Canadian respiratory journal最新文献

{"title":"Patient and Caregiver Perceptions of Airway Clearance Methods Used for Cystic Fibrosis.","authors":"Zoe E Kienenberger, Tyler O Farber, Mary E Teresi, Francesca Milavetz, Sachinkumar B Singh, Katie Larson Ode, Theodosia Thoma, Rebecca L Weiner, Kathryn R Burlage, Anthony J Fischer","doi":"10.1155/2023/1422319","DOIUrl":"10.1155/2023/1422319","url":null,"abstract":"<p><strong>Introduction: </strong>Cystic Fibrosis Foundation guidelines recommend people with CF perform daily airway clearance. This can be difficult for patients, as some find it time consuming or uncomfortable. Data comparing airway clearance methods are limited. We surveyed patients and their families to understand which methods are preferred and identify obstacles to performing airway clearance.</p><p><strong>Methods: </strong>We designed a REDCap survey and enrolled participants in 2021. Respondents reported information on airway clearance usage, time commitment, and medication use. They rated airway clearance methods for effectiveness, comfort, time commitment, importance, and compatibility with other treatments. The analysis included descriptive statistics and clustering.</p><p><strong>Results: </strong>60 respondents started and 52 completed the survey. The median patient age was 20 years. Respondents experienced a median of four airway clearance methods in their lifetime, including chest wall oscillation (vest, 92%), manual chest physical therapy (CPT, 88%), forced expiration technique (huff or cough, 77%), and exercise (75%). Past 30-day use was highest for exercise (62%) and vest (57%). The time commitment was generally less than 2 hours daily. Of those eligible for CFTR modulators, 53% reported decreased time commitment to airway clearance after starting treatment. On a scale of 0-100, respondents rated CFTR modulators as their most important treatment (median 99.5), followed by exercise (88). <i>Discussion</i>. Patients and caregivers are familiar with several methods of airway clearance for CF. They report distinct strengths and limitations of each method. Exercise and vest are the most common methods of airway clearance. The use of CFTR modulators may reduce patient-reported time commitment to airway clearance.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"1422319"},"PeriodicalIF":2.1,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9953110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"YAP1 as a Novel Negative Biomarker of Immune Checkpoint Inhibitors for EGFR-Mutant Non-Small-Cell Lung Cancer.","authors":"Ling-Chen Li, Xie-Wan Chen, Ling Fang, Chun-Li Jian, Yong-Xin Yu, Xing-Yun Liao, Jian-Guo Sun","doi":"10.1155/2023/4689004","DOIUrl":"10.1155/2023/4689004","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have become a standard care in non-small-cell lung cancer (NSCLC). However, its application to epidermal growth factor receptor (EGFR)-mutant NSCLC patients is confronted with drug resistance. This study aimed to clarify the potential role of Yes1-associated transcriptional regulator (YAP1) in ICIs treatment for EGFR-mutant NSCLC population.</p><p><strong>Methods: </strong>All the clinical data of NSCLC were downloaded from Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) for GSE11969 and GSE72094. Based on YAP1 expression, all the NSCLC patients including the EGFR-mutant and EGFR-wildtype (WT) patients were divided into two groups, YAP1_High and YAP1_Low. Using cBioPortal, genetic alterations were analyzed for identification of immunogenicity in EGFR-mutant NSCLC. MR analysis was used to analyze the hub gene of EGFR. The infiltration of immune cells and the expression of the identified tumor-associated antigens were identified with TIMER. By graph learning-based dimensionality reduction analysis, the immune landscape was visualized. Moreover, survival analysis was performed to verify the predictive value of YAP1 in ICIs treatment for EGFR-mutant NSCLC population using Ren's research data (NCT03513666).</p><p><strong>Results: </strong>YAP1 was a poor prognostic factor of EGFR-mutant NSCLC population rather than lung adenocarcinoma (LUAD) patients. MR analysis revealed that the EGFR gene regulated YAP1 expression. YAP1 was identified as a hub gene closely associated with immunosuppressive microenvironment and poor prognosis in EGFR-mutant NSCLC population in TCGA LUAD. Tumors with YAP1_High showed an immune-\"cold\" and immunosuppressive phenotype, whereas those with YAP1_Low demonstrated an immune-\"hot\" and immunoactive phenotype. More importantly, it was verified that YAP1_High subpopulation had a significantly shorter progression-free survival (PFS) and overall survival (OS) after ICIs treatment in EGFR-mutant NSCLC patients in the clinical trial.</p><p><strong>Conclusions: </strong>YAP1 mediates immunosuppressive microenvironment and poor prognosis in EGFR-mutant NSCLC population. YAP1 is a novel negative biomarker of ICIs treatment in EGFR-mutant NSCLC population. <i>Clinical Trials</i>. This trial is registered with NCT03513666.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"4689004"},"PeriodicalIF":2.2,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10307059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10115501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor Outcome and Mortality in Patients with Lower Lung-Dominant Sarcoidosis.","authors":"Kazunobu Tachibana, Masanori Akira, Toru Arai, Chikatoshi Sugimoto, Seiji Hayashi, Yoshikazu Inoue","doi":"10.1155/2023/3624344","DOIUrl":"10.1155/2023/3624344","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary sarcoidosis predominantly affects the upper lung zones but sometimes affects the lower lung zones. We hypothesised that patients with lower lung zone-dominant sarcoidosis had lower baseline forced vital capacity, progressive restrictive lung function decline, and higher long-term mortality.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical data including the pulmonary function tests of 108 consecutive patients with pulmonary sarcoidosis pathologically confirmed by lung and/or mediastinal lymph node biopsy from 2004 to 2014 from our database.</p><p><strong>Results: </strong>Eleven patients (10.2%) with lower lung zone-dominant sarcoidosis were compared with 97 patients with nonlower lung zone-dominant sarcoidosis. The median age of the patients with lower dominance was significantly older (71 vs. 56, <i>p</i> = 0.0005). The patient with lower dominance had a significantly lower baseline percent forced vital capacity (FVC) (96.0% vs. 103%, <i>p</i> = 0.022). The annual change in FVC was -112 mL in those with lower dominance vs. 0 mL in nonlower dominance (<i>p</i> = 0.0033). Fatal acute deterioration was observed in three patients (27%) in the lower dominant group. Overall survival in the lower dominant group was significantly worse.</p><p><strong>Conclusions: </strong>Patients with lower lung zone-dominant sarcoidosis had an older age and lower baseline FVC with disease progression and acute deterioration associated with higher long-term mortality.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"3624344"},"PeriodicalIF":2.2,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9772826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Flow Nasal Cannula versus Noninvasive Ventilation in AECOPD Patients with Respiratory Acidosis: A Retrospective Propensity Score-Matched Study.","authors":"Meng Wang, Feifan Zhao, Lina Sun, Ying Liang, Wei Yan, Xiaoyan Sun, Qingtao Zhou, Bei He","doi":"10.1155/2023/6377441","DOIUrl":"10.1155/2023/6377441","url":null,"abstract":"<p><strong>Background: </strong>Limited data are available about the clinical outcomes of AECOPD patients with respiratory acidosis treated with HFNC versus NIV.</p><p><strong>Methods: </strong>We conducted a retrospective study to compare the efficacy of HFNC with NIV as initial ventilation support strategy in AECOPD patients with respiratory acidosis. Propensity score matching (PSM) was implemented to increase between-group comparability. Kaplan-Meier analysis was utilized to evaluate differences between the HFNC success, HFNC failure, and NIV groups. Univariate analysis was performed to identify the features that differed significantly between the HFNC success and HFNC failure groups.</p><p><strong>Results: </strong>After screening 2219 hospitalization records, 44 patients from the HFNC group and 44 from the NIV group were successfully matched after PSM. The 30-day mortality (4.5% versus 6.8%, <i>p</i> = 0.645) and 90-day mortality (4.5% versus 11.4%, <i>p</i> = 0.237) did not differ between the HFNC and NIV groups. Length of ICU stay (median: 11 versus 18 days, <i>p</i> = 0.001), length of hospital stay (median: 14 versus 20 days, <i>p</i> = 0.001), and hospital cost (median: 4392 versus 8403 $USD, <i>p</i> = 0.001) were significantly lower in the HFNC group compared with NIV group. The treatment failure rate was much higher in the HFNC group than in the NIV group (38.6% versus 11.4%, <i>p</i> = 0.003). However, patients who experienced HFNC failure and switched to NIV showed similar clinical outcomes to those who first received NIV. Univariate analysis showed that log NT-proBNP was an important factor for HFNC failure (<i>p</i> = 0.007).</p><p><strong>Conclusions: </strong>Compared with NIV, HFNC followed by NIV as rescue therapy may be a viable initial ventilation support strategy for AECOPD patients with respiratory acidosis. NT-proBNP may be an important factor for HFNC failure in these patients. Further well-designed randomized controlled trials are needed for more accurate and reliable results.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"6377441"},"PeriodicalIF":2.2,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9409961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Validation of a Predictive Model for the Risk of Ventilator-Associated Pneumonia in Elderly ICU Patients.","authors":"Shuhua Li, Linping Shang, Lirong Yuan, Wei Li, Hongyun Kang, Wenting Zhao, Xiaojuan Han, Danxia Su","doi":"10.1155/2023/7665184","DOIUrl":"10.1155/2023/7665184","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is among the most important hospital-acquired infections in an intensive-care unit setting. However, clinical practice lacks effective theoretical tools for preventing VAP in the elderly.</p><p><strong>Aim: </strong>To describe the independent factors associated with VAP in elderly intensive-care unit (ICU) patients on mechanical ventilation (MV) and to construct a risk prediction model.</p><p><strong>Methods: </strong>A total of 1851 elderly patients with MV in ICUs from January 2015 to September 2019 were selected from 12 tertiary hospitals. Study subjects were divided into a model group (<i>n</i> = 1219) and a validation group (<i>n</i> = 632). Two groups of patients were divided into a VAP group and a non-VAP group and compared. Univariate and logistic regression analyses were used to explore influencing factors for VAP in elderly ICU patients with MV, establish a risk prediction model, and draw a nomogram. We used the area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test to evaluate the predictive effect of the model. Findings regarding the length of ICU stay, surgery, C-reactive protein (CRP), and the number of reintubations were independent risk factors for VAP in elderly ICU patients with MV. Predictive-model verification results showed that the area under the curve (AUC) of VAP risk after MV in the modeling and verification groups was 0.859 and 0.813 (<i>P</i> < 0.001), respectively, while <i>P</i> values for the Hosmer-Lemeshow test in these two groups were 0.365 and 0.485, respectively.</p><p><strong>Conclusion: </strong>The model could effectively predict the occurrence of VAP in elderly patients with MV in ICUs. This study is a retrospective study, so it has not been registered as a clinical study.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"7665184"},"PeriodicalIF":2.2,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9851783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9134261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative versus Nonoperative Treatment in Patients with Advanced Non-Small-Cell Lung Cancer: Recommended for Surgery.","authors":"Hui Wang, Di Yang, Yan Lv, Jing Lin, Haibin Wang","doi":"10.1155/2023/4119541","DOIUrl":"10.1155/2023/4119541","url":null,"abstract":"<p><strong>Background: </strong>There is currently limited evidence for a correlation between the recommended operation and overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>NSCLC patients with stages III and IV, recommended for operation, were identified in the US National Cancer Institute Surveillance, Epidemiology, and End Results database (SEER).We used propensity score matching (PSM) and multivariable Cox proportional hazards regression to ensure the robustness of our findings. The cumulative rates of death were compared between patients with and without recommended operations using the Kaplan-Meier curves.</p><p><strong>Results: </strong>Operation was recommended for 3331 patients but was not performed in 912 (27.4%) patients (then on-operative group). After PSM, 553 pairs matched. Compared to the nonoperative group, the hazard ratios (HRs) in the operative group were 0.46 (95% CI 0.23-0.95 and <i>p</i>=0.037) in stage IIIA and 0.54 (95% CI 0.42-0.68 and <i>p</i> < 0.001) in stage IVA. However, in stages IIIB, IIIC, and IVB, the recommended operative group was not associated with better OS. The OS was not different in stage IIIA-N2, stage IVA-N1, and stage IVA-N3 patients between groups (<i>p</i>=0.28, <i>p</i>=0.14, and <i>p</i>=0.79, respectively). Moreover, the recommended operative group had better OS than the nonoperative group in stage IIIA-N0 (<i>p</i>=0.00085), stage IIIA-N1 (<i>p</i>=0.009), stage IVA-N0 (<i>p</i> < 0.001), and stage IVA-N2 (<i>p</i>=0.034).</p><p><strong>Conclusion: </strong>Compared to the nonoperative group, recommended operation improved survival in NSCLC patients with stage IIIA-N0, stage IIIA-N1, stage IVA-N0, and stage IVA-N2. However, in stages IIIA-N2, IIIB, IIIC, IVA-N1, IVA-N3, and IVB, recommended operation did not lead to significantly improved survival time.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"4119541"},"PeriodicalIF":2.2,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9851779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10637720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downregulation of VRK1 Inhibits Progression of Lung Squamous Cell Carcinoma through DNA Damage.","authors":"Ning Du,&nbsp;Boxiang Zhang,&nbsp;Yunfeng Zhang","doi":"10.1155/2023/4533504","DOIUrl":"https://doi.org/10.1155/2023/4533504","url":null,"abstract":"<p><strong>Background: </strong>Lung squamous cell carcinoma (LUSC) is a common malignancy. And the antitumor effect of bovine pox virus-associated kinase 1 (VRK1) is becoming a hot research topic.</p><p><strong>Methods: </strong>VRK1 expression and prognosis in LUSC were analyzed using the GEPIA database. The expression of VRK1 mRNA was detected in 25 LUSC clinical tissue samples by RT-PCR. VRK1 shRNA was transfected into LUSC NCI-H520 and SK-MES-1 cell lines to interfere with VRK1 expression, and the efficiency of VRK1 shRNA interference was detected by the western blot. The effects of VRK1 downregulation on LUSC cell viability, migration, cell cycle, and apoptosis were analyzed by the CCK8 assay, scratch assay, transwell assay, and flow cytometry. The effect of VRK1 downregulation on DNA damage response (DDR) was examined by immunofluorescence staining and western blot assays and further validated by in vivo experiments.</p><p><strong>Results: </strong>VRK1 was highly expressed in both LUSC tissues and cells. Survival analysis showed that the overall survival of LUSC patients with high VRK1 expression was significantly lower than that of LUSC patients with low VRK1 expression (<i>P</i>=0.0026). The expression level of the VRK1 gene was significantly higher in cancer tissues of LUSC patients than in paracancerous tissues. After transfection of VRK1 shRNA in both LUSC cells, cell activity decreased (<i>P</i> < 0.001), migration ability started to be inhibited (<i>P</i> < 0.001), the ratio of G0/G1 phase cells increased (<i>P</i> < 0.001), and apoptosis rate increased (<i>P</i> < 0.001). Immunofluorescence and western blot results showed that shVRK1 increased the level of <i>γ</i>-H2A.X (<i>P</i> < 0.001) and promoted apoptosis of tumor cells (<i>P</i> < 0.001). In addition, the results of animal experiments showed that shVRK1 had antitumor effects (<i>P</i> < 0.001) and a combined effect with DOX (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The downregulation of VRK1 significantly affected the proliferation, apoptosis, migration, and cell cycle progression of LUSC cells via DDR, suggesting that VRK1 is a suitable target for potential LUSC therapy.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"4533504"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10316269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Ectopic Lymphoid Aggregates in Sheep and Murine Models of Bleomycin-Induced Pulmonary Fibrosis.","authors":"Udari Eshani Perera,&nbsp;Louise Organ,&nbsp;Simon G Royce,&nbsp;Chrishan S Samuel,&nbsp;Habtamu B Derseh,&nbsp;Sasika N V Dewage,&nbsp;Emmanuel Koumoundouros,&nbsp;Andrew Stent,&nbsp;Kenneth J Snibson","doi":"10.1155/2023/1522593","DOIUrl":"https://doi.org/10.1155/2023/1522593","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a chronic disease characterized by excessive deposition of extracellular matrix in the interstitial lung parenchyma, often manifested by dyspnea and progressive loss of lung function. The role of inflammation in the pathogenesis of IPF is not well understood. This study evaluated the histopathological and inflammatory components of bleomycin-induced pulmonary fibrosis in mouse and sheep models, in terms of their ability to translate to the human IPF. Merino sheep (<i>n</i> = 8) were bronchoscopically administered with two bleomycin infusions, two weeks apart, into a caudal lung segment, with a saline (control) administered into a caudal segment in the opposite lung. Balb/c mice were twice intranasally instilled, one week apart, with either bleomycin (<i>n</i> = 7); or saline (control, <i>n</i> = 7). Lung samples were taken for the histopathological assessment 28 days in sheep and 21 days in mice after the first bleomycin administration. We observed tertiary lymphoid aggregates, in the fibrotic lung parenchyma of sheep, but not in mouse lung tissues exposed to bleomycin. B-cell and T-cell infiltration significantly increased in sheep lung tissues compared to mouse lung tissues due to bleomycin injury. Statistical analysis showed that the fibrotic score, fibrotic fraction, and tissue fraction significantly increased in sheep lung tissues compared to murine lung tissues. The presence of tertiary lymphoid aggregates in the lung parenchyma and increased infiltration of T-cells and B-cells, in the sheep model, may be useful for the future study of the underlying inflammatory disease mechanisms in the lung parenchyma of IPF patients.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"1522593"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10643034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Sequential ROX-Index Score Beyond 12 Hours in Predicting Treatment Failure and Mortality in COVID-19 Patients Receiving Oxygen via High-Flow Nasal Cannula.","authors":"Dimitris Basoulis,&nbsp;Pantelis Avramopoulos,&nbsp;Maria Aggelara,&nbsp;Georgios Karamanakos,&nbsp;Pantazis-Michail Voutsinas,&nbsp;Amalia Karapanou,&nbsp;Mina Psichogiou,&nbsp;Michalis Samarkos,&nbsp;Foteini Ntziora,&nbsp;Nikolaos V Sipsas","doi":"10.1155/2023/7474564","DOIUrl":"https://doi.org/10.1155/2023/7474564","url":null,"abstract":"<p><strong>Background: </strong>High-flow nasal cannula (HFNC) is an oxygen delivery method shown to reduce the risk of intubation and mortality in patients with type 1 respiratory failure. The ROX-index score can predict HFNC failure. This study aims to evaluate sequential ROX-index assessments as predictors of HFNC failure and mortality.</p><p><strong>Methods: </strong>Prospective observational single-center study including all adult patients with positive SARS-CoV-2 PCR placed under HFNC from 1st November 2020 to 31st May 2021, and patients with hemodynamic instability or unable to tolerate HFNC were excluded. The primary endpoint was successful HFNC de-escalation.</p><p><strong>Results: </strong>In univariate analysis, HFNC de-escalation was associated with younger age (59.2 ± 14 vs. 67.7 ± 10.5 and <i>p</i> < 0.001), lower levels of serum lactate (1.1 vs. 1.5 and <i>p</i>=0.013), and higher ROX-index at 12 hrs (5.09 vs. 4.13 and <i>p</i> < 0.001). ROC curve analysis of ROX-index at 12 hrs yielded a c-statistic of 71.2% (95% CI 61.6-80.9 and <i>p</i> < 0.001). ROX-index at 12 hrs and age retained significance in multivariate analysis. Using an optimal cutoff point of 4.43, we calculated a sensitivity of 64.5% and specificity of 69.6%. In univariate survival analysis, older age (68.8 ± 9.7 vs. 58.9 ± 13.9 and <i>p</i> < 0.001), greater creatinine values (0.96 vs. 0.84 and <i>p</i>=0.022), greater SOFA score (<i>p</i>=0.039), and a lower 12 hrs ROX-index (4.22 vs. 4.95 and <i>p</i>=0.02) were associated with hospital mortality. The SOFA score and age retained significance in multivariate survival analysis.</p><p><strong>Conclusion: </strong>ROX-index is proven to be a valuable and easy-to-use tool for clinicians in the assessment of COVID-19 patients under HFNC.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"7474564"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10828164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Nebulized Inhaled Triptolide on Airway Inflammation in a Mouse Model of Asthma.","authors":"Yafang Miao,&nbsp;Li Wei,&nbsp;Hao Chen,&nbsp;Zeming Zhang,&nbsp;Li Han","doi":"10.1155/2023/2983092","DOIUrl":"https://doi.org/10.1155/2023/2983092","url":null,"abstract":"<p><p>Inhalation of nebulized TP has received little attention in the past. Here, we intend to investigate the effect of nebulized inhaled TP on airway inflammation in a mouse model of asthma. 29 SPF BALB/c mice were divided into four groups: blank control (Blk, <i>n</i> = 5), normal saline (NS, <i>n</i> = 8), dexamethasone (Dex, <i>n</i> = 8), and TP (<i>n</i> = 8). During the process of sensitization, mice in the three intervention groups were treated with nebulized NS, an injection of Dex, and nebulized triptolide, respectively. Then bronchoalveolar lavage fluid (BALF), peripheral blood, and lung tissue were collected. Relevant cytokines, transcriptional factors, and CD4+Th17+ T cell proportions were assessed and compared. IL-6, IL-17, IL-23, and TGF-<i>β</i>1 demonstrated a significant difference between groups in the following order: Dex < TP < NS (<i>P</i> ≤ 0.001), while IL-10 changed in the opposite direction (<i>P</i> < 0.001). At the transcriptional level in lung tissue, the Ct value of IL-17 in the Dex group was significantly higher than in the NS and TP groups (<i>P</i> < 0.001). Meanwhile, it was higher in the TP group than in the NS group (<i>P</i> < 0.001). The Ct value of ROR<i>γ</i>t demonstrated a significant difference among three groups in the following order: Dex > TP > NS (<i>P</i> < 0.001). An opposite trend of FoxP3 Ct value was revealed in the order: NS > TP > Dex. The proportion of CD4+Th17+ cells was 9.53 ± 2.74% in the NS group, 4.23 ± 2.26% in the Dex group, and 6.76 ± 2.99% in the TP group, which shows significant differences between the NS and Dex (<i>P</i> < 0.001) or NS and TP groups (<i>P</i> < 0.05). Inhalation of nebulized triptolide can play a role in suppressing airway inflammation with inflammatory cytokines and transcriptional factors reduced and CD4+Th17+ T cells dampened, also in a manner less than injected dexamethasone.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"2983092"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10475397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}