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Lung Disease and Pulmonary Rehabilitation, Respiratory Health, Public Health

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Guest Editor
Pneumology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, 11009 Cádiz, Spain
Interests: COPD; pulmonary rehabilitation; muscle training; asthma

Special Issue Information

Dear Colleagues,

Pulmonary rehabilitation is recognized as a core component of the management of patients with chronic respiratory diseases and has been demonstrated to be effective mainly in COPD patients, but also in others with respiratory diseases such as interstitial lung disease, bronchiectasis, cystic fibrosis, asthma, pulmonary hypertension, etc., improving symptoms, exercise tolerance, and quality of life.

Pulmonary rehabilitation is related to respiratory health, as well as other aspects such as smoking cessation, indoor and outdoor air pollution, respiratory infections, physical activity, nutrition, and maintaining a healthy weight. Many of these are related to public health as well, as we have seen, for example, with the recent COVID-19 pandemic, meaning that respiratory and public health are intrinsically linked.

In this Special Issue of the International Journal of Environmental Research and Public Health, we are going to focus on these aspects related to respiratory and public health and pulmonary rehabilitation in respiratory diseases and offer an opportunity to publish multidisciplinary research and reviews related to them.

We encourage you to send your manuscripts and contribute with them to the success of this Special Issue.

Dr. Aurelio Arnedillo
Guest Editor

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Keywords

  • respiratory diseases
  • pulmonary rehabilitation
  • respiratory health
  • public health
  • smoking cessation
  • exercise

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Published Papers (10 papers)

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Research

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13 pages, 814 KiB  
Article
The Association of Self-Reported Birthweight with Lung Function and Respiratory Diseases: Results from a Multi-Centre, Multi-Case Control Study in Italy
by Ilaria Tocco Tussardi, Ahmad Tfaily, Francesca Locatelli, Leonardo Antonicelli, Salvatore Battaglia, Roberto Bono, Angelo G. Corsico, Nicola Murgia, Pietro Pirina, Marcello Ferrari, Stefano Tardivo, Deborah L. Jarvis and Giuseppe Verlato
Int. J. Environ. Res. Public Health 2022, 19(22), 15062; https://doi.org/10.3390/ijerph192215062 - 16 Nov 2022
Viewed by 1578
Abstract
Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW), however, is conflicting. We examined associations of self-reported BW with lung function and the development of respiratory and also non-respiratory diseases within [...] Read more.
Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW), however, is conflicting. We examined associations of self-reported BW with lung function and the development of respiratory and also non-respiratory diseases within the GEIRD (Gene–Environment Interaction in Respiratory Diseases) project, an Italian multi-centre, multi-case control study involving cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status as response variable; BW as main determinant; and adjusting for sex, age and smoking status. Of the 2287 participants reporting BW, 6.4% (n = 147) had low BW (<2500 g), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Both men and women with low BW were shorter than those with normal BW (mean ± SD: 160.2 ± 5.5 vs. 162.6 ± 6.5 cm in women, p = 0.009; 172.4 ± 6.1 vs. 174.8 ± 7.2 cm in men, p < 0.001). Although FEV1 and FVC were reduced in individuals with low BW, this was explained by associations with sex and height. In multivariable analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before the age of two (10.3% vs. 4.1%; p < 0.001), severe respiratory infection before the age of five (16.9% vs. 8.8%; p = 0.001) and hypertension in adulthood (29.9% vs. 23.7%; p = 0.001); however, they had a lower risk of arrhythmia (2.7% vs. 5.8%; p = 0.027). Full article
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11 pages, 334 KiB  
Article
Prevalence and Predictors of Sleep Disturbance, Anxiety and Depression among Patients with Chronic Respiratory Diseases
by Yousef S. Aldabayan, Jaber S. Alqahtani, Ahmed M. Al Rajeh, Amal Ismael Abdelhafez, Rayan A. Siraj, Vidhya Thirunavukkarasu and Abdulelah M. Aldhahir
Int. J. Environ. Res. Public Health 2022, 19(19), 12819; https://doi.org/10.3390/ijerph191912819 - 6 Oct 2022
Cited by 5 | Viewed by 2499
Abstract
Background: Poor sleep quality, depression, and anxiety are common comorbidities among individuals with chronic respiratory diseases (CRDs). However, there has been no work to estimate their prevalence and assess their associations among the CRDs population in Saudi Arabia. Methods: A cross-sectional study was [...] Read more.
Background: Poor sleep quality, depression, and anxiety are common comorbidities among individuals with chronic respiratory diseases (CRDs). However, there has been no work to estimate their prevalence and assess their associations among the CRDs population in Saudi Arabia. Methods: A cross-sectional study was conducted in primary healthcare centers and included a total of 390 patients. Structured self-administered questionnaires were completed that included the Sleep Quality Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Score (HADS). Multiple linear regression analyses were performed to assess the associations between patients’ characteristics and sleep disturbance, anxiety and depression. Results: Poor sleep quality, depression, and anxiety affect 75%, 49.2%, and 36.4% of the study participants, respectively. The PSQI was significantly correlated with anxiety (r = 0.30) and depression (r = 0.16). Furthermore, a significant correlation was found between anxiety and depression (r = 0.44). The predictors of poor sleep quality were age, gender, and family history of CRDs, education level and anxiety and these variables accounted for 0.19% of the variance in PSQI. Variables that independently predicted an increased level of depression were age, gender, marital status, family history of CRDs, diagnosis, previous hospital admission, the presence of comorbidities, dyspnea last month and anxiety. On the other hand, the variables that independently predicted an increased level of anxiety were age, BMI, family history of CRDs, previous hospital admission, the presence of comorbidities, dyspnea last month and depression. Conclusion: Healthcare providers managing patients with CRDs should be alert to the high prevalence of poor sleep quality, depression, and anxiety. Appropriate interventions to reduce the prevalence should be developed and timely applied. Full article
14 pages, 1114 KiB  
Article
Exercise Capacity and Physical Activity in Non-Cystic Fibrosis Bronchiectasis after a Pulmonary Rehabilitation Home-Based Programme: A Randomised Controlled Trial
by Sindy Cedeño de Jesús, Virginia Almadana Pacheco, Agustín Valido Morales, Ana Miriam Muñíz Rodríguez, Rut Ayerbe García and Aurelio Arnedillo-Muñoz
Int. J. Environ. Res. Public Health 2022, 19(17), 11039; https://doi.org/10.3390/ijerph191711039 - 3 Sep 2022
Cited by 7 | Viewed by 3108
Abstract
Background: Patients with chronic respiratory disease have low exercise capacity and limited physical activity (PA), which is associated with worsening dyspnoea, exacerbations, and quality of life. The literature regarding patients with non-cystic fibrosis bronchiectasis (non-CF BQ) is scarce, especially regarding the use of [...] Read more.
Background: Patients with chronic respiratory disease have low exercise capacity and limited physical activity (PA), which is associated with worsening dyspnoea, exacerbations, and quality of life. The literature regarding patients with non-cystic fibrosis bronchiectasis (non-CF BQ) is scarce, especially regarding the use of cardiopulmonary exercise tests (CPET) to assess the effects of home-based pulmonary rehabilitation programmes (HPRP). The aim was to evaluate the effect of an HPRP on the exercise capacity of non-CF BQ patients using CPET and PA using an accelerometer. Methods: Our study describes a non-pharmacological clinical trial in non-CF BQ patients at the Virgen Macarena University Hospital (Seville, Spain). The patients were randomised into two groups: a control group (CG), which received general advice on PA and educational measures, and the intervention group (IG), which received a specific 8-week HPRP with two hospital sessions. The variables included were those collected in the CPET, the accelerometer, and others such as a 6 min walking test (6MWT) and dyspnoea. The data were collected at baseline and at an 8-week follow-up. Results: After the intervention, there was a significant increase in peak VO2 in the IG, which was not evidenced in the GC (IG 66.8 ± 15.5 mL/min p = 0.001 vs. CG 62.2 ± 14.14 mL/min, p = 0.30). As well, dyspnoea according to the mMRC (modified Medical Research Council), improved significantly in IG (2.19 ± 0.57 to 1.72 ± 0.05, p = 0.047) vs. CG (2.07 ± 0.7 to 2.13 ± 0.64, p = 0.36). In addition, differences between the groups in walked distance (IG 451.19 ± 67.99 m, p = 0.001 vs. CG 433.13 ± 75.88 m, p = 0.981) and in physical activity (IG 6591 ± 3482 steps, p = 0.007 vs. CG 4824 ± 3113 steps, p = 0.943) were found. Conclusion: Participation in a specific HPRP improves exercise capacity, dyspnoea, walked distance, and PA in non-CF BQ patients. Full article
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16 pages, 1563 KiB  
Article
Rationale and Purpose: The FLUTE Study to Evaluate Fluorography Mass Screening for Tuberculosis and Other Diseases, as Conducted in Eastern Europe and Central Asia Countries
by Vitaly Smelov, Olga Trusova, Sylvaine Barbier, Richard Muwonge, Viatcheslav Grankov, Valiantsin Rusovich, Armando Baena, Mary Lyn Gaffield, Marilys Anne Corbex and Masoud Dara
Int. J. Environ. Res. Public Health 2022, 19(14), 8706; https://doi.org/10.3390/ijerph19148706 - 17 Jul 2022
Viewed by 1996
Abstract
In Belarus and several EECA countries, periodic population-based chest X-ray “fluorography programme” use as a mass screening tool for the diagnosis of tuberculosis (TB) has been used for decades. This mass screening has also often been justified for the early detection of lung [...] Read more.
In Belarus and several EECA countries, periodic population-based chest X-ray “fluorography programme” use as a mass screening tool for the diagnosis of tuberculosis (TB) has been used for decades. This mass screening has also often been justified for the early detection of lung cancer (LC), although no mortality benefits were demonstrated by screening with chest X-ray in international randomized trials. In Belarus, fluorography testing is mandatory every one to three years for all adults depending on age and the so-called “risk groups”. The World Bank and WHO estimate that Belarus spends USD11 million annually on mass fluorography screening and advocate for more targeted screening approaches to increase diagnostic yield for TB and not to use it for screening for LC. The study is a retrospective review of medical records to assess the yield of fluorography to detect true cases of LC and/or TB in asymptomatic patients in two rural and two urban districts in Belarus for 2015–2017 with positive screening results for presumed of TB or LC. The study provided the rationale to implement the improved policy and practices regarding the role of fluorography in the early detection of LC and TB in Belarus and elsewhere. Full article
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10 pages, 347 KiB  
Article
Sedentary Time and Cognitive Impairment in Patients Using Long-Term Oxygen Therapy: A Cross-Sectional Study
by Hiroki Annaka, Tomonori Nomura and Hiroshi Moriyama
Int. J. Environ. Res. Public Health 2022, 19(3), 1726; https://doi.org/10.3390/ijerph19031726 - 2 Feb 2022
Cited by 3 | Viewed by 3023
Abstract
Physical inactivity is a predictor of death in patients with chronic respiratory disease. Cognitive impairment is common among patients with chronic respiratory disease. However, the association between sedentary time and cognitive impairment in patients with chronic respiratory disease using long-term oxygen therapy is [...] Read more.
Physical inactivity is a predictor of death in patients with chronic respiratory disease. Cognitive impairment is common among patients with chronic respiratory disease. However, the association between sedentary time and cognitive impairment in patients with chronic respiratory disease using long-term oxygen therapy is unclear. This study aimed to determine the relationship between sedentary time and cognitive impairment in patients on long-term oxygen therapy. This cross-sectional study included 96 patients with chronic respiratory disease on long-term oxygen therapy (mean age 77.3 years; female, 22%). The primary outcomes measured were sedentary time (Japanese version of the International Physical Activity Questionnaire Short Form), cognitive function (Montreal Cognitive Assessment), and dyspnea (modified Medical Research Council scale). The factors associated with sedentary time were confirmed by multiple regression analysis. The median sedentary time was 600.0 min. The median Montreal Cognitive Assessment score was 24.0 points, and 67 (70%) patients had mild cognitive impairment. In multiple regression analysis, sedentary time was associated with dyspnea (β = 0.397, p < 0.001) and cognitive function (β = −0.239, p = 0.020). This study indicates that sedentary time in patients on long-term oxygen therapy was associated with dyspnea and cognitive impairment. Full article

Review

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13 pages, 399 KiB  
Review
The Bidirectional Relationship between Pulmonary Tuberculosis and Lung Cancer
by Mădălina Preda, Bogdan Cosmin Tănase, Daniela Luminița Zob, Adelina Silvana Gheorghe, Cristian Virgil Lungulescu, Elena Adriana Dumitrescu, Dana Lucia Stănculeanu, Loredana Sabina Cornelia Manolescu, Oana Popescu, Elmira Ibraim and Beatrice Mahler
Int. J. Environ. Res. Public Health 2023, 20(2), 1282; https://doi.org/10.3390/ijerph20021282 - 10 Jan 2023
Cited by 14 | Viewed by 4286
Abstract
Lung cancer and pulmonary tuberculosis are two significant public health problems that continue to take millions of lives each year. They may have similar symptoms and, in some cases, are diagnosed simultaneously or may have a causal relationship. In tuberculosis disease, the chronic [...] Read more.
Lung cancer and pulmonary tuberculosis are two significant public health problems that continue to take millions of lives each year. They may have similar symptoms and, in some cases, are diagnosed simultaneously or may have a causal relationship. In tuberculosis disease, the chronic inflammation, different produced molecules, genomic changes, and fibrosis are believed to be important factors that may promote carcinogenesis. As a reverse reaction, the development of carcinogenesis and the treatment may induce the reactivation of latent tuberculosis infection. Moreover, the recently used checkpoint inhibitors are a debatable subject since they help treat lung cancer but may lead to the reactivation of pulmonary tuberculosis and checkpoint-induced pneumonitis. Pulmonary rehabilitation is an effective intervention in post-tuberculosis patients and lung cancer patients and should be recommended to improve outcomes in these pathologies. Full article
12 pages, 1858 KiB  
Review
Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients
by Lorenzo Lippi, Francesco D’Abrosca, Arianna Folli, Alberto Dal Molin, Stefano Moalli, Antonio Maconi, Antonio Ammendolia, Alessandro de Sire and Marco Invernizzi
Int. J. Environ. Res. Public Health 2022, 19(15), 9150; https://doi.org/10.3390/ijerph19159150 - 27 Jul 2022
Cited by 16 | Viewed by 3394
Abstract
Pulmonary rehabilitation (PR) is a well-established intervention supported by strong evidence that is used to treat patients affected by chronic respiratory diseases. However, several barriers still affect its spreading in rehabilitation clinical practices. Although chronic respiratory diseases are common age-related disorders, there is [...] Read more.
Pulmonary rehabilitation (PR) is a well-established intervention supported by strong evidence that is used to treat patients affected by chronic respiratory diseases. However, several barriers still affect its spreading in rehabilitation clinical practices. Although chronic respiratory diseases are common age-related disorders, there is still a gap of knowledge regarding the implementation of sustainable strategies integrating PR in the rehabilitation management of frail patients at high risk of respiratory complications. Therefore, in the present study, we characterized the effects of PR in frail patients, highlighting the evidence supporting its role in improving the complex rehabilitative management of these patients. Moreover, we propose a novel organizational model promoting PR programs for frail patients in both inpatient and outpatient settings. Our model emphasizes the role of interdisciplinary care, specifically tailored to patients and environmental characteristics. In this scenario, cutting-edge technology and telemedicine solutions might be implemented as safe and sustainable strategies filling the gap between inpatient and outpatient settings. Future research should focus on large-scale sustainable interventions to improve the quality of life and global health of frail patients. Moreover, evidence-based therapeutic paths should be promoted and taught in training courses promoting multiprofessional PR knowledge to increase awareness and better address its delivery in frail patients. Full article
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14 pages, 905 KiB  
Review
Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review
by Eva Vázquez-Gandullo, Antonio Hidalgo-Molina, Francisca Montoro-Ballesteros, María Morales-González, Isabel Muñoz-Ramírez and Aurelio Arnedillo-Muñoz
Int. J. Environ. Res. Public Health 2022, 19(9), 5564; https://doi.org/10.3390/ijerph19095564 - 3 May 2022
Cited by 17 | Viewed by 8262
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease, with pulmonary and extrapulmonary manifestations, which leads to the need to personalize the assessment and treatment of these patients. The latest updates of national and international guidelines for the management of COPD [...] Read more.
Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease, with pulmonary and extrapulmonary manifestations, which leads to the need to personalize the assessment and treatment of these patients. The latest updates of national and international guidelines for the management of COPD reveal the importance of respiratory rehabilitation (RR) and its role in improving symptoms, quality of life, and psychosocial sphere of patients. Within RR, the inspiratory muscle training (IMT) has received special interest, showing benefits in maximum inspiratory pressure, perception of well-being, and health status in patients with chronic heart disease, respiratory diseases, and dyspnea during exercise. The aim of this review is to assess the efficacy of IMT in COPD patients through the use of inspiratory muscle training devices, compared with respiratory rehabilitation programs without inspiratory muscle training. In the last years, many mechanical devices focused on inspiratory muscle training have been developed, some of them, such as the AirOFit PRO™, PowerBreath®, or FeelBreathe®, have shown clear benefits. The active search for candidate patients to undergo the RR program with inspiratory muscle training using this type of device in COPD patients represents an advance in the treatment of this disease, with direct benefits on the quality of life of the patients. In this article, we review the available evidence on IMT in these patients and describe the different devices used for it. Full article
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Other

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3 pages, 293 KiB  
Reply
Reply to Yigit, S.; Akinci, B. Comment on “Vázquez-Gandullo et al. Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 5564”
by Eva Vázquez-Gandullo, Antonio Hidalgo-Molina, Francisca Montoro-Ballesteros, María Morales-González, Isabel Muñoz-Ramírez and Aurelio Arnedillo-Muñoz
Int. J. Environ. Res. Public Health 2023, 20(6), 4801; https://doi.org/10.3390/ijerph20064801 - 9 Mar 2023
Viewed by 1172
Abstract
We would like to thank you for your interest [...] Full article
2 pages, 279 KiB  
Comment
Comment on Vázquez-Gandullo et al. Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 5564
by Safak Yigit and Buket Akinci
Int. J. Environ. Res. Public Health 2023, 20(5), 4629; https://doi.org/10.3390/ijerph20054629 - 6 Mar 2023
Cited by 1 | Viewed by 1754
Abstract
In May 2022, the paper “Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review” was published in the International Journal of Environmental Research and Public Health [...] [...] Read more.
In May 2022, the paper “Inspiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease (COPD) as Part of a Respiratory Rehabilitation Program Implementation of Mechanical Devices: A Systematic Review” was published in the International Journal of Environmental Research and Public Health [...] Full article
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