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.

Dedication

by

This post is dedicated to my father. He was a kind hearted man who worked hard to have a humble and good life for the family. My father and mother have been a great role models for my brother and I. While he was taken away way too sudden and soon, I am blessed to have had him in my life.

Thanks for all you have done for me, dad.

With love,

Farzad

Let’s read an article a month – April 2021

by
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 great piece to share with you.  This one is about chronic bronchitis. The objective of this paper is to “assess the prevalence of chronic bronchitis in young adults in a Swedish population-based birth cohort and to identify early-life risk factors, including environmental exposures, for disease development” (p2). 

Assessment of chronic bronchitis and risk factors in young adults: results from BAMSE

By: Gang Wang, Jenny Hallberg, Petra Um Bergström, Christer Janson, Göran Pershagen, Olena Gruzieva, Marianne van Hage, Antonios Georgelis, Anna Bergström, Inger Kull, Anders Lindén, and Erik Melén. 

European Respiratory Journal (ERJ) 2021 57: 2002120 ; DOI: 10.1183/13993003.02120-2020

Link to the ERJ page: https://erj.ersjournals.com/content/57/3/2002120?etoc

Link to the pdf page: https://erj.ersjournals.com/content/erj/57/3/2002120.full.pdf

3 Reasons why I found this article interesting

  • Authors comment on the impact of cigarette and e-cigarettes and chronic bronchitis in young adults (direct and indirect). Also, authors included factors such as breastfeeding as a protective factor which is something I would not have immediately thought of.
  • It includes a 24-year follow up assessment. They have excluded asthmatic patients to make their observation more accurate.  Various assessment tools were included, including self-assessments, pre and post spirometry, and FeNO2. 
  • This study reminded me that this condition “may exist with our without airway obstruction” p7.

What’s your experience with chronic bronchitis in young adults? Have you noticed a pattern?

Happy learning and reading!

Farzad Refahi
April 16, 2021

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

Taking back the power

by

I sure have got lost in the feeds of different social media platforms… Have got anxious about having the phone notification light blinking and not being able to look at my phone… Have made impulsive Amazon purchases… Have procrastinated by watching back to back Standup Comedy shows on Netflix… and have unfortunately made empty and impulsive, reactionary or inappropriate comments out of feeling of void? or lack of attention? I believe that while social media platforms and apps serve a purpose, they can still be programmed to be addictive! I can say that my addiction to social media and phone is stronger than the one to coffee/caffeine.

I have recently unsubscribed from a lot of junk emails or modified my notification preferences. I have uninstalled unnecessary apps, turned off notifications for messaging apps, I listen to services that have few to no advertisement..etc
I don’t rely on seeing feeds and posts from friends to be reminded to check in with them, I try to proactively contact friends.

https://youtu.be/4NgtEfg3vJk



Some useful tip in this video. Not sure how much of it I can pull off but worth the consideration.

What are some ways that you have successfully modified your routine, dependence or reliance on your phone /social media?

Let’s read an article a month – March 2021

by
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 article is about COPD and COPD exacerbation. The authors describe the objectives of this paper as following: 

 The first objective of this study was to evaluate whether the data from the ECLIPSE and SPIROMICS studies support the presence of an individual-specific, underlying AECOPD rate which is stable over time. The second objective was to explore, based on the findings from the first objective, the randomness of observed AECOPD counts in a 12-month period, in order to determine the suitability of this factor for phenotypic classification.

p2

Should the number of acute exacerbations in the previous year be used to guide treatments in COPD?

By: Mohsen Sadatsafavi, James McCormack, John Petkau, Larry D. Lynd, Tae Yoon Lee, Don D. Sin

European Respiratory Journal (ERJ) 2021 57: 2002122; DOI: 10.1183/13993003.02122-2020

Link to the journal ERJ: https://erj.ersjournals.com/content/57/2/2002122?etoc

Direct link to the article (pdf):  https://erj.ersjournals.com/content/erj/57/2/2002122.full.pdf

Reasons I enjoyed reading this article

  • It makes you appreciate the complexity involved in predicting future COPD exacerbation.  It is not as simple as looking at a patient’s number of exacerbations in the previous year.
  • The ECLIPSE and SPIROMICS studies are looked at and comments are made about the “difference” in findings.  
  • It is always nice to see the work of Canadian clinicians and researchers! 

Read the article and let me know what you think!  What are the factors used by your organization to predict and prevent future COPD exacerbations? 

Happy learning and reading!

Farzad Refahi

March 28, 20201 

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

Let’s read an article a month – February 2021

by
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 tittle and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

Link to the article: https://erj.ersjournals.com/content/56/6/2000556?etoc

Link to the blog post: https://respiratory.blog/lets-read-an-article-a-month-february-2021/

This month I found a great piece to share with you.  This one is a prospective, open-label, single-arm study. The objective of this paper is to “evaluate the feasibility, efficacy and safety of metered cryospray therapy to treat patients with chronic bronchitis in COPD”  p3.

A prospective safety and feasibility study of metered cryospray for patients with chronic bronchitis in COPD

By Justin L. Garner, Tawimas Shaipanich, Jorine E. Hartman, Christopher M. Orton, Cielito Caneja, Karin Klooster, John Thornton, Don D. Sin, Dirk-Jan Slebos and Pallav L. Shah.

Eur Respir J 2020 56:2000556; published ahead of print 2020,

doi:10.1183/13993003.00556-2020
Link to the article: https://erj.ersjournals.com/content/56/6/2000556?etoc

Reasons I found this article interesting 

  • I didn’t know about metered cryospray therapy (MCS) and this article introduced me to its application in chronic bronchitis. Its intent is to “cryoablate abnormal epithelium and excessive mucous-producing goblet cells” p2.
  • The method of application is clearly explained in this article.  On page 3, the authors explain the three treatments and which lobes and airway pathways received the MCS therapy in each of those treatment sessions. 

While I am still unsure about the safety of this therapy until further research and improvements are done, I enjoyed learning about the unique approach.  I say this as the sample was only 34 subjects.  Also, “no definitive histological differences were observed between baseline and day 60 endobronchial biopsies” p10. 

If you were not aware of this therapy, this may be a good article for you to read. If you have applied this therapy in the past, I would love to hear about your thoughts and experiences.  Leave a comment and let me know!

Happy learning!

Farzad Refahi

Feb. 1st, 2021

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