GAP Score and CA-153 Associated with One-Year Mortality in Anti-MDA-5 Antibody-Positive Patients: A Real-World Experience

Background. Anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is associated with respiratory failure and death in patients with idiopathic inflammatory myositis (IIM) and interstitial lung disease (ILD). This study aimed to investigate clinical parameters associated with mortality in anti-MDA-5 antibody-positive patients. Methods. We retrospectively reviewed the clinical and laboratory data, and pulmonary function test results in 55 anti-MDA-5 antibody-positive patients. A comparison was made between the survivors and non-survivors at the 12-month follow-up. Results. A total of 13 patients (23.6%) died within 12 months. Non-survivors had higher GAP scores (gender, age, and physiology score for idiopathic pulmonary fibrosis) (1 vs. 6, p < 0.01) and CA-153 (16.4 vs. 72.9, p < 0.01). In addition, rapid progressive ILD, fever, peak ferritin, leukocyte count, lactate dehydrogenase, CT score, intravenous immunoglobulin, mycophenolic acid, CMV infections, pneumocystis pneumonia, and pneumothorax were significantly associated with increased risks of 1-year mortality, while forced vital capacity, forced expiratory volume in one second, and diffusion capacity for carbon monoxide were correlated with decreased risk of 1-year mortality. Conclusions. Our study results suggest that GAP scores and CA-153 could be prognostic factors for 1-year mortality in anti-MDA-5 antibody-positive patients. A prompt pulmonary function test and CA-153 are essential for these patients to guide further management.

Download Full-text

Pattern of Pulmonary Function Test in Patients with Severe Mitral Stenosis

Bangladesh Critical Care Journal ◽

10.3329/bccj.v2i2.24078 ◽

2015 ◽

Vol 2 (2) ◽

pp. 57-59

Author(s):

Umme Salma Khan ◽

Abdullah Al Shafi Majumder ◽

AKM Monwarul Islam ◽

Fazle Rabbi Mohammed

Keyword(s):

Pulmonary Function ◽

Pulmonary Function Test ◽

Mitral Stenosis ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Female Ratio ◽

Function Test ◽

Male Female Ratio ◽

Restricted Type ◽

Impaired Pulmonary Function

Background: The deterioration in lung function in mitral stenosis correlates with the severity of stenotic valves. A correlation is noted between vital capacity and the severity of dyspnoea in patients with mitral stenosis. This study tried to evaluate the pattern of pulmonary function test in patient with severe mitral stenosis.Materials & Methods: This study involving 56 patients of severe mitral stenosis was performed in a referral cardiovascular center at Dhaka, Bangladesh from January to September, 2011. Colour doppler echocardiography and pulmonary function test were performed in each cases. Forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC and peak expiratory flow (PEF) rate was assessed from pulmonary function test. Finally, pattern of pulmonary function test in severe mitral stenosis was assessed.Results: Amomg 56 patients, 46 were female with a male female ratio 1: 0.22 and the mean age of patients was 28.76 ± 7.2. Among patients with severe mitral stenosis, mean FEV1 (%) was 60.18 ± 13.054. Minimum FVC (%) was 26, maximum was 90 with mean 53.80 ± 12.313. The PEF varied from 150 to 330 L/minute with mean 223.75 ± 62.3251. In current study, out of 56 patients, 2 cases had obstructive type and rest of the patients had restricted type of airway on pulmonary function.Conclusion: The brief results of this study reveal that severe mitral stenosis is associated with impaired pulmonary function, usually presenting restrictive airway pattern.Bangladesh Crit Care J September 2014; 2 (2): 57-59

Download Full-text

Lung ultrasound B-lines and serum KL-6 correlate with the severity of idiopathic inflammatory myositis-associated interstitial lung disease

Rheumatology ◽

10.1093/rheumatology/kez571 ◽

2019 ◽

Vol 59 (8) ◽

pp. 2024-2029 ◽

Cited By ~ 1

Author(s):

Yukai Wang ◽

Shaoqi Chen ◽

Jianqun Lin ◽

Xuezhen Xie ◽

Shijian Hu ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Pulmonary Function ◽

Lung Disease ◽

Lung Ultrasound ◽

Pulmonary Function Tests ◽

Forced Expiratory Volume ◽

Inflammatory Myositis ◽

Idiopathic Inflammatory Myositis ◽

Function Tests ◽

B Lines

Abstract Objective Idiopathic inflammatory myositis-associated interstitial lung disease (IIM-ILD) significantly increases morbidity and mortality. Lung ultrasound B-lines and Krebs von den Lungen-6 (KL-6) are identified as new sonographic and serum markers of ILD, respectively. The aim of our work was to assess the role of B-lines and KL-6 as markers of the severity of IIM-ILD. For this purpose, the correlation among B-lines score, serum KL-6 levels, high-resolution CT (HRCT) score, and pulmonary function tests were investigated in IIM-ILD patients. Methods Thirty-eight patients with IIM-ILD underwent chest HRCT scans, lung ultrasound and pulmonary function tests (independently performed within 1 week) examination. To assess severity and extent of ILD at HRCT, the Warrick score was used. The B-lines score denoting the extension of ILD was calculated by summing the number of B-lines on a total of 50 scanning sites. Serum KL-6 levels (U/ml) was measured by chemiluminescent enzyme immunoassay. Results A significant correlation was found between the B-lines score and serum KL-6 levels (r = 0.43, P < 0.01), and between the Warrick score and serum KL-6 levels (r = 0.45, P < 0.01). A positive correlation between B-lines score and the Warrick score (r = 0.87, P < 0.0001) was also confirmed. Both B-lines score and KL-6 levels inversely correlated to diffusion capacity for carbon monoxide (r = −0.77, P < 0.0001 and r = −0.42, P < 0.05, respectively) and total lung capacity (r = −0.73, P < 0.0001 and r = −0.36, P < 0.05, respectively). Moreover, B-lines correlated inversely with forced vital capacity (r = −0.73, P < 0.0001), forced expiratory volume in 1 s (r = −0.69, P < 0.0001). Conclusion B-lines score and serum KL-6 levels correlate with HRCT findings and pulmonary function tests, supporting their use as measures of IIM-ILD severity.

Download Full-text

Importance of Pre Operative Pulmonary Function Test to Predict Risk of Pulmonary Complications after Abdominal Surgery- An Evidence Based Study

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20210741 ◽

2021 ◽

Vol 6 (3) ◽

pp. 236-243

Author(s):

Krupa Pareshbhai Patel ◽

Anjali Bhise

Keyword(s):

Abdominal Surgery ◽

Pulmonary Function ◽

Pulmonary Function Test ◽

Meta Analysis ◽

Pulmonary Function Tests ◽

Forced Expiratory Volume ◽

Pulmonary Complications ◽

Evidence Based ◽

Function Tests ◽

Function Test

Background: Spirometry is a universal, simple, and non-invasive pulmonary function test. Spirometry, along with calculation of the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), is helpful for diagnosing obstructive or restrictive lung disease. Postoperative Pulmonary Complications are defined as unintended pulmonary abnormalities that occur as a result of surgery which cause identifiable dysfunction. Purpose: To find the evidence showing the importance of pre-operative PFT to predict risk of pulmonary complications after abdominal surgery Methodology: The study was conducted according to Preferred Reporting Items for systematic reviews and meta-analysis guidelines. Evidences selected since year 2002- 2020 from PubMed, Google Scholar, Physiotherapy Evidence Database (PEDro), ResearchGate and ScienceDirect. Key words used were: Pulmonary Function Tests, Post-Operative Pulmonary Complications, and Abdominal Surgery. Analysis was done using 2 scales: Centre for Evidence-Based Medicine Levels of Evidence Scale. Total 12 articles were found. Among them 10 were selected. Results: 5 articles showed that preoperative PFT is important in prediction of PPCs while the other half concluded that routine preoperative spirometry is not necessary before non-thoracic surgeries. Conclusion: Based on evidences, in the nutshell it is reviewed that there is controversy regarding the value of preoperative pulmonary functions test in non-thoracic surgeries. Keywords: Pulmonary Function Tests, Post-Operative Pulmonary Complications, and Abdominal Surgery

Download Full-text

Prediction of Forced Expiratory Volume in Pulmonary Function Test using Radial Basis Neural Networks and k-means Clustering

Journal of Medical Systems ◽

10.1007/s10916-008-9196-y ◽

2008 ◽

Vol 33 (5) ◽

pp. 347-351 ◽

Cited By ~ 2

Author(s):

Sujatha C. Manoharan ◽

Swaminathan Ramakrishnan

Keyword(s):

Neural Networks ◽

Pulmonary Function ◽

Pulmonary Function Test ◽

Forced Expiratory Volume ◽

Radial Basis Neural Networks ◽

Function Test ◽

Radial Basis

Download Full-text

Effect of acute respiratory infections in infancy on pulmonary function test at 3 years of age: a prospective birth cohort study

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2019-000436 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000436

Author(s):

Prawin Kumar ◽

Aparna Mukherjee ◽

Shivani Randev ◽

Guruprasad R Medigeshi ◽

Kana Ram Jat ◽

...

Keyword(s):

Cohort Study ◽

Pulmonary Function ◽

Pulmonary Function Test ◽

Respiratory Infections ◽

Forced Expiratory Volume ◽

Acute Respiratory Infections ◽

Function Test ◽

Forced Expiratory Flow ◽

Expiratory Flow ◽

The Impact

IntroductionAcute respiratory infections (ARIs) in infancy may have a long-term impact on the developing respiratory system. We planned a prospective cohort study to determine the impact of ARI during infancy on the pulmonary function test indices at 3 years of age.MethodsA cohort of normal, full-term newborns were followed up 6 monthly and during ARI episodes. Infant pulmonary function tests (IPFTs) were performed at baseline and each follow-up visit using tidal breathing flow-volume loop, rapid thoracoabdominal compression (RTC) and raised volume RTC manoeuvres. During each ARI episode, nasopharyngeal aspirates were tested for respiratory pathogens by real-time PCR.ResultsWe screened 3421 neonates; 310 were enrolled; IPFT was performed in 225 (boys: 125 (55.6%)) at 3 years. During infancy, 470 ARI episodes were documented in 173 infants. At 3 years, children with history of any ARI episode during infancy had lower forced expiratory volume in 1 s (FEV1.0), forced expiratory volume in 0.75 s (FEV0.75), forced expiratory volume in 0.5 s (FEV0.5), forced expiratory flow between 25% and 75% of FVC (FEF25–75), and maximal expiratory flow at 25% of FVC (MEF25) as compared with those without any ARI episode during infancy. The ratio of tidal expiratory flow (TEF) at 25% or 50% of tidal expiratory volume to peak TEF (TEF50 or TEF25/peak TEF) at 3 years was significantly increased in children who had ARI in infancy.ConclusionsARI during infancy is associated with impaired pulmonary function indices such as increased resistance and decreased forced expiratory flow and volume at 3 years of age.

Download Full-text

“Pulmonary dysfunction in children with Duchenne muscular dystrophy may appear earlier than we thought – analysis using novel methodology based on z-scores."

Archives of Medical Science ◽

10.5114/aoms/119782 ◽

2021 ◽

Author(s):

Eliza Wasilewska ◽

Sylwia Małgorzewicz ◽

Jarosław Meyer-Szary ◽

Karolina Sledzinska ◽

Marek Niedoszytko ◽

...

Keyword(s):

Duchenne Muscular Dystrophy ◽

Muscular Dystrophy ◽

Pulmonary Function ◽

Steroid Therapy ◽

Pulmonary Function Test ◽

Forced Expiratory Volume ◽

Z Score ◽

Factors Affecting ◽

Function Test ◽

Z Scores

IntroductionRespiratory status is one of the main factors affecting the length of survival in patients with Duchenne muscular dystrophy (DMD) – the most common, severe, progressive muscular dystrophy.The aim: (1) to assess pulmonary function in DMD patients using the z-score method and (2) to identify factors affecting it, irrespective of the disease progress.Material and methodsWe evaluated 55 boys (aged 5 – 18 years) with DMD. The spirometry was performed with: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF) analysis as absolute values (in litres or litres/min), % predicted value (%pv) and z-scores [z]. The need of ventilation support, ambulatory status, steroid therapy were collected.Results25(45%) subjects were non-ambulatory, 38(69%) used steroid therapy. Mean FVC[z] -2.4±2.2, FEV1[z] -2.0±1.9, PEF[z] -1.5±1.3 value significantly decrease with age (r=-0.62/-0.65/-0.55; p<0.001 respectively), after reaching the peak values between 9-12 or 6-9 years of age depending on analysis method (absolute, %pv or z-score). The results fell below normal range (z-score<-1.64) at the age of 9.8/10.4/11.6 years and below 80%pv at 10.7/13.2/13.2 for FVC/FEV1/PEF, respectively. The pulmonary function test results were significantly lower in non-ambulant (p<0.001) and non-steroid patients (p<0.02).ConclusionsAnalysis of pulmonary function test based on z-score shows that deterioration of pulmonary function in DMD males may appear earlier than we thought measured by %pv and absolute values. Early loss of ambulation, lack of or delayed steroid therapy are risk factors for worse pulmonary outcomes. To confirm these findings cohort longitudinal studies are necessary.

Download Full-text

Increased Levels of Soluble CD206 Associated with Rapidly Progressive Interstitial Lung Disease in Patients with Dermatomyositis

Mediators of Inflammation ◽

10.1155/2020/7948095 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Ya-Wen Shen ◽

Ya-Mei Zhang ◽

Zhen-Guo Huang ◽

Guo-Chun Wang ◽

Qing-Lin Peng

Keyword(s):

Interstitial Lung Disease ◽

Pulmonary Function ◽

Lung Disease ◽

Pulmonary Function Test ◽

Multivariable Analysis ◽

Forced Expiratory Volume ◽

Enzyme Linked Immunosorbent Assay ◽

Physician Global Assessment ◽

Potential Biomarker ◽

Function Test

Objective. Soluble CD206 (sCD206) is considered a macrophage activation marker, and a previous study proved it as a potential biomarker to predict the severity of anti-melanoma differentiation-associated gene 5- (anti-MDA-5-) positive dermatomyositis- (DM-) associated interstitial lung disease (ILD). To investigate the role of sCD206 in various subtypes of DM, we evaluated the serum level of sCD206 in patients with different myositis-specific autoantibodies besides anti-MDA-5 and clarified its clinical significance. Methods. Commercial enzyme-linked immunosorbent assay kits were used to detect serum concentrations of sCD206 in 150 patients with DM and 52 healthy controls (HCs). Correlations between sCD206 levels and clinical features, laboratory examinations, and pulmonary function test parameters were analysed. Results. The median concentrations of serum sCD206 in DM patients were significantly higher than those in HCs ( p < 0.0001 ). Furthermore, median sCD206 levels were elevated in patients with ILD ( p = 0.001 ), especially in those with rapidly progressive ILD (RP-ILD) ( p < 0.0001 ). In addition, sCD206 levels were negatively correlated with the pulmonary function test results, including the percent predicted forced vital capacity ( r = − 0.234 , p = 0.023 ), percent predicted forced expiratory volume in one second ( r = − 0.225 , p = 0.030 ), and percent predicted carbon monoxide diffusion capacity ( r = − 0.261 , p = 0.014 ). Age- and gender-adjusted multivariable analysis showed that sCD206 was an independent prognostic factor for RP-ILD in patients with DM. A longitudinal study showed that sCD206 levels were positively correlated with the physician global assessment visual analog scale scores ( β = 54.201 , p = 0.001 ). Conclusion. Serum sCD206 levels were significantly increased in patients with DM and significantly associated with RP-ILD, suggesting that sCD206 is an important biological predictor of RP-ILD in patients with DM.

Download Full-text

Endoscopic sinus surgery and its effects on pulmonary function test in patients of chronic rhinosinusitis with nasal polyposis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203200 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1484

Author(s):

Dameshwa S. Lyngdoh ◽

Subrat Kumar Behera ◽

Smruti Swain ◽

Manoranjan Pattnaik

Keyword(s):

Pulmonary Function ◽

Chronic Rhinosinusitis ◽

Pulmonary Function Test ◽

Endoscopic Sinus Surgery ◽

Airway Disease ◽

Sinus Surgery ◽

Lower Airway ◽

Study Results ◽

Objective Evidence ◽

Function Test

Background: The human upper and lower respiratory tract share a close relationship in respect to existence of diseases. The objectives of this study were to evaluate the outcome of endoscopic sinus surgery with the Lund- Mackay staging system and to find any objective changes between the pre and post-operative pulmonary function test values in patients with chronic rhinosinusitis undergoing endoscopic sinus surgery.Methods: A total of 50 patients of CRSwNP refractory to maximal medical treatment (for 1 month) planned for endoscopic sinus surgery were included in the study. Results were assessed on the basis of pre and post-operative endoscopic and CT scores and PFT (FEV1, FVC and FEV1/FVC) values. Results: Postoperatively, Lund Mackay endoscopic and CT scores improved from the preoperative values, which were statistically significant with p values<0.05. Comparing FEV1/FVC, FVC and FEV1 values in three situations- preoperative versus postoperative 1 month, preoperative versus postoperative 3rd month and post-operative 1st month versus postoperative 3rd month, the difference between the means were found to be statistically significant (p=0.000), except for FVC between postoperative 3rd month and 1st month.Conclusions: This study provides objective evidence that patients with CRSwNP may have non clinical lower airway disease detected by PFT and ESS is effective in improvement of both nasal and lower airway disease as evident from the improvements in PFT values.

Download Full-text

Evaluation of the Pulmonary Function Test (PFT) in Patients Affected by Severe COVID-19 Pneumonia: 6 to 12 Weeks After Discharge

ACTA MEDICA IRANICA ◽

10.18502/acta.v59i11.7780 ◽

2021 ◽

Author(s):

Akbar Soleymani Babadi ◽

Alireza Kashefizadeh ◽

Nooshin Dalili ◽

Laya Ohadi ◽

Abbas Gheisoori ◽

...

Keyword(s):

Pulmonary Function ◽

Pulmonary Function Test ◽

Forced Expiratory Volume ◽

Diffusion Capacity ◽

Inspiratory Muscles ◽

Function Test ◽

Expiratory Muscles ◽

Mixed Pattern ◽

Restricted Pattern

The most lethal adverse effect of COVID-19 is acute respiratory distress syndrome, which can lead to rapid death. This symptom even causes concern for patients who have recovered and have been discharged. Therefore, it is obligatory to test and monitor variations in their lungs’ function after recovery. In this study, we evaluated the pulmonary function of 64 patients with severe COVID-19, six weeks to 3 months after discharge. Pulmonary function parameters were measured by spirometry and body box according to the criteria of the American Thoracic Society and under the supervision of an adult pulmonologist. According to the forced expiratory volume (FEV1)/forced vital capacity (FVC) ratio and total lung capacity (TLC) values, it was found that 3.1% of people had an obstructive pattern, 40.63% of patients had the restrictive pattern, and 6.25% of improved individuals showed a mixed pattern. Furthermore, the study of diffusion capacity of carbon monoxide (DLCO) index revealed that 13.3%, 25%, and 53% of cases had mild, moderate, and severe disorders of gas exchange, respectively. In addition, determining the maximum amount of inspiratory muscles (PI max) and expiratory muscles (PE max) disclosed that the rate of these two indicators in 62.5% and 71.88% of the subjects were less than 50%, respectively. In general, the results of the present study suggest that pulmonary function test and follow-up of patients' condition are not only recommended but seems to be essential after recovery due to the large percentage of patients with the restricted pattern a few weeks after recovery.

Download Full-text