The Egyptian Journal of Bronchology最新文献

{"title":"A conversation with ChatGPT about community-acquired pneumonia","authors":"Mohamed Kamal Mansour","doi":"10.1186/s43168-024-00318-6","DOIUrl":"https://doi.org/10.1186/s43168-024-00318-6","url":null,"abstract":"<p>To the Editor</p><p>ChatGPT is an artificial intelligence (AI) driven language model that uses deep learning techniques to produce human-like responses to natural language inputs [1]. It was developed by Open AI in November 2022 and belongs to the family of generative pre-training transformer (GPT) models. It is considered to be one of the largest publicly available language models [1]. The application of ChatGPT in fields such as medicine, where complex thinking and analysis are needed is uncertain and raises multiple ethical concerns [2]. The performance of ChatGPT in the context of difficult real-life scenarios is not clear, especially in a field such as medicine, where complex mental work is required [2]. ChatGPT has been receiving extensive attention lately, and it is expected that the general public will start using it to explore information about certain diseases in medicine. A study published in the Journal of American Medical Association (JAMA) in 2023, concluded that ChatGPT generated quality and empathetic responses to patient questions posted in an online forum [3].</p><p>Community-acquired pneumonia is a leading cause of hospitalization and death in the United States with approximately 6 million cases reported each year [4]. It is an infection of the pulmonary parenchyma that occurs acutely in a patient who has acquired the infection in the community [4]. It is diagnosed based on the presence of compatible symptoms and signs, with evidence of new infiltration in imaging studies [4]. With the increased public awareness about certain health conditions, individuals in the community are likely to use new technologies such as ChatGPT to answer questions related to these conditions. Table 1 outlines a conversation comprised of six questions between a common person and ChatGPT about community-acquired pneumonia.\u0000</p><figure><figcaption><b data-test=\"table-caption\">Table 1 A conversation with ChatGPT about community-acquired pneumonia</b></figcaption><span>Full size table</span><svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-chevron-right-small\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></figure><p>We have observed from this conversation, that ChatGPT generates easy-to-understand and largely correct answers to questions it is asked. It was able to accurately list all the possible microorganisms that can cause community-acquired pneumonia and was able to provide the names of specific bacteria that are well-known to cause this infection: “The most common bacterial causes of CAP include Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae”. It also provided realistic information about the symptoms of the infection: “It’s important to note that not everyone with CAP will experience all of these symptoms, and the severity can vary widely. Additionally, individuals with certain underlying ","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183008","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}

{"title":"A challenging coexistence: community-acquired methicillin-resistant Staphylococcus aureus and Mycobacterium tuberculosis","authors":"Emine Afşin, Aslı Sümbül, Adem Emre Gülözer","doi":"10.1186/s43168-024-00319-5","DOIUrl":"https://doi.org/10.1186/s43168-024-00319-5","url":null,"abstract":"Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) usually emerges after a viral infection and causes severe disease in immunocompetent individuals. Concurrent infection with tuberculosis (TB) is generally very rare in immunocompetent patients. Our case is the first report of the coexistence of CA-MRSA and TB in an immunocompetent patient. A 24-year-old male patient of African origin, who has been living in Turkey for a year, was admitted to our hospital 3 months ago with fever, cough, and sputum complaints, which developed following symptoms of influenza infection. More intense bilateral infiltration and cavitary appearance were observed on the left in the chest radiography of the patient who did not respond to amoxicillin and gemifloxacin treatments. The patient’s sputum culture showed MRSA growth, and his sputum acid-resistant bacteria (ARB) was reported as three positive. Vancomycin, isoniazid, rifampicin, pyrazinamide, and ethambutol treatments were started. Subsequently, Mycobacterium Tuberculosis growth was also detected in the mycobacteria culture. Vancomycin treatment was completed in 14 days. There was no growth in the control sputum culture. When the patient, who gave clinical and laboratory response, was admitted with increased shortness of breath complaint two months after discharge, it was observed that minimal spontaneous pneumothorax developed in the left lung, and it was decided to follow up without intervention. In the second month of tuberculosis treatment, sputum ARB and mycobacteria culture became negative, and the patient was switched to dual antituberculosis treatment (isoniazid, rifampicin), and his treatment is still ongoing. Mixed infections should be considered in case of non-response to treatment in patients with pneumonia. Mixed infections should also be followed closely as they may be more complicated.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183005","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}

{"title":"Ultrasound assessment of diaphragmatic excursion in chronic obstructive pulmonary disease patients with different severities","authors":"Kholod Tarek Fekri, Waleed Kamal Eldin El-Sorougi, Fatmaalzahraa Saad Abdalrazik","doi":"10.1186/s43168-024-00315-9","DOIUrl":"https://doi.org/10.1186/s43168-024-00315-9","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is associated with dysfunctional diaphragmatic breathing we assess the diaphragmatic excursion at different stages of COPD patients by transthoracic ultrasound. The present study aimed to assess the diaphragmatic excursion at different stages of COPD patients by transthoracic ultrasound. In this observational case–control study, 80 COPD patients were included according to GOLD guidelines 2020 attending the Chest Clinic in Badr Hospital, Helwan University. All patients were divided equally into 5 groups according to FEV1 measured by spirometer: group (1) normal person; group (2) mild stage FEV1_80% predicted; group (3) moderate stage 50%_FEV1 < 80% predicted; group (4) severe stage 30%_FEV1 < 50% predicted; and group (5) very severe stage FEV1 < 30% predicted. We measured diaphragmatic movement in all these patients using ultrasound. The outcomes result of normal, mild, moderate, severe, and very severe groups in terms of post-bronchodilator FEV1/FVC are 0.66 ± 0.05, 0.65 ± 0.05, 0.63 ± 0.04, 0.51 ± 0.068 respectively showed was a significant difference. There was a significant difference of FEV1 are 86.70 ± 5.62, 63.00 ± 13.81, 43.00 ± 6.78, 24.00 ± 4.17, respectively (P < 0.001). There was a significant difference in diaphragmatic thickness at the end of normal expiration are 0.49 ± 0.12, 0.51 ± 0.09, 0.47 ± 0.16, 0.37 ± 0.07, respectively (P < 0.001). There was a significant difference in the diaphragmatic thickness during maximum inspiration are 0.70 ± 0.16, 0.8 ± 0.17, 0.64 ± 0.19, and 0.47 ± 0.08, respectively (P < 0.001). There was a significant difference in the diaphragmatic excursion during normal breathing are 2.45 ± 0.39, 1.78 ± 0.67, 1.86 ± 0.67, 1.09 ± 0.16, respectively (P < 0.001). There was a significant difference in diaphragmatic Excursion during maximum inspiration are 4.41 ± 0.91, 3.83 ± 0.78, 3.36 ± 0.74, 2.36 ± 0.66 respectively (P < 0.001). The use of ultrasonography for assessing the diaphragmatic excursion. Sonographically determined diaphragmatic excursion strongly correlates with FEV1/FVC.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183007","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}

{"title":"The effect of tocilizumab administration on inflammatory markers in COVID-19 patients","authors":"Engy Mohamed Riyad Soliman, Khaled Mohamed Wageh, Mahmoud Mokhtar Mohamed, Hoda Attiatullah Mohamed","doi":"10.1186/s43168-024-00314-w","DOIUrl":"https://doi.org/10.1186/s43168-024-00314-w","url":null,"abstract":"The COVID-19 outbreak was declared a worldwide emergency as a result of its rapid spread. The number of people infected with COVID-19 is increasing rapidly around the world, and pneumonia can develop in COVID-19 cases. The monoclonal antibody tocilizumab blocks the interleukin-6 receptor, which in turn reduces inflammation. of the work The study aims to determine how tocilizumab affects inflammatory markers, laboratory indices, and oxygen therapy. Subjects and methods This retrospective observational study aimed to assess the effect of tocilizumab on inflammatory markers, laboratory parameters, and short-term outcomes in COVID-19 cases. Data was collected from 55 patients with COVID-19 who tested positive for SARS-CoV-2 using PCR. These patients were admitted to Ain Shams University Specialized Hospital—Obour between June 1, 2021, and May 31, 2022. After tocilizumab administration, C-reactive protein levels decreased significantly, but there was no statistically significant change in hemoglobin, serum ferritin, or D-dimer levels. Following tocilizumab administration, the leukocyte counts, and platelet count increased significantly. There was a significant correlation between the presence of comorbidities in the studied patients (e.g., heart failure, post-renal transplantation, and hepatitis C virus) and the risk of mortality. The study's final result showed a significant decrease in platelet count in dead patients compared to discharged patients after receiving tocilizumab. Regarding oxygen therapy following tocilizumab administration, the use of face masks and non-rebreather facemasks was high in dead patients, while nasal prong usage was high in discharged patients. After receiving tocilizumab, there was an increase in the mean liters of oxygen required in dead patients compared to discharged patients. After administration of tocilizumab in COVID-19 hospitalized patients who have progressing disease, there was highly and significantly decrease in CRP level with no statistically significant alteration in the levels of hemoglobin, serum ferritin, and D-dimer and an increase in TLC and platelets was observed. Following tocilizumab administration, there was a decrease in oxygen demands, an improvement in oxygen therapy and oxygen saturation. Tocilizumab is a recommended therapy option.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223820","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}

{"title":"The role of flexible bronchoscope in the evaluation of chronic cough with and without wheeze in children","authors":"Ahmed M.Elniny, Ahmed Mohamed Abdel Razik, Ahmed A.Abo-Elezz, Rehab Elmeazawy, Amira Youssef, Mahitab Morsy Hussein","doi":"10.1186/s43168-024-00317-7","DOIUrl":"https://doi.org/10.1186/s43168-024-00317-7","url":null,"abstract":"Chronic cough in children is a challenging symptom for clinicians. So, we aimed in this study to evaluate the diagnostic role of flexible bronchoscope in differentiating between the underlying causes of chronic wet cough and chronic cough associated with wheeze. This was a prospective cross-sectional study conducted on children referred to Tanta University Hospitals and Ain-Shams University Hospitals between January 2021 and January 2023, presenting with a primary complaint of chronic cough lasting more than 4 weeks. The children were further classified into two groups: the first group included children with chronic wet cough not associated with wheezing (Cohort A) and the second group included children with chronic cough associated with wheezing (Cohort B). The study enrolled 64 children. During clinical evaluation, 25 (39.1%) children had a chronic cough without wheezing and 39 (60.9%) had a chronic wheezy cough. Bronchoscopic examination findings indicated a notable disparity between the two groups of patients with chronic cough (p=0.006). Among Cohort A patients, the most prevalent bronchoscopic observation was purulent inflammatory secretions in 16 cases (64.0%), followed by congenital airway anomalies in 3 cases (12.0%). Conversely, Cohort B patients exhibited congenital airway anomalies as the primary finding in 14 cases (35.9%), followed by purulent secretions in 7 cases (17.9%). Flexible bronchoscopy is a valuable and safe tool for diagnosing chronic cough in children. It helped differentiate between the underlying causes of chronic cough in children with and without wheezing.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183006","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}

{"title":"Iron status and anemia as predictors for acute bronchiolitis severity","authors":"Shereen A. Ragab, Ahmed Abdel Razik, Radwa El Sharaby, Rehab Elmeazawy","doi":"10.1186/s43168-024-00316-8","DOIUrl":"https://doi.org/10.1186/s43168-024-00316-8","url":null,"abstract":"The aim of this study was to determine the effect of iron deficiency anemia (IDA) on the severity of symptoms in infants hospitalized for acute bronchiolitis. This is a case–control study, which was carried out on 80 infants from November 2022 to April 2023. The study involved 60 infants ranging in age from 2 months to 2 years, who were admitted to the Pediatric Pulmonology Unit and met the diagnostic criteria for acute bronchiolitis. Furthermore, a control group of 20 apparently healthy infants was incorporated into the study. This study showed that patients with moderate and severe bronchiolitis exhibited notably reduced levels of hemoglobin, HCT, MCV, MCH, and MCHC. Concerning the iron status, a substantial decrease in serum iron and increase in TIBC in the severe group (P = 0.012, 0.001, respectively). No substantial correlation was detected between the severity of acute bronchiolitis and serum ferritin levels. Hemoglobin and serum iron were found to be independent predictors of the severity of acute bronchiolitis. Infants suffering from IDA exhibit increased vulnerability to acute bronchiolitis. The low levels of hemoglobin and serum iron may function as prognostic indicators for the severity of the condition in infants with acute bronchiolitis.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183009","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}

{"title":"Characterising aetiologies and clinical-radiological factors of non-resolving pneumonia in a tertiary care centre","authors":"Ajitha Raj, Kummannor Parameswaran Pillai Venugopal, Sajitha Musthafa, Kiran Vishnu Narayan","doi":"10.1186/s43168-024-00312-y","DOIUrl":"https://doi.org/10.1186/s43168-024-00312-y","url":null,"abstract":"Non-resolving pneumonia poses a significant clinical challenge. It is common to treat non-resolving pneumonia over an extended period of time, without evaluating the cause of failure or eliciting the exact aetiology. To determine the aetiology and clinical-radiological profile of non-resolving pneumonia. Analytical, observational study done among 77 consecutive patients with non-resolving pneumonia, who attended a tertiary care centre over 1 year. Clinical details were obtained using prefixed questionnaires. Necessary diagnostic procedures like bronchoscopy and image guided transthoracic sampling along with histopathological and microbiological investigations were done to obtain final diagnosis. The most common aetiology was lung malignancy (44.2%) followed by chronic infections (40.3%) dominated by tuberculosis (14.3%). Adenocarcinoma (32.5%) was the commonest malignancy presenting as non-resolving consolidation. History of smoking (p value 0.001), chest pain (p value 0.001), and haemoptysis (p value 0.006) was associated with a diagnosis of malignancy. Actinomycosis (7%) had a significant association with chest pain (p value 0.032). Transthoracic image-guided tissue sampling had a high diagnostic yield of 84.8% and bronchoscopy of 66.9%. Malignancy needs to be considered promptly once we encounter with non-resolution of consolidation. The clinical pointers like advanced age, smoking history, symptoms more than 8 weeks, symptoms like chest pain, and haemoptysis mandate evaluation for malignancy in non-resolving pneumonia. The labyrinth of diabetes mellitus impedes the timely resolution of infections.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183051","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}

{"title":"Neurofibromatosis 1-associated diffuse lung disease in an elderly man—a case report","authors":"Subho Sarkar, Aswathy Girija, Manoj Kumar Panigrahi","doi":"10.1186/s43168-024-00311-z","DOIUrl":"https://doi.org/10.1186/s43168-024-00311-z","url":null,"abstract":"Neurofibromatosis 1 is a form of phacomatosis or neurocutaneous disease inherited as an autosomal dominant disease. Thoracic involvement is rare and involves the lung parenchyma, mediastinum, and thoracic cage, including ribs and the spine. Lung parenchymal involvement includes airspace abnormalities like cysts, bullae, and emphysema with an upper lobe predominance and interstitial abnormality in the form of reticulations and fibrosis in the lower lobes. The structural abnormality of the lung resembles numerous other diseases. Hence, properly identifying and recognizing neurofibromatosis 1-associated diffuse lung disease (NF-1 DLD) is crucial in avoiding misdiagnosis. NF1-DLD is associated with many complications like pulmonary hypertension, lung malignancy, aspergilloma, secondary bacterial infections, and pneumothorax. An elderly male with neurofibromatosis type-1 presented with breathlessness, cough, and mucopurulent expectoration and was found to have diffuse involvement of the lung parenchyma involving cysts, bullae, emphysema, fibrosis, and traction bronchiectasis. He was managed conservatively, controlling infection and optimizing respiratory symptoms. Neurofibromatosis-associated diffuse lung disease is a rare disorder. There is no definitive treatment that can reverse the pulmonary lesions. However, early diagnosis will help plan effective preventive measures and avoid complications. We present this case to increase awareness regarding the various pulmonary manifestations of neurofibromatosis.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141940132","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}

{"title":"Post COVID-19 persistent symptoms and functional status in COVID-19 survivors: a multi-center study","authors":"Amal Mahmoud Ibrahim Goda, Osama Amin Abd Elhamid Ahmed, Ahmed Moustafa Abdel Samad Wedn, Ayat F. Manzour","doi":"10.1186/s43168-024-00309-7","DOIUrl":"https://doi.org/10.1186/s43168-024-00309-7","url":null,"abstract":"Post COVID symptoms are a series of chronic symptoms that patients may experience after resolution of acute COVID-19. Different post-COVID-19 condition phenotypes might exist, although exact causes, management, and outcomes are not known. To assess the functional status among post-COVID-19 survivors and identify the associated socio-demographic, clinical, and laboratory risk factors of the poor functional status among those cases and to identify the most common persistent symptoms among post-COVID-19 survivors after discharge. This was a cross-sectional study conducted on 150 recovered cases who had been infected with COVID-19 as confirmed by swab during hospitalization and being interviewed regarding functional status 6 months post-hospital discharge. Cases were divided into two groups: the decreased functional status group (n = 74) and the non-decreased functional status group (n = 76). The present study indicated statistically significant differences between the studied groups; receiving the influenza vaccine was significantly associated with keeping the pre-COVID functional status (p = 0.02). The reduced functional status group had a significantly more severe disease course, prolonged hospital as well as ICU stay (p < 0.001), and worse CT findings than the normal functional status group (p = 0.004). Long-term symptoms such as headache, mood changes, insomnia, hearing problems, dry eyes, breathlessness, and chest tightness were significantly more prevalent among those who reported limitations in their functional status (p < 0.001). There were significantly higher CRP, serum ferritin, and D-dimer in the reduced functional status group. The present study highlights that most COVID-19 recovered cases have different degrees of functional limitations ranging from null to severe based on the PCFS scale. These limitations were affected by periodic influenza vaccination, ICU admission, and length of hospital stay. Some laboratory parameters were associated with reduced functionality: CRP, D-dimer, and serum ferritin. Psychological/neurological symptoms and breathlessness were significantly associated with reduced PCFS. This calls for public health action and necessitates widespread health education of post-COVID-19 health consequences.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141940131","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}

{"title":"Assessment of exercise tolerance using cardiopulmonary exercise test in patients with chronic obstructive pulmonary disease and secondary pulmonary arterial hypertension treated with Sildenafil versus those receiving only standard-of-care","authors":"Darwish Ibrahim Darwish, Yasser Moustafa, Hossam M. Abdel-Hamid, Rehab M. Mohammed","doi":"10.1186/s43168-024-00307-9","DOIUrl":"https://doi.org/10.1186/s43168-024-00307-9","url":null,"abstract":"Pulmonary arterial hypertension (PAH) is a common complication of chronic obstructive pulmonary disease (COPD), which can lead to shorter survival and poor clinical outcomes. Patients suffering from PAH display a cardiopulmonary exercise testing (CPET) profile with several atypical factors, such as decreased work rate, limited ability to do aerobic activities, and ventilatory insufficiency. To assess and compare exercise tolerance by CPET in COPD patients with secondary PAH receiving cGMP-specific phosphodiesterase type-5 (PDE-5) inhibitor (sildenafil) versus those who are receiving standard-of-care only. This is a prospective, cross-sectional research in which a total of 30 COPD patients with mild to severe obstruction and secondary PAH were recruited; all patients were treated with standard-of-care treatment for COPD; moreover, half of the recruited patients were also on sildenafil 60 mg/day for at least 3 months at the time of recruitment (sildenafil users) as specific therapy for PAH while the other half were not (non-users). All patients underwent CPET to assess their exercise capacity. No significant statistical differences were observed between sildenafil users and non-users in all CPET parameters except in respiratory exchange ratio (RER) during both exercise and recovery with sildenafil users showing a lower RER in both phases compared to non-users (p = 0.02, 0.01, respectively). Also, resting diastolic blood pressure (DBP) was significantly lower in sildenafil users (p = 0.02). In addition, sildenafil users did not exhibit significant differences compared to non-users in terms of Modified Medical Research Council (mMRC) score, COPD assessment test (CAT) score, or spirometric parameters. Our findings suggest that there were no significant differences in overall exercise capacity, nor in symptoms or spirometric parameters between COPD patients with secondary PAH receiving sildenafil and those who were not.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141868269","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}