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Transbronchial Cryobiopsy Validity in Diagnosing Indefinite Usual Interstitial Pneumonia in High Resolution Computed Tomography in Egyptian Population 埃及人群高分辨率计算机断层扫描经支气管冷冻活检诊断不确定间质性肺炎的有效性
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4729
H. Shafiek, S. Elbialy, Samar Elachy, A. Gad
Background and Objectives: Histopathology is a key element for the multidisciplinary diagnosis of diffuse parenchymal lung diseases (DPLD). We aimed to evaluate the efficacy, safety and diagnostic utility of bronchoscopic transbronchial cryobiopsy in diagnosing DPLD in Egyptian population and to identify the common DPLD pathologies in them. Methods: A prospective interventional study that enrolled 25 Egyptian patients presented to Main Alexandria University Hospital (Egypt) who had clinical and radiologic features of DPLD, but insufficient elements to achieve definite features of usual interstitial pneumonia (UIP/IPF) in chest high resolution computed tomography (HRCT). Twelve patients were subjected to transbronchial cryobiopsy and 13 patients to TBLB. Results: The diagnostic yield was significantly higher among transbronchial cryobiopsy group (83.3%) that increased to 100% with clinic-pathological correlation vs. TBLB group (38.5%,p= 0.041). Granulomatous diseases (24%; either sarcoidosis or hypersensitivity pneumonitis) were the common pathology followed by malignancy (12%) in both groups. The size of the TBLB was ranging from 1-3 mm vs. 2.5-5 mm in transbronchial cryobiopsy (p Conclusion: Transbronchial cryobiopsy is a safe tolerable procedure with high diagnostic yield for evaluating DPLD with indefinite UIP/IPF in HRCT.
背景与目的:组织病理学是弥漫性肺实质疾病(DPLD)多学科诊断的关键因素。我们的目的是评估支气管镜下经支气管低温活检诊断埃及人群DPLD的有效性、安全性和诊断价值,并确定其中常见的DPLD病理。方法:一项前瞻性介入研究,纳入25例埃及患者,这些患者在埃及亚历山大大学医院就诊,具有DPLD的临床和放射学特征,但胸部高分辨率计算机断层扫描(HRCT)缺乏明确的常规间质性肺炎(UIP/IPF)特征。经支气管冷冻活检12例,TBLB 13例。结果:经支气管冷冻活检组的诊断率(83.3%)明显高于TBLB组(38.5%,p= 0.041),临床病理相关性提高至100%。肉芽肿性疾病(24%;结节病或过敏性肺炎是两组最常见的病理,其次是恶性肿瘤(12%)。结论:经支气管冷冻活检是一种安全、可耐受的方法,对于HRCT评估UIP/IPF不确定的DPLD具有较高的诊断率。
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引用次数: 0
A Combined Rheumatology/ILD Service. The Wolverhampton Experience 风湿病/ILD联合服务。伍尔弗汉普顿体验
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4738
A. Zahid, P. Chohan, T. Sheeran, A. Fahim
Introduction: Interstitial lung diseases (ILD), in the context of rheumatological disorders, present difficult diagnostic and management challenges.A combined rheumatology-ILD service has a potential to improve clinical outcomes in CTD-ILD. New Cross Hospital, a large district general hospital commenced providing this service in 2014 and we present an audit data over a 2 year period. Aims: To assess the effectiveness of combine rheumatology/ILD service at New Cross Hospital. Methods: A retrospective analysis of CTD-ILD clinic data over 2 years (January 2014- December 2015) was carried out. 78 patients, with known CTD, seen by both rheumatology and respiratory consultants in a combined clinical setting. All patients had proven pulmonary fibrosis on HRCT Chest. Results: Of the 78 patients, 10 patients (12%) had change in the diagnosis after clinic review. All patients (100%) had full lung functions after their first combined clinic review. Twenty five patients (32%) had a change in their management, (5 were treated with IV cyclophosphamide, 19 had an increase in prednisolone dosage while one patient received rituximab). No patient was felt to be a suitable candidate for lung transplantation. All patients had a transthoracic echocardiogram requested at their first clinic appointment to screen for pulmonary hypertension. Conclusions: Combined Rheumatology/ILD service reduces number of outpatient clinic appointments for patients with CTD-ILD. Moreover, it alters clinical management in a significant proportion of patients, improving diagnostic accuracy and clinical therapeutics.
在风湿病的背景下,间质性肺疾病(ILD)呈现出难以诊断和管理的挑战。风湿病- ild联合服务有可能改善CTD-ILD的临床结果。新十字医院是一家大型地区综合医院,于2014年开始提供这项服务,我们提供了两年的审计数据。目的:评价新十字医院风湿病/ILD联合服务的有效性。方法:回顾性分析2014年1月- 2015年12月2年的CTD-ILD临床资料。78例已知CTD的患者,由风湿病学和呼吸学顾问在联合临床环境中就诊。所有患者HRCT胸部检查均证实肺纤维化。结果:78例患者中,10例(12%)患者经临床复查后诊断发生改变。所有患者(100%)在第一次联合临床复查后均有完整的肺功能。25例(32%)患者的治疗方法发生了变化,其中5例接受静脉注射环磷酰胺治疗,19例泼尼松龙剂量增加,1例接受利妥昔单抗治疗。没有患者被认为是肺移植的合适人选。所有患者在第一次门诊预约时要求进行经胸超声心动图检查以筛查肺动脉高压。结论:风湿病学/ILD联合服务减少了CTD-ILD患者的门诊预约次数。此外,它改变了相当比例患者的临床管理,提高了诊断准确性和临床治疗方法。
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引用次数: 0
Health-related quality of life in children interstitial lung disease 儿童间质性肺病的健康相关生活质量
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5184
N. Nathan, Clara Lauby, R. A. Taam, K. Bessaci, J. Brouard, M. Dalphin, C. Delacourt, C. Delestrain, A. Deschildre, J. Dubus, M. Fayon, L. Giovannini-Chami, V. Houdouin, A. Houzel, C. Marguet, I. Pin, P. Reix, M. Renoux, C. Schweitzer, A. Tatopoulos, C. Thumerelle, F. Troussier, S. Wanin, L. Weiss, A. Clément, P. Böelle, R. Epaud
Introduction: Health-related quality of life (HR-QoL) is an understudied area in rare diseases. Interstitial lung diseases in children (chILD) are heterogeneous disorders that are associated with a high morbidity and mortality. The impaired lung function, the nutritional impact and the burden of the treatments can impair the HR-QoL of these children. The aim of this study was to compare the HR-QoL in chILD to an aged-matched healthy population and to identify the factors that were associated to an altered QoL. Methods: Patients were recruited in the French RespiRare network. Patients with chILD of all causes, aged 1 month to 18 years were prospectively included. The children over 8 years old and the 2 parents of all children were asked to complete the PedsQLTM 4.0 Generic Core Scale (0 to 100 points). Results: A total of 78 children were included in the RespiRare centres. Total mean scores appeared to be significantly reduced in child self-report and in parent proxy-report (11.94 points (p=0.0003) and 14.08 points (p Conclusion: The study shows that HR-QoL is significantly impaired in chILD compared to a healthy population, using a validated generic QoL scale. Factors altering QoL score are easy to recognize and could help identify children at a heightened risk of low QoL. A longitudinal follow-up of HR-QoL in chILD is necessary to follow the impact of the disease and the treatments. To better appreciate chILD QoL, a specific scale is currently under study by the chILD-EU group.
与健康相关的生活质量(HR-QoL)在罕见病中是一个未被充分研究的领域。儿童间质性肺病(chILD)是一种异质性疾病,具有高发病率和高死亡率。肺功能受损、营养影响和治疗负担会影响这些儿童的HR-QoL。本研究的目的是比较儿童的HR-QoL与年龄匹配的健康人群,并确定与生活质量改变相关的因素。方法:在法国呼吸器网络中招募患者。所有原因的儿童患者,年龄1个月至18岁前瞻性纳入。8岁以上儿童及所有儿童的2位家长完成PedsQLTM 4.0通用核心量表(0 ~ 100分)。结果:共有78名儿童被纳入呼吸器中心。儿童自我报告和家长代理报告的总平均得分显著降低,分别为11.94分(p=0.0003)和14.08分(p=0.0003)。结论:使用经过验证的通用生活质量量表,研究表明儿童的HR-QoL与健康人群相比显着降低。改变生活质量评分的因素很容易识别,可以帮助识别低生活质量风险较高的儿童。对患儿进行HR-QoL的纵向随访,以了解疾病和治疗的影响。为了更好地了解儿童生活质量,儿童-欧盟小组目前正在研究一个具体的量表。
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引用次数: 0
Disease course and outcome of progressive interstitial lung disease in systemic sclerosis 系统性硬化症患者进行性间质性肺病的病程和预后
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa3598
A. Hoffmann-Vold, Y. Allanore, M. Alves, N. Graf, P. Airó, L. Ananyeva, L. Czirják, S. Guiducci, E. Hachulla, Mengtao Li, C. Mihai, G. Riemekasten, P. Sfikakis, G. Valentini, O. Kowal-Bielecka, O. Distler
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引用次数: 3
Prognostic factors in patients with EAA EAA患者预后因素分析
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa5190
P. Sojka, M. Sterclova, N. Kaspříková, M. Vašáková
Aim: To assess prognostic factors in patients with extrinsic allergic alveolitis (EAA). Material and methods: Into retrospective study 157 patients with EAA, 69 male (M); 88 female (F) were involved (mean age 57±15 years; 58±14 M; 57±16 F). At the time of diagnosis patients underwent assessment of history of exposure and sensitization to inhalations antigens (specific IgGs), bronchoalveolar lavage fluid (BALF) cellular analysis, lung function tests and high resolution computed tomography (HRCT) of the chest. Diagnosis of EAA was established by multidisciplinary team and treatment decision was made according to severity of symptoms, pulmonary functions and HRCT findings. Effect of demographic parameters, exposure and BALF lymphocytosis on outcome after 12 months observation period were investigated. Results: There was found positive correlation between CD4/CD8 ratio and treatment initiation (OR 5.6; 95% CI=1.55–22.5; p=0,003). Conclusion: The significant decline of lung functions showed patients with BALF LY
目的:探讨外源性变应性肺泡炎(EAA)患者预后的影响因素。材料与方法:对157例EAA患者进行回顾性研究,其中男69例;女性88例(F),平均年龄57±15岁;58±14 M;57±16 F)。在诊断时,对患者进行了吸入抗原(特异性igg)暴露史和致敏性评估,支气管肺泡灌洗液(BALF)细胞分析,肺功能检查和胸部高分辨率计算机断层扫描(HRCT)。多学科团队对EAA进行诊断,并根据症状严重程度、肺功能及HRCT表现做出治疗决定。观察12个月后,调查人口统计学参数、暴露和BALF淋巴细胞计数对结果的影响。结果:CD4/CD8比值与治疗开始呈正相关(OR 5.6;95%可信区间= 1.55 - -22.5;p = 0003)。结论:balfly患者肺功能明显下降
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引用次数: 0
Lung involvement in autoimmune liver diseases 自身免疫性肝病的肺部病变
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1374
M. Brovko, M. Kalashnikov, L. Akulkina, V. Sholomova, Alisa Yanakaewa, D. Konovalov, M. Lebedeva, T. Rosina, S. Moiseev
{"title":"Lung involvement in autoimmune liver diseases","authors":"M. Brovko, M. Kalashnikov, L. Akulkina, V. Sholomova, Alisa Yanakaewa, D. Konovalov, M. Lebedeva, T. Rosina, S. Moiseev","doi":"10.1183/13993003.congress-2019.pa1374","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1374","url":null,"abstract":"","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115387729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnosing Sjogrën’ syndrome in patients with Interstitial Lung Disease by minor salivary gland biopsy 小涎腺活检诊断间质性肺病患者Sjogrën综合征
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1368
Paloma Millán Billi, I. Castellví, Silvia Barril Farre, H. Park, Laura Martinez Martinez, L. Vilaro, Tomás Fraquet Casas, Francisco Aparicio, O. S. Vidal, H. Corominas, D. C. Villegas
{"title":"Diagnosing Sjogrën’ syndrome in patients with Interstitial Lung Disease by minor salivary gland biopsy","authors":"Paloma Millán Billi, I. Castellví, Silvia Barril Farre, H. Park, Laura Martinez Martinez, L. Vilaro, Tomás Fraquet Casas, Francisco Aparicio, O. S. Vidal, H. Corominas, D. C. Villegas","doi":"10.1183/13993003.congress-2019.pa1368","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1368","url":null,"abstract":"","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125427714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction of a new approach to interpret pulmonary function tests (PFT) based on Machine learning and Game theory 介绍一种基于机器学习和博弈论的新方法来解释肺功能测试(PFT)
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4726
N. Le-Dong, T. Hua-Huy, M. Topalovic, A. Dinh-Xuan
Objective: We introduce a new interpretation method for PFT data. Methods: Our new method consists of 3 steps: To build a diagnostic rule for a specific target from multi-PFT parameters. To estimate the Shapley-score, a game-theory based metric which measures the importance of each PFT index by comparing the model’s predictions with and without that index. To generate the interpretation, indicating the contribution level of each parameter to the positive/negative diagnosis. We applied this method to detect interstitial lung disease (ILD) in patients with systemic sclerosis. A machine learning diagnostic rule was developed from data of 300 patients undergoing 5 PFT techniques. Results: Validated on unseen data (n=100), the rule showed a good clinical performance (Sensitivity=0.86, Specificity=0.89, Positive and negative Likelihood-ratios of 7.86 and 0.16 respectively). At population level, the interpretation revealed that AV, TLCO-NO and FEV1 were the most important contributors to positive diagnosis. Personalized interpretations (Fig. 1) allow to verify the model’s plausibility in difficult cases with false negative/positive diagnosis and identify individual patterns of lung function impairments. Conclusion: Compared to the conventional approaches, our new method offers more advantages including ability of multivariate interpretation and valuable information for personalized treatment plan.
目的:介绍一种新的PFT数据解释方法。方法:该方法包括3个步骤:从多个pft参数中建立针对特定目标的诊断规则;Shapley-score是一种基于博弈论的指标,通过比较模型在有和没有该指数的情况下的预测,来衡量每个PFT指数的重要性。生成解释,表明每个参数对阳性/阴性诊断的贡献水平。我们应用这种方法检测系统性硬化症患者的间质性肺疾病(ILD)。从300名接受5种PFT技术的患者的数据中开发了机器学习诊断规则。结果:未见数据(n=100)验证,该规则具有良好的临床效果(敏感性为0.86,特异性为0.89,阳性似然比为7.86,阴性似然比为0.16)。在人群水平上,解释显示AV, TLCO-NO和FEV1是阳性诊断的最重要因素。个性化解释(图1)允许在假阴性/阳性诊断的困难病例中验证模型的合理性,并识别肺功能损伤的个体模式。结论:与传统方法相比,新方法具有多变量解释能力和个性化治疗方案提供有价值的信息等优势。
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引用次数: 0
Correlations of endomicroscopic and high-resolution computer tomography patterns in patients with interstitial lung diseases 肺间质性疾病患者的显微内镜和高分辨率计算机断层扫描模式的相关性
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1364
O. Danilevskaya, A. Averyanov, V. Lesnyak
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引用次数: 0
Induced sputum in systemic sclerosis: A new potential for biomarkers in SSc 系统性硬化症诱导痰:SSc生物标志物的新潜力
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1369
P. Jacquerie, B. André, M. Henquet, C. Moermans, D. Seny, F. Gester, R. Louis, M. Malaise, J. Guiot
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引用次数: 1
期刊
ILD/DPLD of known origin
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