is 7 Surprising Goat Milk Soap Benefits By www.medicinenet.com Published On :: Fri, 12 Aug 2022 00:00:00 PDT Title: 7 Surprising Goat Milk Soap BenefitsCategory: Health and LivingCreated: 8/12/2022 12:00:00 AMLast Editorial Review: 8/12/2022 12:00:00 AM Full Article
is Nerve Block Plus Lidocaine Clears Psoriasis in Small Study By www.medicinenet.com Published On :: Tue, 16 Aug 2022 00:00:00 PDT Title: Nerve Block Plus Lidocaine Clears Psoriasis in Small StudyCategory: Health NewsCreated: 8/15/2022 12:00:00 AMLast Editorial Review: 8/16/2022 12:00:00 AM Full Article
is What Is a Good Height for a Man? By www.medicinenet.com Published On :: Thu, 7 Jul 2022 00:00:00 PDT Title: What Is a Good Height for a Man?Category: Health and LivingCreated: 7/7/2022 12:00:00 AMLast Editorial Review: 7/7/2022 12:00:00 AM Full Article
is Here Is Why Men Should Take Vitamin B12: 10 Health Benefits By www.medicinenet.com Published On :: Wed, 27 Jul 2022 00:00:00 PDT Title: Here Is Why Men Should Take Vitamin B12: 10 Health BenefitsCategory: Health and LivingCreated: 7/27/2022 12:00:00 AMLast Editorial Review: 7/27/2022 12:00:00 AM Full Article
is Prostatitis (Inflammation of the Prostate Gland) By www.medicinenet.com Published On :: Fri, 29 Jul 2022 00:00:00 PDT Title: Prostatitis (Inflammation of the Prostate Gland) Category: Diseases and ConditionsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 7/29/2022 12:00:00 AM Full Article
is Swimmer's Ear (External Otitis) By www.medicinenet.com Published On :: Wed, 29 Jun 2022 00:00:00 PDT Title: Swimmer's Ear (External Otitis)Category: Diseases and ConditionsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 6/29/2022 12:00:00 AM Full Article
is COVID Crisis Has Stalled Fight Against HIV/AIDS By www.medicinenet.com Published On :: Fri, 29 Jul 2022 00:00:00 PDT Title: COVID Crisis Has Stalled Fight Against HIV/AIDSCategory: Health NewsCreated: 7/28/2022 12:00:00 AMLast Editorial Review: 7/29/2022 12:00:00 AM Full Article
is Menopause Linked With Higher Alzheimer's Risk By www.medicinenet.com Published On :: Thu, 30 Jun 2022 00:00:00 PDT Title: Menopause Linked With Higher Alzheimer's RiskCategory: Health NewsCreated: 6/30/2022 12:00:00 AMLast Editorial Review: 6/30/2022 12:00:00 AM Full Article
is Why is My Blood Pressure Suddenly High and Low? By www.medicinenet.com Published On :: Wed, 6 Jul 2022 00:00:00 PDT Title: Why is My Blood Pressure Suddenly High and Low?Category: Diseases and ConditionsCreated: 7/6/2022 12:00:00 AMLast Editorial Review: 7/6/2022 12:00:00 AM Full Article
is What Time of Day Is Blood Pressure Highest? By www.medicinenet.com Published On :: Thu, 14 Jul 2022 00:00:00 PDT Title: What Time of Day Is Blood Pressure Highest?Category: Diseases and ConditionsCreated: 7/14/2022 12:00:00 AMLast Editorial Review: 7/14/2022 12:00:00 AM Full Article
is When Is Blood Pressure Lowest and Highest During the Day? By www.medicinenet.com Published On :: Tue, 26 Jul 2022 00:00:00 PDT Title: When Is Blood Pressure Lowest and Highest During the Day?Category: Diseases and ConditionsCreated: 7/26/2022 12:00:00 AMLast Editorial Review: 7/26/2022 12:00:00 AM Full Article
is Wisdom Teeth By www.medicinenet.com Published On :: Thu, 4 Aug 2022 00:00:00 PDT Title: Wisdom TeethCategory: Diseases and ConditionsCreated: 1/31/2005 12:00:00 AMLast Editorial Review: 8/4/2022 12:00:00 AM Full Article
is Health Conditions a Dentist Might Find That Have Nothing to Do With Your Teeth By www.medicinenet.com Published On :: Fri, 12 Aug 2022 00:00:00 PDT Title: Health Conditions a Dentist Might Find That Have Nothing to Do With Your TeethCategory: Health NewsCreated: 8/11/2022 12:00:00 AMLast Editorial Review: 8/12/2022 12:00:00 AM Full Article
is Why Is My Period More Heavy Than Usual? By www.medicinenet.com Published On :: Tue, 28 Jun 2022 00:00:00 PDT Title: Why Is My Period More Heavy Than Usual?Category: Diseases and ConditionsCreated: 6/28/2022 12:00:00 AMLast Editorial Review: 6/28/2022 12:00:00 AM Full Article
is What's the Key to Battling UTIs? By www.medicinenet.com Published On :: Fri, 15 Jul 2022 00:00:00 PDT Title: What's the Key to Battling UTIs?Category: Health NewsCreated: 7/14/2022 12:00:00 AMLast Editorial Review: 7/15/2022 12:00:00 AM Full Article
is MS (Multiple Sclerosis) vs. ALS (Amyotrophic Lateral Sclerosis) By www.medicinenet.com Published On :: Thu, 4 Aug 2022 00:00:00 PDT Title: MS (Multiple Sclerosis) vs. ALS (Amyotrophic Lateral Sclerosis)Category: Diseases and ConditionsCreated: 6/16/2017 12:00:00 AMLast Editorial Review: 8/4/2022 12:00:00 AM Full Article
is Who Fares Worse After Multiple Sclerosis Strikes? By www.medicinenet.com Published On :: Fri, 12 Aug 2022 00:00:00 PDT Title: Who Fares Worse After Multiple Sclerosis Strikes?Category: Health NewsCreated: 8/11/2022 12:00:00 AMLast Editorial Review: 8/12/2022 12:00:00 AM Full Article
is Your Brain Gets Tired, and Scientists Now Know Why By www.medicinenet.com Published On :: Mon, 15 Aug 2022 00:00:00 PDT Title: Your Brain Gets Tired, and Scientists Now Know WhyCategory: Health NewsCreated: 8/12/2022 12:00:00 AMLast Editorial Review: 8/15/2022 12:00:00 AM Full Article
is Major Gene Study Spots DNA Tied to Autism, Other Disorders By www.medicinenet.com Published On :: Fri, 19 Aug 2022 00:00:00 PDT Title: Major Gene Study Spots DNA Tied to Autism, Other DisordersCategory: Health NewsCreated: 8/19/2022 12:00:00 AMLast Editorial Review: 8/19/2022 12:00:00 AM Full Article
is Is It Parkinson's? These 10 Signs Could Tell By www.medicinenet.com Published On :: Fri, 19 Aug 2022 00:00:00 PDT Title: Is It Parkinson's? These 10 Signs Could TellCategory: Health NewsCreated: 8/19/2022 12:00:00 AMLast Editorial Review: 8/19/2022 12:00:00 AM Full Article
is New Multiple Sclerosis Treatment Shows Promise in Trial By www.medicinenet.com Published On :: Fri, 26 Aug 2022 00:00:00 PDT Title: New Multiple Sclerosis Treatment Shows Promise in TrialCategory: Health NewsCreated: 8/25/2022 12:00:00 AMLast Editorial Review: 8/26/2022 12:00:00 AM Full Article
is U.S. HPV Vaccination Rates Rising, Even Among Boys By www.medicinenet.com Published On :: Thu, 23 Jun 2022 00:00:00 PDT Title: U.S. HPV Vaccination Rates Rising, Even Among BoysCategory: Health NewsCreated: 6/22/2022 12:00:00 AMLast Editorial Review: 6/23/2022 12:00:00 AM Full Article
is Is Syphilis Completely Curable? By www.medicinenet.com Published On :: Fri, 15 Jul 2022 00:00:00 PDT Title: Is Syphilis Completely Curable?Category: Diseases and ConditionsCreated: 7/15/2022 12:00:00 AMLast Editorial Review: 7/15/2022 12:00:00 AM Full Article
is Is Syphilis 100% Curable? By www.medicinenet.com Published On :: Fri, 15 Jul 2022 00:00:00 PDT Title: Is Syphilis 100% Curable?Category: Diseases and ConditionsCreated: 7/15/2022 12:00:00 AMLast Editorial Review: 7/15/2022 12:00:00 AM Full Article
is Is Chlamydia Contagious? By www.medicinenet.com Published On :: Mon, 1 Aug 2022 00:00:00 PDT Title: Is Chlamydia Contagious?Category: Diseases and ConditionsCreated: 5/28/2015 12:00:00 AMLast Editorial Review: 8/1/2022 12:00:00 AM Full Article
is 'Virtual' Museum Visits Are Good Medicine for Seniors By www.medicinenet.com Published On :: Tue, 16 Aug 2022 00:00:00 PDT Title: 'Virtual' Museum Visits Are Good Medicine for SeniorsCategory: Health NewsCreated: 8/16/2022 12:00:00 AMLast Editorial Review: 8/16/2022 12:00:00 AM Full Article
is You Could Live 9 Years Longer in Hawaii Than in Mississippi, New Data Shows By www.medicinenet.com Published On :: Tue, 23 Aug 2022 00:00:00 PDT Title: You Could Live 9 Years Longer in Hawaii Than in Mississippi, New Data ShowsCategory: Health NewsCreated: 8/23/2022 12:00:00 AMLast Editorial Review: 8/23/2022 12:00:00 AM Full Article
is Picture of Nickel Contact Dermatitis By www.medicinenet.com Published On :: Thu, 23 Jun 2022 00:00:00 PDT Title: Picture of Nickel Contact DermatitisCategory: ImagesCreated: 2/22/2010 3:07:00 PMLast Editorial Review: 6/23/2022 12:00:00 AM Full Article
is Picture of Nickel Contact Dermatitis from Necklace By www.medicinenet.com Published On :: Tue, 28 Jun 2022 00:00:00 PDT Title: Picture of Nickel Contact Dermatitis from NecklaceCategory: ImagesCreated: 2/22/2010 3:21:00 PMLast Editorial Review: 6/28/2022 12:00:00 AM Full Article
is Stay Independent of Asthma, Allergies This July 4th By www.medicinenet.com Published On :: Fri, 1 Jul 2022 00:00:00 PDT Title: Stay Independent of Asthma, Allergies This July 4thCategory: Health NewsCreated: 7/1/2022 12:00:00 AMLast Editorial Review: 7/1/2022 12:00:00 AM Full Article
is Prehistoric People Drank Animal Milk, Despite Lactose Intolerance By www.medicinenet.com Published On :: Thu, 28 Jul 2022 00:00:00 PDT Title: Prehistoric People Drank Animal Milk, Despite Lactose IntoleranceCategory: Health NewsCreated: 7/27/2022 12:00:00 AMLast Editorial Review: 7/28/2022 12:00:00 AM Full Article
is Hepatitis (Viral Hepatitis A, B, C, D, E, G) By www.medicinenet.com Published On :: Mon, 8 Aug 2022 00:00:00 PDT Title: Hepatitis (Viral Hepatitis A, B, C, D, E, G)Category: Diseases and ConditionsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 8/8/2022 12:00:00 AM Full Article
is Hepatitis C Infection Can Kill, But Less Than a Third of Patients Get Treatment By www.medicinenet.com Published On :: Wed, 10 Aug 2022 00:00:00 PDT Title: Hepatitis C Infection Can Kill, But Less Than a Third of Patients Get TreatmentCategory: Health NewsCreated: 8/10/2022 12:00:00 AMLast Editorial Review: 8/10/2022 12:00:00 AM Full Article
is What Is the Main Cause of Leaky Gut, and How Do You Fix It? By www.medicinenet.com Published On :: Tue, 23 Aug 2022 00:00:00 PDT Title: What Is the Main Cause of Leaky Gut, and How Do You Fix It?Category: Diseases and ConditionsCreated: 8/23/2022 12:00:00 AMLast Editorial Review: 8/23/2022 12:00:00 AM Full Article
is CDC Panel Urges Seniors to Get New, More Potent Flu Shot This Fall By www.medicinenet.com Published On :: Thu, 23 Jun 2022 00:00:00 PDT Title: CDC Panel Urges Seniors to Get New, More Potent Flu Shot This FallCategory: Health NewsCreated: 6/23/2022 12:00:00 AMLast Editorial Review: 6/23/2022 12:00:00 AM Full Article
is Is Laryngitis Contagious? By www.medicinenet.com Published On :: Fri, 22 Jul 2022 00:00:00 PDT Title: Is Laryngitis Contagious?Category: Diseases and ConditionsCreated: 9/10/2015 12:00:00 AMLast Editorial Review: 7/22/2022 12:00:00 AM Full Article
is Mastoiditis By www.medicinenet.com Published On :: Sat, 30 Jul 2022 00:00:00 PDT Title: MastoiditisCategory: Diseases and ConditionsCreated: 1/4/2018 12:00:00 AMLast Editorial Review: 7/30/2022 12:00:00 AM Full Article
is Australia's Current Flu Season Is Tough: Will America's Be the Same? By www.medicinenet.com Published On :: Fri, 5 Aug 2022 00:00:00 PDT Title: Australia's Current Flu Season Is Tough: Will America's Be the Same?Category: Health NewsCreated: 8/4/2022 12:00:00 AMLast Editorial Review: 8/5/2022 12:00:00 AM Full Article
is What Are 4 Symptoms of Seasonal Affective Disorder? By www.medicinenet.com Published On :: Wed, 6 Jul 2022 00:00:00 PDT Title: What Are 4 Symptoms of Seasonal Affective Disorder?Category: Diseases and ConditionsCreated: 12/10/2021 12:00:00 AMLast Editorial Review: 7/6/2022 12:00:00 AM Full Article
is Evidence-based management of symptoms in serious respiratory illness: what is in our toolbox? By err.ersjournals.com Published On :: 2024-10-30T01:30:15-07:00 Extract Living with a respiratory illness requires patients to manage a wide range of symptoms, many of which will worsen as a disease progresses. Breathlessness is a hallmark feature of respiratory conditions, occurring in almost all individuals with COPD and interstitial lung disease (ILD) [1, 2]. Cough is present in 78% of people with ILD and is frequently distressing, with physical, social and emotional impacts [1, 3]. Full Article
is Treating central sleep apnoea in heart failure: is positive airway pressure and adaptive servo-ventilation in particular the gold standard? By err.ersjournals.com Published On :: 2024-10-30T01:30:15-07:00 Extract We read with great interest the review article by Randerath et al. [1] recently published in the European Respiratory Review. We would like to congratulate the authors on this clearly structured review, which emphasises the urgent need for an increasingly differentiated view of central sleep apnoea (CSA) in the context of precision medicine. Full Article
is Impaired lung function and associated risk factors in children born prematurely: a systematic review and meta-analysis By err.ersjournals.com Published On :: 2024-10-09T00:15:15-07:00 Background Immature lung development and respiratory morbidity place preterm-born children at high risk of long-term pulmonary sequelae. This systematic review and meta-analysis aims to quantify lung function in preterm-born children and identify risk factors for a compromised lung function. Methods We searched MEDLINE, Embase, Cochrane Library, Web of Science and Scopus for relevant studies published on preterm cohorts born since 1990. Studies comparing forced expiratory volume in 1 s (FEV1) in preterm-born children aged ≥5 years to term-born controls or normative data were included. Study quality was assessed using the Newcastle–Ottawa Scale for cohort studies. Standardised mean differences in FEV1 and secondary spirometry outcomes per study were pooled using meta-analysis. The impact of different demographic and neonatal variables on studies’ FEV1 effect sizes was investigated by meta-regression analyses. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework. Results We identified 42 studies with unique cohorts including 4743 preterm children and 9843 controls. Median gestational age in the studies was 28.0 weeks and age at assessment ranged from 6.7 to 16.7 years. Preterm children had lower FEV1 than controls (–0.58 sd, 95% CI –0.69– –0.47 sd, p<0.001) resulting in a relative risk of 2.9 (95% CI 2.4–3.4) for abnormal outcome, with high certainty of evidence. FEV1 was significantly associated with gestational age, birthweight, bronchopulmonary dysplasia and invasive mechanical ventilation in univariate meta-regression analyses (R2=36–96%). Conclusion This systematic review shows robust evidence of impaired lung function in preterm-born children with a high certainty of evidence. Full Article
is Epidemiology of severe asthma in children: a systematic review and meta-analysis By err.ersjournals.com Published On :: 2024-10-09T00:15:15-07:00 Background Severe asthma significantly impacts a minority of children with asthma, leading to frequent symptoms, hospitalisations and potential long-term health consequences. However, accurate global data on severe asthma epidemiology is lacking. This study aims to address this gap, providing data on severe asthma epidemiology, regional differences and associated comorbidities. Methods We conducted a rigorous systematic review and meta-analysis following a registered protocol (PROSPERO CRD42023472845). We searched PubMed, Scopus and Web of Science for cohort or cross-sectional studies published since 2003, evaluating severe asthma incidence and prevalence in children. Study quality and risk of bias were assessed using STROBE guidelines. Results Nine studies investigating European children with asthma (aged 5–18 years) were included in the meta-analysis. No significant publication bias was found. The overall severe asthma prevalence in children with asthma was 3% (95% CI 1–6; I2=99.9%; p<0.001), with no significant difference between males and females. Prevalence estimates varied significantly depending on the diagnostic criteria used (Global Initiative for Asthma: 6%; European Respiratory Society/American Thoracic Society: 1%; other: 3%). Because none of the examined studies were prospectively designed, incidence rates could not be determined. Conclusions This systematic review and meta-analysis provide the first robust assessment of severe asthma prevalence among European children. Our findings underscore the need for comprehensive research to address knowledge gaps in severe asthma, including determining incidence rates, standardising definitions, investigating regional differences and evaluating comorbidities and treatment strategies. Full Article
is Noninvasive diagnostic modalities and prediction models for detecting pulmonary hypertension associated with interstitial lung disease: a narrative review By err.ersjournals.com Published On :: 2024-10-09T00:15:15-07:00 Pulmonary hypertension (PH) is highly prevalent in patients with interstitial lung disease (ILD) and is associated with increased morbidity and mortality. Widely available noninvasive screening tools are warranted to identify patients at risk for PH, especially severe PH, that could be managed at expert centres. This review summarises current evidence on noninvasive diagnostic modalities and prediction models for the timely detection of PH in patients with ILD. It critically evaluates these approaches and discusses future perspectives in the field. A comprehensive literature search was carried out in PubMed and Scopus, identifying 39 articles that fulfilled inclusion criteria. There is currently no single noninvasive test capable of accurately detecting and diagnosing PH in ILD patients. Estimated right ventricular pressure (RVSP) on Doppler echocardiography remains the single most predictive factor of PH, with other indirect echocardiographic markers increasing its diagnostic accuracy. However, RVSP can be difficult to estimate in patients due to suboptimal views from extensive lung disease. The majority of existing composite scores, including variables obtained from chest computed tomography, pulmonary function tests and cardiopulmonary exercise tests, were derived from retrospective studies, whilst lacking validation in external cohorts. Only two available scores, one based on a stepwise echocardiographic approach and the other on functional parameters, predicted the presence of PH with sufficient accuracy and used a validation cohort. Although several methodological limitations prohibit their generalisability, their use may help physicians to detect PH earlier. Further research on the potential of artificial intelligence may guide a more tailored approach, for timely PH diagnosis. Full Article
is Epidemiology of bronchiectasis By err.ersjournals.com Published On :: 2024-10-09T00:15:15-07:00 Bronchiectasis is a chronic respiratory disease characterised by permanent enlargement of the airways associated with cough, sputum production and a history of pulmonary exacerbations. In the past few years, incidence and prevalence of bronchiectasis have increased worldwide, possibly due to advances in imaging techniques and disease awareness, leading to increased socioeconomic burden and healthcare costs. Consistently, a mortality increase in bronchiectasis patient cohorts has been demonstrated in certain areas of the globe, with mortality rates of 16–24.8% over 4–5 years of follow-up. However, heterogeneity in epidemiological data is consistent, as reported prevalence in the general population ranges from 52.3 to more than 1000 per 100 000. Methodological flaws in the designs of available studies are likely to underestimate the proportion of people suffering from this condition worldwide and comparisons between different areas of the globe might be unreliable due to different assessment methods or local implementation of the same method in different contexts. Differences in disease severity associated with diverse geographical distribution of aetiologies, comorbidities and microbiology might explain an additional quota of heterogeneity. Finally, limited access to care in certain geographical areas is associated with both underestimation of the disease and increased severity and mortality. The aim of this review is to provide a snapshot of available real-world epidemiological data describing incidence and prevalence of bronchiectasis in the general population. Furthermore, data on mortality, healthcare burden and high-risk populations are provided. Finally, an analysis of the geographical distribution of determinants contributing to differences in bronchiectasis epidemiology is offered. Full Article
is Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects By err.ersjournals.com Published On :: 2024-10-30T01:30:15-07:00 Bronchiectasis is a chronic lung condition which is characterised by recurrent chest infections, chronic sputum production and cough, and limited exercise tolerance. While bronchiectasis may be caused by various aetiologies, these features are shared by most patients with bronchiectasis regardless of the cause. This review consolidates the existing evidence on patient-managed interventions for adults with bronchiectasis, while also outlining areas for future research. Airway clearance techniques and hyperosmolar agents are key components of the bronchiectasis management and consistently recommended for clinical implementation. Questions around their prescription, such as optimal sequence of delivery, are still to be answered. Pulmonary rehabilitation and exercise are also recommended for patients with bronchiectasis. Relatively strong evidence underpins this recommendation during a clinically stable stage of the disease, although the role of pulmonary rehabilitation following an exacerbation is still unclear. Additionally, self-management programmes feature prominently in bronchiectasis treatment, yet the lack of consensus regarding their definition and outcomes presents hurdles to establishing a cohesive evidence base. Moreover, cough, a cardinal symptom of bronchiectasis, warrants closer examination. Although managing cough in bronchiectasis may initially appear risky, further research is necessary to ascertain whether strategies employed in other respiratory conditions can be safely and effectively adapted to bronchiectasis, particularly through identifying patient responder populations and criteria where cough may not enhance airway clearance efficacy and its control is needed. Overall, there is a growing recognition of the importance of patient-managed interventions in the bronchiectasis management. Efforts to improve research methodologies and increase research funding are needed to further advance our understanding of these interventions, and their role in optimising patient care and outcomes. Full Article
is The ageing of people living with cystic fibrosis: what to expect now? By err.ersjournals.com Published On :: 2024-10-30T01:30:15-07:00 The prognosis of people with cystic fibrosis (pwCF) has improved dramatically with the introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators (CFTRm). The ageing of the cystic fibrosis (CF) population is changing the disease landscape with the emergence of different needs and increasing comorbidities related to both age and long-term exposure to multiple treatments including CFTRm. Although the number of pwCF eligible for this treatment is expected to increase, major disparities in care and outcomes still exist in this population. Moreover, the long-term impact of the use of CFTRm is still partly unknown due to the current short follow-up and experience with their use, thus generating some uncertainties. The future spread and initiation of these drugs at an earlier stage of the disease is expected to reduce the systemic burden of systemic inflammation and its consequences on health. However, the prolonged life expectancy is accompanied by an increasing burden of age-related comorbidities, especially in the context of chronic disease. The clinical manifestations of the comorbidities directly or indirectly associated with CFTR dysfunction are changing, along with the disease dynamics and outcomes. Current protocols used to monitor slow disease progression will need continuous updates, including the composition of the multidisciplinary team for CF care, with a greater focus on the needs of the adult population. Full Article
is Multicomponent services for symptoms in serious respiratory illness: a systematic review and meta-analysis By err.ersjournals.com Published On :: 2024-10-30T01:30:15-07:00 Background People living with serious respiratory illness experience a high burden of symptoms. This review aimed to determine whether multicomponent services reduce symptoms in people with serious illness related to respiratory disease. Methods Electronic databases were searched to identify randomised controlled trials (RCTs) evaluating multicomponent services that enrolled patients due to symptoms, rather than underlying disease, and provided at least one nonpharmacological intervention. The primary outcome was chronic breathlessness and secondary outcomes were health-related quality of life (HRQoL), cough, fatigue and adverse events. At least two authors independently screened studies, assessed risk of bias and extracted data. Results Five RCTs, involving 439 patients, were included. In comparison to usual care, multicomponent services improved breathlessness mastery (Chronic Respiratory Questionnaire (CRQ) mastery scale, mean difference (MD) 0.43 points, 95% CI 0.20–0.67, three RCTs, 327 participants) and HRQoL (CRQ total score, MD 0.24 points, 95% CI 0.04–0.40, two RCTs, 237 participants). Fatigue did not improve with multicomponent services and no studies evaluated cough. No serious adverse events were reported. The one study evaluating mortality found increased survival in those accessing a multicomponent service. The certainty of evidence was very low, mainly due to detection and reporting bias. Conclusion Multicomponent services improve breathlessness mastery and HRQoL, with minimal risk. These findings support the use of multicomponent symptom-directed services for people living with serious respiratory illness. Full Article
is The effect of graded exercise therapy on fatigue in people with serious respiratory illness: a systematic review By err.ersjournals.com Published On :: 2024-10-09T00:15:15-07:00 Background In adults with serious respiratory illness, fatigue is prevalent and under-recognised, with few treatment options. The aim of this review was to assess the impact of graded exercise therapy (GET) on fatigue in adults with serious respiratory illness. Methods Electronic databases were searched to identify randomised controlled trials (RCTs) testing GET (involving incremental increases in exercise from an established baseline) in adults with serious respiratory illness. The primary outcome was fatigue and secondary outcomes were health-related quality of life (HRQoL) and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data. Results 76 RCTs were included with 3309 participants, most with a diagnosis of COPD or asthma. Reductions in fatigue measured by the Chronic Respiratory Disease Questionnaire fatigue domain score were demonstrated following GET consisting of aerobic with/without resistance training (mean difference (MD) 0.53 points, 95% CI 0.41–0.65, 11 RCTs, 624 participants) and GET using resistance training alone (MD 0.58 points, 95% CI 0.21–0.96, two RCTs, 82 participants) compared with usual care. Although the mean effect exceeded the minimal important difference, the lower end of the confidence intervals did not always exceed this threshold so the clinical significance could not be confirmed. GET consistently improved HRQoL in people with a range of chronic respiratory diseases on multiple HRQoL measures. No serious adverse events related to GET were reported. Conclusion GET may improve fatigue alongside consistent improvements in HRQoL in people with serious respiratory illness. These findings support the use of GET in the care of people with serious respiratory illness. Full Article
is Opioids for the palliation of symptoms in people with serious respiratory illness: a systematic review and meta-analysis By err.ersjournals.com Published On :: 2024-10-09T00:15:15-07:00 Background People living with serious respiratory illness experience a high burden of distressing symptoms. Although opioids are prescribed for symptom management, they generate adverse events, and their benefits are unclear. Methods We examined the efficacy and safety of opioids for symptom management in people with serious respiratory illness. Embase, MEDLINE and the Cochrane Central Register of Controlled Trials were searched up to 11 July 2022. Reports of randomised controlled trials administering opioids to treat symptoms in people with serious respiratory illness were included. Key exclusion criteria included <80% of participants having a nonmalignant lung disease. Data were extracted regarding study characteristics, outcomes of breathlessness, cough, health-related quality of life (HRQoL) and adverse events. Treatment effects were pooled using a generic inverse variance model with random effects. Risk of bias was assessed using the Cochrane Risk of Bias tool version 1. Results Out of 17 included trials, six were laboratory-based exercise trials (n=70), 10 were home studies measuring breathlessness in daily life (n=788) and one (n=18) was conducted in both settings. Overall certainty of evidence was "very low" to "low". Opioids reduced breathlessness intensity during laboratory exercise testing (standardised mean difference (SMD) –0.37, 95% CI –0.67– –0.07), but not breathlessness measured in daily life (SMD –0.10, 95% CI –0.64–0.44). No effects on HRQoL (SMD –0.42, 95% CI –0.98–0.13) or cough (SMD –1.42, 95% CI –3.99–1.16) were detected. In at-home studies, opioids led to increased frequency of nausea/vomiting (OR 3.32, 95% CI 1.70–6.51), constipation (OR 3.08, 95% CI 1.69–5.61) and drowsiness (OR 1.37, 95% CI 1.01–1.86), with serious adverse events including hospitalisation and death identified. Conclusions Opioids improved exertional breathlessness in laboratory exercise studies, but did not improve breathlessness, cough or HRQoL measured in daily life at home. There were significant adverse events, which may outweigh any benefits. Full Article