Background: Earlier detection of chronic obstructive pulmonary disease (COPD) exacerbations may facilitate more rapid treatment with reduced risk of hospitalization. Changes in pulse oximetry may permit early detection of exacerbations. We hypothesized that overnight pulse oximetry would be superior to once-daily monitoring for the early detection of exacerbations. Objective: This study aims to evaluate whether measuring changes in heart rate and oxygen saturation overnight is superior to once-daily monitoring of both parameters and to assess symptom changes in facilitating earlier detection of COPD exacerbations. Methods: A total of 83 patients with COPD were randomized to once-daily or overnight pulse oximetry. Both groups completed the COPD assessment test questionnaire daily. The baseline mean and SD for each pulse oximetry variable were calculated from 14 days of stable monitoring. Changes in exacerbation were expressed as Z scores from this baseline. Results: The mean age of the patients was 70.6 (SD 8.1) years, 52% (43/83) were female, and the mean FEV1 was 53.0% (SD 18.5%) predicted. Of the 83 patients, 27 experienced an exacerbation. Symptoms were significantly elevated above baseline from 5 days before to 12 days after treatment initiation. Day-to-day variation in pulse oximetry during the stable state was significantly less in the overnight group than in the once-daily group. There were greater relative changes at exacerbation in heart rate than oxygen saturation. An overnight composite score of change in heart rate and oxygen saturation changed significantly from 7 days before initiation of treatment for exacerbation and had a positive predictive value for exacerbation of 91.2%. However, this was not statistically better than examining changes in symptoms alone. Conclusions: Overnight pulse oximetry permits earlier detection of COPD exacerbations compared with once-daily monitoring. Monitoring physiological variables was not superior to monitoring symptoms, and the latter would be a simpler approach, except where there is a need for objective verification of exacerbations. Trial Registration: ClinicalTrials.gov NCT03003702; https://clinicaltrials.gov/ct2/show/NCT03003702

Introduction: Telehealth (TH) interventions with Chronic Obstructive Pulmonary Disease (COPD) management were introduced in the literature more than 20 years ago with different labeling, but there was no summary for the overall acceptance and dropout rates as well as associated variables. Objective: This review aims to summarize the acceptance and dropout rates used in TH interventions and identify to what extent clinical settings, sociodemographic factors, and intervention factors might impact the overall acceptance and completion rates of TH interventions. Methods: We conducted a systematic search up to April 2021 on CINAHL, PubMed, MEDLINE (Ovid), Cochrane, Web of Sciences, and Embase to retrieve randomized and non-randomized control trials that provide TH interventions alone or accompanied with other interventions to individuals with COPD. Results: Twenty-seven studies met the inclusion criteria. Overall, the unweighted average of acceptance and dropout rates for all included studies were 80% and 19%, respectively. A meta-analysis on the pooled difference between the acceptance rates and dropout rates (weighted by the sample size) revealed a significant difference in acceptance and dropout rates among all TH interventions 51% (95% CI 49% to 52; p < 0.001) and 63% (95% CI 60% to 67; p < 0.001), respectively. Analysis revealed that acceptance and dropout rates can be impacted by trial-related, sociodemographic, and intervention-related variables. The most common reasons for dropouts were technical difficulties (33%), followed by complicated system (31%). Conclusions: Current TH COPD interventions have a pooled acceptance rate of 51%, but this is accompanied by a high dropout rate of 63%. Acceptance and dropout levels in TH clinical trials can be affected by sociodemographic and intervention-related factors. This knowledge enlightens designs for well-accepted future TH clinical trials. PROSPERO registration number CRD4201707854.

This review focuses on the potential health risks of artificial food additives, especially their effects on lung health. Preservatives, synthetic colorants, and flavor enhancers, which are commonly used in processed foods, play roles in worsening respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD). These additives cause oxidative stress, systemic inflammation, and immune dysregulation, often through the gut-lung axis. The preservatives sodium nitrite and sulfites have the risk of causing bronchial hyper-responsiveness and allergic reactions. The synthetic colorant, Ponceau 4R, is also related to immune-mediated lung inflammation. Flavoring agents such as diacetyl contribute to occupational respiratory diseases like bronchiolitis obliterans. In animal models, prenatal exposure to additives, such as titanium dioxide (E171), might disrupt the development of respiratory neural networks, with long-term consequences. Ultra-processed foods (UPFs), which also contain a high concentration of additives, lead to systemic inflammation and impair lung function. Despite their wide usage, the use of these additives has become a warning sign due to their safety issue, particularly in sensitive people like children, pregnant women, and patients with pre-existing respiratory and chronic conditions. The review highlights the serious need for strict regulation and further research on the long-term effects of food additives on respiratory health. Policymakers should ban these food additives that are more harmful to human health. As an alternative to artificial additives, natural flavors and colors from fruits and vegetables, safe preservatives, and minimally processed ingredients can be used.

Introduction: The process of weaning patients off mechanical ventilation (MV) is difficult and complex. Critical care nurses must maintain continuity of care for patients undergoing MV weaning, assess patients’ overall condition, and meet patients’ needs. Objectives: The study aimed to explore clinical factors of MV weaning success and 28-day survival among patients with acute respiratory distress syndrome secondary to COVID-19. Methods: This prospective observational study was conducted on 90 newly admitted patients in the general intensive care unit Assiut Univeristy Main Hospital in Egypt from October 2021 to March 2022. The researchers applied a standard weaning protocol for all of the patients in this study and then assessed the outcome variables: success or failure of weaning trials from a mechanical ventilator, and 28-day survival. Results: In total, 50 (55.6%) patients were successfully weaned from MV, and 45 (50%) patients survived at 28 days. In a multivariate regression analysis, dynamic compliance (OR, 1.115; 95% CI, 1.010–1.230, p = .031*), lymphocyte count (OR, 3.025; 95% CI, 1.322–6.923, p = .009*), urine output (OR, 1.002; 95% CI, 1.001–1.004, p = .002*), and alanine aminotransferase (ALT; OR, 0.993; 95% CI, 0.988–0.999, p = .017*) were significantly associated with weaning success. In addition, age (OR, 1.058; 95% CI, 1.015–1.102; p = .007*), lymphocyte count (OR, 3.304; 95% CI, 1.348–8.100; p = .009*), urine output (OR, 1.003; 95% CI, 1.001–1.004; p = .001*), and ALT (OR, 0.994; 95% CI, 0.989–0.99, p = .015*) were significantly associated with survival at 28 days. Conclusion: Dynamic lung compliance, lymphocyte count, urine output, and ALT were found to be predictive parameters that may affect the success of weaning off MV. Additionally, it was found that age, lymphocyte count, urine output, and ALT are predictors of survival at 28 days. We recommend further studies with larger, more systematic samples and complete follow-up, focusing on pulmonary function and quality of life in postweaning patients with acute respiratory distress syndrome.

Objectives The objective of this study is to examine the hospitalisation profile for respiratory diseases in Australia between 1998 and 2019. Design An ecological study. Setting A population study that involved all private and public hospitalisations for respiratory diseases in Australia from 1998 to 2019. Data were gathered from the National Hospital Morbidity Database. Participants All patients who were hospitalised at all private and public hospitalisations for respiratory diseases in Australia. Primary outcome measure Hospitalisation rates related to respiratory diseases. Results A total of 8 090 021 hospital admission episodes for diseases of the respiratory system were recorded in Australia between 1998 and 2019. Hospital admission rates increased by 12.4%, from 1766.45 (95% CI 1760.50 to 1772.41) in 1998 to 1985.86 (95% CI 1980.43 to 1991.28) in 2019 per 100 000 persons, p<0.05. Patients who were admitted for an overnight stay made up 82.2% of the total admissions. Females showed a greater increase in hospital admission rates (18.4%) compared with males (7.0%). The age group 15–59 years accounted for 31.0% of the total admissions. The most frequent respiratory system hospital admissions were for chronic lower respiratory diseases; these accounted for 27.8% of all admissions. Conclusion Hospital admissions due to diseases of the respiratory system increased significantly in the last two decades in Australia. Male gender and younger age groups were more likely to be hospitalised for respiratory diseases. Strong public health measures are crucial to raising awareness about diseases of the respiratory system and their implications.

A cross-sectional survey was conducted among 823 health science students to assess the knowledge, attitudes, and practices (KAP) of health science students regarding honey as a prebiotic and yoghurt as a probiotic, using an online questionnaire. Prebiotics and probiotics offer health benefits for the digestive system, respiratory health, and immune system, and healthcare providers should be well-informed to advise patients effectively. Data was analyzed using SPSS software. The results reveal significant differences in knowledge and practices across gender, geographical location, and smoking status. Females consistently outperformed males, with higher scores in knowledge assessment (3.9 vs. 3.4), practices and usage (3.7 vs. 3.1), awareness and attitudes (4.2 vs. 3.6), comparative perception (3.9 vs. 3.3), and recommendations (4.0 vs. 3.5). The data indicates that honey (39.5%) is the most preferred natural remedy for respiratory health among Saudi healthcare students, followed by yoghurt (26.9%). In comparison, 22.7% consider both equally beneficial. Using the Chi-square test (χ²) to determine statistical significance and Cramér’s V to measure effect size, the study found that 45.9% of participants demonstrated high knowledge of honey’s health benefits, with males (48.2%) exhibiting slightly greater awareness than females (44.2%). The findings indicated that healthcare students in Saudi Arabia have good knowledge about probiotics. A structured and inclusive health education approach can increase acceptance of natural health solutions, improving respiratory health outcomes across various populations. The study suggests that educational interventions on prebiotics and probiotics should be incorporated into health programs to help students manage respiratory health using safe, natural therapies.