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BMJ Open Respiratory Research Jul 2023Aboriginal Australians are reported to have higher presence of chronic respiratory diseases. However, comprehensive evidence surrounding this is sparse. Hence, a...
BACKGROUND
Aboriginal Australians are reported to have higher presence of chronic respiratory diseases. However, comprehensive evidence surrounding this is sparse. Hence, a systematic review was undertaken to appraise the current state of knowledge on respiratory health in the adult Aboriginal Australians, in particular among the three most common respiratory disorders: asthma, bronchiectasis and chronic obstructive pulmonary disease (COPD).
METHODS
A systematic review of primary literature published between January 2012 and October 2022, using the databases and , was conducted. Studies were included if they reported adult Aboriginal Australian prevalence's or outcomes related to asthma, bronchiectasis or COPD, and excluded if adult data were not reported separately, if Aboriginal Australian data were not reported separately or if respiratory disorders were combined into a single group. Risk of bias was assessed by both Joanne Briggs Institute checklists and Hoys' bias assessment. Summary data pertaining to prevalence, lung function, symptoms, sputum cultures and mortality for each of asthma, bronchiectasis and COPD were extracted from the included studies.
RESULTS
Thirty-seven studies were included, involving approximately 33 364 participants (71% female). Eighteen studies reported on asthma, 21 on bronchiectasis and 30 on COPD. The majority of studies (94%) involved patients from hospitals or respiratory clinics and were retrospective in nature. Across studies, the estimated prevalence of asthma was 15.4%, bronchiectasis was 9.4% and COPD was 13.7%, although there was significant geographical variation. Only a minority of studies reported on clinical manifestations (n=7) or symptoms (n=4), and studies reporting on lung function parameters (n=17) showed significant impairment, in particular among those with concurrent bronchiectasis and COPD. Airway exacerbation frequency and hospital admission rates including mortality are high.
DISCUSSION
Although risk of bias globally was assessed as low, and study quality as high, there was limited diversity of studies with most reporting on referred populations, and the majority originating from two centres in the Northern Territory. The states with the greatest Aboriginal Australian population (Victoria and New South Wales) reported the lowest number of studies and patients. This limits the generalisability of results to the wider Aboriginal Australian population due to significant environmental, cultural and socioeconomic variation across the population. Regardless, Aboriginal Australians appear to display a high prevalence, alongside quite advanced and complex chronic respiratory diseases. There is however significant heterogeneity of prevalence, risk factors and outcomes geographically and by patient population. Further collaborative efforts are required to address specific diagnostic and management pathways in order to close the health gap secondary to respiratory disorders in this population.
Topics: Humans; Adult; Female; Male; Australian Aboriginal and Torres Strait Islander Peoples; Retrospective Studies; Australia; Pulmonary Disease, Chronic Obstructive; Asthma; Bronchiectasis; Respiration Disorders
PubMed: 37451702
DOI: 10.1136/bmjresp-2023-001738 -
Clinical Infectious Diseases : An... Sep 2017Rapid diagnosis of respiratory virus infections contributes to patient care. This systematic review evaluates the diagnostic accuracy of rapid tests for the detection of... (Meta-Analysis)
Meta-Analysis Review
Rapid diagnosis of respiratory virus infections contributes to patient care. This systematic review evaluates the diagnostic accuracy of rapid tests for the detection of respiratory viruses. We searched Medline and EMBASE for studies evaluating these tests against polymerase chain reaction as the reference standard. Of 179 studies included, 134 evaluated rapid tests for influenza viruses, 32 for respiratory syncytial virus (RSV), and 13 for other respiratory viruses. We used the bivariate random effects model for quantitative meta-analysis of the results. Most tests detected only influenza viruses or RSV. Summary sensitivity and specificity estimates of tests for influenza were 61.1% and 98.9%. For RSV, summary sensitivity was 75.3%, and specificity, 98.7%. We assessed the quality of studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Because of incomplete reporting, the risk of bias was often unclear. Despite their intended use at the point of care, 26.3% of tests were evaluated in a laboratory setting. Although newly developed tests seem more sensitive, high-quality evaluations of these tests are lacking.
Topics: Diagnostic Techniques, Respiratory System; Early Diagnosis; Humans; Influenza, Human; Point-of-Care Testing; Polymerase Chain Reaction; Respiratory Syncytial Virus Infections; Respiratory Tract Diseases; Sensitivity and Specificity; Time Factors
PubMed: 28520858
DOI: 10.1093/cid/cix461 -
International Journal of Environmental... Nov 2022To estimate the global risk and risk factors associated with acute respiratory distress syndrome (ARDS) among patients with COVID-19: Design: A systematic review,... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To estimate the global risk and risk factors associated with acute respiratory distress syndrome (ARDS) among patients with COVID-19: Design: A systematic review, meta-analysis and meta-regression.
SETTING AND PARTICIPANTS
Hospitals or nursing homes and patients with acute respiratory distress syndrome after COVID-19.
METHODS
The literature review was systematically conducted on Embase, MEDLINE, CINAHL, and Web of Science, in addition to manual searches and reference list checking from 1 January 2019 to 2 March 2022. The search terms included coronavirus, acute respiratory syndrome, acute respiratory distress syndrome and observational studies. Three reviewers independently appraised the quality of the studies and extracted the relevant data using the Joanna Briggs Institute abstraction form and critical appraisal tools. A study protocol was registered in PROSPERO (CRD42022311957). Eligible studies were meta-analyzed and underwent meta-regression.
RESULTS
A total of 12 studies were included, with 148,080 participants. The risk ratio (RR) of ARDS was 23%. Risk factors were age ≥ 41-64 years old (RR = 15.3%, 95% CI =0.14-2.92, = 0.03); fever (RR = 10.3%, 95% CI = 0.03-2.03, = 0.04); multilobe involvement of the chest (RR = 33.5%, 95% CI = 0.35-6.36, = 0.02); lymphopenia (RR = 25.9%, 95% CI = 1.11-4.08, = 0.01); mechanical ventilation with oxygen therapy (RR = 31.7%, 95% CI = 1.10-5.25, = 0.002); European region (RR = 16.3%, 95% CI = 0.09-3.17, = 0.03); sample size ≤ 500 (RR = 18.0%, 95% CI = 0.70-2.89, = 0.001).
CONCLUSIONS AND IMPLICATIONS
One in four patients experienced ARDS after having COVID-19. The age group 41-64 years old and the European region were high-risk groups. These findings can be used by policymakers to allocate resources for respiratory care facilities and can also provide scientific evidence in the design of protocols to manage COVID-19 worldwide.
Topics: Humans; Adult; Middle Aged; COVID-19; Respiratory Distress Syndrome; Respiration, Artificial; Risk Factors; Respiratory Therapy
PubMed: 36429842
DOI: 10.3390/ijerph192215125 -
Journal of Global Health Dec 2018Non-communicable diseases (NCDs) are the leading cause of death globally. Eighty-two percent of premature NCD deaths occur within low- and lower middle-income countries... (Review)
Review
BACKGROUND
Non-communicable diseases (NCDs) are the leading cause of death globally. Eighty-two percent of premature NCD deaths occur within low- and lower middle-income countries (LLMICs). Research to date, largely drawn from high-income countries, suggests that disadvantaged and marginalized groups have a higher NCD burden, but there has been a dearth of research studying this relationship within LLMICs. The purpose of this systematic review is to map the literature on evidence from LLMICs on the socio-economic status (SES) gradient of four particular NCDs: cardiovascular disease, cancer, diabetes, and chronic respiratory diseases.
METHODS
We conducted a comprehensive literature search for primary research published between 1 January 1990 and 27 April 2015 using six bibliographic databases and web resources. We included studies that reported SES and morbidity or mortality from cardiovascular disease, cancer, diabetes and chronic respiratory diseases within LLMICs.
RESULTS
Fifty-seven studies from 17 LLMICs met our inclusion criteria. Fourteen of the 18 papers that reported significant associations between cancer and SES suggested that low SES groups had the highest cancer risk. Eleven of 15 papers reporting significant relationships between CVD and SES suggested that low SES groups have higher risk. In contrast, seven of 12 papers reporting significant findings related to diabetes found that higher SES groups had higher diabetes risk. We identified just three studies on the relationship between chronic respiratory diseases and SES; none of them reported significant findings.
CONCLUSIONS
Only 17 of the 84 LLMICs were represented, highlighting the need for more research on NCDs within these countries. The majority of studies were medium to high quality cross-sectional studies. When we restricted our analyses to high quality studies only, for both cancer and cardiovascular disease more than half of studies found a significantly higher risk for those of lower SES. The opposite was true for diabetes, whilst there was a paucity of high quality research on chronic respiratory disease. Development programmes must consider health alongside other aims and NCD prevention interventions must target all members of the population.
SYSTEMATIC REVIEW REGISTRATION NUMBER
Prospero: CRD42015020169.
Topics: Cardiovascular Diseases; Chronic Disease; Developing Countries; Diabetes Mellitus; Health Status Disparities; Humans; Neoplasms; Noncommunicable Diseases; Respiration Disorders; Social Class
PubMed: 30140435
DOI: 10.7189/jogh.08.020409 -
Journal of Sleep Research Dec 2023Comorbid insomnia and sleep apnoea (COMISA) is a highly prevalent and debilitating sleep disorder. Cognitive behavioural therapy for insomnia (CBTi) may be an... (Meta-Analysis)
Meta-Analysis Review
Comorbid insomnia and sleep apnoea (COMISA) is a highly prevalent and debilitating sleep disorder. Cognitive behavioural therapy for insomnia (CBTi) may be an appropriate treatment for COMISA; however, no previous study has systematically reviewed and meta-analysed literature reporting on the effect of CBTi in people with COMISA. A systematic literature search was conducted across PsychINFO and PubMed (n = 295). In all, 27 full-text records were independently reviewed by at least two authors. Forward- and backward-chain referencing, and hand-searches were used to identify additional studies. Authors of potentially eligible studies were contacted to provide COMISA subgroup data. In total, 21 studies, including 14 independent samples of 1040 participants with COMISA were included. Downs and Black quality assessments were performed. A meta-analysis including nine primary studies measuring the Insomnia Severity Index indicated that CBTi is associated with a large improvement in insomnia severity (Hedges' g = -0.89, 95% confidence interval [CI] -1.35, -0.43). Subgroup meta-analyses indicated that CBTi is effective in samples with untreated obstructive sleep apnoea (OSA) (five studies, Hedges' g = -1.19, 95% CI -1.77, -0.61) and treated OSA (four studies, Hedges' g = -0.55, 95% CI -0.75, -0.35). Publication bias was evaluated by examining the Funnel plot (Egger's regression p = 0.78). Implementation programmes are required to embed COMISA management pathways in sleep clinics worldwide that currently specialise in the management of OSA alone. Future research should investigate and refine CBTi interventions in people with COMISA, including identifying the most effective CBTi components, adaptations, and developing personalised management approaches for this highly prevalent and debilitating condition.
Topics: Humans; Sleep Initiation and Maintenance Disorders; Cognitive Behavioral Therapy; Sleep; Sleep Apnea, Obstructive; Comorbidity
PubMed: 36872072
DOI: 10.1111/jsr.13847 -
Critical Care (London, England) Apr 2021High-flow nasal cannula oxygenation (HFNC) and noninvasive positive-pressure ventilation (NPPV) possibly decrease tracheal reintubation rates better than conventional... (Meta-Analysis)
Meta-Analysis
BACKGROUND
High-flow nasal cannula oxygenation (HFNC) and noninvasive positive-pressure ventilation (NPPV) possibly decrease tracheal reintubation rates better than conventional oxygen therapy (COT); however, few large-scale studies have compared HFNC and NPPV. We conducted a network meta-analysis (NMA) to compare the effectiveness of three post-extubation respiratory support devices (HFNC, NPPV, and COT) in reducing the mortality and reintubation risk.
METHODS
The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Ichushi databases were searched. COT, NPPV, and HFNC use were assessed in patients who were aged ≥ 16 years, underwent invasive mechanical ventilation for > 12 h for acute respiratory failure, and were scheduled for extubation after spontaneous breathing trials. The GRADE Working Group Approach was performed using a frequentist-based approach with multivariate random-effect meta-analysis. Short-term mortality and reintubation and post-extubation respiratory failure rates were compared.
RESULTS
After evaluating 4631 records, 15 studies and 2600 patients were included. The main cause of acute hypoxic respiratory failure was pneumonia. Although NPPV/HFNC use did not significantly lower the mortality risk (relative risk [95% confidence interval] 0.75 [0.53-1.06] and 0.92 [0.67-1.27]; low and moderate certainty, respectively), HFNC use significantly lowered the reintubation risk (0.54 [0.32-0.89]; high certainty) compared to COT use. The associations of mortality with NPPV and HFNC use with respect to either outcome did not differ significantly (short-term mortality and reintubation, relative risk [95% confidence interval] 0.81 [0.61-1.08] and 1.02 [0.53-1.97]; moderate and very low certainty, respectively).
CONCLUSION
NPPV or HFNC use may not reduce the risk of short-term mortality; however, they may reduce the risk of endotracheal reintubation.
TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION
PROSPERO (registration number: CRD42020139112, 01/21/2020).
Topics: Airway Extubation; Humans; Oxygen Inhalation Therapy; Respiratory Insufficiency; Ventilator Weaning
PubMed: 33836812
DOI: 10.1186/s13054-021-03550-4 -
PloS One 2016Because mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings... (Review)
Review
Mass Gatherings and Respiratory Disease Outbreaks in the United States - Should We Be Worried? Results from a Systematic Literature Review and Analysis of the National Outbreak Reporting System.
BACKGROUND
Because mass gatherings create environments conducive for infectious disease transmission, public health officials may recommend postponing or canceling large gatherings during a moderate or severe pandemic. Despite these recommendations, limited empirical information exists on the frequency and characteristics of mass gathering-related respiratory disease outbreaks occurring in the United States.
METHODS
We conducted a systematic literature review to identify articles about mass gathering-related respiratory disease outbreaks occurring in the United States from 2005 to 2014. A standard form was used to abstract information from relevant articles identified from six medical, behavioral and social science literature databases. We also analyzed data from the National Outbreaks Reporting System (NORS), maintained by the Centers for Disease Control and Prevention since 2009, to estimate the frequency of mass gathering-related respiratory disease outbreaks reported to the system.
RESULTS
We identified 21 published articles describing 72 mass gathering-related respiratory disease outbreaks. Of these 72, 40 (56%) were associated with agriculture fairs and Influenza A H3N2v following probable swine exposure, and 25 (35%) with youth summer camps and pandemic Influenza A H1N1. Outbreaks of measles (n = 1) and mumps (n = 2) were linked to the international importation of disease. Between 2009 and 2013, 1,114 outbreaks were reported to NORS, including 96 respiratory disease outbreaks due to Legionella. None of these legionellosis outbreaks was linked to a mass gathering according to available data.
CONCLUSION
Mass gathering-related respiratory disease outbreaks may be uncommon in the United States, but have been reported from fairs (zoonotic transmission) as well as at camps where participants have close social contact in communal housing. International importation can also be a contributing factor. NORS collects information on certain respiratory diseases and could serve as a platform to monitor mass gathering-related respiratory outbreaks in the future.
Topics: Disease Outbreaks; Humans; Mass Behavior; Population Surveillance; Respiratory Tract Diseases; United States
PubMed: 27536770
DOI: 10.1371/journal.pone.0160378 -
Clinical Genetics Jan 2020This article provides an overview of the current knowledge on medical complications, health characteristics, and psychosocial issues in adults with achondroplasia. We... (Review)
Review
This article provides an overview of the current knowledge on medical complications, health characteristics, and psychosocial issues in adults with achondroplasia. We have used a scoping review methodology particularly recommended for mapping and summarizing existing research evidence, and to identify knowledge gaps. The review process was conducted in accordance with the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews). The selection of studies was based on criteria predefined in a review protocol. Twenty-nine publications were included; 2 reviews, and 27 primary studies. Key information such as reference details, study characteristics, topics of interest, main findings and the study author's conclusion are presented in text and tables. Over the past decades, there has only been a slight increase in publications on adults with achondroplasia. The reported morbidity rates and prevalence of medical complications are often based on a few studies where the methodology and representativeness can be questioned. Studies on sleep-related disorders and pregnancy-related complications were lacking. Multicenter natural history studies have recently been initiated. Future studies should report in accordance to methodological reference standards, to strengthen the reliability and generalizability of the findings, and to increase the relevance for implementing in clinical practice.
Topics: Achondroplasia; Adult; Bone Diseases; Female; Female Urogenital Diseases; Humans; Obesity; Otorhinolaryngologic Diseases; Pain; Pregnancy; Quality of Life; Reproducibility of Results; Respiration Disorders; Sleep Wake Disorders; Spinal Stenosis
PubMed: 30916780
DOI: 10.1111/cge.13542 -
Respiratory Care Nov 2021Results of recent studies suggest that the incidence and mortality of ARDS may be higher than previously thought in pediatric trauma patients. We conducted a systematic... (Review)
Review
BACKGROUND
Results of recent studies suggest that the incidence and mortality of ARDS may be higher than previously thought in pediatric trauma patients. We conducted a systematic review of the literature on incidence, risk factors, prognostic factors, and outcomes of ARDS after pediatric trauma in the ICU.
METHODS
Medical literature databases were searched up to April 2020. Guidelines for reporting systematic reviews and meta-analyses were followed. Articles that reported quantitative data with regard to the incidence, risk factors, prognostic factors, mortality, or other outcomes for ARDS in subjects with pediatric trauma admitted to the ICU were included. Two authors independently screened and assessed eligibility of all identified studies, collected data, and assessed the methodological quality of selected studies. Data extraction was performed by using a standardized data extraction sheet. Quality assessment was performed by using the Newcastle-Ottawa scale for cohort studies. A meta-analysis was not performed because the studies used overlapping cohorts or different ARDS criteria.
RESULTS
Nine studies were included. The incidence was reported in 4 studies, risk factors in 1, mortality in 7, and other outcomes in 2. The largest cohort included 148,749 subjects from a national trauma database. The ARDS incidence was 1.8%-7.6% when using adult ARDS criteria, with 1.8% in the largest cohort, and 4.2% when using pediatric ARDS criteria. Mortality was 7.6%-22.9% when using adult ARDS criteria and 11.1%-34.0% when using the pediatric ARDS criteria. Identified risk factors included mechanism of injury, higher injury severity scores, abnormal breathing frequencies, and lower Glasgow coma scale scores at hospital presentation. ARDS was associated with a longer duration of mechanical ventilation, longer ICU and hospital length of stay, and a higher likelihood of requiring post-discharge care.
CONCLUSIONS
The ARDS incidence of 4.2% in the subjects with pediatric trauma in the ICU was comparable with 3.2% in the general pediatric ICU population; however, mortality associated with trauma-associated ARDS was higher and more commonly due to multi-system organ failure rather than hypoxemia.
Topics: Adult; Aftercare; Child; Humans; Injury Severity Score; Intensive Care Units; Length of Stay; Patient Discharge; Respiration, Artificial; Respiratory Distress Syndrome
PubMed: 34548409
DOI: 10.4187/respcare.09091 -
Poultry Science Apr 2023Particulate matter (PM) is one of the essential environmental stressors for the poultry industry in the world. Given its large specific surface area, PM can adsorb and... (Review)
Review
Particulate matter (PM) is one of the essential environmental stressors for the poultry industry in the world. Given its large specific surface area, PM can adsorb and carry a variety of pollutants, including heavy metal ions, ammonia, and persistent organic pollutants such as pathogenic microorganisms. High concentrations of PM induce poultry respiratory inflammation and trigger various diseases. However, the pathogenic mechanism of PM in poultry houses on respiratory diseases has not been clarified due to its complexity and lack of accurate assays. In terms of pathogenesis, there are 3 ways to explain this phenomenon: Inhaled PM irritates the respiratory tract, decreases immune resistance, and causes a respiratory disease; respiratory tract irritation by compounds presents in PM; infections with pathogenic and non-pathogenic microorganisms attached to PM. The latter 2 modes of influence are more harmful. Specifically, PM can induce the respiratory disease through several toxic mechanisms, including ammonia ingestion and bioaccumulation, lung flora dysbiosis, oxidative stress, and metabolic disorders. Therefore, this review summarizes the characteristics of PM in the poultry house and the impact of poultry PM on respiratory disease and proposes potential pathogenic mechanisms.
Topics: Animals; Particulate Matter; Poultry; Air Pollutants; Ammonia; Chickens; Respiratory Tract Diseases; Inflammation
PubMed: 36848758
DOI: 10.1016/j.psj.2023.102556