scholarly journals Impact of Low-Dose Irradiation of the Lung and Heart on Toxicity and Pulmonary Function Parameters after Thoracic Radiotherapy

Cancers ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 22
Author(s):  
Christina Schröder ◽  
André Buchali ◽  
Paul Windisch ◽  
Erwin Vu ◽  
Lucas Basler ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Low Dose ◽  
Pulmonary Function Tests ◽  
Thoracic Radiotherapy ◽  
Dose Irradiation ◽  
Dosimetric Data ◽  
Diffusion Parameters ◽  
Blood Gas Parameters ◽  
The Impact

Objective: To assess the impact of (low) dose irradiation to the lungs and heart on the incidence of pneumonitis and pulmonary function changes after thoracic radiotherapy (RT). Methods/Material: Data of 62 patients treated with curative thoracic radiotherapy were analyzed. Toxicity data and pulmonary function tests (PFTs) were obtained before RT and at 6 weeks, at 12 weeks, and at 6 months after RT. PFTs included ventilation (e.g., vital capacity) and diffusion parameters (e.g., diffusion capacity for carbon monoxide (DLCO)). Dosimetric data of the lung and heart were extracted to assess the impact of dose on PFT changes and radiation pneumonitis (RP). Results: No statistically significant correlations between dose parameters and changes in ventilation parameters were found. There were statistically significant correlations between DLCO and low-dose parameters of the lungs (V5Gy–V30Gy (%)) and irradiation of the heart during the follow-up up to 6 months after RT, as well as a temporary correlation of the V60Gy (%) on the blood gas parameters at 12 weeks after RT. On multivariate analysis, both heart and lung parameters had a significant impact on DLCO. There was no statistically significant influence of any patient or treatment-related (including dose parameters) factors on the incidence of ≥G2 pneumonitis. Conclusion: There seems to be a lasting impact of low dose irradiation to the lung as well as irradiation to the heart on the DLCO after thoracic radiotherapy. No influence on RP was found in this analysis.

scholarly journals A qualitative study of pulmonary function tests between smokers and non smokers in Telangana state

2021 ◽  
Vol 8 (3) ◽  
pp. 219-225
Author(s):  
Farzana Mustafa ◽  
Abdul Hai Mohammad
Keyword(s):  
Qualitative Study ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Medical College ◽  
Quit Smoking ◽  
The Mean ◽  
Telangana State ◽  
Gandhi Medical College ◽  
The Impact

 In a few examinations, low spirometric levels have been displayed to expand the achievement paces of smoking discontinuance, while different investigations have demonstrated that aspiratory work affects stopping smoking. Given the way that there are conflicting outcomes regarding this matter, we expected to research the impact of distinguishing aviation route obstacle by means of spirometry and its clarification to subjects on the achievement pace of smoking discontinuance temporarily. The current study was led in Gandhi Medical College, Hyderabad, India, Subjects who were conceded to the smoking discontinuance out-patient facility, went through pneumonic capacity tests (PFTs) and finished somewhere around 90 days of the suspension program following their induction were remembered for the investigation. The mean age of the 563 subjects was 41.9 ± 12.1 y 340 subjects (60.4%) were male. An aggregate of 162 subjects (28.8%) went to the subsequent visits following the primary meeting. The accomplishment of smoking suspension for 90 days was 11.3% for all subjects and 39.5% for subjects who came to follow-up visits. Of the subjects with impediment on PFT; 22.8% quit smoking, while 8.4% of the subjects without block did as such (P < .001). The level of subjects with impediment on PFT was altogether higher (P < .001) and the FEV1 % (P = .005), FEV1/FVC (P < .001), and constrained expiratory stream 25–75% (P = .008) levels were fundamentally lower in the weaklings contrasted and the non-slackers. Strategic relapse investigation showed that age (P = .001) and the presence of impediment on pft (p = .029) were autonomous factors. Old age and the presence of impediment on PFT increment the accomplishment of smoking end. Aspiratory work tests ought to be performed on all patients who apply to smoking end out-patient facilities, and patients ought to be educated with regards to their condition.

scholarly journals Responses to Incremental Exercise and the Impact of the Coexistence of HF and COPD on Exercise Capacity: A Follow-up Study

2021 ◽  
Author(s):  
Polliana B. Dos Santos ◽  
Rodrigo P. Simões ◽  
Cassia L. Goulart ◽  
Guilherme P. T. Arêas ◽  
Renan S. Marinho ◽  
...  
Keyword(s):  
Body Composition ◽  
Oxygen Uptake ◽  
Pulmonary Function ◽  
Lean Mass ◽  
Exercise Performance ◽  
Pulmonary Function Tests ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Obstructive ◽  
The Impact

Abstract Aim: Our aim was to evaluate: 1) the prevalence of coexistence of heart failure (HF) and chronic obstructive pulmonary disease (COPD) in the studied population; 2) the impact of HF+COPD on exercise performance and contrasting exercise responses in patients with only a diagnosis of HF or COPD; and 3) the relationship between clinical characteristics and measures of cardiorespiratory fitness; 4) verify the occurrence of cardiopulmonary events in the follow-up period of up to 24 months years.Methods: The current study included 124 patients (HF:46, COPD: 53 and HF+COPD:25) that performed advanced pulmonary function tests, echocardiography, analysis of body composition by bioimpedance and symptom-limited incremental cardiopulmonary exercise testing (CPET) on a cycle ergometer. All patients were contacted by telephone every 6 months and questioned about exacerbations, hospitalizations for cardiopulmonary causes and death. Results: We found a 20% prevalence of HF + COPD overlap in the studied population. Patients with HF+COPD demonstrated a lower work rate (WR), peak oxygen uptake (V̇O2), rate pressure product (RPP), circulatory power (CP) and ventilatory power (VP) compared to those only diagnosed with HF and COPD. In addition, significant correlations were observed between lean mass and peak V̇O2 (r: 0.56 p< 0.001), the oxygen uptake efficiency slope (OUES) (r: 0.42 p<0.001), and O2 pulse (r: 0.58 p<0.001), lung diffusing factor for carbon monoxide (DLCO) and WR (r: 0.51 p< 0.001), DLCO and VP (r: 0.40 p: 0.002), forced expiratory volume in first second (FEV1) and peak V̇O2 (r: 0.52; p< 0.001), and FEV1 and WR (r: 0.62; p<0.001). There were no significant differences in the occurrence of events and deaths contrasting both groups.Conclusion: the coexistence of HF+COPD induces greater impairment on exercise performance when compared to patients without overlapping diseases, however the overlap of the two diseases did not increase the probability of the occurrence of cardiopulmonary events and deaths when compared to groups with isolated diseases in the period studied. CPET provides important information to guide effective strategies for these patients with the goal of improving exercise performance and functional capacity. Moreover, given our findings related to pulmonary function, body composition and exercise responses, evidenced that the lean mass, FEV1 and DLCO influence important responses to exercise.

scholarly journals Serum IGFBP-2 in systemic sclerosis as a prognostic factor of lung dysfunction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julien Guiot ◽  
Makon-Sébastien Njock ◽  
Béatrice André ◽  
Fanny Gester ◽  
Monique Henket ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Prognostic Factor ◽  
Pulmonary Function ◽  
Lung Disease ◽  
Pulmonary Function Tests ◽  
Serum Levels ◽  
Roc Curve Analysis ◽  
Significant Deterioration ◽  
Lung Dysfunction

AbstractSystemic sclerosis (SSc) is a rare connective tissue disease associated with rapid evolving interstitial lung disease (ILD), driving its mortality. Specific biomarkers associated with the progression of this lung disease are highly needed. We aimed to identify specific biomarkers of SSc-ILD to predict the evolution of the disease. For this, we compared prospectively serum levels of several biomarkers associated with lung fibrosis in SSc patients (n = 102), among which SSc-no ILD (n = 63) and SSc-ILD (n = 39), compared to healthy subjects (HS) (n = 39). We also performed a longitudinal study in a subgroup of 28 patients analyzing biomarkers variations and pulmonary function tests over a period of 2 years. Serum level of IGFBP-2 was significantly increased in SSc patients compared to HS, and negatively correlated with pulmonary function (assessed by carbon monoxide transfer coefficient (KCO)) (r = − 0.29, p < 0.01). Two-year longitudinal analysis in a subgroup of 28 SSc patients determined that IGFBP-2 variation was positively correlated with KCO at 2-year follow-up (r = 0.6, p < 0.001). SSc patients with a lower variation of IGFBP-2 (less than 22%) presented significant deterioration of pulmonary function at 2-year follow-up (p < 0.01). ROC curve analysis enabled us to identify that baseline IGFBP-2 > 105 ng/ml was associated with a poor outcome (KCO < 70% predicted) at 2-year follow-up (AUC = 0.75, p < 0.05). We showed for the first time that serum levels of IGFBP-2 might be a prognostic factor of the development of SSc-ILD.

scholarly journals Computed tomography findings as determinants of pulmonary function tests in fibrotic interstitial lung diseases—Network-analyses and multivariate models

2020 ◽  
Vol 17 ◽  
pp. 147997312096702
Author(s):  
David Lang ◽  
Kaveh Akbari ◽  
Stefan Walcherberger ◽  
Benedikt Hergan ◽  
Andreas Horner ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Information Criterion ◽  
Forced Expiratory Volume ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Diffusion Capacity ◽  
Network Analyses ◽  
The Impact

The aim was to evaluate the impact of multiple high-resolution computed tomography (HRCT) features on pulmonary function test (PFT) biomarkers in fibrotic interstitial lung disease (FILD) patients. HRCT of subsequently ILD-board-discussed FILD patients were semi-quantitatively evaluated in a standardized approach: 18 distinct lung regions were scored for noduli, reticulation, honeycombing, consolidations, ground glass opacities (GGO), traction bronchiectasis (BRK) and emphysema. Total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, diffusion capacity for carbon monoxide (DLCO) and transfer coefficient (KCO) were assessed. Interactions between each PFT biomarker and all HRCT scores were visualized by network analyses, modeled according to the Schwarz Bayesian Information Criterion and incorporated in uni- and multivariate stepwise regression analyses. Among 108 FILD patients (mean age 67 years, 77% male), BRK extent was a major significant uni- or multivariate determinant of all PFT analyzed. Besides that, diffusion-based variables DLCO and KCO showed a larger dependency on reticulation, emphysema and GGO, while forced expiratory volume-based measures FEV1, FVC and FEV1/FVC were more closely associated with consolidations. For TLC, the only significant multivariate determinant was reticulation. In conclusion, PFT biomarkers derived from spirometry, body plethysmography and diffusion capacity in FILD patients are differentially influenced by semi-quantified HRCT findings.

scholarly journals Serum biomarker CA 15-3 as predictor of response to antifibrotic treatment and survival in idiopathic pulmonary fibrosis

2020 ◽  
Vol 14 (11) ◽  
pp. 997-1007
Author(s):  
Sofia A Moll ◽  
Ivo A Wiertz ◽  
Adriane DM Vorselaars ◽  
Pieter Zanen ◽  
Henk JT Ruven ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pulmonary Function ◽  
Vital Capacity ◽  
Mixed Model ◽  
Pulmonary Function Tests ◽  
Hazard Ratio ◽  
Poor Survival ◽  
Function Test

Aim: Cancer antigen 15-3 (CA 15-3) is a baseline biomarker in idiopathic pulmonary fibrosis (IPF), but its value during follow-up is unknown. Materials and methods: Associations between serum CA 15-3 and pulmonary function tests during 1-year follow-up were evaluated by a mixed model in 132 IPF treated with pirfenidone or nintedanib. Results: Increased baseline (median: 56 kU/l) and follow-up CA 15-3 levels were inversely associated with forced vital capacity and diffusing capacity of the lung for carbon monoxide (estimates respectively: -5.21 and -4.69; p < 0.001). Baseline and 6-month CA 15-3 above 58.5 (hazard ratio: 1.67; p = 0.031) and 50.5 kU/l (hazard ratio: 2.99; p < 0.001), respectively, showed impaired survival compared with lower levels. Conclusion: CA 15-3 is associated with pulmonary function test during follow-up in IPF on antifibrotic treatment. Higher (follow-up) values are related with poor survival. Therefore, CA 15-3 is a promising follow-up biomarker in IPF.

scholarly journals Contribution of pulmonary function tests (PFTs) to the diagnosis and follow up of connective tissue diseases

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Nicola Ciancio ◽  
Mauro Pavone ◽  
Sebastiano Emanuele Torrisi ◽  
Ada Vancheri ◽  
Domenico Sambataro ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Connective Tissue Diseases ◽  
Function Tests

scholarly journals Dual T-Cell Depletion with a Very Low Dose of ATG and Ptcy Provides an Effective Control of Acute Gvhd in PBSC RIC Allo-HSCT

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5669-5669
Author(s):  
Maria Queralt Salas ◽  
Arjun Law ◽  
Wilson Lam ◽  
David Loach ◽  
Zeyad Al-Shaibani ◽  
...  
Keyword(s):  
Low Dose ◽  
Acute Gvhd ◽  
Effective Control ◽  
Post Transplant ◽  
Transplant Outcomes ◽  
Gvhd Prophylaxis ◽  
Unrelated Donors ◽  
Grade Ii ◽  
The Impact

Introduction As has been described by Dr. Viswabandya et al, the combination of anti-thymoglobulin (ATG), post-transplant cyclophosphamide (PTCy) and cyclosporine (CsA) provides an effective control of graft-versus host disease (GVHD) in peripheral blood (PB) allo-HSCT. We aim to report our experience in reduced intensity conditioning (RIC) allo-HSCT using a novel GVHD prophylaxis composed by a very low dose of ATG, PTCy and CsA for GVHD prophylaxis. Patients and methods Between May 2018 and April 2019, 106 adult patients underwent RIC allo-HSCT with the present GVHD prophylaxis. All these recipients were included in the study. RIC regimen was composed by fludarabine, busulfan, and 200cGy of total body irradiation. For GVHD prophylaxis all recipients received a total dose of 2mg/kg of rabbit-ATG on day -3 (0.5mg/kg) and -2 (1.5mg/kg), PTCy 50mg/m2/day on day +3 and +4, and CsA since day +5. Data was collected retrospectively and updated on July 2019. The median follow-up was 7.6 months (range: 0.4-14.6) and survival percentages were calculated at 6 months. The cum.Inc of GVHD was assessed accounting relapse and death as competing events. Results The main baseline and post-transplant information is summarized in the Table 1 and 2. The cum.Inc of grade II-IV and III-IV acute GVHD at day +100 was 19% and 7.7%. The cum.Inc of grade II- IV was not significantly affected by donor type (P=0.787). However, the cum.Inc of grade III-IV was significantly higher in those recipients who received haploidentical or 9/10 matched unrelated donor (MUD) grafts (p=0.048). Rates of CMV and EBV reactivation were respectively 62.3% and 68.9%. No patients were diagnosed with CMV disease. Biopsy proven post-transplant lymphoproliferative disorder was diagnosed in only 1 recipient and successfully resolved after rituximab. Thirty-two (30.2%) recipients died and 16 (15.1%) relapsed during the follow-up. Main causes of death were relapse 13 (12.3%) and infection 6 (5.7%). The main outcome information is reported in the Table 2 and Plot 1 and 2. Those recipients who received grafts from matched related and unrelated donors had a significant better non-relapse mortality (NRM) (P=0.001), overall survival (OS) (P=0.02), relapse-free survival (RFS) (P=0.03) and GVHD-free/RFS (P=0.006). Table 3 shows the impact of risk factors in transplant outcomes. Those recipients with an HCT-CI score ≥3 had a significant worse OS (HR 2.5; P=0.024) and RFS (HR 2.5; P=0034). Those recipients who received grafts from 9/10 MUD and haploidentical donors had a significant worse RFS (HR 2.1; P=0.049). Disease risk index was not a significant risk factor for OS or RFS. Lastly, those recipients who received grafts from haploidentical donors had a significant worse GRFRS (HR 2.9; P=0.04). Conclusion The dose of ATG for GVHD prophylaxis is not well established. The combination of ATG (2mg/kg), PTCy, and CsA is safe and provides an effective acute GVHD prophylaxis in PB RIC allo-HSCT. Further investigations are required to analyze the effect of this prophylaxis in chronic GVHD to better state long-term outcome conclusions and to improve post-transplant outcomes in those recipients who received grafts from mismatched donor sources (haploidentical and 9/10 matched unrelated donors). Disclosures Michelis: CSL Behring: Other: Financial Support. Mattsson:Celgene: Honoraria; Therakos: Honoraria; Gilead: Honoraria.

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