International journal of clinical practice
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Int. J. Clin. Pract. · Sep 2021
Advanced counseling using training device and smartphone application on inhalation technique from metered-dose inhaler with spacer equipped with different interfaces in asthmatic children.
Spacers are equipped with either facemask or mouthpiece as an interface through which patient inhale their dose. The present study aimed to evaluate the effect of advanced counselling using training devices and smartphone applications on inhalation techniques from the metered-dose inhaler (MDI) with a spacer equipped with different interfaces. ⋯ The Flo-Tone with its positive reinforcement whistle and the Trainhaler smartphone application significantly improved the inhalation technique by decreasing the total number of mistakes especially in important steps eg, shaking MDI, maintaining slow inhalation rate, breath-holding after inhalation and appropriate facemask fitting. Also, they increased the duration of inhalation of asthmatic children from MDI with a spacer. Both spacer interfaces are easy to handle once taught well.
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Int. J. Clin. Pract. · Sep 2021
Observational StudyRed cell distribution width. A new parameter for predicting the risk of exacerbation in COPD patients.
Red cell distribution width (RDW) is a numerical measurement of the size variability of erythrocytes and is routinely reported as a component of complete blood count in the differential diagnosis of anemia. In recent years, researchers have reported high mortality and poor prognosis associated with higher RDW in populations with cardiovascular disease, cancer, pneumonia, and chronic obstructive pulmonary disease (COPD). The aim of the study is to evaluate the role of RDW in predicting the risk of COPD exacerbations and the impact of symptoms. ⋯ Our data show that elevated RDW may be a useful tool in predicting the risk of exacerbation in COPD patients and may be a good indicator of the impact of symptoms.
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Int. J. Clin. Pract. · Sep 2021
TAS1R2 rs35874116 and TRPM5 rs886277 polymorphisms are not related with risk of obesity.
Obesity is one of the most serious public health problems due to its high morbidity and mortality rates. The taste perception is a powerful factor affecting food acceptance and may be one of the causes of tendency to obesity. Genetic variations in TAS1R2 and TRPM5 genes that affect taste preferences may cause inter-individual differences in food selection and thus increase the risk of obesity. We hypothesised that genetic variations in TAS1R2 and TRPM5 genes may contribute to obesity phenotypes by influencing food intake and body mass index (BMI). The aim of this study is to analyse the association of TAS1R2 rs35874116 and TRPM5 rs886277 polymorphisms with BMI and obesity. ⋯ Although TAS1R2 and TRPM5 genes were associated with taste preferences in previous studies, we found out that TAS1R2 rs35874116 and TRPM5 rs886277 variants are not associated with obesity. The functional potency of the genetic variants within TAS1R2 and TRPM5 may be different between ethnic groups and this requires further investigations.
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Int. J. Clin. Pract. · Sep 2021
Comparing cost of intravenous infusion and subcutaneous biologics in COVID-19 pandemic care pathways for Rheumatoid Arthritis and Inflammatory Bowel Disease - A brief UK stakeholder survey.
One important group of people at higher risk from the SARS-CoV-2(COVID-19) pandemic are those with autoimmune conditions including rheumatoid arthritis/inflammatory bowel disease. To minimise infection risk, many people have been switched from intravenous to subcutaneous biologics including biosimilars. ⋯ Switching from infusion to subcutaneous routes is currently driven by the COVID-19 pandemic in many services. A case for biologics (infusion vs subcutaneous) must be made on accurate real-world economic analysis. In an analysis of direct/indirect costs, excluding medicine acquisition costs, subcutaneous administration appears to be the more cost saving option for many patients even without the benefit of industry funded home-care. What's known One important group of people at high risk in COVID-19 pandemic are those with autoimmune conditions, including those with rheumatoid arthritis and inflammatory bowel disease. Depending on the complexity of their condition, some of the patients in this group may be receiving intravenous biologic infusion therapy which under normal circumstances is administered within a hospital or day hospital setting. The National Institute for Health and Care Excellence has published new guidance to ensure that patients having intravenous treatment are assessed for possible switching to the same treatment in subcutaneous form. What's new A cost analysis showed that administration costs for subcutananous routes are 50% lower than for infusion routes, with most patients administering subcutaneous medicines themselves. Other indirect benefits to this route included less pressure on infusion unit waiting times and reduced risk of COVID-19 infection, along with reduced patient costs. Cost savings were partly offset by increased pressure on home-care and community/primary care services.
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Int. J. Clin. Pract. · Sep 2021
Cone beam computed tomography analysis results in patients with obstructive sleep apnoea syndrome.
The present study aimed to investigate the contribution of cone-beam computed tomography (CBCT) to the diagnosis of obstructive sleep apnoea syndrome (OSAS). ⋯ This study concluded that patients with OSAS had marked narrowing of the upper airway, nasal cavity and maxillary width, shortening and enlargement of the soft palate, and marked increase in BMI. However, to gather sufficiently reliable data for routine use in orthodontic analyses, there is a need for greater number of samples to improve the database.