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Fujiki RB, Thibeault SL. Diagnostic utility of spirometry for children with induced laryngeal obstruction or chronic non-specific cough. Am J Otolaryngol 2024; 45:104316. [PMID: 38677150 DOI: 10.1016/j.amjoto.2024.104316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE To determine the diagnostic utility of spirometry in distinguishing children with Induced Laryngeal Obstruction (ILO) or chronic non-specific cough (a.k.a. tic cough) from those with mild or moderate to severe asthma. METHODS Retrospective cross sectional design. Children diagnosed with ILO (N = 70), chronic non-specific cough (N = 70), mild asthma (N = 60), or moderate to severe asthma (N = 60) were identified from the electronic medical record of a large children's hospital. Spirometry was completed before ILO, non-specific cough, or asthma diagnoses were made by pediatric laryngologists or pulmonologists. Spirometry was performed following American Thoracic Society guidelines and was interpreted by a pediatric pulmonologist. Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 Second (FEV1), FEV1/FVC Ratio (FEV1/FVC), Forced Mid-Expiratory Flow 25--75 % (FEF25-75%), pulmonologist interpretation of flow volume loops, and overall exam findings were extracted from the medical record. RESULTS Ninety seven percent of children with ILO or chronic non-specific cough presented with spirometry values within normative range. Patients with ILO, non-specific cough, and mild asthma presented with FVC, FEV1, FEV1/FVC, and FEF25-75% values in statistically similar range. Children with moderate to severe asthma presented with significantly reduced FVC (p < .001), FEV1 (p < .001), FEV1/FVC (p < .001), and FEF25-75% (p < .001) values when compared with patients in the other groups. Flow volume loops were predominantly normal for children with ILO and non-specific cough. CONCLUSIONS Findings indicate that ILO and chronic non-specific cough can neither be diagnosed nor differentiated from mild asthma using spirometry alone. Spirometry should therefore be used judiciously with this population, bearing in mind the limitations of the procedure. Future research should determine the most effective and efficient ways of delineating ILO and non-specific cough from other respiratory conditions in children.
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Affiliation(s)
- Robert Brinton Fujiki
- Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States of America
| | - Susan L Thibeault
- Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States of America.
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Bradley J, Xu Q, Touloumes N, Lusciks E, Ali T, Huang EC, Chen J, Ghafghazi S, Arnold FW, Kong M, Huang J, Cavallazzi R. Association of pulmonary function test abnormalities and quality-of-life measures after COVID-19 infection. Am J Med Sci 2024:S0002-9629(24)01170-4. [PMID: 38636655 DOI: 10.1016/j.amjms.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/29/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Long-COVID is a multisystem disease that can lead to significant impairments in health-related quality of life (HRQoL). Following COVID-19 infection, abnormalities on pulmonary function tests (PFT) are common. The primary aim of this study is to evaluate for any correlation between PFT abnormalities and impairment in HRQoL scores following COVID-19 infection. METHODS This is an analysis of a prospective cohort of patients in Louisville, KY who were infected with COVID-19. Data collected included demographics, past medical history, laboratory tests, PFTs, and several HRQoL questionnaires such as the EuroQol 5 Dimension HRQoL questionnaire (EQ-5D-5 L), Generalized Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire (PHQ-9), and Posttraumatic stress disorder checklist for DSM-5 (PCL-5). Descriptive statistics were performed, comparing PFTs (normal vs abnormal) and time since COVID-19 infection (3- vs 6- vs ≥ 12 months). RESULTS There were no significant differences in FEV1, FVC, or the percentage of patients with abnormal PFTs over time after COVID-19 infection. Following COVID-19, patients with normal PFTs had worse impairment in mobility HRQoL scores and change in GAD-7 scores over time. There were no differences over time in any of the HRQoL scores among patients with abnormal PFTs. CONCLUSIONS Among patients with an abnormal PFT, there was no temporal association with HRQoL scores as measured by EQ-5D-5 L, GAD-7, PHQ-9, and PCL-5. Among patients with a normal PFT, mobility impairment and anxiety may be associated with COVID-19 infection. Following COVID-19 infection, impairment in HRQoL scores is not completely explained by the presence of abnormalities on spirometry.
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Affiliation(s)
- James Bradley
- Division of Pulmonary, Critical Care Medicine and Sleep Disorders, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Qian Xu
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA; Biometrics and Data Science, Fosun Pharma, Beijing, 100026, PR China
| | - Nikolas Touloumes
- Division of General Internal Medicine, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Eugene Lusciks
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - T'shura Ali
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA; Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Emma C Huang
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
| | - James Chen
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Shahab Ghafghazi
- Division of Cardiovascular Medicine, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Forest W Arnold
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Maiying Kong
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Rodrigo Cavallazzi
- Division of Pulmonary, Critical Care Medicine and Sleep Disorders, Department of Medicine, University of Louisville, Louisville, KY, USA.
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Abstract
This article focuses on the monitoring of pulmonary sarcoidosis. The monitoring of sarcoidosis is, in part, focused on serial change in major organ involvement but also includes diagnostic re-evaluation and review of change in quality of life. Recent criteria for progression of fibrotic interstitial lung disease are adapted to pulmonary sarcoidosis. The frequency and nature of monitoring are discussed, integrating baseline risk stratification and strategic treatment goals. Individual variables used to identify changes in pulmonary disease severity are discussed with a focus on their flaws and the need for a multidimensional approach. Other key monitoring issues are covered briefly.
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Affiliation(s)
- Vasileios Kouranos
- Interstitial Lung Disease/Sarcoidosis Unit, Royal Brompton Hospital, Sydney street, London, SW3 6NP; National Heart and Lung Institute, Imperial College London, Guy Scadding Building, Cale Street, London, SW3 6LY.
| | - Athol Umfrey Wells
- Interstitial Lung Disease/Sarcoidosis Unit, Royal Brompton Hospital, Sydney street, London, SW3 6NP; National Heart and Lung Institute, Imperial College London, Guy Scadding Building, Cale Street, London, SW3 6LY
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Souza AV, da Cunha Carvalho R, da Cruz Dias D, Santana DGT, de Cássia Mascarenhas H, Cordeiro ALL, Guimarães ARF. Clinical and functional outcomes associated with pulmonary complications after coronary artery bypass grafting. J Cardiothorac Surg 2024; 19:92. [PMID: 38355549 PMCID: PMC10865619 DOI: 10.1186/s13019-024-02538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Coronary artery bypass grafting(CABG) is a surgical treatment for coronary artery disease aiming at improving symptoms and life expectancy. Despite this, there are pulmonary and functional complications that may arise during the postoperative period due to invasive mechanical ventilation(IMV), cardiopulmonary bypass and immobility, leading to longer hospital stays. OBJECTIVE To evaluate the clinical and functional outcomes related to pulmonary complications in the postoperative period of CABG. METHODS Prospective cohort. During the ICU stay the patients were divided into: Non Complicated Group(NCG) who did not present complications and Complicated Group(CG) who presented complication. Functional variables were applied as the six-minute walk test(6MWT), gait speed, sit up and stand up test, Timed Up and Go, peripheral muscle strength, ventilatory, pulmonary function and Functional Independence Measure. These tests were applied preoperatively, at ICU discharge, hospital discharge and six months after surgery. RESULTS The study evaluated 90 patients, 59 in the NCG and 31 CG. In the 6MWT there was a 2%(p = 0.43) decrease in the NCG, while the decrease was 13%(p < 0.01) in the CG. In the MRC the drop was 2%(p = < 0.01) in the CNG, while in the CG the drop was 14%(p = < 0.01). In MIP the NCG had a 6%(p = 0.67) decrease, while the CG had a 16%(p = < 0.01) decrease. CONCLUSION Patients with postoperative complications of CABG may have reduced functional performance, muscle strength, and pulmonary function at hospital discharge and after six months.
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Affiliation(s)
- Altina Vitória Souza
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Raquel da Cunha Carvalho
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Daniela da Cruz Dias
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Darley Gabrielle Teles Santana
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - Hayssa de Cássia Mascarenhas
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil
| | - André Luiz Lisboa Cordeiro
- Centro Universitário Nobre, Red Bird Street, without number, Condominio Salvador Dali, house 47, Feira de Santana, BA, Brazil.
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
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Kołtowski Ł, Basza M, Bojanowicz W, Dąbrowiecki P, Soliński M, Górska K, Korczyński P, Eggert LE. Remotely supervised spirometry versus laboratory-based spirometry during the COVID-19 pandemic: a retrospective analysis. Respir Res 2024; 25:39. [PMID: 38238745 PMCID: PMC10797720 DOI: 10.1186/s12931-023-02586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/28/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has constrained access to spirometry, and the inherent risk of infectious transmission during aerosol-generating procedures has necessitated the rapid development of Remotely Supervised Spirometry (RSS). This innovative approach enables patients to perform spirometry tests at home, using a mobile connected spirometer, all under the real-time supervision of a technician through an online audio or video call. METHODS In this retrospective study, we examined the quality of RSS in comparison to conventional Laboratory-based Spirometry (LS), using the same device and technician. Our sample included 242 patients, with 129 undergoing RSS and 113 participating in LS. The RSS group comprised 51 females (39.5%) with a median age of 37 years (range: 13-76 years). The LS group included 63 females (55.8%) with a median age of 36 years (range: 12-80 years). RESULTS When comparing the RSS group to the LS group, the percentage of accurate Forced Expiratory Volume in one second (FEV1) measurements was 78% (n = 101) vs. 86% (n = 97), p = 0.177; for Forced Vital Capacity (FVC) it was 77% (n = 99) vs. 82% (n = 93), p = 0.365; and for both FEV1 and FVC, it was 75% (n = 97) vs. 81% (n = 92), p = 0.312, respectively. CONCLUSIONS Our findings demonstrate no significant difference in the quality of spirometry testing between RSS and LS, a result that held true across all age groups, including patients aged over 65 years. The principal advantages of remote spirometry include improved access to pulmonary function tests, reduced infectious risk to curtail disease spread, and enhanced convenience for patients.
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Affiliation(s)
- Łukasz Kołtowski
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Piotr Dąbrowiecki
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04141, Warsaw, Poland
| | - Mateusz Soliński
- School of Biomedical Engineering & Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, Strand, London, WC2R 2LS, UK
| | - Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Korczyński
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Lauren E Eggert
- Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University, Stanford, CA, USA
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Yao L, Meng L, Liu X, Li X, Liu F, Shang Y, Feng Y. The initial angle of the maximum expiratory flow-volume curve: a novel start-of-test criteria of spirometry in children. Eur J Pediatr 2024; 183:435-444. [PMID: 37924349 DOI: 10.1007/s00431-023-05323-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 10/11/2023] [Accepted: 10/29/2023] [Indexed: 11/06/2023]
Abstract
The aim of the present study was to define an initial angle called β and to assess its diagnostic value for identifying poor-quality maneuvers in spirometry testing in children. Furthermore, its predictive equation or normal value was explored. Children aged 4-14 years with respiratory symptoms who underwent spirometry were enrolled. Based on the efforts labeled during maneuvering and the quality control criteria of the guidelines, children were categorized into good-quality and poor-quality groups. According to ventilatory impairment, children in the good-quality group were divided into three subgroups: normal, restricted, and obstructed. Angle β was the angle between the line from the expiratory apex to the origin of coordinates and the x-axis of the maximal expiratory flow-volume (MEFV) curve. Demographic characteristics, angle β, and other spirometric parameters were compared among groups. The diagnostic values of angle β, forced expiratory time (FET), and their combination were assessed using receiver operating characteristic curves. Data from 258 children in the good-quality group and 702 healthy children in our previous study were used to further explore the predictive equation or normal value of angle β. The poor-quality group exhibited a significantly smaller angle β (76.44° vs. 79.36°; P < 0.001), significantly lower peak expiratory flow (PEF), FET, and effective FET (ETe), and significantly higher expiratory volume at peak flow rate (FEV-PEF) and ratio of extrapolated volume and forced vital capacity (EV/FVC) than the good-quality group. There was no significant difference in angle β among the normal, restricted, and obstructed groups. Logistic regression analysis revealed that smaller angle β and FET values indicated poor-quality MEFV curves. The combination of angle β < 74.58° and FET < 4.91 s had a significantly larger area under the curve than either one alone. The normal value of angle β of children aged 4-14 years was 78.40 ± 0.12°. Conclusions: Angle β contributes to the quality control evaluation of spirometry in children. Both angle β < 74.58° and FET < 4.91 s are predictors of poor-quality MEFV curves, while their combination offers the highest diagnostic value. What is Known: • A slow start is one of the leading causes of poor-quality maximal expiratory flow-volume (MEFV) curves, which is a particularly prominent issue among children due to limited cooperation, especially those younger than 6 years old. • It is relatively difficult to differentiate between ventilatory dysfunction and poor cooperation when a slow start occurs in children; therefore, there is an urgent need for an objective indicator that is unaffected by ventilatory impairment to evaluate quality control of spirometry. What is New: • The initial angle β, which was introduced at the ascending limb of the MEFV curve in the present study, has a certain diagnostic value for poor-quality MEFV curves in children. • Angle β < 74.58° is a predictor of poor-quality MEFV curves, and its combination with FET < 4.91 s offers a higher diagnostic value.
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Affiliation(s)
- Luanjie Yao
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Lingdong Meng
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Xin Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Xiaowen Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Fen Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Yunxiao Shang
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Yong Feng
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China.
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de Oliveira Saraiva NA, de Oliveira Farias I, Dos Santos BM, Xavier RS, Lopes AJ. Reply to letter to the editor: "Why 43.5% of Brazilian women with systemic sclerosis have an abnormal 6-min walk distance? The implication of parity". Clin Biomech (Bristol, Avon) 2023; 110:106134. [PMID: 37913629 DOI: 10.1016/j.clinbiomech.2023.106134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023]
Affiliation(s)
| | | | | | - Rosemere Saldanha Xavier
- Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
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Strauss R, Leflein H, Kolesar A, Hammel J. Long-Term Efficacy and Safety Among Patients With Severe Eosinophilic Asthma Treated With Mepolizumab and Its Effect on Small Airways. J Allergy Clin Immunol Pract 2023; 11:3670-3679.e2. [PMID: 37572752 DOI: 10.1016/j.jaip.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND The major problem at the Cleveland Allergy and Asthma Center was the need for additional therapy for severe eosinophilic asthma patients who were steroid-dependent or required frequent bursts of prednisone. OBJECTIVES The objectives of this study were to determine the efficacy of monthly mepolizumab (MP) injections up to 6½ years using Asthma Control Quesitonnaire-7 (ACQ-7), forced expiratory volume in 1 second (FEV1), forced expiratory flow at 25% to 75% (FEF25%-75%) overall and among super-responders, and to understand whether FEF25%-75% is an effective parameter to evaluate MP efficacy. METHODS We reviewed the charts of 67 patients with severe eosinophilic asthma and compared the results between 47 super-responders and the rest of the cohort regarding ACQ-6, ACQ-7, eosinophils, FEV1, and FEF25%-75%. The groups of super-responders and all other patients were described with respect to initial and current values of the study end points using medians and 25th and 75th percentiles. Changes from the initial to the current values in the study end points were measured using percent changes. The Wilcoxon signed rank test was used within each group to test the null hypothesis of 0 median percent change. RESULTS After 6½ years, there were no significant changes in FEV1. The FEF25%-75%, had a significant median percent increase of 40% among the super-responders (P < .001), which was substantially higher (P = .026) than the median percent increase of 13.8% observed among all other patients. CONCLUSIONS The use of MP up to 6½ years was safe and effective, with significant changes to ACQ-7 and FEF25%-75% associated with MP treatment, but not the FEV1. A higher magnitude of changes was observed among super-responders than the rest of the cohort. Changes in FEF25%-75% were more meaningful than changes in FEV1 in evaluating pulmonary function responsiveness of severe eosinophilic asthma to MP.
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Affiliation(s)
- Ronald Strauss
- Cleveland Allergy and Asthma Center and Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Hannah Leflein
- Case Western Reserve University, Cleveland Allergy and Asthma Center, Cleveland, Ohio
| | - Anna Kolesar
- Case Western Reserve University, Cleveland Allergy and Asthma Center, Cleveland, Ohio
| | - Jeffrey Hammel
- Case Western Reserve University, Cleveland Allergy and Asthma Center, Cleveland, Ohio
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Karanović B, Barešić M, Merkler Šorgić A, Anić B. Angiotensin-converting enzyme 1 gene polymorphisms in patients with systemic sclerosis-associated interstitial lung disease: a single centre retrospective observational study. Rheumatol Int 2023; 43:2303-2309. [PMID: 37736811 DOI: 10.1007/s00296-023-05462-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
Angiotensin-converting enzyme (ACE) 1 gene polymorphisms have been associated with vascular permeability, alveolar endothelial dysfunction and fibroblast proliferation and have been studied in pulmonary diseases such as COPD and idiopathic pulmonary fibrosis. Similar mechanisms of ACE 1 polymorphisms have been seen in patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD). We are presenting a retrospective observational study in patients with SSc-ILD and analysing the association of ACE 1 gene polymorphisms (DD, II and ID) with the features of SSc, changes in pulmonary function tests (PFTs) and lung HRCT over three different periods of time (at the time of the diagnosis, 5 and 10 years after the diagnosis). The aim of the study was to determine whether ACE 1 gene polymorphisms have an effect on the severity of SSc-ILD. We found no statistically significant differences in the development and severity of SSc-ILD and changes in PFTs between subgroups of ACE 1 gene polymorphism over the analysed periods (at the time of diagnosis HRCT changes p = 0.270, FEV1 p = 0.483, FVC p = 0.497, DLco p = 0.807, after 5 years HRCT changes p = 0.163, FEV1 p = 0.551, FVC p = 0.362, DLco p = 0.620 and 10 years of follow-up HRCT changes p = 0.853, FEV1 p = 0.589, FVC p = 0.328, DLco p = 0.992). However, patients with the ID genotype showed a significant reduction in FEV1 after 10 years of follow-up in comparison to baseline levels (91.0 (IR 80.0-105.0) at the time of diagnosis and 84.0 (IR 69.0-99.0) after 10 years, p = 0.014). Our study suggests that ACE 1 gene polymorphisms do not have a role in the severity of SSc-ILD. Further studies are needed to explain the exact role of ACE 1 gene polymorphisms in SSc-ILD and SSc in general.
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Affiliation(s)
- Boris Karanović
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia.
| | - Marko Barešić
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Ana Merkler Šorgić
- Division of Molecular Laboratory Diagnostics, Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Branimir Anić
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University of Zagreb, School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
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Diesler R, Cottin V, Gallien Y, Turquier S, Traclet J, Ahmad K, Glerant JC. Pulmonary function test results are correlated with 6-minute walk distance, distance-saturation product, and 6-minute walk work in patients with lymphangioleiomyomatosis. Respir Med Res 2023; 85:101071. [PMID: 38141576 DOI: 10.1016/j.resmer.2023.101071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/12/2023] [Accepted: 11/20/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND AND OBJECTIVE Lymphangioleiomyomatosis (LAM) is a rare multicystic lung disease. Although a correlation between pulmonary function test (PFT) results and exercise capacity appears probable, it has not yet been demonstrated. The aim of this study was to assess whether PFT results correlate with 6-minute walk test (6MWT) results in patients with LAM. METHODS We conducted a retrospective study of all patients with a diagnosis of LAM followed in a French reference centre over a 13-year period. PFT and 6MWT data were collected. Distance-saturation product (DSP) and 6-minute walk work (6MWORK) were calculated. RESULTS A total of 62 patients were included. Their median forced expiratory volume in 1 s (FEV1) was 82.7 % predicted and their median forced vital capacity (FVC) was 96.7 % predicted. The median diffusing capacity of the lungs for carbon monoxide (DLCO) was 58.5 % predicted and was decreased in 79 % of the patients. The median 6-minute walk distance was 535 m, which was 90.9 % of the 602 m predicted distance. The median DSP was 497.4 m % and the median 6MWORK was 32,910 kg.m. The distance walked during the 6MWT was significantly correlated with FVC%predicted (R = 0.435), FEV1 %predicted (R = 0.303), TLC%predicted (R = 0.345), FRC%predicted (R = 0.262), RV/TLC ratio (R = -0.271), and DLCO%predicted (R = 0.279). DSP and 6MWORK were each significantly correlated with different PFT results. CONCLUSION The present study shows that PFT results are potential predictors of the exercise capacity in patients with LAM. Additional studies are required to evaluate the interest of DSP and 6MWORK in LAM.
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Affiliation(s)
- Rémi Diesler
- National Reference Center for Rare Pulmonary Diseases, Hôpital Louis Pradel Hospices Civils de Lyon, University of Lyon, INRAE, Lyon, France.
| | - Vincent Cottin
- National Reference Center for Rare Pulmonary Diseases, Hôpital Louis Pradel Hospices Civils de Lyon, University of Lyon, INRAE, Lyon, France
| | - Yves Gallien
- Service de Biostatistique et d'Information Médicale, INSERM U1153, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Université de Paris Cité, Paris, France
| | - Ségolène Turquier
- Service d'Explorations Fonctionnelles Respiratoires, Hôpital Louis Pradel, Hospices Civils de Lyon, University of Lyon, Lyon, France
| | - Julie Traclet
- National Reference Center for Rare Pulmonary Diseases, Hôpital Louis Pradel Hospices Civils de Lyon, University of Lyon, INRAE, Lyon, France
| | - Kais Ahmad
- National Reference Center for Rare Pulmonary Diseases, Hôpital Louis Pradel Hospices Civils de Lyon, University of Lyon, INRAE, Lyon, France
| | - Jean-Charles Glerant
- Service d'Explorations Fonctionnelles Respiratoires, Hôpital Louis Pradel, Hospices Civils de Lyon, University of Lyon, Lyon, France
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Mohamed HSM, Ali IA. Comparative study of pulmonary functions test among different substances abusers. BMC Pulm Med 2023; 23:452. [PMID: 37986058 PMCID: PMC10662557 DOI: 10.1186/s12890-023-02760-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/10/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Substance use is a problem that affects people all over the world and is prevalent in different age groups. The lungs in particular, with their unique exposure to the environment and the bloodstream, are vulnerable to damage from substance use and can affect lung function. Efforts have generally focused on cigarettes, while there is little research on different substances of use. The study aimed to detect changes in pulmonary function tests in different substance users. METHODS An analytical cross-sectional study was carried out among different substance users at the Abdalaal Elidridi Psychiatric Hospital. A total of 60 adults were included: 16 cannabis users, 16 heroin users, 16 methamphetamine users, and 12 alcohol users. Participants used only one substance. Height and weight were measured, and BMI was calculated. For each participant, pulmonary function tests (PFTs) including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio and peak expiratory flow rate (PEFR) were measured using an electronic spirometer, and the results were compared with normal reference values for Sudanese subjects matched for age, sex, and height. RESULTS A high prevalence of lung function abnormalities (100.0%) is seen in all abusers. Obstructive lung disease is found in 80.0% of patients, and restrictive lung disease is found in 20.0% of cases. The measured FEV1/FVC ratio in different substance groups was lower than the expected normal values of (88.2 ± 2.9%). The mean FEV1/FVC ratio of alcohol was (83.6 ± 7.6%), for heroin, it was (77.3 ± 15.8%), for methamphetamine, it was (77.7 ± 17.8%) and for cannabis, it was (71.03 ± 11.3%), the latter was significantly lower than the other two groups (P < 0.001). Duration of substance use was inversely correlated with the FEV1/FVC ratio (r = -0.378, P 0.001), indicating that a longer duration of substance use correlates with lower FEV1/FVC ratios. CONCLUSIONS Obstructive lung abnormalities are frequent in substance abusers. All types of substances have a major deleterious effect on PFTs and harm the respiratory system. More action should be taken to address the effects of substances on the lungs. Awareness, early detection, and intervention are essential.
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Affiliation(s)
- Hana Salah Musa Mohamed
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan
| | - Ibrahim Abdelrhim Ali
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan.
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12
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Snyder M, Njie BY, Grabenstein I, Viola S, Abbas H, Bhatti W, Lee R, Traficante R, Yeung SYA, Chow JH, Tabatabai A, Taylor BS, Dahi S, Scalea T, Rabin J, Grazioli A, Calfee CS, Britton N, Levine AR. Functional recovery in a cohort of ECMO and non-ECMO acute respiratory distress syndrome survivors. Crit Care 2023; 27:440. [PMID: 37964311 PMCID: PMC10644522 DOI: 10.1186/s13054-023-04724-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND The mortality benefit of VV-ECMO in ARDS has been extensively studied, but the impact on long-term functional outcomes of survivors is poorly defined. We aimed to assess the association between ECMO and functional outcomes in a contemporaneous cohort of survivors of ARDS. METHODS Multicenter retrospective cohort study of ARDS survivors who presented to follow-up clinic. The primary outcome was FVC% predicted. Univariate and multivariate regression models were used to evaluate the impact of ECMO on the primary outcome. RESULTS This study enrolled 110 survivors of ARDS, 34 of whom were managed using ECMO. The ECMO cohort was younger (35 [28, 50] vs. 51 [44, 61] years old, p < 0.01), less likely to have COVID-19 (58% vs. 96%, p < 0.01), more severely ill based on the Sequential Organ Failure Assessment (SOFA) score (7 [5, 9] vs. 4 [3, 6], p < 0.01), dynamic lung compliance (15 mL/cmH20 [11, 20] vs. 27 mL/cmH20 [23, 35], p < 0.01), oxygenation index (26 [22, 33] vs. 9 [6, 11], p < 0.01), and their need for rescue modes of ventilation. ECMO patients had significantly longer lengths of hospitalization (46 [27, 62] vs. 16 [12, 31] days, p < 0.01) ICU stay (29 [19, 43] vs. 10 [5, 17] days, p < 0.01), and duration of mechanical ventilation (24 [14, 42] vs. 10 [7, 17] days, p < 0.01). Functional outcomes were similar in ECMO and non-ECMO patients. ECMO did not predict changes in lung function when adjusting for age, SOFA, COVID-19 status, or length of hospitalization. CONCLUSIONS There were no significant differences in the FVC% predicted, or other markers of pulmonary, neurocognitive, or psychiatric functional recovery outcomes, when comparing a contemporaneous clinic-based cohort of survivors of ARDS managed with ECMO to those without ECMO.
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Affiliation(s)
| | - Binta Y Njie
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Sara Viola
- Department of Medicine, Division of Critical Care Medicine, University of Maryland Baltimore Washington Medical Center, Baltimore, MD, USA
| | - Hatoon Abbas
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA
| | - Waqas Bhatti
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA
| | - Ryan Lee
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA
| | - Rosalie Traficante
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA
| | - Siu Yan Amy Yeung
- Department of Pharmacy Services, University of Maryland Medical Center, Baltimore, MD, USA
| | - Jonathan H Chow
- Department of Anesthesiology and Critical Care Medicine, The George Washington University School of Medicine, Washington, DC, USA
| | - Ali Tabatabai
- Department of Medicine, Division of Education, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Bradley S Taylor
- Division of Cardiothoracic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Siamak Dahi
- Division of Cardiothoracic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Thomas Scalea
- Department of Surgery and Program in Trauma, R Adams Crowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joseph Rabin
- Department of Surgery and Program in Trauma, R Adams Crowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alison Grazioli
- Department of Medicine, University of Maryland School of Medicine, Program in Trauma, Baltimore, MD, USA
| | - Carolyn S Calfee
- Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, CA, USA
| | - Noel Britton
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrea R Levine
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 S. Paca St, Baltimore, MD, 21231, USA.
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13
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Alshareef W, Almutairi N, Sindi A, Almakoshi L, Zakzouk A, Aljasser A, Alammar A. Spirometry in laryngotracheal stenosis: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:4783-4792. [PMID: 37522909 DOI: 10.1007/s00405-023-08159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE This study aimed to assess the changes in spirometry parameters or indices after relieving laryngotracheal stenosis (LTS) in adult patients. METHODS A systematic review and meta-analysis of studies from PubMed, Scopus, Web of Science, Cochrane Library, and EBSCO databases was conducted for assessing changes in spirometry values after endoscopic balloon dilatation of LTS in adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Relevant data, such as changes in mean spirometry values between preoperative and postoperative interventions, and findings of receiver operating characteristic curve analyses for predicting the need for surgical intervention, were extracted. RESULTS Ten studies including 330 patients overall met the inclusion criteria. Significant improvements were observed from preoperative to postoperative mean values of different spirometry parameters and indices. The overall mean differences in peak expiratory flow (ΔPEF), expiratory disproportion index (ΔEDI), and peak inspiratory flow (ΔPIF) were 2.26 L/s (95% CI 2.14-2.38), 27.94 s (95% CI 26.36-29.52), and 1.21 L/s (95% CI 0.95-1.47), respectively. ΔPEF and ΔPIF values increased, while ΔEDI decreased. In predicting the need for surgical intervention, EDI had the highest sensitivity (88%), and forced expiratory volume per second/forced vital capacity had the highest specificity (85%). CONCLUSION Spirometry is a valuable tool for assessing patients with LTS. PEF, EDI, and PIF were the most commonly reported spirometry parameters that significantly improved after airway stenosis was relieved.
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Affiliation(s)
- Waleed Alshareef
- Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia.
- Department of Otolaryngology-Head and Neck Surgery, Maternity and Children Hospital, Makkah, Saudi Arabia.
| | - Nasser Almutairi
- Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
- Department of Otolaryngology-Head and Neck Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdullah Sindi
- Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Latifah Almakoshi
- Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdulmajeed Zakzouk
- Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdullah Aljasser
- Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ahmed Alammar
- Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
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14
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Soumagne T, Quétant S, Guillien A, Falque L, Hess D, Aguilaniu B, Degano B. Insight into the relationship between forced vital capacity and transfer of the lungs for carbon monoxide in patients with idiopathic pulmonary fibrosis. Respir Med Res 2023; 84:101042. [PMID: 37734234 DOI: 10.1016/j.resmer.2023.101042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/17/2023] [Accepted: 07/11/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Forced vital capacity (FVC) is routinely used to quantify the severity and identify the progression of idiopathic pulmonary fibrosis (IPF). Although less commonly used, lung transfer of carbon monoxide (TLCO) correlates better with the severity of IPF than does FVC. METHODS Aiming at studying how FVC behaves in relation to TLCO, we analysed cross-sectional data from 430 IPF patients, of which 221 had at least 2 assessments (performed 2.4 ± 1.9 years apart) available for longitudinal analyses. Thresholds for identifying "abnormal" FVC and TLCO values were the statistically-defined lower limits of normal (LLN). For patients with longitudinal data, mean annual absolute declines of FVC and TLCO were calculated. RESULTS The correlation between FVC and TLCO (%predicted) was weak (R2=0.21). FVC was "abnormal" (i.e., CONCLUSION In IPF, a "normal" FVC should be viewed with caution as it is most often associated with an "abnormal" TLCO, a parameter that is strongly correlated with the morphological extent of the disease. Only 1/3 of the patients with a FVC-based progression criterion also had a TLCO progression criterion. In contrast, 2/3 of patients with a TLCO progression criterion also had a FVC progression criterion.
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Affiliation(s)
- Thibaud Soumagne
- Service de Pneumologie et Soins intensifs respiratoires, Hôpital Européen Georges-Pompidou, Assistance Publique des hôpitaux de Paris, Paris, France
| | - Sébastien Quétant
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Alicia Guillien
- Épidemiologie environnementale appliquée à la reproduction et à la santé respiratoire, INSERM, CNRS, Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), U1209, Grenoble, France
| | - Loïc Falque
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - David Hess
- Programme Colibri, Association pour la complémentarité des connaissances et des pratiques de la pneumologie (aCCPP), 19 avenue Marcelin Berthelot, 38100, Grenoble, France
| | - Bernard Aguilaniu
- Programme Colibri, Association pour la complémentarité des connaissances et des pratiques de la pneumologie (aCCPP), 19 avenue Marcelin Berthelot, 38100, Grenoble, France; Université Grenoble Alpes, Grenoble, France
| | - Bruno Degano
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France; Laboratoire HP2, INSERM U1300, Université Grenoble Alpes, Grenoble, France.
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15
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Freund O, Breslavsky A, Fried S, Givoli-Vilensky R, Cohen-Rubin S, Zacks N, Kleinhendler E, Unterman A, Frydman S, Wand O, Bilenko N, Bar-Shai A. Interactions and clinical implications of serological and respiratory variables 3 months after acute COVID-19. Clin Exp Med 2023; 23:3729-3736. [PMID: 37479879 DOI: 10.1007/s10238-023-01139-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023]
Abstract
Medical follow-up of symptomatic patients after acute Coronavirus Disease 2019 (COVID-19) results in major burdens on patients and healthcare systems. The value of serological markers as part of this follow-up remains undetermined. We aimed to evaluate the clinical implications of serological markers for follow-up of acute COVID-19. For this purpose, we conducted an observational cohort study of patients 3 months after acute COVID-19. Participants visited a respiratory-clinic between October 2020 and March 2021, and completed pulmonary function tests (PFTs), serological tests, symptom-related questionnaires, and chest CT scans. Overall, 275 patients were included at a median of 82 days (IQR 64-111) post infection. 162 (59%) patients had diffusing capacity for carbon monoxide corrected for hemoglobin (DLCOc) below 80%, and 69 (25%) had bilateral chest abnormalities on CT scan. In multivariate analysis, anti-S levels were an independent predictor for DLCOc (β = - 0.14, p = 0.036). Anti-S levels were also associated with severe COVID-19 and older age, and correlated with anti-nucleocapsid (r = 0.30, p < 0.001) and antibodies to receptor binding domain (RBD, r = 0.37, p < 0.001). Other serological variables were not associated with clinical outcomes. In conclusion, symptomatic patients 3-months after COVID-19 had high respiratory symptomatic burden, in which anti-S levels were significantly associated with previous severe COVID-19 and DLCOc.
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Affiliation(s)
- Ophir Freund
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Waizman 6, Tel Aviv, Israel.
| | - Anna Breslavsky
- Division of Pulmonary Medicine, Barzilai University Medical Center, Ashkelon, and Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sabrina Fried
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Waizman 6, Tel Aviv, Israel
| | | | - Shira Cohen-Rubin
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nadav Zacks
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Kleinhendler
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Waizman 6, Tel Aviv, Israel
| | - Avraham Unterman
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Waizman 6, Tel Aviv, Israel
| | - Shir Frydman
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Waizman 6, Tel Aviv, Israel
| | - Ori Wand
- Division of Pulmonary Medicine, Barzilai University Medical Center, Ashkelon, and Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Natalya Bilenko
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Medical Office of Southern District, Ministry of Health, Ashkelon, Israel
| | - Amir Bar-Shai
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Waizman 6, Tel Aviv, Israel
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16
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Apollonatou V, Lykouras D, Kargiotis O, Kasdagli MI, Lagiou O, Papathanasopoulos P, Spiropoulos K, Karkoulias K. Cardiopulmonary exercise testing in people with minimally impaired multiple sclerosis. Mult Scler Relat Disord 2023; 79:105016. [PMID: 37748258 DOI: 10.1016/j.msard.2023.105016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic demyelinating inflammatory disorder of the central nervous system that may affect respiratory system at the later stages of the disease. The aim of our study was to evaluate respiratory function and cardiopulmonary exercise testing in ambulatory without aid people with MS (pwMS), and to investigate quality of life parameters and fatigue in this population. METHODS 25 pwMS and 16 healthy controls were included in this study. Pulmonary function tests were performed and were followed by proper cardiopulmonary exercise testing with the use of treadmill. Quality of life assessment was done with SF-36 questionnaire. RESULTS The mean age of the patient group was 38.4 ± 8.2 years. Spirometric values were within normal limits, and so did lung diffusion capacity, while maximal voluntary ventilation was reduced. In cardiopulmonary exercise testing the patient group showed impairment compared to control group. The statistically significant lower parameters were V'O2 peak, V'CO2 peak, RER, V'O2/kg peak, V'CO2/kg peak, oxygen pulse peak and V'E/V'CO2 slope. Moreover, there was a negative and statistically significant correlation between CPET values and BMI and MFIS, while there was a positive and statistically significant correlation with quality of life, evaluated by SF-36. CONCLUSION Our study showed that the main cardiopulmonary exercise testing parameters were affected in ambulatory pwMS, even without evidence of respiratory symptoms. Therefore, these people should be evaluated for pulmonary function compromise.
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Affiliation(s)
- Vasiliki Apollonatou
- 2nd Pulmonary Medicine Department, Athens Medical School, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece.
| | - Dimosthenis Lykouras
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | - Odysseas Kargiotis
- Department of Neurology, University General Hospital of Patras, Patras, Greece; Stroke Unit, Metropolitan Hospital, Piraeus, Greece
| | - Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Olga Lagiou
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
| | | | | | - Kiriakos Karkoulias
- Department of Respiratory Medicine, University General Hospital of Patras, Patras, Greece
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17
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Freund O, Breslavsky A, Givoli-Vilensky R, Zacks N, Gershman E, Melloul A, Wand O, Bilenko N, Bar-Shai A. Assessment of a close respiratory follow-up schedule at 3 and 6 months after acute COVID-19 and its related investigations. Respir Med 2023; 217:107367. [PMID: 37479120 DOI: 10.1016/j.rmed.2023.107367] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Respiratory sequela after acute COVID-19 is common and requires medical follow-up. Considering its vast economic impact, there is still no consensus regarding the mid-term follow-up plan after recovery. OBJECTIVE To evaluate the necessity of a close pulmonary follow-up schedule after acute COVID-19 and its related investigations. METHODS A prospective cohort study including adult patients after acute COVID-19 pneumonia. Patients were invited or referred to a 3- and 6-month follow-up visits at a large pulmonary institute in a tertiary center. Before each visit, patients completed demographic and clinical questionnaires, pulmonary function tests (PFTs), and chest CT scans. RESULTS 168 patients were included after completing both visits (medians of 80 and 177 days). Their mean age was 58 ± 15 and 52% recovered from severe or critical COVID-19. Between the two visits, there was no change in DLCOc (mean 73 ± 18 %predicted in both visits) and FVC (mean 90 ± 16 vs. 89 ± 16 %predicted). The COPD assessment tool and modified Medical Research Council scale had inverse correlations with the DLCOc, and similarly did not change between the visits. Occupational exposures were the only factor associated with a change in DLCOc during follow-up (3% decrease, p = 0.04). An improvement in chest CT findings at the second visit was not associated with a change in PFTs. CONCLUSIONS Most clinical variables did not change during a close follow-up schedule in the first six months after acute COVID-19. Such a follow-up plan does not appear necessary and should be personalized to limit excessive costs and resources.
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Affiliation(s)
- Ophir Freund
- The Institute of Pulmonary Medicine, Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Anna Breslavsky
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Nadav Zacks
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Evgeni Gershman
- The Institute of Pulmonary Medicine, Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ariel Melloul
- The Institute of Pulmonary Medicine, Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ori Wand
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Natalya Bilenko
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Medical Office of Southern District, Ministry of Health, Ashkelon, Israel
| | - Amir Bar-Shai
- The Institute of Pulmonary Medicine, Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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18
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de Oliveira Saraiva NA, de Oliveira Farias I, Dos Santos BM, Xavier RS, Lopes AJ. Reference value for the 6-min walking distance in women with systemic sclerosis considering the impact of muscle strength. Clin Biomech (Bristol, Avon) 2023; 109:106094. [PMID: 37725867 DOI: 10.1016/j.clinbiomech.2023.106094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 09/02/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Early triage, the search for new therapies, and closer monitoring of patients with systemic sclerosis before their lung function irreversibly deteriorates are urgent concerns. Because it is an independent predictor of systemic sclerosis-related mortality, the 6-min walk test is a potentially useful tool to evaluate outcomes, along with pulmonary function and computed tomography. This study aimed to establish a reference value for the 6-min walking distance in women with diffuse cutaneous systemic sclerosis-associated interstitial lung disease that takes into account the effects of muscle and lung function. METHODS This was a cross-sectional study in which 69 women with systemic sclerosis underwent the 6-min walk test, Health Assessment Questionnaire-Disability Index, pulmonary function, handgrip strength test, and quadriceps strength test. FINDINGS The mean 6-min walking distance was 447 ± 78 m, and 43.5% of the participants did not reach 80% of their predicted value. 6-min walking distance correlated positively with quadriceps strength (r = 0.418, P = 0.0004), forced vital capacity (r = 0.306, P = 0.011), pulmonary diffusion (r = 0.360, P = 0.002), maximum inspiratory pressure (r = 0.268, P = 0.029), and maximum expiratory pressure (r = 0.288, P = 0.019) and negatively with age (r = -0.378, P = 0.001), body mass index (r = -0.248, P = 0.039), and Health Assessment Questionnaire-Disability Index (r = -0.438, P = 0.0001). In the multiple linear regression analysis, quadriceps strength, body mass index, pulmonary diffusion, age, and maximum expiratory pressure explained 72% of the 6-min walking distance variability. INTERPRETATION Muscle function and, to a lesser extent, lung function are key contributors in determining the reference value for the 6-min walking distance in women with diffuse cutaneous systemic sclerosis-associated interstitial lung disease.
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Affiliation(s)
| | | | | | - Rosemere Saldanha Xavier
- Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil; Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
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19
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Jat KR, Agarwal S. Lung Function Tests in Infants and Children. Indian J Pediatr 2023; 90:790-797. [PMID: 37261706 PMCID: PMC10233185 DOI: 10.1007/s12098-023-04588-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/17/2023] [Indexed: 06/02/2023]
Abstract
Lung function testing is an essential modality of investigation in children as it provides objective evidence of lung disease/health. With advances in technology, various tests are available that can aid in the diagnosis of lung disease, assess the progression and response to therapy and document the lung development and evolving lung diseases in infants. This narrative review discusses lung function tests in infants and children. Currently, lung function tests can be performed in every age group, from neonates to the elderly. Spirometry and peak expiratory flow rate (PEFR) are the most employed tests in children more than six years of age. Spirometry helps diagnose and monitoring of both obstructive and restrictive diseases. There is a need for expertise to perform and interpret spirometry correctly. The forced oscillation technique (FOT) or impulse oscillometry (IOS) is done with tidal volume breathing and is feasible even in preschool children. Their utility is mainly restricted to asthma in children at present. Lung function tests can be performed in neonates, infants and children using infant pulmonary function test (PFT) equipment, although their availability is limited. Diffusion capacity for carbon monoxide (DLCO) is a valuable tool in restrictive lung diseases. Lung volumes can be assessed by body plethysmography and multiple washout technique. The latter can also assess lung clearance index. It is essential to perform and interpret the lung function test results correctly and correlate them with the clinical condition for optimum treatment and outcome.
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Affiliation(s)
- Kana Ram Jat
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Sheetal Agarwal
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
- Department of Pediatrics, ABVIMS and Dr. RML Hospital, New Delhi, India
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Cordeiro ALL, Soares LO, Gomes-Neto M, Petto J. Inspiratory Muscle Training in Patients in the Postoperative Phase of Cardiac Surgery: A Systematic Review and Meta-Analysis. Ann Rehabil Med 2023; 47:162-172. [PMID: 37403313 DOI: 10.5535/arm.23022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/23/2023] [Indexed: 07/06/2023] Open
Abstract
To review the evidence about inspiratory muscle training (IMT) in patients in postoperative of cardiac surgery. We conducted this systematic review used the databases Ovid, LILACS, CINAHL, PubMed, PEDro, and CENTRAL. Randomized clinical trials that addressed IMT after cardiac surgery were selected. The outcomes assessed were maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), tidal volume (TV), peak expiratory flow (PEF), functional capacity (6-minute walk test) and length of hospital stay. The mean difference between groups and the respective 95% confidence interval (CI) were calculated and used to quantify the effect of continuous outcomes. Seven studies were selected. The IMT was superior to the control over MIP 15.77 cmH2O (95% CI, 5.95-25.49), MEP 15.87 cmH2O (95% CI, 1.16-30.58), PEF 40.98 L/min (95% CI, 4.64-77.32), TV 184.75 mL (95% CI, 19.72-349.77), hospital stay -1.25 days (95% CI, -1.77 to -0.72), but without impact on functional capacity 29.93 m (95% CI, -27.59 to 87.45). Based on the results presented, IMT was beneficial as a form of treatment for patients after cardiac surgery.
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Affiliation(s)
- André Luiz Lisboa Cordeiro
- Department of Medicine and Human Health, Bahiana School of Medicine and Public Health, Salvador, Brazil
- Department of Physical Therapy, Centro Universitário Nobre, Feira de Santana, Brazil
| | - Lucas Oliveira Soares
- Department of Physical Therapy, Centro Universitário Nobre, Feira de Santana, Brazil
- Physiotherapy Department, Hospital Geral Clériston Andrade, Feira de Santana, Brazil
| | - Mansueto Gomes-Neto
- Department of Physical Therapy, Universidade Federal da Bahia, Salvador, Brazil
| | - Jefferson Petto
- Department of Medicine and Human Health, Bahiana School of Medicine and Public Health, Salvador, Brazil
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Johnson DC, Johnson BG. Spirometry Reference Equations Including Existing and Novel Parameters. Open Respir Med J 2023; 17:e187430642212260. [PMID: 37916135 PMCID: PMC10351349 DOI: 10.2174/18743064-v16-e221227-2022-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/09/2022] [Accepted: 11/04/2022] [Indexed: 12/28/2022] Open
Abstract
Introduction Spirometry is an essential component of pulmonary function testing, with interpretation dependent upon comparing results to normal. Reference equations for mean and lower limit of normal (LLN) are available for usual parameters, including forced vital capacity (FVC), forced expiratory volume in the first second of an FVC maneuver (FEV1), and FEV1/FVC. However, standard parameters do not fully characterize the flow-volume loop and equations are unavailable for the upper limit of normal (ULN). The aim of this study was to develop reference equations for existing and novel spirometry parameters, which more fully describe the flow-volume loop, and to compare these to previously reported equations. Methods Data from healthy participants in NHANES III was used to derive reference equations for existing and novel spirometry parameters accounting for birth sex, age, height, and ethnicity (Caucasian, Mexican American, Black) for ages 8 to 90 years. An iterative process determined %predicted LLN and ULN. Equations were compared to published reported equations. Results Reference equations were developed for mean, LLN and ULN for existing and novel spirometry parameters for ages 8 to 90. The derived equations closely match mean values of previously published equations, but more closely fit the LLN. Mexican-American and Caucasian values were similar (within 2%) so they were combined, while Black relative to Caucasian/Mexican-American values were lower for some parameters. Conclusion These reference equations, which account for birth sex, age, height, and ethnicity for existing and novel spirometry parameters, provide a more comprehensive and quantitative evaluation of spirometry and the flow-volume curve.
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Affiliation(s)
- Douglas Clark Johnson
- Department of Medicine, Baystate Medical Center 759 Chestnut Street Springfield, MA 01199, USA
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Murphy VE, Jensen ME. Longitudinal Changes in Upper and Lower Airway Function in Pregnancy. Immunol Allergy Clin North Am 2023; 43:17-26. [PMID: 36411003 DOI: 10.1016/j.iac.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Physiologic changes during pregnancy have implications for both upper and lower airway function. Upper airway resistance increases, and total lung capacity decreases. Upper airway symptoms increase; some women develop pregnancy-induced rhinitis and there is an increased prevalence of sleep-disordered breathing compared to prepregnancy. Longitudinal studies examining changes in upper and lower airway function parameters are limited, particularly in women with asthma. Some studies have observed reduced lung function with advancing gestation; however, changes are small and unlikely to be of major clinical significance. Spirometry is therefore a useful tool for clinical assessment of women with asthma during pregnancy.
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Affiliation(s)
- Vanessa E Murphy
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Level 2 West, c/- University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia.
| | - Megan E Jensen
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, Level 2 West, c/- University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia
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Hegewald MJ, DeCato TW, Weaver LK, Jensen RL. Effect of barometric pressure on single-breath carbon monoxide diffusing capacity. Respir Physiol Neurobiol 2023; 308:103997. [PMID: 36402362 DOI: 10.1016/j.resp.2022.103997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Single-breath diffusing capacity for carbon monoxide (DLCO) quantifies gas transfer in the lungs. DLCO measurement is affected by barometric pressure (Pb) and alveolar partial pressure of oxygen (PAO2). The current equations for adjusting DLCO for Pb and PAO2 may not be accurate given advances in test performance and technology. We quantify changes in DLCO with alterations in Pb in normal and COPD subjects, determine the accuracy of the current Pb and PAO2 adjustment equations and develop updated adjustment equations. METHODS We measured DLCO in 13 normal and 10 COPD subjects at 1330 m altitude and in a hypobaric/hyperbaric chamber at altitudes of sea-level and 2500 m; six normal subjects were tested at 3600 m. We determined if there were significant differences in DLCO between altitudes. We developed an equation for adjusting DLCO for changes in Pb from sea-level. We compared this equation with the existing Pb adjustment equation in normal and COPD subjects. We determined the accuracy of the current PAO2 adjustment equation and developed a new PAO2 adjustment equation. RESULTS DLCO significantly increased with decreasing Pb. We developed a Pb adjustment equation that adjusts DLCO measured at altitudes between 1330 m and 3600 m to sea-level values. This Pb adjustment equation yields DLCO results that are not significantly different than the currently recommended equation. We developed a more accurate PAO2 adjustment equation. CONCLUSION DLCO measurement is significantly affected by altitude. We developed equations that accurately adjust DLCO for changes in Pb and PAO2 in normal and COPD subjects.
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Affiliation(s)
- Matthew J Hegewald
- Pulmonary and Critical Care Medicine, Intermountain Medical Center and the University of Utah, Murray, UT, United States.
| | - Thomas W DeCato
- Division of Respiratory & Critical Care Physiology & Medicine, Harbor-UCLA Medical Center and the Lundquist Institute for Biomedical Innovation, Torrance, CA, United States.
| | - Lindell K Weaver
- Hyperbaric Medicine, Intermountain Medical Center and the University of Utah, Murray, UT, United States.
| | - Robert L Jensen
- Pulmonary and Critical Care Medicine, Intermountain Medical Center and the University of Utah, Murray, UT, United States.
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Bongiolatti S, Salvicchi A, Mugnaini G, Vokrri E, Viggiano D, Gonfiotti A, Lavorini F, Voltolini L. Does thoracoscopic basal pyramid segmentectomy really offer functional advantages in comparison with thoracoscopic lower lobectomy? Interdiscip Cardiovasc Thorac Surg 2023; 36:7005201. [PMID: 36847673 PMCID: PMC9901411 DOI: 10.1093/icvts/ivad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/08/2022] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The functional impact of thoracoscopic basal segmentectomy in comparison with lower lobectomy has not been investigated in-depth and the aim of this study was to clarify this topic. METHODS We retrospectively analysed a cohort of patients who underwent surgery between 2015 and 2019 for non-small-cell lung cancer, peripherally located lung nodules, far enough from both the apical segment and the lobar hilum to allow an oncologically safe thoracoscopic lower lobectomy or basal segmentectomy. Pulmonary function tests (PFTs) including spirometry and plethysmography were performed 1 month after surgery and forced expiratory volume in 1 s, forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) were collected; the difference, the loss and the recovery rate of pulmonary function were calculated and compared with the Wilcoxon-Mann-Whitney test. RESULTS During the study period, n = 45 and n = 16 patients for video-assisted thoracoscopic surgery (VATS) lower lobectomy and for VATS basal segmentectomy, respectively, completed the study protocol: the 2 groups were homogeneous as to preoperative variables and PFT values. Postoperative outcomes were similar and PFTs revealed significant differences between postoperative forced expiratory volume in 1 s %, FVC%, ΔFVC and ΔFVC%. The loss percentage of FVC%, DLCO% and the recovery rate was better for FVC and DLCO in the VATS basal segmentectomy group. CONCLUSIONS Thoracoscopic basal segmentectomy seems to be associated with a more preserved lung function, maintaining more FVC and DLCO levels than lower lobectomy, and could be performed in selected cases ensuring also adequate oncological margins.
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Affiliation(s)
- Stefano Bongiolatti
- Corresponding author. Thoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134 Florence, Italy. Tel: +39-55-7946807; fax: +39-55-7949557; e-mail: (S. Bongiolatti)
| | | | | | - Eduart Vokrri
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
| | | | - Alessandro Gonfiotti
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Federico Lavorini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Luca Voltolini
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Fillard A, Licari A, Molinari N, Marseglia G, Demoly P, Caimmi D. Sensitivity of FEV 1 and Clinical Parameters in Children With a Suspected Asthma Diagnosis. J Allergy Clin Immunol Pract 2023; 11:238-247. [PMID: 36280139 DOI: 10.1016/j.jaip.2022.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Asthma is the most common chronic disease in children and a robust diagnosis is crucial to optimize patient care and reduce its burden. To diagnose asthma in children, the Global Initiative for Asthma (GINA) recommendations propose a 12% improvement in forced expiratory volume in 1 second (FEV1) after a bronchodilation test. Nevertheless, such a criterion is rarely confirmed in these patients in clinical practice. OBJECTIVE The objective of this study was to evaluate the sensitivity of spirometric and clinical parameters in identifying children with possible asthma. METHODS The VERI-VEMS Study is a multicenter international retrospective cohort study. Data were collected, from January 2008 until January 2019, for all consecutive children (aged 5-18 years), with a diagnosis of asthma, who performed a spirometry at the time of the diagnosis. We compared the sensitivity of the reversibility criterion proposed by GINA guidelines, with other spirometric and clinical variables, using physician-diagnosed asthma and response to treatment as the standard. RESULTS The study included 871 children. The reversibility criterion of 12% of FEV1 showed a sensitivity of 30.4%. The 3 best spirometric or clinical criteria were the presence of dry cough, or wheezing or atopy and dry cough, or wheezing or exercise-induced dyspnea, with a sensitivity reaching 99.5%, with no added value of the spirometric parameters in the calculation of the cumulated sensitivity for the diagnosis of pediatric asthma. CONCLUSIONS Postbronchodilator reversibility of 12%, although essential for patients' follow-up, has an insufficient low sensitivity in reaching a diagnosis of asthma in pediatric patients, compared with a combination of clinical symptoms, that show a better sensitivity. Further studies on specificity will help clarify the role of this change in the diagnostic paradigm in formally diagnosing children with asthma.
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Affiliation(s)
- Anouchka Fillard
- Allergy Unit, Département de Pneumologie et Addictology, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, Montpellier, France
| | - Amelia Licari
- Pediatric Unit, University of Pavia, San Matteo Hospital, Pavia, Italy
| | - Nicolas Molinari
- Department of Statistics, IMAG UMR5149 S, University Hospital of Montpellier, Montpellier, France; Debrest Institute of Epidemiology and Public Health (IDESP), UMR UA11, University of Montpellier - INSERM, Montpellier, France
| | | | - Pascal Demoly
- Allergy Unit, Département de Pneumologie et Addictology, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, Montpellier, France; Debrest Institute of Epidemiology and Public Health (IDESP), UMR UA11, University of Montpellier - INSERM, Montpellier, France
| | - Davide Caimmi
- Allergy Unit, Département de Pneumologie et Addictology, Arnaud de Villeneuve Hospital, University Hospital of Montpellier, Montpellier, France; Debrest Institute of Epidemiology and Public Health (IDESP), UMR UA11, University of Montpellier - INSERM, Montpellier, France.
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Alsina-Restoy X, Torres-Castro R, Torralba-García Y, Burgos F, Barberà JA, Agustí À, Blanco I. Does arterial oxygenation during exercise add prognostic value in pulmonary arterial hypertension? Respir Med 2023; 206:107070. [PMID: 36508987 DOI: 10.1016/j.rmed.2022.107070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The 6-min walking distance (6MWD) is often used to assess prognosis in pulmonary arterial hypertension (PAH) patients. Whether or not changes in arterial oxygen saturation (SpO2) during exercise add prognostic value to the 6MWD in these patients is unclear. The objective of this study was to investigate if SpO2 changes during exercise adds prognostic value to the 6MWD in PAH patients. METHODS Ambispective study that includes 137 patients with PAH: 38 idiopathic/heritable (i/h PAH), 42 with connective tissue disease (CTD-PAH), 34 with porto-pulmonary hypertension (PoPH), 21 with HIV-associated PAH and 2 with pulmonary venous occlusive disease (PVOD). Patients were characterized and, treated according to international recommendations, and were followed-up for 5 years. To integrate SpO2 changes during exercise, we calculated the desaturation distance ratio (DDR) either in its original form (from a maximal theoretical value of 100%) or the actual resting SpO2 value of the patient (new DDR) as well as the distance saturation product (DSP). RESULTS (1) during follow-up, 40 patients died (29.2%); (2) results confirmed the prognostic value of the 6MWD (AUC 0.913 [IQR 0.868-0.958]; p < 0.0001), original DDR (AUC 0.923 [0.881-0.966]; p < 0.001), New DDR (AUC 0.917 [0.872-0.961], p < 0.001), and DSP (AUC 0.914 [0.869-0.959], p < 0.001); and, (3) neither the original or new DDR or DSP added significant prognostic value to 6MWD in these patients. CONCLUSIONS Consideration of three different composite indices of arterial oxygenation changes during exercise does not add prognostic value to that of the 6MWD in patients with PAH.
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Affiliation(s)
- Xavier Alsina-Restoy
- Pulmonary Medicine Department, Respiratory Institute, Hospital Clinic Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain
| | - Rodrigo Torres-Castro
- Pulmonary Medicine Department, Respiratory Institute, Hospital Clinic Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Yolanda Torralba-García
- Pulmonary Medicine Department, Respiratory Institute, Hospital Clinic Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; CIBER Enfermedades Respiratorias (CIBERES), Spain
| | - Felip Burgos
- Pulmonary Medicine Department, Respiratory Institute, Hospital Clinic Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; University of Barcelona, Spain
| | - Joan Albert Barberà
- Pulmonary Medicine Department, Respiratory Institute, Hospital Clinic Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; CIBER Enfermedades Respiratorias (CIBERES), Spain; University of Barcelona, Spain
| | - Àlvar Agustí
- Pulmonary Medicine Department, Respiratory Institute, Hospital Clinic Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; CIBER Enfermedades Respiratorias (CIBERES), Spain; University of Barcelona, Spain
| | - Isabel Blanco
- Pulmonary Medicine Department, Respiratory Institute, Hospital Clinic Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; CIBER Enfermedades Respiratorias (CIBERES), Spain; University of Barcelona, Spain.
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Zhang H, Li X, Huang L, Gu X, Wang Y, Liu M, Liu Z, Zhang X, Yu Z, Wang Y, Huang C, Cao B. Lung-function trajectories in COVID-19 survivors after discharge: A two-year longitudinal cohort study. EClinicalMedicine 2022; 54:101668. [PMID: 36188433 PMCID: PMC9514976 DOI: 10.1016/j.eclinm.2022.101668] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 12/15/2022] Open
Abstract
Background Data on the long-term trajectories of lung function are scarce in COVID-19 survivors. Methods We re-analyzed the data from a prospective longitudinal cohort follow-up study of COVID-19 survivors over 2 years after infection. All participants were divided into scale 3, scale 4 and scale 5-6 groups according to seven-category ordinal scale. The changes of pulmonary function tests (PFTs), the Modified Medical Research Council (mMRC) Dyspnea Scale, 6-min walking test health-related quality of life (HRQoL) across the three serial follow-up visits were evaluated, and compared among three groups. We performed liner regression to determine potential factors that were associated with changes of PFTs and distance walked in 6 minutes (6MWD). Findings In this study, 288 participants generally presented an improvement of PFTs parameters from 6 months to 1 year after infection. The scale 5-6 group displayed a significantly higher increase of PFTs compared with scale 3 and scale 4 groups (all p<0.0167), and corticosteroids therapy was identified as a protective factor for the PFTs improvement with a correlation coefficient of 2.730 (0.215-5.246) for forced vital capacity (FVC), 2.909 (0.383-5.436) for total lung capacity (TLC), and 3.299 (0.211-6.387) for diffusion capacity for carbon monoxide (DLco), respectively. From 1-year to 2-year follow-up, the PFTs parameters generally decreased, which was not observed to be associated with changes of 6MWD and HRQoL. Dyspnea (mMRC≥1) generally decreased over time (23.3% [61/262] for 6-month, 27.9% [67/240] for 1-year, 13.4% [35/261] for 2-year), and 6MWD increased continuously (500.0 m vs 505.0 m vs 525.0 m). Interpretation Corticosteroids therapy during hospitalization was a protective factor for PFTs improvement from 6 months to 1 year. The relatively fast decline trend of PFTs from 1 year to 2 years needs to be paid attention and further validated in the future follow-up study. Fundings This work was supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS 2021-I2M-1-048) and the National Key Research and Development Program of China (2021YFC0864700).
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Affiliation(s)
- Hui Zhang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship hospital, Capital Medical University, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Xia Li
- Hubei Provincial Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Lixue Huang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship hospital, Capital Medical University, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Xiaoyin Gu
- Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Yimin Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Hubei Provincial Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Zhibo Liu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Xueyang Zhang
- Tsinghua University School of Medicine, Beijing, China
| | - Zhenxing Yu
- Department of Pulmonary and Critical Care Medicine, Hubei Provincial Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Yeming Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Changping Laboratory, Beijing, China
| | - Chaolin Huang
- Hubei Provincial Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship hospital, Capital Medical University, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
- Tsinghua University School of Medicine, Beijing, China
- Changping Laboratory, Beijing, China
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Kumar V, Vatkar AJ, Baburaj V, Najjar E, Bansal P. Pulmonary function after thoracoplasty for adolescent idiopathic scoliosis: a systematic review and meta-analysis. Eur Spine J 2022; 31:2972-2986. [PMID: 36069937 DOI: 10.1007/s00586-022-07375-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/28/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Thoracoplasty is a procedure which involves rib resection from the costovertebral junction to the apex of the rib hump deformity to address the cosmetic concerns of patients of scoliosis. There is conflicting literature on its effect on pulmonary function. The present meta-analysis was conducted to review and analyze the available literature and ascertain the effect of thoracoplasty on pulmonary function. METHODS Search was conducted according to PRISMA guidelines on three databases. After analysis of all the search results by title, abstracts and full texts-10 studies were identified for inclusion in the review. We included studies which had analyzed preoperative and postoperative pulmonary function tests (PFTs) after thoracoplasty. Pooled estimates were calculated for pulmonary function, and effect of other factors was analyzed by subgroup analysis and meta-regression. RESULTS The included studies were published between 1998 and 2019. A total of 385 patients were included in these studies, with a mean age of 15.01 years, with a female preponderance. Apprehension over appearance of rib hump was the most common indication for thoracoplasty. Percent-predicted forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV-1) were significantly decreased on follow-up. Anterior approach to corrective surgery and lower age were found to be associated with worse pulmonary function. Preoperative Cobb's angle was found to have significant impact on decrease in FEV-1 only, but not on other PFT parameters. CONCLUSION Overall decrease in pulmonary function after thoracoplasty necessitates the need of adequate preoperative pulmonary function to mitigate its effect on patient well-being. Use of a posterior approach for corrective surgery when thoracoplasty is planned might lead to better outcomes. More research is needed to study effect of preoperative Cobb's angle on pulmonary function.
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Affiliation(s)
- Vishal Kumar
- Department of Orthopaedics, PGIMER, Chandigarh, India
| | | | | | | | - Parth Bansal
- Department of Orthopaedics, PGIMER, Chandigarh, India.
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Pai KM, Pillai S, Pai HS, Shetty S. A Comparative Study of Symptoms, Nasal Eosinophilia and Pulmonary Function Tests Before and After Short Term Treatment with Corticosteroid Nasal Spray in Patients with Allergic Rhinitis. Indian J Otolaryngol Head Neck Surg 2022; 74:1001-1008. [PMID: 36452835 PMCID: PMC9702249 DOI: 10.1007/s12070-020-02034-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022] Open
Abstract
Allergic rhinitis has been on the rise because of urbanization and major population shift in addition to changes in the particulate matter in the atmosphere. Intranasal corticosteroid sprays are recommended as first-line prescription treatment in all cases of allergic rhinitis. The propensity of co-existing non-apparent lower airway hyper-responsiveness is also on the rise and must be evaluated. The aim of this study is to compare the symptomatic improvement, changes in nasal eosinophilia and asymptomatic airway hyper responsiveness before and after short term treatment with steroid nasal spray. Fifty patients meeting the inclusion criteria for allergic rhinitis with no symptoms of asthma underwent pulmonary function tests and assessment of symptoms before and after one-month treatment with inhalational steroid nasal spray (Fluticasone Furoate), in the standard adult dosage. Based on TNSS (Total nasal symptom score) and TOSS (Total ocular symptom score), all 50 patients showed significant improvement after treatment. Among 20 patients with > 50 eosinophils per high power field, 80% had 0-10 eosinophils per high power field on nasal smear after treatment. Among 40 patients with mild large airway obstruction, 37 showed significant improvement in FEV1 data. Also FEV1/FVC data showed significant improvement. Significant improvement (FEF25-75 > 50%) was also noticed in small airway disease after treatment among the 5 patients. The study showed that lower airway hyper responsiveness coexists with allergic rhinitis and treating allergic rhinitis with just steroid nasal spray assists in reducing the former, supporting the concept of Unified Airway Disease (UAD).
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Affiliation(s)
| | - Suresh Pillai
- Dept of Otorhinolaryngolgy- Head & Neck Surgery, Kasturba Medical College Hospital, MAHE, Manipal, Karnataka India
| | | | - Shama Shetty
- Dept of Otorhinolaryngolgy- Head & Neck Surgery, Kasturba Medical College Hospital, MAHE, Manipal, Karnataka India
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Gülhan PY, Arbak PM, Annakkaya AN, Balbay EG, Balbay ÖA. An assessment of post-COVID-19 infection pulmonary functions in healthcare professionals. Am J Infect Control 2022; 50:1125-1132. [PMID: 35870662 PMCID: PMC9296374 DOI: 10.1016/j.ajic.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The medium- and long-term effects of COVID-19 infection on pulmonary function are still unknown. The present study aimed to investigate the pulmonary functions in healthcare professionals who had persistent complaints after contracting COVID-19 and returning to work. METHODS The study included COVID-19-infected healthcare professionals from the Düzce University Medical Faculty Hospital who volunteered to participate. Medical histories, medical records, pulmonary function tests, the diffusing capacity of the lungs for carbon monoxide (DLCO) test, and the 6-minute walk test (6MWT) were used to collect data from all participants. RESULTS The study included 53 healthcare professionals, with an average age of 38 ± 10 years (min: 24 years and max: 71 years), including 29 female (54.7%) and 24 male (45.3%) participants. Of the participants, 22.6% were smokers, 35.8% (19 individuals) had comorbidities, and 17% (9 individuals) were hospitalized. The mean length of stay was 9 ± 4 days (mean ± standard deviation). The most prevalent symptoms were weakness (88.7%), muscle aches (67.9%), inability to smell/taste (60.4%), headache (54.7%), fever (45.3%), cough (41.5%), and shortness of breath (37.7%). The mean time to return to work after a positive polymerase chain reaction (PCR) test for COVID-19 was 18 ± 13 days. The average time among post-disease pulmonary function, 6MW, and DLCO tests was 89 ± 36 days (min: 15 and max: 205). The DLCO level decreased in 39.6% (21) of the participants. Female participants had a significantly higher rate of decreased DLCO levels than male participants (25% vs. 55.2%, P = .026). DLCO levels were significantly higher in participants with long-term persistent complaints (P = .043). The later the time to return to work, the lower the DLCO value (r = -0.290 and P = .035). The 6MWT distance was positively correlated with hemoglobin and lymphocyte levels at the time of the disease onset and negatively correlated with D-dimer levels. The most prevalent symptoms during the control visits were shortness of breath/effort dyspnea (24.6%), weakness (9.5%), and muscle aches (7.6%). CONCLUSION Significant persistent complaints (47.2%) and low DLCO levels (39.6%) were observed in healthcare professionals during control visits at a mean time of 3 months after the COVID-19 infection. Symptoms and spirometry measurements, including DLCO, may be helpful in the follow-up of healthcare professionals who contracted COVID-19. Further comprehensive studies with long-term follow-up periods are required.
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Affiliation(s)
- Pınar Y. Gülhan
- Address correspondence Pınar Yıldız, Department of Chest Diseases, Duzce University Faculty of Medicine, Konuralp campus. 81010 Duzce, Turkey
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Chaudhary A, Harshvardhan R, Meena R, Sharma S, Sharma BB, Agarwal S, Sehra R. A Study of Pulmonary Function Tests in Patients with Chronic Rhinosinusitis Following Endoscopic Sinus Surgery. Indian J Otolaryngol Head Neck Surg 2022; 74:1597-1604. [PMID: 36452847 PMCID: PMC9701940 DOI: 10.1007/s12070-021-02759-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022] Open
Abstract
Chronic inflammatory disorders of the upper airways are extremely prevalent and they have a major impact on public health.To assess the change in pulmonary function tests in patients of chronic rhinosinusitis undergoing functional endoscopic sinus surgery pre operatively and post operatively.To evaluate the difference in mean of FEV1, FEV1%, FVC, FVC%, FEV1/FVC in patients of chronic rhinosinusitis undergoing functional endoscopic sinus surgery.Prospective observational study.From July 2019 to September 2020 in Department of ENT and Head & Neck surgery, SMS Medical College, Jaipur.There was a significant improvement in the mean FEV1, FEV1%, FVC, and FVC% values post-surgically (p < 0.05). In our study, there was also a significant improvement in the FEV1/FVC value at one month postoperatively, reflecting the effect of FESS on relieving the symptomatic lower airway obstruction.Our study concludes that following Functional Endoscopic Sinus Surgery there is significant improvement in pulmonary function tests reflecting the improvement of asymptomatic lower airway disease in cases of chronic rhinosinusitis.
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Affiliation(s)
- Ankita Chaudhary
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, Rajasthan India
| | - Rekha Harshvardhan
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, Rajasthan India
| | - Ramlakhan Meena
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, Rajasthan India
| | - Shraddha Sharma
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, Rajasthan India
| | - Bharat Bhushan Sharma
- Department of Medicine, Head of Allergy and Pulmonary Medicine Division, SMS Medical College, Jaipur, Rajasthan India
| | - Sunita Agarwal
- Department of Otorhinolaryngology, SMS Medical College, Jaipur, Rajasthan India
| | - Ritu Sehra
- Ministry of Health and Family Welfare, Jaipur, Rajasthan India
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Saad-Hussein A, Moubarz G, Mahdy-Abdallah H, Helmy MA. Impact of mannose-binding lectin gene polymorphism on lung functions among workers exposed to airborne Aspergillus in a wastewater treatment plant in Egypt. Environ Sci Pollut Res Int 2022; 29:63193-63201. [PMID: 35449337 PMCID: PMC9477903 DOI: 10.1007/s11356-022-20234-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
In this study, the risk of Aspergillus (Asp.) positivity and its respiratory health impacts on wastewater treatment plant (WWTP) workers were studied. In addition, it identified the geno-susceptibility role of mannose-binding lectin 2 (MBL2) gene polymorphisms and the mannose-binding lectin (MBL) serum levels on the pulmonary functions of the Asp.-positive workers. Pulmonary function tests (PFTs) were performed for 89 workers from a selected WWTP, after exclusion of the smokers. Molecular identification of Asp. blood positivity was done by 18S rRNA sequencing. Determination of MBL2 gene polymorphism and estimation of MBL serum levels were done. PFTs revealed abnormalities in 49.2% of the workers. Asp. was positive in 42.5% of the workers with different species. Among the Asp.-positive workers, 6.5% of the workers were with obstructive PFTs, 12.9% with restriction, and 22.6% with combined PFT abnormalities. MBL2 genotyping showed that wild genotype AA was common (68.5%) among Asp.-positive workers compared to the other genotypes. This allele, whether homozygous or heterozygous, was significantly associated with decline in PFTs of the exposed workers. MBL serum levels were significantly lower in workers with obstructive, restrictive, and combined PFT abnormalities compared to those with normal PFTs, and in the workers with Asp.-positive species than the Asp.-negative workers. Moreover, it was significantly lower in workers with Asp. fumigatus compared to that in the workers with other Asp. species, and in the Asp.-positive workers with homozygous or heterozygous A allele compared to that in the Asp.-positive workers with homozygous B allele. Working in a WWTP can be associated with impaired PFTs due to exposure to airborne fungi. MBL2 genotyping showed that Asp.-positive workers with homozygous or heterozygous A allele were at risk to develop decline in their PFTs.
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Affiliation(s)
- Amal Saad-Hussein
- Environmental and Occupational Medicine Department, National Research Centre, Environment and Climate Change Research Institute, Cairo, Egypt
| | - Gehan Moubarz
- Environmental and Occupational Medicine Department, National Research Centre, Environment and Climate Change Research Institute, Cairo, Egypt
| | - Heba Mahdy-Abdallah
- Environmental and Occupational Medicine Department, National Research Centre, Environment and Climate Change Research Institute, Cairo, Egypt.
| | - Mona Adel Helmy
- Environmental and Occupational Medicine Department, National Research Centre, Environment and Climate Change Research Institute, Cairo, Egypt
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Prashanth JB, Reddy KRBK, Nanjundappa N. Evaluation of Pulmonary Functions in Children with Type 1 Diabetes Mellitus: A Case-Control Study. Indian J Pediatr 2022; 89:801-803. [PMID: 35099717 DOI: 10.1007/s12098-021-04059-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/25/2021] [Indexed: 11/05/2022]
Abstract
Type 1 diabetes mellitus (T1DM) is one of the most prevalent chronic diseases in children and adolescents with the risk of development and progression of chronic complications. This study evaluates the pulmonary functions with spirometry in children with T1DM in relation with glycemic control. Ninety-six children with T1DM were matched with 102 healthy controls. All the spirometry parameters including FVC, FEV1, FEV1/FVC, PEFR, and MMFR were significantly reduced (p = < 0.001) in T1DM patients when compared with the controls. Compared to the children with fair glycemic control, the children with poor glycemic control were seen to have a significant decrease in FEV1 (p = 0.001) and FVC (p = 0.001) with no significant change in FEV1/FVC ratio (p = 0.9), PEFR (p = 0.4) and MMFR (p = 0.1). Restrictive lung pattern was the most common pulmonary dysfunction in children with T1DM and it worsened with poor glycemic control. This necessitates the need for adequate glycemic control and periodic lung function assessment.
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Affiliation(s)
- J B Prashanth
- Department of Pediatrics, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, 560029, India.
| | - K R Bharath Kumar Reddy
- Department of Pediatrics, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, 560029, India
| | - Nijaguna Nanjundappa
- Department of Pediatrics, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, 560029, India
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R PH, Gopalakrishna Mithra CA, Ratageri VH. Pulmonary Function Tests in Childhood Asthma: Which indices are Better for Assessment of Severity? Indian J Pediatr 2022; 90:566-571. [PMID: 35834127 DOI: 10.1007/s12098-022-04258-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study pulmonary function tests in childhood asthma and to determine which indices are better for assessment of severity. METHODS This was a hospital-based, cross-sectional study. All consecutive children aged between 5 and 15 y with mild and severe persistent asthma were enrolled. Children in whom diagnosis of asthma was doubtful and those with chronic lung disease or suppurative lung disease were excluded. Diagnosis and classification was based on GINA guidelines. Age-/sex-matched controls who did not have history of wheezing any time in the past were selected. Detailed spirometry was performed on all children enrolled using RMS HELIOS 401. RESULTS A total of 144 children were enrolled in the study (48 children in each group, i.e., control, mild and severe). Mean age of the study population was 9.06 ± 2.604 y with M:F ratio of 1.9:1. Mean percent of predicted values of FEV1, FVC, FEV1/FVC, FEF25-75, and PEFR in the control group was 94.83, 92.63, 103.25, 73.90, and 93.60; in the mild group was 90.58, 83.52, 111.10, 76.50, and 92.00; and in the severe group 57.56, 62.83, 92.85, 40.15, and 62.12, respectively. Values of all the indices decreased with increase in severity. FEV1 (95% CI: 0.884 to 0.971) having the highest correlation coefficient (-0.652) with respect to severity of asthma and FEV1/FVC having the least (-0.202). FEF25-75 (95% CI: 0.652 to 0.803) having a higher area under the curve, was a better spirometric parameter in predicting mild asthma. CONCLUSION FEV1 was better index for assessing severity of asthma and FEF25-75 better in predicting mild asthma.
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Affiliation(s)
- Puneeth H R
- Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, Karnataka, 580021, India
| | - C A Gopalakrishna Mithra
- Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, Karnataka, 580021, India
| | - Vinod H Ratageri
- Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, Karnataka, 580021, India.
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Bouriez D, Belaroussi Y, Boubaddi M, Martre P, Najah H, Berger P, Gronnier C, Collet D. Laparoscopic fundoplication for para-oesophageal hernia repair improves respiratory function in patients with dyspnoea: a prospective cohort study. Surg Endosc 2022; 36:7266-7278. [PMID: 35732837 PMCID: PMC9216289 DOI: 10.1007/s00464-022-09127-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/07/2022] [Indexed: 01/20/2023]
Abstract
Background Dyspnoea in patients with a para-oesophageal hernia (PEH) occurs in 7% to 32% of cases and is very disabling, especially in elderly patients, and its origin is not well defined. The present study aims to assess the impact of PEH repair on dyspnoea and respiratory function. Methods From January 2019 to May 2021, all consecutive patients scheduled for PEH repair presenting with a modified Medical Research Council (mMRC) score ≥ 2 for dyspnoea were included. Before and 2 months after surgery, dyspnoea was assessed by both the dyspnoea visual analogue scale (DVAS) and the mMRC scale, as well as pulmonary function tests (PFTs) by plethysmography. Results All 43 patients that were included had pre- and postoperative dyspnoea assessments and PFTs. Median age was 70 years (range 63–73.5 years), 37 (86%) participants were women, median percentage of the intrathoracic stomach was 59.9% (range 44.2–83.0%), and median length of hospital stay was 3 days (range 3–4 days). After surgery, the DVAS decreased statistically significant (5.6 [4.7–6.7] vs. 3.0 [2.3–4.4], p < 0.001), and 37 (86%) patients had a clinically significant decrease in mMRC score. Absolute forced expiratory volume in one second (FEV1), total lung capacity, and forced vital capacity also statistically significantly increased after surgery by an average of 11.2% (SD 17.9), 5.0% (SD 13.9), and 10.7% (SD 14.6), respectively. Furthermore, from the subgroup analysis, it was identified that patients with a lower preoperative FEV1 were more likely to have improvement in it after surgery. No correlation was found between improvement in dyspnoea and FEV1. There was no correlation between the percentage of intrathoracic stomach and dyspnoea or improvement in PFT parameters. Conclusion PEH repair improves dyspnoea and FEV1 in a statistically significant manner in a population of patients presenting with dyspnoea. Patients with a low preoperative FEV1 are more likely to have improvement in it after surgery.
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Affiliation(s)
- Damien Bouriez
- Esophagogastric Surgery Unit, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France
| | - Yaniss Belaroussi
- Thoracic Surgery Unit, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France
- INSERM, Bordeaux Population Health Research Center, ISPED, University of Bordeaux, 33076, Bordeaux, France
| | - Mehdi Boubaddi
- Esophagogastric Surgery Unit, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France
| | - Paul Martre
- Esophagogastric Surgery Unit, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France
| | - Haythem Najah
- Esophagogastric Surgery Unit, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France
| | - Patrick Berger
- Pulmonary Function Tests Department, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France
- University of Bordeaux, Bordeaux, France
| | - Caroline Gronnier
- Esophagogastric Surgery Unit, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France.
- University of Bordeaux, Bordeaux, France.
- INSERM, U1053, Bordeaux, France.
| | - Denis Collet
- Esophagogastric Surgery Unit, Haut Lévêque Hospital, CHU Bordeaux, Bordeaux, France
- University of Bordeaux, Bordeaux, France
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Aiolfi A, Cavalli M, Sozzi A, Lombardo F, Mendogni P, Nosotti M, Bonitta G, Bruni PG, Campanelli G, Bona D. Paraesophageal hernia repair with laparoscopic Toupet fundoplication: impact on pulmonary function, respiratory symptoms and quality of life. Hernia 2022. [PMID: 35578061 DOI: 10.1007/s10029-022-02623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Paraesophageal hiatal hernia (PEH) is characterized by protrusion of intra-abdominal organs into the posterior mediastinum. Respiratory symptoms and reduced pulmonary function have been described as possibly related to lung compression. OBJECTIVE To assess the effect of laparoscopic Toupet fundoplication (LTF) for PEH repair on pulmonary function, measured with pulmonary function tests (PFTs), and respiratory symptoms. METHODS Retrospective, single-center, cohort study (November 2015-2020). All patients that completed pre- and postoperative (12 months) PFTs assessment were included. The gastroesophageal reflux disease health-related quality of life (GERD-HRQL), reflux symptom index (RSI) and short form-36 (SF-36) were used. RESULTS Overall, 71 patients were included. The median age was 67.1 years and the majority were females (78.8%). Baseline PFTs were within normal limits in 91% of patients. At 12 month follow-up, total lung capacity (TLC) (4.77 vs. 5.07 L; p = 0.0251), vital capacity (VC) (2.97 vs. 3.31 L; p = 0.0065), forced expiratory volume in one second (FEV1) (2.07 vs. 2.44 L; p < 0.001) and forced vital capacity (FVC) (2.78 vs. 3.19 L; p < 0.001) were significantly improved. No significant differences were found for diffusing capacity of lung for carbon monoxide (DLCO) (17.09 vs. 17.24; p = 0.734), and FEV1/FVC (0.77 vs. 0.77; p = 0.967). Interestingly, improvements were more pronounced in patients with large PEH (type IIIb and IV). At 12 month follow-up, both gastrointestinal and respiratory symptoms were significantly improved and 94% of patients were satisfied with the operation. The GERD-HRQL (18.1 ± 7.9 vs. 4.01 ± 2.4; p = 0.001), RSI (37.8 ± 9.7 vs. 10.6 ± 8.9; p < 0.001) and all SF-36 items were improved. CONCLUSIONS LTF for the treatment of PEH is safe and seems to be effective up to 12 month follow-up with improved lung volumes, spirometry values, quality of life, gastrointestinal and respiratory symptoms.
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Bonella F, Cottin V, Valenzuela C, Wijsenbeek M, Voss F, Rohr KB, Stowasser S, Maher TM. Meta-Analysis of Effect of Nintedanib on Reducing FVC Decline Across Interstitial Lung Diseases. Adv Ther 2022; 39:3392-3402. [PMID: 35576048 PMCID: PMC9239974 DOI: 10.1007/s12325-022-02145-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022]
Abstract
Introduction The effect of nintedanib on slowing the rate of decline in forced vital capacity (FVC) has been investigated in randomized placebo-controlled trials in subjects with idiopathic pulmonary fibrosis (IPF), other progressive fibrosing interstitial lung diseases (ILDs), and ILD associated with systemic sclerosis (SSc-ILD). We assessed the consistency of the effect of nintedanib on the rate of decline in FVC over 52 weeks across four placebo-controlled phase III trials. Methods We used data on FVC decline from the INPULSIS-1 and INPULSIS-2 trials in subjects with IPF, the INBUILD trial in subjects with progressing fibrosing ILDs other than IPF, and the SENSCIS trial in subjects with SSc-ILD. In each trial, the primary endpoint was the annual rate of decline in FVC (mL/year) assessed over 52 weeks. We performed fixed effect and random effects meta-analyses based on the relative treatment effect of nintedanib versus placebo on the rate of decline in FVC (mL/year) over 52 weeks. Heterogeneity of the relative treatment effect of nintedanib across populations was assessed using the I2 statistic, τ2 and corresponding p value from a Q test for heterogeneity. Results The combined analysis comprised 1257 subjects treated with nintedanib and 1042 subjects who received placebo. Nintedanib reduced the rate of decline in FVC (mL/year) over 52 weeks by 51.0% (95% CI 39.1, 63.0) compared with placebo. The relative effect (95% CI) was the same using the fixed effect and random effects models. There was no evidence of heterogeneity in the relative treatment effect of nintedanib across the populations studied (I2 = 0%, τ2 = 0, p = 0.93). Conclusions A meta-analysis of data from four placebo-controlled trials demonstrated that nintedanib approximately halved the rate of decline in FVC over 52 weeks across subjects with different forms of pulmonary fibrosis, with no evidence of heterogeneity in its relative treatment effect across patient populations. Graphical abstract ![]()
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Affiliation(s)
- Francesco Bonella
- Interstitial and Rare Lung Disease Unit, Pneumology Department, Ruhrlandklinik, Duisburg-Essen University, Essen, Germany.
| | - Vincent Cottin
- National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1, UMR 754, Lyon, France
| | - Claudia Valenzuela
- Hospital Universitario de la Princesa, Universidad Autonoma de Madrid, Madrid, Spain
| | - Marlies Wijsenbeek
- Centre for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Florian Voss
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - Klaus B Rohr
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Susanne Stowasser
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Toby M Maher
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Alavinezhad A, Ghorani V, Rajabi O, Boskabady MH. Zataria multiflora extract influenced asthmatic patients by improving respiratory symptoms, pulmonary function tests and lung inflammation. J Ethnopharmacol 2022; 285:114888. [PMID: 34863879 DOI: 10.1016/j.jep.2021.114888] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/23/2021] [Accepted: 11/29/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Anti-inflammatory and anti-oxidant effects of Zataria multiflora Boiss (Z. multiflora) were reported in previous studies which is using in traditional and modern medicine. This plant is traditional used as an anti-tussive agent and for the management of respiratory disorders. AIM OF THE STUDY The preventive effect of the extract of leaves and stems of Z. multiflora on respiratory symptoms, pulmonary function tests, hematological indices, high sensitivity C-reactive protein (hs-CRP), level of interleukin-10 (IL-10) in the serum and supernatant of cultured peripheral blood mononuclear cells (PBMC) and gene expression of IL-10 in these cells in asthmatic patients was studied. MATERIALS AND METHODS 36 asthmatic patients in three groups (randomly divided) of placebo group (P), two groups treated with 5 and 10 mg/kg/day doses of Z. multiflora (Z5 and Z10) for two months completed the study. Drugs were administered double-blindly and different variables were assessed before and after (one and two months) starting treatment including respiratory symptoms, pulmonary function tests (PFT), hematological indices, hs-CRP, serum and supernatant levels as well as gene expression of IL-10. RESULTS Two months treatment with Z5 and Z10 led to significant reduction of respiratory symptoms (p < 0.05 to p < 0.001). Pulmonary function test values in treated groups were also significantly increased two months after starting treatment (p < 0.05 to p < 0.001). Total WBC, monocytes and eosinophils were also decreased in treated groups with the extract at the end of study period (p < 0.05 to p < 0.01). Hemoglobin and hematocrit in Z10 treated group (p < 0.05 and p < 0.01, respectively) and mean corpuscular volume (MCV) in both treated groups (p < 0.05 to p < 0.01) were significantly reduced. In addition, the level of hs-CRP in both treated groups was significantly reduced after two months (p < 0.05 to p < 0.01). IL-10 concentration in Z10 treated group in supernatant of PBMC was also significantly enhanced (p < 0.01). All comparisons were made compared to the baseline (beginning of the treatment) values. CONCLUSION Z. multiflora improved respiratory symptoms and increased pulmonary function tests in asthmatic patients. In addition, the plant was effective in decrement of inflammatory cells and hs-CRP as well as enhanced IL-10. Therefore, the plant showed possible preventive therapeutic effect on asthma.
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Affiliation(s)
- Azam Alavinezhad
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahideh Ghorani
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Clinical Research Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Rajabi
- Department of Drug and Food Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Lee SY, Ryu CG, Koo YH, Cho H, Jung H, Park YH, Kang H, Lee SE, Shin HY. The effect of ultrasound-guided transversus abdominis plane block on pulmonary function in patients undergoing laparoscopic cholecystectomy: a prospective randomized study. Surg Endosc 2022; 36:7334-7342. [PMID: 35182213 DOI: 10.1007/s00464-022-09131-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Transversus abdominis plane block (TAPB) is commonly used for postoperative pain control after laparoscopic cholecystectomy. However, few studies have analyzed its effect on pulmonary function. The goal of this study was to elucidate the effect of ultrasound-guided bilateral TAPB on pulmonary function preservation and analgesia after laparoscopic cholecystectomy. METHODS We enrolled 58 patients who underwent laparoscopic cholecystectomy. Among them, 53 were randomized to group T (n = 27) and group C (n = 26). Group T and group C received ultrasound-guided bilateral TAPB with 40 ml of 0.375% ropivacaine and 40 ml of 0.9% normal saline, respectively. Visual analog scale (VAS) scores, patient-controlled analgesia (PCA) consumption, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow rate (PEF), and modified Borg scale scores were measured until 24 h post-surgery. RESULTS The VAS scores were significantly lower in group T than in group C at 1 and 8 h after the surgery. PCA consumption was significantly lower in group T than in group C at all postoperative time points. FEV1, PEF, and FEV1/FVC were more preserved in group T than in group C at 1 h. Group T had significantly lower modified Borg scale scores than did group C at 1 and 8 h. CONCLUSION Ultrasound-guided TAPB is effective in pulmonary function preservation and pain control after laparoscopic cholecystectomy. Therefore, it could be a great option for multimodal analgesia, preservation of pulmonary function, prevention of pulmonary complications including atelectasis, and promotion of postoperative recovery after laparoscopic cholecystectomy. CLINICAL REGISTRATION This study was enrolled in the Clinical Research Information Service (Clinical Research Information Service, KCT0004435, Hwa Yong Shin, 2019-08-19).
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Affiliation(s)
- Seung Young Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Choon Gun Ryu
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Young Hyun Koo
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Hana Cho
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Haesun Jung
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Yong Hee Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Seung Eun Lee
- Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Hwa Yong Shin
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea.
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Öztürk GK, Beken B, Doğan S, Akar HH. Pulmonary function tests in the follow-up of children with COVID-19. Eur J Pediatr 2022; 181:2839-47. [PMID: 35522314 DOI: 10.1007/s00431-022-04493-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/03/2022]
Abstract
The SARS-CoV-2 virus has infected more than 235 million people since it was accepted as a pandemic in March 2020. Although a milder disease is seen in the pediatric age group, the extent of lung damage and its long-term effects are still unknown. In this study, persistent respiratory symptoms and pulmonary function tests were investigated in children with COVID-19. Fifty children with a confirmed diagnosis of COVID-19 were included in the study. Patients were evaluated for ongoing respiratory symptoms and pulmonary function tests 3 months after infection. Patients with and without persistent symptoms were compared in terms of demographic, clinical, laboratory, and radiological characteristics and also disease severity. Three months after infection, persistent respiratory symptoms were found to be present in 28% of patients; cough, chest pain and tightness, dyspnea, and exertional dyspnea were the most common symptoms. Three patients had an obstructive deficit, and one had a restrictive deficit. Four patients had impaired diffusing capacity of the lungs for carbon monoxide (DLCO). A significant decrease in FEV1/FVC and an increase in lung clearance index were found in the patients with persistent respiratory symptoms. Persistent respiratory symptoms were present in 50% of patients who had severe disease and 12.5% with non-severe disease. DLCO was also significantly lower in the severe disease group. Conclusions: Our study suggests that the persistence of respiratory symptoms is not related to the severity of acute COVID-19 in children. The inflammatory process due to COVID-19 may continue regardless of its severity, and consequently, peripheral airways may be affected. What is Known: • As compared with adults, children with COVID-19 exhibit a milder disease course and lower mortality rates. However, due to the lack of follow-up studies on children, the long-term effects of their contracting the disease are unknown. What is New: • Although COVID-19 has been thought to have a milder course in children, respiratory system symptoms persist in approximately 30% of patients 3 months after infection. The persistent respiratory symptoms suggest that the inflammatory process due to COVID-19 may continue in some children, even if the clinical findings at admission are not severe, and that the peripheral airways may be affected accordingly.
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Marzban-Rad S, Bozorgmehr R, Sattari P, Azimi G, Azimi A. Radical extrapleural pneumonectomy with bronchial fistula by pulmonary function test evaluation technique. Ann Med Surg (Lond) 2021; 72:103071. [PMID: 34840777 PMCID: PMC8605380 DOI: 10.1016/j.amsu.2021.103071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 10/24/2022] Open
Abstract
Introduction and importance: Pulmonary Function Tests (PFTS) is an important tool in the assessment of pulmonary pathologies and preoperative evaluation. Case presentation: A 54-year-old man with history of massive pleurisy in the left thorax, treated by placing chest tube and drainage of bloody effusion, was readmitted for epithelioid mesothelioma. He was then presented with pneumothorax due by a refractory bronchial fistula while having a plural catheter. Based on the consultation, the whole-body bone scan was conducted, and findings demonstrated epithelioid mesothelioma (stage 1) with the refractory fistula for which the patient was candidate for thoracic surgery. Decreased lung capacity was seen by Pulmonary Function Testing - PFTS. Clinical discussion The novel PFTS Evaluation Technique was designed to measure the true pulmonary capacities in order to evaluate the pulmonary post-operative tolerance. In this technique the chest tube was placed for 4 weeks until the patient reaches mediastinal fixation then the measurements by PFTS were carried out in two steps. First, using an open chest tube and second, using a clamped chest tube. In both steps, the pulmonary capacities were measured and provided to the pulmonologist for consultation. Conclusion In this case, after acquiring the approval of the specialist depended on PFTS after PFTS Evaluation Technique, the radical extra pleural pneumonectomy surgery was conducted, and the patient was discharged with a good general appearance and treated fistula.
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Affiliation(s)
- Saeid Marzban-Rad
- Department of Thoracic Surgery, Imam-Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
| | - Rama Bozorgmehr
- Clinical Research Development Unit, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parastesh Sattari
- General Practitioner, Institute of Health Education and Research, Chamran Hospital, Tehran, Iran
| | - Ghasem Azimi
- Department of Internal Medicine, School of Medicine, Shahed University, Tehran, Iran
| | - Ali Azimi
- Student of Research Committee, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Mohammed SH, Jabbr AS, Ibrahim NK. Impact of parasitic infection with Ascaris lumbricoides on pulmonary function tests in asthmatic and non-asthmatic children. Respir Med Case Rep 2021; 34:101552. [PMID: 34820258 PMCID: PMC8600146 DOI: 10.1016/j.rmcr.2021.101552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background There is strong evidence for a causal relationship between helminthes infection and allergic disease like asthma due to the similarity in the way they respond. This study aimed to investigate the effects of Ascaris infection on pulmonary function tests (PFTs) to reveal the relationship between ascariasis and asthma in children. Patients and methods This a randomized-control study conducted in Basrah City, Iraq, in which four groups of a total of 490 children were enrolled: Group1 included 120 normal children; Group 2 included 135 asthmatic children; Group 3 who were 150 Ascaris infected children and group G4 included 85 asthmatic and Ascaris infected. PFTs, IgE level, differential blood count and parasitic examination were done for all groups. Results Both group2 and 4, which included asthmatic children showed a significant decrease in PFT (P > 0.05),while the PFT of parasitic infected group was not affected. There were no significant changes in WBC, eosinophils and IgE between asthmatic and parasitic infected groups. Conclusion Ascaris infection could induce the inflammatory immune response in children, but couldn't cause a significant effect on pulmonary function tests in these children; The impairment in PFT was due to asthma disease and not correlated to ascariasis.
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Affiliation(s)
- Suha Haithem Mohammed
- Department of Clinical Laboratory Sciences, College of Pharmacy, University of Basrah, Iraq
| | - Azza Sajid Jabbr
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Basrah, Iraq
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Reuss JE, Brigham E, Psoter KJ, Voong KR, Shankar B, Ettinger DS, Marrone KA, Hann CL, Levy B, Feliciano JL, Brahmer JR, Feller-Kopman D, Lerner AD, Lee H, Yarmus L, Hales RK, D'Alessio F, Danoff SK, Forde PM, Suresh K, Naidoo J. Pretreatment Lung Function and Checkpoint Inhibitor Pneumonitis in NSCLC. JTO Clin Res Rep 2021; 2:100220. [PMID: 34746881 PMCID: PMC8552105 DOI: 10.1016/j.jtocrr.2021.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/12/2021] [Accepted: 08/06/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Checkpoint inhibitor pneumonitis (CIP) is a serious toxicity of anti-programmed death-(ligand) 1 immunotherapy. Whether pretreatment differences in pulmonary function exist in patients who develop CIP is unknown. We analyzed the pulmonary function tests (PFTs) of patients with NSCLC treated with immune checkpoint inhibitors (ICIs) to evaluate whether pretreatment lung function was associated with CIP development. Methods Patients were included if they completed greater than or equal to 1 PFT within 2 years preceding ICI initiation. CIP status (CIP+: developed CIP, CIP-: did not develop CIP) was determined clinically. Generalized estimating equation-based linear regression was used to evaluate the effects of time and CIP on lung function. Primary outcomes included the following: percent-predicted forced expiratory volume in 1 second (FEV1pp), percent-predicted forced vital capacity (FVCpp), and FEV1/FVC. Results A total of 43 patients (34 CIP-, 9 CIP+) with 79 PFTs (59 CIP-, 20 CIP+) were included. CIP+ patients had a 21.7% lower pretreatment FEV1pp compared with the CIP- group (95% confidence interval: -38.6 to -4.7). No statistically significant differences in FVCpp or FEV1/FVC were observed. The prevalence of obstructive lung disease was similar in both groups at 67% and 62% for the CIP+ and CIP- cohorts, as was the prevalence of current/former smoking at 100% and 93%, respectively. Conclusions Pretherapy differences in lung function were evident between patients who did and did not develop CIP, though the prevalence of obstructive lung disease was similar. Prospective studies are needed to validate these findings, inform potential risk factors for CIP, and investigate the effects of ICI treatment and CIP on pulmonary function in patients with NSCLC.
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Affiliation(s)
- Joshua E Reuss
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
| | - Emily Brigham
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kevin J Psoter
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Khinh Ranh Voong
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bairavi Shankar
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David S Ettinger
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kristen A Marrone
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
| | - Christine L Hann
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
| | - Benjamin Levy
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
| | - Josephine L Feliciano
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
| | - Julie R Brahmer
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
| | - David Feller-Kopman
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrew D Lerner
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hans Lee
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lonny Yarmus
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Russell K Hales
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Franco D'Alessio
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sonye K Danoff
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patrick M Forde
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
| | - Karthik Suresh
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jarushka Naidoo
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, Maryland
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Nasser M, Si-Mohamed S, Turquier S, Traclet J, Ahmad K, Philit F, Bonniaud P, Chalabreysse L, Thivolet-Béjui F, Cottin V. Nintedanib in idiopathic and secondary pleuroparenchymal fibroelastosis. Orphanet J Rare Dis 2021; 16:419. [PMID: 34627338 PMCID: PMC8501734 DOI: 10.1186/s13023-021-02043-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 09/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Pleuroparenchymal fibroelastosis (PPFE) has a variable disease course with dismal prognosis in the majority of patients with no validated drug therapy. This study is to evaluate the effect of nintedanib in patients with idiopathic and secondary PPFE. Patients admitted to a tertiary care center (2010–2019) were included into this retrospective analysis if they had a multidisciplinary diagnosis of PPFE, had been followed-up for 3 months or more, and had lung function tests and chest CTs available for review. Changes in pulmonary function tests were assessed using non-parametric tests and linear mixed effect model. Lung volumes were measured with lobar segmentation using chest CT. Results Out of 21 patients with PPFE, nine had received nintedanib, six had received another treatment and another six patients were monitored without drug therapy. Annual FVC (% of predicted) relative decline was − 13.6 ± 13.4%/year before nintedanib and − 1.6 ± 6.02%/year during nintedanib treatment (p = 0.014), whereas no significant change in FVC% relative decline was found in patients receiving another treatment (− 13.25 ± 34 before vs − 16.61 ± 36.2%/year during treatment; p = 0.343). Using linear mixed effect model, the slope in FVC was − 0.97%/month (95% CI: − 1.42; − 0.52) before treatment and − 0.50%/month (95% CI: − 0.88; 0.13) on nintedanib, with a difference between groups of + 0.47%/month (95% CI: 0.16; 0.78), p = 0.004. The decline in the upper lung volumes measured by CT was − 233 mL/year ± 387 mL/year before nintedanib and − 149 mL/year ± 173 mL/year on nintedanib (p = 0.327). Nintedanib tolerability was unremarkable. Conclusion In patients with PPFE, nintedanib treatment might be associated with slower decline in lung function, paving the way for prospective, controlled studies. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02043-5.
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Affiliation(s)
- Mouhamad Nasser
- Department of Respiratory Medicine, National Coordinating Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677, Lyon, France
| | - Salim Si-Mohamed
- Radiology Department, Hospices Civils de Lyon, Lyon, France.,CREATIS, CNRS UMR 5220, INSERM U1206, INSA-Lyon, University Claude Bernard Lyon1, Lyon, France
| | - Ségolène Turquier
- Department of Respiratory Physiology, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France
| | - Julie Traclet
- Department of Respiratory Medicine, National Coordinating Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677, Lyon, France
| | - Kaïs Ahmad
- Department of Respiratory Medicine, National Coordinating Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677, Lyon, France
| | - François Philit
- Department of Respiratory Medicine, Croix Rousse Hospital, Hospices Civil de Lyon, Lyon, France
| | - Philippe Bonniaud
- Department of Pulmonary Medicine and Intensive Care Unit, Constitutive Reference Center for Rare Pulmonary Diseases, François Mitterrand Teaching Hospital, Inserm U1231, University Bourgogne-Franche Comté, Dijon, France
| | - Lara Chalabreysse
- Department of Pathology, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.,UMR754, INRAE, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Françoise Thivolet-Béjui
- Department of Pathology, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.,UMR754, INRAE, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Vincent Cottin
- Department of Respiratory Medicine, National Coordinating Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, 28 avenue Doyen Lepine, 69677, Lyon, France. .,UMR754, INRAE, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
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Xu Q, Fang Y, Jing Q, Hu N, Lin K, Pan Y, Xu L, Gao H, Yuan M, Chu L, Ma Y, Xie Y, Chen J, Wang L. A portable triboelectric spirometer for wireless pulmonary function monitoring. Biosens Bioelectron 2021; 187:113329. [PMID: 34020223 PMCID: PMC8118703 DOI: 10.1016/j.bios.2021.113329] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/26/2021] [Accepted: 05/07/2021] [Indexed: 12/31/2022]
Abstract
Coronavirus disease 2019 (COVID-19) as a severe acute respiratory syndrome infection has spread rapidly across the world since its emergence in 2019 and drastically altered our way of life. Patients who have recovered from COVID-19 may still face persisting respiratory damage from the virus, necessitating long-term supervision after discharge to closely assess pulmonary function during rehabilitation. Therefore, developing portable spirometers for pulmonary function tests is of great significance for convenient home-based monitoring during recovery. Here, we propose a wireless, portable pulmonary function monitor for rehabilitation care after COVID-19. It is composed of a breath-to-electrical (BTE) sensor, a signal processing circuit, and a Bluetooth communication unit. The BTE sensor, with a compact size and light weight of 2.5 cm3 and 1.8 g respectively, is capable of converting respiratory biomechanical motions into considerable electrical signals. The output signal stability is greater than 93% under 35%-81% humidity, which allows for ideal expiration airflow sensing. Through a wireless communication circuit system, the signals can be received by a mobile terminal and processed into important physiological parameters, such as forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). The FEV1/FVC ratio is then calculated to further evaluate pulmonary function of testers. Through these measurement methods, the acquired pulmonary function parameters are shown to exhibit high accuracy (>97%) in comparison to a commercial spirometer. The practical design of the self-powered flow spirometer presents a low-cost and convenient method for pulmonary function monitoring during rehabilitation from COVID-19.
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Affiliation(s)
- Qinghao Xu
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China
| | - Yunsheng Fang
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Qingshen Jing
- Department of Materials Science and Metallurgy, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Ning Hu
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China
| | - Ke Lin
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Yifan Pan
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, 90007, USA
| | - Lin Xu
- Jiangsu Key Laboratory of New Power Batteries, Collaborative Innovation Center of Biomedical Functional Materials, School of Chemistry and Materials Science, Nanjing Normal University, Nanjing, Jiangsu, 210023, China
| | - Haiqi Gao
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China
| | - Ming Yuan
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China
| | - Liang Chu
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China
| | - Yanwen Ma
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China
| | - Yannan Xie
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China.
| | - Jun Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| | - Lianhui Wang
- State Key Laboratory of Organic Electronics and Information Displays & Institute of Advanced Materials, Jiangsu Key Laboratory for Biosensors, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing, Jiangsu, 210023, China.
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Wang Y, Chen S, Zheng S, Lin J, Hu S, Zhuang J, Lin Q, Xie X, Zheng K, Zhang W, Du G, Zhang G, Hoffmann-Vold AM, Matucci-Cerinic M, Furst DE. The role of lung ultrasound B-lines and serum KL-6 in the screening and follow-up of rheumatoid arthritis patients for an identification of interstitial lung disease: review of the literature, proposal for a preliminary algorithm, and clinical application to cases. Arthritis Res Ther 2021; 23:212. [PMID: 34391465 PMCID: PMC8364073 DOI: 10.1186/s13075-021-02586-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/04/2021] [Indexed: 02/05/2023] Open
Abstract
Screening and follow-up of interstitial lung disease associated with rheumatoid arthritis (RA-ILD) is a challenge in clinical practice. In fact, the majority of RA-ILD patients are asymptomatic and optimal tools for early screening and regular follow-up are lacking. Furthermore, some patients may remain oligosymptomatic despite significant radiological abnormalities. In RA-ILD, usual interstitial pneumonia (UIP) is the most frequent radiological and pathological pattern, associated with a poor prognosis and a high risk to develop acute exacerbations and infections. If RA-ILD can be identified early, there may be an opportunity for an early treatment and close follow-up that might delay ILD progression and improve the long-term outcome.In connective tissue disease-associated interstitial lung disease (CTD-ILD), lung ultrasound (LUS) with the assessment of B-lines and serum Krebs von den Lungen-6 antigen (KL-6) has been recognized as sensitive biomarkers for the early detection of ILD. B-line number and serum KL-6 level were found to correlate with high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), and other clinical parameters in systemic sclerosis-associated ILD (SSc-ILD). Recently, the significant correlation between B-lines and KL-6, two non-ionizing and non-invasive biomarkers, was demonstrated. Hence, the combined use of LUS and KL-6 to screen and follow up ILD in RA patients might be useful in clinical practice in addition to existing tools. Herein, we review relevant literature to support this concept, propose a preliminary screening algorithm, and present 2 cases where the algorithm was used.
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Affiliation(s)
- Yukai Wang
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China.
- Department of Experimental and Clinical Medicine & Division of Rheumatology, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy.
- Department of Geriatric Medicine, Division of Rheumatology, AOUC, Florence, Italy.
| | - Shaoqi Chen
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
| | - Shaoyu Zheng
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Jianqun Lin
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Shijian Hu
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Jinghua Zhuang
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Qisheng Lin
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Xuezhen Xie
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Kedi Zheng
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Weijin Zhang
- Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Guangzhou Du
- Department of Radiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Guohong Zhang
- Department of Pathology, Shantou University Medical College, Shantou, Guangdong, China
| | | | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine & Division of Rheumatology, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
- Department of Geriatric Medicine, Division of Rheumatology, AOUC, Florence, Italy
| | - Daniel E Furst
- Department of Experimental and Clinical Medicine & Division of Rheumatology, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy
- Department of Geriatric Medicine, Division of Rheumatology, AOUC, Florence, Italy
- Division of Rheumatology, Department of Medicine, University of California at Los Angeles, Los Angeles, USA
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Robey RC, Kemp K, Hayton P, Mudawi D, Wang R, Greaves M, Yioe V, Rivera-Ortega P, Avram C, Chaudhuri N. Pulmonary Sequelae at 4 Months After COVID-19 Infection: A Single-Centre Experience of a COVID Follow-Up Service. Adv Ther 2021; 38:4505-4519. [PMID: 34278556 PMCID: PMC8286847 DOI: 10.1007/s12325-021-01833-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION At the end of the first year of the COVID-19 pandemic, more than 78 million known survivors were recorded. The long-term pulmonary sequelae of COVID-19 remain unknown. METHODS We performed a retrospective analysis of a post-COVID follow-up service to estimate the burden of persistent pulmonary morbidity in hospitalised COVID survivors. RESULTS A total of 221 patients were followed-up: 44 intensive care unit (ICU) and 177 ward patients. Further investigations were planned as per British Thoracic Society Guidelines: For all ICU patients (n = 44) and for 38 of 177 (21%) ward-based patients who had persistent symptoms and/or persistent radiographic changes on CXR at their initial 8-week follow-up visit. In the ward-based cohort, statistically significant associations with persistent symptoms were being an ex- or current smoker, having pre-existing diabetes, and having a longer length of stay. In patients requiring further investigations, pulmonary function tests (PFTs; n = 67) at an average of 15 weeks post-discharge showed abnormalities in at least one PFT parameter in 79% (equating to 24% of the entire cohort). The most common abnormality was an abnormal diffusion capacity of carbon monoxide (TLCO), highest in the ICU cohort (64% ICU vs. 38% non-ICU). TLCO correlated negatively with length of stay and with maximum inspired FiO2 in the patient group as a whole. In ICU patients, TLCO correlated negatively with maximum inspired positive airway pressure. Computed tomography scans (n = 72) at an average of 18 weeks post-discharge showed evidence of persistent ground glass opacities in 44% and fibrosis in 21% (equating to 7% of the entire cohort). CONCLUSION Our data add to the growing evidence that there will be pulmonary sequelae in a proportion of COVID survivors, providing some insight into what may become a significant chronic global health problem.
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Affiliation(s)
- Rebecca C Robey
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK.
| | - Katie Kemp
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Philip Hayton
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Dalia Mudawi
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Ran Wang
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre and NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Melanie Greaves
- Department of Radiology, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Veronica Yioe
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Pilar Rivera-Ortega
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Cristina Avram
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Nazia Chaudhuri
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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Silva MC, Ladeira I, Lima R, Guimarães M. Pulmonary function tests: The patient´s perspective. Pulmonology 2021:S2531-0437(21)00132-X. [PMID: 34301515 DOI: 10.1016/j.pulmoe.2021.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/20/2022] Open
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Levin JC, Sheils CA, Gaffin JM, Hersh CP, Rhein LM, Hayden LP. Lung function trajectories in children with post-prematurity respiratory disease: identifying risk factors for abnormal growth. Respir Res 2021; 22:143. [PMID: 33971884 PMCID: PMC8112031 DOI: 10.1186/s12931-021-01720-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background Survivors of prematurity are at risk for abnormal childhood lung function. Few studies have addressed trajectories of lung function and risk factors for abnormal growth in childhood. This study aims to describe changes in lung function in a contemporary cohort of children born preterm followed longitudinally in pulmonary clinic for post-prematurity respiratory disease and to assess maternal and neonatal risk factors associated with decreased lung function trajectories. Methods Observational cohort of 164 children born preterm ≤ 32 weeks gestation followed in pulmonary clinic at Boston Children’s Hospital with pulmonary function testing. We collected demographics and neonatal history. We used multivariable linear regression to identify the impact of neonatal and maternal risk factors on lung function trajectories in childhood. Results We identified 264 studies from 82 subjects with acceptable longitudinal FEV1 data and 138 studies from 47 subjects with acceptable longitudinal FVC and FEV1/FVC data. FEV1% predicted and FEV1/FVC were reduced compared to childhood norms. Growth in FVC outpaced FEV1, resulting in an FEV1/FVC that declined over time. In multivariable analyses, longer duration of mechanical ventilation was associated with a lower rate of rise in FEV1% predicted and greater decline in FEV1/FVC, and postnatal steroid exposure in the NICU was associated with a lower rate of rise in FEV1 and FVC % predicted. Maternal atopy and asthma were associated with a lower rate of rise in FEV1% predicted. Conclusions Children with post-prematurity respiratory disease demonstrate worsening obstruction in lung function throughout childhood. Neonatal risk factors including exposure to mechanical ventilation and postnatal steroids, as well as maternal atopy and asthma, were associated with diminished rate of rise in lung function. These results may have implications for lung function trajectories into adulthood. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01720-0.
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Affiliation(s)
- Jonathan C Levin
- Division of Newborn Medicine, Boston Children's Hospital, 300 Longwood Ave Hunnewell 4, Boston, MA, 02115, USA. .,Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Catherine A Sheils
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Craig P Hersh
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Lawrence M Rhein
- Department of Pediatrics, University of Massachusetts, Worcester, MA, USA
| | - Lystra P Hayden
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Ghorani V, Alavinezhad A, Rajabi O, Boskabady MH. Carvacrol improves pulmonary function tests, oxidant/antioxidant parameters and cytokine levels in asthmatic patients: A randomized, double-blind, clinical trial. Phytomedicine 2021; 85:153539. [PMID: 33773189 DOI: 10.1016/j.phymed.2021.153539] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Carvacrol effects on inflammatory mediators, lung pathology and tracheal responsiveness were indicated in animal models of pulmonary diseases. PURPOSE To evaluate carvacrol effects on respiratory symptoms, pulmonary function tests (PFT), oxidative stress markers and cytokine levels in asthmatic patients. STUDY DESIGN This study was a randomized, placebo-controlled double-blind, clinical trial. METHODS Thirty-three moderate asthmatic patients were divided to the two groups of: placebo group (n = 16) and carvacrol group (1.2 mg/kg/day, n = 17). Prepared capsules were taken for two months along, 3 times/day along with routine medications. Respiratory symptoms, PFT, and oxidative stress markers were evaluated before the treatment (step 0), and one (step I) and two months (step II) after the beginning of the treatment. However, cytokine levels in serum and supernatant of peripheral blood mononuclear cells (PBMC), and their gene expression were evaluated in step 0 and II. RESULTS In carvacrol-treated group, respiratory symptoms significantly decreased after one- and two-month treatment with carvacrol compared to pre-treatment values (p < 0.05 to p < 0.001). Compared to step 0, PFT values were significantly increased in step I and II, in treated group with carvacrol (p < 0.05 to p < 0.001). Most oxidative stress markers were improved following carvacrol treatment (p < 0.05 to p < 0.001). Treatment with carvacrol for two-month also significantly improved cytokine levels in serum and supernatant of PBMC, compared to step 0 (p < 0.05 to p < 0.001). However, no significant changes were observed in the above-noted parameters in the placebo group. CONCLUSION Due to anti-inflammatory and antioxidant effect, carvacrol could be suggested as a therapeutic agent for asthma.
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Affiliation(s)
- Vahideh Ghorani
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Alavinezhad
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Rajabi
- Department of Drug and Food Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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