Let’s read an article a month – November 2021

The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

This paper investigated “causal associations to estimate the causal effects of fathers’ smoking initiation in prepuberty (generation G1) and grandmothers’ smoking in pregnancy (generation G0) on offspring’s lung function (generation G2) within the paternal line” (p2).


Prenatal and prepubertal exposures to tobacco smoke in men may cause lower lung function in future offspring: a three-generation study using a causal modelling approach

By: Simone Accordini, Lucia Calciano, Ane Johannessen, Bryndis Benediktsdóttir, Randi Jacobsen Bertelsen, Lennart Bråbäck, Shyamali C. Dharmage, Bertil Forsberg, Francisco Gómez Real, John W. Holloway, Mathias Holm, Christer Janson, Nils O. Jõgi, Rain Jõgi, Andrei Malinovschi, Alessandro Marcon, Jesús Martínez-Moratalla Rovira, José Luis Sánchez-Ramos, Vivi Schlünssen, Kjell Torén, Deborah Jarvis, and Cecilie Svanes.

European Respiratory Journal 2021 58: 2002791; DOI: 10.1183/13993003.02791-2020 

Link to the article: https://erj.ersjournals.com/content/58/4/2002791?etoc


Reasons you may find this article interesting:

  • Perhaps not surprising: “Fathers’ smoking initiation in prepuberty was associated with an increased risk for nonallergic asthma in offspring” (p9).
  • Interesting finding from the analyses of the collected data:  “fathers’ overweight onset before 15 years of age had a direct effect on nonallergic asthma in the next generation” (p9).
  • Lastly, check out one of their conclusions:

“Men who initiated smoking before 15 years of age may have offspring with lower lung function compared with men who had never smoked. Grandmothers’smoking in pregnancy may have a negative impact on their sons’ lung function, an effect that could be carried over to their grandchildren. These results support the concept that lifestyle-related exposures in male prepuberty and in pregnancy influence the health of future generations. ”

(p10)

As always, I encourage you to read the article to learn about all the details.

Happy reading and learning,

Farzad Refahi

November 5, 2021

https://respiratory.blog/lets-read-an-article-a-month-November-2021/

2021 RT Week

My respiratory therapy (RT) week tradition is to sit back, reflect, and thank those who have positively impacted my life and career over the past twelve months.

Please forgive me if I missed including your name in this blog post, as it has been a very unique and unusual year for me.
It has been a bitter-sweet year for sure. We unexpectantly lost my father to a massive heart attack. Also, the RT community lost Kevin Taylor, a great leader and advocate. I want to express eternal gratitude to Kevin Taylor and my father, Mohsen Refahi. My mother, Sherry, and wife, Jessica, have been strong and supportive, and they have my utmost love and respect.
My wife and I had our first child around five weeks ago. I am currently on parental leave and loving every second of it. My wife is a lovely person, and my admiration and respect have grown beyond possible levels. Thank you to the PFT RTs at Markham-Stouffville Hospital for accommodating my time off (with a special thanks to Carolyn Greer).

Respiratory therapists, in all settings and positions, continue to help during this pandemic. I recognize and applaud you for your dedication and hard work!

My online presence is because of followers like you who have taken the time to view and share my content. Thanks for including me in your journey of growth.

John Meloche sponsors my website. Despite his busy schedule and family responsibilities, he does not hesitate to lend a helping hand. So shout out to MeloTel Inc.!

The following individuals have been very kind to me; they include me in different and exciting projects: Carolyn McCoy, Micah Kooperberg, Elizabeth French, Carly Brockington and Andrea White-Markham.

I also recognize the work of RTs in the background who support our profession, including instructors, clinical educators, researchers and administrative staff. Some of the names that come to my mind are Carole Hamp, Kevin Taylor, Andrew West, Paula Smith, Nancy Garvey, and Cheryl Connors.

I have also enrolled in the Clinical Educator certificate program through The Michener Institute. While going through the course content, I recalled three exceptional preceptors I met during my clinical years (2013-2014). While I mentioned them in my final written assignment, they also deserve public recognition: Sandra Said, Ron Boudah, and Gary Ackerman.

Dan Pinard, thanks for taking the time to answer my technical/equipment questions.

Sheery Tse, you continue to remind me of the CE opportunities. I appreciate it!

Deidre Kelly, I appreciate that you made the decision to highlight an RT, and the respiratory therapy field, in York University’s magazine.

Happy RT / RC Week!

Farzad

Let’s read an article a month – October 2021

The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

The objective of this paper is to “evaluate respiratory function 4 months after diagnosis in patients who survive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the difference between patients with or without initial lung involvement” (p1).


Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

By: Fabio Anastasio, Sarah Barbuto, Elisa Scarnecchia, Paolo Cosma, Alessandro Fugagnoli, Giulio Rossi, Mirco Parravicini, and Pierpaolo Parravicini.

European Respiratory Journal 2021 58: 2004015; DOI: 10.1183/13993003.04015-2020

Link to the article: https://erj.ersjournals.com/content/58/3/2004015?etoc


Reasons I liked this article

  • The age range for this study was 18 to 80 years old (p2).  Also, a detailed assessment was attained from the subjects, of course post infection, which included SF-12 and IPAQ questionnaires, 6MWT,  and a comprehensive PFT (p2).
  • This study shows “a reduction of respiratory function and exercise capacity secondary to SARS-CoV-2 pneumonia, mostly in patients who developed ARDS during the acute phase” (p9). 
  • The authors suggest that the data may indicate that “respiratory evaluation does not appear to be necessary in patients without pneumonia and without symptoms. DLCO, 6MWT and plethysmography could be avoided in patients without pneumonia, performing only spirometry with bronchodilator responsiveness testing…In contrast, in patients who developed ARDS, DLCO, 6MWT and complete spirometry could uncover presence of residual pulmonary and functional impairment, with need for respiratory rehabilitation and gradual physical activity “ (p10). 

As always, take the time to read this study. There is a lot of information and data covered in the study which I cannot cover here.  As a disclaimer, continue to follow guidelines for ordering PFTs and providing patient care as recommended by your employer and regulatory body.

Happy reading and learning,

Farzad Refahi

October 6th, 2021

https://respiratory.blog/lets-read-an-article-a-month-october-2021/

Let’s read an article a month – September 2021

The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

This month I found a piece on cardiopulmonary exercise capacity and COVID19 recovery. The objective of this paper is to “determine cardiopulmonary function during exercise 3–4 months after hospital discharge for COVID-19 compared with a reference population and to describe the characteristics of participants with exercise limitations. ” p2.


Cardiopulmonary exercise capacity and limitations 3 months after COVID-19 hospitalisation

By: Ingunn Skjørten, Odd Andre Wathne Ankerstjerne, Divna Trebinjac, Eivind Brønstad, Øystein Rasch-Halvorsen, Gunnar Einvik, Tøri Vigeland Lerum, Knut Stavem, Anne Edvardsen, and Charlotte Björk Ingul

European Respiratory Journal 2021 58: 2100996; DOI: 10.1183/13993003.00996-2021

Link to the article: https://erj.ersjournals.com/content/58/2/2100996?etoc


The reasons I found this article interesting 

  • Regaining exercise capacity after COVID-19 is an important finding (p7).
  • Brings more weight to self-reported dyspnea as it was “associated with lower ventilatory efficiency and lower V′O2peak·kg−1 due to higher BMI” (p7).
  • In order of relevance: deconditioning, circulatory factors, and ventilatory limitation were the top three exercise limitations (p7).

This is a great article so I encourage you to take the time to read it.  

Happy learning and reading!

Farzad Refahi

September 30, 2021

https://respiratory.blog/lets-read-an-article-a-month-september-2021/

Let’s read an article a month – August 2021

The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I try to read an open-access article. After reading the article, I share the title and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

The objective of this paper is to use the “data from the INMARK trial to assess the feasibility and validity of home spirometry as a measure of lung function decline in subjects with IPF “ p2.


Home spirometry in patients with idiopathic pulmonary fibrosis: data from the INMARK trial

By: Imre Noth, Vincent Cottin, Nazia Chaudhuri, Tamera J. Corte, Kerri A. Johannson, Marlies Wijsenbeek, Stephane Jouneau, Andreas Michael, Manuel Quaresma, Klaus B. Rohr, Anne-Marie Russell, Susanne Stowasser and Toby M. Maher

Eur Respir J 2021 58:2001518; published ahead of print 2021,

doi:10.1183/13993003.01518-2020 OPEN ACCESS ARTICLE

Link to the article: http://erj.ersjournals.com/content/58/1/2001518?etoc


Reasons you may find this article interesting 

  • I like the idea of patients with chronic conditions being able to perform spirometry at home.  I value the time and technology advancement to make these tests available at home, and having the ability to remotely tracking patients’ progress. This empowers patients to be more aware of their health status and to be more conscious of their well being.
  • Authors conclude that there is a “strong correlation where observed between FVC measurements abstain at home and in clinic at individual time-points, but correlations between changes in FVC measurements over time estimated using home and clinic spirometry were weak, mainly due to variability in the measurements obtained using home spirometry” p8. (side note: researchers did provide re-training as required). I encourage you to read the full article to view all the details.

Happy reading and learning!

Farzad Refahi

August 25, 2021
https://respiratory.blog/lets-read-an-article-a-month-august-2021/