scholarly journals Diagnosing ventilation inhomogeneity after COVID-19 by multiple-breath nitrogen washout test

2021 ◽  
Vol 31 (1) ◽  
pp. 30-36
Author(s):  
E. V. Kryukov ◽  
O. I. Savushkina ◽  
A. V. Chernyak ◽  
I. C. Kulagina
Keyword(s):  
Frequency Dependence ◽  
Lung Damage ◽  
Study Cohort ◽  
Impulse Oscillometry ◽  
Body Plethysmography ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Nitrogen Washout ◽  
Ventilation Inhomogeneity ◽  
Group 2

The aim was to evaluate the ventilation inhomogeneity (VIH) by the multiple-breath nitrogen washout test (MBNW) after COVID-19 and to identify the relationship of the lung clearance index (LCI) with other functional parameters of the respiratory system. Methods. The cross-sectional study included 35 patients (97% men); the median age was 44 years. Spirometry, body plethysmography, diffusing capacity of the lung for carbon monoxide (DLco), MBNW test, and impulse oscillometry were performed. Dyspnea was evaluated by mMRC scale. MBNW test was performed using the Easy-one Pro, MBW Module (ndd Medizintechnik AG, Switzerland). Results. The patients were divided into 2 groups. Group 1 included 21 (60%) patients who were not diagnosed with VIH. Group 2 included 14 (40%) patients with VIH. The median testing period was 72 (47 - 109) days from the onset of COVID-19. The median of the maximum volume of lung damage determined by high-resolution computed tomography (CTmax) was 50% in the acute period of the disease and 12% during the study. The medians of all analyzed parameters remained normal in the study cohort as well as in groups 1 and 2, except the resonance frequency (fres) in group 2. Statistically significant differences were found between groups 1 and 2 in the absolute frequency dependence of resistance (R5 - R20), reactance area (AX), fres. Significant differences were also found in pathological changes of vital capacity, forced expiratory volume in the first second (FEV1), (R5 - R20). The abnormalities were more common in group 2. A significant correlation was shown between LCI with the ratio of residual lung volume to total lung capacity, (R5 - R20), AX, fres, relative frequency dependence of resistance, CTmax, FEV1 and trasfer-factor (DLco). Conclusion. Seventy-two days after the onset of CoVID-19, the ventilation inhomogeneity was detected in 40% of the patients, decreased DLco - in 23%, airway obstruction - in 11.4%, and restrictive ventilatory defect - in 8.6%. Correlations were found between LCI and DLco, spirometry parameters, body plethysmography, impulse oscillometry, and CTmax.

Possibilities of pulse oscillometry in the diagnosis of small airway dysfunction in patients with bronchial asthma

MedAlliance ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 72-78
Keyword(s):  
Vital Capacity ◽  
Cross Sectional Study ◽  
Functional Method ◽  
Small Airway ◽  
Entire Group ◽  
Body Plethysmography ◽  
Air Trapping ◽  
Cross Sectional ◽  
Group 2 ◽  
Group 1

Small airway dysfunction (SAD) is associated with poorly controlled asthma and frequent exacerbations. Objective: To assess the prevalence of SAD in asthmatics using spirometry, body plethysmography, and impulse oscillometry (IOS). Materials and methods: The observational cross-sectional study of 61 patients with asthma was performed. Conclusion available SAD was made on the basis of identifying one of the criteria or their combination: 1) slow vital capacity (SVC) - forced vital capacity (FVC) >10% according spirometry; 2) "air trapping" according body plethysmography; 3) presence of pathological frequency dependence of the resistance (R) at 5 and 20 Hz (R5-R20 > 0,07 kPa•sec/l) according IOS. Results: The analysis was performed for the entire group as well as for patients with FEV1 > 80 %pred. and FEV1/SVC < 0,7 (group 1) and patients with FEV1 > 80 %pred. and normal FEV1/SVC (group 2). SAD was most often diagnosed using IOS and the selected criterion R5-R20>0,07 kPa •sec/l since 75% of patients had this deviation in the entire group, 65% of patients in group 1 and 55% of patients in group 2 whereas only in 48% and 24% of cases in the entire group according body plethysmography and spirometry, respectively. Conclusion: SAD is definitely observed in patients with asthma. IOS is a more effective method of diagnosing SAD compared to spirometry and body plethysmography and can serve as a supplement functional method, especially in cases of normal parameters of spirometry and body plethysmography in asthmatics.

The Impulse oscillometry in the diagnosis of respiratory mechanics defects in elderly patients with lung cancer

MedAlliance ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 69-74
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Respiratory Mechanics ◽  
Pulmonary Function Tests ◽  
The Elderly ◽  
Impulse Oscillometry ◽  
Body Plethysmography ◽  
Quiet Breathing ◽  
Cross Sectional ◽  
Lung Cancer Patients

Traditional pulmonary function tests (PFTs) (spirometry, body plethysmography, diffusion test) are quite time-consuming and difficult to perform methods, especially in the elderly patients. Impulse oscillometry (IOS) is advantageous in that all measurements are carried out with quiet breathing for 30–60 s and do not require the active participation of the patient. Objective: to compare IOS with traditional PFTs and to study its capabilities in the diagnosis of respiratory disorders in patients with lung cancer in the elderly patients. Materials and methods: an observational cross-sectional cohort study was performed. The study included 57 patients (55 (97%) male and 2 (3%) female, median age 69 (65–73) years). Smokers or ex-smokers accounted for 93% (39% and 54%, respectively), non-smokers — 7%. Central lung cancer was diagnosed in 22 (39%), peripheral lung cancer — in 35 (61%) patients. Results: ventilation disorders were detected in 54 (95%) patients, including 52 (96%) of obstructive, 1 — restrictive and 1 — mixed respiratory defects. Lung diffusion capacity was reduced in 30 (53%) patients. According to IOS data, deviations from the norm of R5, X5, AX (R5–R20) were detected in 43 (75%) patients. There was a statistically significant correlation between the parameters of the IOS with para­meters of spirometry and most of the parameters of body plethysmography. Conclusion: IOS can be used to assess respiratory mechanics in elderly lung cancer patients.

scholarly journals Anti-carbamylated proteins antibody repertoire in rheumatoid arthritis: evidence of a new autoantibody linked to interstitial lung disease

2020 ◽  
Vol 79 (5) ◽  
pp. 587-594 ◽  
Author(s):  
Raul Castellanos-Moreira ◽  
Sebastian Cruz Rodríguez-García ◽  
Maria Jose Gomara ◽  
Virginia Ruiz-Esquide ◽  
Andrea Cuervo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Calf Serum ◽  
Cross Sectional Study ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Replication Sample ◽  
Group 2 ◽  
Diagnostic Work

ObjectiveTo analyse the association between anti-carbamylated protein antibodies (Anti-CarP) and interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients.MethodsCross-sectional study including RA patients fulfilling the 2010 ACR/EULAR criteria. The main population comprised two groups: (1) RA patients diagnosed with RA-ILD (RA-ILD group); (2) RA patients without ILD (non-ILD RA group). Non-ILD RA patients in whom ILD was suspected underwent a diagnostic work-up and, if ILD was diagnosed, were switched to the RA-ILD group. ILD was diagnosed by high-resolution computed tomography and confirmed by a multidisciplinary committee. An independent replication sample was also obtained. Three Anti-CarP IgG autoantibodies against fetal calf serum (Anti-FCS), fibrinogen (Anti-Fib) and chimeric fibrine/filagrine homocitrullinated peptide (Anti-CFFHP) and one Anti-CarP IgA against FCS (Anti-FCS-IgA) were determined by home-made ELISA. Associations between Anti-CarP and ILD were analysed using multivariable logistic regression adjusted by smoking, sex, age, RA disease duration, rheumatoid factor and anticitrullinated protein antibodies.ResultsWe enrolled 179 patients: 37 (21%) were finally diagnosed with RA-ILD. Anti-CarP specificities were more frequent in RA-ILD patients (Anti-FCS 70% vs 43%; Anti-Fib 73% vs 51%; Anti-CFFHP 38% vs 19%; Anti-CarP-IgA 51% vs 20%, p<0.05 for all comparisons). Serum titers of Anti-CarP were significantly higher in RA-ILD patients. Anti-CarP specificities showed a robust effect towards increasing the odds of ILD in the multivariate analysis (Anti-FCS (OR: 3.42; 95% CI: 1.13 to 10.40), Anti-Fib (OR: 2.85; 95% CI: 0.83 to 9.70), Anti-CFFHP (OR: 3.11; 95% CI: 1.06 to 9.14) and Anti-FCS-IgA (OR: 4.30; 95% CI: 1.41 to 13.04)). Similar findings were observed in the replication sample.ConclusionsAnti-CarP were strongly associated with ILD. The role of homocitrullination in RA-ILD merits further investigation.

scholarly journals Multiple Breath Wash-out for early assessment of pulmonary complications in patients with Primary Antibody Deficiencies: an observational study in pediatric age

2021 ◽  
Author(s):  
Teresa Secchi ◽  
Lucia Augusta Baselli ◽  
Maria Chiara Russo ◽  
Irene Borzani ◽  
Federica Carta ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pulmonary Function Tests ◽  
Pulmonary Complications ◽  
Lung Damage ◽  
Primary Antibody ◽  
Early Assessment ◽  
High Resolution Computed Tomography ◽  
Specific Test ◽  
Ventilation Inhomogeneity ◽  
Primary Antibody Deficiencies

Abstract Purpose. In Primary Antibody Deficiencies (PADs), pulmonary complications are the main cause of morbidity, despite immunoglobulin substitutive therapy, antibiotic treatment of exacerbations and respiratory physiotherapy. Current recommendations for surveillance of PADs respiratory complications include the annual assessment of spirometry and the execution of chest High Resolution Computed Tomography (HRCT) every four years.This study aims to evaluate the effectiveness of Lung Clearance Index (LCI) as early marker of lung damage in patients with PADs. LCI is measured by Multiple Breath Wash-out, a non-invasive and highly specific test widely used in Cystic Fibrosis patients.Methods. Pediatric patients with PADs (n=17, 10, M, 7, F, age range 5-15 years) underwent baseline assessment of lung involvement with chest HRCT, Spirometry and Multiple Breath nitrogen Wash-out. Among them, 13 patients were followed up to repeat HRCT after four years, while performing Pulmonary Function Tests annually. Their baseline and control LCI and FEV1 values were compared, taking HRCT as gold standard, using logistic regression analysis.Results. LCI (OR 2.43 at baseline, OR 14.95 at control) has a stronger discriminating power between altered and normal HRCT rather than FEV1 (OR 0.82 at baseline, OR 1.91 at control).Conclusion. Within the context of a limited sample size, LCI seems to be more predictive of HRCT alterations than FEV1 and more sensitive than HRCT in detecting ventilation inhomogeneity, in absence of bronchiectasis. A study of a larger cohort of pediatric patients followed longitudinally in adulthood is needed to challenge these findings.

scholarly journals An informative value of impulse oscillonetry for detecting restrictive abnormalities in idiopathic pulmonary fibrosis

2018 ◽  
Vol 28 (3) ◽  
pp. 325-331
Author(s):  
O. I. Savushkina ◽  
A. V. Chernyak ◽  
M. Yu. Kameneva ◽  
Е. V. Kryukov ◽  
A. A. Zaytsev
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Frequency Dependence ◽  
Respiratory Diseases ◽  
Body Plethysmography ◽  
Diffusion Test ◽  
Lung Diffusion ◽  
Group 2 ◽  
Group 1

The aim of this study was to investigate a role of impulse oscillometry (IO) for diagnosis of restrictive abnormalities in patients with idiopathic pulmonary fibrosis (IPF). Methods. Seventy two patients with restrictive ventilatory disorders diagnosed with spirometry and body plethysmography were involved in the study. The patients were divided into two groups: the group 1 (n = 34) comprised IPF patients, the group 2 (n = 38) comprised patients with respiratory diseases without extended pulmonary fibrosis. Data of spirometry, body plethysmography, lung diffusion test, and IO were analyzed. Results. IO was the most informative method for diagnosis of restrictive abnormalities in IPF patients: abnormal values, predominantly deltaXrs5, were found in 68% of the patients. IO was less useful in patients with non-fibrotic respiratory diseases where abnormal basic IO values were found in 39% of the patients. Decreased Xrs5, increased fres, unchanged Rrs5 and Rrs20, and abnormal absolute frequency dependence of Rrs were found in IPF patients with restrictive abnormalities; these changes could be seen in any respiratory disease with TLC ≤ 69%pred. Moreover, abnormal relative frequency dependence of Rrs (D(Rrs5–Rrs20)/Rrs20%) was detected. Conclusion. IO could be used as additional method for detecting restrictive abnormalities in patients with significant fibrotic lesions of the lungs.

scholarly journals Phosphate levels and pulmonary damage in COVID-19 patients based on CO-RADS scheme: is there any link between parathyroid gland and COVID-19?

2020 ◽  
Author(s):  
Farshid Javdani ◽  
Shima Parsa ◽  
Heshmatollah Shakeri ◽  
Naser Hatami ◽  
Navid Kalani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Ct Scan ◽  
Parathyroid Gland ◽  
Previous History ◽  
Lung Damage ◽  
Common Symptom ◽  
High Resolution Computed Tomography ◽  
Laboratory Findings ◽  
Cross Sectional

Background: Preliminary studies of COVID-19 have provided some evidence that electrolyte disturbances may also be present in patients. In this study we aimed to evaluate the role of the arrival electrolytes and symptoms in prediction of Lung damage in CT scan based on the CO-RADS system. Methods: This was a retrospective cross-sectional analytical study. We included patients with laboratory confirmed COVID-19 infection, June 15 to July 7. Patients were included in study if there were no previous history of kidney disease. Demographic, clinical characteristics, laboratory findings, and CO-RADS High-resolution computed tomography (HRCT) of lung report were collected. Univariate logistic regression was employed first to identify the effective, correlated items. All statistics were performed with SPSS version 18.0. Results: In the current study, 36 (20 male- 16 female) patients with mean age of the 54.7 (STD:17.5) years old were studied. Most common symptom at the arrival was the Fever (52.8%), followed by Fatigue (18%), and dyspnea (44.4%). Computed tomography assessment revealed CO-RADS 2 in 4 (11.1%) patients, CO-RADS 3 in 1 (2.8%), CO-RADS 4 in 20 (55.6%), and CO-RADS 5 in 11 (30.6%) patients. In the comparison with the study groups based on the HRCT status (CO-RADS II,III vs. CO-RADS IV,V), patients with severe HRCT damage had significantly lower level of Phosphorus (P<0.05). Univariate logistic regression analysis showed that only one factors was associated with HRCT damage status (Phosphorus, P=0.040). Phosphorus upper than 4.5 was associated with better HRCT results with OR ratio of 3.71 (X2(1)=5.69; p=0.017). Conclusion: Our study illustrates that higher phosphate levels may be associated with better CT scan of lung outcomes in COVID-19; while hypophosphatemia is associated with severe lung injuries. This could help clinicians to manage hospitalized patients and may link the COVID-19 and parathyroid gland.

scholarly journals IMPULSE OSCILLOMETRY FOR DIAGNOSIS OF EARLY CHANGES IN THE RESPIRATORY SYSTEM FUNCTIONAL STATE IN PATIENTS WITH MILD ASTHMA

2019 ◽  
Vol 9 (3) ◽  
pp. 213-221 ◽  
Author(s):  
N. M. Leontieva ◽  
I. V. Demko ◽  
E. A. Sobko ◽  
O. P. Ishchenko ◽  
I. A. Solov’yova
Keyword(s):  
Frequency Dependence ◽  
Mild Asthma ◽  
Control Group ◽  
Impulse Oscillometry ◽  
Body Plethysmography ◽  
Respiratory Resistance ◽  
Absolute Frequency ◽  
Respiratory Dysfunction ◽  
Informative Parameters ◽  
Resistive Component

Currently, the analysis of respiratory function of lungs at suspicion of obstructive pulmonary diseases is recommended to start with spirometry as the most sensitive method of obstruction detection. However, data on informative value and specificity of a method are contradictory. To obtain reliable results good cooperation of the patient and health professionals is necessary. Impulse oscillometry is a noninvasive method of general respiratory resistance assessment, which does not require forced exhalations. The sensitivity and specificity of this method remain undecided as well as the obtained parameter interpretation. The objective of this work was to study opportunities of impulse oscillometry in diagnostics of early respiratory dysfunctions of ist most informative indicators correlating with parameters of spirometry and body plethysmography.Materials and methods. Patients with the established diagnosis of mild asthma (n=68) were examined. In 71% of patients, obstructive respiratory dysfunction was revealed. In the control group (n=41) there were no abnormalities.Results. In most of patients with revealed via spirometry and body plethysmography obstructive disturbances the increase in indicators of absolute frequency dependence of the resistive component of the respiratory impedance at the oscillation frequency of 5 and 20 Hz (Rrs5-Rrs20) and the reactance area (AX). Increase in Rrs5-Rrs20 was revealed in 48 (71%) patients and the increase in AX was observed in 44 (65%) of the surveyed, patients with 42 (61%) patients without the increase of reactance (Xrs5) and resistance (Rrs5).Conclusion. The absolute frequency dependence of Rrs5-Rrs20 and AX are the most informative parameters of impulse oscillometry. In some patients the IOM findings were more significant in comparison with spirometry ones.

Pulmonary function after COVID-19 in early convalescence phase

2020 ◽  
pp. 7-12 ◽  
Author(s):  
O. I. Savushkina ◽  
A. V. Cherniak ◽  
E. V. Kryukov ◽  
I. Ts. Kulagina ◽  
M. V. Samsonova ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Lung Damage ◽  
Diffusing Capacity ◽  
Diffusion Test ◽  
High Resolution Computed Tomography ◽  
Oxygen Saturation Level ◽  
Group 2 ◽  
Convalescence Phase ◽  
Group 1

Pulmonary function after COVID-19 in early convalescence phase. The aim of the study is to investigate the influence of Coronavirus disease 2019 (COVID-19) on pulmonary function in early convalescence phase.Materials and methods. The study included 44 patients (35 male) after COVID-19 without concomitant bronchopulmonary pathology, with a median age of 47.5 years. All patients underwent standard pulmonary function tests (PFTs): spirometry, body plethysmography, diffusion test. Besides, dyspnea on the mMRC scale was assessed, oxygen saturation level (SpO2 ) was measured. Depending on degree of lung damage determined using high-resolution computed tomography (CT), the patients were divided into 2 groups: group 1 (22 patients) — CT 1 and CT 2, group 2 (22 patients) — CT 3 and CT 4.Results. The medians of standard PFTs parameters were in normal values. However, there were statistically significant differences between groups: VC, FVC, FEV1 and TLC were lower in second group. Diffusing capacity was reduced in 52% of patients. Statistical significant correlations were established between lung damage by CT and the parameters of VC, FVC, FEV1 , TLC, IC and DLCO.Conclusion. The degree of functional disorders of lungs depended on the extent of abnormal CT. Impaired diffusing capacity were detected in more than half of the COVID-19 patients in early convalescence phase.

Clinical-Reported Outcomes Of Deferoxamine Versus Deferasirox In The Treatment Of Homozygous BetaThalassemia

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Zeina A Munim Al-Thanoon ◽  
Zeina A Munim Al-Thanoon ◽  
Mustafa Basil ◽  
Nasih A Al-Kazzaz
Keyword(s):  
Serum Ferritin ◽  
Iron Chelation ◽  
Iron Chelator ◽  
Beta Thalassemia ◽  
Control Group ◽  
Current Standard ◽  
Cross Sectional ◽  
Significant Difference ◽  
Multiple Blood ◽  
Group 2

Iron chelation therapy with deferoxamine (DFO),the current standard for the treatment of iron overload in patients with betathalassemia,requires regular subcutaneous or intravenous infusions. This can lead to reduced quality of life and poor adherence,resulting in increased morbidity and mortality in iron-overloaded patients with beta-thalassemia. Deferasirox (DFX) is an orally administered iron chelator that has been approved for use in many countries. The requirement of an effective,well tolerated iron chelator with a less demanding mode of administration has led to the development of deferasirox. The present study was aimed to compare the satisfaction and compliance with deferoxamine versus deferasirox (Exjade®),a novel oral iron chelator in patients with transfusion - dependent beta- thalassemia. A cross-sectional,single-center investigation study was carried out in the Thalassemia Center of Ibn-Atheer Teaching Hospital in Nineveh province,Iraq. One hundred and eight thalassemic patients aged between 2- 20 years old having received multiple blood transfusions and a serum ferritin greater than 1500 ng/ml. Patients were randomised into two groups. Group 1 received deferoxamine at a dose of 20-50mg/kg/day and group 2 received deferasirox at the dose of 10-30 mg/kg/day. Another 56 apparently healthy volunteers were used as a control group. The assessment of chelation was done during the period between November 2013 and February 2014 by measurement of serum ferritin. Satisfaction and compliance was assessed by using a special questionnaire prepared by the researcher. Out of the 108 thalassemic patients enrolled there was no discontinuation in treatment with the two drugs under study. The serum ferritin did not change significantly in any of the chelation groups. In comparison with the patients who were treated with DFO,those receiving DFX reported a significantly higher rate of compliance and satisfaction (P < 0.05). However,no significant difference was observed between the two groups regarding their satisfaction (P > 0.05).Compliance with deferasirox (50 %) was more than that with deferoxamine (20 %). Satisfaction with deferoxamine was significantly lower than deferasirox (p= 0.00).

scholarly journals Effect of the Cut-Off Level for Thyroid-Stimulating Hormone on the Prevalence of Subclinical Hypothyroidism among Infertile Mexican Women

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 417
Author(s):  
Lidia Arce-Sánchez ◽  
Salvatore Giovanni Vitale ◽  
Claudia Montserrat Flores-Robles ◽  
Myrna Souraye Godines-Enriquez ◽  
Marco Noventa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Subclinical Hypothyroidism ◽  
Thyroid Autoimmunity ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Mexican Women ◽  
Cross Sectional ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The primary aim of this study was to compare the prevalence of subclinical hypothyroidism (SCH) using two different cut-off levels for TSH values (≥2.5 mIU/L versus ≥4.1 mIU/L). The secondary objective was to analyze the clinical-biochemical characteristics in women with and without SCH. This was a retrospective cross-sectional study. In total, 1496 Mexican women with infertility were included: Group 1, women with TSH levels ranging between 0.3 and 2.49 mIU/L, n = 886; Group 2, women with TSH between 2.5 and 4.09 mIU/L, n = 390; and Group 3, women with TSH ≥4.1 mIU/L n = 220. SCH prevalence was 40.7% (CI 95%: 38.3–43.3%) with TSH cut-off ≥ 2.5 mIU/L, and 14.7% (CI 95%: 12.7–16.5%) with TSH cut-off ≥ 4.1 mIU/L, (p = 0.0001). The prevalence of overweight was higher in Group 2 than in Groups 1 and 3. Thyroid autoimmunity, obesity and insulin resistance were higher in Group 3 than in Group 1 (p < 0.05). No other differences were observed between groups. Conclusions: The prevalence of SCH in our selected patients increased almost three times using a TSH cut-off ≥ 2.5 mIU/L compared with a TSH cut-off ≥ 4.1 mIU/L. Women with TSH ≥4.1 mIU/L compared with TSH cut-off ≤ 2.5 mIU/L more often presented with obesity, thyroid autoimmunity and insulin resistance.

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