BackgroundClinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pul... more BackgroundClinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pulmonary disease (COPD) has been widely investigated. However, there is no systematic review assessing the clinical values of non-cardiac US techniques in COPD.MethodsWe systematically searched electronic databases from inception to 24 June 2020. Two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines extracted data. A narrative synthesis of the results was conducted considering non-cardiac US techniques that looked for diaphragm, muscles and bones in patients with COPD.ResultsIn total, 2573 abstracts were screened, and 94 full-text papers were reviewed. A total of 54 studies met the inclusion criteria. Thirty-five studies assessed the diaphragm, while 19 studies evaluated different muscles, including limb muscles and pulmonary lesions in COPD using US. Of the 54 included studies, 30% (16/54) evaluated the changes in ei...
BackgroundWhile the number of COVID-19 cases and deaths around the world is starting to peak, it ... more BackgroundWhile the number of COVID-19 cases and deaths around the world is starting to peak, it is essential to point out how different countries manage the outbreak and how different measures and experience resulted in different outcomes. This study aimed to compare the effect of the measures taken by Saudi Arabia and the United Kingdom (UK) governments on the outcome of the COVID-19 pandemic as predicted by a mathematical model.MethodData on the numbers of cases, deaths and government measures were collected from Saudi’s Ministry of Health and Public Health England. A prediction of the trend of cases, deaths and days to peak was then modelled using the mathematical technique, Exponential Logistic Growth and Susceptible Infectious Recovered (SIR) model. The measures taken by the governments and the predicted outcomes were compared to assess effectiveness.ResultWe found over three months that 22 fast and extreme measures had been taken in Saudi Arabia compared to eight slow and lat...
BackgroundReadmission rates following hospitalisation for COPD exacerbations are unacceptably hig... more BackgroundReadmission rates following hospitalisation for COPD exacerbations are unacceptably high, and the contributing factors are poorly understood. Our objective was to summarise and evaluate the factors associated with 30- and 90-day all-cause readmission following hospitalisation for an exacerbation of COPD.MethodsWe systematically searched electronic databases from inception to 5 November 2019. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using a modified version of the Newcastle–Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis where this was possible using a random-effects model.ResultsIn total, 3533 abstracts were screened and 208 full-text manuscripts were reviewed. A total of 32 papers met the inclusion criteria, and 14 studies were included in the meta-analysis. The readmission rate ranged ...
Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chroni... more Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chronic obstructive pulmonary disease (COPD) has been limited by an absence of rigorous evidence-based studies supporting use. Our objective were to report and summarise the current evidence supporting use of nutritional supplementation to improve outcomes during pulmonary rehabilitation in stable COPD patients. A systematic search was conducted up to May 7th, 2019 (registration number CRD42018089142). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Six databases were included: Medical Literature Analysis and Retrieval System Online or MEDLARS Online (Medline), Allied and Complementary Medicine Database (AMED), the Cochrane Database of Systematic Reviews, Excerpta Medica dataBASE (Embase), Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science. This systematic search generated 580 initial matches, of which 24 ...
Background:
Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatical... more Background: Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarised the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers. Methods: We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI). Results: In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 6.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%–3%) and 9% (95% CI, 4%–14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4– 2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03–2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%. Conclusion: Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.
The last 2 decades have seen a growing trend towards the use of noninvasive ventilation)NIV(thera... more The last 2 decades have seen a growing trend towards the use of noninvasive ventilation)NIV(therapy in the management of many conditions that cause acute respiratory failure. However, there is a serious side effect that results in using these devices; the development of facial skin pressure damage, specifically pressure ulcers. This skin damage has a considerable effect on patients' quality of life, treatment adherence and patients' comfort in addition to the therapy challenges of wound care. The aim of this clinical review is to discuss the different characteristics of NIV interfaces and to provide evidence based recommendations to facilitate the selection and application of such interfaces to reduce NIV interfaces related pressure ulcers.
BACKGROUND: The use of noninvasive ventilation masks is known to cause damage to facial skin tiss... more BACKGROUND: The use of noninvasive ventilation masks is known to cause damage to facial skin tissue, which affects both the efficacy of the intervention and the patient's quality of life. The use of humidification with noninvasive ventilation is a common practice, but its relative role in the development of facial pressure ulcers has not been fully studied. METHODS: A crossover cohort design was used in this study, with 15 healthy volunteers. Each volunteer randomly received both 10 cm H 2 O of CPAP with and without humidification through an oronasal mask. Skin integrity was evaluated by measuring transepidermal water loss, skin hydration, and skin pH at the bridge of the nose. Device-skin interface conditions (pressure and microclimate) were recorded at the bridge of the nose and both cheeks. The pro-inflammatory cytokine interleukin-1 was collected from the nose bridge before and after CPAP application by using a skin analysis tape. Nasal symptoms were collected by using a validated 6-point score. RESULTS: Humidified CPAP significantly increased transepidermal water loss (P < .001) and skin humidity (P .02) compared with non-humidified CPAP. There were no significant differences in skin hydration, skin pH, skin temperature, and cytokine expression between both conditions. However, there was a trend of increased median ratios of interleukin-1 concentrations in the humidified CPAP. There was a significant increase in the interface pressure at the bridge of the nose after CPAP application (P .02), with higher interface pressure values at the nose bridge compared with both left (P .002) and right (P .003) cheeks. The participants reported elevated nasal discomfort during non-humidified CPAP. CONCLUSIONS: These findings indicated that noninvasive ventilation with humidifi-cation had a potential disrupting effect on the barrier function of facial skin, associated with changes in skin microclimate and function. Further research is required to establish the cause of mask-related skin damage and to evaluate the effects of mask design, application techniques, and air flow and humidity settings.
BackgroundClinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pul... more BackgroundClinical and research utility of non-cardiac ultrasound (US) in chronic obstructive pulmonary disease (COPD) has been widely investigated. However, there is no systematic review assessing the clinical values of non-cardiac US techniques in COPD.MethodsWe systematically searched electronic databases from inception to 24 June 2020. Two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines extracted data. A narrative synthesis of the results was conducted considering non-cardiac US techniques that looked for diaphragm, muscles and bones in patients with COPD.ResultsIn total, 2573 abstracts were screened, and 94 full-text papers were reviewed. A total of 54 studies met the inclusion criteria. Thirty-five studies assessed the diaphragm, while 19 studies evaluated different muscles, including limb muscles and pulmonary lesions in COPD using US. Of the 54 included studies, 30% (16/54) evaluated the changes in ei...
BackgroundWhile the number of COVID-19 cases and deaths around the world is starting to peak, it ... more BackgroundWhile the number of COVID-19 cases and deaths around the world is starting to peak, it is essential to point out how different countries manage the outbreak and how different measures and experience resulted in different outcomes. This study aimed to compare the effect of the measures taken by Saudi Arabia and the United Kingdom (UK) governments on the outcome of the COVID-19 pandemic as predicted by a mathematical model.MethodData on the numbers of cases, deaths and government measures were collected from Saudi’s Ministry of Health and Public Health England. A prediction of the trend of cases, deaths and days to peak was then modelled using the mathematical technique, Exponential Logistic Growth and Susceptible Infectious Recovered (SIR) model. The measures taken by the governments and the predicted outcomes were compared to assess effectiveness.ResultWe found over three months that 22 fast and extreme measures had been taken in Saudi Arabia compared to eight slow and lat...
BackgroundReadmission rates following hospitalisation for COPD exacerbations are unacceptably hig... more BackgroundReadmission rates following hospitalisation for COPD exacerbations are unacceptably high, and the contributing factors are poorly understood. Our objective was to summarise and evaluate the factors associated with 30- and 90-day all-cause readmission following hospitalisation for an exacerbation of COPD.MethodsWe systematically searched electronic databases from inception to 5 November 2019. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using a modified version of the Newcastle–Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis where this was possible using a random-effects model.ResultsIn total, 3533 abstracts were screened and 208 full-text manuscripts were reviewed. A total of 32 papers met the inclusion criteria, and 14 studies were included in the meta-analysis. The readmission rate ranged ...
Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chroni... more Uptake of nutritional supplementation during pulmonary rehabilitation (PR) for people with chronic obstructive pulmonary disease (COPD) has been limited by an absence of rigorous evidence-based studies supporting use. Our objective were to report and summarise the current evidence supporting use of nutritional supplementation to improve outcomes during pulmonary rehabilitation in stable COPD patients. A systematic search was conducted up to May 7th, 2019 (registration number CRD42018089142). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Six databases were included: Medical Literature Analysis and Retrieval System Online or MEDLARS Online (Medline), Allied and Complementary Medicine Database (AMED), the Cochrane Database of Systematic Reviews, Excerpta Medica dataBASE (Embase), Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science. This systematic search generated 580 initial matches, of which 24 ...
Background:
Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatical... more Background: Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarised the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers. Methods: We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI). Results: In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 6.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%–3%) and 9% (95% CI, 4%–14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4– 2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03–2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%. Conclusion: Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.
The last 2 decades have seen a growing trend towards the use of noninvasive ventilation)NIV(thera... more The last 2 decades have seen a growing trend towards the use of noninvasive ventilation)NIV(therapy in the management of many conditions that cause acute respiratory failure. However, there is a serious side effect that results in using these devices; the development of facial skin pressure damage, specifically pressure ulcers. This skin damage has a considerable effect on patients' quality of life, treatment adherence and patients' comfort in addition to the therapy challenges of wound care. The aim of this clinical review is to discuss the different characteristics of NIV interfaces and to provide evidence based recommendations to facilitate the selection and application of such interfaces to reduce NIV interfaces related pressure ulcers.
BACKGROUND: The use of noninvasive ventilation masks is known to cause damage to facial skin tiss... more BACKGROUND: The use of noninvasive ventilation masks is known to cause damage to facial skin tissue, which affects both the efficacy of the intervention and the patient's quality of life. The use of humidification with noninvasive ventilation is a common practice, but its relative role in the development of facial pressure ulcers has not been fully studied. METHODS: A crossover cohort design was used in this study, with 15 healthy volunteers. Each volunteer randomly received both 10 cm H 2 O of CPAP with and without humidification through an oronasal mask. Skin integrity was evaluated by measuring transepidermal water loss, skin hydration, and skin pH at the bridge of the nose. Device-skin interface conditions (pressure and microclimate) were recorded at the bridge of the nose and both cheeks. The pro-inflammatory cytokine interleukin-1 was collected from the nose bridge before and after CPAP application by using a skin analysis tape. Nasal symptoms were collected by using a validated 6-point score. RESULTS: Humidified CPAP significantly increased transepidermal water loss (P < .001) and skin humidity (P .02) compared with non-humidified CPAP. There were no significant differences in skin hydration, skin pH, skin temperature, and cytokine expression between both conditions. However, there was a trend of increased median ratios of interleukin-1 concentrations in the humidified CPAP. There was a significant increase in the interface pressure at the bridge of the nose after CPAP application (P .02), with higher interface pressure values at the nose bridge compared with both left (P .002) and right (P .003) cheeks. The participants reported elevated nasal discomfort during non-humidified CPAP. CONCLUSIONS: These findings indicated that noninvasive ventilation with humidifi-cation had a potential disrupting effect on the barrier function of facial skin, associated with changes in skin microclimate and function. Further research is required to establish the cause of mask-related skin damage and to evaluate the effects of mask design, application techniques, and air flow and humidity settings.
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Papers by Jaber S. Alqahtani
Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically
spread all over the world in the early part of 2020. No studies have yet summarised the
potential severity and mortality risks caused by COVID-19 in patients with chronic
obstructive pulmonary disease (COPD), and we update information in smokers.
Methods:
We systematically searched electronic databases from inception to March 24, 2020. Data
were extracted by two independent authors in accordance with the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a
modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible
studies and conducted a meta-analysis using a random-effects model to calculate pooled
prevalence rates and 95% confidence intervals (95%CI).
Results:
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of
15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19
patients. All studies were included in the meta-analysis. The crude case fatality rate of
COVID-19 was 6.4%. The pooled prevalence rates of COPD patients and smokers in
COVID-19 cases were 2% (95% CI, 1%–3%) and 9% (95% CI, 4%–14%) respectively.
COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35)
compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4–
2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139)
of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated
RR showed that current smokers were 1.45 times more likely [95% CI: 1.03–2.04] to have
severe complications compared to former and never smokers. Current smokers also had a
higher mortality rate of 38.5%.
Conclusion:
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19
infection was associated with substantial severity and mortality rates in COPD. Compared to
former and never smokers, current smokers were at greater risk of severe complications and
higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in
COPD patients and current smokers.
Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically
spread all over the world in the early part of 2020. No studies have yet summarised the
potential severity and mortality risks caused by COVID-19 in patients with chronic
obstructive pulmonary disease (COPD), and we update information in smokers.
Methods:
We systematically searched electronic databases from inception to March 24, 2020. Data
were extracted by two independent authors in accordance with the Preferred Reporting Items
for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a
modified version of the Newcastle-Ottawa Scale. We synthesised a narrative from eligible
studies and conducted a meta-analysis using a random-effects model to calculate pooled
prevalence rates and 95% confidence intervals (95%CI).
Results:
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of
15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19
patients. All studies were included in the meta-analysis. The crude case fatality rate of
COVID-19 was 6.4%. The pooled prevalence rates of COPD patients and smokers in
COVID-19 cases were 2% (95% CI, 1%–3%) and 9% (95% CI, 4%–14%) respectively.
COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35)
compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4–
2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139)
of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated
RR showed that current smokers were 1.45 times more likely [95% CI: 1.03–2.04] to have
severe complications compared to former and never smokers. Current smokers also had a
higher mortality rate of 38.5%.
Conclusion:
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19
infection was associated with substantial severity and mortality rates in COPD. Compared to
former and never smokers, current smokers were at greater risk of severe complications and
higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in
COPD patients and current smokers.