Author Interviews, Pulmonary Disease, Sleep Disorders / 21.05.2024

MedicalResearch.com Interview with: [caption id="attachment_61753" align="alignleft" width="154"]Dr. Parekh Dr. Parekh[/caption] Ankit Parekh, PhD Director of the Sleep And Circadian Analysis (SCAN) Group Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sleep apnea is associated with incident cardiovascular disease, and is a common chronic condition affecting over a billion people worldwide. In diagnosing and treating sleep apnea, it is imperative to establish the type of sleep apnea—whether it is obstructive or central sleep apnea. The differential contribution of central vs. obstructive sleep apnea toward incidental cardiovascular disease in those with significant sleep apnea has not been well studied. Our group has developed an automated algorithm that deduces on a breath-by-breath level whether reductions in airflow are predominantly due to obstructive or central phenomena. Our algorithm uses several features that are known to be key in distinguishing the type of events and derives a probability of obstruction across each “small” (reduced amplitude) breath. The breath-by-breath probability is then used to determine whether a patient’s burden of sleep apnea is predominantly obstructive or central. In this work, we analyzed sleep study data from The Osteoporotic Fractures in Men (MrOS) cohort (N=2793) consisting of elderly men, across two visits separated on average by 6.5 years, and derived the probability of obstruction on a breath-by-breath level. The median probability of obstruction for each subject was computed and analyzed against outcomes of cardiovascular disease. We also assessed the stability of the metric in those without any prevalent cardiovascular disease. We find that median probability of obstruction was stable across the two visits, and those with any incident cardiovascular disease had a lower median probability of obstruction: patients with incident cardiovascular outcomes had a significant burden of sleep apnea that was predominantly “central” in nature.
Author Interviews, Boehringer Ingelheim, NEJM, Pulmonary Disease / 15.05.2022

MedicalResearch.com Interview with: [caption id="attachment_59143" align="alignleft" width="160"]Professor Luca Richeldi MD PhD Chair and Head, Division of Pulmonary Medicine Gemelli University Hospital - IRCCS Catholic University of the Sacred Heart Rome Prof. Richeldi[/caption] Professor Luca Richeldi MD PhD Chair and Head, Division of Pulmonary Medicine Gemelli University Hospital - IRCCS Catholic University of the Sacred Heart Rome MedicalResearch.com:  What is the background for this study?  Would you briefly explain the condition of Idiopathic Pulmonary Fibrosis? Response: As you may know, Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible lung disease with high mortality. IPF is one of the more common forms of progressive fibrosing interstitial lung diseases and its symptoms of IPF include breathlessness during activity, a dry and persistent cough, chest discomfort, fatigue and weakness. IPF is considered a “rare” disease, but it affects more than 3 million people worldwide. Currently, there are two approved antifibrotic drugs that slow, but do not stop, the progression of fibrosis. Therefore, there is a need for additional treatments that can be used alone or with existing antifibrotic therapies. Pre-clinical research indicated that phosphodiesterase 4 (PDE4) inhibition is associated with anti-inflammatory and antifibrotic effects that may be beneficial in patients with idiopathic pulmonary fibrosis. In this Phase 2, double-blind, placebo-controlled trial, we investigated the efficacy and safety of BI 1015550, an oral preferential inhibitor of the PDE4B subtype, in patients with IPF. Patients were randomly assigned in a 2:1 ratio to receive BI 1015550 at a dose of 18 mg twice daily or placebo.
Author Interviews, COVID -19 Coronavirus, Pulmonary Disease / 12.01.2021

MedicalResearch.com Interview with: [caption id="attachment_56399" align="alignleft" width="200"]MedicalResearch.com Interview with: Dr. Townsend Department of Infectious Diseases St. James's Hospital and Department of Clinical Medicine Trinity Translational Medicine Institute Trinity College, Dublin, Ireland MedicalResearch.com: What is the background for this study? Response: Much is known about the clinical characteristics and pathological features of acute SARS-CoV-2 infection, but there is relatively little known about post-COVID recovery. This has come under increasing scrutiny in light of reports that patients suffer persistent symptoms beyond resolution of initial infection, known as long COVID. We set out to assess patients in our post-COVID clinic for ongoing ill-health, with particular focus on fatigue and breathlessness. Given that COVID-19 primarily affects the respiratory system, we also evaluated respiratory recovery. Patients underwent chest radiography and six-minute-walk testing, as well as routine blood tests including inflammatory markers and D-dimers. We included both patients who were admitted during their acute infection as well as those managed in the community in order to capture the full spectrum of disease. MedicalResearch.com: What are the main findings? Are there any markers that suggest a higher risk of persistent post-Covid symptoms? Response: We assessed 153 patients, of whom 74 had required admission during initial infection, at a median of 75 days post-infection. We found persistent ill-health was common in those attending our clinic, with 62% reporting that they did not feel back to full health. Almost half (47%) met the case definition for fatigue, as assessed by the Chalder Fatigue Scale. Patients also reported moderate breathlessness on six-minute-walk-test, with a median modified Borg score of 3. Reassuringly, we saw persistent abnormal chest x-rays in only 4% of patients, and the median distance covered during walk test was 460m, which approaches the normal range for healthy populations. Furthermore, there were only two patients that experienced oxygen desaturation to less than 90% during walk test. We investigated the potential predictors and associations of breathless, distance covered and abnormal chest x-ray using a multivariate regression analysis model. Interestingly, we found that severity of initial infection, as defined by requirement for admission to hospital, peak CRP and peak oxygen requirement, was not associated with severity of self-reported symptoms. Thus, there were no features from initial infection identified that could predict persistence of symptoms beyond initial infection. MedicalResearch.com: What should readers take away from your report? Response: This study highlights several important points: 1. Ill-health, fatigue and breathlessness are common in the aftermath of SARS-CoV-2 infection 2. These appear unrelated to initial severity of infection. This has implications for the potential number of patients who may be affected, as well as increased burden on the healthcare system 3. We show reassuringly low rates of abnormal chest x-rays as well as reassuring objective six-minute-walk test results, suggesting that clinically significant pulmonary damage is uncommon. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: We would suggest that future studies on the aftermath of COVID-19 include patients across the spectrum of disease severity, rather than focusing only on those who required hospitalization. The range and frequency of post-COVID symptoms are being emerging in the literature, and there is a need for mechanistic studies to understand the underlying pathology. We have no disclosures to declare. Citation: Liam Townsend, Joanne Dowds, Kate O'Brien, Grainne Sheill, Adam H Dyer, Brendan O'Kelly, John P. Hynes, Aoife Mooney, Jean Dunne, Cliona Ni Cheallaigh, Cliona O'Farrelly, Nollaig M Bourke, Niall Conlon, Ignacio Martin-Loeches, Colm Bergin, Parthiban Nadarajan, Ciaran Bannan. Persistent Poor Health Post-COVID-19 Is Not Associated with Respiratory Complications or Initial Disease Severity. Annals of the American Thoracic Society, 2021; DOI: 10.1513/AnnalsATS.202009-1175OC MedicalResearch.com is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional. The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. Dr. Townsend[/caption] Dr. Liam Townsend, PhD Department of Infectious Diseases St. James's Hospital and Department of Clinical Medicine Trinity Translational Medicine Institute Trinity College, Dublin, Ireland  MedicalResearch.com: What is the background for this study? Response: Much is known about the clinical characteristics and pathological features of acute SARS-CoV-2 infection, but there is relatively little known about post-COVID recovery. This has come under increasing scrutiny in light of reports that patients suffer persistent symptoms beyond resolution of initial infection, known as long COVID. We set out to assess patients in our post-COVID clinic for ongoing ill-health, with particular focus on fatigue and breathlessness. Given that COVID-19 primarily affects the respiratory system, we also evaluated respiratory recovery. Patients underwent chest radiography and six-minute-walk testing, as well as routine blood tests including inflammatory markers and D-dimers. We included both patients who were admitted during their acute infection as well as those managed in the community in order to capture the full spectrum of disease.
Author Interviews, COVID -19 Coronavirus, Infections, Pulmonary Disease / 08.05.2020

MedicalResearch.com Interview with: [caption id="attachment_54138" align="alignleft" width="200"]Jehan Alladina MD Massachusetts General Hospital Pulmonary and Critical Care Medicine Boston, Massachusetts Dr. Alladina[/caption] Jehan Alladina MD Massachusetts General Hospital Pulmonary and Critical Care Medicine Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: During the pandemic, clinicians around the world have shared anecdotal experiences to help inform care of patients with COVID-19. However, these anecdotes and observations, without careful analysis, can bias clinicians; many clinicians have even recommended experimental therapies based on this information alone. To that end, the goal of our study was to rigorously examine the respiratory failure experienced by critically ill patients with COVID-19 and understand their response to the standards of care for respiratory failure.
Author Interviews, Beth Israel Deaconess, Race/Ethnic Diversity / 17.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52803" align="alignleft" width="160"]John Danziger, MD Harvard Medical Faculty Physicians, Nephrology Beth Israel Deaconess Medical Center  Dr. Danziger[/caption] John Danziger, MD Harvard Medical Faculty Physicians, Nephrology Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: Racial health disparities have long been described, extending even into the highest levels of medical care, namely the Intensive Care Unit (ICU). Accordingly, we wanted to know whether improvements in ICU care seen over the last decade are equally observed in minority and non-minority serving hospitals.
Author Interviews, Blood Pressure - Hypertension, Obstructive Sleep Apnea / 13.09.2019

MedicalResearch.com Interview with: Mireia Dalmases Cleries, MD Hospital Universitari Arnau de Vilanova and Santa Maria Group of Translational Research in Respiratory Medicine Lleida, Cataluña, Spain MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea has been associated with poor blood pressure control and resistant hypertension. Moreover, it has been described that its treatment with continuous positive pressure (CPAP) could be an effective means of controlling blood pressure in this population. Nevertheless, studies assessing OSA prevalence, characteristics and association with blood pressure control in resistant hypertensive patients are limited and that’s the reason why we decided to perform this study.