7^th International Chronic Obstructive Pulmonary Disease Conference October 22-23, 2018 Rome, Italy

Zhanna Laushkina works as a leading Senior Researcher and a Physician at the Novosibirsk Tuberculosis Research Institute. At the age of 28 she successfully presented results of her PhD research work. In 2016 she defended her doctoral dissertation. The areas of her research work are the problems of differential diagnosis of pulmonary tuberculosis and other lung diseases and treatment of pulmonary tuberculosis. She is has published 35 papers in reputed journals.

Background: Lung cancer is one of the leading causes of death worldwide. The delay in diagnosis of lung cancer worsens prognosis of the disease. Reducing diagnostic delay could reduce mortality.

Aim: The purpose of the study was to define factors associated with a delay of lung cancer diagnostics.

Methods: Medical reports of 55 patients with lung cancer were analyzed. Clinical presentation, radiological, laboratory data of all patients was collected. Odds ratios (OR) and nominal 95% confidence intervals (CI) were presented.

Results: Mean age of patients 58.4±13.8 yrs. Men in the study were 37 (67%). The period from the disease manifestation up to making a true diagnosis was 90.4±77.3 days, patients delay was 32±38 days. 44% of the patients were previously treated of an assumed pneumonia before hospitalization in TB hospital. All patients have been hospitalized with wrong diagnosis of pulmonary TB, a principal cause-misinterpretation of chest radiogram. 48% of lung cancer patients mistakenly treated for TB for a long time. Factors associated with increase of diagnostic delay were: acute onset of the disease (OR: 0.4, 95% CI: 0.2–0.8), fever (OR: 0.4, 95% CI: 0.2–0.8), absence of symptoms (OR: 0.4, 95% CI: 0.1–0.9), absence of hematological changes (OR: 0.3, 95% CI: 0.1–0.7), nonspecific microbial growth in sputum (OR: 0.1, 95% CI: 0.01–0.7) and detection of acid-fast bacillus (AFB) in sputum (OR: 0.2, 95% CI: 0.06–0.7). Factors associated with decrease of diagnostic delay were also found.

Conclusions: Before the establishment of a true diagnosis, patients with lung cancer had over diagnosis of tuberculosis and community-acquired pneumonia. It can be said that diagnosis requires histological confirmation.

Junling Huang has her frontline experience in pharmaceutical and medical device industry. Mercury previously worked in hospital and the pharmacy as a licensed pharmacist in China. She also had led Global Brand strategy Director role and served in several pipeline and marketing roles at large pharmaceutical enterprise in China. Strength areas cover: research, program set up & strategy implement, key account build up & maintenance, business development, marketing and customer service.

Nebulizer therapy is an effective and efficient way to deliver medications directly into the lungs by inhalation. Since the medication goes straight to the lungs, onset of the medication’s action often takes place rapidly. Nebulizers are used to treat the symptoms of conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, emphysema and chronic bronchitis. Also, it minimizes the risk of side effects of the medication, preventing the medication from being metabolized into a less effective form by the body. Several classes of drugs can be used in a nebulizer, depending on the condition for which the nebulizer is being used. Particle size for inhaled medications must be smaller than 5 microns for the medication to reach the smaller tubes in the lungs. Using a nebulizer can be a simple, beneficial and safe way to deliver inhaled medications directly into the lungs. Nebulizers can be used at home, or in a hospital or another medical setting. For those with lung conditions, treatments may be used several times a day or only when the condition is acute. There are several types of nebulizers, and some may be incompatible with certain medications. Smart and portable Mush nebulizer are produced for home use and are the least expensive and most popular.

Randall Debattista is a Junior Physiotherapist in University of Malta with special interest in Respiratory Physiotherapy. He is currently working at the main Rehabilitation Hospital on the Maltese Islands. His interest in Pulmonary Rehabilitation inspired him to look into further details with regards to new modalities which are being investigated in order to help patients with respiratory complications, mainly COPD. He is aiming to further his studies in this field especially looking more in depth with regards to the use of NMES in COPD patients.

Neuromuscular electrical nerve stimulation (NMES) is a new modality being investigated for its effect related to quadriceps strength and walking distance in chronic obstructive pulmonary disease (COPD) patients. The purpose of this small pilot study was to observe and absorb as much information possible on the methodology and learning outcomes. Information from this small pilot study would present recommendations for the possibility of a larger national study regarding this new modality. For this aim, a mixed method approach was deemed appropriate. A total of seven moderate to severe COPD patients were included in this feasibility study, four in the experimental group and three in the control group. Following patient consent, the quadriceps strength as well as a 6-minute walk test (6MWT) was completed. The objective measures were taken at the baseline of this study, i.e. week four and week eight. Positive outcomes were reported in all subjects with the experimental group benefitting the most. However, the results are insignificant in view of the small population sampling. A self-designed questionnaire was distributed to the experimental group at the end of the study, with the aim to get a better view on how patients felt during the duration of NMES. Constant feedback was kept during the study duration between the researcher, intermediary physiotherapist and the subjects. Constant feedback and the results from the questionnaire were important for the researcher to present recommendations based on the strength, limitations and learning outcomes. This feasibility study provided guidance for larger more randomized national studies to maximize the benefits of NMES in COPD patients.

Maritess Jewson is a certified Music Therapist in the UK and was diagnosed with Pulmonary Hypertension in 2008 by the specialists at the Royal Brompton Hospital in London. Since Maritess’ diagnosis she is passionate about raising as much awareness as possible for this condition. Maritess leads awareness campaigns online to reach people in the social media network to help those with PH to understand their condition and to make people who have not heard of Pulmonary Hypertension aware of the seriousness of this condition and how it affects people’s lives. Maritess’ awareness campaigns reach thousands of people everyday and she works endlessly to make these campaigns heard across the world. Maritess is an Ambassador for the Pulmonary Hypertension Association UK (PHA UK) and works with them to help support people living with PH and raise awareness.

Statement: People around the world are waiting too long to be diagnosed with the rare, incurable heart and lung condition of pulmonary hypertension (PH) because its symptoms are often mistaken for other diseases. Its rarity and the ‘invisible’ nature of its symptoms also mean that the public do not understand how serious PH is, making life harder for those who live with it and so to help to understand PH, the author has started online awareness campaigns to help those with PH live an ‘ordinary life’.

Methodology & Theoretical Orientation: To help the public and medical professionals to understand what we have to deal with every day, the best way to reach these people is through social media channels, such as Facebook, Twitter, YouTube and Instagram.

Findings: My awareness campaigns have caught the attention of many people around the world who either have PH, don’t know what it is, or have not heard of it. People have been coming forward to speak out about having PH and it is helping them to understand their condition. Those who do not know about PH have contacted me to say they have learnt a lot from my awareness campaigns.

Conclusion & Significance: Sadly, PH will probably always exist as a condition but with the awareness that I, and others, are generating on social platforms, I believe that one day it will be understood and diagnosed sooner. I also hope that with people coming forward and taking part in medical research, thanks to the awareness campaigns, one day a cure will be found.