It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2022 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 – Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.

BackgroundInterstitial lung disease (ILD) is the leading cause of mortality in systemic sclerosis (SSc) patients. Treatment options are rather limited in SSc associated ILD (SSc-ILD).ObjectivesObjective of this study was to report the experience of RTX treatment in a series of patients with longstanding SSc-ILD in whom unsatisfactory response in lung functions was noted under conventional treatments.MethodsWe retrospectively reviewed charts of 197 SSc patients evaluated between April 2015 and November 2016. 14 patients who received rituximab (RTX) for SSc-ILD participated in this analysis. The severity of ILD based on PFTs was defined as follows; mild (FVC between 71% and 80% of predicted), moderate (FVC between 51% and 70% of predicted) and severe (FVC ≤50%). The extent of skin disease was clinically measured by using Modified Rodnan Skin Score (mRSS) tool. End of follow-up was considered as six months after the last RTX dose.ResultsMedian (IQR, interquartile range) age was 53.2 (46.8–55.5) and median disease duration was 9.1 (5.1–13.6) years. Median FVC was 52.5 (41.5–64.0) prior to RTX. At the end of follow-up, no significant change was revealed in FVC when compared with pre-RTX values [58.0 (44.7–58.7), p=0.065]. FVC was improved in four patients and stabilized remaining ten patients. All of the patients with improvement of PFTs had moderate or severe restrictive lung disease. High resolution thorax computed tomography (HRCT) findings remained stable in 7 and showed progression of ILD in 3 patients. In total, mRSS remained stable at the end of follow-up when compared with baseline [8.0 (5.2–12.2) vs. 6.0 (4.0–12.2),p=0,026].Table 1.Demographic, clinical and laboratory data of patientsAge/SexDisease duration, yearsCutaneous subsetAutoantibodiesPrevious immunosupresive treatmentRTX cyclesFollow-up after RTX, monthsFVC (predicted%) Before RTXAfter RTX 52/F7.0DiffuseANA, Scl-70CYC, MMF212444439/M10.1DiffuseANA, Scl-70MMF424757955/F5.0DiffuseANA, Scl-70MMF424757043/F16.6LimitedANA, Scl-70CYC, MMF16384750/F4.6LimitedANA, Scl-70CYC, MMF424525765/F13,0DiffuseANA, Scl-70CYC, MMF16424148/F5.7LimitedANA, Scl-70CYC424676454/F18.9DiffuseANA, Scl-70CYC, MMF212395753/F15.0LimitedANA, Scl-70CYC, MMF530534456/F5,1LimitedANA, Scl-70CYC16404552/F8.2LimitedANA–312595918/F11.2DiffuseANA, Scl-70MMF16637362/F4.6LimitedANA, Scl-70CYC, MMF318516154/F13.1LimitedANA, Scl-70CYC, MMF5305467FVC, forced vital capacity; ANA, antinuclear antibody; Scl-70, antitopoisomerase-1 antibody; CYC, cyclophosphamide; MMF,mycophenolate mofetil; RTX, rituximab.ConclusionsIn this case series of SSc patients treated with RTX, improvement or stabilization of pulmonary functions was observed in most of SSc patients. RTX may be useful in SSc-ILD patients with longer disease duration and resistant to conventional immunsupresive therapies.Disclosure of InterestNone declared

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Background: The coronavirus disease-2019 pandemic has contributed to work-related psychosocial risks in healthcare workers. Aims: To evaluate the perceived need for mental health services and related factors in Turkish healthcare workers practicing in pandemic hospitals. Study Design: Cross-sectional study. Methods: Data were collected from face-to-face interviews with healthcare workers at 19 pandemic hospitals in 13 provinces between September and November 2021. The study survey included the evaluation of the perceived need for and utilization of mental health services in the previous year, as well as sociodemographic, health-related, and work-related characteristics, the General Health Questionnaire-12, the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaire, and the Fear of coronavirus disease-2019 scale (FCV-19S). Results: Of 1,556 participants, 522 (33.5%) reported a perceived need for mental health services, but only 133 (8.5%) reported receiving these services. Multiple logistic regression analysis of the perceived need for mental health services revealed significant relationships with lower age, female sex, being a current smoker, having a chronic disease, having a mental disorder, coronavirus disease-2019 contact within the last three months in settings other than the home or workplace, a positive coronavirus disease-2019 vaccination history, being a physician, being a non-physician healthcare professional, and coronavirus disease-2019 contact within the last three months at work. After adjustment for these characteristics, higher General Health Questionnaire-12 and FCV-19S scores and lower WHOQoL-BREF domain scores were related to the perceived need for mental health services in logistic regression analyses. Conclusion: The findings indicate a substantial need for mental health services amongst Turkish healthcare workers during the pandemic and outline participants’ characteristics regarding high-priority groups for the intervention. Future research may focus on developing actions and evaluating their efficiency.

Background COVID-19 creates a hypercoagulable state with a wide spectrum of clinical manifestations. Of those, venous thromboembolism (VTE) is prevalent, and numerous studies have highlighted the importance of VTE prophylaxis. Pre-pandemic VTE prophylaxis practices have already been poor, despite guidelines. We hypothesized that the gap between guidelines and practices might have been closed due to increased awareness. Materials and Methods Non-COVID-19 patients hospitalized in the internal medicine ward of a university hospital between January 1st, 2021, and June 30th, 2021, were assessed. VTE risk and thromboprophylaxis requirements were assessed using the Padua Prediction Score (PPS). The results were compared with the findings of the study conducted in the same setting before the pandemic. Results A total of 267 patients were included, and 81 patients (30.3%) received prophylaxis. A total of 128 patients’ (47.9%) PPS was ≥ 4, and 69 patients (53.9%) received prophylaxis; 12 low-risk patients (8.6%) received prophylaxis although it was not indicated. Compared to the pre-pandemic figures, both appropriate prophylaxis use and overuse rates have risen. While the increment rate of appropriate prophylaxis was statistically significant, the increment rate of overuse did not reach statistical significance. Patients hospitalized for infectious diseases and respiratory failure were more likely to receive appropriate prophylaxis. Conclusion We have demonstrated a significant increase in appropriate pharmacologic prophylaxis rates among high-risk patients. Besides all the collateral damage the pandemic has created, it might also have brought collateral benefits with regards to VTE prophylaxis.