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"Preface: New Year, New Goals of the Journal" 《前言:新的一年,本刊的新目标》
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-02-01 DOI: 10.2174/1573398x1801220518103252
J. Varon, N. Hussaini
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引用次数: 0
An Investigation of the Factors Affecting Compliance When Using Home Non-Invasive Ventilation Therapy 影响家庭无创通气治疗依从性的因素分析
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-31 DOI: 10.2174/1573398x18666220131100128
Abdulrahman Kashkosh
Home non-invasive ventilation has become a well-established form of therapy over the last few decades. Many conditions benefit from home NIV, for instance, patients with motor neurone disease (MND) and chest wall deformities that lead to respiratory complications. Home NIV has been shown to increase survival and improve quality of life in many chest wall diseases and MND. There is also substantial evidence to indicate that NIV can palliate symptoms of Obesity Hypoventilation Syndrome (OHS). Also, Home NIV is a valuable tool in the management of patients with severe COPD and has been shown to reduce mortality and morbidity in patients with chronic respiratory failure. However, the usefulness of home NIV varies according to compliance. This review investigates the factors affecting compliance with home NIV. Compliance remains to be an incredibly complex matter. Yet, due to the importance of compliance and its effect on outcomes, investigating influencing variables is a priority.
在过去的几十年里,家庭无创通气已经成为一种公认的治疗方式。许多情况都受益于家庭NIV,例如,运动神经元疾病(MND)和胸壁畸形导致呼吸道并发症的患者。在许多胸壁疾病和MND中,家庭NIV已被证明可以提高生存率并提高生活质量。也有大量证据表明NIV可以缓解肥胖低通气综合征(OHS)的症状。此外,家庭NIV是治疗严重COPD患者的宝贵工具,已被证明可以降低慢性呼吸衰竭患者的死亡率和发病率。然而,家庭NIV的有用性因依从性而异。本综述调查了影响家庭NIV依从性的因素。合规仍然是一个极其复杂的问题。然而,由于合规的重要性及其对结果的影响,调查影响变量是当务之急。
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引用次数: 0
Clinical Evaluation of Exertional Dyspnea in Adult Pectus Excavatum Patients 成人挖掘胸肌患者运动性呼吸困难的临床评价
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-28 DOI: 10.2174/1573398x18666220128110107
Mateo C. Houle, T. Sjulin, I. Mcinnis, R. Walter, M. Morris
Evaluation of patients with pectus excavatum has primarily been focused on the pediatric population who undergo surgical correction of sternal defects mainly for cosmetic reasons combined with exercise-limiting symptoms. The extent of cardiopulmonary improvement in this population based on cardiac imaging, pulmonary function testing, and cardiopulmonary exercise testing may be highly variable. There is no current consensus on the limitations of cardiopulmonary impairment or potential improvement from surgical repair in pediatric patients. Limited data has published in the medical literature on the evaluation of adults with pectus excavatum who may also present with a variety of clinical symptoms. Adult patients with exercise limitation and pectus excavatum may present with exertional dyspnea, chest discomfort, palpitations/tachycardia, exercise-induced wheezing, and use of bronchodilators for asthma-like symptoms. While numerous published review articles outline clinical evaluation and surgical treatment for younger patients, comprehensive evaluation for these adult patients has not been fully elucidated. There is no current consensus on the underlying cause of cardiopulmonary impairment in adult patients or their potential improvement from surgical repair. This review focuses on the recommended evaluation of adult patients to discern the potential cardiopulmonary limitations to exercise due to pectus excavatum, especially in physically fit adults such as active duty military personnel. Two illustrative cases are presented to describe the complexity of the evaluation of adult patients and potential need for surgical correction.
对漏斗胸患者的评估主要集中在主要因美观原因并伴有运动限制症状而接受胸骨缺损手术矫正的儿科人群。基于心脏成像、肺功能测试和心肺运动测试,这一人群的心肺改善程度可能是高度可变的。目前还没有共识的心肺功能障碍的局限性或潜在的改善手术修复在儿科患者。有限的数据已发表在医学文献评价成人漏斗胸谁也可能出现各种临床症状。运动受限和漏斗胸的成年患者可能表现为运动性呼吸困难、胸部不适、心悸/心动过速、运动性喘息,并使用支气管扩张剂治疗哮喘样症状。虽然许多已发表的综述文章概述了年轻患者的临床评估和手术治疗,但对这些成年患者的综合评估尚未完全阐明。目前对于成人患者心肺功能障碍的潜在原因或手术修复对其的潜在改善尚无共识。这篇综述的重点是对成年患者的推荐评估,以识别因漏斗胸肌而导致的潜在心肺功能限制,特别是对身体健康的成年人,如现役军人。两个说明性的情况下,提出了描述的复杂性评估成人患者和手术矫正的潜在需求。
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引用次数: 0
Simultaneous Bilateral Secondary Pneumothorax Complicating Osteosarcoma: A Case Report 并发骨肉瘤的双侧继发性胸腔积液1例
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-28 DOI: 10.2174/1573398x18666220128110553
Faradila Nur Aini, I. A. Marhana
The incidence of Simultaneous Bilateral Secondary Pneumothorax (SBSP) occurring as a complication of neoplasm is rare, only <1%. The lungs can be the site for spreading metastatic osteosarcoma.We investigated a 16-year-old female who was diagnosed with right distal femur osteosarcoma, pulmonary metastasis, and a rare SBSP complication. Pneumothorax was observed in both sites of pulmonary metastases and bronchopleural fistula by contrasting chest computed tomography.This pneumothorax is the second one; the previous one was only on one side, before chemotherapy. 12 months after osteosarcoma was diagnosed and four months after SBSP occurred. The progression of osteosarcoma lesions was the cause of patient’s death. SBSP is the leading cause of severe complications in osteosarcoma.The clinician must perform diagnostic strategies for early detection of osteosarcoma and its proper management, which can reduce a patient’s suffering and impairment of the patient’s quality of life, thus decreasing morbidity and risk of mortality.
同时发生双侧继发性胸腔积液(SBSP)作为肿瘤并发症的发生率很低,仅<1%。肺部可能是转移性骨肉瘤扩散的部位。我们调查了一名16岁的女性,她被诊断为右股骨远端骨肉瘤、肺转移和一种罕见的SBSP并发症。通过对比胸部计算机断层扫描,在肺转移和支气管胸膜瘘的两个部位都观察到了胸腔。这是第二例;前一个只是在一侧,在化疗之前。骨肉瘤诊断后12个月和SBSP发生后4个月。骨肉瘤病变的进展是患者死亡的原因。SBSP是骨肉瘤严重并发症的主要原因。临床医生必须执行诊断策略,以早期发现骨肉瘤并进行适当的管理,这可以减少患者的痛苦和对患者生活质量的损害,从而降低发病率和死亡率。
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引用次数: 0
Noninvasive or invasive mechanical ventilation in oncohematologic patients with acute respiratory failure: a systematic review and meta-analysis 无创或有创机械通气在血液肿瘤患者急性呼吸衰竭中的应用:一项系统综述和荟萃分析
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-27 DOI: 10.2174/1573398x18666220127104656
L. Barreto, C. Ravetti, N. S. Guimarães, V. Nobre
Acute respiratory failure [ARF] in oncohematologic subjects is one of the most common causes of high mortality rates. Noninvasive mechanical ventilation [NIMV] has arisen as an accessory treatment in this clinical scenario.This study aimed to compare mortality rates and severity of illness associated with NIMV or invasive mechanical ventilation [IMV] in oncohematologic patients with ARF.A search was conducted in the PubMed, SCOPUS, Cochrane Library, LILACS, Web of Science, and gray literature databases, published between November 2007 and May 2021.Eight studies with a total of 570 patients were included. Patients with good responses to NIMV showed lower values of the Simplified Acute Physiology Score III [SAPS 3] [range: 42±7 to 53±17] when compared to those intubated following NIMV failure [range: 50±11 to 63.3±17.4] and those who underwent IMV as the primary ventilator support [range: 64.9±17.5 to 66±17]. Similarly, patients whose NIMV treatment failed and those that initially used IMV had higher baseline values of Sequential Organ Failure Assessment Score [SOFA] when compared to the group with a good response to NIMV. ICU mortality ranged from 40% to 68% in NIMV success, 54% to 79% in NIMV failure, and from 54% to 80% in the group treated with IMV. NIMV therapy had a significant protective effect on mortality [RR=0.71, 95% CI: 0.53-0.94, p=0.02].NIMV use in oncohematologic patients admitted to the ICU with ARF was associated with lower mortality. Patients successfully treated with the NIMV group showed lower values of SOFA and SAPS 3 [Prospero Systematic Review -protocol number: 132770].
急性呼吸衰竭(ARF)是导致血液肿瘤患者高死亡率的最常见原因之一。无创机械通气(NIMV)已成为这种临床情况下的辅助治疗方法。本研究旨在比较血液肿瘤合并急性肾功能衰竭患者与NIMV或有创机械通气(IMV)相关的死亡率和疾病严重程度。在PubMed、SCOPUS、Cochrane Library、LILACS、Web of Science和灰色文献数据库中进行了检索,检索时间为2007年11月至2021年5月。8项研究共纳入570例患者。与NIMV失败后插管的患者[范围:50±11至63.3±17.4]和将IMV作为主要呼吸机支持的患者[范围:64.9±17.5至66±17]相比,NIMV反应良好的患者的简化急性生理评分III [SAPS 3][范围:42±7至53±17]值较低。同样,NIMV治疗失败的患者和最初使用IMV的患者与NIMV反应良好的组相比,序贯器官衰竭评估评分(SOFA)的基线值更高。NIMV成功组ICU死亡率为40% - 68%,NIMV失败组为54% - 79%,IMV治疗组为54% - 80%。NIMV治疗对死亡率有显著的保护作用[RR=0.71, 95% CI: 0.53-0.94, p=0.02]。NIMV在急性肾功能衰竭住院ICU的血液肿瘤患者中使用与较低的死亡率相关。NIMV组成功治疗的患者SOFA和SAPS 3值较低[普洛斯普洛斯系统评价-方案号:132770]。
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引用次数: 0
Estrogen receptor beta (ERβ) expression in different subtypes of malignant pleural mesothelioma 雌激素受体β (ERβ)在不同亚型恶性胸膜间皮瘤中的表达
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-11 DOI: 10.2174/1573398x18666220111144745
Guitti Pourdowlat, M. Parvizi, Shogher Boyadjian, M. Shamaei, M. Pourabdollah
Estrogen receptor beta (ERβ) is a potential target for cancer therapy as a tumor suppressor. Malignant pleural mesothelioma (MPM) is a rare but fatal cancer. This study tries to estimate the incidence of ERβ expression in the various subtypes of MPM tumors.In a retrospective study performed at a pulmonary tertiary referral hospital, formalin-fixed paraffin-embedded human tissues of 46 definitive MPM were evaluated for expression of ERβ by immunohistochemistry.ERβ was detected in 14 cases (30.4%) out of the total 46 patients with a mean age of 58.08±11.59 SD, including 33 (71.7%) males. There was no statistically significant difference in patients with positive ERβ staining versus negative cases in age and sex (P >0.05). MPM subtypes included 36 (78.2%) cases of epithelioid mesothelioma, 3 (6.5%) cases of sarcomatoid, 5 (10.8%) cases of biphasic, and 2 (4.3%) cases of desmoplastic subtype. ERβ expression was observed only in epithelioid (11 of total 36 cases) and biphasic (3 of total 5 cases) tumors. There was no significant difference in the incidence of ERβ expression in different subtypes of malignant pleural mesothelioma. Statistical analysis shows a significant difference in the expression of ERβ in the epithelioid subtype (with a more favorable prognosis) versus non-epithelioid subtypes (with poor prognosis, including sarcomatoid, desmoplastic, and biphasic) (P = 0.024).Considering the higher proportion of the epithelioid type of MPM with ERβ expression, this highlights the role of ERβ in target therapy of MPM tumor, especially in the epithelioid subtype with a more favorable prognosis. A better understanding of the pathology of mesothelioma will eventually contribute to the development of therapies beyond the existing therapeutic platform.
雌激素受体β (ERβ)作为肿瘤抑制因子是癌症治疗的潜在靶点。恶性胸膜间皮瘤(MPM)是一种罕见但致命的癌症。本研究试图估计ERβ表达在MPM不同亚型肿瘤中的发生率。在一家肺部三级转诊医院进行的一项回顾性研究中,用免疫组织化学方法评估了46例终末MPM的福尔马林固定石蜡包埋人体组织中ERβ的表达。46例患者(平均年龄58.08±11.59 SD)中检出ERβ 14例(30.4%),其中男性33例(71.7%)。ERβ染色阳性患者与阴性患者的年龄、性别差异无统计学意义(P < 0.05)。MPM亚型包括上皮样间皮瘤36例(78.2%),肉瘤样间皮瘤3例(6.5%),双相间皮瘤5例(10.8%),结缔组织增生亚型2例(4.3%)。ERβ仅在上皮样瘤(36例中11例)和双相瘤(5例中3例)中表达。ERβ在不同亚型恶性胸膜间皮瘤中的表达发生率无显著差异。统计分析显示,ERβ在上皮样亚型(预后较好)和非上皮样亚型(预后较差,包括肉瘤样、结缔组织增生和双相)中的表达差异有统计学意义(P = 0.024)。考虑到上皮样型MPM中表达ERβ的比例较高,这突出了ERβ在MPM肿瘤靶向治疗中的作用,特别是在预后较好的上皮样亚型中。更好地了解间皮瘤的病理将最终有助于超越现有治疗平台的治疗方法的发展。
{"title":"Estrogen receptor beta (ERβ) expression in different subtypes of malignant pleural mesothelioma","authors":"Guitti Pourdowlat, M. Parvizi, Shogher Boyadjian, M. Shamaei, M. Pourabdollah","doi":"10.2174/1573398x18666220111144745","DOIUrl":"https://doi.org/10.2174/1573398x18666220111144745","url":null,"abstract":"\u0000\u0000Estrogen receptor beta (ERβ) is a potential target for cancer therapy as a tumor suppressor. Malignant pleural mesothelioma (MPM) is a rare but fatal cancer. This study tries to estimate the incidence of ERβ expression in the various subtypes of MPM tumors.\u0000\u0000\u0000\u0000In a retrospective study performed at a pulmonary tertiary referral hospital, formalin-fixed paraffin-embedded human tissues of 46 definitive MPM were evaluated for expression of ERβ by immunohistochemistry.\u0000\u0000\u0000\u0000ERβ was detected in 14 cases (30.4%) out of the total 46 patients with a mean age of 58.08±11.59 SD, including 33 (71.7%) males. There was no statistically significant difference in patients with positive ERβ staining versus negative cases in age and sex (P >0.05). MPM subtypes included 36 (78.2%) cases of epithelioid mesothelioma, 3 (6.5%) cases of sarcomatoid, 5 (10.8%) cases of biphasic, and 2 (4.3%) cases of desmoplastic subtype. ERβ expression was observed only in epithelioid (11 of total 36 cases) and biphasic (3 of total 5 cases) tumors. There was no significant difference in the incidence of ERβ expression in different subtypes of malignant pleural mesothelioma. Statistical analysis shows a significant difference in the expression of ERβ in the epithelioid subtype (with a more favorable prognosis) versus non-epithelioid subtypes (with poor prognosis, including sarcomatoid, desmoplastic, and biphasic) (P = 0.024).\u0000\u0000\u0000\u0000Considering the higher proportion of the epithelioid type of MPM with ERβ expression, this highlights the role of ERβ in target therapy of MPM tumor, especially in the epithelioid subtype with a more favorable prognosis. A better understanding of the pathology of mesothelioma will eventually contribute to the development of therapies beyond the existing therapeutic platform.\u0000","PeriodicalId":44030,"journal":{"name":"Current Respiratory Medicine Reviews","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48556149","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
Association of Serum Malondialdehyde and C-reactive protein Levels with Exacerbations of Chronic Obstructive Pulmonary Disease 血清丙二醛和c反应蛋白水平与慢性阻塞性肺疾病恶化的关系
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-04 DOI: 10.2174/1573398x18666220104143532
Amir Behnam Kharazmi, A. Abedini, A. Kiani, S. Barouti, Shooka Mohammadi
Chronic obstructive pulmonary disease (COPD) is related to oxidant/antioxidant imbalance and systemic inflammationThis study was conducted to evaluate associations of serum levels of C-reactive protein (CRP) and malondialdehyde (MDA) with the severity and exacerbations of COPD.A matched case-control study was performed among 200 COPD patients (100 cases and 100 controls) who were referred to Masih Daneshvari Hospital in Tehran, Iran. Cases were exacerbators with equal to or greater than two ambulatory exacerbations or one hospitalization; controls were non-exacerbators who had one/no ambulatory exacerbation during the preceding 12 months. Blood samples were collected for CRP, MDA, and erythrocyte sedimentation rate (ESR) analysis. In addition, spirometry, the COPD assessment test (CAT) score, the modified Medical Research Council (mMRC) dyspnea scale, and the BODEx index were applied.The mean (SD) age of the patients was 65.31 (8.46) years. Those with exacerbations had significantly lower FEV1 and higher CRP, MDA, ESR, BMI, BODEx index, CAT, and mMRC scores compared to non-exacerbators. There were significant differences in CRP, MDA, ESR, FVC, FEV1, FEV1/FVC, BMI, BODEx index, mMRC, and CAT scores between the GOLD group. Moreover, multivariate analysis showed that higher levels of CRP (OR=0.61, p=0.023), MDA (OR=0.28, p=0.001), ESR (OR=0.86, p=0.029), CAT score (OR=0.84, p=0.012), BODEx index (OR=0.89, p <0.001), BMI (OR=0.42, p <0.001), and lower FEV1% (OR=0.77, p <0.001) were independent risk factors for frequent exacerbations.In conclusion, elevated serum MDA and CRP levels in combination may serve as prognostic indicators of the severity and exacerbation of COPD.
慢性阻塞性肺病(COPD)与氧化剂/抗氧化剂失衡和全身炎症有关。本研究旨在评估血清C反应蛋白(CRP)和丙二醛(MDA)水平与COPD的严重程度和恶化程度的关系伊朗德黑兰的Masih Daneshvari医院。病例为病情加重,有两次或两次以上门诊病情加重或一次住院治疗;对照组为在前12个月内有一次/无动态恶化的非加重患者。采集血样进行CRP、MDA和血沉(ESR)分析。此外,还应用了肺活量测定法、COPD评估测试(CAT)评分、改良医学研究委员会(mMRC)呼吸困难量表和BODEx指数。患者的平均(SD)年龄为65.31(8.46)岁。与非加重组相比,加重组的FEV1明显较低,CRP、MDA、ESR、BMI、BODEx指数、CAT和mMRC评分较高。GOLD组的CRP、MDA、ESR、FVC、FEV1、FEV1/FVC、BMI、BODEx指数、mMRC和CAT评分存在显著差异。此外,多变量分析显示,较高水平的CRP(OR=0.61,p=0.023)、MDA(OR=0.28,p=0.001)、ESR(OR=0.86,p=0.029)、CAT评分(OR=0.84,p=0.012)、BODEx指数(OR=0.89,p<0.001)、BMI(OR=0.42,p<0.001)和较低的FEV1%(OR=0.77,p<0.001)是频繁恶化的独立风险因素。总之,血清MDA和CRP水平升高可作为COPD严重程度和恶化的预后指标。
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引用次数: 1
Susceptibility to rhinovirus-induced early wheezing as a risk factor for subsequent asthma development 鼻病毒诱导的早期喘息易感性是随后哮喘发展的危险因素
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-03 DOI: 10.2174/1573398x18666220103113813
Hannele Mikkola, Minna Honkila, T. Tapiainen, T. Jartti
Rhinovirus is one of the two most common viral agents that cause bronchiolitis in young children. During the first 12 months, it is second to the respiratory syncytial virus, but after 12 months, it begins dominating the statistics. Wheezing and dry cough are typical clinical symptoms indicative of rhinovirus-induced bronchiolitis, although overlap of symptoms with other virus infections is common. Several studies have shown that atopic predisposition and reduced interferon responses increase susceptibility to rhinovirus-induced wheezing. More recent studies have found that certain genetic variations at strong asthma loci also increase susceptibility. Rhinovirus-induced wheezing in the early years of life is known to increase the risk of subsequent asthma development and may be associated with airway remodeling. This risk is increased by aeroallergen sensitization. Currently, there are no clinically approved preventive treatments for asthma. However, studies show promising results indicating that children with rhinovirus-affected first-time wheezing respond to bronchodilators in terms of less short-term symptoms and that controlling airway inflammatory responses with anti-inflammatory medication may markedly decrease asthma development. Also, enhancing resistance to respiratory viruses has been a topic of discussion. Primary and secondary prevention strategies are being developed with the aim of decreasing the incidence of asthma. Here, we review the current knowledge on rhinovirus-induced early wheezing as a risk factor for subsequent asthma development and related asthma-prevention strategies.
鼻病毒是引起幼儿毛细支气管炎的两种最常见的病毒制剂之一。在最初的12个月里,它仅次于呼吸道合胞病毒,但在12个月之后,它开始在统计数据中占据主导地位。喘息和干咳是鼻病毒引起的毛细支气管炎的典型临床症状,尽管与其他病毒感染的症状重叠是常见的。一些研究表明,特应性易感性和干扰素反应减少会增加对鼻病毒诱导的喘息的易感性。最近的研究发现,在哮喘强位点的某些遗传变异也会增加易感性。已知生命早期鼻病毒引起的喘息会增加随后哮喘发展的风险,并可能与气道重塑有关。空气过敏原致敏会增加这种风险。目前,还没有临床批准的哮喘预防性治疗方法。然而,研究显示了令人鼓舞的结果,表明鼻病毒感染的首次喘息儿童对支气管扩张剂的短期症状反应较少,并且用抗炎药物控制气道炎症反应可能显著减少哮喘的发展。此外,增强对呼吸道病毒的抵抗力一直是讨论的话题。正在制定一级和二级预防战略,目的是减少哮喘的发病率。在这里,我们回顾了鼻病毒引起的早期喘息作为随后哮喘发展的危险因素和相关的哮喘预防策略的现有知识。
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引用次数: 0
Feasıbılıty of Transcutaneous Method for Carbon Dıoxıde Monıtorıng in an Intensive Care Unıt Feasıbılıty经皮碳法Dıoxıde Monıtorıng在重症监护Unıt
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2022-01-03 DOI: 10.2174/1573398x18666220103113003
N. Boyacı, S. Mammadova, Nurgul Naurzvai (Naurizbay), Merve Güleryüz, Kamil İnci, G. Gürsel
Transcutaneous partial pressure of carbon dioxide (PtCO2) monitorization provides a continuous and non-invasive measurement of partial pressure of carbon dioxide (pCO2). In addition, peripheral oxygen saturation (SpO2) can also be measured and followed by this method. However, data regarding the correlation between PtCO2 and arterial pCO2 (PaCO2) measurements acquired from peripheric arterial blood gas is controversial.We aimed to determine the reliability of PtCO2 with PaCO2 based on its advantages, like non-invasiveness and continuous applicability.Thirty-five adult patients with hypercapnic respiratory failure admitted to our tertiary medical intensive care unit (ICU) were included. Then we compared PtCO2 and PaCO2 and both SpO2 measurements simultaneously. Thirty measurements from the deltoid zone and 26 measurements from the cheek zone were applied.PtCO2 could not be measured from the deltoid region in 5 (14%) patients. SpO2 and pulse rate could not be detected at 8 (26.7%) of the deltoid zone measurements. Correlation coefficients between PtCO2 and PaCO2 from deltoid and the cheek region were r: 0,915 and r: 0,946 (p = 0,0001). In comparison with the Bland-Altman test, difference in deltoid measurements was -1,38 ± 1,18 mmHg (p = 0.252) and in cheek measurements it was -5,12 ± 0,92 mmHg (p = 0,0001). There was no statistically significant difference between SpO2 measurements in each region.Our results suggest that PtCO2 and SpO2 measurements from the deltoid region are reliable compared to the arterial blood gas analysis in hypercapnic ICU patients. More randomized controlled studies investigating the effects of different measurement areas, hemodynamic parameters, and hemoglobin levels are needed.
经皮二氧化碳分压(PtCO2)监测提供了连续和无创的二氧化碳分压(pCO2)测量。此外,外周氧饱和度(SpO2)也可以通过该方法测量和跟踪。然而,从外周动脉血气中获得的PtCO2与动脉pCO2 (PaCO2)测量值之间的相关性数据存在争议。我们的目的是根据PtCO2与PaCO2的无创性和持续适用性等优点来确定其可靠性。我们的三级医疗重症监护室(ICU)收治了35例成人高碳酸血症性呼吸衰竭患者。然后我们同时比较了PtCO2和PaCO2以及SpO2的测量值。三角肌30次测量,脸颊26次测量。5例(14%)患者无法从三角肌区测量PtCO2。在8(26.7%)的三角带测量中未检测到SpO2和脉搏率。三角肌和颊区PtCO2和PaCO2的相关系数分别为r: 0.915和r: 0.946 (p = 0.0001)。与Bland-Altman试验相比,三角肌测量值的差异为-1,38±1,18 mmHg (p = 0.252),脸颊测量值的差异为-5,12±0,92 mmHg (p = 0,0001)。各地区SpO2测量值差异无统计学意义。我们的研究结果表明,与高碳酸血症ICU患者的动脉血气分析相比,三角肌区域的PtCO2和SpO2测量是可靠的。需要更多的随机对照研究来调查不同测量区域、血流动力学参数和血红蛋白水平的影响。
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引用次数: 0
Treatment Outcomes of the Standardized Shorter MDR-TB Regimen under Programmatic Setting: A Retrospective Study from a Tertiary Care Centre, India 在程序设置下标准化短期耐多药结核病方案的治疗结果:来自印度一家三级护理中心的回顾性研究
IF 0.2 Q4 RESPIRATORY SYSTEM Pub Date : 2021-12-10 DOI: 10.2174/1573398x17666211210143240
Swathi Karanth M.P, Somashekar M, A. Chakraborty, Swapna R, Akshata J.S, Nagaraja C
The shorter regimen was widely accepted and advocated for MDR-TB treatment compared tothe conventional longer regimen. Evaluating the performance of both regimens in a programmatic setting will help in tailoring the treatment regimen of MDR-TB. 1. To estimate the duration of sputum smear conversion in the shorter MDR-TB regimen. 2. To compare the treatment outcomes of the shorter MDR-TB regimen with that of the longer conventional MDR regimen in a programmatic set up in India. 3. To estimate the adverse drug reactions in the shorter MDR-TB regimen. A retrospective cross-sectional study was conducted on 320 patients enrolled under programmatic management of drug resistant tuberculosis (PMDT) from April 2017 to May 2019 at a nodal DRTB center and a tertiary care hospital in India. Demographic and clinical characteristics of those who received a shorter MDR-TB regimen were recorded. Treatment outcomes of both regimens were recorded. Treatment success is defined as ‘disease cured and treatment completed’, whereas treatment failure was considered when the treatment was either terminated or changed due to lack of bacteriological conversion at the end of an extended intensive phase or culture reversion in the continuation phase. The treatment success observed in the shorter MDR-TB regimen was 61.25%, which was significantly higher than the conventional longer regimen (p=0.0007). Treatment failures were higher with a shorter MDR-TB regimen (p=0.0001). Treatment success with the shorter MDR-TB regimen though higher than the conventional regimen, is still way behind the target treatment success rate. Improving treatment adherence remains pivotal for achieving end TB targets.
与传统的较长方案相比,较短方案被广泛接受并提倡用于耐多药结核病治疗。在方案环境中评估这两种方案的效果将有助于调整耐多药结核病的治疗方案。1.估计较短耐多药结核病方案中痰涂片转化的持续时间。2.在印度设立的一个项目中,比较较短耐多药结核病方案与较长常规耐多药方案的治疗结果。3.估计较短耐多药结核病方案中的药物不良反应。2017年4月至2019年5月,在印度的一个节点DRTB中心和一家三级护理医院,对320名接受耐药性结核病(PMDT)计划管理的患者进行了回顾性横断面研究。记录了接受较短耐多药结核病治疗的患者的人口统计学和临床特征。记录两种方案的治疗结果。治疗成功被定义为“疾病治愈并完成治疗”,而当治疗因在延长强化期结束时缺乏细菌转化或在继续期中培养物逆转而终止或改变时,则视为治疗失败。较短耐多药结核病方案的治疗成功率为61.25%,显著高于常规较长方案(p=0.0007)。较短耐多药结核病方案治疗失败率更高(p=0.0001)。较低耐多药结核方案的治疗失败率虽然高于常规方案,但仍远落后于目标治疗成功率。提高治疗依从性仍然是实现最终结核病目标的关键。
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Current Respiratory Medicine Reviews
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