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Oxidative Stress Markers in COPD Patients Admitted to Pulmonary Rehabilitation COPD肺康复患者的氧化应激标志物
Q3 Medicine Pub Date : 2021-12-31 DOI: 10.2174/1874306402115010068
C. Romero-Dapueto, R. Castillo
Chronic obstructive pulmonary disease (COPD) is a pathology, which leads to an irreversible and progressive reduction of the airflow, usually caused by smoking, but only present in 25% of smokers. Some mechanisms involved in the onset and progression of the disease are local and systemic factors such as inflammation, exacerbated immune response and the appearance of oxidative stress. For all these reasons, the use of oxidative stress parameters as progression markers or even as a way to monitor the response of any kind of non-pharmacological interventions, like the use of pulmonary rehabilitation (PR), is feasible. The study aims to determine markers of oxidative stress levels in plasma and erythrocytes in patients with COPD through the application of a PR protocol. The study included 25 patients diagnosed with COPD according to the GOLD criteria with a medical indication of PR and attendance at the gym in San José Hospital, Santiago, Chile. Blood samples were obtained before the start of the protocol, in the 10th session, and at the end of the protocol (20th session). These samples were stored for oxidative stress determinations: FRAP (ferric reducing ability of plasma), F2-isoprostanes, reduced (GSH)/oxidized (GSSG) ratio and antioxidant enzyme activity in the erythrocyte. In all stages, associations between events and clinical parameters in patients have been observed. The clinical parameters assessed were the six-minute walking test (6MWT), maximal inspiratory and expiratory pressure, the BODE index and Saint George’s respiratory questionnaire, which includes quality of life. The intracellular and extracellular capacity (GSH/GSSG and FRAP) in patients in PR at the 10th session were 53.1 and 34% higher than basal values, respectively. Only the GSH/GSSG ratio was 38.2% lower at the 20th session, related in part with higher plasma and erythrocyte lipid peroxidation at baseline. This could be due to the high concentration of reactive oxygen species in the first sessions, which has been reported in the literature as the acute effect of controlled exercise. Blood lipid peroxidation was 43.34 and 58.34% lower at the 10th and 20th sessions, respectively, demonstrating the improvements in the oxidative parameters with long-term exercise. With respect to oxidative enzyme activity, superoxide dismutase and catalase showed higher values of activity at the 10th and 20th sessions compared to the baseline. In the clinical parameters of the PR, significant changes were found in the BODE index and Saint George’s questionnaire, with these results being associated with a less predictive mortality score and a better understanding of the disease. This may be because the patients achieved longer distances in the 6MWT and better understood the disease at the end of the PR. The goal of this study was to contribute to the pathophysiological basis for further research on COPD patients, a disease of high prevalence in Chile. This study c
慢性阻塞性肺病(COPD)是一种病理学,通常由吸烟引起,但只存在于25%的吸烟者中。参与疾病发作和进展的一些机制是局部和全身因素,如炎症、免疫反应加剧和氧化应激的出现。出于所有这些原因,使用氧化应激参数作为进展标志物,甚至作为监测任何类型的非药物干预措施(如肺康复(PR))反应的一种方式,是可行的。该研究旨在通过应用PR方案来确定COPD患者血浆和红细胞中氧化应激水平的标志物。该研究纳入了25名根据GOLD标准诊断为COPD的患者,这些患者的医学指征为PR,并参加了智利圣地亚哥圣何塞医院的健身房。在方案开始前、第10次会议和方案结束时(第20次会议)采集血样。这些样品被储存用于氧化应激测定:FRAP(血浆铁还原能力)、F2异丙肾上腺素、还原的(GSH)/氧化的(GSSG)比率和红细胞中的抗氧化酶活性。在所有阶段,都观察到了患者的事件和临床参数之间的关联。评估的临床参数为6分钟步行试验(6MWT)、最大吸气和呼气压力、BODE指数和包括生活质量在内的圣乔治呼吸问卷。PR患者在第10疗程的细胞内和细胞外容量(GSH/GSSG和FRAP)分别比基础值高53.1%和34%。只有GSH/GSSG比率在第20次治疗时降低了38.2%,这在一定程度上与基线时较高的血浆和红细胞脂质过氧化有关。这可能是由于第一次训练中活性氧浓度高,文献中报道称这是受控运动的急性影响。第10次和第20次运动时,血脂过氧化分别降低了43.34%和58.34%,表明长期运动后氧化参数有所改善。关于氧化酶活性,与基线相比,超氧化物歧化酶和过氧化氢酶在第10和第20疗程显示出更高的活性值。在PR的临床参数中,BODE指数和圣乔治问卷发生了显著变化,这些结果与预测死亡率得分较低和对疾病的更好了解有关。这可能是因为患者在6MWT中获得了更长的距离,并在PR结束时更好地了解了疾病。本研究的目的是为进一步研究COPD患者(一种在智利高患病率的疾病)提供病理生理基础。这项研究可以为PR等非药理学策略提供依据。
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引用次数: 0
Pathophysiology of Acute Respiratory Failure by CoV-2 Infection: Role of Oxidative Stress, Endothelial Dysfunction and Obesity CoV-2感染急性呼吸衰竭的病理生理学:氧化应激、内皮功能障碍和肥胖的作用
Q3 Medicine Pub Date : 2021-12-31 DOI: 10.2174/1874306402115010076
R. Castillo, Alejandro González-Candia, Alejandro A. Candia
Coronavirus disease 2019 (COVID-19) due to CoV-2 (coronavirus type 2) virus possess a particular risk of developing acute respiratory distress syndrome (ARDS) or SARS (severe acute respiratory syndrome coronavirus 2)-CoV2 in people with pre-existing conditions related to endothelial dysfunction and increased pro-inflammatory and pro-oxidant state. In between these conditions, chronic systemic inflammation related to obese patients is associated with the development of atherosclerosis, type 2 diabetes, and hypertension, comorbidities that adversely affect the clinical outcome in critical patients with COVID-19. Obesity affects up to 40% of the general population in the USA and more than 30% of the adult population in Chile. Until April 2021, 1,019,478 people have been infected, with 23,524 deaths. Given the coexistence of this worldwide obesity epidemic, COVID-19 negative outcomes are seriously enhanced in the current scenario. On the other hand, obesity is characterized by endothelial dysfunction observed in different vascular beds, an alteration which can be associated with impaired vasodilation, oxidative stress, and inflammatory events. Emerging evidence shows that obesity-related conditions such as endothelial dysfunction are associated with detrimental outcomes for COVID-19 evolution, especially if the patient derives to Intensive Care Units (ICU). This implies the need to understand the pathophysiology of the infection in the obese population, in order to propose therapeutic alternatives and public health policies, especially if the virus remains in the population. In this review, we summarize evidence about the pathogeny of Cov-2 infection in obese individuals and discuss how obesity-associated inflammatory and prooxidant status increase the severity of COVID-19.
由CoV-2(冠状病毒2型)病毒引起的2019冠状病毒病(新冠肺炎)在已有与内皮功能障碍和促炎和促氧化状态增加相关的疾病的人中具有发展急性呼吸窘迫综合征(ARDS)或SARS(严重急性呼吸综合征冠状病毒2)-CoV2的特殊风险。在这些情况之间,与肥胖患者相关的慢性全身炎症与动脉粥样硬化、2型糖尿病和高血压的发展有关,这些合并症对新冠肺炎危重患者的临床结果产生不利影响。肥胖影响着美国高达40%的普通人口,智利超过30%的成年人口。截至2021年4月,已有1019478人感染,23524人死亡。鉴于这一全球肥胖流行病的共存,在当前情况下,新冠肺炎的负面后果将严重加剧。另一方面,肥胖的特征是在不同的血管床中观察到内皮功能障碍,这种改变可能与血管舒张受损、氧化应激和炎症事件有关。新出现的证据表明,肥胖相关疾病(如内皮功能障碍)与新冠肺炎演变的有害结果有关,尤其是当患者进入重症监护室(ICU)时。这意味着需要了解肥胖人群感染的病理生理学,以便提出治疗替代方案和公共卫生政策,特别是如果病毒仍在人群中。在这篇综述中,我们总结了肥胖人群中Cov-2感染病因的证据,并讨论了肥胖相关的炎症和促氧化剂状态如何增加新冠肺炎的严重程度。
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引用次数: 0
Food and Aeroallergen Sensitization in IgE -Mediated Asthma in Egypt 埃及IgE介导哮喘的食物和空气过敏原致敏
Q3 Medicine Pub Date : 2021-12-31 DOI: 10.2174/1874306402115010052
A. Ali
Purpose: Identifying the distribution of allergens is valuable to the effective diagnosis and treatment of allergic disease. So, our aim is to explore the sensitization of food and aeroallergens in Egyptian patients with atopic asthma. Methods: Cross-sectional study recruited 268 Egyptian patients with atopic asthma. Asthmatic patients were assessed by the enzyme allegro sorbent test (EAST) method for specific IgE to a panel of 19 common regional inhaled allergens and 15 food allergens. Results and Discussion: One hundred percent of the patients were sensitive to at least one allergen. Allergy to food allergens only was 2.9%; inhaled allergens only were 26.2% and both were70.9%. Fungi (62%) were the most frequent sensitizing aeroallergen amongst our asthmatic patients, followed by the pollen allergens (42.5%) and house dust mites (HDMs) (26%). Cows’ milk (30.5%) was the most frequent sensitizing food amongst our asthmatic patients, followed by eggs (22.4%) and fish (21.6%). Mono-sensitized patients accounted for 6.7% of all cases, while polysensitized was 93.3%. Moderate and severe asthma showed a significantly higher frequency of polysensitization compared to mild asthma. Conclusion: Fungi and cow's milk are the chief sensitizing allergens in Egyptian patients with atopic asthma. This study represents the first report of sensitization in atopic adult asthma using a large extract panel in Upper Egypt.
目的:确定过敏原的分布对过敏性疾病的有效诊断和治疗有价值。因此,我们的目的是探索埃及特应性哮喘患者对食物和空气过敏原的致敏作用。方法:横断面研究招募了268名埃及特应性哮喘患者。通过酶快板吸附试验(EAST)方法评估哮喘患者对19种常见区域吸入性过敏原和15种食物过敏原的特异性IgE。结果与讨论:100%的患者对至少一种过敏原敏感。食物过敏原仅占2.9%;在哮喘患者中,真菌(62%)是最常见的致敏空气过敏原,其次是花粉过敏原(42.5%)和屋尘螨(26%)。在我们的哮喘患者中,牛奶(30.5%)是最常见的致敏食物,其次是鸡蛋(22.4%)和鱼(21.6%)。单致敏患者占所有病例的6.7%,而多致敏患者为93.3%。与轻度哮喘相比,中度和重度哮喘表现出明显更高的多致敏频率。结论:真菌和牛奶是埃及特应性哮喘患者的主要致敏原。这项研究代表了上埃及首次使用大型提取物小组对特应性成人哮喘进行致敏的报告。
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引用次数: 2
Effect of Ivacaftor on Objective and Subjective Measures of Cough in Patients with Cystic Fibrosis 依vacaftor对囊性纤维化患者咳嗽主客观指标的影响
Q3 Medicine Pub Date : 2016-12-30 DOI: 10.2174/1874306401610010105
S. Faruqi, D. Shiferaw, A. Morice
Background and Objectives: Cough is a major symptom in cystic fibrosis. Ivacaftor is a novel drug which targets the G551D mutation and has been demonstrated to improve lung function and weight in the long term. It also improves symptoms of extra-oesophageal reflux. We wanted to evaluate the effect of ivacaftor on cough in cystic fibrosis. Methods: In two patients with cystic fibrosis the Hull Airway Reflux Questionnaire (HARQ) was completed and objective cough counts were measured prior to and within 4 weeks after initiation of treatment with ivacaftor. Spirometry was also undertaken and weight checked at these time frames. Results: In the first patient the HARQ score decreased from 29 to 11 and objective cough counts from 29 to 9 cough events per hour. Similarly in the second patient the HARQ score decreased from 13 to 9 and objective cough count from 76 to 5 cough events per hour. There was no significant change in spirometric parameters or weight. Conclusion: We have observed early subjective and objective improvement in cough measures on treatment with ivacaftor. We suggest that this improvement could be attributed to improvement of gastro-intestinal function and that cough metrics could be used as early and accurate end points of drug efficacy.
背景与目的:咳嗽是囊性纤维化的主要症状。Ivacaftor是一种针对G551D突变的新药,已被证明可以长期改善肺功能和体重。它还能改善食管外反流的症状。我们想评价依vacaftor对囊性纤维化患者咳嗽的影响。方法:对2例囊性纤维化患者进行赫尔气道反流问卷调查(HARQ),并在伊vacaftor治疗前和开始治疗后4周内测量客观咳嗽计数。在这些时间框架内还进行了肺活量测定和体重检查。结果:第1例患者的HARQ评分从29降至11,客观咳嗽次数从每小时29次降至9次。同样,第二例患者的HARQ评分从13降至9,客观咳嗽次数从每小时76次降至5次。呼吸参数和体重没有明显变化。结论:观察到依伐他特治疗咳嗽措施的主客观早期改善。我们认为这种改善可能归因于胃肠道功能的改善,咳嗽指标可以作为药物疗效的早期和准确终点。
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引用次数: 8
Effect of Short-Term Exposure to High Particulate Levels on Cough Reflex Sensitivity in Healthy Tourists: A Pilot Study 短期暴露于高颗粒水平对健康游客咳嗽反射敏感性的影响:一项初步研究
Q3 Medicine Pub Date : 2016-12-30 DOI: 10.2174/1874306401610010096
Ryuhei Sato, Peijun Gui, Kumiko Ito, M. Kohzuki, S. Ebihara
Background: Previous studies have reported a relationship between particulate air pollution and respiratory symptoms or decline in lung function, but information about acute effects of short-term exposure to airborne particulate matter (PM) on cough and pulmonary function is scarce. Objective: To investigate the effect of short-term exposure to high concentrations of PM on the cough reflex threshold, urge-to-cough, pulmonary function, and cough-related quality of life in a group of healthy non-resident volunteers visiting Beijing, China. Methods: Seventeen healthy residents of Sendai, Japan, who planned to attend a meeting in Beijing, were recruited. We checked local air quality and measured cough reflex thresholds, urge-to-cough, pulmonary function, and Leicester Cough Questionnaire-acute (LCQ-acute) scores in the volunteers before, during, and after their trip to Beijing. Results: The PM2.5 and PM10 concentrations in Beijing were significantly higher than those in Japan on the measurement days. Cough reflex thresholds, expressed as nebulized citric acid concentrations required to induce ≥ 2 and ≥ 5 coughs, were significantly lower during the stay in Beijing than before or after the visit. Vital capacity, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC were significantly lower during the stay in Beijing than before the trip. Similarly, the urge-to-cough threshold was significantly lower during the stay in Beijing than after the trip, as was the total LCQ-acute score. Conclusion: We tentatively concluded that short-term exposure to high PM concentrations may have adverse effects on cough reflex and urge-to-cough thresholds, pulmonary function, and cough-related quality of life.
背景:以前的研究报道了空气颗粒物污染与呼吸道症状或肺功能下降之间的关系,但关于短期暴露于空气颗粒物(PM)对咳嗽和肺功能的急性影响的信息很少。目的:探讨短期暴露于高浓度PM对中国北京非居民健康志愿者咳嗽反射阈值、急咳、肺功能和咳嗽相关生活质量的影响。方法:选取拟赴北京参加会议的日本仙台市健康居民17人。我们检查了当地的空气质量,并测量了志愿者在北京旅行之前、期间和之后的咳嗽反射阈值、急切咳嗽、肺功能和莱斯特咳嗽急性问卷(lcq -急性)得分。结果:北京PM2.5和PM10浓度显著高于日本。咳嗽反射阈值(以诱导≥2次和≥5次咳嗽所需的雾化柠檬酸浓度表示)在北京期间显著低于就诊前后。肺活量、用力呼气量(FEV1)、用力肺活量(FVC)和FEV1/FVC在京期间均明显低于出行前。同样,在北京逗留期间,咳嗽冲动阈值明显低于旅行后,lcq -急性总分也是如此。结论:我们初步得出短期暴露于高浓度PM可能对咳嗽反射和急咳阈值、肺功能和咳嗽相关生活质量产生不利影响。
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引用次数: 15
Predicted Values for Spirometry may Underestimate Long-Standing Asthma Severity 肺活量测定的预测值可能低估了长期存在的哮喘严重程度
Q3 Medicine Pub Date : 2016-11-30 DOI: 10.2174/1874306401610010070
B. Sposato
Background: Asthma may show an accelerated lung function decline. Asthmatics, although having FEV1 and FEV1/VC (and z-scores) higher than the lower limit of normality, may show a significant FEV1 decline when compared to previous measurements. We assessed how many asymptomatic long-standing asthmatics (LSA) with normal lung function showed a significant FEV1 decline when an older FEV1 was taken as reference point. Methods: 46 well-controlled LSA (age: 48.8±12.1; 23 females) with normal FEV1 and FEV1/VC according to GLI2012 references (FEV1: 94.8±10.1%, z-score:-0.38±0.79; FEV1/VC: 79.3±5.2, z-score:-0.15±0.77) were selected. We considered FEV1 decline, calculated by comparing the latest value to one at least five years older or to the highest predicted value measured at 21 years for females and 23 for males. A FEV1 decline >15% or 30 ml/years was regarded as pathological. Results: When comparing the latest FEV1 to an at least 5-year-older one (mean 8.1±1.4 years between 2 measurements), 14 subjects (30.4%) showed a FEV1 decline <5% (mean: -2.2±2.6%), 19 (41.3%) had a FEV1 5-15% change (mean: -9.2±2.5%) and 13 (28.3%) a FEV1 decrease>15% (mean: -18.3±2.4). Subjects with a FEV1 decline>30 ml/year were 28 (60.8%). When using the highest predicted FEV1 as reference point and declines were corrected by subtracting the physiological decrease, 6 (13%) patients showed a FEV1 decline higher than 15%, whereas asthmatics with a FEV1 loss>30 ml/year were 17 (37%). Conclusion: FEV1 decline calculation may show how severe asthma actually is, avoiding a bronchial obstruction underestimation and a possible under-treatment in lots of apparent “well-controlled” LSA with GLI2012-normal-range lung function values.
背景:哮喘可表现为肺功能加速衰退。虽然哮喘患者的FEV1和FEV1/VC(和z分数)高于正常值的下限,但与之前的测量结果相比,可能会出现明显的FEV1下降。我们评估了有多少肺功能正常的无症状长期哮喘患者(LSA)在以老年FEV1为参考点时表现出明显的FEV1下降。方法:46例控制良好的LSA(年龄:48.8±12.1;23名女性)FEV1和FEV1/VC正常(FEV1: 94.8±10.1%,z-score:-0.38±0.79;FEV1/VC: 79.3±5.2,z-score:-0.15±0.77)。我们考虑了FEV1的下降,通过将最新值与至少五年前的值或与女性21岁和男性23岁时测量的最高预测值进行比较来计算。FEV1下降15%或30 ml/年视为病理性。结果:将最新FEV1与至少5岁(两次测量平均8.1±1.4岁)的FEV1进行比较,14例(30.4%)患者FEV1下降15%(平均-18.3±2.4)。FEV1下降至30 ml/年的28例(60.8%)。当使用最高预测FEV1作为参考点,并通过减去生理下降来纠正下降时,6例(13%)患者的FEV1下降高于15%,而FEV1下降低于30ml /年的哮喘患者为17例(37%)。结论:FEV1下降计算可以显示哮喘的实际严重程度,避免了对许多明显“控制良好”且gli2012 -肺功能值正常的LSA的支气管阻塞低估和可能的治疗不足。
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引用次数: 2
Determinants of Restrictive Spirometric Pattern in a Sub-Saharan Urban Setting: A Cross-sectional Population-based Study 撒哈拉以南城市环境中限制性肺活量测定模式的决定因素:一项基于人口的横断面研究
Q3 Medicine Pub Date : 2016-11-30 DOI: 10.2174/1874306401610010086
E. Pefura-Yone, A. Balkissou, A. Kengne
Background Restrictive spirometric pattern is a risk factor for all-cause and cause-specific mortality. Objective We assessed the prevalence of restrictive pattern and investigated its determinants in a major sub-Saharan Africa city. Methods Participants were adults (≥ 19 years) who took part in a population-based survey in Yaounde (Cameroon) between December 2013 and April 2014. Restrictive pattern was based on a FVC below the lower limit of the normal (LLN) and a ratio forced expiratory volume in one second (FEV1)/FVC ≥ LLN (LLN-based restrictive pattern) or a FVC <80% and FEV1/FVC ≥ LLN (fixed cut-off based restrictive pattern). Determinants were investigated by logistic regressions. Results In all, 1003 participants [514 (51.2%) women] with a mean age of 33.7 years were included. The prevalence of restrictive pattern was 18.8% (95%CI: 16.6-21.2) based on LLN and 15.0% (13.0-17.2) based on fixed cut-off. LLN-based restrictive pattern was mild in 148 (78.3%) subjects, moderate in 35 (18.5%) and severe in 6 (3.2%). Determinants of LLN-based restrictive pattern were age ≥ 60 years [adjusted odds ratio 2.90 (95%CI 1.46-5.77), p=0.002), history of pulmonary tuberculosis [3.81(1.42-10.20), p=0.008], prevalent heart diseases [3.81 (1.20-12.12), p=0.024] and underweight [5.15(1.30-20.39), p=0.020]. Determinants were largely similar with slightly different effect sizes for fixed cut-off based restrictive pattern. Conclusion Restrictive pattern was very frequent in this city. Clinical implications These results enhance the needs to increase the efforts to prevent and control tuberculosis, cardiovascular diseases and underweight in this setting.
背景:限制性肺活量测定模式是全因和特定病因死亡率的危险因素。目的评估撒哈拉以南非洲一个主要城市限制模式的流行程度,并调查其影响因素。方法2013年12月至2014年4月在喀麦隆雅温得参加人口调查的成人(≥19岁)。限制模式以FVC低于正常下限(LLN)和1秒用力呼气量(FEV1)/FVC比值≥LLN(基于LLN的限制模式)或FVC <80%且FEV1/FVC≥LLN(基于固定截止的限制模式)为基础。通过逻辑回归研究决定因素。结果共纳入1003名参与者[514名(51.2%)女性],平均年龄33.7岁。基于LLN的限制性模式患病率为18.8% (95%CI: 16.6-21.2),基于固定截止的患病率为15.0%(13.0-17.2)。其中轻度148例(78.3%),中度35例(18.5%),重度6例(3.2%)。以lln为基础的限制性模式的决定因素为年龄≥60岁[校正优势比2.90 (95%CI 1.46 ~ 5.77), p=0.002]、肺结核史[3.81(1.42 ~ 10.20),p=0.008]、流行心脏病[3.81(1.20 ~ 12.12),p=0.024]和体重过轻[5.15(1.30 ~ 20.39),p=0.020]。决定因素在很大程度上是相似的,只是基于固定的限制模式的效应大小略有不同。结论我市的限制性模式较为常见。这些结果加强了在这种情况下加大努力预防和控制结核病、心血管疾病和体重不足的必要性。
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引用次数: 6
Evaluation of Pulmonary Nodules Using the Spyglass Direct Visualization System Combined With Radial Endobronchial Ultrasound: A Clinical Feasibility Study 望远镜直接显像系统联合桡骨支气管超声评价肺结节的临床可行性研究
Q3 Medicine Pub Date : 2016-11-30 DOI: 10.2174/1874306401610010079
K. Godbout, S. Martel, Mathieu Simon, N. Lampron, A. Delage
Background: Sampling of peripheral pulmonary nodules with radial endobronchial ultrasound (p-EBUS) increases diagnostic yield of bronchoscopy. However, diagnostic yield is influenced by numerous factors. Objective: We evaluated the use of SpyGlass, a one millimeter diameter optic fiber, to obtain images of the distal mucosa and of pulmonary lesions detected with p-EBUS to determine if visual aspect of the distal mucosa was predictive of diagnosis. Methods: We prospectively recruited subjects investigated for peripheral nodules. Bronchoscopy was performed and p-EBUS was used to locate the lesion through a guide sheath. The Spyglass fiber was introduced in the sheath to obtain images of the distal bronchial mucosa. Tissue sampling was subsequently done. Results: Fifteen patients were enrolled in the study. A final diagnosis of malignancy was confirmed in 80%. All lesions could be located using p-EBUS (100%). Diagnostic sensitivity for p-EBUS was 58.3%. Distal mucosa could be imaged with SpyGlass in 14/15 patients (93.3%). Mucosal appearance was described as abnormal in 7 out of the 15 subjects. Mean SpyGlass procedure time was 6.5 minutes. No direct complication was reported. Conclusion: Spyglass can be used in combination with p-EBUS to obtain images of the distal bronchial mucosa and peripheral pulmonary nodules. More patients will be needed to confirm whether mucosal appearance can be predictive of malignancy.
背景:桡骨支气管内超声(p-EBUS)对周围性肺结节取样可提高支气管镜检查的诊断率。然而,诊断率受到许多因素的影响。目的:我们评估使用SpyGlass,一种直径1毫米的光纤,获得远端粘膜和p-EBUS检测到的肺病变的图像,以确定远端粘膜的视觉方面是否可以预测诊断。方法:我们前瞻性地招募外周结节患者。行支气管镜检查,p-EBUS通过引导鞘定位病变。在鞘中引入望远镜纤维以获得远端支气管粘膜的图像。随后进行组织取样。结果:15例患者入组研究。80%的患者最终确诊为恶性肿瘤。p-EBUS可定位所有病变(100%)。p-EBUS的诊断敏感性为58.3%。14/15(93.3%)的患者可以使用SpyGlass成像远端粘膜。15例受试者中有7例粘膜外观异常。平均SpyGlass手术时间为6.5分钟。无直接并发症报道。结论:望远镜联合p-EBUS可获得支气管远端粘膜和肺周围结节的图像。需要更多的患者来证实粘膜外观是否可以预测恶性肿瘤。
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引用次数: 2
Association Between Health Symptoms and Particulate Matter from Traffic and Residential Heating − Results from RHINE III in Tartu 交通和住宅供暖产生的颗粒物与健康症状之间的关系——塔尔图莱茵河III的结果
Q3 Medicine Pub Date : 2016-09-30 DOI: 10.2174/1874306401610010058
Mihkel Pindus, H. Orru, M. Maasikmets, M. Kaasik, R. Jõgi
Background: Traffic and residential heating are the main sources of particulate matter (PM) in Northern Europe. Wood is widely used for residential heating and vehicle numbers are increasing. Besides traffic exhaust, studded tires produce road dust that is the main source of traffic-related PM10. Several studies have associated total PM mass with health symptoms; however there has been little research on the effects of PM from specific sources. Objective: To study the health effects resulting from traffic and local heating PM. Methods: Data on respiratory and cardiac diseases were collected within the framework of RHINE III (2011/2012) in Tartu, Estonia. Respondents’ geocoded home addresses were mapped in ArcGIS and linked with local heating-related PM2.5, traffic-related PM10 and total PM2.5 concentrations. Association between self-reported health and PM was assessed using multiple logistic regression analysis. Results: The annual mean modelled exposure for local heating PM2.5 was 2.3 μg/m3, for traffic PM10 3.3 μg/m3 and for all sources PM2.5 5.6 μg/m3. We found relationship between traffic induced PM10 as well as all sources induced PM2.5 with cardiac disease, OR=1.45 (95% CI 1.06−1.93) and 1.42 (95% CI 1.02−1.95), respectively. However, we did not find any significant association between residential heating induced particles and self-reported health symptoms. People with longer and better confirmed exposure period were also significantly associated with traffic induced PM10, all sources induced PM2.5 and cardiac diseases. Conclusion: Traffic-related PM10 and all sources induced PM2.5 associated with cardiac disease; whereas residential heating induced particles did not.
背景:交通和住宅供暖是北欧颗粒物(PM)的主要来源。木材被广泛用于住宅供暖,车辆数量也在增加。除了交通废气外,镶钉轮胎还会产生道路粉尘,这是与交通有关的PM10的主要来源。几项研究将PM总质量与健康症状联系起来;然而,关于特定来源的PM的影响的研究很少。目的:研究交通和局部供暖PM对健康的影响。方法:在爱沙尼亚塔尔图的RHINE III(2011/2012)框架内收集呼吸和心脏疾病的数据。受访者的地理编码家庭住址在ArcGIS中被映射,并与当地供暖相关的PM2.5、交通相关的PM10和PM2.5总浓度相关联。采用多元逻辑回归分析评估自我报告健康状况与PM之间的关系。结果:当地供暖PM2.5年均暴露量为2.3 μg/m3,交通PM10年均暴露量为3.3 μg/m3,所有来源年均暴露量为5.6 μg/m3。我们发现交通引起的PM10以及所有来源引起的PM2.5与心脏病之间的关系,OR分别=1.45 (95% CI 1.06 - 1.93)和1.42 (95% CI 1.02 - 1.95)。然而,我们没有发现住宅供暖诱导的颗粒与自我报告的健康症状之间有任何显著关联。暴露时间较长和较好的人与交通诱发的PM10、所有来源诱发的PM2.5和心脏病也显著相关。结论:交通相关PM10及各来源诱发的PM2.5与心脏病相关;而住宅加热诱导的颗粒则没有。
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引用次数: 10
Physiotherapy Intervention During Level I of Pulmonary Rehabilitation on Chronic Obstructive Pulmonary Disease: A Systematic Review 慢性阻塞性肺疾病一级康复期间的物理治疗干预:系统综述
Q3 Medicine Pub Date : 2016-02-29 DOI: 10.2174/1874306401610010012
Guilherme Medeiros de Alvarenga, H. Gamba, Lilian Elisa Hellman, Vanusa Ganzert Ferrari, R. Macedo
Background: The progressive and chronic course of COPD, characterized by difficulty in breathing, can be aggravated by periods of increased symptoms (exacerbation). The treatment often involves in-hospital care and among the interventions applied in COPD patients, physical therapy prompts good results. However the most used techniques are not properly pinpointed and there is no consensus in the literature regarding its effectiveness.
背景:以呼吸困难为特征的进行性和慢性COPD病程可因症状加重(加重)而加重。治疗通常包括住院治疗,在COPD患者中应用的干预措施中,物理治疗效果良好。然而,最常用的技术并没有被正确地确定,并且在文献中没有关于其有效性的共识。
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引用次数: 10
期刊
Open Respiratory Medicine Journal
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