Impulse оscillometry in the diagnosis of moderate airway obstruction

Background: Impulse oscillometry (IOS) is a non-invasive method for determining respiratory impedance and its parameters. IOS has certain advantages over traditional spirometry. Aim: To assess the potential of IOS in the diagnosis of moderately severe airway obstruction. Methods: We examined 53 patients divided in two groups. The first group consisted of 29 patients (26 males and 3 females aged 42 to 89 years) with moderately severe obstructive abnormalities; the second group included 24 patients (17 males and 7 females aged from 18 to 68 years) without ventilatory defects. Results: Obstructive abnormalities were detected by IOS in 93% of patients in group 1, and the severity of obstruction was more pronounced compared to the results of spirometry in 37% of patients. In group 2, the IOS parameters were normal. There were significant differences in the lung function and IOS parameters between the first and second groups. There were significant correlations between airway resistance and IOS parameters in patients with moderately severe obstructive abnormalities. Conclusion: Thus impulse oscillometry can be used in the clinical practice to diagnose disorders of respiratory mechanics in patients with moderately severe airway obstruction.

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Factors affecting expression of estrus in dairy cows with high milk yields

Medycyna Weterynaryjna ◽

10.21521/mw.6011 ◽

2018 ◽

Vol 74 (1) ◽

pp. 6011-2018

Author(s):

AURIMAS GAVELIS ◽

VYTUOLIS ŽILAITIS ◽

ARŪNAS JUOZAITIS ◽

VIDA JUOZAITIENĖ ◽

GIEDRIUS PALUBINSKAS ◽

...

Keyword(s):

Dairy Cows ◽

Milk Yield ◽

Artificial Insemination ◽

Progesterone Concentration ◽

Factors Affecting ◽

Non Invasive ◽

Invasive Method ◽

Group 3 ◽

Group 2 ◽

Group 1

The objectives of this study were to define the effect of the milk progesterone (P4) concentration on estrus expression in dairy cows with high milk yield and to identify the effect of milk yield and parity on the milk P4 concentration and cow’s pregnancy after artificial insemination (AI). In this study, 48 clinically healthy cows without reproduction disorders, on day 90-100 after calving were used. At the beginning of estrus and 12 hours after the beginning of estrus, the milk P4 concentration in dairy cows with high milk yield (group 3) was higher than in group 2 (33.66; 22.36%) and in group 1 (51.60; 65.26%) (P <0.001). The milk P4 concentration in the ≥3 lactation cows was higher than the second (13.45%; P>0.05) and the first (28.28%; P<0.01) lactation ones (28.28%; P<0.01). The milk P4 concentration at the beginning of estrus and 12 hours after the beginning of estrus in pregnant and non-pregnant cows was 2.58 and 3.32; 4.20 and 5.00 ng/ml, respectively (P<0.001). As a result, it was concluded that high progesterone concentration affected the expression of estrus and pregnancy results in dairy cows, and the measuring of progesterone concentration in milk can be used as a non-invasive method to provide detailed information about fertility in high milk yield cows..

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Detailed pathologic evaluation of low dose CT (LDCT) detected stage I/0 lung adenocarcinomas (ADCA).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.8543 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 8543-8543

Author(s):

Eric Burks ◽

Jacob Sands ◽

Travis B. Sullivan ◽

Kimberly M. Rieger-Christ

Keyword(s):

Lymphatic Invasion ◽

Stage I ◽

Non Invasive ◽

Pathologic Evaluation ◽

Lower Stage ◽

Stage Ia ◽

Group 2 ◽

Lung Adenocarcinomas ◽

Lung Screening ◽

Group 1

8543 Background: Although LDCT lung screening improves survival, some worry that indolent BAC-like ADCA may be over-detected/treated. Comprehensive histologic subtyping has recently been adopted to improve grading and thus risk stratification in lung ADCA. We report a detailed pathologic comparison of stage I/0 lung ADCAs detected by LDCT screening vs. incidentally discovered ADCAs stratified by NCCN risk criteria. Methods: We performed comprehensive histologic subtyping on 35 consecutive stage I/0 LDCT screen detected ADCAs in patients meeting NCCN group 1/2 high risk (HR) criteria and compared to incidentally detected stage I/0 ADCAs meeting HR (n = 41) or low-risk (LR, n = 28) criteria. Results: Screen detected and incidentally detected ADCAs from HR groups show an equally low-rate of indolent, non-invasive/minimally invasive ADCAs (9%) compared to LR patients (36%). Aggressive solid predominant ADCAs were equally more frequent in HR patients from screen and incidentally detected patients (19%) compared to LR patients (6%). The rate of angiolymphatic invasion (59%) and air space invasion (32-34%) were similarly elevated in HR screen and incidental patients compared to LR patients (39% & 17% respectively). A collection of lepidic predominant (BAC-like) ADCAs associated with aggressive non-predominant cribriform and/or solid patterns, elevated mitotic rates, and high proportion of lymphatic invasion were uniquely observed in the screen-detected group (12%). Subgroup analysis of screen detected NCCN group 1 vs. 2 shows group 2 tumors exhibit histologic features which are at least as aggressive as group 1 tumors, albeit at smaller invasive sizes (1.2 cm vs. 1.5 cm) and lower stage (IA 75% vs. 61%). Conclusions: This is the first detailed pathologic comparison of LDCT screen detected vs incidentally discovered stage I/0 ADCA. Tumors from HR patients are pathologically more aggressive than LR tumors. Not all BAC-like tumors in LDCT screen detected patients should be presumed indolent given that approximately half of these bear histologic features of aggressive ADCAs while still in a lepidic predominant phase. NCCN group 2 tumors are similar to group 1 and should be further studied.

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Socioeconomic Status and COVID-19 Related Outcomes in India: Hospital Based Study

10.1101/2021.05.17.21257364 ◽

2021 ◽

Author(s):

Arvind K Sharma ◽

Rajeev Gupta ◽

Vaseem N Baig ◽

Tejaveer Singh ◽

Surabhi Chakraborty ◽

...

Keyword(s):

Socioeconomic Status ◽

Tobacco Use ◽

Educational Status ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

High Flow Oxygen ◽

Group 3 ◽

Group 2 ◽

Group 1

ABSTRACT Background & Objective: COVID-19 infection has disproportionately affected ethnic minorities and deprived populations in Europe and North America. Influence of socioeconomic status on COVID-19 related outcomes has not been studied in India. To determine association of educational status, as marker of socioeconomic status, with COVID-19 related outcomes we performed a study. Methods: Clinically and virologically confirmed successive patients of COVID-19 presenting at a government hospital in India were recruited. Demographic and clinical details were recorded. The cohort was classified according to educational status into Group 1- illiterate or < primary, Group 2- higher secondary, and Group 3- some college. To compare outcomes among groups we performed univariate and multivariate logistic regression and odds ratios (OR) and 95% confidence intervals (CI) were calculated. Results: From March-September 2020 we recruited 4645 patients (men 3386, women 1259) with laboratory confirmed COVID-19. Mean age was 46+18y, most lived in moderate or large households and 30.5% had low educational status. Smoking or tobacco use was in 29.5%, co-morbidities in 28.6% and low oxygen concentration (SpO2 <95%) at admission in 30%. Average length of hospital stay was 6.8+3.7 days, supplemental oxygen was provided in 18.4%, high flow oxygen or non-invasive ventilation 7.1%, and mechanical ventilation in 3.6%. 340 patients (7.3%) died. Group 1 patients were younger, more women, larger households, higher tobacco use and were more hypoxic at admission with lower lymphocyte counts, elevated liver enzymes and greater kidney dysfunction. In Group 1 vs Groups 2 and 3 requirement of oxygen (21.6 vs 16.7 and 17.0%), non-invasive ventilation (8.0 vs 5.9 and 7.1%), invasive ventilation (4.6 vs 3.5 and 3.1%) and deaths (10.0 vs 6.8 and 5.5%) were significantly greater (p<0.05). Compared to Group 3, OR for deaths were significantly higher in Group 1 (1.91, 1.46-2.51) and Group 2 (1.24, 0.93-1.66). Adjustment for age, sex, household size, risk factors and comorbidities led to attenuation in OR in Groups 1 (1.44, 1.07-1.93) and 2 (1.38, 1.02-1.85) that remained with adjustments for clinical and laboratory parameters and oxygen support in Groups 1 (1.38, 0.99-1.93) and 2 (1.52, 1.01-2.11). Conclusion: Illiterate and less educational (socioeconomic) status patients with COVID-19 in India have significantly greater adverse in-hospital outcomes and mortality. This is related to more severe disease at presentation.

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Impulse oscillometry in evaluation bronchial hyperresponsivness in patients with persistent allergic rhinitis

Vojnosanitetski pregled ◽

10.2298/vsp160407236k ◽

2018 ◽

Vol 75 (1) ◽

pp. 39-45

Author(s):

Dragan Koruga ◽

Nenad Baletic ◽

Kristina Tot-Veres ◽

Aleksandar Peric

Keyword(s):

Allergic Rhinitis ◽

Lung Function ◽

Challenge Test ◽

Provocation Test ◽

High Sensitivity ◽

Poor Correlation ◽

Impulse Oscillometry ◽

Persistent Allergic Rhinitis ◽

Group 2 ◽

Group 1

Background/Aim. Impulse oscillometry (IOS) is a method for estimating lung function which is used for early detection of bronchial hyperresponsiveness (BHR) and asthma. The aim of the study was to determine the prevalence of BHR, the correlation between spirometry and IOS and sensitivity and specificity of IOS in proving BHR in patients with persistent allergic rhinitis. Methods. The study included 81 patients with allergic rhinitis. From all of them, medical history was taken, allergy testing was done, as well as measurements of parameters of lung function by the IOS and spirometry before and after nonspecific bronchial provocation test with histamin via Aerosol provocative system. Changes of the IOS parameters to fall in FEV1 of 20% were measured and compared with changes in the spirometry parameters. After bronchial challenge test subjects were divided into two groups: the group with BHR (group 1) and that without BHR (group 2). Results. The mean age of participants was 25.7 ? 5.7 years, and 50.5% were men. Out of the total number of subjects with allergy rhinitis, 56 (58.9%) had a positive BPT. After bronchoprovocation an average increase in the group 1 was 88.15% for Rrs5, 111.98% for Fres, and for AX 819.69%. The high degree of correlation between the IOS and spirometry was proven in the group 2, while the whole group 1 had a weak correlation between parameters of these two methods. High sensitivity and low specificity for Rrs5 and Fres compared to FEV1 in diagnosing BHR was proven. Conclusion. The study demonstrated a high prevalence of BHR in the study group of patients with persistent allergic rhinitis, poor correlation in relation to the spirometric measurements in the group with BHR and a high sensitivity and low specificity of IOS for the detection of early changes in the airways.

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13C-sodium acetate breath test for evaluation of gastric emptying times in dogs with gastric dilatation-volvulus

Tierärztliche Praxis Ausgabe K Kleintiere / Heimtiere ◽

10.1055/s-0038-1623691 ◽

2013 ◽

Vol 41 (02) ◽

pp. 87-92 ◽

Cited By ~ 3

Author(s):

S. Schmitz ◽

N. Jansen ◽

K. Failing ◽

R. Neiger

Keyword(s):

Gastric Emptying ◽

Abdominal Surgery ◽

Sodium Acetate ◽

Breath Test ◽

Solid Phase ◽

Gastric Dilatation ◽

Non Invasive ◽

History Of ◽

Group 2 ◽

Group 1

Summary Objective: The aim of the study was to assess solid phase gastric emptying via non-invasive 13C-sodium acetate breath test in large breed dogs with or without gastric dilatation-volvulus (GDV). Material and methods: Dogs were recruited into one of the following groups: group 1 = healthy large breed dogs with no history of GDV, group 2 = dogs that underwent elective abdominal surgery for reasons unrelated to the gastrointestinal tract, and group 3 = dogs that underwent laparotomy and gastropexy to correct GDV. The dogs were fed a test meal containing 100 mg 13C-sodium acetate (for group 2 and 3, this was < 48 hours post-operatively). Breath samples were obtained at baseline and every 30 minutes for 3 hours, then every hour for a total of 7 hours. 12CO2/13CO2 ratio was measured for each breath sample via non-dispersive infrared spectroscopy and 25%, 50% and 75% gastric emptying times were calculated and compared between groups. Results: Gastric emptying times were significantly prolonged in dogs undergoing surgery (group 2) compared to group 1 and 3. Also, gastric emptying times of dogs with GDV were significantly prolonged compared to controls, but not to the same extent as dogs in group 2. Conclusion and clinical significance: There was a significant effect of abdominal surgery on gastric emptying times. Surprisingly, dogs after GDV surgery and gastropexy had shorter gastric emptying times than dogs undergoing laparotomy for reasons other than GDV, but still prolonged compared to healthy controls. The reason for these differences requires further study.

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Non-invasive assessment of the arrhythmogenic substrate in Brugada syndrome using signal-averaged electrocardiogram: clinical implications from a prospective clinical trial

EP Europace ◽

10.1093/europace/euz295 ◽

2019 ◽

Cited By ~ 1

Author(s):

Giuseppe Ciconte ◽

Vincenzo Santinelli ◽

Gabriele Vicedomini ◽

Valeria Borrelli ◽

Michelle M Monasky ◽

...

Keyword(s):

Risk Stratification ◽

Brugada Syndrome ◽

Predictive Value ◽

Area Under The Curve ◽

Late Potentials ◽

Non Invasive ◽

Arrhythmogenic Substrate ◽

Risk Stratification Tool ◽

Group 2 ◽

Group 1

Abstract Aims Brugada syndrome (BrS) represents a major cause of sudden cardiac death in young individuals. The risk stratification to forecast future life-threatening events is still controversial. Non-invasive assessment of late potentials (LPs) has been proposed as a risk stratification tool. However, their nature in BrS is still undetermined. The purpose of this study is to assess the electrophysiological determinants of non-invasive LPs. Methods and Results Two hundred and fifty consecutive patients with (Group 1, n = 96) and without (Group 2, n = 154) BrS-related symptoms were prospectively enrolled in the registry. Signal-averaged electrocardiogram (SAECG) was performed in all subjects before undergoing epicardial mapping. Group 1 patients exhibited larger arrhythmogenic substrates (AS; 5.8 ± 2.8 vs. 2.6 ± 2.1 cm2, P < 0.001) with more delayed potentials (220.4 ± 46.0 vs. 186.7 ± 42.3 ms, P < 0.001). Late potentials were present in 82/96 (85.4%) Group 1 and in 31/154 (20.1%) Group 2 individuals (P < 0.001). Patients exhibiting LPs had more frequently a spontaneous Type 1 pattern (30.1% vs. 10.9%, P < 0.001), SCN5A mutation (34.5% vs. 21.2%, P = 0.02), and exhibited a larger AS with longer potentials (5.8 ± 2.7 vs. 2.2 ± 1.7 cm2; 231.2 ± 37.3 vs. 213.8 ± 39.0 ms; P < 0.001, respectively). Arrhythmogenic substrate dimension was the strongest predictor of the presence of LPs (odds ratio 1.9; P < 0.001). An AS area of at least 3.5 cm2 identified patients with LPs (area under the curve 0.88, 95% confidence interval 0.843–0.931; P < 0.001) with a sensitivity of 86%, specificity 88%, positive predictive value 85%, and negative predictive value 89%. Conclusion The results of this study support the role of the epicardial AS as an electrophysiological determinant of non-invasive LPs, which may serve as a tool in the non-invasive assessment of the BrS substrate, as SAECG-LPs could be considered an expression of the abnormal epicardial electrical activity. ClinicalTrials.gov number (NCT02641431; NCT03106701).

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Relationship between disease severity and D-dimer levels measured with two different methods in pulmonary embolism patients

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2010.524 ◽

2010 ◽

Vol 5 ◽

Cited By ~ 1

Author(s):

Funda Coskun ◽

Dilber Yilmaz ◽

Ahmet Ursavas ◽

Esra Uzaslan ◽

Ercument Ege

Keyword(s):

Pulmonary Embolism ◽

Disease Severity ◽

Diagnostic Procedures ◽

Diagnostic Methods ◽

Non Invasive ◽

Antibody Method ◽

The Mean ◽

Group 2 ◽

D Dimer ◽

Group 1

Pulmonary embolism (PE) is diagnosed with increasing fre- quency nowadays due to advances in the diagnostic methods and the increased awareness of the disease. There is a tenden- cy to use non invasive diagnostic methods for all diseases. D-dimer is a fibrin degradation product. We aimed to detect the relationship between disease severity and the D-dimer levels measured with two different methods. We compared D-dimer levels in cases of massive vs. non-massive PE. A total of 89 patients who were diagnosed between 2006 and 2008 were included in the study. Group 1 included patients whose D-dimer levels were measured with the immunoturbidimetric polyclonal antibody method (D-dimerPLUS®), while Group 2 patients made use of the immunoturbidimetric monoclonal antibody method (InnovanceD-DIMER®). In each group, the D-dimer levels of those with massive and non-massive PE were compared, using the Mann Whitney U test. The mean age of Group 1 (25F/26M) was 56.0 ± 17.9 years, and that of Group 2 (22F/16M) was 52.9 ± 17.9 years. There was no sta- tistical difference in gender and mean age between the two groups (p > 0.05). In Group 1, the mean D-dimer level of mas- sive cases (n = 7) was 1444.9 ± 657.9 μg/L and that of non- massive PE (n = 34) was 1304.7 ± 350.5 μg/L (p > 0.05). In Group 2, the mean D-dimer level of massive cases (n = 6) was 9.7 ± 2.2 mg/L and that of non-massive PE (n = 32) was 5.9 ± 1.3 mg/L (p < 0.05). The mean D-dimer levels of massive cases as measured with the immunoturbidimetric monoclonal anti- body method were significantly higher. Pulmonary embolism patients whose D-dimer levels are higher (especially higher than 6.6 mg/L) should be considered as possibly having massive embolism. Diagnostic procedures and management can be planned according to this finding.

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The diagnostics intracranial hypertension using ultrasound of the optic nerve channel in patients with intracranial hemorrhage

Medical Visualization ◽

10.24835/1607-0763-2018-3-6-16 ◽

2018 ◽

pp. 6-16

Author(s):

S. S. Petrikov ◽

М. I. Andreytseva ◽

L. Т. Khamidova ◽

A. A. Solodov

Keyword(s):

Optic Nerve ◽

Intracranial Hypertension ◽

Healthy Volunteers ◽

Postoperative Period ◽

Optic Nerve Sheath Diameter ◽

Non Invasive ◽

Optimal Value ◽

Optic Nerve Diameter ◽

Group 2 ◽

Group 1

The purpose.To determine relationshipsbetween the value of intracranial pressure obtained by direct measurement (using ICP sensors), the optic nerve sheath diameter (ONSD), and the optic nerve diameter obtained by ultrasound; to define a threshold for ONSD for diagnosing ICP more than 20 mm Hg.Materials and methods.33 patients with traumatic and non-traumatic intracranial hemorrhages were examined. All patients were continuously monitored by ICP and ultrasound of the optic nerve channel. We evaluated the ONSD and optic nerve diameter (OND) using ultrasound. 16 healthy volunteers were examined to determine the normal values of ONSD and OND.Results.All patients were divided into 2 groups depending on the type of ICP dynamics. Group 1 (n = 26): an initial value of ICP is less than 20 mm Hg, group 2 (n = 7): initially high ICP values. Group 1 was divided into 3 subgroups: 1a (n = 7) – ICP did not increase during the whole monitoring period, 1b1 (n = 10) – ICP transiently increased in the postoperative period and normalized after treating, 1b2 (n = 9) – refractory intracranial hypertension was developed in the postoperative period. Group 2 was divided into two subgroups: 2a (n = 4) – ICP normalized in the postoperative period, 2b (n = 3) – refractory intracranial hypertension was developed in the postoperative period. There was a significant relationship between ICP and ONSD (Spearman n = 318, R = 0.31, p < 0.001; Kruskal– Wallis p < 0.001)in all groups of patients. The diameter of the optic nerve was the same for both groups: healthy volunteers and the experimental group (Spearmann = 334, R = 0.0054, p = 0.96). The optimal value of ONSD for detection the ICP > 20 mm Hg was morethan 5.8 mm.Conclusion.The ultrasound of the optic nerve channel can be an additional screening non-invasive diagnostic method for patients with intracranial hypertension.

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Coexistence of Upper Airway Obstruction and Primary and Secondary Enuresis Nocturna in Children and the Effect of Surgical Treatment for the Resolution of Enuresis Nocturna

Advances in Medicine ◽

10.1155/2014/656431 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Gül Soylu Özler ◽

Serkan Özler

Keyword(s):

Airway Obstruction ◽

Upper Airway ◽

Strong Relationship ◽

Upper Airway Obstruction ◽

Etiologic Factor ◽

Enuresis Nocturna ◽

Improvement Rate ◽

The Difference ◽

Group 2 ◽

Group 1

Objective.The aim of this study is to investigate the coexistence of upper airway obstruction (UAO) and primary enuresis nocturna (PEN) and secondary enuresis nocturna (SEN) in children. Besides, the efficacy of surgery on resolution of enuresis nocturna is evaluated.Materials and Methods.The children with PEN and SEN were included in the first group and investigated for UAO in the Department of Otorhinolaryngology. During the same period, children who had been planned for an operation to treat UAO over 5 years old were included in the second group and were evaluated in the Department of Urology for PEN and SEN before the operation.Results.A hundred patients completed the study (50 patients in Group 1, 50 patients in Group 2). According to the otolaryngologic examination, 20 of 25 PEN patients and 9 of 25 SEN patients also had UAO. The difference was statistically different (P<0.05). The second group consisted of fifty patients on the surgery list for upper airway obstructive pathologies. Coexistence of PEN and SEN is found in 12 and 3 of children, respectively. These ratios were statistically significant (P<0.05). The improvement rate of PEN and SEN after operation in the second group was 83.3% and 33.3%, respectively. The difference was statistically significant (P<0.05).Conclusion.There is a strong relationship between PEN and UAO, but it cannot be declared for SEN patients. UAO should be kept in mind as a possible etiologic factor for PEN.

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