti-inflammatory effects.84,85 Although it is currently unclear whether the effectiveness of treating the inflammation response is more effective in the primary disease. There are novel treatment strategies available related to the iron regulatory pathway and hypoxia-inducible factor stabilizers for inflammatory anemia, but their efficacy needs to be further evaluated in clinical trials.76

COPD and Locomotor System Diseases

Skeletal muscle dysfunction and osteoporosis are locomotor system comorbidities found in COPD, and the risk of incidence is 1.9 times higher than in normal individuals.86 The incidence of reduced muscle mass in COPD patients is about 15.5%-34%,87 and it is approximately 38.5% in patients affected with osteoporosis.88 Osteoporosis is a systemic metabolic bone disease characterized by a decrease in bone mass and structural deterioration of bone tissue, leading to an increase in bone fragility and the risk of fractures.89 In contrast, osteoporosis is mostly asymptomatic in COPD patients and is typically only detected when a fracture takes place. Therefore, special attention should be paid to the early identification of high-risk patients with COPD combined with osteoporosis.

It has been found that most pathogenic factors can simultaneously affect muscle strength and bone strength in COPD patients. In addition to the patient’s low body mass index, malnutrition and decreased exercise tolerance, systemic inflammatory responses, OS, hypoxia, intake of hormone drugs and vitamin D deficiency are all considered as potential risk factors, increasing bone loss and even leading to fragility fractures.90,91 Furthermore, fractures associated with osteoporosis could further increase the poor prognosis of COPD due to lack of exercise and prolonged bed rest, such as deterioration of the lung function, poor quality of life, as well as increased hospitalization and mortality rates.92 This can potentially create a vicious cycle of these two diseases and places a heavy burden on patients. Under the normal circumstances, bone resorption by osteoclasts and bone formation by osteoblasts alternate in bone tissues to maintain the balance of bone mass.93 However, both the hypoxic state and systemic inflammation in COPD patients could effectively stimulate the proliferation and differentiation of osteoclasts, thus affecting the bone metabolism.94,95 In addition, in patients who smoke, nicotine not only stimulates osteoclast activity, but also triggers apoptosis in osteoblasts, thereby further contributing to osteoporosis.96,97 It is important not to overlook that COPD patients may suffer from deficiency of Vitamin D due to limited activity, reduced sunlight exposure, malnutrition, and the promotion of Vitamin D metabolism by corticosteroids. This deficiency can potentially lead to bone loss as a result of the inability to maintain calcium homeostasis.98

In terms of pharmacological treatment, corticosteroid is an effective treatment for COPD, however, the potential development of secondary osteoporosis due to prolonged usage should not be ignored.99 Although oral administration has been reported to cause apoptosis of bone cells and loss of bone strength,100 there is still controversy regarding the impact of inhaled corticosteroids (ICS) on bone strength.91,101 Currently, the GOLD does not explicitly state that using ICS could lead to significant negative impacts associated with osteoporosis. However, numerous studies have indicated that the use of ICS raises the risk of osteoporosis regardless of the duration of exposure.102 In general, except in patients with COPD in the acute exacerbation stage, systemic application of corticosteroids should be avoided to reduce the risk of bone related adverse effects. In the treatment of osteoporosis, bisphosphonates have been shown to be effective in the treatment of hormone-related bone loss, and are usually combined with calcium and vitamin D.103 In addition, some novel drugs, including denosumab and teriparatide, have been found to have more potent effects in improving the bone density, preventing fractures, and have higher safety.104–106 Hence, these are expected to become a first-line medication for the treatment of osteoporosis-related corticosteroids.107 It has also been suggested that romosozumab, a sclerostin inhibitor that both induces bone formation and inhibits bone resorption, could possibly reduce the risk of fracture to a greater extent in comparison to alendronate.108 Additionally, the use of some antioxidants is considered as a new potential therapeutic direction to prevent and reduce the negative effects of OS on bone remodeling and osteoblastic cells.109 However, additional research is necessary in order to thoroughly investigate the potential risks associated with them.

COPD and Mental Disorders

The combined nervous system diseases associated with COPD mainly include emotional disorders, cognitive impairments, pulmonary encephalopathy and consciousness disorders. Emotional disorders (eg, anxiety and depression) are the most common and easily misdiagnosed. Interestingly, a systematic retrospective study found that the incidence of COPD patients developing emotional disorders was approximately three times higher in comparison to the control group.110 However, the incidence of COPD combined with anxiety and depression has been shown to be between 19.5% −50% in China, and the incidence varies between different studies due to various factors, such as sample size, diagnostic tools, and disease severity.111,112

Patients with COPD often find themselves in a vicious cycle of “dyspnea- decreased activity- increased mental symptoms - dyspnea exacerbation”.113 However, a variety of factors such as behavior, societal influence, and the illness itself contribute to the development of anxiety and depression. In addition, COPD patients suffer from recurrent illness and reduced social engagement that perpetuates anxiety/depression, which in turn can increase the risk of acute exacerbation of COPD. In addition, to the emotional disorders caused by reduced social participation primarily induced by the degradation of body function, this phenomenon could also be related to the influences of hypoxemia and hypercapnia on areas of the brain areas involved in regulation of both ventilation and defensive behaviors.114,115 For chronic smokers, long-term inhalation of nicotine stimulates the body’s inflammatory response and can cause damage to the glial cells. Consequently, this leads to brain damage and the development of mood disorders,116 and potential impact of cigarette smoke on the regulation of neurohormonal secretion rhythms can also contribute to mood disorders in patients.117 Moreover, the chronic inflammatory response in COPD can also have a direct impact on the central nervous system, including an increase in negative emotions.118 In addition, imbalance of inflammatory factors can also increase risk of mood disorders in COPD patients119. Recently, the potential relationship between imbalance in immune system response and emotional disorders has also been suggested.120 However, the relationship between COPD combined with emotional disorders and immunological mechanisms is complex, and further research is still needed for more in-depth exploration.

COPD catalyzes the development of emotional disorders, and emotional disorders can influence both the occurrence and development of COPD. Therefore, early intervention should be carried out in patients with COPD, focusing on the impact of psychological changes on the development and prognosis of the physical diseases. Currently, the main treatment includes pharmacological therapy and non-pharmacological therapy, while non-pharmacological therapy also includes various treatment methods, such as comprehensive pulmonary rehabilitation therapy, psychological therapy and collaborative nursing mode.121 Although pulmonary rehabilitation is known to improve mood and provide several other benefits to COPD patients, studies have found that it has inconsistent rates of continuation and completion, with only half of participants continuing in a rehabilitation center and merely 30% completing the full duration of their treatment.122 Therefore, it is imperative to conduct further studies on pulmonary rehabilitation programs aimed at providing adequate support and ensuring participants’ successful completion. Additionally, it is crucial to discover viable alternative interventions for patients who are unable to participate in routine pulmonary rehabilitation. It is worth noticing that there could be potential interactions between drugs for COPD and those for anxiety/depression. Tricyclic antidepressants (TCA) may potentiate other adverse effects of beta-2 adrenergic agonists and anticholinergic bronchodilators, but tricyclic antidepressants are not considered absolutely contraindicated for use in patients with COPD because of the above mentioned interactions.123,124 Therefore, both the efficacy and safety of anxiolytic/depressant medications for the treatment of COPD-associated mood disorders still needs to be confirmed by more clinical trials. Additionally, considering the potential influence of inflammatory cytokines on depression, the emergence of cytokine modulators as a potential treatment for depression in individuals with chronic inflammation chronic inflammation125 should be explored. However, it is crucial to conduct more extensive randomized controlled trials with robust evidence to thoroughly assess this field. Overall, to minimize the adverse effects of emotional disorders and improve quality of life, comprehensive interventions including medication, psychology and rehabilitation are required.

COPD and Digestive System Diseases

Common digestive system comorbidities associated with COPD include gastroesophageal reflux, chronic gastritis, peptic ulcer, irritable bowel syndrome and inflammatory bowel disease. Among these, gastroesophageal reflux disease (GERD) is a common but frequently overlooked condition, which can markedly increase the frequency of acute exacerbation of COPD. This primarily results because of airway irritation and damage from reflux of acidic gastric contents, bronchoconstriction due to the cough reflex triggered by vagal stimulation, bacterial reflux and even bacterial colonization due to aspiration.126–128 Similarly, changes in chest pressure due to COPD may increase the risk of GERD. Additionally, recurrent coughing in COPD patients can also exacerbate reflux, and the use of receptor agonists commonly prescribed for COPD have a diastolic effect on the esophageal sphincter while dilating the bronchial tubes, potentially increasing the likelihood of the development of gastroesophageal reflux.129–131 Thus, GERD and COPD can interact with each other. However, there remains a lack of comprehensive knowledge regarding the exact causal relationship between them.

At present, there is a lack of sufficient information on the impact of anti-reflux therapy on COPD, and there is ongoing controversy regarding the appropriateness of using acid-inhibitory drugs, specifically proton pump inhibitors (PPIs). Several studies have indicated that PPI treatment could potentially exacerbate COPD,132 yet others have suggested that the risk of pneumonia was not increased by PPI treatment.133 In addition, some studies have demonstrated that acid-suppressing therapy could improve the scores of lung symptom,134 but paradoxically, the lung function of the majority of patients does not show significant improvement.135,136 In addition, use of azithromycin has been found to be noteworthy as it can promote cholinergic activity to accelerate gastric emptying.137 For the moment, the efficacy and safety of PPIs in patients with chronic obstructive pulmonary disease (COPD), as well as the relationship between increased gastric acidity and progression of COPD, still need to be studied on a larger scale.

Conclusions

COPD is usually accompanied by one or more comorbidities that interact with each other. Chronic inflammation, oxidative stress, hypoxia, and smoking serve as mutual links connecting COPD and comorbidities. Although the mechanisms remain elusive and the current guidelines recommend a management according to the principle of single-disease guideline-directed medical treatment,1 it’s appropriate to treat them as a whole (Figure 1).138 For almost every patient with COPD, the clinical reality is that the disease is a component of multimorbidity. Therefore, we need to find integrated multimorbidity management, considering both pharmacological and nonpharmacological strategies. It’s important for every clinician to realize that an effective patient-centered management approach is a more efficient treatment option. So, multi-disciplinary, multi-level, and effective research is necessary to thoroughly investigate and develop targeted treatment strategies that are more appropriate for COPD and its comorbidities. This strategy can provide strong theoretical support for the management and prevention of these conditions. Moreover, the clinicians should also improve their cognitive and diagnostic abilities in management of COPD-related comorbidities. They should develop personalized and effective diagnosis and treatment approaches for individual patients to optimize their clinical outcomes.

Figure 1 COPD and multimorbidity. This conceptual framework represents the most important change in disease concept since the Review139 by Decramer and Janssens on COPD and comorbidities was published in the first volume of The Lancet Respiratory Medicine, and demands a shift in the management paradigm from an approach that focuses on COPD as a single disease of the respiratory system with comorbidities, to one in which COPD is viewed as a component of multimorbidity. (A) Previously COPD was seen as a single disease. (B) COPD and different comorbidities have generally gained attention because of the progress in understanding, but they were still viewed separately. (C) Patients with COPD and comorbidities should be considered as suffering from a multimorbid state, which should be treated as a whole. COPD=chronic obstructive pulmonary disease. FVC=forced vital capacity.

Note: Reprinted from The Lancet Respiratory Medicine, 11/11, Leonardo M Fabbri, Bartolome R Celli, Alvar Agustí, Gerard J Criner, Mark T Dransfield, Miguel Divo, Jamuna K Krishnan, Lies Lahousse, Maria Montes de Oca, Sundeep S Salvi, Daiana Stolz, Lowie E G W Vanfleteren, Claus F Vogelmeier, COPD and multimorbidity: recognising and addressing a syndemic occurrence, 1020-1034, Copyright 2023, with permission from Elsevier.138

Acknowledgments

We thank all the reviewers who participated in the review, as well as MJE editor (www.mjeditor.com) for the linguistic editing and proof reading of the manuscript.

Disclosure

The authors declare that they have no conflicts of interest in this work.

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58. Ho TW, Huang CT, Tsai YJ, et al. Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease. Respir Res. 2019;20(1):69. doi:10.1186/s12931-019-1035-9

59. Wang MT, Lai JH, Huang Y-L, et al. Use of antidiabetic medications and risk of chronic obstructive pulmonary disease exacerbation requiring hospitalization: a disease risk score-matched nested case-control study. Respir Res. 2020;21(1):319. doi:10.1186/s12931-020-01547-1

60. Chen KY, Wu SM, Tseng CH, et al. Combination therapies with thiazolidinediones are associated with a lower risk of acute exacerbations in new-onset COPD patients with advanced diabetic mellitus: a cohort-based case-control study. BMC Pulm Med. 2021;21(1):141. doi:10.1186/s12890-021-01505-7

61. Yen FS, Wei JC, Yu TS, et al. Sulfonylurea use in patients with type 2 diabetes and COPD: a nationwide population-based cohort study. Int J Environ Res Public Health. 2022;19(22):15013. doi:10.3390/ijerph192215013

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95. Liang B, Feng Y. The association of low bone mineral density with systemic inflammation in clinically stable COPD. Endocrine. 2012;42(1):190–195. doi:10.1007/s12020-011-9583-x

96. Lu Y, Di YP, Chang M, et al. Cigarette smoke-associated inflammation impairs bone remodeling through NFκB activation. J Transl Med. 2021;19(1):163. doi:10.1186/s12967-021-02836-z

97. Marinucci L, Balloni S, Fettucciari K, et al. Nicotine induces apoptosis in human osteoblasts via a novel mechanism driven by H2O2 and entailing Glyoxalase 1-dependent MG-H1 accumulation leading to TG2-mediated NF-kB desensitization: implication for smokers-related osteoporosis. Free Radic Biol Med. 2018;117:6–17. doi:10.1016/j.freeradbiomed.2018.01.017

98. Kokturk N, Baha A, Oh YM, et al. Vitamin D deficiency: what does it mean for chronic obstructive pulmonary disease (COPD)? A compherensive review for pulmonologists. Clin Respir J. 2018;12(2):382–397. doi:10.1111/crj.12588

99. Compston J. Glucocorticoid-induced osteoporosis: an update. Endocrine. 2018;61(1):7–16. doi:10.1007/s12020-018-1588-2

100. Chotiyarnwong P, McCloskey EV. Pathogenesis of corticosteroids-induced osteoporosis and options for treatment. Nat Rev Endocrinol. 2020;16(8):437–447. doi:10.1038/s41574-020-0341-0

101. Gonçalves PA, Dos Santos Neves R, Neto LV, et al. Inhaled glucocorticoids are associated with vertebral fractures in COPD patients. J Bone Mineral Metab. 2018;36(4):454–461. doi:10.1007/s00774-017-0854-3

102. Chiu KL, Lee CC, Chen CY. Evaluating the association of osteoporosis with inhaled corticosteroid use in chronic obstructive pulmonary disease in Taiwan. Sci Rep. 2021;11(1):724. doi:10.1038/s41598-020-80815-y

103. Allen CS, Yeung JH, Vandermeer B, et al. Bisphosphonates for steroid-induced osteoporosis. Cochrane Database Syst Rev. 2016;10(10):CD001347. doi:10.1002/14651858.CD001347.pub2

104. Lewiecki EM. New and emerging concepts in the use of denosumab for the treatment of osteoporosis. Therapeutic Advan Musculosk Dis. 2018;10(11):209–223. doi:10.1177/1759720X18805759

105. Saag KG, Wagman RB, Geusens P, et al. Denosumab versus risedronate in corticosteroids-induced osteoporosis: a multicentre, randomised, double-blind, active-controlled, double-dummy, non-inferiority study. Lancet Diabetes Endocrinol. 2018;6(6):445–454. doi:10.1016/S2213-8587(18)30075-5

106. Ding L, Hu J, Wang D, et al. Efficacy and safety of first- and second-line drugs to prevent glucocorticoid-induced fractures. J Clin Endocrinol Metab. 2020;105(1):dgz023. doi:10.1210/clinem/dgz023

107. Yuan C, Liang Y, Zhu K, et al. Clinical efficacy of denosumab, teriparatide, and oral bisphosphonates in the prevention of corticosteroids-induced osteoporosis: a systematic review and meta-analysis. J Orthopaedic Surg Res. 2023;18(1):447. doi:10.1186/s13018-023-03920-4

108. Anagnostis P, Gkekas NK, Potoupnis M, et al. New therapeutic targets for osteoporosis. Maturitas. 2019;120:1–6. doi:10.1016/j.maturitas.2018.11.010

109. Marcucci G, Domazetovic V, Nediani C, et al. Oxidative stress and natural antioxidants in osteoporosis: novel preventive and therapeutic approaches. Antioxidants. 2023;12(2):373. doi:10.3390/antiox12020373

110. Zareifopoulos N, Bellou A, Spiropoulou A, et al. Prevalence, contribution to disease burden and management of comorbid depression and anxiety in chronic obstructive pulmonary disease: a narrative review. COPD. 2019;16(5–6):406–417. doi:10.1080/15412555.2019.1679102

111. Huang J, Bian Y, Zhao Y, et al. The impact of depression and anxiety on chronic obstructive pulmonary disease acute exacerbations: a prospective cohort study. J Affective Disorders. 2021;281:147–152. doi:10.1016/j.jad.2020.12.030

112. Liu YJ, Tian XL, Guo XH, et al. Prevalence of anxiety and depression in chronic obstructive pulmonary disease. Chin J Respir Crit Care Med. 2020;19(5):425–429.

113. Montserrat-Capdevila J, Godoy P, Marsal JR, et al. Overview of the impact of depression and anxiety in chronic obstructive pulmonary disease. Lung. 2017;195(1):77–85. doi:10.1007/s00408-016-9966-0

114. Riske L, Thomas RK, Baker GB, et al. Lactate in the brain: an update on its relevance to brain energy, neurons, glia and panic disorder. Therap Advan Psychopharmacol. 2017;7(2):85–89. doi:10.1177/2045125316675579

115. Freire RC, Perna G, Nardi AE. Panic disorder respiratory subtype: psychopathology, laboratory challenge tests, and response to treatment. Harvard Rev Psych. 2010;18(4):220–229. doi:10.3109/10673229.2010.493744

116. De Luca SN, Chan SMH, Dobric A, et al. Cigarette smoke-induced pulmonary impairment is associated with social recognition memory impairments and alterations in microglial profiles within the suprachiasmatic nucleus of the hypothalamus. Brain Behav Immun. 2023;109:292–307. doi:10.1016/j.bbi.2023.02.005

117. Sundar IK, Yao H, Huang Y, et al. Serotonin and corticosterone rhythms in mice exposed to cigarette smoke and in patients with COPD: implication for COPD-associated neuropathogenesis. PLoS One. 2014;9(2):e87999. doi:10.1371/journal.pone.0087999

118. Pelgrim CE, Peterson JD, Gosker HR, et al. Psychological co-morbidities in COPD: targeting systemic inflammation, a benefit for both? Eur J Pharmacol. 2019;842:99–110. doi:10.1016/j.ejphar.2018.10.001

119. Zhang T, Wang G, Li Q, et al. Relationship between serum Th1/Th2 imbalance and depression in elderly patients with COPD and its clinical implications. Technol Health Care. 2023;31(6):2047–2058. doi:10.3233/THC-230665

120. Foley ÉM, Parkinson JT, Mitchell RE, et al. Peripheral blood cellular immunophenotype in depression: a systematic review and meta-analysis. Mol Psychiatry. 2023;28(3):1004–1019. doi:10.1038/s41380-022-01919-7

121. Recio Iglesias J, Díez-Manglano J, López García F, et al. Management of the COPD patient with comorbidities: an experts recommendation document. Int J Chronic Obstr. 2020;15:1015–1037. doi:10.2147/COPD.S242009

122. Taylor SJC, Sohanpal R, Steed L, et al. Tailored psychological intervention for anxiety or depression in COPD (TANDEM): a randomised controlled trial. Eur Respir J. 2023;62(5):2300432. doi:10.1183/13993003.00432-2023

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127. Harding SM, Allen JE, Blumin JH, et al. Respiratory manifestations of gastroesophageal reflux disease. Ann N Y Acad Sci. 2013;1300:43–52. doi:10.1111/nyas.12231

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Having chronic obstructive pulmonary disease (COPD) makes us patients more susceptible to lung infections. These infections can creep up on us quickly and progress to a severe condition in just a few days. This was the case for me two summers ago.

During my hospital stay, I was given six treatments of chemotherapy. The nurse told me I was being given it because I had skin cancer removed. The doctor then clarified that the treatment aimed to reduce the inflammation. The doctor’s explanation was quite a relief as I knew they were investigating a spot on my lung.

After treatment, when I wanted to brush my hair, I wasn’t initially alarmed by the handful of hair that was left in my brush. At the time, I hadn’t brushed my hair for several days. But once I returned home, the hair kept falling out. I didn’t lose all of it, and most of it grew back. I didn’t think much more about it.

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In the grand scheme of things, hair isn’t that important to me. I actually enjoyed the extraordinarily little amount of hair that was left under my arms and on my legs. I dealt well with all of the hair depletion — except my eyebrows. Eyebrows frame a person’s eyes and add a lot of individuality to the face.

I still struggle to fill in the blank spots with an eyebrow pencil. Some days, I think I’ve made them look like my natural eyebrows, while on other days, not so much.

I write about this because our appearance has a lot of influence on our self-esteem. In an article published by the The Peak Counseling Group, I learned that people who struggle with self-esteem are prone to negativity. Further reading supports the idea that self-esteem is related to mental health.

I don’t want to look into the mirror to brush my teeth, wash my face, or comb my hair. A few days ago, I realized this was holding me back from starting the day. Identifying the problem is the first step in the scientific method of problem-solving.

The problem is that I try not to let having so few hairs in my eyebrows bother me, but it does bother me — a lot. Admitting this to a friend and writing about it has helped me feel better about this issue. I will try to become more proficient in filling in the blank spots.

This problem might be a reason to treat myself to a day at the beauty salon to learn from the experts. We need to take care of ourselves to do and be our best.


Note: COPD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of COPD News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to chronic obstructive pulmonary disease.

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RICHMOND HILL, ON, Feb. 28, 2024 /PRNewswire/ -- Olympus Canada Inc. (OCI) announced today the expansion of its respiratory portfolio with the availability of the Spiration™ Valve System for the treatment of severe emphysema.

The Spiration Valve System (SVS), previously only indicated for the treatment of prolonged air leaks, is now indicated for the treatment of severe emphysema, a form of chronic obstructive pulmonary disease (COPD).

"Olympus Canada is excited to strengthen its leadership role in the respiratory space with the expanded use of the Spiration Valve System for the treatment of severe emphysema," said Mike Lauzon, OCI Medical Business Unit Vice President. "Studies looking at the durability of SVS treatment point to the positive, long-term impact it can have on emphysema patients. We are pleased to offer a treatment option that could bring meaningful improvement to people's lives."

Emphysema is characterized by a loss of elasticity and enlargement of the air sacs of the lung. The diseased lobes of the lungs become hyperinflated causing patients to have significant challenges with breathing.

The Spiration Valve is an umbrella-shaped device that is placed in the most diseased parts of the lung during a short bronchoscopic procedure. Treatment with endobronchial valves such as the Spiration Valve, the only endobronchial valve treatment option available in Canada, can improve lung function by redirecting air away from hyperinflated portions of the lung to healthier portions. Results from the EMPROVE trial showed sustained clinical benefits at 24 months in severe emphysema patients treated with the Spiration Valve System. These benefits include statistically significant improvements in lung function, shortness of breath and quality of life.1

Annual hospital admissions for COPD in Canada have risen sharply since 2002, according to study findings published in the Canadian Medical Association Journal. Researchers identified 1.13 million COPD hospitalizations between 2002 and 2017. Annual hospital admissions over that period increased more than 68% from 52,937 to 89,384. The study also noted that about 21% of the admissions were for younger adults between the ages of 40-64. Researchers suggested that environmental factors such as air pollution and wildfire smoke may be among the factors contributing to the increase in admissions.2

While smoking rates appear to have plateaued in Canada, researchers expect the burden of COPD treatment and hospitalizations to increase due to population growth and aging; smoking is a main contributor to emphysema. COPD hospitalizations could be avoided with proper preventive or early therapeutic interventions, according to the study.2

Potential adverse events which may be associated with the use of the Spiration Valve System may include, but are not limited to, pneumothorax, worsening of COPD symptoms, pneumonia, and dyspnea. A full list of prescriptive information and additional information on indications, contraindications, warnings, precautions and potential complications is available here.

For more information, visit the Spiration Valve System product page or the OCI pulmonology product page for information about the entire Olympus portfolio.

About Olympus Canada
Olympus is passionate about creating customer-driven solutions. For more than 100 years, Olympus has focused on making people's lives healthier, safer and more fulfilling by helping to detect, prevent, and treat disease. Olympus Canada Inc. (OCI) – a subsidiary of Olympus Corporation of the Americas – manages the company's operations and workforce throughout Canada in roles such as sales, marketing, service, and support functions. Based in Richmond Hill, ON, OCI is committed to developing our employees and supporting our local communities. For more information, visit olympuscanada.com.

1 Criner GJ, Mallea JM, Abu-Hijleh M, et al. Sustained Clinical Benefits of Spiration Valve System in Severe Emphysema Patients: 24-Month Follow-Up of EMPROVE [published online ahead of print, 2023 Nov 10] Ann Am Thorac Soc. 2023;10.1513/AnnalsATS.202306-520OC
2 Amegadzie, J. E., et al. "Trends in hospital admissions for chronic obstructive pulmonary disease over 16 years in Canada." Pub. Sept. 11, 2023, Canadian Medical Association Journal. doi.org/10.1503/cmaj.221051

SOURCE Olympus Canada

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In a world increasingly aware of the microscopic dangers that lurk within our environment, two researchers stand at the forefront of a battle not just for the health of our crops, but for the very wellbeing of humanity itself. Dr. Oluwadara Pelumi Omotayo from Nigeria and Martha Mushi from Tanzania are pioneering research that seeks to mitigate the adverse effects of fungal pathogens, which pose significant risks to both human and animal health. Their work, rooted in the fertile grounds of scientific curiosity and innovation, spans the continent of Africa yet has implications that reverberate across the globe.

Guardians of the Grain: Combatting Fumonisins

Omotayo's research at North-West University, South Africa, dives deep into the soil of cornfields, where Fusarium verticillioides, a fungus responsible for producing fumonisins, thrives. These toxins not only harm livestock by causing liver and kidney damage but are also linked to esophageal cancer in humans. By harnessing the power of beneficial microbes such as Bacillus spp, Enterobacter, Pseudomonas, and Microbacterium oleovorans, Omotayo is developing a biological shield to protect crops from this insidious threat. Her work is not just about safeguarding crops; it's a quest to preserve our food supply and protect public health. Read more about Omotayo’s research.

Breathing Easier: Addressing Lung Fungal Infections

Meanwhile, Mushi's work at the Catholic University of Health and Allied Sciences in Tanzania tackles a different but equally daunting fungal foe: lung diseases caused by fungi in tuberculosis (TB) patients. Chronic pulmonary aspergillosis (CPA), a lung infection, exacerbates the suffering of TB patients, leading to higher mortality rates. Mushi's research focuses on understanding the prevalence and risk factors of CPA among TB patients and enhancing diagnostic capabilities to improve patient outcomes. With tuberculosis already a significant health challenge across Africa, Mushi's work is critical in ensuring that fungal infections do not add to the continent's health burden. Discover more about Mushi’s efforts.

Innovating for a Healthier Tomorrow

Both Omotayo and Mushi exemplify the potential of scientific innovation emerging from the Global South to address universal challenges. Their work not only confronts the immediate threats posed by fungal pathogens but also contributes to the broader fight against food insecurity and infectious diseases. By exploring the microscopic world, these scientists are making giant leaps toward safeguarding our health and ensuring a more secure future for our global food supply. Their research underscores the critical role of science in solving some of the most pressing issues of our time, demonstrating that even the smallest organisms require our attention and respect.

Their ongoing studies and discoveries encourage a rethinking of how we approach the protection of our health and food systems. As we continue to face global challenges, the work of Omotayo, Mushi, and their colleagues around the world serves as a beacon of hope, guiding us toward innovative solutions that harness the power of the natural world. Their efforts remind us of the importance of supporting scientific research and collaboration across borders to build a healthier, more sustainable future for all.



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A recent study found that individuals who survived a severe COVID-19 infection experienced lung function damage. Researchers noted that half of the participants reported experiencing shortness of breath, potentially influenced by factors such as underlying health conditions and environmental pollution.

The research conducted by the Christian Medical College, Vellore, studying the effects of Covid-19 on lung function, analyzed 207 individuals.

The study analyzed significant declines in lung function, exercise capacity, and quality of life among recovered individuals.

The research revealed a notable occurrence of respiratory symptoms among Indian individuals post-recovery, persisting even beyond two months of acute Covid-19 illness. Shortness of breath was reported by 49.3% of participants, while 27.1% experienced coughing.

“It is clear from the study that lung function is affected more in the Indian population compared to data from other countries across every category of disease severity,” said study lead researcher D J Christopher, professor of pulmonary medicine at CMC Vellore.

The expert said that although it is impossible to know the exact cause of worse impairment among Indians, co-morbidities may be a factor. Co-morbidities describe when a person has more than one disease or condition at the same time.

The researchers, whose findings were published in the journal PLOS Global Public Health, conducted a comparative analysis of data from Europe and China.

An Italy-based study found dyspnoea present in 43% and cough in less than 20% of subjects, with lower figures in a Chinese study compared to the Indian study. However, the CMC study didn’t provide specific data from China or other European countries.

Regarding comorbidities, CMS Vellore researchers found 72.5% reporting conditions like type 2 diabetes, systemic hypertension, and chronic lung diseases.

Lung function tests revealed concerning trends, notably in diffusion capacity for carbon monoxide (DLCO). About 44.4% had DLCO issues, higher in severe Covid-19 cases. The study highlighted worse lung function impairment in Indian subjects compared to predominantly Caucasian cohorts, underscoring post-Covid-19 lung damage’s significant impact on function, quality of life, and effort tolerance.

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