Multidisciplinary Respiratory Medicine最新文献

{"title":"Nebivolol: an effective option against long-lasting dyspnoea following COVID-19 pneumonia - a pivotal double-blind, cross-over controlled study.","authors":"Roberto W Dal Negro, Paola Turco, Massimiliano Povero","doi":"10.4081/mrm.2022.886","DOIUrl":"https://doi.org/10.4081/mrm.2022.886","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary microvascular occlusions can aggravate SARS-CoV-2 pneumonia and result in a variable decrease in capillary blood volume (Vc). Dyspnoea may persist for several weeks after hospital discharge in many patients who have \"radiologically recovered\" from COVID-19 pneumonia. Dyspnoea is frequently \"unexplained\" in these cases because abnormalities in lung vasculature are understudied. Furthermore, even when they are identified, therapeutic options are still lacking in clinical practice, with nitric oxide (NO) supplementation being used only for severe respiratory failure in the hospital setting. Nebivolol is the only selective β<sup>1</sup> adrenoceptor antagonist capable of inducing nitric oxide-mediated vasodilation by stimulating endothelial NO synthase <i>via</i> β<sub>3</sub> agonism. The purpose of this study was to compare the effect of nebivolol <i>versus</i> placebo in patients who had low Vc and complained of dyspnoea for several weeks after COVID-19 pneumonia.</p><p><strong>Methods: </strong>Patients of both genders, aged ≥18 years, non-smokers, who had a CT scan that revealed no COVID-related parenchymal lesions but still complaining of dyspnoea 12-16 weeks after hospital discharge, were recruited. Spirometrical volumes, blood haemoglobin, SpO<sub>2</sub>, simultaneous diffusing capacity for carbon monoxide (CO) and NO (DL<sub>CO</sub> and DL<sub>NO</sub>, respectively), DL<sub>NO</sub>/DL<sub>CO</sub> ratio, Vc and exhaled NO (eNO) were measured together with their dyspnoea score (DS), heart frequency (HF), and blood arterial pressure (BAP). Data were collected before and one week after both placebo (P) and nebivolol (N) (2.5 mg od) double-blind cross-over administered at a two-week interval. Data were statistically compared, and p<0.05 assumed as statistically significant.</p><p><strong>Results: </strong>Eight patients (3 males) were investigated. In baseline, their mean DS was 2.5±0.6 SD, despite the normality of lung volumes. DL<sub>CO</sub> and DL<sub>NO</sub> mean values were lower than predicted, while mean DL<sub>NO</sub>/DL<sub>CO</sub> ratio was higher. Mean Vc proved substantially reduced. Placebo did not modify any variable (all p=ns) while N improved DLco and Vc significantly (+8.5%, p<0.04 and +17.7%, p<0.003, respectively). eNO also was significantly increased (+17.6%, p<0.002). Only N lowered the dyspnoea score (-76%, p<0.001). Systolic and diastolic BAP were slightly lowered (-7.5%, p<0.02 and -5.1%, p<0.04, respectively), together with HF (-16.8%, p<0.03).</p><p><strong>Conclusions: </strong>The simultaneous assessment of DL<sub>NO</sub>, DL<sub>CO</sub>, DL<sub>NO</sub>/DL<sub>CO</sub> ratio, and Vc confirmed that long-lasting dyspnoea is related to hidden abnormalities in the lung capillary vasculature. These abnormalities can persist even after the complete resolution of parenchymal lesions regardless of the normality of lung volumes. Nebivolol, but not placebo, improves DS and Vc","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"17 ","pages":"886"},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/e8/mrm-17-1-886.PMC9830396.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10528022","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":"Saudi Arabian real-life experience with biologic therapy in severe asthma.","authors":"Safwat Eldaboussi, Ahmed Qabil, Ahmed Lotfi, Amgad Awad, Eman Abdel Salam, Abdullah Alkhamis, Usama E Abuelhassan","doi":"10.4081/mrm.2021.807","DOIUrl":"10.4081/mrm.2021.807","url":null,"abstract":"<p><strong>Background: </strong>Severe asthma (SA) is a common health problem associated with increased morbidity and mortality and high medical costs. Biological therapies have emerged in recent decades as promising treatment options for patients with high type 2 (T2) SA. This retrospective observational study from Saudi Arabia aimed to investigate the effects of additional biologics therapy on reducing oral corticosteroid (OCS) consumption, frequency of asthma exacerbations, improvement in lung function, and asthma control.</p><p><strong>Methods: </strong>This multicenter observational study enrolled a cohort of 97 patients from March 2019 to February 2021. Outcomes of anti-IgE, anti-IL5/IL5R, and anti-IL4R therapies in severe type 2 asthma were recorded and analyzed in terms of number of exacerbations (emergency visits or hospitalizations required), asthma symptoms, and use of oral corticosteroids, blood eosinophil count, asthma control according to GINA classification, and FEV₁ before and during biologic therapy.</p><p><strong>Results: </strong>Ninety-seven patients were included in the analysis The mean age was 46.7±14.1 years, and 69.1% of them were female. The average duration of biological treatment was 16.4±6.8 months. At the time of data collection, the four biologic therapies reduced the exacerbation rate per year from 82/97 (84.5%) to 14/97 (14.4%) with a percent improvement of 83% from 2.9 per year in the year before biologic treatment to 1.6 per year (p<0.001). OCS was reduced from 75/97 (77.3%) to 10/97 (10.3%) for a percent improvement of 86.7%, and the average OCS dose decreased from 7.12 mg to 6.8 mg. Mean blood eosinophil count also decreased after biologic therapy from 750.5±498.5 to 188.0±122.4 cells/μl, most significant result achieved with benralizumab, and mean FEV₁ improved from 59.0±12.9% to 76.0±10.2%, most significant result achieved with omalizumab. ll patients had uncontrolled asthma before biologics therapy, but asthma control improved by 91.8% after treatment.</p><p><strong>Conclusions: </strong>Biologic as add-on therapy for high T2 SA was found to reduce asthma exacerbations, systemic glucocorticoid doses, and SA symptoms.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"807"},"PeriodicalIF":2.3,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/f3/mrm-16-1-807.PMC8743612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39962756","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":"Microbiological profiles of tracheostomy patients: a single-center experience.","authors":"Abdulaziz Alrabiah,&nbsp;Khaled Alhussinan,&nbsp;Mohammed Alyousef,&nbsp;Ahmed Alsayed,&nbsp;Abdullah Aljasser,&nbsp;Shatha Alduraywish,&nbsp;Ahmed Alammar","doi":"10.4081/mrm.2021.811","DOIUrl":"https://doi.org/10.4081/mrm.2021.811","url":null,"abstract":"<p><strong>Background: </strong>This study compared the prevalence of common microorganisms in obstructed and non-obstructed cases across the four quarters on the first post-tracheostomy year.</p><p><strong>Methods: </strong>A retrospective chart review of the microbiological profiles of all adult patients who underwent a tracheostomy was conducted between June 2015 and September 2019 at our hospital. Based on the tracheostomy indications, patients were allocated to obstructed or non-obstructed group. Any patient with at least one positive sample was followed up quarterly for a year. The first culture result obtained was recorded at least one month following the last antibiotic dose in each quarter.</p><p><strong>Results: </strong>Out of the 65 tracheal aspirate results obtained from 58 patients (mean age, 57.5±16.48 years), the most common procedure and indications were surgical tracheostomy (72.4%) and non-obstructed causes (74.1%), respectively. Moreover, 47.7% of the culture results indicated <i>Pseudomonas aeruginosa</i>, which showed significantly different proportions across the quarters (p=0.006). Among obstructed patients, <i>P. aeruginosa</i> was the most common (35%), followed by methicillin-resistant <i>Staphylococcus aureus</i> (MRSA; 23.5%).</p><p><strong>Conclusions: </strong>The most common post-tracheostomy microorganism was <i>P. aeruginosa</i>. MRSA showed a strong association with tracheostomy for obstructive indications.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"811"},"PeriodicalIF":2.3,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/18/mrm-16-1-811.PMC8743611.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39962757","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":"Standard spirometry to assess emphysema in patients with chronic obstructive pulmonary disease: the Emphysema Severity Index (ESI).","authors":"Roberto W Dal Negro, Matteo Paoletti, Massimo Pistolesi","doi":"10.4081/mrm.2021.805","DOIUrl":"10.4081/mrm.2021.805","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a generic term identifying a condition characterized by variable changes in peripheral airways and lung parenchyma. Standard spirometry cannot discriminate the relative role of conductive airways inflammatory changes from destructive parenchymal emphysema changes. The aim of this study was to quantify the emphysema component in COPD by a simple parameter (the Emphysema Severity Index - ESI), previously proved to reflect CT-assessed emphysema.</p><p><strong>Methods: </strong>ESI was obtained by fitting the descending limb of MEFV curves by a fully automated procedure providing a 0 to 10 score of emphysema severity. ESI was computed in COPD patients enrolled in the CLIMA Study.</p><p><strong>Results: </strong>The vast majority of ESI values ranged from 0 to 4, compatible with no-to-mild/moderate emphysema component. A limited proportion of patients showed ESI values >4, compatible with severe-to-very severe emphysema. ESI values were greatly dispersed within each GOLD class indicating that GOLD classification cannot discriminate emphysema and conductive airways changes in patients with similar airflow limitation. ESI and diffusing capacity (DL_CO) were significantly correlated (p<0.001). However, the great dispersion in their correlation suggests that ESI and DL_CO reflect partially different anatomo-functional determinants in COPD.</p><p><strong>Conclusions: </strong>Airflow limitation has heterogenous determinants in COPD. Inflammatory and destructive changes may combine in CT densitometric alterations that cannot be detected by standard spirometry. ESI computation from spirometric data helps to define the prevailing pathogenetic mechanism underlying the measured airflow limitation. ESI could be a reliable advancement to select large samples of patients in clinical or epidemiological trials, and to compare different pharmacological treatments.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"805"},"PeriodicalIF":2.3,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/a6/mrm-16-1-805.PMC8672489.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39889969","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":"Correlation between clinical-functional parameters and number of lobes involved in non-cystic fibrosis bronchiectasis.","authors":"Valeria Giacon, Stefano Sanduzzi Zamparelli, Alessandro Sanduzzi Zamparelli, Dario Bruzzese, Marialuisa Bocchino","doi":"10.4081/mrm.2021.791","DOIUrl":"10.4081/mrm.2021.791","url":null,"abstract":"<p><strong>Background: </strong>Currently, the prognosis of bronchiectasis is based on different prognostic indicators, like BSI and FACED score, founded on clinical-demographic, functional and radiological criteria. Both scoring systems include the number of lobes involved in bronchiectasis, which represents an adverse prognostic index. Our study aimed to investigate the prognostic role of the clinical-functional parameters and the number of involved lobes ratio in adult bronchiectasis.</p><p><strong>Methods: </strong>The study was conducted on 52 patients diagnosed with non-cystic fibrosis bronchiectasis (NCFB) between 2015 and 2017 who attended the Pneumology Unit of Monaldi Hospital in Naples, Italy. Correlations between clinical- functional parameters (BMI, smoking history, number of exacerbations in the previous year, spirometry, DL_CO, ABG test, and 6MWT) and number of involved lobes were investigated.</p><p><strong>Results: </strong>At baseline, the number of exacerbations in the previous year had a statistically significant association with the number of involved lobes. Furthermore, at baseline, the radiological criterion was also negatively associated with some functional parameters (FEV₁/FVC ratio e FEF_25-75%). Statistical significance was lost during the follow up, demonstrating the effectiveness of the therapy.</p><p><strong>Conclusions: </strong>Imaging extension represents a promising biomarker of disease severity as well as a helpful follow up tool for non-Cystic Fibrosis bronchiectasis (NCFB).</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"791"},"PeriodicalIF":2.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/37/mrm-16-1-791.PMC8672485.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39889968","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":"Thunderstorm allergy and asthma: state of the art.","authors":"Gennaro D'Amato,&nbsp;Isabella Annesi-Maesano,&nbsp;Marilyn Urrutia-Pereira,&nbsp;Stefano Del Giacco,&nbsp;Nelson A Rosario Filho,&nbsp;Herberto J Chong-Neto,&nbsp;Dirceu Solé,&nbsp;Ignacio Ansotegui,&nbsp;Lorenzo Cecchi,&nbsp;Alessandro Sanduzzi Zamparelli,&nbsp;Emma Tedeschini,&nbsp;Benedetta Biagioni,&nbsp;Margarita Murrieta-Aguttes,&nbsp;Maria D'Amato","doi":"10.4081/mrm.2021.806","DOIUrl":"https://doi.org/10.4081/mrm.2021.806","url":null,"abstract":"<p><p>Thunderstorm-triggered asthma (TA) can be defined as the occurrence of acute asthma attacks immediately following a thunderstorm during pollen seasons. Outbreaks have occurred across the world during pollen season with the capacity to rapidly inundate a health care service, resulting in potentially catastrophic outcomes for allergic patients. TA occurs when specific meteorological and aerobiological factors combine to affect predisposed atopic patients with IgE-mediated sentitization to pollen allergens. Thunderstorm outflows can concentrate aeroallergens, most commonly grass pollen but also other pollens such as <i>Parietaria</i> and moulds in TA, at ground level to release respirable allergenic particles after rupture by osmotic shock related to humidity and rainfall. Inhalation of high concentrations of these aeroallergens by sensitized individuals can induce early asthmatic responses which can be followed by a late inflammatory phase. There is evidence that, during pollen season, thunderstorms can induce allergic asthma outbreaks, sometimes also severe asthma crisis and sometimes deaths in patients suffering from pollen allergy. It has been observed that changes in the weather such as rain or humidity may induce hydratation of pollen grains during pollen seasons and sometimes also their fragmentation which generates atmospheric biological aerosols carrying allergens. Asthma attacks are induced for the high concentration at ground level of pollen grains which may release allergenic particles of respirable size after rupture by osmotic shock. In other words, it is a global health problem observed in several cities and areas of the world that can strike without sufficient warning, inducing sometimes severe clinical consequences also with deaths of asthma patients. Due to constant climate change, future TA events are likely to become more common, more disastrous and more unpredictable, as a consequence it is important to have deep knowledge on this topic to prevent asthma attacks. Other environmental factors, such as rapid changes in temperature and agricultural practices, also contribute to causing TA.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"806"},"PeriodicalIF":2.3,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/e8/mrm-16-1-806.PMC8672486.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39889970","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":"Predictors of hypoxemia after general anesthesia in the early postoperative period in a hospital in Ethiopia: an observational study.","authors":"Moges Gelaw Taye, Amelework Molla, Diriba Teshome, Metages Hunie, Simegnew Kibret, Yewlsew Fentie, Netsanet Temesgen, Melaku Tadege Engidaw, Efrem Fenta","doi":"10.4081/mrm.2021.782","DOIUrl":"10.4081/mrm.2021.782","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative hypoxemia is a common problem after general anesthesia. The identification of factors associated with an increased occurrence of it might help healthcare professionals to hypoxemia risk patients, therefore this study aims to assess the incidence and factors associated with early postoperative hypoxemia among surgical procedures.</p><p><strong>Methods: </strong>A prospective cohort study design was conducted from February 1, 2020 to June 30, 2020, on a total of 424 patients who underwent surgery under general anesthesia in Debre Tabor Comprehensive Specialized Hospital. The data was collected using a structured checklist. Bivariable and multivariable logistic regressions were used to check the association.</p><p><strong>Results: </strong>The incidence of early postoperative hypoxemia was 45.8%. Patients having a BMI of 25-29.9 kg/m² and BMI of 30-39.9 kg/m², patients having a chronic disease, current smokers, SPO₂ reading before induction of less than 95%, emergency surgery, and the absence of oxygen therapy during the period of transfer and/or in the post anesthesia care unit were significantly associated with an increased risk of hypoxemia in the early postoperative period.</p><p><strong>Conclusions: </strong>The incidence of early postoperative hypoxemia was high in Debre Tabor Comprehensive Specialized Hospital. Obese patients, patients having a chronic disease, current smokers, and lower oxygen saturations before induction, emergency surgery, and the absence of oxygen therapy were the main predictors of an increased occurrence of early postoperative hypoxemia.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"782"},"PeriodicalIF":2.3,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/3c/mrm-16-1-782.PMC8672487.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39889967","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 burden of influenza and other respiratory viruses in hospitalized infants and children in a university hospital, Jordan.","authors":"Enas Al-Zayadneh,&nbsp;Dina Mohammad Abu Assab,&nbsp;Esraa Adeeb Arabiat,&nbsp;Montaha Al-Iede,&nbsp;Hanin Ahmad Kayed,&nbsp;Amirah Daher","doi":"10.4081/mrm.2021.763","DOIUrl":"https://doi.org/10.4081/mrm.2021.763","url":null,"abstract":"<p><strong>Background: </strong>Acute lower respiratory infection (ALRI) is a major cause of morbidity and mortality worldwide in young children and is predominately caused by viral respiratory pathogens. This study aims to identify the viral etiologies of ALRI in hospitalized children in Jordan University Hospital and compare the clinical characteristics of influenza virus infection with other respiratory viruses.</p><p><strong>Methods: </strong>A retrospective viral surveillance study that included 152 children below 15 years of age admitted with ALRI from December 2018 through April 2019 was conducted. We recorded results of real-time reverse transcriptasepolymerase chain reaction (RT-PCR) for common respiratory viruses. Clinical and demographic information of the study population was collected from patients' electronic medical records.</p><p><strong>Results: </strong>152 patients were identified with a median age of 1 year (mean was 2.1 years). Ninety-five patients (62.5%) were males. One or more viral respiratory pathogens were detected in 145 (95.3%) children. Respiratory syncytial virus was the most detected virus in 68 patients (44.8%). Influenza virus was detected in 25 patients (16.4%). Children with influenza infection had more fever and lower leukocyte count compared to children infected with other viruses. The severity of the ALRI correlated significantly with several factors, including age less than six months and the presence of neuromuscular disease (p<0.05).</p><p><strong>Conclusion: </strong>Viral detection was common among children admitted with ALRI. Viruses, including influenza, are recognized as significant contributors to the morbidity associated with ALRI. More attention is needed on strategies for the prevention and detection of viral ALRI in developing countries.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"763"},"PeriodicalIF":2.3,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/72/mrm-16-1-763.PMC8607186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39720654","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 role of peripheral eosinophilia in diagnosing lung disorders: experience from a single pneumonological center.","authors":"Justyna Fijolek,&nbsp;Elzbieta Wiatr,&nbsp;Dorota Piotrowska-Kownacka,&nbsp;Kazimierz Roszkowski-Sliz","doi":"10.4081/mrm.2021.770","DOIUrl":"https://doi.org/10.4081/mrm.2021.770","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilia is rare but one of the important reasons to refer patients to pneumonological centers. Determining etiology of eosinophilia has practical implications for therapeutic intervention and disease prognosis. The study aimed to determine the role of peripheral eosinophilia in the diagnosis of lung disorders.</p><p><strong>Methods: </strong>In this retrospective study were included 46 patients diagnosed with peripheral eosinophilia with coexisting respiratory symptoms and/or radiologically detected lung lesions. All patients underwent standard diagnostic procedures, including a detailed clinical history review, physical examination, routine laboratory tests with basal cardiological examinations, and serological tests to detect parasites and allergies. Other procedures carried out depended on the symptoms of each patient. The relation between eosinophil counts in the blood and patients' clinical manifestation was investigated to identify the degree of eosinophilia requiring immediate diagnostic procedures and treatment. Statistical analyses were performed using scientific computation libraries in the Python programming language, SciPy, v. 1.3.1. Briefly, the following tests were used: parametric Kruskal-Wallis H test, an independent t-test, ANOVA, the Shapiro- Wilk test, Fisher's and Chi-squared tests, and the Holm-Bonferroni method.</p><p><strong>Results: </strong>Severe eosinophilia (≥5,000 cells/μl) was associated with extrapulmonary involvement and constitutional symptoms. Skin, heart, and pleural diseases were more frequent in these patients than in patients with mild or moderate eosinophilia (p=0.010, p=0.040, and p=0.007, respectively), and only these patients showed signs of kidney disease (p=0.006). Vasculitis was significantly more frequent in the severe eosinophilia group (p=0.048) than in the other two groups. In patients with moderate eosinophilia (1,500-5,000 cells/μl), extrapulmonary symptoms were less common, although signs of cardiac involvement were confirmed in 44% of subjects. In this group, vasculitis was the most commonly observed disease (42% of cases). Mild eosinophilia (<1,500 cells/μl) was mainly associated with airway disease. In this group, vasculitis and interstitial lung diseases were identified, but most were not typically connected with eosinophilia.</p><p><strong>Conclusions: </strong>Identification of peripheral eosinophilia may essentially determine diagnostic procedures in patients with lung disorders and may be a useful indicator of disease etiology.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"770"},"PeriodicalIF":2.3,"publicationDate":"2021-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/b5/mrm-16-1-770.PMC8581820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39940194","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":"Retinal vascular impairment in patients newly diagnosed with obstructive sleep apnea syndrome.","authors":"Tomás Loureiro,&nbsp;Sandra Rodrigues-Barros,&nbsp;Diogo Lopes,&nbsp;Ana Rita Carreira,&nbsp;Ricardo Gomes,&nbsp;Nadine Marques,&nbsp;Paula Telles,&nbsp;Ana Vide Escada,&nbsp;Nuno Campos","doi":"10.4081/mrm.2021.773","DOIUrl":"https://doi.org/10.4081/mrm.2021.773","url":null,"abstract":"<p><strong>Background: </strong>To evaluate retinal morphological and vascular parameters in patients recently diagnosed with obstructive sleep apnea syndrome (OSAS) and determine the correlation between retinal vascular density and the severity of OSAS.</p><p><strong>Methods: </strong>We performed a retrospective study on the retinal vasculature of patients with OSAS and age-match healthy controls. OSAS was confirmed by full-night cardiorespiratory polygraphy. Patients were divided into three groups according to disease severity given by apnea-hypopnea index (AHI) i.e., mild, moderate or severe. Retinal thicknesses and vascular density were compared among groups, for both the macula and optic disc. Correlation between vascular density and clinical features were also assessed.</p><p><strong>Results: </strong>The study included 30 eyes of patients with OSAS and 12 controls. No differences were found regarding retinal thickness in both the macula and the optic disc between OSAS patients and controls. In contrast, significant differences were found in the peripapillary vessel density between groups <i>versus</i> control patients. The greatest difference being between severe OSAS and controls (49.4% ± 2.1 <i>versus</i> 40.4% ± 4.2 respectively, p=0.01). Peripapillary vessel density was found to significantly and negatively correlate with AHI (p=0.02; r= -0.74) and directly correlate with the lowest percutaneous oxygen saturation (p=0.02; r= 0.58).</p><p><strong>Conclusions: </strong>This study indicates that OSAS is associated with retinal microvasculature impairment, that seems to mainly affect the optic disc. This suggests that microvascular damage increases with the increasing severity of OSAS. As such, prospective trials are needed to clarify if this vascular peripapillary damage precedes glaucomatous optic neuropathy in OSAS patients.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"16 1","pages":"773"},"PeriodicalIF":2.3,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/18/mrm-16-1-773.PMC8581819.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39940195","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}