Suchergebnisse

Wei Zhang,1,* Lili Xu,1,* Shen Gao,2 Nan Ding,2 Ping Shu,1 Zhuo Wang,2 Yuping Li1 1Department of Pharmacy, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, People's Republic of China; 2Department of Pharmacy, Changhai Hospital Affiliated to The Second Military Medical University, Shanghai 200433, People's Republic of China*These authors contributed equally to this workCorrespondence: Zhuo Wang; Yuping Li Email wztgyx223@163.com; grace_li_2020@126.comBackground: Proper inhaler technique is highly relevant to the effective management of chronic obstructive pulmonary disease (COPD). The tiotropium bromide spray (TBS) (Spiriva® Respimat®) is a soft mist inhaler (SMI) preferred by patients to pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) because of its convenience in use. However, the technique of using TBS inhaler in the real world is unclear.Objective: To evaluate techniques in using TBS inhaler and investigate the association between the patient characteristics and the correct use of TBS inhaler.Methods: This cross-sectional study enrolled 74 COPD patients who used TBS inhaler device for more than 3 months. The sociodemographic and clinical characteristics of the patients were recorded. The technique of using TBS inhaler was evaluated step by step. Incorrect use was defined as the patient's inability to complete the key steps in the inhalation manoeuvre. The percentage of incorrect use was compared between the groups. Risk factors related to incorrect use were analyzed by logistic regression analysis.Results: Of the 74 participants, only 2 (2.7%) patients completed all the steps correctly, and 48 (64.9%) patients misused the key steps in the inhalation manoeuvre. Incorrect preparation of the TBS inhaler for the first use was the most frequently misused step, accounting for 77.0%. Factors associated with misuse of TBS inhaler included the educational background (p=0.010), living state (p=0.031) and COPD assessment test (CAT) score (p=0.005) of the patients. Additionally, logistic regression analysis showed that the COPD duration was significantly associated with the incorrect use (p=0.019). Compared with patients with a higher educational background, patients with an elementary school background [OR 11652.99, CI: 22.72– 5975697.72], junior high school background [OR 7187.78, CI: 16.41– 3146787] and high school background [OR 1563, CI: 4.27– 572329.67] were more likely to misuse TBS inhaler. Patients living with their spouses alone were also more likely to commit errors in using TBS inhaler as compared with those living with their children [OR 12.29, CI of 1.14– 1.96]. Clinical factors like the COPD symptoms were relative to the technical use of the device. Better technique was accompanied by a lower CAT score [OR 1.49, CI of 1.14– 1.96].Conclusion: The incorrect use of TBS inhaler was common in COPD patients. Healthcare providers should not only teach the patients about the drug preparation but help them use the inhaler correctly. Special attention should be paid to patients with a short COPD duration and a low educational background and those who live without the company of their children. Proper use of TBS inhaler can significantly improve the symptom control of COPD patients.Keywords: chronic obstructive pulmonary disease, inhaler technique, soft mist inhaler, incorrect use

Smoking has a substantial impact on deaths from non-communicable chronic diseases (NCDs). Quantitatively measuring the impact of tobacco control on population health is of great theoretical and practical importance, for governments to make health policy decisions. Focusing on premature deaths, we predicted the deaths by 2030 from major NCDs caused by smoking among people aged 30–69 years in Sichuan Province, Southwest China. We extracted data for 1990–2015 from the Global Burden of Disease Study 2015 and calculated the population attributable fraction, to estimate the proportion of deaths caused by smoking. Four different tobacco control standards were used to estimate 2030 projections for the prevalence of smoking and premature mortality. If smoking prevalence were reduced by 30% from 2015 levels, premature mortality could be expected to decline by 24.4% in 2030, achieving 81.3% of the World Health Organization target for reducing premature mortality by 30%. Compared with the continuation of historical trends, the strongest tobacco control policy scenario would reduce premature mortality by 6.6%, prevent 23,600 deaths, reduce mortality by 7.8%, and increase life expectancy at birth by 0.3 years. Smoking bans represent an important action toward achieving national health goals.

BACKGROUND: Hypertension is highly prevalent and is the primary risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD). While declining in some developed countries, it is increasing rapidly in some developing countries. Sichuan province is the largest and underdeveloped region in southwest China, with 486 thousand square kilometers, more than 80 million residents, unbalanced economic development, and high prevalence, low awareness, low treatment and low control rate of hypertension. We forecasted the death burden due to high systolic blood pressure (SBP) in Sichuan from 1990 to 2030, to raise the awareness of public and government of the importance and benefits of hypertension control. METHODS: We conducted secondary analysis based on data of Global Burden of Disease (GBD) 1990–2015, and predicted the population SBP level, population attributable fraction, and death burden for people aged 30–69 under different scenarios in 2030. RESULTS: Comparing with natural trend, if the prevalence of high SBP can be reduced relatively by 25% by 2030, the deaths of non-communicable chronic diseases (NCDs), CVD and CKD would be reduced by 27.1 thousand, 26.2 thousand and 0.8 thousand for people aged 30–69; the mortality would be reduced by 10.8, 32.8 and 16.0%; and the premature mortality would be reduced by 9.9, 32.0 and 16.0%, respectively. CONCLUSIONS: Controlling or decreasing the prevalence of high SBP can significantly reduce the deaths, death rate and premature mortality of NCDs, CVD and CKD for the 30–69 years old population in Sichuan. There would be huge benefits for the governments to take cost-effective measures to control or reduce the prevalence of hypertension.

Nanometer‐scale tuning of the optical properties of prefabricated photonic crystals is achieved via layer‐by‐layer assembly of polyelectrolytes in the interstitial spaces of the photonic lattice. The key to the approach is using polyelectrolytes with controlled short chain lengths. This ensures they do not block the air voids, thereby maintaining uniform coating and thus precise and reproducible optical tuning. ; Ministerio de Economía y Competitividad MAT2011-23593, CSD2007-00007 ; Junta de Andalucía FQM3579, FQM5247 ; European Union 307081