Changes in lung inflation in asthma in patients with osmotic airway hyperresponsiveness

2021 ◽  
Vol 31 (6) ◽  
pp. 749-758
Author(s):  
Evgeniya Yu. Аfanas’eva ◽  
Anna G. Prikhodko ◽  
Andrey V. Il’in ◽  
Juliy M. Perelman
Keyword(s):  
Airway Hyperresponsiveness ◽  
Bronchial Hyperresponsiveness ◽  
Three Dimensional ◽  
Lung Ventilation ◽  
Body Plethysmography ◽  
Lung Inflation ◽  
Asthma Patients ◽  
Average Residual ◽  
Group 2 ◽  
Group 1

The scientific literature does not provide enough information on whether bronchial hyperresponsiveness to hypoosmotic stimulus in patients with asthma can lead to more pronounced disturbances of regional lung ventilation.Aim. to characterize lung inflation in asthma patients with osmotic airway hyperresponsiveness.Methods. The lung inflation was studied by body plethysmography, as well as by three-dimensional volumetry, planimetry, and multispiral CT densitometry in 24 patients (group 1) with persistent mild asthma and osmotic airway hyperresponsiveness, identified by the bronchoprovocation test with inhalation of distilled water (IDW) (the average ДРБУ1 was —21.1 ± 3.2%). The comparison group (group 2) consisted of 49 patients with no response to IDW (the average ДББУ1 was —3.7 ± 0.5%; p = 0.00001).Results. Group 1 had lower lung function (FEVj was 83.6 ± 4.5%; FEF50 was 58.1 ± 5.8%) at baseline in comparison with the group 2 (96.7 ± 2.2%, p = 0.0042 and 75.5 ± 2.2%, p = 0.016, respectively) and higher indices of lung inflation at body plethysmography (RV was 153.2 ± 12.5 and 127.5 ± 4.0%, respectively; p = 0,027; RV/TLC was 128.8 ± 5.5 and 109.9 ± 2.8%, respectively; p = 0.015). According to three-dimensional volumetry, the indicators of expiratory lung inflation (526.0 ± 117.8 vox) and average residual inflation of both lungs (13.1 ± 2.6 vox) in group 1 were significantly higher than in group 2 (301.5 ± 55.8 vox, р < 0.05 and 9.1 ± 1.6 vox,р < 0,05, respectively). The patients with osmotic airway hyperresponsiveness also showed higher values of the expiratory area in the middle zone (235.3 ± 29.4 and 149.2 ± 14.9 pix, respectively; p = 0.00 47) and the lower zone (292.3 ± 37.9 and 178.6 ± 18.6 pix, respectively; p = 0.0034) of the lungs.Conclusion. Asthma patients with osmotic airway hyperresponsiveness have lung hyperinflation with impaired lung ventilation predominantly in the middle and lower zones.

scholarly journals Comparative characteristics of the quality of life of asthma patients with different types of airway hyperresponsiveness to physical stimules

2021 ◽  
pp. 55-61
Author(s):  
N. L. Perelman
Keyword(s):  
Quality Of Life ◽  
Airway Hyperresponsiveness ◽  
Group 4 ◽  
Sf 36 ◽  
Different Types ◽  
Asthma Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To compare the nature and degree of influence of different types of airway hyperresponsiveness (AHR) on the general and specific quality of life (QoL) of patients with asthma and control over the disease.Materials and methods. 234 patients with mild-to-moderate asthma, aged from 18 to 60 years old, were interviewed and examined. Depending on the presence of one or another type of AHR, 4 groups were formed: group 1 included 60 patients with cold AHR, group 2 – 75 patients with hypoosmotic AHR, group 3 – 35 patients with hyperosmotic AHR, group 4 – 64 patients with exercise-induced bronchoconstriction (EIB). QoL and the state of the emotional sphere were assessed using the SF-36, AQLQ, HADS questionnaires. The level of asthma control was determined using the ACT questionnaire. Lung function was assessed by spirometry.Results. When comparing QoL between groups, statistical differences were obtained for most of the SF-36 scales, with the exception of the domains “Role Physical” (RP) and “Bodily Pain” (BP), and their presence and significance varied depending on the types of AHR being compared. The lowest QoL indices were found in group 1 of patients with cold AHR according to the domains “Physical Activity” (PA), RP, BP, and “Role Emotional” (RE). The lowest indices for the domains “General Health” (GH), “Vitality” (V) and “Mental health” (MH) were found in the respondents of the 2nd group. Most of the highest QoL indicators in the compared groups were found in patients of group 4 with EIB in the domains PA, RP, V, RE, and MH. When carrying out a comparative analysis, the maximum number of significant differences was found between the groups with cold AHR and EIB. A comparative study of QoL using a special AQLQ questionnaire showed the lowest indices for the “Activity” and “Symptoms” domains in groups 1 and 2 of asthma patients. In addition, in group 1, the minimum QoL values were recorded for the “General QoL” domain (3.6±0.2 points), and in group 2, for the “Environment” domain (2.9±0.3 compared with 3.9±0.2 points in group 3, p<0.01).Conclusion. This study has demonstrated the multifaceted effect of AHR on health-related QoL, dependent on sensitivity to a particular physical stimulus and the season of maximum trigger action. The subjective assessment of psychosocial functioning is most differentiated according to the GH domain of the SF-36 questionnaire. The greatest negative impact on the QoL indices is exerted by the cold and hypoosmotic AHR, the least – by the EIB. The assessment of QoL allows to get a full picture of the perception of the patient's health level at the moment and in the given conditions.

A volumetric three-dimensional evaluation of invasiveness of an endoscopic and microscopic approach for transmeatal visualisation of the middle ear

2021 ◽  
pp. 1-5
Author(s):  
A H A Baazil ◽  
J G G Dobbe ◽  
E van Spronsen ◽  
F A Ebbens ◽  
F G Dikkers ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Middle Ear ◽  
Three Dimensional ◽  
Endoscopic Approach ◽  
Microscopic Approach ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Abstract Objective This study aimed to compare the necessary scutum defect for transmeatal visualisation of middle-ear landmarks between an endoscopic and microscopic approach. Method Human cadaveric heads were used. In group 1, middle-ear landmarks were visualised by endoscope (group 1 endoscopic approach) and subsequently by microscope (group 1 microscopic approach following endoscopy). In group 2, landmarks were visualised solely microscopically (group 2 microscopic approach). The amount of resected bone was evaluated via computed tomography scans. Results In the group 1 endoscopic approach, a median of 6.84 mm3 bone was resected. No statistically significant difference (Mann–Whitney U test, p = 0.163, U = 49.000) was found between the group 1 microscopic approach following endoscopy (median 17.84 mm3) and the group 2 microscopic approach (median 20.08 mm3), so these were combined. The difference between the group 1 endoscopic approach and the group 1 microscopic approach following endoscopy plus group 2 microscopic approach (median 18.16 mm3) was statistically significant (Mann–Whitney U test, p < 0.001, U = 18.000). Conclusion This study showed that endoscopic transmeatal visualisation of middle-ear landmarks preserves more of the bony scutum than a microscopic transmeatal approach.

scholarly journals Perioperative Hemodynamic Changes During Video-Assisted Thoracoscopic Decortication for empyema

2017 ◽  
Vol 11 (1) ◽  
pp. 88-96
Author(s):  
Fang-Ting Chen ◽  
An-Hsun Chou ◽  
Chun-Yu Chen ◽  
Pei-Chi Ting ◽  
Ming-Wen Yang ◽  
...  
Keyword(s):  
Lung Ventilation ◽  
Lateral Decubitus Position ◽  
Time Interval ◽  
Hemodynamic Parameters ◽  
Hemodynamic Changes ◽  
Video Assisted ◽  
Lateral Decubitus ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background and Objective: Hemodynamic consequences during video-assisted thoracoscopic surgery (VATS) with decortication during empyema drainage are unclear. The aim of the study was to assess the perioperative hemodynamic changes decortication during empyema drainage. Methods: A prospective study enrolled 23 patients with empyema who underwent decortication. Hemodynamic parameters were continuously obtained at 15 time points: supine two lung ventilation after induction, lateral decubitus position and two lung ventilation, lateral decubitus position and one-lung ventilation, every 5 min after decortication upto 60 minutes and at the end of surgery. We divided patients into three groups according to microorganisms, group 1: patients with no growth of organism; group 2: patients with staphylococcus aureus and pseudomonas; group 3: patients with streptococcus, yeast and fungus, gram-positive bacilli, and mycobacterium tuberculosis. The hemodynamic variables were recorded by the third-generation Vigileo/FloTracTM system and variables for each time interval were compared with the baseline by Wilcoxon Signed Ranks Test. Results: In group 1, hemodynamic parameters showed no significant changes over time. However, in group 2 and 3, both CO and CI increased 10 to 15 minutes after decortication and remained elevated during the remainder of surgery. However, SVR and SVRI decreased 10 to 15 minutes after decortication in both groups, especially, with a more significant decrease noted in group 2 than group 3. Conclusion: Close perioperative hemodynamic monitoring during decortication in empyema patients is required because of potential hemodynamic disturbances especially patients with toxic microorganisms.

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.

scholarly journals Three dimensional evaluation of alveolar bone changes in response to different rapid palatal expansion activation rates

2017 ◽  
Vol 22 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Brian LaBlonde ◽  
Manuel Lagravere Vich ◽  
Paul Edwards ◽  
Katherine Kula ◽  
Ahmed Ghoneima
Keyword(s):  
Alveolar Bone ◽  
Three Dimensional ◽  
Rank Test ◽  
Bone Thickness ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Group 2 ◽  
Activation Rates ◽  
Bone Height ◽  
Group 1

ABSTRACT Introduction: The aim of this multi-center retrospective study was to quantify the changes in alveolar bone height and thickness after using two different rapid palatal expansion (RPE) activation protocols, and to determine whether a more rapid rate of expansion is likely to cause more adverse effects, such as alveolar tipping, dental tipping, fenestration and dehiscence of anchorage teeth. Methods: The sample consisted of pre- and post-expansion records from 40 subjects (age 8-15 years) who underwent RPE using a 4-banded Hyrax appliance as part of their orthodontic treatment to correct posterior buccal crossbites. Subjects were divided into two groups according to their RPE activation rates (0.5 mm/day and 0.8 mm/day; n = 20 each group). Three-dimensional images for all included subjects were evaluated using Dolphin Imaging Software 11.7 Premium. Maxillary base width, buccal and palatal cortical bone thickness, alveolar bone height, and root angulation and length were measured. Significance of the changes in the measurements was evaluated using Wilcoxon signed-rank test and comparisons between groups were done using ANOVA. Significance was defined at p ≤ 0.05. Results: RPE activation rates of 0.5 mm per day (Group 1) and 0.8 mm per day (Group 2) caused significant increase in arch width following treatment; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Buccal alveolar height and width decreased significantly in both groups. Both treatment protocols resulted in significant increases in buccal-lingual angulation of teeth; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Conclusion: Both activation rates are associated with significant increase in intra-arch widths. However, 0.8 mm/day resulted in greater increases. The 0.8 mm/day activation rate also resulted in more increased dental tipping and decreased buccal alveolar bone thickness over 0.5 mm/day.

Teaching of distal radius shortening osteotomy: three-dimensional procedural simulator versus bone procedural simulator

2018 ◽  
Vol 43 (9) ◽  
pp. 961-966 ◽  
Author(s):  
Ismaël Naroura ◽  
Juan José Hidalgo Diaz ◽  
Fred Xavier ◽  
Florent Baldairon ◽  
Henri Favreau ◽  
...  
Keyword(s):  
Distal Radius ◽  
Teaching And Learning ◽  
Three Dimensional ◽  
Bone Model ◽  
Bone Surgery ◽  
Main Assumption ◽  
Shortening Osteotomy ◽  
Group 2 ◽  
Better Than ◽  
Group 1

In order to facilitate the learning of distal radius shortening osteotomy by junior surgeons, the main assumption was that using a three-dimensional procedural simulator was better than a bone procedural simulator. After viewing a video, ten junior surgeons performed a distal radius shortening osteotomy: five with a bone procedural simulator (Group 1) and five with a three-dimensional procedural simulator (Group 2). All subsequently performed the same surgery on fresh cadaveric bones. The duration of the procedure, shortening of the radius, and the level of osteotomy were significantly better in Group 2. The three-dimensional procedural simulator seems to teach distal radius osteotomy better than a bone model and could be useful in teaching and learning bone surgery of the wrist.

scholarly journals Group of Investigators for ERAs Program, Russia. Allergic rhinitis and asthma in real clinical practice in Russia: multicenter clinical study

2012 ◽  
Vol 9 (1) ◽  
pp. 29-36
Author(s):  
A V Emelyanov ◽  
L A Goryachkina ◽  
N G Astafeva ◽  
R S Fassakhov ◽  
B A Chernyak ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Case Report ◽  
Clinical Study ◽  
Outpatient Visit ◽  
Asthma Control Questionnaire ◽  
Asthma Patients ◽  
Group 2 ◽  
Multicenter Clinical Study ◽  
Real Clinical Practice ◽  
Group 1

The aim of the study which included 2311 patients (aged 18—80 yrs), examined by 100 physicians (57% allergists, 37% pulmonologists and 7% general practitioner) in 18 Russian cities, was to assess the prevalence of allergic rhinitis in patients with asthma, as well as to evaluate the specifics of the course of these diseases, when concomitant or not. The study design included one outpatient visit, followed by the completion of studyspecific case report forms and Asthma Control Questionnaire (ACQ) validated for use in Russia. The vast majority (88%)of asthma patients had concomitant allergic rhinitis (Group 1). Patients with asthma only (Group 2) were older (50,6±0,78 vs 41,9±0,35 yr, p

scholarly journals Effect of biomimetic material on stress distribution in mandibular molars restored with inlays: a three-dimensional finite element analysis

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7694
Author(s):  
Junxin Zhu ◽  
Danmei Luo ◽  
Qiguo Rong ◽  
Xiaoyan Wang
Keyword(s):  
Stress Distribution ◽  
Three Dimensional ◽  
Biomimetic Materials ◽  
Biomimetic Material ◽  
Dimensional Finite Element ◽  
Group 2 ◽  
Three Dimensional Finite Element ◽  
Lateral Walls ◽  
Cavity Floor ◽  
Group 1

Background Although biomimetic material has become increasingly popular in dental cosmetology nowadays, it remains unclear how it would affect the restored teeth during chewing. It is necessary to study the influence of biomimetic material on stress distribution in the restored teeth. Methods Eight three-dimensional finite element (FE) models were constructed and divided into two groups. Group 1 included the FE model of intact molar, and the FE models of inlay-restored molars fabricated from IPS e.max CAD, Lava Ultimate and biomimetic materials individually. Enamel was considered a homogeneous material. Group 2 included the FE models of intact molar and molars restored with inlays using IPS e.max CAD, Lava Ultimate and biomimetic materials individually, considering enamel as an inhomogeneous material. Results In Group 1, compared with that in the intact molar, the maximum tensile stress (MTS) in the occlusal grooves decreased in the inlay-restored molars fabricated from IPS e.max CAD and was concentrated on the cavity floor at the buccal side in the inner dentin around inlay. When Lava Ultimate was selected, MTS decreased in the occlusal grooves and on the cavity floor but increased in the lateral walls. In the restored molar using biomimetic material, the MTS on the cavity floor was distributed more evenly than that in the molar using IPS e.max CAD, and no obvious changes were noted in the lateral walls. The same changes were observed in Group 2. No differences in the stress distribution pattern were noted among the FE models in Groups 1 and 2. Conclusions Molars restored with inlays fabricated from biomimetic material exhibit a more uniform stress distribution in the dentin around restoration. The consideration of enamel as a homogeneous tissue is acceptable for analyzing the maximum principal stress distribution in the inlay-restored molar.

scholarly journals Use of a Spacer Block Tool for Assessment of Joint Line Position during Revision Total Knee Arthroplasty

2021 ◽  
Author(s):  
Harun R. Gungor ◽  
Nusret Ok
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Computer Software ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Contralateral Knee ◽  
Total Knee ◽  
Group 2 ◽  
Group 1

AbstractThere is a tendency of orthopaedic surgeons to elevate joint line (JL) in revision total knee arthroplasty (RTKA). Here, we ascertain the use of the spacer block tool (SBT) to determine JL more accurately for less experienced RTKA surgeons. To perform more precise restoration of JL, an SBT with markers was developed and produced using computer software and three-dimensional printers. The study was planned prospectively to include patients who received either condylar constrained or rotating hinge RTKA between January 2016 and December 2019. To determine JL, distance from fibular head (FH), adductor tubercle (AT), and medial epicondyle (ME) were measured on contralateral knee preoperative radiographs and on operated knee postoperative radiographs. Patients were randomized and grouped according to the technique of JL reconstruction. In Group 1, conventional methods by evaluating aforementioned landmarks and preoperative contralateral knee measurements were used to determine JL, whereas in Group 2, the SBT was used. The main outcome measure was the JL change in revised knee postoperatively in contrast to contralateral knee to compare effective restoration of JL between the groups. Twenty-five patients in Group 1 (3 males, 22 females, 72 years, body mass index [BMI] 32.04 ± 4.45) and 20 patients (7 males, 13 females, 74 years, BMI 30.12 ± 5.02) in Group 2 were included in the study. JL measurements for the whole group were FH-JL = 18.3 ± 3.8 mm, AT-JL = 45.8 ± 4.6 mm, and ME-JL = 27.1 ± 2.8 mm preoperatively, and FH-JL = 20.7 ± 4.2 mm, AT-JL = 43.4 ± 5.2 mm, and ME-JL = 24.7 ± 3.1 mm postoperatively. JL level differences in reference to FH, AT, and ME in Group 1 were 3.6 ± 3.1, 3.6 ± 3.5, and 3.4 ± 3.1 mm, respectively, and in Group 2 were 1.0 ± .0.9, 1.3 ± 1.3, and 1.1 ± 1.3 mm, respectively. There were statistically significant differences between the two groups in JL changes referenced to all of the specific landmarks (p < 0.05). The use of the SBT helped restore JL effectively in our cohort of RTKA patients. Therefore, this tool may become a useful and inexpensive gadget for less experienced and low-volume RTKA surgeons.

scholarly journals Three-dimensional cone-beam computed tomography comparison of shorty and standard Class II Carriere Motion appliance

2021 ◽  
Author(s):  
Brian Wilson ◽  
Nikoleta Konstantoni ◽  
Ki Beom Kim ◽  
Patrick Foley ◽  
Hiroshi Ueno
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Treatment Effects ◽  
Three Dimensional ◽  
Class Ii ◽  
Cone Beam ◽  
Class Ii Malocclusion ◽  
Dimensional Cone ◽  
Group 2 ◽  
Group 1

ABSTRACT Objectives To compare treatment effects of the standard and shorty Class II Carriere Motion appliances (CMAs) on adolescent patients. Materials and Methods Fifty adolescents with Class II malocclusion formed group 1, who were treated with shorty CMA (n = 25, 12.66 ± 1.05 years), and age- and sex–matched group 2, who were treated with standard CMA (n = 25, 12.73 ± 1.07 years). Treatment effects were analyzed by tracing with Invivo software to compare pretreatment (T1) cone-beam computed tomography (CBCT) images with post-CMA (T2) CBCT images. A total of 23 measurements were compared within and between groups. Results In groups 1 and 2, maxillary first molars showed significant distal movement from T1 to T2 (1.83 ± 2.11 mm and 2.14 ± 1.34 mm, respectively), with distal tipping and rotation in group 1 (6.52° ± 3.99° and 3.15° ± 7.52°, respectively) but only distal tipping (7.03° ± 3.45°) in group 2. Similarly, in both groups, the maxillary first premolars experienced significant distal movement with distal tipping but no significant rotation. In group 1, maxillary canines did not undergo significant distal movement. In both groups 1 and 2, mandibular first molars experienced significant mesial movement (1.85 ± 1.88 mm and 2.44 ± 2.02 mm, respectively). Group 1 showed statistically significantly less reduction in overjet and less canine distal movement with less distal tipping than group 2 (α &lt; .05). Conclusions The shorty CMA achieved Class II correction similarly to the standard CMA, with less change in overjet and distal tipping movement of the maxillary canines.

Sign in / Sign up

Export Citation Format

Share Document