scholarly journals Pathophysiology of worsening lung function in COVID-19

2020 ◽  
Vol 19 (2) ◽  
pp. 40
Author(s):  
Giulliano Gardenghi
Keyword(s):  
Lung Function ◽  
Gas Exchange ◽  
Health Professionals ◽  
Complex Disease ◽  
Pulmonary Complications ◽  
Pathophysiological Process ◽  
Search Terms ◽  
Pulmonary Impairment ◽  
Ventilatory Capacity ◽  
Present Part

Introduction: The new coronavirus pneumonia (COVID-19) has emerged as the main threats to global health since December 2019. Addressing part of the pulmonary pathophysiology involved in the disease is important to help interested health professionals better understand the different aspects of this complex pathology. Aim: This article aims to present part of the pathophysiological process involved in pulmonary complications associated with Covid-19. Methods: An integrative literature review was carried out, with articles published between 2019 and 2020, in the Google and PubMed databases, using the following search terms: coronavirus, COVID-19, pulmonary complications, pneumonia. Results: 6 articles were included, addressing the proposed theme. Conclusion: The individual's infection with COVID-19 has the potential to cause significant changes in ventilatory capacity, leading to diffuse pulmonary impairment and worsening gas exchange. Further studies are needed to clarify the pathophysiology of this complex disease with a high potential for contagion, morbidity and mortality.Keywords: coronavirus infections, communicable diseases, pneumonia.  

scholarly journals Pulmonary restriction predicts long-term pulmonary impairment in people with HIV and tuberculosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara C. Auld ◽  
Hardy Kornfeld ◽  
Pholo Maenetje ◽  
Mandla Mlotshwa ◽  
William Chase ◽  
...  
Keyword(s):  
Lung Function ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Logistic Regression Models ◽  
Pulmonary Impairment ◽  
Mixed Pattern

Abstract Background While tuberculosis is considered a risk factor for chronic obstructive pulmonary disease, a restrictive pattern of pulmonary impairment may actually be more common among tuberculosis survivors. We aimed to determine the nature of pulmonary impairment before and after treatment among people with HIV and tuberculosis and identify risk factors for long-term impairment. Methods In this prospective cohort study conducted in South Africa, we enrolled adults newly diagnosed with HIV and tuberculosis who were initiating antiretroviral therapy and tuberculosis treatment. We measured lung function and symptoms at baseline, 6, and 12 months. We compared participants with and without pulmonary impairment and constructed logistic regression models to identify characteristics associated with pulmonary impairment. Results Among 134 participants with a median CD4 count of 110 cells/μl, 112 (83%) completed baseline spirometry at which time 32 (29%) had restriction, 13 (12%) had obstruction, and 9 (7%) had a mixed pattern. Lung function was dynamic over time and 30 (33%) participants had impaired lung function at 12 months. Baseline restriction was associated with greater symptoms and with long-term pulmonary impairment (adjusted odds ratio 5.44, 95% confidence interval 1.16–25.45), while baseline obstruction was not (adjusted odds ratio 1.95, 95% confidence interval 0.28–13.78). Conclusions In this cohort of people with HIV and tuberculosis, restriction was the most common, symptomatic, and persistent pattern of pulmonary impairment. These data can help to raise awareness among clinicians about the heterogeneity of post-tuberculosis pulmonary impairment, and highlight the need for further research into mediators of lung injury in this vulnerable population.

Surfactant protein D as a marker for pulmonary complications in pediatric patients with sickle cell disease: Relation to lung function tests

2019 ◽  
Vol 54 (5) ◽  
pp. 610-619 ◽  
Author(s):  
Azza A. Tantawy ◽  
Amira A. Adly ◽  
Fatma S. E. Ebeid ◽  
Eman A. Ismail ◽  
Mahitab M. Hussein ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Lung Function ◽  
Sickle Cell ◽  
Pediatric Patients ◽  
Surfactant Protein ◽  
Pulmonary Complications ◽  
Surfactant Protein D ◽  
Lung Function Tests ◽  
Cell Disease ◽  
Function Tests

scholarly journals Mechanisms of gas exchange response to lung volume reduction surgery in severe emphysema

2011 ◽  
Vol 110 (4) ◽  
pp. 1036-1045 ◽  
Author(s):  
George Cremona ◽  
Joan A. Barbara ◽  
Teresa Melgosa ◽  
Lorenzo Appendini ◽  
Josep Roca ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Gas Exchange ◽  
Pulmonary Disease ◽  
Lung Volume ◽  
Chronic Obstructive ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Obstructive Pulmonary Disease

Lung volume reduction surgery (LVRS) improves lung function, respiratory symptoms, and exercise tolerance in selected patients with chronic obstructive pulmonary disease, who have heterogeneous emphysema. However, the reported effects of LVRS on gas exchange are variable, even when lung function is improved. To clarify how LVRS affects gas exchange in chronic obstructive pulmonary disease, 23 patients were studied before LVRS, 14 of whom were again studied afterwards. We performed measurements of lung mechanics, pulmonary hemodynamics, and ventilation-perfusion (V̇a/Q̇) inequality using the multiple inert-gas elimination technique. LVRS improved arterial Po2 (PaO2) by a mean of 6 Torr ( P = 0.04), with no significant effect on arterial Pco2 (PaCO2), but with great variability in both. Lung mechanical properties improved considerably more than did gas exchange. Post-LVRS PaO2 depended mostly on its pre-LVRS value, whereas improvement in PaO2 was explained mostly by improved V̇a/Q̇ inequality, with lesser contributions from both increased ventilation and higher mixed venous Po2. However, no index of lung mechanical properties correlated with PaO2. Conversely, post-LVRS PaCO2 bore no relationship to its pre-LVRS value, whereas changes in PaCO2 were tightly related ( r2 = 0.96) to variables, reflecting decrease in static lung hyperinflation (intrinsic positive end-expiratory pressure and residual volume/total lung capacity) and increase in airflow potential (tidal volume and maximal inspiratory pressure), but not to V̇a/Q̇ distribution changes. Individual gas exchange responses to LVRS vary greatly, but can be explained by changes in combinations of determining variables that are different for oxygen and carbon dioxide.

Respiration in man during metabolic alkalosis

1962 ◽  
Vol 17 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Daniel J. Stone
Keyword(s):  
Carbon Dioxide ◽  
Steady State ◽  
Lung Function ◽  
Gas Exchange ◽  
Metabolic Alkalosis ◽  
Time Lag ◽  
Respiratory Compensation ◽  
Arterial Ph ◽  
Oral Sodium ◽  
Ventilation Response

A steady state metabolic alkalosis was induced in two subjects over a period of several days utilizing oral sodium bicarbonate in dosages of 50 g/day. The purpose of inducing steady state metabolic alkalosis was to study the effects of such a state on the respiratory center responses to inspired gas mixtures, containing carbon dioxide, and to contrast these results with the control studies. The experiment was so designed that the arterial pH in both subjects tended to return toward normal in the presence of significant increases in blood bicarbonate. Repeated study of ventilation responses with room air and 4% and 6% carbon dioxide in inspired air revealed a definite and significant decrease in ventilation response to carbon dioxide during the periods of steady state alkalosis as compared to the control periods. Normal responses returned after some time lag. A consistent rise in paCOCO2 occurred with alkalosis, thus demonstrating respiratory compensation. In neither subject was total lung function or gas exchange affected by the alkalosis. The experiment was confirmed on several occasions with reproducible results. Note: (With the Research Assistance of Mary Di Lieto) Submitted on May 22, 1961

The multidisciplinary team

2021 ◽  
pp. 561-592
Author(s):  
Terry Robinson ◽  
Jane Scullion
Keyword(s):  
Lung Function ◽  
Respiratory Disease ◽  
Social Services ◽  
Health Professionals ◽  
Multidisciplinary Team ◽  
Secondary Care ◽  
Patient Population ◽  
Community Pharmacists ◽  
Occupational Therapists

Respiratory services should be delivered in an integrated way, taking into account the overlap in patient population and in the personnel providing care. The majority of patients with respiratory disease are cared for by a team of health professionals from both primary and secondary care. Respiratory nurses work as part of the multidisciplinary team. This team includes doctors, ward-based, and outpatient nurses, physiotherapists, occupational therapists, lung-function technicians, community pharmacists, social services and, of course, the patient, and their family and carers. This chapter outlines the responsibilities and contributions of each member of the multidisciplinary team in providing respiratory services.

Benign disease of the vulva

2020 ◽  
pp. 627-636
Author(s):  
Rosalind Simpson ◽  
David Nunns
Keyword(s):  
Health Professionals ◽  
Complex Disease ◽  
Treatment Strategies ◽  
Pain Syndrome ◽  
Skin Condition ◽  
Knowledge And Skills ◽  
Level Of Functioning ◽  
Individualized Management ◽  
Vulval Disease ◽  
Careful Assessment

This chapter aims to enhance knowledge and skills in patient assessment, vulval examination, and treatment of vulval disease, specifically dermatological conditions and vulval pain. The prompt identification and treatment of vulval conditions can reduce anxiety, alleviate symptoms, and preserve an acceptable level of functioning for patients. Often simple measures can benefit the patient (e.g. use of emollients), but many have complex disease and can present with more than one condition so careful assessment and individualized management is essential. Combining treatment strategies is sometimes needed. Vulvodynia is not a skin condition but a chronic pain syndrome and is also covered in this chapter. It is important that health professionals work within their own competencies. Patients with complicated, rare, and treatment-refractory disease should be referred on to a vulval service for a multidisciplinary opinion.

scholarly journals Damaged lung gas exchange function of discharged COVID-19 patients detected by hyperpolarized 129Xe MRI

2020 ◽  
Vol 7 (1) ◽  
pp. eabc8180
Author(s):  
Haidong Li ◽  
Xiuchao Zhao ◽  
Yujin Wang ◽  
Xin Lou ◽  
Shizhen Chen ◽  
...  
Keyword(s):  
Lung Function ◽  
Gas Exchange ◽  
Recovery Process ◽  
Blood Exchange ◽  
Structural Abnormalities ◽  
Hyperpolarized 129Xe ◽  
Magnetic Resonance Imaging Mri ◽  
And Function ◽  
Exchange Function ◽  
The Impact

The recovery process of COVID-19 patients is unclear. Some recovered patients complain of continued shortness of breath. Vasculopathy has been reported in COVID-19, stressing the importance of probing pulmonary microstructure and function at the alveolar-capillary interface. While computed tomography (CT) detects structural abnormalities, little is known about the impact of disease on lung function. 129Xe magnetic resonance imaging (MRI) is a technique uniquely capable of assessing ventilation, microstructure, and gas exchange. Using 129Xe MRI, we found that COVID-19 patients show a higher rate of ventilation defects (5.9% versus 3.7%), unchanged microstructure, and longer gas-blood exchange time (43.5 ms versus 32.5 ms) compared with healthy individuals. These findings suggest that regional ventilation and alveolar airspace dimensions are relatively normal around the time of discharge, while gas-blood exchange function is diminished. This study establishes the feasibility of localized lung function measurements in COVID-19 patients and their potential usefulness as a supplement to structural imaging.

scholarly journals Pre–Hematopoietic Stem Cell Transplant Lung Function and Pulmonary Complications in Children

2014 ◽  
Vol 11 (10) ◽  
pp. 1576-1585 ◽  
Author(s):  
Ashok Srinivasan ◽  
Saumini Srinivasan ◽  
Sudeep Sunthankar ◽  
Anusha Sunkara ◽  
Guolian Kang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Lung Function ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Pulmonary Complications ◽  
Cell Transplant ◽  
Hematopoietic Stem

24 An analysis of sentiment and publicity of functional neurological disorder and non-epileptic attack disorder on twitter

2020 ◽  
Vol 91 (8) ◽  
pp. e17.3-e18
Author(s):  
Felix May ◽  
Rohan Kandasamy
Keyword(s):  
Health Professionals ◽  
Neurological Disorder ◽  
Public Discourse ◽  
Medically Unexplained Symptoms ◽  
Awareness Campaigns ◽  
Search Terms ◽  
Epileptic Attack ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Functional Neurological Disorder

ObjectivesTwitter may provide a platform for clinicians and allied health professionals to publicise Functional Neurological Disorder (FND) and Non-Epileptic Attack Disorder (NEAD), and also provides a platform for patients and their communities to discuss the disorders. The prevalence and sentiment of discussions of these disorders have not been reported before now. We wrote a program to collect and analyse ‘Tweets’ about the subjects in their sentiment, connectivity and content.MethodsPreliminary searches and graph analyses identified the most relevant search terms. Tweets were collected automatically, along with available metadata. Sentiment analysis was performed using natural language processing with valence aware dictionary analysis, allowing automatic interpretation of text including idioms and ‘emojis’.Results13347 tweets were collected, with tweets not in English having been excluded from the analysis. The analysis showed a majority positive sentiment in the tweets. The most negative discourse was related to search terms: ‘Medically Unexplained Symptoms’ and ‘Psychosomatic’. Engagement with charities and tweets aiming to promote awareness of the disorders in question were common. Most frequent links to posts about FND were synonyms for the disorder, along with NEAD and charities and awareness movements. For NEAD, the most common links made were with FND, awareness campaigns, synonyms for NEAD, and Chronic Fatigue Syndrome.ConclusionsFND and NEAD have active communities on Twitter. These include both health professionals, patients and lay advocates. The overall sentiment is positive (p<0.05), but with some negativity from sceptical patients and some who are disappointed with their care, and with more negativity associated with certain search terms. (For example, more negative sentiment in tweets about ‘Medically Unexplained Symptoms’ compared to ones about ‘Functional Neurological Disorder’, p<0.0005). Public discourse analysis on websites such as Twitter may prove fruitful for monitoring patient understanding, trends in patient acceptance of diagnosis and factors contributing to these.

Prolonged methacholine-induced bronchoconstriction in dogs

1979 ◽  
Vol 47 (2) ◽  
pp. 418-424 ◽  
Author(s):  
J. W. Ramsdell ◽  
P. F. Georghiou
Keyword(s):  
Lung Function ◽  
Gas Exchange ◽  
Lung Compliance ◽  
Cholinergic Stimulation ◽  
Partial Pressure Of Oxygen ◽  
Pulmonary Resistance ◽  
Mechanically Ventilated ◽  
Arterial Partial Pressure ◽  
Dynamic Lung Compliance ◽  
And Control

We studied the effect of prolonged airways obstruction induced by extended cholinergic stimulation in five anesthetized, mechanically ventilated dogs. A continuous intravenous metacholine infusion was utilized to maintain pulmonary resistance (RL) at 200--1500% preinfusion levels for 13--23 h. At maximum RL (18.86 +/- 7.74 vs. 2.09 +/- 0.18 (mean +/- SD) cmH2O/ (L/S) PREINfusion; P less than 0.01), dynamic lung compliance (Cdyn) fell from 67.5 +/- 14.6 to 32.7 +/- 11.6 ml/cmH2O (P less than 0.005) and arterial partial pressure of oxygen (PaO2) fell modestly from 95.8 +/- 6.1 Torr preinfusion to 83.2 +/- 12.7 Torr (P less than 0.05). Tachyphylaxis to methacholine developed, requiring increases in infusion rates to maintain elevated RL. Abnormalities in lung function resolved promptly upon termination of the infusion. Two similarly instrumented control animals ventilated for 19 and 25 h without metacholine infusion had no change in RL, Cdyn, or PaO2. Histological examination of the lungs revealed no differences between infused and control animals. In spite of marked increases in RL, prolonged cholinergic stimulation produced only mild changes in gas exchange and no sustained changes in lung function or structure.

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