Bronchodilator Efficacy of High-Flow Nasal Cannula in COPD: Vibrating Mesh Nebulizer Versus Jet Nebulizer.

Background: Jet nebulizers are commonly used for bronchodilator therapy in COPD. High-flow nasal cannula with vibrating mesh nebulizer (HFNC-VMN) is a recently developed system; however, few studies have compared the efficacy of bronchodilator administration via HFNC-VMN to jet nebulizer in stable COPD. This study aimed to compare the effect of salbutamol administered via HFNC-VMN versus jet nebulizer on airway and lung function in subjects with stable COPD.

Cognitive impairment according to Montreal Cognitive Assessment independently predicts the ability of chronic obstructive pulmonary disease patients to maintain proper inhaler technique.

Background: Maintaining correct inhaler technique is crucial in the management of chronic obstructive pulmonary disease (COPD). We aimed to investigate the inhaler technique in patients with COPD, to compare it immediately after and at 1 month after training, and to identify the predictors of incorrect inhaler use at 1 month after training.

Methods: This prospective study was conducted at the COPD clinic of Siriraj Hospital (Bangkok, Thailand).

Characteristics, complications, and mortality of respiratory syncytial virus compared with influenza infections in hospitalized adult patients in Thailand.

Introduction: RSV is increasingly recognized in adults. An improved understanding of clinical manifestations and complications may facilitate diagnosis and management.

Methods: This was a retrospective study of hospitalized patients aged ≥ 18 years with RSV or influenza infection at Siriraj hospital, Thailand between January 2014 and December 2017.

Ultrasound Evaluation of Diaphragm Force Reserve in Patients with Chronic Obstructive Pulmonary Disease.

Diaphragm function is a key determinant of dyspnea in chronic obstructive pulmonary disease (COPD); however, it is rarely assessed in clinical practice. Lung hyperinflation can also impair diaphragm function. Ultrasound can assess the activity, function, and force reserve of the diaphragm.

Comparison of immunogenicity between intradermal and intramuscular injections of repeated annual identical influenza virus strains post-pandemic (2011-2012) in COPD patients.

We compared the antibody responses and persistence of the reduced-dose, 9 µg hemagglutinin (HA)/strain intradermal (ID) injection via the Mantoux technique and the 15 μg HA/strain intramuscular (IM) injection of the repeated annual identical trivalent, inactivated, split-virion vaccine 2011-2012 in chronic obstructive pulmonary disease (COPD) patients. Eighty patients were randomized to ID (n = 41) and IM (n = 39) groups. Four weeks post-vaccination, the antibody responses of the two groups were similar; those for influenza A(H1N1)pdm09 and influenza A(H3N2)-but not influenza B-met the criteria of the Committee for Proprietary Medicinal Products (CPMP).

Effectiveness of Incentive Spirometry on Inspiratory Muscle Strength After Coronary Artery Bypass Graft Surgery.

Background: Although the use of incentive spirometry with a deep breathing exercise (DBE) is widely used in clinical practice in patients who have undergone coronary artery bypass graft (CABG) surgery, the effect of this combination therapy has not been conclusively elucidated. The aim of this study was to investigate the effect of postoperative combined incentive spirometry and DBE versus DBE alone on inspiratory muscle strength following CABG.

Method: This randomised clinical trial was conducted in patients scheduled to undergo CABG surgery at Siriraj Hospital, Bangkok Thailand.

Clinical manifestations and outcomes of respiratory syncytial virus infection in adult hospitalized patients.

Background: Respiratory syncytial virus (RSV) is an important virus found in adult hospitalized patients.

Objectives: To study the clinical outcomes of hospitalized patients aged ≥ 15 years and diagnosed with RSV infection.

Study Design: Both retrospective and prospective cohort studies were conducted at a university hospital between May 2014 and December 2015.

Correlation of vitamin D binding protein gene polymorphism and protein levels in chronic obstructive pulmonary disease compared with non-chronic obstructive pulmonary disease subjects.

Aim: The risk of vitamin D binding protein (DBP) variations in chronic obstructive pulmonary disease (COPD) compared with non-COPD Thai males were investigated.

Materials & Methods: The rs7041 and rs4588 polymorphisms of the DBP gene and protein level were measured in 136 COPD and 68 non-COPD Thai males.

Results: In the COPD group, GC1-1 gave increased forced expiratory volume at 1 s % predicted compared with GC1-2 but with no significant difference.

Burden of respiratory disease in Thailand: Results from the APBORD observational study.

Asia-Pacific Burden of Respiratory Diseases (APBORD) was a cross-sectional, observational study examining the burden of respiratory disease in adults across 6 Asia-Pacific countries.This article reports symptoms, healthcare resource utilization (HCRU), work impairment and cost burden associated with allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis in Thailand.Consecutive participants aged ≥18 years with a primary diagnosis of AR, asthma, COPD, or rhinosinusitis were enrolled at 4 hospitals in Thailand during October 2012 and October 2013.

Impact of GLI-2012 Spirometric References and Lower Limit of Normal on Prevalence of COPD in Older Urban Thai Persons.

Background: Previous analysis of survey data from a study in older urban Thai persons reported prevalence of chronic obstructive pulmonary disease (COPD) of 7.11% according to formerly recommended criteria that used fixed ratio (70%) of pre-bronchodilator FEV1/FVC as the cut-off value. In 2012, the Global Lung Initiative (GLI)-2012 equations for spirometric reference were established and the diagnostic criteria for COPD were changed.

The immunogenicity of the intradermal injection of seasonal trivalent influenza vaccine containing influenza A(H1N1)pdm09 in COPD patients soon after a pandemic.

The antibody responses of a reduced-dose intradermal seasonal influenza vaccination have never been studied in COPD patients soon after a pandemic. A total of 149 COPD patients (60 y of age or older) were randomized to receive trivalent influenza vaccine (Sanofi-Pasteur, France) either 9 µg of hemagglutinin (HA) per strain split into 2-site intradermal (ID) injections via the Mantoux technique or one intramuscular (IM) injection of 15 µg of HA per strain. The geometric mean titers, seroconversion factors, seroconversion rates and seroprotection rates for influenza A(H3N2) and B administered through the ID injection (n = 75) were similar to those obtained with the IM injection (n = 74) 4 weeks post-vaccination.

Pathological confirmed diagnosis of asbestosis: the first case report in Thailand.

Asbestosis is an occupational lung disease defined as pulmonary fibrosis caused by asbestos. Asbestosis was previously reported in Thailand based on radiologic findings, which demonstrated interstitial lung with calcified pleural plaques, and the patient worked in a fiber cement factory. However there was some doubt about the diagnosis because clinical and radiological findings are nonspecific; there was no data support of asbestos exposure in the patient and no histologic confirmed diagnosis.

Relationship between emphysema quantification and COPD severity.

Objective: To determine the association between emphysema extent from high-resolution computed tomography (HRCT) and the physiological derangement in patients with chronic obstructive pulmonary disease (COPD).

Material And Method: A cross-sectional study was undertaken to quantify the emphysema severity in 23 COPD patients by automated HRCT scoring techniques. Correlation with phenotypic characters in term of exercise capacity [Modified Medical Research Council (mMRC) dyspnea scale, and 6-minute walk distance (6MWD)], pulmonary function testing [spirometry (forced expiratory volume in 1 second, FEV1 and forced vital capacity, FVC), and diffusing capacity (DLCO)], were then assessed.

Substrate utilization during and after high intensity exercise in healthy lean and obese men.

Objective: To compare lipid and carbohydrate use during and after a high-intensity endurance exercise bout between lean and obese subjects.

Material And Method: Lean and obese healthy male subjects with energetic physical activity and stable body weight were recruited to participate in the present study. The respiratory exchange ratio (RER), lipid and carbohydrate oxidation, and lipid and carbohydrate energy expenditure during resting condition, high-intensity exercise and 180 min after exercise were determined by indirect calorimetry

Results: Ten lean and ten obese healthy male subjects, aged 26+/-4 years, completed a 300-kcal high-intensity exercise session.

Prevalence of osteoporosis and osteopenia in Thai COPD patients.

Objective: To study the prevalence of osteoporosis and osteopenia in Thai COPD patients and the factors associated with osteoporosis.

Material And Method: A cross sectional study was used to evaluate 102 male stable COPD patients. Bone mineral density at lumbar spine (L2-4) and femoral neck were measured by dual energy x-ray absorptiometer scan.

The immunogenicity of intradermal influenza vaccination in COPD patients.

We evaluated the immunogenicity of a reduced-dose intradermal trivalent, inactivated, split-virion seasonal influenza vaccine compared to that of a conventional intramuscular vaccination in chronic obstructive pulmonary disease (COPD) patients. One hundred and fifty-six COPD patients randomly received either 0.2 ml (6 microg hemagglutinin (HA) per strain) split into two-site intradermal (ID) injections or a single 0.

Evidence for both adenosine A1 and A2A receptors activating single vagal sensory C-fibres in guinea pig lungs.

We addressed the hypothesis that single vagal afferent C-fibres can be stimulated via either the adenosine A1 or A2A receptor subtypes. The effect of adenosine on the nerve terminals of vagal sensory nerve subtypes was evaluated in an ex vivo perfused guinea pig lung preparation using extracellular recording techniques. Adenosine (10 microm) consistently evoked action potential discharge in lung C-fibre terminals arising from the nodose ganglia, but failed to evoke action potential discharge in most jugular ganglion C-fibres.

Allergen-induced substance P synthesis in large-diameter sensory neurons innervating the lungs.

Background: Tachykinins such as substance P are localized in unmyelinated slow-conducting C fibers that can be activated by noxious stimuli and tissue inflammation. Substance P is seldom expressed in fast-conducting large-diameter (A-fiber) vagal sensory neurons. We have previously found that allergic inflammation causes a phenotypic change in tachykinergic innervation of the trachea such that the production of substance P is induced in large-diameter sensory neurons projecting mechanosensitive A fibers to the trachea.

Effect of 5-hydroxytryptamine on vagal C-fiber subtypes in guinea pig lungs.

5-Hydroxytryptamine (5-HT, serotonin) evokes pulmonary reflexes partially by activating vagal bronchopulmonary C-fibers. In the guinea pig, vagal bronchopulmonary C-fibers arise from cell bodies situated in the nodose and the jugular ganglia. The nodose and the jugular C-fibers differ both pharmacologically and neurochemically, and may subserve different functions.

Ionotropic and metabotropic receptor mediated airway sensory nerve activation.

There are several receptors capable of inducing activating generator potentials in cough-associated afferent terminals in the airways. The chemical receptors leading to generator potentials can be subclassified into ionotropic and metabotropic types. An ionotropic receptor has an agonist-binding domain, and also serves directly as an ion channel that is opened upon binding of the agonist.

The most cost-effective screening method for chronic obstructive pulmonary disease among the Bangkok elderly.

Our previous studies demonstrated the high prevalence and incidence of Chronic Obstructive Pulmonary Disease (COPD) among the Bangkok elderly, as well as the cost-effectiveness of a questionnaire, chest radiography, and mini peak expiratory flow rate (miniPEF) as screening tools. This final study aimed to identify the most cost-effective screening method among individual, serial and parallel combinations of the above tools, based on the guidelines for diagnosing COPD of the Thoracic Society of Thailand. There were 3,094 elderly aged 60 years and over in 124 urban communities around Siriraj Hospital who participated and completed all the tests.

The cost-effectiveness of mini peak expiratory flow as a screening test for chronic obstructive pulmonary disease among the Bangkok elderly.

This study aims to explore the cost-effectiveness of Mini Peak Expiratory Flow (miniPEF) as a screening test for Chronic Obstructive Pulmonary Disease (COPD) among the elderly in 124 urban communities around Siriraj Hospital, using the gold standard of diagnosis based on the guidelines of the Thoracic Society of Thailand. There were 3,094 subjects who participated and completed all the tests. The results showed that the cut-off miniPEF percentage of predicted value of highest average accuracy was 62 per cent.

The cost-effectiveness of chest radiography as a screening test for chronic obstructive pulmonary disease among the Bangkok elderly.

Regular screening with chest radiography (CXR) in an annual physical check up of the elderly is most frequently practiced. This study aimed to identify the CXR indices and the cost-effectiveness of CXR as a screening test for Chronic Obstructive Pulmonary Disease (COPD) among the elderly in 124 urban communities of Bangkok around Siriraj Hospital. The gold standard for diagnosing COPD followed the guidelines of the Thoracic Society of Thailand.