FRIDAY, May 27, 2022 (HealthDay News) -- Chronic exposure to air pollution, especially ground-level ozone (O3), may contribute to severe outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, according to a study published online May 24 in CMAJ, the journal of the Canadian Medical Association.

Chen Chen, Ph.D., from the University of California San Diego in La Jolla, and colleagues explored long-term exposure to ambient air pollution as a potential contributor to COVID-19 severity in a cohort of all people with confirmed SARS-CoV-2 infection aged 20 years and older. The association of long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and O3 with the risk for COVID-19-related admission, intensive care unit (ICU) admission, and death was examined.

The researchers observed 8,630 hospital admissions, 1,912 ICU admissions, and 2,137 deaths related to COVID-19 among 151,105 people with confirmed SARS-CoV-2 infection in Ontario in 2020. The estimated odds ratios (95 percent confidence intervals) were 1.06 (1.01 to 1.12), 1.09 (0.98 to 1.21), and 1.00 (0.90 to 1.11) for hospital admission, ICU admission, and death, respectively, for each interquartile range increase in exposure to PM2.5. Smaller estimates were seen for NO2. For each interquartile range increase of 5.14 ppb in O3, the corresponding odds ratios (95 percent confidence intervals) were estimated at 1.15 (1.06 to 1.23), 1.30 (1.12 to 1.50), and 1.18 (1.02 to 1.36).

"Uncertainty still remains in the mechanisms of how long-term air pollution might affect COVID-19 severity, which calls for future research," the authors write.

Abstract/Full Text

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This article was originally published here

Am J Emerg Med. 2022 May 4;58:5-8. doi: 10.1016/j.ajem.2022.04.052. Online ahead of print.

ABSTRACT

BACKGROUND: Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator and mild bronchodilator that has been shown to improve systemic oxygenation, but has rarely been administered in the Emergency Department (ED). In addition to its favorable pulmonary vascular effects, in-vitro studies report that NO donors can inhibit replication of viruses, including SARS Coronavirus 2 (SARS-CoV-2). This study evaluated the administration of high-dose iNO by mask in spontaneously breathing emergency department (ED) patients with respiratory symptoms attributed to Coronavirus disease 2019 (COVID-19).

METHODS: We designed a randomized clinical trial to determine whether 30 min of high dose iNO (250 ppm) could be safely and practically administered by emergency physicians in the ED to spontaneously-breathing patients with respiratory symptoms attributed to COVID-19. Our secondary goal was to learn if iNO could prevent the progression of mild COVID-19 to a more severe state.

FINDINGS: We enrolled 47 ED patients with acute respiratory symptoms most likely due to COVID-19: 25 of 47 (53%) were randomized to the iNO treatment group; 22 of 47 (46%) to the control group (supportive care only). All patients tolerated the administration of high-dose iNO in the ED without significant complications or symptoms. Five patients receiving iNO (16%) experienced asymptomatic methemoglobinemia (MetHb) > 5%. Thirty-four of 47 (72%) subjects tested positive for SARS-CoV-2: 19 of 34 were randomized to the iNO treatment group and 15 of 34 subjects to the control group. Seven of 19 (38%) iNO patients returned to the ED, while 4 of 15 (27%) control patients did. One patient in each study arm was hospitalized: 5% in iNO treatment and 7% in controls. One patient was intubated in the iNO group. No patients in either group died. The differences between these groups were not significant.

CONCLUSION: A single dose of iNO at 250 ppm was practical and not associated with any significant adverse effects when administered in the ED by emergency physicians. Local disease control led to early study closure and prevented complete testing of COVID-19 safety and treatment outcomes measures.

PMID:35623183 | DOI:10.1016/j.ajem.2022.04.052



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The Centers for Disease Control and Prevention (CDC) has vowed to exert more effort in better understanding long COVID while still monitoring the ongoing pandemic. 

More than two years into the global health crisis, the medical community has become more perplexed by the syndrome of conditions that continues to persist in millions of people who previously battled COVID-19. 

“A growing number of persons previously infected with SARS-CoV-2, the virus that causes COVID-19, have reported persistent symptoms, or the onset of long-term symptoms, ≥4 weeks after acute COVID-19; these symptoms are commonly referred to as post-COVID conditions, or long COVID,” the public health agency said this week. 

In its latest Morbidity and Mortality Weekly Report, the CDC pointed out how post-COVID syndrome appeared more common among adults, specifically the 18-64 and over 65 age groups in the United States. 

The incidence of long COVID in the 18-64 group was one in five, while the incidence in the over 65 age group was one in four. The CDC also noted that these COVID-19 survivors have a higher risk of developing pulmonary embolism or respiratory conditions. 

As such, the agency has called for the implementation of prevention strategies and routine assessment for post-COVID syndrome in patients who survive COVID-19. This is to reduce the incidence of long COVID and lower the impact of the lingering symptoms on the two age groups, as per Fox News.  

The CDC organized the long COVID symptoms into several categories, including neurologic and mental health conditions, cardiovascular conditions, respiratory conditions, musculoskeletal conditions, blood and vascular tissue problems, and kidney failure. COVID survivors who have any of the symptoms are urged to speak with their health care provider. 

Finally, the agency reiterated the need for vaccinations during the pandemic to prevent infection and the complications that come with the virus. The CDC maintained that vaccination is still the best way to control the long COVID situation. 

“The best way to prevent post-COVID conditions is to protect yourself and others from becoming infected. For people who are eligible, getting vaccinated and staying up to date with vaccines against COVID-19 can help prevent COVID-19 infection and protect against severe illness,” the CDC said. 



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Breathing patterns are an important indicator of an individual’s health. A healthy individual breathes naturally using primary respiratory muscles (e.g., diaphragm muscle) that produce a rhythmic observable movement of the upper rib cage, lower rib cage, and abdomen. This is known as the diaphragmatic breathing pattern, which has been associated with improvements in posture, core stability, and functional performance, as well as reductions in musculoskeletal injury, pain, and stress.

In contrast, individuals with altered or dysfunctional biomechanical breathing patterns are unable to contract their diaphragm to a desired extent and begin relying on accessory respiratory muscles to breathe. They display superior rib cage movement and shoulder elevation, reduced abdominal movements, and lateral rib cage expansion.

Previous research suggests a strong association between altered biomechanical breathing patterns and the development of musculoskeletal conditions, such as lower back pain, neck pain, chronic ankle instability, and temporomandibular joint disorders.

Superior physical performance and prevention of musculoskeletal injuries are crucial for athletes to deliver their best performance at competitive sports. Evidence from previous studies suggests that athletes with diaphragmatic breathing patterns display improved physical and psychological performance. But since athletes with altered breathing patterns might be at an enhanced risk of developing musculoskeletal injuries, identifying the prevalence of altered breathing patterns is of utmost importance to prevent them from developing injuries.

Now, a team of researchers led by Dr. Terada from Ritsumeikan University in Japan has conducted a novel study, published in The Journal of Strength and Conditioning Research, to examine the prevalence of dysfunctional and diaphragmatic breathing patterns in an athletic population, and determine the biomechanical dimensions of these breathing patterns.

The team tested 1933 competitive athletes from schools in Japan, across multiple sports and ages during 2017 and 2020, using a Hi-Lo test — a test that identifies an individual’s breathing pattern. Scores for the Hi-Lo test were determined based on the presence or absence of abdominal excursion, anterior-posterior chest expansion, superior rib cage migration and shoulder elevation. The team further classified these participants into thoracic-dominant and abdomen-only breathers based on the presence of abdominal excursion.

Findings indicate that an alarmingly high proportion (91%) of the athletes displayed dysfunctional breathing patterns, while only 9.4% of them displayed diaphragmatic breathing patterns. In fact, among athletes who played baseball, there was a greater percentage of diaphragmatic breathers than that among those who played tennis, basketball, badminton, and volleyball. This indicates that athletes’ breathing patterns vary depending on the type of sport they are involved in, since each sport has different energy demands and constraints.

Moreover, the team observed that the highest proportion of dysfunctional breathers were middle school student athletes, followed by elementary school student athletes, and high school student athletes. The proportion of collegiate athletes with dysfunctional breathing patterns was slightly lower in comparison.

Further, among the population identified as dysfunctional breathers, 61% of the athletes were found to be thoracic-dominant breathers, as compared to the 39% abdomen-only breathers.

These findings suggest an overall high prevalence of dysfunctional breathing patterns in the athletic population across age groups, which requires immediate addressing as an important sports-medicine issue.

When asked about the implications of these findings, Dr. Terada said “Clinicians need to consider screening breathing patterns and implementing corrective approaches targeted at specific components of dysfunctional breathing patterns. They should also consider evaluating sport-specific adaptations of breathing and implementing sport-specific breathing training protocols.”

The findings also emphasize the importance of the Hi-Lo test in recognizing the differences between sub-categories (thoracic-dominant and abdomen-only) of breathing patterns. An understanding of these breathing patterns can help develop individualized intervention plans. Dr. Terada says, “Incorporating diaphragm breathing exercises and techniques may have beneficial effects on restoring optimal recruitments and motor control patterns of respiratory muscles, improving the efficiency of the biomechanics of breathing and decreasing psychological stress in athletes with dysfunctional breathing patterns.”

Reference:

  1. Yuka Shimozawa, Toshiyuki Kurihara, Yuki Kusagawa, Miyuki Hori, Shun Numasawa, Takashi Sugiyama, Takahiro Tanaka, Tadashi Suga, Ryoko S. Terada, Tadao Isaka, Masafumi Terada. Point Prevalence of the Biomechanical Dimension of Dysfunctional Breathing Patterns Among Competitive Athletes. Journal of Strength and Conditioning Research, 2022; Publish Ahead of Print DOI: 10.1519/JSC.0000000000004253
/Public Release. This material from the originating organization/author(s) may be of a point-in-time nature, edited for clarity, style and length. The views and opinions expressed are those of the author(s).View in full here.

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Background

The airway connects the nose and mouth to the alveoli in the lungs, where oxygen (O2) and carbon dioxide (CO2) are exchanged naturally. Airway management is a technique, maneuver, or equipment used to maintain the patency of the airway so that normal physiological activities, such as gas exchange, can be accomplished.1 Manual ventilation may be required if a person’s O2 and CO2 exchange is inadequate. However, basic airway maneuvers to open the airway are typically enough to regulate or improve spontaneous air movements.2

As airway issues or respiratory failures are the leading causes of death in the first hours after an injury, the basic procedures remain the “cornerstones” of appropriate emergency care.3,4 Airway and breathing management require immediate attention, as patients may die if these actions are not taken. One of the most important emergency airway management procedures for keeping patients alive is airway maintenance without “endotracheal intubation”.5

Opening the airway with manual maneuvers such as head tilt - chin lift, jaw thrust, recovery positioning, keeping the airway open with devices such as oropharyngeal and nasopharyngeal airways, oxygen therapy, suctioning/removing secretion, and ventilation are all basic airway and breathing management. In the event of a foreign body obstruction, numerous treatments such as abdominal thrusts (Heimlich maneuver), chest thrusts, and back blows (slaps) can be used to manage the fundamental airway. The presence of arterial hypoxemia and tissue hypoxia is the most common reasons for supplementary oxygen. High-flow delivery systems (venture masks), low-flow delivery systems (nasal prong/cannula), basic masks, partial rebreathing masks, and Bag-Mask Ventilation are all options for delivering oxygen.2,5–9

In patients who are at risk of secretion, suctioning using large-bore suction catheters can help with emergency airway control. The bag valve mask, which was pioneered by anesthesiologists in the 1950s and 1960s and has saved many lives, takes first place in the revolution of airway management for substantial improvements in anesthesiology and resuscitation.7,8,10–13

In developed countries, well-organized Emergency Medical Service (EMS) systems have been shown to save lives that were previously at high risk of dying at the scene or while being transported to the hospital. However, in developing metropolitan cities such as Addis Ababa, Ethiopia, there is still a high rate of preventable morbidity and mortality. The main causes are a lack of a coordinated EMS system, a designated well-developed emergency center (EC), insufficient human and material resources to care for injured or acutely ill patients, insufficient medical training on triage and emergency management principles, and a lack of long-term funding for emergency care services.14,15

Previous studies have demonstrated inadequate fundamental airway and breathing management with wide variance between emergency departments, despite its clinical and research importance in the management of critically ill and injured patients.16–18 According to a Nepalese study, just 33% of health practitioners knew how to properly open the airway of an unresponsive injured victim. Similarly, an Egyptian study found that more than 85% of respondents could not name the first step in confirming a suspected airway obstruction.9,19

According to the authors’ knowledge, no study has been conducted specifically on nurses’ knowledge and practice of emergency airway and breathing management in our study areas, which is the most important in planning training for its use, differentiating, and preventing the factors linked to poor patient outcomes. As a result, the purpose of this study was to evaluate the knowledge, practice, and associated factors of airway and breathing management among nurses working in the emergency departments of selected public hospitals governed by the Addis Ababa Health Bureau (AAHB) in Addis Ababa, Ethiopia.

Objective

General Objective

To analyze nurses’ emergency airway and breathing management knowledge, practices, and associated factors in the emergency departments of selected public hospitals in Addis Ababa, Ethiopia.

Specific Objective

To assess knowledge of emergency airway and breathing management among nurses working in the emergency departments of selected public hospitals in Addis Ababa, Ethiopia.

To assess practice of emergency airway and breathing management among nurses working in the emergency departments of selected public hospitals in Addis Ababa, Ethiopia.

To find out what factors were linked to emergency airway and breathing management expertise among nurses working in the emergency departments of a few public hospitals in Addis Ababa, Ethiopia.

Materials and Methods

Study Area and Study Period

The research was conducted in Addis Ababa, Ethiopia’s capital city, at AAHB-managed public hospitals. AAHB was in charge of six public hospitals in Addis Ababa. Three of these hospitals were chosen at random for this investigation. Yekatit 12 Hospital, Zewditu Memorial Hospital, and Tirunesh Beijing Hospital are the hospitals in question. There are 44 nurses at Yekatit 12 Hospital; 45 nurses at Zewditu Memorial Hospital; and 17 nurses at Tirunesh Beijing Hospital. A total of 106 nurses were working in the emergency rooms of the three hospitals. The current research took place from April 12 to April 30, 2021.

Study Design

A cross-sectional survey study design was conducted to assess nurses´ knowledge, practice, and associated factors of airway and breathing management in the emergency departments of selected public hospitals in Addis Ababa, Ethiopia.

Population

Source Population

All nurses who were working at the emergency departments of government hospitals under the AAHB.

Study Population

All nurses who were working at the emergency departments of the three randomly selected governmental hospitals under AAHB.

Eligibility Criteria

Inclusion and Exclusion Criteria

Nurses working in the emergency departments of the participating hospitals who were available during the study period and had at least six months of experience had been included, while nurses who did not volunteer to participate in the study were omitted.

Sample Size Determination

There was no need to calculate the sample size because the total number of nurses working in the emergency departments of the three randomly selected hospitals was modest; therefore, all nurses who met the inclusion criteria were included in the study. A total of 102 people were included in the study.

Study Variables

Dependent Variables

Knowledge and practice of nurses toward emergency airway and breathing management were dependent variables of the study.

Independent Variables

Sociodemographic characteristics: age, sex, educational level, work experience, and previous emergency training were independent variables of the study.

Operational Definition

Airway and breathing management: Basic airway management knowledge and skills that include opening the airway, clearing secretion, O2 therapy, bag-mask ventilation, using devices to keep the airway open, and so on.6

Knowledge: The level of understanding of the different subjects regarding airway and breathing management. Good knowledge was defined as a score of greater or equal to the mean value of the knowledge questions, whereas poor knowledge was less than the mean value.

Practice: The necessary actions to be taken to help patients with emergency airway and breathing problems, like opening the airway for patients with trauma or non-trauma, applying maneuvers for choking patients, oxygen administration by bag valve masks for gasping patients, and so on.

Data Collection Tools and Procedures

After evaluating several studies, data was obtained from the study population using a standardized self-administered questionnaire15,20,21 based on the objectives intended for the study. The questionnaire is divided into three sections. Nurses’ sociodemographic features, knowledge of emergency airway and breathing management, and practice of emergency airway and breathing management were all examined. Age, sex, degree of schooling, work experience, and previous emergency-related training are among the sociodemographic questions. There are sixteen (16) multiple-choice questions in the knowledge section, each with one right answer. The correct answer received one point, while all other erroneous responses received zero points. The mean value for the knowledge questions was then determined, and respondents who scored greater or equal to the mean value were regarded to have strong knowledge of emergency airway and breathing management, while those who scored less than the mean value were judged to have poor knowledge. There are ten (10) multiple-choice questions in the practice questions about nurses’ emergency airway and breathing management skills. Descriptive statistics were used to summarize the data on nurse practice in the emergency airway and breathing management. Previous researchers examined the validity and reliability of the questionnaires, which were written in English. For this study, the questionnaire was pre-tested on 5% of nurses working in the emergency department of Menelik II hospital. Based on the results of the pretest, corrections were made to some of the questions by senior emergency physicians of Addis Ababa University. Three bachelors of science degree (BSC) nurses with prior expertise in data gathering were chosen and received a one-day training on the data collection process. For each hospital, a data collector was assigned, and all processes were done under the supervision of the lead investigator.

Data Quality Control

In addition to the training provided to data collectors, the primary investigator was reviewing how the data collectors were doing their jobs and supervising the activity on a daily basis during data collection. The lead investigator checked the completeness of questionnaires at the end of each data collection day.

Data Analysis

The information was double-checked for accuracy, coded, and entered into Epi Data version 3.1 before being transferred to the Statistical Package for Social Science (SPSS) version 25 for further analysis. For continuous variables, descriptive statistics such as mean and standard deviation were utilized, whereas, for categorical variables, frequency, and percentage distribution were used. The study’s findings were then arranged and presented, utilizing narratives, texts, tables, and graphs. The link between dependent and independent factors was demonstrated using bivariable and multivariable logistic regression models. To find variables associated with nurse knowledge and practice, all independent variables with p-values less than 0.25 in the bivariable logistic regression analysis were fitted into the multivariable logistic regression analysis. The strength of the connection was measured using the crude odds ratio (COR) and adjusted odds ratio (AOR) with corresponding 95% confidence intervals (CI). Finally, factors in the multivariable logistic regression were considered statistically significant if their P-values were less than 0.05.

Results

Socio-Demographic Characteristics of Respondents

A total of 102 nurses took part in the survey, with a 96.2% response rate, while four nurses were unavailable throughout data collection. More than half of the study participants (52.9%) were females, ranging in age from 24 to 48 years old, with a mean age of 29.50 (SD 4.96). The majority of the study participants, 92 (90.2%), had a BSc degree, and the majority of them, 74 (72.5%), had emergency job experience ranging from one to five years (Table 1). In terms of past emergency-related training, 53 (52%) of the respondents had had different training, while 49 (48%) had not received any emergency-related training, and 11.32% took other type of training lke infection prevention, and general training on covid (Figure 1).

Table 1 Socio-Demographic Characteristics of Respondents, 2021 (N=102)

Figure 1 Status of the respondents on the emergency related training, 2021 (N=102).

Abbreviations: BLS, basic life support; ATLS, advanced trauma life support; ACLS, advanced cardiac life support; Other*, training like infection prevention, general training on COVID-19, and soft ware training on patient data.

Knowledge of Nurses on the Airway and Breathing Managements

To begin with, the mean value of knowledge questions was determined to be 9.44 (59%). Respondents who scored greater or equal to the mean value were considered knowledgeable about airway and breathing management. As a result, the participants’ overall knowledge of airway and breathing management was 46 (45.1%) (Figure 2). Respondent’s knowledge of the specific cases was variable. Seventy-five (73.5%) and 61 (59.8%) of respondents correctly identified the maneuvers used to open the airway with and without trauma suspicion (jaw thrust maneuver and head tilt-chin lift maneuver), respectively. Eighty-seven (85.3%) of the participants correctly identified difficulty speaking, breathing, or coughing as signs and symptoms of complete airway obstruction, and nearly all 98 (96.1%) of the participants correctly identified positioning a patient as a basic maneuver for airway and breathing management. Only 37 (36.3%) of the total respondents correctly identified endotracheal intubation as a non-basic airway device, and 37 (36.3%) correctly identified bag valve mask as a manual ventilation device that provides high oxygen concentration and artificial ventilation for someone with airway and breathing problems. The knowledge question with the fewest responses was “Not supraglottic airway,” which revealed that only 30.4% of the participants correctly answered that a bag valve mask is not a supraglottic airway (Table 2).

Table 2 Distribution of Responses on Knowledge Assessment of Airway and Breathing Management 2021 (N=102)

Figure 2 Overall level of knowledge of respondents, 2021 (N=102).

Practice of Nurses on the Airway and Breathing Managements

As shown in Table 3, the proper action (jaw thrust) was chosen by 88 (86.3%) of the responders when opening the airway for a patient with a suspected neck injury. The activities to be done for a responsive patient displaying choking symptoms, before suctioning, and a comatose injured patient as a first action was properly answered by about 25 (24.5%), 49 (48.0%), and 74 (72.5%) of the respondents, respectively. When it came to appropriate nursing care during oxygen therapy, only 33 (32.4%) of the study participants were able to provide an accurate response. Only 30 (29.4%) of respondents correctly answered the question about using a face mask for a patient with airway and breathing problems, while the majority of 73 (71.6%) correctly answered the question about using an ambu bag for a patient with airway and breathing problems.

Table 3 Distribution of Responses on the Practice Assessment of Airway and Breathing Management, 2021 (N=102)

Factors Affecting Knowledge of the Respondents

Bivariable logistic regression was used to establish the crude odds ratio of nurses’ strong understanding of airway and breathing management based on socio-demographic parameters such as age, sex, having received related training, emergency work experience, and educational level (Table 4). In bivariable logistic regression, only being trained in related training and job experience were significantly correlated with knowledge of airway and breathing management, with P = 0.029 and P = 0.075, respectively. Nurses who had been trained were 2.72 times more likely to be knowledgeable [COR = 2.72, 95% CI (1.11–6.67)] than those who had not been trained, and nurses with one to five years of emergency work experience were 2.54 times more likely to be knowledgeable [COR = 2.54, 95% CI (0.91–7.12)] than those with less than one year of work experience. Then, with a p-value, less than 0.25, the two variables of being trained in related training and having emergency job experience were included in multivariable logistic regression. In multivariate logistic regression, only individuals who had received related training were significantly correlated with knowledge of airway and breathing management with a p-value less than 0.05. As a result, nurses who had received relevant training were 2.78 times more likely to be informed than nurses who had not [AOR = 2.78, 95% CI (1.01–7.64)].

Table 4 Bivariable and Multivariable Analysis of Factors Affecting the Knowledge Towards Airway and Breathing Management 2021 (N=102)

Discussion

Nurses are the frontline workers in emergency rooms, dealing with a variety of patients with a variety of issues, particularly those with airway and breathing problems that require immediate attention. Nurses’ knowledge and experience are critical in dealing with such issues. As a result, the goal of this study was to analyze nurses’ knowledge, practice, and associated factors related to emergency airway and breathing treatment in public hospitals in Addis Ababa, Ethiopia.

With a score of ≥ mean value of 59% on the knowledge questions, only 45.1% of the respondents had an overall good understanding of airway and breathing management. The findings were consistent with a study conducted across several departments at Jazan University in Saudi Arabia, which found that the majority of students lacked fundamental knowledge of airway and breathing management. However, the current study’s findings were lower than those of a study conducted in India, which revealed a 63% success rate. The writers, on the other hand, described this as an insufficient level of expertise. The disparity could be owing to the study participants, who in the Indian study were undergraduate dental students learning about airway-related diseases and their managements in their courses, whereas in our study, the participants were nurses working in hospitals.22,23

More than half of the study’s participants (52.0%) had received airway and breathing management training. This was in contrast to research conducted at Jazan University in Saudi Arabia, which revealed that 52.3% of the participants had received no training on airway and breathing management. The difference could be due to the fact that the participants in the Jazan University study came from a variety of departments, including health sciences and non-health departments such as engineering, computer science, and business administration, so they were not trained in specific emergency training.22,24

According to the findings of the current study, the vast majority of participants (85.3%) were aware of the symptoms of complete airway obstruction. Our findings compare favorably to those of research conducted in Ethiopia by Legese Mebrahtu (58.9%) and Tiruneh Tafere (22.65%).25,26 Furthermore, a study conducted in Gondar, Ethiopia, differed from this one in that 79.6% of study participants were aware of the signs of airway blockage.27 The discrepancy could be related to the study’s utilization of a variety of health providers, as well as the study’s setting and study period. However, the current study’s findings are remarkably identical to those of Gangadevi Nandasena’s study, which found that 84.3% of the study subjects had knowledge of blocked airway care.28,29

A small but vocal majority in this study, 73.5% of participants correctly identified the procedure performed to open the airway for a patient who has no worry of neck damage. Our findings are similar to those reported in studies by Gondar Comprehensive Hospital in Ethiopia and Ali M. Alabdali, who found that 71.7% and 69.4% of respondents, respectively, were aware of airway opening maneuvers.27,30

When a patient’s airway cannot be protected, airway and breathing management equipment must be employed.25 According to the current study, just 36.3% of respondents recognized the use of an Ambu bag. This was refuted by research conducted in Rwanda, which found that 92.2% of study participants correctly answered questions on how to use the device.15 The discrepancy might be due to the fact that every health professional in our country Ethiopia are un familiar with airway and breathing management because the emergency department was newly emerged in our country. So, many of our study participants were unable to recognize the use of Ambu bag during airway and breathing management. Another prospective study conducted at Nikoukari hospital, a teaching hospital located in Tabriz, Iran showed that most residents who took traditional instructions regarding airway management faced difficult ventilation and intubation; but they improved this gap after rotating of anesthesiology rotation.31 This could also be supported by another study conducted at Nikoukari hospital.32

Only 38.2% of the participants in this study were able to correctly answer the question about why they needed to use an oral airway device. This contrasted with a study conducted in Rwanda, which found that 86.3% of study participants were aware of the objective of using an oral airway device.15 According to a Turkish study, only 7.7% of respondents were able to correctly attach nasal airway devices while regulating their airways and breathing.33 The explanation, in our opinion, could be due to the low value placed on such critical emergency medical equipment.

In multivariable logistic regression, the socio-demographic information being trained on related training on airway and breathing management was statistically connected with the respondents’ knowledge at a p-value less than 0.05, with p = 0.047 and [AOR = 2.783, 95% CI (1.013–7.645)]. The findings of this study are consistent with those of a study conducted in Gondar, Ethiopia, and Rwanda, which found that training improved respondents’ understanding of emergency treatment [AOR: 2.76, 95% CI (1.40–5.42)] and (Chi2 = 12.632, P = 0.006), respectively.15,24,27

The current study’s 86.3% finding is nearly identical to findings from studies conducted in Ethiopia and Rwanda, which revealed that a large majority of respondents, 88.3% and 96.1%, respectively, gave the correct response to the question, “What action should be taken while opening the airway for a patient with a suspected neck injury?” immobilizing the cervical spine by using the jaw thrust maneuver during airway and breathing management.15,26 In contrast to this study, another one conducted in Nepal found that just 33% of volunteers were able to open the injured patient’s airway.33 The explanation for the disparity could be attributed to the fact that the Nepalese study used volunteers who did not all work in the same field.

Only 24.5% of survey participants were aware of the first action that should be taken for a victim who suddenly displayed a sign of choking while eating. The majority of trial participants (71.6%) were able to provide ventilation using an Ambu bag. This is a significant difference from a study conducted in Botswana, which found that 48.2% of respondents were unable to deliver ventilation using an Ambu bag.34 The reason for this could be due to the fact that the study subjects in Botswana were district hospital nurses, and during the management of any emergency situations, the focus should be given to breathing before taking time for any system adjustments. Because oxygen treatment is one of the most important and fundamental abilities in the management of breathing, nurses should be familiar with indications, safe delivery techniques, and the amount of oxygen to be provided during the procedure. If oxygen therapy is chosen, the appropriate delivery device should be employed.20,28,34

This study has its own strength and limitations. As strength, the study tried to find the gaps in knowledge and practice towards airway and breathing management among nurses working in the emergency department which will serve as a source of information for further study. The limitations of this study were: the study used a cross-sectional study design which does not show the cause and effect association; the attitude aspect of respondents towards airway and breathing management was not included in this study even though it is very important for exercise, and the study did not use observation for practical assessment questions rather it used only theoretical information.

Conclusion

Finally, the goal of this research was to assess the nurses’ knowledge and practice in the three hospitals’ emergency departments, as well as the factors that influence airway and breathing care. According to the findings of this study, nurses working in emergency rooms lacked a basic understanding of airway and breathing treatment. Participation in related training was found to be strongly linked to nurses’ expertise. As a result, all nurses working in emergency departments of hospitals in Addis Ababa, Ethiopia, should get in-service training on basic life support.

Abbreviations

AAHB, Addis Ababa Health Bureau; ACLS, advanced cardiac life support; AOR, adjusted odds ratio; ATLS, advanced trauma life support; BLS, basic life support; BSC, bachelor of science degree; CI, confidence interval; CO2, carbondioxide; COR, crude odds ratio; EC, emergency center; EMS, emergency medical service; IRB, institutional review board; O2, oxygen, SD, standard deviation; SPSS, statistical package for social science.

Data Sharing Statement

All the data used to support the findings of this study are found in the hands of the corresponding author.

Ethical Considerations

Ethical clearance was obtained from both Addis Ababa University, College of Health Sciences, Department of Emergency Medicine, and the AAHB Institutional Review Board (IRB). The cooperative letter was written to each hospital’s administration for the activity. The purpose and data collection procedure of the study were communicated with the concerned body of the institutions. Permission was obtained from the relevant personnel in charge of the hospitals. Formal permission was secured from each hospital before distribution of the questionnaires and respondents were informed verbally to identify their willingness to respond to the questionnaires. Finally, written consent was obtained from the respondents who had participated in the study, and the confidentiality of the participants was kept throughout the study by not writing their names on the questionnaire.

Acknowledgments

First and foremost, we would like to express our gratitude to Addis Ababa University, College of Health Sciences, Department of Emergency Medicine, and Addis Ababa Health Bureau for their assistance in obtaining approval. Second, we praised the leadership of each institution, as well as the data collectors and participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Funding

The study was funded by Addis Ababa University, College of Health Sciences.

Disclosure

The authors report no conflicts of interest in relation to this work.

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Asthma is inflammation of the airways that carry air to and from the lungs. Symptoms include things like shortness of breath, chest tightness, and coughing or wheezing.

It’s a common condition. In the United States, 1 in 13 people — both children and adults — have asthma.

While there is no cure for asthma, avoiding triggers and taking certain medications can help manage and relieve symptoms.

Here’s what you need to know about asthma, what type of disease it is, and how it affects your immune system.

In short, no. Asthma is not considered an autoimmune disease.

Autoimmune diseases develop when the body’s immune system sees healthy tissues, organs, or cells as a threat. The immune system then attacks various parts of the body, which can cause a host of symptoms (joint pain, skin rash, heart issues, etc.) as a result.

Scientists have identified more than 80 autoimmune diseases. Examples include:

So, what is asthma?

While asthma is also caused by an immune response, it is not considered an autoimmune disease. Instead, it is a chronic lung disease because it primarily affects the lungs.

Experts share that chronic lung diseases may begin slowly but get worse with time or without treatment.

Common triggers, like smoke, cold air, pollen, illness, etc., can produce inflammation and excess mucus in the lungs and bring about asthma attacks (also called exacerbations).

There are various subtypes of asthma based on things like the severity and what triggers the condition, such as:

Researchers explain that both chronic (or long lasting) disorders, like asthma, and autoimmune diseases are the result of immune system abnormalities.

Both cause attacks of inflammation in the body. And both autoimmune and chronic diseases can cause life threatening issues if not treated properly.

There is no current cure for asthma or autoimmune diseases. But they can be managed and may go into remission periods with occasional flares.

Where they differ is that asthma is caused by the immune system’s response to certain triggers. Autoimmune conditions are caused by the immune system attacking healthy cells within the body.

Beyond that, asthma affects the lungs while autoimmune diseases usually affect many parts of the body with inflammation, pain, swelling, and heat.

Another key difference is the specific kind of helper T cells in the immune system that the conditions involve. Autoimmune diseases result from an “exaggerated” response of Th1 cells. Asthma results from a response of Th2 cells.

Here’s a quick breakdown of their similarities and differences:

Respiratory illnesses can trigger asthma attacks. If you have a compromised immune system, you may be more susceptible to contracting respiratory illnesses, like the common cold, influenza, bronchitis, or COVID-19.

Getting frequent bouts of illness may make asthma worse. In fact, some 75 percent of people share they get asthma flares when they have a respiratory virus, reports the nonprofit Asthma and Lung UK.

Why exactly? When you are sick, your body makes excess mucus and your airways may become inflamed. This setup makes breathing more difficult.

And if your breathing is already difficult, your chronic asthma may be triggered, leading to an asthma attack.

How to reduce your risks

You can reduce your risk of having an asthma attack during an illness by paying attention to your symptoms and taking a preventive inhaler as prescribed. Be sure to keep any other asthma medications close by if you need them as well.

Talk with your doctor about whether adding regular nebulizer treatments or other asthma treatments may help your respiratory symptoms as you recover.

If you have asthma, it may mean that you have a weaker immune system. In a 2017 study, researchers concluded that people with asthma tend to have suppressed immune systems and may be less able to ward off the flu than other groups.

Researchers looked at lung samples via bronchial biopsy from people with asthma and people without asthma. The lungs of people with asthma did not have a strong immune response to the flu when compared with the people who did not have asthma.

On the other hand, researchers noted that people with asthma appear to have some protective qualities. While they are more likely to be hospitalized, researchers said they are less likely to have severe illness and die from flu complications than people who do not have asthma.

More studies are needed to understand exactly why this is.

What about the effect of asthma medications?

The 2017 study also suggests that the use of corticosteroid medications, like asthma inhalers or oral medications, may suppress the immune system over time.

So, the less robust immune response to the flu overall may be from asthma itself or the use of these medications. That said, the benefits of taking inhaled medications for acute asthma attacks likely outweigh this risk.

Talk with your doctor if you have concerns about how your asthma is managed, how it affects your immune system, and how specific asthma treatments may affect your health.

Asthma is not an autoimmune disease. It is a chronic lung condition that can have serious health effects if not managed and treated properly.

Make an appointment with your doctor to find out what things you can do to keep yourself healthy and reduce your risk of asthma attacks during cold and flu season.

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DUBLIN, May 27, 2022 /PRNewswire/ -- The "Therapeutic Respiratory Devices Market Size, Share & Trends Analysis Report by Product Type (Nebulizer, Humidifiers, Oxygen concentrators), by Technology, by Filters, by Region, and Segment Forecasts, 2022-2030" report has been added to ResearchAndMarkets.com's offering.

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The global therapeutic respiratory devices market size is anticipated to reach USD 16.1 billion by 2030. The market is expected to expand at a CAGR of 6.8% from 2022 to 2030.

A growing geriatric population base, rapid technological advancements, and increasing prevalence of respiratory diseases are the key factors that are driving the market. The market is expected to grow due to rapid technological advancements in the healthcare sector. Nowadays, respiratory monitoring devices use software applications for the collection and analysis of data from ventilators equipped with the health system.

The tools in the software application improve patient monitoring through the measurement of parameters such as process and clinical variation in the ventilator therapy. The global increase in the cases of respiratory diseases is one of the major factors that are driving the market for therapeutic respiratory devices. According to the European Academy of Allergy and Clinical Immunology (EAACI) Global Atlas of Asthma 2021, more than 350 million patients around the world are suffering from asthma.

Moreover, waveform capnography is a technical advancement used in monitoring carbon dioxide levels. New product launch such as automated and stand-alone pressure controls for mechanical ventilators boosts the growth of the market. These pressure controllers enable a reduction in the risk of tracheal injuries and Ventilator-associated Pneumonia (VAP).

For instance, in November 2021, Fischer and Paykel launched F&P Visairo, a hospital under-nose mask for noninvasive ventilation, in the United States. F&P Visairo is a new high-performance under-nose hospital mask with dynamic support technology. The company also offers a humidifier with an integrated flow generator, which delivers high flows of air mixture to patients spontaneously breathing. Such factors are bolstering the growth of the market.

Therapeutic Respiratory Devices Market Report Highlights

  • The positive airway pressure devices segment accounted for the largest revenue share in 2021 owing to technological innovations resulting in increased portability and shelf life.

  • The HEPA filter technology segment accounted for the largest revenue share in 2021, because of the increasing prevalence of respiratory diseases coupled with technological advancements in this segment.

  • The humidifiers segment is anticipated to be the fastest-growing segment over the forecast period owing to the rising demand for humidifiers in hospitals, schools, home, and healthcare entities, and the increased prevalence of airborne infections such as tuberculosis.

  • In North America, the market is expected to maintain its dominant position over the forecast period owing to the rising geriatric population base and increasing prevalence of chronic respiratory diseases.

Key Topics Covered:

Chapter 1 Methodology and Scope

Chapter 2 Executive Summary

Chapter 3 Therapeutic Respiratory Devices Industry Outlook
3.1 Market segmentation
3.2 Market size and growth prospects
3.3 Therapeutic respiratory devices market dynamics
3.3.1 Market driver analysis
3.3.1.1 Growing geriatric population base
3.3.1.2 Rising prevalence of respiratory diseases
3.3.1.3 Rapid technological advancements
3.3.2 Market restraint analysis
3.3.2.1 Lack of patient compliance
3.3.2.2 Economic impact of respiratory disorders
3.4 Key opportunities Prioritized
3.5 Industry analysis-Porter's
3.6 Therapeutic respiratory devices PESTEL analysis
3.7 Therapeutic respiratory devices market heat map analysis, 2021
3.8 Impact of COVID-19
3.8.1 Current and Future Impact Analysis
3.8.2 Impact on Market Players
3.8.3 Disease Prevalence Analysis

Chapter 4 Therapeutic Respiratory Devices Product Outlook
4.1 Therapeutic respiratory devices market share, by product, 2021 & 2030
4.2 Nebulizers
4.2.1 Nebulizers market, 2017-2030 (USD Million)
4.2.2 Compressor-based nebulizers
4.2.2.1 Compressor-based nebulizers market, 2017-2030 (USD Million)
4.2.3 Piston-based hand-held nebulizers
4.2.3.1 Piston-based hand-held nebulizers market, 2017-2030 (USD Million)
4.2.4 Ultrasonic nebulizers
4.2.4.1 Ultrasonic nebulizers market, 2017-2030 (USD Million)
4.3 Humidifiers
4.3.1 Humidifiers market, 2017-2030 (USD Million)
4.3.2 Heated humidifiers
4.3.2.1 Heated humidifiers market, 2017-2030 (USD Million)
4.3.3 Passover Humidifiers
4.3.3.1 Passover humidifiers market, 2017-2030 (USD Million)
4.3.4 Integrated humidifiers
4.3.4.1 Integrated humidifiers market, 2017-2030 (USD Million)
4.3.5 Built-in humidifiers
4.3.5.1 Built-in humidifiers market, 2017-2030 (USD Million)
4.3.6 Stand-alone humidifiers
4.3.6.1 Stand-alone humidifiers market, 2017-2030 (USD Million)
4.4 Oxygen concentrators
4.4.1 Oxygen concentrators market, 2017-2030 (USD Million)
4.4.2 Fixed oxygen concentrators
4.4.2.1 Fixed oxygen concentrators market, 2017-2030 (USD Million)
4.4.3 PorTable oxygen concentrators
4.4.3.1 PorTable oxygen concentrators market, 2017-2030 (USD Million)
4.5 Positive airway pressure devices
4.5.1 Positive airway pressure devices market, 2017-2030 (USD Million)
4.5.2 Continuous positive airway pressure devices
4.5.2.1 Continuous positive airway pressure devices market, 2017-2030 (USD Million)
4.5.3 Auto-titrating positive airway pressure devices
4.5.3.1 Auto-titrating positive airway pressure devices market, 2017-2030 (USD Million)
4.5.4 Bi-level positive airway pressure devices
4.5.4.1 Bi-level positive airway pressure devices market, 2017-2030 (USD Million)
4.6 Ventilators
4.6.1 Ventilators market, 2017-2030 (USD Million)
4.6.2 Adult ventilators
4.6.2.1 Adult ventilators market, 2017-2030 (USD Million)
4.6.3 Neonatal ventilators
4.6.3.1 Neonatal ventilators market, 2017-2030 (USD Million)
4.7 Gas analyzers
4.7.1 Gas analyzers market, 2017-2030 (USD Million)
4.8 Capnographs
4.8.1 Capnographs market, 2017-2030 (USD Million)

Chapter 5 Therapeutic Respiratory Devices Technology Outlook
5.1 Therapeutic respiratory devices market share, by technology, 2021 and 2030
5.2 Electrostatic filtration
5.2.1 Electrostatic filtration market, 2017-2030 (USD Million)
5.3 HEPA filter technology
5.3.1 HEPA filter technology market, 2017-2030 (USD Million)
5.4 Hollow fiber filtration
5.4.1 Hollow fiber filtration technology market, 2017-2030 (USD Million)
5.5 Microsphere separation
5.5.1 Microsphere separation technology market, 2017-2030 (USD Million)

Chapter 6 Therapeutic Respiratory Devices Filters Outlook
6.1 Therapeutic respiratory devices market share, by filter, 2021 & 2030
6.2 Nebulizer filters
6.2.1 Nebulizer filters market, 2017-2030 (USD Million)
6.2.2 Inlet filters
6.2.2.1 Inlet filters market, 2017-2030 (USD Million)
6.2.3 Replacement filters
6.2.3.1 Replacement filters market, 2017-2030 (USD Million)
6.2.4 Cabinet filters
6.2.4.1 Cabinet filters market, 2017-2030 (USD Million)
6.3 Humidifier filters
6.3.1 Humidifier filters market, 2017-2030 (USD Million)
6.3.2 Wick filters
6.3.2.1 Wick filters market, 2017-2030 (USD Million)
6.3.3 Permanent cleanable filters
6.3.3.1 Permanent cleanable filters market, 2017-2030 (USD Million)
6.3.4 Mineral absorption pads
6.3.4.1 Mineral absorption pads market, 2017-2030 (USD Million)
6.3.5 Demineralization cartridges
6.3.5.1 Demineralization cartridges market, 2017-2030 (USD Million)
6.4 Positive airway pressure device filters
6.4.1 Positive airway pressure device filters market, 2017-2030 (USD Million)
6.4.2 Ultra fine foam inlet filters
6.4.2.1 Ultra fine foam inlet filters market, 2017-2030 (USD Million)
6.4.3 Polyester non-woven fiber filters
6.4.3.1 Polyester non-woven fiber filters market, 2017-2030 (USD Million)
6.4.4 Acrylic & polypropylene fiber filter
6.4.4.1 Acrylic & polypropylene fiber filters market, 2017-2030 (USD Million)
6.5 Oxygen concentrators filters
6.5.1 Oxygen concentrator filters market, 2017-2030 (USD Million)
6.5.2 HEPA filters
6.5.2.1 HEPA filters market, 2017-2030 (USD Million)
6.5.3 Cabinet filters
6.5.3.1 Cabinet filters market, 2017-2030 (USD Million)
6.5.4 Pre-inlet filters
6.5.4.1 Pre-inlet filters market, 2017-2030 (USD Million)
6.5.5 Inlet filters
6.5.5.1 Inlet filters market, 2017-2030 (USD Million)
6.5.6 Micro disk filters
6.5.6.1 Micro disk filters market, 2017-2030 (USD Million)
6.5.7 Felt intake filters
6.5.7.1 Felt intake filters market, 2017-2030 (USD Million)
6.5.8 Bacterial filters
6.5.8.1 Bacterial filters market, 2017-2030 (USD Million)
6.5.9 Hollow membrane filters
6.5.9.1 Hollow membrane filters market, 2017-2030 (USD Million)
6.6 Ventilator filters
6.6.1 Ventilator filters market, 2017-2030 (USD Million)
6.6.2 Mechanical filters
6.6.2.1 Mechanical filters market, 2017-2030 (USD Million)
6.6.2.2 HEPA filters
6.6.2.2.1 HEPA filters market, 2017-2030 (USD Million)
6.6.2.3 ULPA filters
6.6.2.3.1 ULPA filters market, 2017-2030 (USD Million)
6.6.2.4 Activated carbon filters
6.6.2.4.1 Activated carbon filters market, 2017-2030 (USD Million)
6.6.3 Electrostatic filters
6.6.3.1 Electrostatic filters market, 2017-2030 (USD Billion)
6.6.3.2 Tribocharged filters
6.6.3.2.1 Tribocharged filters market, 2017-2030 (USD Million)
6.6.3.3 Fibrillated filters
6.6.3.3.1 Fibrillated filters market, 2017-2030 (USD Million)

Chapter 7 Therapeutic Respiratory Devices Regional Outlook

Chapter 8 Competitive Landscape
8.1 BD
8.1.1 Company Overview
8.1.2 Financial Performance
8.1.3 Product Benchmarking
8.1.4 Strategic Initiatives
8.2 General Electric Healthcare
8.2.1 Company Overview
8.2.2 Financial Performance
8.2.3 Product Benchmarking
8.2.4 Strategic Initiatives
8.3 CAIRE Inc.
8.3.1 Company Overview
8.3.2 Financial Performance
8.3.3 Product Benchmarking
8.3.4 Strategic Initiatives
8.4 Koninklijke Philips N.V.
8.4.1 Company Overview
8.4.2 Financial Performance
8.4.3 Product Benchmarking
8.4.4 Strategic Initiatives
8.5 Compumedics Limited.
8.5.1 Company Overview
8.5.2 Financial Performance
8.5.3 Product Benchmarking
8.5.4 Strategic Initiatives
8.6 ICU Medical, Inc.
8.6.1 Company Overview
8.6.2 Financial Performance
8.6.3 Product Benchmarking
8.7 Medtronic
8.7.1 Company Overview
8.7.2 Financial Performance
8.7.3 Product Benchmarking
8.7.4 Strategic Initiatives
8.8 Invacare Corporation.
8.8.1 Company Overview
8.8.2 Financial Performance
8.8.3 Product Benchmarking
8.8.4 Strategic Initiatives
8.9 Fisher & Paykel Appliances Ltd
8.9.1 Company Overview
8.9.2 Financial Performance
8.9.3 Product Benchmarking
8.9.4 Strategic Initiatives
8.10 Mindray
8.10.1 Company Overview
8.10.2 Financial Performance
8.10.3 Product Benchmarking
8.10.4 Strategic Initiatives

For more information about this report visit www.researchandmarkets.com/r/5sb6xi

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Scientists show importance of screening breathing patterns in athletic populations
Credit: Ritsumeikan University

Dysfunctional breathing patterns are associated with a high risk of musculoskeletal conditions, resulting in poor physical performance. Now, a study by researchers in Japan has found that among athletes across age groups, there is a high prevalence of dysfunctional breathing patterns. Effective intervention strategies are required to restore normal breathing patterns and prevent injuries among athletes to ensure their superior performance and health.

Breathing patterns are an important indicator of an individual's health. A healthy individual breathes naturally using primary respiratory muscles (e.g., diaphragm muscle) that produce a rhythmic observable movement of the upper rib cage, lower rib cage, and abdomen. This is known as the diaphragmatic breathing pattern, which has been associated with improvements in posture, core stability, and functional performance, as well as reductions in musculoskeletal injury, pain, and stress.

In contrast, individuals with altered or dysfunctional biomechanical breathing patterns are unable to contract their diaphragm to a desired extent and begin relying on accessory respiratory muscles to breathe. They display superior rib cage movement and shoulder elevation, reduced abdominal movements, and lateral rib cage expansion.

Previous research suggests a strong association between altered biomechanical breathing patterns and the development of musculoskeletal conditions, such as lower back pain, neck pain, chronic ankle instability, and temporomandibular joint disorders.

Superior physical performance and prevention of musculoskeletal injuries are crucial for athletes to deliver their best performance at competitive sports. Evidence from previous studies suggests that athletes with diaphragmatic breathing patterns display improved physical and psychological performance. But since athletes with altered breathing patterns might be at an enhanced risk of developing musculoskeletal injuries, identifying the prevalence of altered breathing patterns is of utmost importance to prevent them from developing injuries.

Now, a team of researchers led by Dr. Terada from Ritsumeikan University in Japan has conducted a novel study, published in the Journal of Strength and Conditioning Research , to examine the prevalence of dysfunctional and diaphragmatic breathing patterns in an athletic population, and determine the biomechanical dimensions of these breathing patterns.

The team tested 1,933 competitive athletes from schools in Japan, across multiple sports and ages during 2017 and 2020, using a Hi-Lo test—a test that identifies an individual's breathing pattern. Scores for the Hi-Lo test were determined based on the presence or absence of abdominal excursion, anterior-posterior chest expansion, superior rib cage migration and shoulder elevation. The team further classified these participants into thoracic-dominant and abdomen-only breathers based on the presence of abdominal excursion.

Findings indicate that an alarmingly high proportion (91%) of the athletes displayed dysfunctional breathing patterns, while only 9.4% of them displayed diaphragmatic breathing patterns. In fact, among athletes who played baseball, there was a greater percentage of diaphragmatic breathers than that among those who played tennis, basketball, badminton, and volleyball. This indicates that athletes' breathing patterns vary depending on the type of sport they are involved in, since each sport has different energy demands and constraints.

Moreover, the team observed that the highest proportion of dysfunctional breathers were middle school student athletes, followed by elementary school student athletes, and high school student athletes. The proportion of collegiate athletes with dysfunctional breathing patterns was slightly lower in comparison.

Further, among the population identified as dysfunctional breathers, 61% of the athletes were found to be thoracic-dominant breathers, as compared to the 39% abdomen-only breathers.

These findings suggest an overall high prevalence of dysfunctional breathing patterns in the athletic population across age groups, which requires immediate addressing as an important sports-medicine issue.

When asked about the implications of these findings, Dr. Terada said "Clinicians need to consider screening breathing patterns and implementing corrective approaches targeted at specific components of dysfunctional breathing patterns. They should also consider evaluating sport-specific adaptations of breathing and implementing sport-specific breathing training protocols."

The findings also emphasize the importance of the Hi-Lo test in recognizing the differences between sub-categories (thoracic-dominant and abdomen-only) of breathing patterns. An understanding of these breathing patterns can help develop individualized intervention plans. Dr. Terada says, "Incorporating diaphragm breathing exercises and techniques may have beneficial effects on restoring optimal recruitments and motor control patterns of respiratory muscles, improving the efficiency of the biomechanics of breathing and decreasing psychological stress in athletes with dysfunctional breathing patterns."


Returning to physical activity post COVID-19 infection


More information:
Yuka Shimozawa et al, Point Prevalence of the Biomechanical Dimension of Dysfunctional Breathing Patterns Among Competitive Athletes, Journal of Strength and Conditioning Research (2022). DOI: 10.1519/JSC.0000000000004253

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Ritsumeikan University

Citation:
Importance of screening breathing patterns in athletic populations (2022, May 27)
retrieved 27 May 2022
from medicalxpress.com/news/2022-05-importance-screening-patterns-athletic-populations.html

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Here’s a little secret, though—those characteristics have just as much potential to help you improve your performance on the bike. In addition, they might even be able to help improve your overall quality of life. So, if that sounds like something you’re interested in, please, read on.

I’ve been running, riding bikes, dancing, and playing sports since I was a kid. I also attended a few yoga classes sporadically throughout my early 20s. Although I enjoyed the lessons that I managed to make it to, it was only as I began to reflect on the damage that some of my other activities were doing to my body—in addition to the role that fitness plays in mental health— that I began to take yoga seriously.

Having recently completed a comprehensive Vinyasa yoga teacher certification, I am more convinced than ever of yoga’s benefits, especially for those of us who love to ride. With that in mind, let’s dig into how yoga can benefit you as a cyclist and a few accessible yoga postures that you can get started with today!

Yoga and cycling have more in common than you think

If you think of yoga as a primarily static practice, it is probably because you haven’t tried it. Many types of yoga involve what we call ‘flow’ or moving meditation. You transition seamlessly from one posture to another, using your breath as the bridge that links everything together and creates a cohesive mind-body experience. Not unlike what happens when you get into the zone while riding your bike, you benefit most from your practice when you can maintain fluid breathing and a steady heart rate, keep a handle on what’s going on mentally, and hold an ongoing balance of effort.

Yoga alleviates pain now and protects your future mobility

For all the benefits that cycling offers our bodies, we have to admit that it also confines us to limited movement on a single plan of motion. As you’re likely aware, this repetitive motion can cause significant tightness in the hip flexors, quads, and calves. It can also result in adaptive muscle shortening, and the position we assume on the bike tends to tighten up the back and shoulders.

Yoga is the perfect antidote to lengthen everything back out, relieve tightness, alleviate pain and prevent injuries down the road. We might be focused on one thing while riding but having a limited range of motion means that you’re more likely to rely on a smaller group of muscles to do everything. This tendency towards overuse and adaptively shortened muscles is how injuries sneak up on us years down the road.

Yoga isn’t just about stretching; get ready to gain some serious strength

Although yoga is undoubtedly an excellent tool to improve your range of motion, it isn’t all about stretching and flexibility. If you’ve ever taken a vinyasa flow class before, you’ll know that yoga can be a dynamic and heat-building activity. It uses isometric and bodyweight exercises to challenge and improve functional strength. Many yoga asanas (postures) require balance and control. This means that a bunch of smaller muscles that we rarely use to fire up and help us maintain a stable foundation. As such, yoga can also improve general stability on the bike while building the muscles needed to produce more power with every pedal stroke.

Breathing and focus techniques give you an edge while riding

Most yoga-curious athletes come to class with the notion of doing right by their joints and muscles. However, the multitude of additional benefits start to reveal themselves for those who stick around. Since breathing is so central to the practice, you’ll soon find that regular posture practice translates to a more even breathing cadence throughout all of your athletic pursuits.

Regularly taking the time to practice conscious breathing techniques like those used in yoga can significantly improve your circumferential breathing and train your respiratory muscles to take in more air. Focusing on this aspect of the practice also has an overall calming effect and taps into your ability to summon mental focus and keep a clear head when things get challenging (on or off the bike).

5 great postures for cyclists

If you’re new to yoga, it is essential to take things slow and build a strong foundation for your future practice. Your initial focus should be on proper alignment, knowing that you can refine form and breath as you move deeper into the poses. While you’re moving through the posture, be aware of the quality of your breathing, spinal alignment, and muscle awareness—qualities that will all positively impact your pedal stroke.

Cat-cow pose (Bitilasana Marjaryasana)

Stiffness and back pain is a reality for most cyclists, and that’s why the spinal mobility aspect of yoga is so beneficial. Moving through a cat-cow pose gently stretches and releases the spine, eliminating tension across the shoulders and lower back. As in most yoga poses, you need to maintain an active engagement in the core to keep your spine straight—meaning you’re also helping to tone the muscles that wrap around the centre of your body.

Cow pose
Cow pose. © Profimedia

Method:

• Begin on all fours with your hands placed firmly on the mat, shoulder-width apart. Your knees should be directly below your hips.
• For cow pose, you’ll draw your shoulder blades towards your spine while you open up the chest and lift your gaze forward.
• For the cat pose, you’ll do the opposite by pushing into the ground to draw your shoulders away from one another as you drop your gaze back towards your toes and create roundness in your shoulders.
• When you feel familiar with both poses, you can begin to use the inhale and exhale of your breath to move between each pose.

Downward dog pose (Adho Mukha Svanasana)

Downward facing dog
Downward facing dog. © Profimedia

This is one of the most common postures in yoga for a reason, and its benefits are especially relevant for cyclists. Not only does it strengthen the upper back and shoulders, but it also stretches out your hamstrings and calves.

Method:

• Begin on all fours (like cat-cow) with your hands, knees, and tops of the feet grounded firmly on the mat.
• Once you have established a solid foundation, curl your toes and then slowly extend your hips and knees up and back.
• Keep your gaze back between your legs to allow your neck to relax as you draw your tailbone to the sky and extend through your spine.

Low lunge (Anjaneyasana)

Let’s release those hips! As this is quite a strong pose, it is vital to move into it mindfully. If you allow your body to ease into the stretch gradually, the sensation of release you’ll experience across the hips will feel fantastic. It also helps expand your lungs and chest and open up those shoulders. Lunges also work with balance and concentration while strengthening your core, glutes, and quad muscles.

Low lunge
Low lunge. © Profimedia

Method:

• From Downward-Facing Dog, exhale and step your right foot forward between your hands, aligning the right knee over the heel.
• Then lower your left knee to the floor and, keeping the right knee fixed in place, slide the left back until you feel a comfortable stretch in the left front thigh and groin.
• Turn the top of your left foot to the floor.
• Inhale and lift your torso upright.
• As you do, sweep your arms out to the sides and up perpendicular to the floor.
• Draw the tailbone down toward the floor and lift your pubic bone toward your navel.
• Lift your chest from the firmness of your shoulder blades against the back torso.

Spinal twist (Ardha Matsyendrasana)

Our spine is meant to move in all directions, so spinal twists are the ideal way to relieve some of the tension that builds up after spending a lot of time in the same riding position. When you allow yourself to move more deeply into the posture, you’ll also open up your shoulders, neck, and hips.

Yoga twist
A side twist variation. © Profimedia

Method:

• Sit with your legs straight in front of you.
• Bend your knees and place your feet on the floor.
• Move your left foot to the outside of your right hip and let your left knee rest on the floor.
• Bring your right foot to the outside of your left thigh, with your foot flat on the floor and your right knee pointing up at the ceiling.
• Rest your right hand or fingertips on the floor behind you, and your left hand on your right knee. As you inhale, lengthen your spine by sitting up tall.
• As you exhale, turn your torso toward your right thigh.
• Look gently back over your right shoulder or toward the front of the room.

Legs-Up-the-Wall (Viparita Kirani)

This is the perfect way to relax and give your legs a well-deserved rest after a long ride. This passive pose is like a soothing balm for tired or crampy legs and helps calm the mind and heart rate.

Method:

• Lie flat on your back near a wall. Walk your feet gently up the wall until the soles of your feet are facing the ceiling.
• Shift your torso until it is perpendicular to the wall, and move your buttocks as close to the wall as possible.
• Straighten your legs. If your hamstrings are tight, you can bend your knees slightly.
• Rest your hands by your hips or alongside your head with your elbows bent.
• To stretch the groin, separate the legs into a v-shape, as far as comfortable.
• Stay in this pose for 5 to 15 minutes.
• To come out of the pose, move your butt far enough away from the wall so you can slide the legs to the floor. Roll onto your side and rest for a moment before sitting up.

How to fit yoga into your training plan in a way that works for you

One of the beautiful things about yoga is that it can be as intense or relaxed as you want. Depending on what you need on any given day, you might choose postures that challenge you and hold them longer or opt for a stretchier and more passive practice. These calming sequences can be used as recovery, whereas a more challenging strength-based yoga workout should be seen as a strength training session. Slowly start to incorporate an appropriate yoga practice alongside your cycling routine, and I’m willing to bet that the benefits you see will make it easy to stick with it!

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

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

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


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

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

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

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

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

Reference

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

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In the last year, more than 120 deaths and over 21,000 complaints connected have been reported in connection to problems with Philips ventilators and CPAP and BiPAP machines.

Last June, the company recalled some of its breathing devices and ventilators after finding the polyurethane foam material for dampening the machines sounds may degrade and release small particles that irritate the airways and potentially cause cancer. It said it would replace up to four million devices and conduct more testing on the foam.

Reports of injuries and adverse events skyrocketed in the last year, said the FDA. Calculating 124 deaths and over 21,000 complaints from the medical device reports (MDRs) it received, the agency put out on May 19 a safety communication update. “A wide range of injuries have been reported in these MDRs, including cancer, pneumonia, asthma, other respiratory problems, infection, headache, cough, dyspnea (difficulty breathing), dizziness, nodules and chest pain.”

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According to the FDA, Philips turned over 30 MDRs about the foam deterioration between 2011 and 2021. It also was aware of 14 instances related to the issue that span all the way back to April 2016.

The agency warns that while a serious indicator of potential risks, especially regarding the sound abatement foam’s deterioration, not all MDRs have been definitely connected to the issues, due to “under-reporting of events, inaccuracies in reports, lack of verification that the device caused the reported event and lack of information about frequency of device use.”

The extent of the challenges associated with Philips' ventilators and respirators first came to light in April 2021 when the company revealed a software issue in its V60 and V60 Plus ventilators that reduced oxygen flow to patients. It later issued a Class one recall, the most serious type, for the devices.

It issued another a year later for both, along with its V680 ventilator, due to a circuit issue that causes them to cease operations. The problem affected at least 99,283 devices, according to the company.

And right before this, in March, it flagged its V60 and V60 Plus ventilators for having parts held together by an expired adhesive and risked becoming loose and leading the machines to shut down.

The combination of these problems in 2021 led the company to voluntarily withdraw from the sleep therapy market for at least a year to get to the bottom of the issues. It later said it would expand its ongoing recall, leading to a 15% drop in its stock in January. This also cost it nearly 40% (about $739 million) of its Q4 2021 adjusted EBITDA earnings and eroded its market value by about $5.1 billion.

The Department of Justice subpoenaed Philips in May 2022 for more information on the issues. The company has taken a €65 million (about $70 million) provision for the repair and replacement of its solutions, as well an approximate $107 million provision for potential higher costs.

The FDA says it is behind on the agency's preferred timeline for repairing and replacing the 5.2 million devices affected. Philips says it has so far produced 1.1 million replacement devices and repair kits and expects to complete the vast majority of repair-and-replace programs by the end of the year.



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


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

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

Cultivating Consensus on COPD Management

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

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

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

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

Providing Consistent COPD Guideline Adherence

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

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

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New York, May 27, 2022 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Respiratory Devices And Equipment (Diagnostic) Global Market Report 2022" - www.reportlinker.com/p06277193/?utm_source=GNW

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read the full report: www.reportlinker.com/p06277193/?utm_source=GNW

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

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

Source: www.vinmec.com/en/news/health-news/healthy-lifestyle/things-to-know-about-pursed-lip-breathing/

#pursedlipbreathing #breathingexercise

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

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

Steps you can take on your own include:

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

Source: www.healthline.com/health/what-oxygen-level-is-too-low-covid#symptoms-of-low-oxygen

#pursedlipbreathing #breathingexercise

Coronavirus survivors have twice the risk of developing dangerous blood clots that travel to their lungs compared to people who weren't infected, as well double the chance of respiratory symptoms, says a large new study. — AFP pic

Coronavirus survivors have twice the risk of developing dangerous blood clots that travel to their lungs compared to people who weren't infected, as well double the chance of respiratory symptoms, says a large new study. — AFP pic

Thursday, 26 May 2022 7:41 AM MYT

WASHINGTON, May 26 — Coronavirus survivors have twice the risk of developing dangerous blood clots that travel to their lungs compared to people who weren’t infected, as well double the chance of respiratory symptoms, a large new study said Tuesday.

The research by the Centers for Disease Control and Prevention found that as many as one in five adults aged 18-64 years and one in four of those over 65 went on to experience health conditions that could be related to their bout of Covid — a finding consistent with other research.

Among all conditions, the risk of developing acute pulmonary embolism — a clot in an artery of the lung — increased the most, by a factor of two in both adults younger and older than 65, as did respiratory symptoms like a chronic cough or shortness of breath.

Pulmonary embolisms usually travel to the lungs from a deep vein in the legs, and can cause serious problems, including lung damage, low oxygen levels and death.

The study was based on more than 350,000 patient records of people who had Covid-19 from March 2020 - November 2021, paired with 1.6 million people in a "control" group who had sought medical attention in the same month as a corresponding "case" patient, but weren’t diagnosed with Covid.

The team assessed the records for the occurrence of 26 clinical conditions previously associated with long Covid.

Patients were followed one month out from the time they were first seen until they developed a subsequent condition, or until a year had passed, whichever came first.

The most common conditions in both age groups were respiratory symptoms and musculoskeletal pain.

In patients under 65, risks after Covid elevated for most types of condition, but no significant differences were observed for cerebrovascular disease, mental health conditions, or substance-related disorders.

“Covid-19 severity and illness duration can affect patients’ health care needs and economic well-being," the authors wrote.

"The occurrence of incident conditions following infection might also affect a patient’s ability to contribute to the workforce and might have economic consequences for survivors and their dependents," as well as placing added strain on health systems.

Limitations of the study included the fact that data on sex, race, and geographic region were not considered, nor was vaccination status. Because of the time period, the study also didn’t factor in newer variants. — AFP

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Oxygen Conserving Devices Market: Overview

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

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

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

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

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

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

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Increasing Geriatric Population Fuels Demand for Continuous Innovation in Oxygen Therapy

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

Rising Prevalence of Chronic Bronchitis Drives Demand for Oxygen Conserving Devices

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

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Oxygen Conserving Devices Market: Prominent Regions

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

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

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

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Development of Innovative Disposable Oxygen Conservers Offers Significant Growth Opportunities

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

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

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Experts say even a mild case of COVID-19 can develop into long COVID. Stefan Tomic/Getty Images
  • A new study reports that 75 percent of people with long COVID were not initially hospitalized.
  • Another study estimates that 1 in 5 people between ages 18 and 64 will develop post-COVID conditions with that percentage rising to 1 in 4 for people older than 65.
  • Another study also reports that vaccinations can help reduce the risk of developing long COVID.

About 75 percent of people experiencing long COVID were not hospitalized with their initial COVID-19 illness.

A new analysis suggests that even people with mild or moderate COVID-19 cases that didn’t require hospital admission can still develop long COVID.

“We know that people who get long COVID may have a severe infection, they may be hospitalized or may even have asymptomatic infections. So, it’s not surprising that so many people with long COVID have not been hospitalized, especially if you consider that the vast majority of people with COVID-19 are not hospitalized,” Dr. Dean Blumberg, chief of Pediatric Infectious Diseases at the University of California Davis, told Healthline.

The analysis used data from a registry of private healthcare claims from 78,525 people.

The participants were diagnosed with long COVID between October 2021 and January 2022. The analysis showed a difference between men and women. About 81 percent of the female subjects were not hospitalized compared with 67 percent of males.

Those ages 36 to 50 were most likely to receive a diagnosis of a post-COVID condition, with women being more likely than men.

The most commonly reported long COVID symptoms were abnormalities of breathing, cough and malaise, and fatigue.

The analysis comes as the U.S. Centers for Disease Control and Prevention released a study that found 1 in 5 people between ages 18 and 64 will develop post-COVID conditions, with that number rising to 1 in 4 for those older than 65.

The potentially serious conditions include respiratory conditions, kidney failure, cardiovascular conditions, blood clots, and neurological conditions.

Blumberg says the symptoms of long COVID can vary between people and may be influenced by the symptoms a person experienced in their initial COVID-19 illness.

“Some people have, for example, lung fibrosis, inflammation of the lung that results in decreased breath and oxygen capacity, and that’ll cause more fatigue,” he said. “And other people won’t have that, they’ll have other symptoms such as loss of taste and smell that’s prolonged. And then other people will have a brain fog, a real difficulty concentrating. So it really just depends on the manifestations that are occurring in each individual.”

A recent study based in the United Kingdom found that getting vaccinated after a COVID-19 positive test can reduce the risk of long COVID.

The researchers examined data about 28,000 people between ages 18 and 69 who were given at least one vaccination dose after they had tested positive for COVID-19.

The researchers found that long COVID symptoms were reported in 24 percent of people at least once during the follow-up period of seven months.

A first dose of COVID-19 vaccine was associated with a decrease of 13 percent in the risk of getting long COVID initially, while a second dose was associated with a further 9 percent decrease.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee, says the results of the study are promising.

“We know that people who have recovered from COVID-19 and subsequently get vaccinated had very high levels of antibodies to the virus,” he told Healthline. “That’s a hopeful sign and encourages public health professionals to keep advocating for persuading people to be up to date in their vaccinations, whether or not they have had actual COVID-19 illness in the past.”

When it comes to avoiding long COVID, Schaffner says the best thing to do is avoid getting infected in the first place.

If a positive test does occur, he says it is important to take the time to properly recover.

“Try to prevent yet another infection from occurring, particularly if you’re a person who’s more apt to have serious disease. Keep wearing your mask, avoiding large groups, if at all possible,” Schaffner said.

“Paying attention to your illness, not trying to stretch yourself too much. Listen to your body, and do the degree of exercise and work that you know your body is capable of. But don’t go beyond that,” he added.

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The massive growth of Long COVID in the UK, now rapidly approaching 2 million cases, has exposed the devastating scale of the public health disaster produced by the government’s profit-driven “living with COVID” strategy.

At the beginning of April, the number of people suffering Long COVID reached 1.8 million, 2.8 percent of the UK population, according to data published by the Office for National Statistics. Of these self-reported cases, 1.3 million have suffered one or more COVID symptoms for more than 12 weeks, 791,000 for more than one year, and 235,000 for more than two years.

A rendering of the SARS-CoV-2 virus (National Institute of Allergy and Infectious Diseases)

The World Health Organisation has described the condition as a “pandemic within the pandemic”. The number of cases worldwide has grown to an estimated 100 million as the wealthiest capitalist governments have allowed the virus to spread and mutate without restriction in the name of saving “the economy”—i.e., the profit interests of big business.

The most common symptoms reported are fatigue (51 percent), shortness of breath (33 percent), loss of smell (26 percent), and problems concentrating or brain fog (23 percent). Two-thirds of all cases, 1.2 million people, report being unable to perform some or all their regular daily actives. There are currently 1 million missing from the workforce compared to pre-pandemic employment in the UK, including 400,000 no longer working because of poor health, including Long COVID.

Long COVID is defined as suffering symptoms for 12 weeks or more after a COVID-19 diagnosis, in conditions where no other cause is identified. Half of all people hospitalised with COVID still exhibit at least one symptom two years after infection, according to a study published in the Lancet medical journal.

As with risk of serious illness and death from infection with COVID-19—which kills working-age people in the most deprived areas at nearly four times the rate than among people in the wealthiest areas—Long COVID is primarily a disease of the poor and socially vulnerable. The Imperial College London’s REACT study of 500,000 UK adults found a higher risk of persistent COVID symptoms among women, people who smoke or who are overweight, people who live in deprived areas, and those who have been admitted to hospital with COVID-19.

While some COVID survivors experience persistent symptoms for only a few weeks or months, there is a growing body of scientific research linking Long COVID to a plethora of life-changing and deadly chronic diseases, including brain damage, kidney disease, diabetes, chronic fatigue, nerve damage and heart disease. While these illnesses are more common in those who developed severe illness upon initial infection, Long COVID can also devastate the health of those who experienced only mild symptoms.

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World

Covid-19 Minister Chris Hipkins briefing on the Covid-19 Response and the future of the Covid-19 Response Act.

New US research on long Covid provides fresh evidence that it can happen even after breakthrough infections in vaccinated people, and that older adults face higher risks for the long-term effects.

In a study of veterans published Wednesday, about one-third who had breakthrough infections showed signs of long Covid.

A separate report from the Centres for Disease Control and Prevention found that up to a year after an initial coronavirus infection, 1 in 4 adults aged 65 and older had at least one potential long Covid health problem, compared with 1 in 5 younger adults.

Long Covid refers to any of more than two dozens symptoms that linger, recur or first appear at least one month after a coronavirus infection. These can affect all parts of the body and may include fatigue, shortness of breath, brain fog and blood clots.

Coronavirus vaccines that help prevent initial infections and serious illnesses provide some protection against long Covid but mounting research shows not as much as scientists had first hoped.

The veterans study published in Nature Medicine reviewed medical records of mostly white male veterans, aged 60, on average. Of the 13 million veterans, almost 3 million had been vaccinated last year, through October.

About 1 per cent, or nearly 34,000, developed breakthrough infections. Lead author Dr Ziyad Al-Aly noted that the study was done before the highly contagious Omicron variant appeared at the end of the year and said the rate of breakthrough infections has likely increased.

Breakthrough infections and long Covid symptoms were more common among those who had received Johnson & Johnson's single-dose shot compared with two doses of either Moderna or Pfizer vaccines. Whether any had received booster shots is not known; the first booster wasn't okayed in the US until late September.

Overall, 32 per cent had long Covid symptoms up to six months after breakthrough infections. That's compared with 36 per cent of unvaccinated veterans who had been infected and developed long Covid.

Vaccination reduced the chances for any long Covid symptoms by a "modest" 15 per cent", although it cut the risk in half for lingering respiratory or clotting problems, said Al-Aly, a researcher with Washington University and the Veterans Affairs health system in St Louis. These symptoms included persistent shortness of breath or cough and blood clots in lungs or veins in the legs.

Infectious disease expert Dr Kristin Englund, who runs a centre for long Covid patients at the Cleveland Clinic, said the Nature Medicine study mirrors what she sees at her clinic. Long Covid patients there include people who were vaccinated and received boosters.

"As we have no clear treatments for long Covid, it is important for everyone to get vaccinated and use other proven methods of prevention such as masking and social distancing in order to prevent infections with Covid and thus long Covid," Englund said.

The CDC report, released Tuesday, used medical records for almost 2 million US adults from the start of the pandemic in March 2020 to last November. They included 353,000 who had Covid-19. Patients were tracked for up to a year to determine if they developed any of 26 health conditions that have been attributed to long Covid.

Those who had Covid were much more likely than other adults without Covid to develop at least one of these conditions, and risks were greatest for those aged 65 and older. Information on vaccination, sex and race was not included.

Breathing problems and muscle aches were among the most common conditions.

Older adults' risks were higher for certain conditions, including strokes, brain fog, kidney failure and mental health problems. The findings are worrisome because those conditions can hasten older adults' needs for long-term care, the report authors said.

They stressed that routine assessment of all Covid patients "is critical to reduce the incidence" of long Covid.

- AP

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