The reality of managing asthma in sub-Saharan Africa – Priorities and strategies for improving care

Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relative to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma

The reference site collaborative network of the european innovation partnership on active and healthy ageing

Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, and the development of sustainable economic growth and the creation of jobs

Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update

The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with “mild” asthma) as combination ICS–formoterol taken as needed for symptom relief. For patients with moderate–severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS–formoterol. Asthma treatment is not “one size fits all”; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications

Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.

The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with "mild" asthma) as combination ICS-formoterol taken as needed for symptom relief. For patients with moderate-severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS-formoterol. Asthma treatment is not "one size fits all"; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications

COVID-19 Pandemic and the Global Perspective of Turkish Thoracic Society

It has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.C1 [Kokturk, Nurdan] Gazi Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Itil, Bahriye Oya; Ergan, Begum; Kilinc, Oguz; Simsek, Gokcen Omeroglu; Ucan, Eyup Sabri] Dokuz Eylul Univ, Sch Med, Dept Pulm Med, Izmir, Turkey.[Altinisik, Goksel] Pamukkale Univ, Sch Med, Dept Pulm Med, Denizli, Turkey.[Adiguzel, Nalan; Karkurt, Zuhal] Univ Hlth Sci, Istanbul Sureyyapas Chest Dis Training & Res Hosp, Dept Intens Care Unit Pulm Med, Istanbul, Turkey.[Akgun, Metin] Ataturk Univ, Dept Pulm Med, Sch Med, Erzurum, Turkey.[Akyildiz, Levent] Mem Dicle Hosp, Clin Pulm Med, Diyarbakir, Turkey.[Altin, Sedat; Akyil, Fatma Tokgoz] Univ Hlth Sci, Yedikule Chest Dis & Chest Surg Training & Res Ho, Dept Pulm Med, Istanbul, Turkey.[Arikan, Huseyin] Yuzuncu Yil Univ, Dursun Odaba Med Ctr, Med Intens Care Unit, Van, Turkey.[Ates, Gungor] Sultan Hosp, Dept Pulm Med, Diyarbakir, Turkey.[Ay, Pinar] Marmara Univ, Sch Med, Dept Publ Hlth, Istanbul, Turkey.[Aykac, Nilufer] Gayrettepe Florence Nightingale Hosp, Clin Pulm Med, Istanbul, Turkey.[Babayigit, Cenk] Mustafa Kemal Univ, Sch Med, Dept Pulm Med, Antakya, Turkey.[Bostan, Pinar] Istanbul Bilgi Univ, Sch Hlth Sci, Istanbul, Turkey.[Cinel, Guzin] Ankara Yildirim Beyazit Univ, Sch Med Ankara, Dept Pediat Pulmonol, Ankara, Turkey.[Calisir, Haluk Celaleddin] Yapi Kredi Hlth & Retirement Fdn, Istanbul, Turkey.[Celik, Pinar; Gultekin, Okkes; Havlucu, Yavuz; Yorgancioglu, A. Arzu] Celal Bayar Univ, Sch Med, Dept Pulm Med, Manisa, Turkey.[Cetinkaya, Pelin Duru] Univ Hlth Sci, Adana City Training & Res Hosp, Dept Pulm Med, Adana, Turkey.[Dagli, Elif] Turkish Thorac Soc, Ankara, Turkey.[Demir, Ahmet Ugur] Hacettepe Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Demir, Canan; Sandal, Abdulsamet] Occupat & Environm Dis Hosp, Clin Occupat Dis, Ankara, Turkey.[Dikensoy, Oner] Acibadem Univ, Sch Med, Dept Pulm Med, Istanbul, Turkey.[Edis, Ebru Cakir] Trakya Univ, Sch Med, Dept Pulm Med, Edirne, Turkey.[Elbek, Osman] Kadikoy Florence Nightingale Hosp, Clin Pulm Med, Istanbul, Turkey.[Erdinc, Munevver; Goksel, Tuncay; Gurgun, Alev; Basoglu, Ozen K.; Sayiner, Abdullah] Ege Univ, Sch Med, Dept Pulm Med, Izmir, Turkey.[Eyuboglu, A. Fusun Oner] Baskent Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Gemicioglu, Bilun] Istanbul Univ Cerrahpasa, Cerrahpasa Sch Med, Dept Pulm Dis, Istanbul, Turkey.[Gulhan, Erkmen] Ataturk Chest Dis & Thorac Surg Training & Res Ho, Dept Thorac Surg, Ankara, Turkey.[Gurkan, Canan Gunduz; Yildiz, Tekin] Univ Hlth Sci, Sureyyapasa Chest Dis & Thorac Surg Training & Re, Dept Pulm Med, Istanbul, Turkey.[Karakurt, Sait] Marmara Univ, Sch Med, Dept Intens Care Unit Pulm Med, Istanbul, Turkey.[Kocabas, Ali] Cukurova Univ, Sch Med, Dept Pulm Med, Adana, Turkey.[Kul, Seval] Gaziantep Univ, Sch Med, Dept Biostat, Gaziantep, Turkey.[Nayci, Sibel] Mersin Univ, Sch Med, Dept Pulm Med, Mersin, Turkey.[Ozkan, Metin] Ankara Mem Hosp, Clin Pulm Med, Ankara, Turkey.[Pinarer, Ozgun] Galatasaray Univ, Sch Engn, Istanbul, Turkey.[Salturk, Cuneyt] Istanbul Yeni Yuzyil Univ, Sch Med, Dept Pulm Med, Istanbul, Turkey.[Sen, Elif] Ankara Univ, Sch Med, Dept Pulm Med, Ankara, Turkey.[Karadag, Bulent Taner] Marmara Univ, Sch Med, Dept Pediat Pulmonol, Istanbul, Turkey.[Toreyin, Zehra Nur] Hlth Sci Univ, Adana City Training & Res Hosp, Dept Occupat Dis, Ankara, Turkey.[Varol, Ayhan] Kepez State Hosp, Clin Pulm Med, Antalya, Turkey.[Yasin, Yesim] Acibadem Univ, Sch Med, Dept Publ Hlth, Istanbul, Turkey.[Bayram, Hasan] Koc Univ, Sch Med, Dept Pulm Med, Istanbul, Turkey

Physical activity and dietary habits in patients with asthma: How is it related to asthma control?

© 2022 Elsevier LtdAims: In this study, we aimed to determine the PA and dietary habits of patients with asthma and whether asthma control had a role in these habits. Methods: Adult patients with asthma were included. Three questionnaires were administered to the patients. and daily step counts were recorded for one week. Asthma control level and severe asthma attacks in the previous year were assessed. Results: A total of 277 patients were included. One hundred eighty-two (65.3%) of the patients were overweight/obese. According to FFQ, none of the food groups were comsumed in recommended levels. According to the IPAQ scores, 82.7% of the patients had mild physical activity. The daily step counts and the PA domain of the HLBS-II in obese patients were lower than the nonobese patients (p = 0.001 and p = 0.034,respectively). The rate of obese patients (n = 9; 50%) was higher in the uncontrolled patients. Conclusion: In our study, the majority of patients were physically inactive. Few patients consumed the recommended amount of foods. Being overweight seems to be a significant barrier to the healthy life behaviors. Although these behaviours do not seem to have an effect on asthma controlling this study, further prospective placebo-controlled studies are needed