Farzad 'Raffi' Refahi

Respiratory Blog, associated with Respiratory Therapy by Farzad,  began with a goal of improving the lives of healthcare providers as individuals and as clinicians.   There is a focus on cardio-respiratory concepts from the perspective of a Respiratory Therapist.

Let’s read an article a month – March 06, 2020

by
Snapshot of the first page of the article.

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

I found an article on Feb 27th, 2020. I spent a few days with it, and now I share it with you.

A spatially restricted fibrotic niche in pulmonary fibrosis is sustained
by M-CSF/M-CSFR signalling in monocyte-derived alveolar macrophages by Nikita Joshi et al.
 
 Eur Respir J 2020 55:1900646; published ahead of print 2019, doi: 10.1183/13993003.00646-2019 https://erj.ersjournals.com/content/erj/55/1/1900646.full.pdf

This article is well written and easy to follow. I must admit that it is too specialized and technical for my comfort level, but I still enjoyed it.

What this study demonstrates? Many elements were discussed but here is a very simple summary to get you interested:

“Our findings suggest that inhibition of M-CSFR (macrophage colony-stimulating factor receptor) signalling during fibrosis disrupts an essential fibrotic niche that includes monocyte-derived alveolar macrophages and fibroblasts during asbestos-induced fibrosis.” p1

Happy reading!

Farzad Refahi

Free Online Course by the World Health Organization

by

Recently I came across a post by the World Health Organization (WHO) about a free online training course for clinicians. Curious about the information provided, I created an account with WHO. Enrolling for the course was instantaneous and easy.

This course is made of three “modules” :
1. An overview of Infection Prevention and Control measures
2. An introduction to COVID-19
3. Review of precautions with COVID-19

There is no actual interactive module. Each section is linked to a PDF file (22, 9 and 63 pages). If you work for any large health organization or have had access to COVID-19 resources, you have already seen most of the information. This is not to take any points away. This is still a valuable resource as we continue to try to control the spread of this virus.

To access this course visit: https://openwho.org/courses/COVID-19-IPC-EN

Screenshot of the course description

Get Involved

by

There are various ways that you can get involved with your respiratory therapy organizations in Canada. Some take a minute to do, some five minutes, and some requiring a few hours a week on an ongoing basis. You can make a difference, and you should not take that lightly or for granted.

Fast and Easy Involvement

Takes a minute to find your respiratory therapy organizations on social media platforms. Follow them. It helps you stay up to date, and by sharing the relevant and important posts, you help with spreading the word, advocating and promoting the profession.

Takes a Few Minutes but You Will Help Shape Things On a Larger Scale

Our national organization, Canadian Society of Respiratory Therapists, is filling a few spots on the board of directors. Put aside 5 minutes to read the biographies and letters of intent. The voting process takes just a minute. Have your say, and help shape the future of our profession on the national level. Go to www.CSRT.com and vote! The deadline is tomorrow!

Have Some Time To Volunteer On An Ongoing Basis?

Have a desire to help and support your provincial organization? RTSO is recruiting for various position and roles. Visit www.RTSO.ca for more details. I have been volunteering with RTSO for more than 2 years, and have assisted with various projects. I have learned from many amazing volunteers over this time.

Together, We Are Stronger!

We can make a difference. Renew your national and provincial RT memberships!

Farzad Refahi

Let’s read an article a month –Feb. 21, 2020

by
Photo of the article’s first page.

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

The article I read on Friday was:

Bilateral hypoglossal nerve stimulation for treatment of adult obstructive sleep apnoea by Peter R. Eastwood et al.

Eur Respir J 2020 55:1901320; published ahead of print 2019, doi:10.1183/13993003.01320-2019 OPEN ACCESS ARTICLE http://erj.ersjournals.com/content/55/1/1901320?etoc

I am not here to endorse this technology or this approach to manage Obstructive Sleep Apnea (OSA). I am learning about it and sharing it with you. It did open my eyes to another approach which apparently has been around for some time. I appreciated the innovations. Compliance with CPAP units, the current gold stands, is low. The authors do mention that, and I have personally witnessed it when I worked for a CPAP company (casually for around 2 years).

I don’t need to express my personal thoughts on this as the authors have done a great job of describing the technology (GEnio system), what’s make it unique, the limitation of the study, and also the opportunities it brings.

It is a small study, n=22, with few participants. There is no control group.

This approach did open up the discussion to devices that deliver bilateral stimulation of hypoglossal nerve, includes minimal incision, and lacks an implanted battery (p10).

What are your thoughts and take on this?

Cleaning Products

by

Exposure To Cleaning Products in Childhood

A few days ago I was listening to CBC radio, as I was driving to work, when I heard about a recent study that has shown an association between household cleanings products and increased risk of developing childhood asthma. I totally forgot about it until today when I noticed Mr. Noel Pendergast RRT sharing a link to the content on his Facebook page. My reaction when I first heard about this was: “Of course!”. We never actually think about it, but it sure makes sense.

A Known Concept?

It’s interesting that I can recall a childhood memory when during a family gathering, Dr. Nehzhat shared his concerns about bleach as a routine household cleaning solution. Side note, he is a chemist and one of the most wonderful people I have ever met. Back to the main point… “Please stop using bleach. Don’t breathe that in. Cannot imagine what that will do to your lungs”. Ongoing exposure to the fume, specially in a non vented area, could lead to respiratory changes for any individuals (regardless of the age).

Various Cleaning Chemicals

I worked as a lifeguard for few summers and even then I wondered how dealing with concentrated liquid chlorine may impact people’s breathing.

If I had to share my thoughts with my patients, I would recommend limiting exposure to harmful fumes and chemicals. Also, make sure that the area is well vented. I am not sure if I would be as comfort recommending masks as THE solution, as this false hope may lead to unnecessarily and higher and longer exposure periods. Side note- realistically, how many people are properly mask fitted and educated about the right mask for the right task?

Be Aware and …Clean

This is not to take away anything from proper hygiene, clean environment and limitation of irritants including known triggers.

Thoughts?

What are your thoughts on this?

Resoures

https://www.cmaj.ca/content/192/7/E164

A screenshot of the highlights from the article's abstract
For the full article please visit the following link:https://www.cmaj.ca/content/192/7/E164