Multidisciplinary Respiratory Medicine最新文献

{"title":"Do gene-environment interactions play a role in COVID-19 distribution? The case of Alpha-1 Antitrypsin, air pollution and COVID-19.","authors":"Nicola Murgia,&nbsp;Angelo Guido Corsico,&nbsp;Gennaro D'Amato,&nbsp;Cara Nichole Maesano,&nbsp;Arturo Tozzi,&nbsp;Isabella Annesi-Maesano","doi":"10.4081/mrm.2021.741","DOIUrl":"https://doi.org/10.4081/mrm.2021.741","url":null,"abstract":"<p><strong>Background: </strong>Gene-environment interactions are relevant for several respiratory diseases. This communication raises the hypothesis that the severity of COVID-19, a complex disease where the individual response to the infection may play a significant role, could partly result from a gene-environment interaction between air-pollution and Alpha-1 Antitrypsin (AAT) genes.</p><p><strong>Methods: </strong>To evaluate the impact of the AAT and air pollution interaction on COVID-19, we introduced an AAT*air pollution global risk score summing together, in each country, an air pollution score (ozone, nitrogen dioxide and fine particulate matter) and an AAT score (which sums the ranked frequency of MZ, SZ, MS). We compared this global score with the ranking of European countries in terms of death number per million persons.</p><p><strong>Results: </strong>The ranking of the AAT*air pollution global risk score matched the ranking of the countries in terms of the observed COVID-19 deaths per 1M inhabitants, namely in the case of the first European countries: Belgium, UK, Spain, Italy, Sweden, France. We observed parallelism between the number of COVID deaths and the AAT*air pollution global risk in Europe. AAT anti-protease, immune-modulating and coagulation-modulating activities may explain this finding, although very speculatively.</p><p><strong>Conclusions: </strong>Even if further studies taking into account genetic background, population density, temporal dynamics of individual epidemics, access to healthcare, social disparities and immunological response to SARS-CoV2 are needed, our preliminary observation urges to open a discussion on gene-environment interactions in COVID-19.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/f8/mrm-16-1-741.PMC8114100.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39000207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The contribution of patients' lung function to the inspiratory airflow rate achievable through a DPIs' simulator reproducing different intrinsic resistance rates.","authors":"Roberto W Dal Negro,&nbsp;Paola Turco,&nbsp;Massimiliano Povero","doi":"10.4081/mrm.2021.752","DOIUrl":"https://doi.org/10.4081/mrm.2021.752","url":null,"abstract":"<p><strong>Background: </strong>The performance of DPIs depends on several physiological (patient-dependent) and technological (device-dependent) factors. The inspiratory airflow rate is the only active force generated and operating in the system for inducing the required pressure drop and eliciting the resistance-induced turbulence needed to disaggregate the powder through the device. The present study aimed to investigate in the most prevalent respiratory disorders whether and at what extent the inspiratory airflow rate achievable when inhaling through a DPIs' simulator reproducing different intrinsic resistance regimens (low, mid, and high resistance) is affected by peculiar changes in lung function and/or can be predicted by any specific lung function parameter.</p><p><strong>Methods: </strong>The inspiratory airflow rate was assessed in randomized order by the In-Check DIAL G16 at low, mid, and high resistance regimens in a sample of consecutive subjects at recruitment. Independent predictors of the probability to achieve the expected inhalation airflow rate were investigated by means of a multivariate logistic regression model, specific to the disease.</p><p><strong>Results: </strong>A total of 114 subjects were recruited (asthmatics n=30; COPD n=50, restrictive patients n=16, and normal subjects n=18). The mean values of the expected inspiratory airflow rate achieved proved significantly different within the groups (p<0.0001), independently of sex and age. In asthmatics and in COPD patients, the mid-resistance regimen proved highly associated with the highest mean values of airflow rates obtained. Low- and high-resistance regimens were significantly less likely to consent to achieve the expected level of inspiratory airflow rate (OR<1 in all comparisons). Restrictive patients performed the lowest airflow rates at the low-resistance regimen (p<0.01). Unlike FEV¹, RV in asthmatics (OR=1.008); RV and I_Raw in COPD (OR=0.587 and OR=0.901, respectively), and FIF and TLC in restrictive patients (OR=1.041, and OR=0.962, respectively) proved the only sensitive predictors of the inspiratory airflow rate achievable at the different resistive regimens.</p><p><strong>Conclusions: </strong>The intrinsic resistive regimen of DPIs can play a critical role. The patients' lung function profile also affects the extent of their inhalation airflow rate. Some specific lung function parameters (such as: FIF; RV; I_Raw; TLC, but not FEV₁) may be regarded as specific predictors in real-life. In order to optimize the DPI choice, further to the device's technology, also the current patients' lung function should be properly investigated and carefully assessed.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/03/mrm-16-1-752.PMC8077610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38963988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' response to the Letter to the Editor regarding: Preventive home therapy for symptomatic patients affected by COVID-19 and followed by teleconsultations.","authors":"Gennaro D'Amato, Luca Acanfora, Lucrezia Delli Paoli, Maria D'Amato","doi":"10.4081/mrm.2021.768","DOIUrl":"10.4081/mrm.2021.768","url":null,"abstract":"","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/f2/mrm-16-1-768.PMC8056324.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38848309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Preventive home therapy for symptomatic patients affected by COVID-19 and followed by teleconsultations\" by D'Amato <i>et al.</i>","authors":"Girolamo Adiletta,&nbsp;Stefano Baglioni,&nbsp;Germano Bettoncelli,&nbsp;Pierluigi Bracciale,&nbsp;Mario Cazzola,&nbsp;Enrico M Clini,&nbsp;Renato Cutrera,&nbsp;Franco D'Adduzio,&nbsp;Francesco de Blasio,&nbsp;Fausto Ferraro,&nbsp;Roberto Fumagalli,&nbsp;Cosimo Lequaglie,&nbsp;Maria Gabriella Matera,&nbsp;Fabio Numis,&nbsp;Paolo Palange,&nbsp;Stefano Picciolo,&nbsp;Alfredo Potena,&nbsp;Francesco Romano,&nbsp;Eugenio Sabato,&nbsp;Antonio Sacchetta,&nbsp;Mario Spatafora,&nbsp;Francesco Stefanelli,&nbsp;Carlo Zottola","doi":"10.4081/mrm.2021.757","DOIUrl":"https://doi.org/10.4081/mrm.2021.757","url":null,"abstract":"Girolamo Adiletta,1 Stefano Baglioni,2 Germano Bettoncelli,3 Pierluigi Bracciale,4 Mario Cazzola,5 Enrico M. Clini,6 Renato Cutrera,7 Franco D’Adduzio,8 Francesco de Blasio,9,10 Fausto Ferraro,11 Roberto Fumagalli,12 Cosimo Lequaglie,13 Maria Gabriella Matera,14 Fabio Numis,15 Paolo Palange,16 Stefano Picciolo,17 Alfredo Potena,18 Francesco Romano,19 Eugenio Sabato,20 Antonio Sacchetta,21 Mario Spatafora,22 Francesco Stefanelli,23 Carlo Zottola24 1General Medicine, “Villa Malta” Hospital, Salerno 2Pneumology Department, Perugia Hospital 3General Practitioner, Brescia 4Pneumology Department, \"Ninetto Melli\" Hospital, San Pietro V.co (BR) 5Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome 6Respiratory Disease Unit, University Hospital of Modena and University of Modena Reggio Emilia 7Respiratory Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome 8UO Territorial Pneumology ASL BT, Barletta (BT) 9Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center, Private Hospital, Naples 10Department of Medicine and Health Sciences 'V. Tiberio', University of Molise, Campobasso 11Department of Anesthetic, Surgical and Emergency Science, Second University of Naples 12Department of Medicine and Surgery, University of Milano Bicocca, Department of Anesthesia and Intensive Care, Ospedale Niguarda, Milan 13Department of Thoracic Surgery, IRCCS-CROB Centro Riferimento Oncologico Basilicata, Rionero in Vulture (PZ) 14Unit of Pharmacology, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples 15Emergency Department, Santa Maria delle Grazie Hospital, Naples 16Department of Clinical and Molecular Medicine, Division of Respiratory Diseases, Umberto I Hospital, Sapienza University, Rome 17Unit of Respiratory Medicine, Department of Medical Sciences, University Hospital of Messina 18General Medicine, Casa di Cura S.M. Maddalena Private Hospital, Occhiobello (RO) 19Respiratory Unit, Medical Center, Cosenza 20Pulmonology Ward, \"A. Perrino\" Hospital, Brindisi 21General Medicine, San Camillo Hospital, Treviso 22Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo (retired) 23Department of Pneumology, Monaldi Hospital, Naples 24Rehabilitation and Respiratory Section, INRCA-National Institute of Health and Sciences on Ageing, Cosenza, Italy","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/f4/mrm-16-1-757.PMC8056322.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38848308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid clinical evolution for COVID-19 translates into early hospital admission and unfavourable outcome: a preliminary report.","authors":"Markus Heim, Tobias Lahmer, Sebastian Rasch, Silja Kriescher, Wiebke Berg-Johnson, Kristina Fuest, Barbara Kapfer, Gerhard Schneider, Christoph D Spinner, Fabian Geisler, Johannes R Wießner, Kathrin Rothe, Susanne Feihl, Andreas Ranft","doi":"10.4081/mrm.2021.744","DOIUrl":"10.4081/mrm.2021.744","url":null,"abstract":"<p><strong>Background: </strong>A wide range of mortality rates has been reported in COVID-19 patients on the intensive care unit. We wanted to describe the clinical course and determine the mortality rate in our institution's intensive care units.</p><p><strong>Methods: </strong>To this end, we performed a retrospective cohort study of 50 COVID-19 patients admitted to the ICU at a large German tertiary university hospital. Clinical features are reported with a focus on ICU interventions, such as mechanical ventilation, prone positioning and extracorporeal organ support. Outcome is presented using a 7-point ordinal scale on day 28 and 60 following ICU admission.</p><p><strong>Results: </strong>The median age was 64 years, 78% were male. LDH and D-Dimers were elevated, and patients were low on Vitamin D. ARDS incidence was 75%, and 43/50 patients needed invasive ventilation. 22/50 patients intermittently needed prone positioning, and 7/50 required ECMO. The interval from onset of the first symptoms to admission to the hospital and to the ICU was shorter in non-survivors than in survivors. By day 60 after ICU admission, 52% of the patients had been discharged. 60-day mortality rate was 32%; 37% for ventilated patients, and 42% for those requiring both: ventilation and renal replacement therapy.</p><p><strong>Conclusions: </strong>Early deterioration might be seen as a warning signal for unfavourable outcome. Lung-protective ventilation including prone positioning remain the mainstay of the treatment.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/6a/mrm-16-1-744.PMC8056325.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38848307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in spirometric parameters with position in asymptomatic Egyptian young males with central obesity.","authors":"Nermeen A Abd-Elaleem,&nbsp;Sherif A A Mohamed,&nbsp;Wael M Wagdy,&nbsp;Reham A Abd-Elaleem,&nbsp;Azza S Abdelhafeez,&nbsp;Hassan A Bayoumi","doi":"10.4081/mrm.2021.745","DOIUrl":"https://doi.org/10.4081/mrm.2021.745","url":null,"abstract":"<p><strong>Background: </strong>Central obesity is a chronic condition that can contribute to impairments in lung functions. Body position is an important technique that effectively restores and increases lung functions. We aimed to address the possible changes in spirometric parameters in asymptomatic overweight individuals with central obesity with a change in posture from sitting to supine in comparison to normal weight non-obese ones.</p><p><strong>Methods: </strong>Enrolled subjects were healthy Egyptian males, aged between 20-45 years old, asymptomatic and nonsmokers. They underwent spirometry. The following parameters were measured; forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), FEV₁/FVC ratio, and forced expiratory flow (FEF)25-75%. They were classified into overweight with central obesity (n=40) and healthy control (n=40) groups based on their body mass index (BMI), weight-hip ratio (WHR), and waist circumference (WC). Spirometric parameters were compared between the 2 groups and in both setting and supine positions.</p><p><strong>Results: </strong>The central obesity group showed significantly lower all spirometric parameters in comparison to the control one. All measured spirometric parameters had a significant reduction with supine position. There were negative correlations between both the WC and WHR and spirometric parameters.</p><p><strong>Conclusion: </strong>In this study of young Egyptian males, individuals with central obesity had reduced spirometric parameters in comparison to healthy ones. Change in position from sitting to supine has significant effects on spirometric parameters in both healthy middle age males with normal weight and those with overweight and central obesity. These results could have important clinical implications.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/10/mrm-16-1-745.PMC8054763.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38928435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early responders within seven days of dupilumab treatment for severe asthma evaluated by patient-reported outcome: a pilot study.","authors":"Nozomi Tani,&nbsp;Nobutaka Kataoka,&nbsp;Yusuke Kunimatsu,&nbsp;Yusuke Tachibana,&nbsp;Takumi Sugimoto,&nbsp;Izumi Sato,&nbsp;Yuri Ogura,&nbsp;Kazuki Hirose,&nbsp;Takayuki Takeda","doi":"10.4081/mrm.2021.736","DOIUrl":"https://doi.org/10.4081/mrm.2021.736","url":null,"abstract":"<p><strong>Background: </strong>The management of severe asthma-associated symptoms is essential since they are distressing to the affected patients, and also greatly impair their quality of life. Dupilumab, a monoclonal antibody, blocks interleukin (IL)-4 and IL-13 signaling, both of which are crucial in acquired and innate immunity pathways through fast signal transduction, leading to an early response to treatment. Although rapid improvement within 1-3 days after dupilumab treatment was observed in moderate-to-severe atopic dermatitis, an early response within 7 days of dupilumab treatment in severe asthma has not been reported.</p><p><strong>Methods: </strong>Twelve consecutive patients with severe asthma who were newly treated with dupilumab between July 2019 and April 2020 were retrospectively investigated. We evaluated the early response (within 7 days) of patients with severe asthma receiving dupilumab therapy. Asthma control test (ACT) and the daily ACT, which was modified from the ACT to evaluate daily symptoms associated with asthma, were adopted as patient-reported outcomes (PROs) at week 8 and within 7 days, respectively. Patients were stratified into early responders (7 days), late responders (week 8), and non-responders without significant improvement in PROs. Descriptive statistics were adopted due to the limited number of patients.</p><p><strong>Results: </strong>Four of these 12 patients were early responders, with the following baseline characteristics: body mass index, <25 kg/m²; without depression; baseline forced expiratory volume in 1 second, <1.50 L; and more than one exacerbation in 1 year. On the other hand, five were late responders, and 44.4% of the nine responders were early responders. The higher the eosinophilic count and/or FeNO did not show any relationship between the early responder and nonresponder.</p><p><strong>Conclusions: </strong>The effect of dupilumab on severe asthma in patients with atopic features could be started earlier than 2 weeks, similar to atopic dermatitis. Daily ACT may be useful in monitoring the early efficacy of dupilumab in treating severe asthma.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/fd/mrm-16-1-736.PMC7993019.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25574123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified PIRO (predisposition, insult, response, organ dysfunction) severity score as a predictor for mortality of children with pneumonia in Hasan Sadikin Hospital, Bandung, Indonesia.","authors":"Vebri Valentania,&nbsp;Dadang H Somasetia,&nbsp;Dany Hilmanto,&nbsp;Djatnika Setiabudi,&nbsp;Heda Melinda N Nataprawira","doi":"10.4081/mrm.2021.735","DOIUrl":"https://doi.org/10.4081/mrm.2021.735","url":null,"abstract":"<p><strong>Background: </strong>Clinical manifestations for pneumonia vary from mild to severe. The PIRO model (predisposition, insult, response, organ dysfunction) was used as scoring system to determine severity of sepsis and pneumonia in adult patients. The PIRO model was modified for sorting the severity of pneumonia in children and predicting its risk of mortality.</p><p><strong>Methods: </strong>An ambispective cohort study of pneumonia patients aged 1 month to ≤ 18 years admitted over the period from May to September 2020. Data were collected from history, physical examination, laboratory examination, and chest radiography. Based on bivariate analysis (p<0.05 and relative risk (RR) with 95% confidence interval), variables of each PIRO component that were significant for mortality were assigned a value of 1. The cut-off score for predictor of mortality was calculated using the receiver operating characteristics (ROC) curve and the scores were stratified into three degrees of risk based on interquartile range, score ≤Q1 was categorized as low risk; Q1-Q3 was categorized as moderate risk; and score >Q3 was categorized as high risk.</p><p><strong>Results: </strong>Out of the 80 subjects enrolled, 6 months-5 years was the largest age group (56.3%). The observed mortality was 15/80 (18.8%). The modified PIRO severity score was compiled from significant variables of predisposition (malnutrition), insult (chest radiograph), response (hypoxemia, hypotension, CRP >0.5 mg/dL, PCT >0.5 ng/dL) and organ dysfunction, with range of score 0-7. Score >3 was categorized as a cut-off point score for predictor of mortality with AUC 0.919 (95% CI 0.836-0.968), sensitivity of 80%, and specificity of 84.62%. Subjects with score >3 have RR of 10.544 compared to those with score ≤3. The stratification of score level was low (≤2), moderate (3-4), and high (5-7). The mortality levels were 0%, 46.7%, and 53.3%, respectively.</p><p><strong>Conclusions: </strong>Modified PIRO severity score can be used as a sorting tool and predictor of mortality risk in children with pneumonia. This score can also be used to select candidates for intensive care, especially in health facilities with limited intensive care capacity.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/a9/mrm-16-1-735.PMC7967494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25501094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiopulmonary exercise pattern in patients with persistent dyspnoea after recovery from COVID-19.","authors":"Arno Mohr,&nbsp;Laura Dannerbeck,&nbsp;Tobias J Lange,&nbsp;Michael Pfeifer,&nbsp;Stefan Blaas,&nbsp;Bernd Salzberger,&nbsp;Florian Hitzenbichler,&nbsp;Myriam Koch","doi":"10.4081/mrm.2021.732","DOIUrl":"https://doi.org/10.4081/mrm.2021.732","url":null,"abstract":"Cause and mechanisms of persistent dyspnoea after recovery from COVID-19 are not well described. The objective is to describe causal factors for persistent dyspnoea in patients after COVID-19. We examined patients reporting dyspnoea after recovery from COVID-19 by cardiopulmonary exercise testing. After exclusion of patients with pre-existing lung diseases, ten patients (mean age 50±13.1 years) were retrospectively analysed between May 14th and September 15th, 2020. On chest computed tomography, five patients showed residual ground glass opacities, and one patient showed streaky residua. A slight reduction of the mean diffusion capacity of the lung for carbon monoxide was noted in the cohort. Mean peak oxygen uptake was reduced with 1512±232 ml/min (72.7% predicted), while mean peak work rate was preserved with 131±29 W (92.4% predicted). Mean alveolar-arterial oxygen gradient (AaDO2) at peak exercise was 25.6±11.8 mmHg. Mean value of lactate post exercise was 5.6±1.8 mmol/l. A gap between peak work rate in (92.4% predicted) to peak oxygen uptake (72.3% pred.) was detected in our study cohort. Mean value of lactate post exercise was high in our study population and even higher (n.s.) compared to the subgroup of patients with reduced peak oxygen uptake and other obvious reason for limitation. Both observations support the hypothesis of anaerobic metabolism. The main reason for dyspnoea may therefore be muscular.","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/34/mrm-16-1-732.PMC7893311.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25398652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, utility, and safety of transbronchial cryobiopsy for interstitial lung diseases in Japan.","authors":"Takato Ikeda, Akira Nakao, Fumiyasu Igata, Yoshiaki Kinoshita, Hisako Kushima, Takemasa Matsumoto, Hiroshi Ishii, Kazuki Nabeshima, Masaki Fujita","doi":"10.4081/mrm.2021.731","DOIUrl":"10.4081/mrm.2021.731","url":null,"abstract":"<p><strong>Background: </strong>Transbronchial lung cryobiopsy (TBLC) is a new technique that enables larger tissue collection than can be obtained by conventional transbronchial lung biopsy. TBLC is becoming popular worldwide and is performed for diffuse lung disease and lung cancer. However, only a few reports of TBLC have been published in Japan. This study was performed to evaluate the efficacy and safety of TBLC at our hospital and compare these findings with past reports.</p><p><strong>Methods: </strong>From April 2018 to January 2020, 38 patients who underwent TBLC for diffuse lung disease at our hospital were evaluated with respect to age, sex, biopsy site, biopsy size, diagnostic disease, and complications.</p><p><strong>Results: </strong>The patients who underwent TBLC were 20 men and 18 women with an average age of 63.7 years. The average sample size was 5.7 mm, and the diagnostic rate was 65.7% (25/38). Grade ≥2 complications included bleeding (15.8%), pneumothorax (2.6%), and atrial fibrillation (2.6%).</p><p><strong>Conclusions: </strong>TBLC was considered to be useful for the diagnosis of diffuse lung disease and could be safely performed.</p>","PeriodicalId":49031,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/dd/mrm-16-1-731.PMC7941050.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25468588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}