1. Mortality, seasonal variation, and susceptibility to acute exacerbation of COPD in the pandemic year : a nationwide population studyIrena Šarc, Aleša Lotrič Dolinar, Tina Morgan, Jože Sambt, Kristina Ziherl, Dalibor Gavrić, Julij Šelb, Aleš Rozman, Petra Došenović Bonča, 2022, original scientific article Abstract: Background: Previous studies have suggested that the coronavirus disease 2019 (COVID-19) pandemic was associated with a decreased rate of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Data on how the COVID-19 pandemic has influenced mortality, seasonality of, and susceptibility to AECOPD in the chronic obstructive pulmonary disease (COPD) population is scarce. Methods: We conducted a national population-based retrospective study using data from the Health Insurance Institute of Slovenia from 2015 to February 2021, with 2015–2019 as the reference. We extracted patient and healthcare data for AECOPD, dividing AECOPD into severe, resulting in hospitalisation, and moderate, requiring outpatient care. The national COPD population was generated based on dispensed prescriptions of inhalation therapies, and moderate AECOPD events were analysed based on dispensed AECOPD medications. We extracted data on all-cause and non-COVID mortality. Results: The numbers of severe and moderate AECOPD were reduced by 48% and 34%, respectively, in 2020. In the pandemic year, the seasonality of AECOPD was reversed, with a 1.5-fold higher number of severe AECOPD in summer compared to winter. The proportion of frequent exacerbators (2 AECOPD hospitalisations per year) was reduced by 9% in 2020, with a 30% reduction in repeated severe AECOPD in frequent exacerbators and a 34% reduction in persistent frequent exacerbators (2 AECOPD hospitalisations per year for 2 consecutive years) from 2019. The risk of two or more moderate AECOPD decreased by 43% in 2020. In the multivariate model, pandemic year follow-up was the only independent factor associated with a decreased risk for severe AECOPD (hazard ratio [HR]: 0.71; 95% confidence interval [CI]: 0.61–0.84; p < 0.0001). In 2020, non-COVID mortality decreased (−15%) and no excessive mortality was observed in the COPD population. Conclusion: In the pandemic year, we found decreased susceptibility to AECOPD across severity spectrum of COPD, reversed seasonal distribution of severe AECOPD and decreased non-COVID mortality in the COPD population. Keywords: chronic obstructive pulmonary disease -- mortality, pandemics, seasons, exacerbation, acute exacerbation, seasonal variations, population study Published in DiRROS: 14.03.2022; Views: 970; Downloads: 517 Link to file This document has many files! More... |
2. Mnenje za spremljanje bolnikov po preboleli covidni pljučniciMatjaž Turel, Natalija Edelbaher, Matjaž Fležar, Matevž Harlander, Peter Kecelj, Izidor Kern, Majda Kočar, Peter Kopač, Mitja Košnik, Robert Marčun, Igor Požek, Mirjana Rajer, Irena Šarc, Jurij Šorli, Dušanka Vidovič, Katarina Osolnik, 2021, original scientific article Abstract: Pljučnica je najpogostejši vzrok za težji potek okužbe z virusom SARS-CoV-2 in s hospitalizacijo. Potek covidne pljučnice je lahko različen; infiltrati, vidni na rentgenski sliki, se lahko resorbirajo spontano, včasih pa je potrebno zdravljenje s sistem-skimi glukokortikoidi. Ob odpustu iz bolnišnice zdravljenje običajno še ni končano, zato je Združenje pulmologov Slovenije v želji po enotnem obravnavanju bolnikov s covidno pljučnico izdelalo mnenje za obravnavo in sledenje bolnikov po od-pustu iz bolnišnice. Zavedamo se, da ob novi bolezni ne gre za dokončno priporočilo, saj bodo nova spoznanja o covidni pljučnici zanesljivo zahtevala obnavljanje priporočil. Keywords: covid-19, mnenja, pljučnica, pulmologija, sistemski glukokortikoidi, covidna pljučnica Published in DiRROS: 15.12.2021; Views: 1569; Downloads: 347 Link to file |
3. Noninvasive ventilation : education and training. A narrative analysis and an international consensus documentHabib Mohammad Reazaul Karim, Karen E. A. Burns, Laura D. Ciobanu, Mohamad F. El-Khatib, Antonello Nicolini, Nicola Vargas, Thierry Hernández-Gilsoul, Szymon Skoczyński, Vito Antonio Falcone, Jean-Michel Arnal, Irena Šarc, 2019, original scientific article Abstract: Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients’ lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated.
Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries. Keywords: noninvasive ventilation -- education, health personnel -- education, training, staff Published in DiRROS: 22.10.2020; Views: 1792; Downloads: 1118 Full text (258,13 KB) This document has many files! More... |
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5. Non-invasive ventilation in patients with an altered level of consciousness : a clinical review and practical insightsGil Gonçalves, Haitham Saeed, Mohamed E Abdelrahim, Hadeer S Harb, Yasmin M Madney, Kevin Eng, Habib Mohammad Reazaul Karim, Mohamad F. El-Khatib, Bushra Mina, Szymon Skoczyński, Irena Šarc, 2020, review article Abstract: Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respiratory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preservation of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed. Keywords: noninvasive ventilation, brain diseases, consciousness disorders, coma, altered consciousness, encephalopathy Published in DiRROS: 09.09.2020; Views: 1759; Downloads: 949 Full text (375,01 KB) This document has many files! More... |
6. Continuous positive airway pressure in non-apneic asthma : a clinical review of the current evidenceHabib Mohammad Reazaul Karim, Antonio M. Esquinas, Sally Ziatabar, Giuseppe Insalaco, Szymon Skoczyński, Irena Šarc, Luigi Ferini-Strambi, Leyla Pur Ozyigit, Thierry Hernández-Gilsoul, Subrata Kumar Singha, 2020, review article Abstract: The use of continuous positive airway pressure (CPAP) in the asthma has been a question of debate over the past several years. Various studies, including animal and human studies have attempted to understand the role and pathophysiology of CPAP in patients with either well controlled or poorly controlled asthma. The aim of this manuscript is to review the current available literature on the physiologic and clinical effects of CPAP in animal models of asthma and humans with stable asthma. Keywords: asthma, bronchoconstriction, continuous positive airway pressure, CPAP Published in DiRROS: 10.08.2020; Views: 1827; Downloads: 499 Link to file |