scholarly journals A STUDY OF PULMONARY FUNCTION TESTS IN A PATIENTS WITH TYPE 2 DIABETES MELLITUS AND THEIR ASSOCIATION WITH GLYCAEMIC CONTROL AND DURATION OF DIABETES AT TERTIARY CARE HOSPITAL

Author(s):  
Dr. Sonam Gupta ◽  
Dr. Yadvendra Gupta

Background- The pulmonary and other late complications of diabetes share a similar microangiopathy mechanism. Since, they share common mechanisms there may be associations between lung function and markers of microangiopathy. Therefore, we aimed to determine the association of pulmonary function with diabetes and the correlation of pulmonary function abnormalities with microvascular complications. Methods- This was a cross sectional comparative study carried out in a tertiary care teaching hospital in Jaipur,Rajasthan, India. Eligible participants included 100 adults below 60 years of age with T2DM attending the outpatient clinics or admitted to the wards during the study period, and an equal number of non-diabetic adults matched for age and gender who served as the comparative controls. Results- The present study clearly showed a highly statistically significant p value when the lung function tests (FVC, FEV1, and PEFR) were compared between type 2 diabetics and age, sex, BMI matched controls. The duration of DM and PFT correlation was found stastically significant and HbA1c and PFT correlation was found stastically Insignificant. Conclusion- Chronic hyperglycemia in diabetes may lead to diabetes associated systemic inflammation which results in airway and lung damage. Diabetes was more common in the sixth decade of life with slight male preponderance. The most common PFT derangement pattern in diabetic subjects is a restrictive pattern and having a significantly longer duration of a diabetic. The short-term indicators of glycemic controls were not significantly associated with a restrictive pattern of PFT. Keywords: Diabetes, Pulmonary function test, HbA1c, Duration of diabetes.

Author(s):  
Mahendrakumar Kalappan ◽  
Kannan Rajendran ◽  
Prasanna Suthakaran ◽  
Priyanka Thangaraj ◽  
Gayathri Ganapathy ◽  
...  

Lupus ◽  
2021 ◽  
pp. 096120332110103
Author(s):  
Alfonso Ragnar Torres Jimenez ◽  
Nayma Ruiz Vela ◽  
Adriana Ivonne Cespedes Cruz ◽  
Alejandra Velazquez Cruz ◽  
Alma Karina Bernardino Gonzalez

Shrinking Lung Syndrome (SLS) is a rare and little known complication associated with Systemic Lupus Erythematosus (SLE), characterized by progressive and unexplainable dyspnea, pleuritic pain, small pulmonary volumes and elevation of the diaphragm on chest X-rays as well as restrictive pattern on pulmonary function tests. Objective To describe clinical, radiological and treatment characteristics in pediatric patients with SLS. Material and methods This is a descriptive and retrospective study in patients under 16 years old with the diagnosis of SLE complicated by SLS at the General Hospital. National Medical Center La Raza. Clinical, radiological and treatment variables were analyzed. Results are shown in frequencies and percentages. Results Data from 11 patients, 9 females and 2 males were collected. Mean age at diagnosis of SLS was 12.2 years. Age at diagnosis of SLE was 11.1 years. SLEDAI 17.3. Renal desease 72%, hematological 91%, lymphopenia 63%, mucocutaneous 72%, neurological 9%, arthritis 54%, serositis 91%, fever 81%, secondary antiphospholipid syndrome, low C3 72%, low C4 81%, positive ANA 91%, positive anti-DNA 91%. Regarding clinical manifestations of SLE: cough 81%, dyspnea 91%, hipoxemia 81%, pleuritic pain 71%, average oxygen saturation 83%. Chest X-rays findings: right hemidiaphragm affection 18%, left 63%, bilateral 18%. Elevated hemidiaphragm 91%, atelectasis 18%, pleural effusion 91%, over one third of the cardiac silhouette under the diphragm 36%, bulging diaphragm 45%, 5th. anterior rib that crosses over the diaphragm 91%. M-mode ultrasound: diaphragmatic hypomotility 100%, pleural effusion 63%. Pulmonary function tests: restrictive pattern in 45% of the cases. Treatment was with supplementary oxygen 100%, intubation 18%, antibiotics 100%, steroids 100%, intravenous immunoglobulin 54%, plasmapheresis 18%, cyclophosphamide 54% and rituximab 18%. The clinical course was favorable in 81%. Conclusions SLS should be suspected in patients with SLE and active disease who present hipoxemia, pleuritic pain, cough, dyspnea, pleural effusion and signs of restriction on chest X-rays. Therefore, a diaphragmatic M-mode ultrasound should be performed in order to establish the diagnosis.


Diagnostics ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 33 ◽  
Author(s):  
Joshua Gawlitza ◽  
Timo Sturm ◽  
Kai Spohrer ◽  
Thomas Henzler ◽  
Ibrahim Akin ◽  
...  

Introduction: Quantitative computed tomography (qCT) is an emergent technique for diagnostics and research in patients with chronic obstructive pulmonary disease (COPD). qCT parameters demonstrate a correlation with pulmonary function tests and symptoms. However, qCT only provides anatomical, not functional, information. We evaluated five distinct, partial-machine learning-based mathematical models to predict lung function parameters from qCT values in comparison with pulmonary function tests. Methods: 75 patients with diagnosed COPD underwent body plethysmography and a dose-optimized qCT examination on a third-generation, dual-source CT with inspiration and expiration. Delta values (inspiration—expiration) were calculated afterwards. Four parameters were quantified: mean lung density, lung volume low-attenuated volume, and full width at half maximum. Five models were evaluated for best prediction: average prediction, median prediction, k-nearest neighbours (kNN), gradient boosting, and multilayer perceptron. Results: The lowest mean relative error (MRE) was calculated for the kNN model with 16%. Similar low MREs were found for polynomial regression as well as gradient boosting-based prediction. Other models led to higher MREs and thereby worse predictive performance. Beyond the sole MRE, distinct differences in prediction performance, dependent on the initial dataset (expiration, inspiration, delta), were found. Conclusion: Different, partially machine learning-based models allow the prediction of lung function values from static qCT parameters within a reasonable margin of error. Therefore, qCT parameters may contain more information than we currently utilize and can potentially augment standard functional lung testing.


2020 ◽  
Author(s):  
Pagé C. Goddard ◽  
Kevin L. Keys ◽  
Angel C.Y. Mak ◽  
Eunice Yujung Lee ◽  
Amy K. Liu ◽  
...  

AbstractBronchodilator drugs are commonly prescribed for treatment and management of obstructive lung function present with diseases such as asthma. Administration of bronchodilator medication can partially or fully restore lung function as measured by pulmonary function tests. The genetics of baseline lung function measures taken prior to bronchodilator medication has been extensively studied, and the genetics of the bronchodilator response itself has received some attention. However, few studies have focused on the genetics of post-bronchodilator lung function. To address this gap, we analyzed lung function phenotypes in 1,103 subjects from the Study of African Americans, Asthma, Genes, and Environment (SAGE), a pediatric asthma case-control cohort, using an integrative genomic analysis approach that combined genotype, locus-specific genetic ancestry, and functional annotation information. We integrated genome-wide association study (GWAS) results with an admixture mapping scan of three pulmonary function tests (FEV1, FVC, and FEV1/FVC) taken before and after albuterol bronchodilator administration on the same subjects, yielding six traits. We identified 18 GWAS loci, and 5 additional loci from admixture mapping, spanning several known and novel lung function candidate genes. Most loci identified via admixture mapping exhibited wide variation in minor allele frequency across genotyped global populations. Functional fine-mapping revealed an enrichment of epigenetic annotations from peripheral blood mononuclear cells, fetal lung tissue, and lung fibroblasts. Our results point to three novel potential genetic drivers of pre- and post-bronchodilator lung function: ADAMTS1, RAD54B, and EGLN3.


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