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Speranskaya, A. A., O. P. Baranova, M. A. Vasilyeva, and I. V. Amosov. "RADIATION DIAGNOSIS OF RARE FORMS OF RESPIRATORY ORGAN SARCOIDOSIS." Journal of radiology and nuclear medicine 99, no. 4 (August 31, 2018): 175–83. http://dx.doi.org/10.20862/0042-4676-2018-99-4-175-183.
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Objective: to evaluate the clinical and radiological features of rare forms of sarcoidosis of the respiratory organs (SRO).Material and methods. In 2006 to 2016, the Research Institute of Interstitial and Orphan Lung Diseases followed up 599 patients with sarcoidosis. 36 patients (6.0%) of them had atypical clinical and radiation manifestations that did not correspond to the traditional radiation pattern and the existing X-ray classification of SRO. Stages 2, 3, and 4 pulmonary sarcoidosis was diagnosed in 26, 7, and 3 patients, respectively. The patients’ mean age was 38.2±7.4 years (the female/male ratio was 26:10). All the patients underwent traditional X-ray studies (radiography in two projections), high-resolution computed tomography (CT), complex external respiratory function examination, and echocardiography.Results. Analysis of the results of radiation examinations revealed the following rare forms of SRO: interstitial edematous, fibrous, and cavitary ones that had recognizable CT patterns. Each of these forms had clinical and functional features. In single cases, the CT pattern combined the features incompatible with the generally accepted classification (Stages 1 and 4 SRO); this was an offstage form. The features of the radiation pattern and clinical course required the differential diagnosis of these patients with more severe diseases (idiopathic pulmonary fibrosis, lymphogenic carcinomatosis, pulmonary edema, diffuse connective tissue diseases, pneumoconiosis, mycobacteriosis, and exogenous allergic alveolitis) and morphological verification.Conclusion. The accumulation of experience with clinical and radiological examination of patients with SRO revealed its rare forms that are difficult to diagnose and necessitate the development of new approaches to therapy policy.
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Dokur, Zümray. "Respiratory sound classification by using an incremental supervised neural network." Pattern Analysis and Applications 12, no. 4 (June 10, 2008): 309–19. http://dx.doi.org/10.1007/s10044-008-0125-y.
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Bahoura, Mohammed. "Pattern recognition methods applied to respiratory sounds classification into normal and wheeze classes." Computers in Biology and Medicine 39, no. 9 (September 2009): 824–43. http://dx.doi.org/10.1016/j.compbiomed.2009.06.011.
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Boulding, Richard, Rebecca Stacey, Rob Niven, and Stephen J. Fowler. "Dysfunctional breathing: a review of the literature and proposal for classification." European Respiratory Review 25, no. 141 (August 31, 2016): 287–94. http://dx.doi.org/10.1183/16000617.0088-2015.
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Dysfunctional breathing is a term describing breathing disorders where chronic changes in breathing pattern result in dyspnoea and other symptoms in the absence or in excess of the magnitude of physiological respiratory or cardiac disease. We reviewed the literature and propose a classification system for the common dysfunctional breathing patterns described. The literature was searched using the terms: dysfunctional breathing, hyperventilation, Nijmegen questionnaire and thoraco-abdominal asynchrony. We have summarised the presentation, assessment and treatment of dysfunctional breathing, and propose that the following system be used for classification. 1) Hyperventilation syndrome: associated with symptoms both related to respiratory alkalosis and independent of hypocapnia. 2) Periodic deep sighing: frequent sighing with an irregular breathing pattern. 3) Thoracic dominant breathing: can often manifest in somatic disease, if occurring without disease it may be considered dysfunctional and results in dyspnoea. 4) Forced abdominal expiration: these patients utilise inappropriate and excessive abdominal muscle contraction to aid expiration. 5) Thoraco-abdominal asynchrony: where there is delay between rib cage and abdominal contraction resulting in ineffective breathing mechanics.This review highlights the common abnormalities, current diagnostic methods and therapeutic implications in dysfunctional breathing. Future work should aim to further investigate the prevalence, clinical associations and treatment of these presentations.
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DOKUR, ZÜMRAY, and TAMER ÖLMEZ. "CLASSIFICATION OF RESPIRATORY SOUNDS BY USING AN ARTIFICIAL NEURAL NETWORK." International Journal of Pattern Recognition and Artificial Intelligence 17, no. 04 (June 2003): 567–80. http://dx.doi.org/10.1142/s0218001403002526.
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In this paper, a classification method for respiratory sounds (RSs) in patients with asthma and in healthy subjects is presented. Wavelet transform is applied to a window containing 256 samples. Elements of the feature vectors are obtained from the wavelet coefficients. The best feature elements are selected by using dynamic programming. Grow and Learn (GAL) neural network, Kohonen network and multi-layer perceptron (MLP) are used for the classification. It is observed that RSs of patients (with asthma) and healthy subjects are successfully classified by the GAL network.
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Wang, Qisong, Zhening Dong, Dan Liu, Tianao Cao, Meiyan Zhang, Runqiao Liu, Xiaocong Zhong, and Jinwei Sun. "Frequency-Modulated Continuous Wave Radar Respiratory Pattern Detection Technology Based on Multifeature." Journal of Healthcare Engineering 2021 (August 9, 2021): 1–18. http://dx.doi.org/10.1155/2021/9376662.
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Respiratory diseases including apnea are often accompanied by abnormal respiratory depth, frequency, and rhythm. If different abnormal respiratory patterns can be detected and recorded, with their depth, frequency, and rhythm analyzed, the detection and diagnosis of respiratory diseases can be achieved. High-frequency millimeter-wave radar (76–81 GHz) has low environmental impact, high accuracy, and small volume, which is more suitable for respiratory signal detection and recognition compared with other contact equipment. In this paper, the experimental platform of frequency-modulated continuous wave (FMCW) radar was built at first, realizing the noncontact measurement of vital signs. Secondly, the energy intensity and threshold of respiration signal during each period were calculated by using the rectangular window, and the accurate judgment of apnea was realized via numerical comparison. Thirdly, the features of respiratory and heart rate signals, the number of peaks and valleys, the difference between peaks and valleys, the average and the standard deviation of normalized short-term energy, and the average and the standard deviation and the minimum of instantaneous frequency, were extracted and analyzed. Finally, support vector machine (SVM) and K-nearest neighbor (KNN) were used to classify the extracted features, and the accuracy was 98.25% and 88.75%, respectively. The classification and recognition of respiratory patterns have been successfully realized.
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Stacey, RM, A. Vyas, and SJ Fowler. "P231 Breathing pattern disorders in a complex breathlessness service; classification and clinical characteristics." Thorax 71, Suppl 3 (November 15, 2016): A212.1—A212. http://dx.doi.org/10.1136/thoraxjnl-2016-209333.374.
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Hung, Jung-Jyh, Yi-Chen Yeh, Wen-Juei Jeng, Kou-Juey Wu, Biing-Shiun Huang, Yu-Chung Wu, Teh-Ying Chou, and Wen-Hu Hsu. "Predictive Value of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification of Lung Adenocarcinoma in Tumor Recurrence and Patient Survival." Journal of Clinical Oncology 32, no. 22 (August 1, 2014): 2357–64. http://dx.doi.org/10.1200/jco.2013.50.1049.
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Purpose This study investigated the pattern of recurrence of lung adenocarcinoma and the predictive value of histologic classification in resected lung adenocarcinoma using the new International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification system. Patients and Methods Histologic classification of 573 patients undergoing resection for lung adenocarcinoma was determined according to the IASLC/ATS/ERS classification system, and the percentage of each histologic component (lepidic, acinar, papillary, micropapillary, and solid) was recorded. The pattern of recurrence of those components and their predictive value were investigated. Results The predominant histologic pattern was significantly associated with sex (P < .01), invasive tumor size (P < .01), T status (P < .01), N status (P < .01), TNM stage (P < .01), and visceral pleural invasion (P < .01). The percentage of recurrence was significantly higher in micropapillary- and solid-predominant adenocarcinomas (P < .01). Micropapillary- and solid-predominant adenocarcinomas had a significantly higher possibility of developing initial extrathoracic-only recurrence than other types (P < .01). The predominant pattern group (micropapillary or solid v lepidic, acinar, or papillary) was a significant prognostic factor in overall survival (OS; P < .01), probability of freedom from recurrence (P < .01), and disease-specific survival (P < .01) in multivariable analysis. For patients receiving adjuvant chemotherapy, solid-predominant adenocarcinoma was a significant predictor for poor OS (P = .04). Conclusion In lung adenocarcinoma, the IASLC/ATS/ERS classification system has significant prognostic and predictive value regarding death and recurrence. Solid-predominant adenocarcinoma was also a significant predictor in patients undergoing adjuvant chemotherapy. Prognostic and predictive information is important for stratifying patients for aggressive adjuvant chemoradiotherapy.
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Warth, Arne, Thomas Muley, Michael Meister, Albrecht Stenzinger, Michael Thomas, Peter Schirmacher, Philipp A. Schnabel, Jan Budczies, Hans Hoffmann, and Wilko Weichert. "The Novel Histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification System of Lung Adenocarcinoma Is a Stage-Independent Predictor of Survival." Journal of Clinical Oncology 30, no. 13 (May 1, 2012): 1438–46. http://dx.doi.org/10.1200/jco.2011.37.2185.
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Purpose Our aim was to analyze and validate the prognostic impact of the novel International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) proposal for an architectural classification of invasive pulmonary adenocarcinomas (ADCs) across all tumor stages. Patients and Methods The architectural pattern of a large cohort of 500 patients with resected ADCs (stages I to IV) was retrospectively analyzed in 5% increments and classified according to their predominant architecture (lepidic, acinar, solid, papillary, or micropapillary), as proposed by the IASLC/ATS/ERS. Subsequently, histomorphologic data were correlated with clinical data, adjuvant therapy, and patient outcome. Results Overall survival differed significantly between lepidic (78.5 months), acinar (67.3 months), solid (58.1 months), papillary (48.9 months), and micropapillary (44.9 months) predominant ADCs (P = .007). When patterns were lumped into groups, this resulted in even more pronounced differences in survival (pattern group 1, 78.5 months; group 2, 67.3 months; group 3, 57.2 months; P = .001). Comparable differences were observed for overall, disease-specific, and disease-free survival. Pattern and pattern groups were stage- and therapy-independent prognosticators for all three survival parameters. Survival differences according to patterns were influenced by adjuvant chemoradiotherapy; in particular, solid-predominant tumors had an improved prognosis with adjuvant radiotherapy. The predominant pattern was tightly linked to the risk of developing nodal metastases (P < .001). Conclusion Besides all recent molecular progress, architectural grading of pulmonary ADCs according to the novel IASLC/ATS/ERS scheme is a rapid, straightforward, and efficient discriminator for patient prognosis and may support patient stratification for adjuvant chemoradiotherapy. It should be part of an integrated clinical, morphologic, and molecular subtyping to further improve ADC treatment.
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Purnomo, Ariana Tulus, Ding-Bing Lin, Tjahjo Adiprabowo, and Willy Fitra Hendria. "Non-Contact Monitoring and Classification of Breathing Pattern for the Supervision of People Infected by COVID-19." Sensors 21, no. 9 (May 3, 2021): 3172. http://dx.doi.org/10.3390/s21093172.
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During the pandemic of coronavirus disease-2019 (COVID-19), medical practitioners need non-contact devices to reduce the risk of spreading the virus. People with COVID-19 usually experience fever and have difficulty breathing. Unsupervised care to patients with respiratory problems will be the main reason for the rising death rate. Periodic linearly increasing frequency chirp, known as frequency-modulated continuous wave (FMCW), is one of the radar technologies with a low-power operation and high-resolution detection which can detect any tiny movement. In this study, we use FMCW to develop a non-contact medical device that monitors and classifies the breathing pattern in real time. Patients with a breathing disorder have an unusual breathing characteristic that cannot be represented using the breathing rate. Thus, we created an Xtreme Gradient Boosting (XGBoost) classification model and adopted Mel-frequency cepstral coefficient (MFCC) feature extraction to classify the breathing pattern behavior. XGBoost is an ensemble machine-learning technique with a fast execution time and good scalability for predictions. In this study, MFCC feature extraction assists machine learning in extracting the features of the breathing signal. Based on the results, the system obtained an acceptable accuracy. Thus, our proposed system could potentially be used to detect and monitor the presence of respiratory problems in patients with COVID-19, asthma, etc.
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Raji, Rafiu King, Michael Adjeisah, Xuhong Miao, and Ailan Wan. "A novel respiration pattern biometric prediction system based on artificial neural network." Sensor Review 40, no. 1 (February 26, 2020): 8–16. http://dx.doi.org/10.1108/sr-10-2019-0235.
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Purpose The purpose of this paper is to introduce a novel respiration pattern-based biometric prediction system (BPS) by using artificial neural network (ANN). Design/methodology/approach Respiration patterns were obtained using a knitted piezoresistive smart chest band. The ANN model was implemented by using four hidden layers to help achieve the best complexity to produce an adequate fit for the data. Not only did this study give a detailed distribution of an ANN model construction including the scheme of parameters and network layers, ablation of the architecture and the derivation of back-propagation during the iterations but also engaged a step-based decay to systematically drop the learning rate after specific epochs during training to minimize the loss and increase the model’s accuracy as well as to limit the risk of overfitting. Findings Findings establish the feasibility of using respiratory patterns for biometric identification. Experimental results show that, with a learning rate drop factor = 0.5, the network is able to continue to learn past epoch 40 until stagnation occurs which yielded a classification accuracy of 98 per cent. Out of 51,338 test set, the model achieved 51,557 correctly classified instances and 169 misclassified instances. Practical implications The findings provide an impetus for possible studies into the application of chest breathing sensors for human machine interfaces in the area of entertainment. Originality/value This is the first time respiratory patterns have been applied in biometric prediction system design.
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Perez, I., C. Vadillo, M. A. Nieto, D. Freites, Z. Rosales, A. Mucientes, L. León, J. Font, J. A. Jover, and L. Abasolo. "SAT0535 CLINICAL COURSE IN PATIENTS WITH INTERSTITIAL PNEUMONIA WITH AUTOIMMUNE FEATURES (IPAF) IN A MULTIDISCIPLINARY CONSULTATION." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1225.1–1225. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4607.
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Background:A proportion of patients with Interstitial Lung Disease (ILD) show autoimmune characteristics but do not completely meet the classification criteria for a definitive connective tissue disease. In order to unify the nomenclature and criteria to define this condition, the classification of patients with Interstitial Pneumonia with Autoimmune Features (IPAF) has recently been adopted (Fisher, et al).Objectives:To describe the sociodemographic, clinical, functional characteristics and therapeutic management of IPAF patients in clinical practice and to evaluate the incidence rate of functional respiratory impairment over time.Methods:A longitudinal observational study was performed. Patients with IPAF classification criteria (Fischer et al) were included from the time of ILD diagnosis (Feb 2017 to Sept 2018) and followed until loss of follow-up or end of the study (Oct 2019), in a multidisciplinary team, carried by a pneumologist and a rheumatologist in a Tertiary Hospital in Madrid. Main outcome: relative functional respiratory impairment: defined as decline in percent predicted forced vital capacity (FVC%) of ≥ 5% compared to the previous visit. Respiratory function was measured at baseline and every 6 months. Covariates: a) sociodemographic, b) clinical, c) radiological pattern (non-specific interstitial pneumonia [NSIP]; usual interstitial pneumonia [UIP], others); d) FVC%, DLCO%; e) laboratory tests; f) therapy used (glucorticosteroids, disease modifying antirheumatic drugs (DMARDs) and Biologic Agents). Statistical analysis: description of the sociodemographic, clinical, radiological, functional and treatment characteristics of the patients. Survival techniques were used to estimate the incidence rate (IR) of relative functional respiratory impairment, expressed per 100 patient-semester with their respective confidence interval [95 % CI].Results:17 patients were included with a mean follow-up of 3 ± 1.5 years, 70.6% were women with a mean age of 65±10 years. The most frequent IPAF classification criteria were: a) clinical: arthritis (50%), Raynaud`s phenomenon (33%) and mechanical hands (17%); b) serological: 65% had ANA ≥1/360; 31% FR> 40; 30% Anti-Ro positive; c) morphologic: 59% presented NSIP pattern and 29.4% was UIP. The baseline median FVC% and DLCO% were 89 [83-107.7] and 63 [50-79.8] respectively. During the study period, 94% received treatment: 87.5% glucorticosteroids, 68.5% mycophenolate, 56% azathioprine, 18.7% cyclophosphamide iv and 33% antifibrotics. During the follow-up (104.6 patient - semester), 15 patients presented relative functional respiratory impairment, with an IR of 23.8 [16.1-35.3]. After 14 months from IPAF diagnosis 50% of the patients had relative functional respiratory impairment. At the end of the follow-up, 50% showed a worsening of the DLCO%.Conclusion:IPAF patients are mostly women in their sixties. The most frequent clinical criteria are arthritis and Raynaud`s phenomenon and the serological were FR and ANAs. The most frequent radiological pattern was NSIP. The therapeutic management is mainly with glucorticosteroids, mycophenolate and azathioprine. At the beginning, patients have a slightly diminished lung function. These patients have significant functional impairment over time that will impact in their prognosis. Longitudinal and multicenter studies are necessary to advance in the knowledge and management of these patients.References:[1]Fischer A, Antoniou KM, Brown KK, Cadranel J, Corte TJ, du Bois RM, et al. An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features. Eur Respir J [Internet]. 2015 Oct;46(4):976–87. Available from:http://www.ncbi.nlm.nih.gov/pubmed/26160873Disclosure of Interests:None declared
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Lenshin, A. V., E. A. Ignat’eva, A. V. Il’in, and J. M. Perelman. "To the question of reforming the classification of thoracic sarcoidosis." Bulletin Physiology and Pathology of Respiration, no. 79 (April 2, 2021): 8–20. http://dx.doi.org/10.36604/1998-5029-2021-79-8-20.
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Since the beginning of the 50s of the last century, numerous classifications of sarcoidosis have been proposed, which to one degree or another satisfied specialists at certain stages of the development of medical technologies. Currently, sarcoidosis of the respiratory system is divided into five stages (from 0 to IV) based on the results of chest Xray examination. Active introduction into clinical practice of computed tomography and its more advanced version – lowdose multislice computed tomography (MSCT) – allows to carry out an effective diagnosis of sarcoidosis, including in outpatient practice, as well as when performing active screening and dynamic monitoring of the course of the disease. On the basis of the studies which were carried out, the dissonance between the progress in technology (from X-ray pattern to MSCT) and the stagnation of the conceptual issues of the classification of sarcoidosis is discussed, which urgently requires its reforming. Firstly, the category of patients with concomitant lesions of the intrathoracic lymph nodes (ITLN) and parenchyma (stage II) has sharply increased, which reflects the increased technological level of radiological diagnostics. As a result, the percentage of stages with isolated lymph node involvement (stage I) and isolated dissemination of the parenchyma (stage III) decreased. The classification based on MSCT data allows to more accurately determine the severity of the disease. This is of therapeutic and prognostic importance, since most patients of stage I generally do not need treatment, while symptomatic stage II requires hormone therapy. One should also take into account the possibility of spontaneous remission, which is observed more often in stage I. The main conclusion is that at present day the principle of staging in the classification of sarcoidosis can no longer satisfy the realities of modern clinics. It is more correct to single out the clinical and radiological forms of sarcoidosis: sarcoidosis of the ITLN, sarcoidosis of the ITLN and lungs, sarcoidosis of the lungs, as well as sarcoidosis of the respiratory system, combined with a single lesion of other organs.
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Bettermann, H., D. Amponsah, D. Cysarz, and P. van Leeuwen. "Musical rhythms in heart period dynamics: a cross-cultural and interdisciplinary approach to cardiac rhythms." American Journal of Physiology-Heart and Circulatory Physiology 277, no. 5 (November 1, 1999): H1762—H1770. http://dx.doi.org/10.1152/ajpheart.1999.277.5.h1762.
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The purpose of this study was to expand classic heart period analysis methods by techniques from ethnomusicology that explicitly take complex musical rhythm principles into consideration. The methods used are based on the theory of African music, the theory of symbolic dynamics, and combinatorial theory. Heart period tachograms from 192 24-h electrocardiograms of 96 healthy subjects were transformed into binary symbol sequences that were interpretable as elementary rhythmic (percussive) patterns, the time lines in African music. Using a hierarchical rhythm pattern scheme closely related to the Derler Rhythm Classification (from jazz theory), we calculated the predominance and stability of pattern classes. The results show that during sleep certain classes, specific to individuals, occurred in a cyclically recurrent manner and many times more often than expected. Simultaneously, other classes disappeared more or less completely. Moreover, the most frequent classes obviously originate from phase-locking processes in autonomic regulation (e.g., between respiratory and cardiac cycles). In conclusion, the new interdisciplinary method presented here demonstrates that heart period patterns, in particular those occurring during night sleep, can be interpreted as musical rhythms. This method may be of great potential use in music therapy research.
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Wang, Liang, Xing Wang, Miao Huang, Shi Yan, Shaolei Li, Chao Lv, Nan Wu, and Yue Yang. "High-risk-pattern lung adenocarcinoma with epidermal growth factor receptor mutation is associated with distant metastasis risk and may benefit from adjuvant targeted therapy." Interactive CardioVascular and Thoracic Surgery 33, no. 3 (April 21, 2021): 395–401. http://dx.doi.org/10.1093/icvts/ivab099.
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Abstract OBJECTIVES This study aimed to evaluate the value of the high-risk-pattern histology (micropapillary and solid components) for predicting distant metastasis in lung adenocarcinoma and to determine the survival benefit with adjuvant targeted therapy for resected non-small cell lung cancer with high-risk-pattern histology. METHODS Patients receiving surgery for non-small cell lung cancer were included in this retrospective study. Histological classification was performed according to 2015 World Health Organization classification. Tumours with micropapillary and solid components were defined as high-risk-pattern tumours. Univariable and multivariable Cox regression analyses were used for survival analysis. Adjuvant targeted therapy was alternative for patients with epidermal growth factor receptor (EGFR)-mutation and refusing adjuvant chemotherapy, and outcome was evaluated between 2 groups. RESULTS The 514 patients (78 in high-risk group and 436 in low-risk group) were followed up for a median of 64 months. High-risk-pattern adenocarcinoma was significantly more common in male patients (P < 0.001) and in smokers (P < 0.001). Among patients with EGFR mutation (n = 164), the high-risk pattern was significantly associated with distant metastasis (P = 0.028) including brain metastasis (P = 0.022). In the 42 patients with high-risk pattern plus EGFR mutation, survival was significantly better after treatment with adjuvant targeted therapy than with chemotherapy (5-year overall survival: 56.4 ± 2.6 vs 44.7 ± 3.7 months, P = 0.011; 5-year disease-free survival: 54.0 ± 3.3 vs 41.9 ± 4.5 months, P = 0.006). CONCLUSIONS High-risk pattern is associated with distant metastasis in non-small cell lung cancer after surgery. Adjuvant targeted therapy may be superior to chemotherapy for treatment of patients with high-risk pattern and EGFR mutation.
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Gonem, Sherif, Wim Janssens, Nilakash Das, and Marko Topalovic. "Applications of artificial intelligence and machine learning in respiratory medicine." Thorax 75, no. 8 (May 14, 2020): 695–701. http://dx.doi.org/10.1136/thoraxjnl-2020-214556.
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The past 5 years have seen an explosion of interest in the use of artificial intelligence (AI) and machine learning techniques in medicine. This has been driven by the development of deep neural networks (DNNs)—complex networks residing in silico but loosely modelled on the human brain—that can process complex input data such as a chest radiograph image and output a classification such as ‘normal’ or ‘abnormal’. DNNs are ‘trained’ using large banks of images or other input data that have been assigned the correct labels. DNNs have shown the potential to equal or even surpass the accuracy of human experts in pattern recognition tasks such as interpreting medical images or biosignals. Within respiratory medicine, the main applications of AI and machine learning thus far have been the interpretation of thoracic imaging, lung pathology slides and physiological data such as pulmonary function tests. This article surveys progress in this area over the past 5 years, as well as highlighting the current limitations of AI and machine learning and the potential for future developments.
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Ibrahim, Riyadh M. "Morbidity and Mortality Pattern of Neonates Admitted to Neonatal Care Unit.Central Teaching Pediatric Hospital Baghdad." AL-Kindy College Medical Journal 16, no. 1 (September 5, 2020): 38–48. http://dx.doi.org/10.47723/kcmj.v16i1.188.
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Background; Neonatal period is a very vulnerable period of life due to many problems, In spite of advances in perinatal and neonatal care still, the mortality rate of neonate high especially in developing country The World Health Organization estimates that globally four million neonatal deaths per year, Developing countries account for around 99% of the neonatal mortality in the world, In Iraq. Neonatal mortality rate about 19 per 1000 live births which represent 56% of child death below 5 years age in 2012. .Objectives The aims of the study were to determine the institutional new-born case fatality rate and the cause of admission and death in the neonatal care unit.Method; Across-section study was carried out of the Neonatal Care Unit of Central Teaching Hospital of Pediatric in Baghdad Al-krakh Health DirectorateResult; During 2015, 1977 neonates were admitted, Mortality rate was 9%, Four main causes of death were identified; Respiratory related condition, Bacterial sepsis, premature neonate (Disorder related to short gestational and low birth weight not relayed to elsewhere classification) and congenital malformation 37.5%, 33.3%, 7.1% and 7.1% respectively , The main causes of morbidity were Neonatal jaundice, Respiratory related condition, Bacterial sepsis 37.5%, 35.2%. 14.1% respectively Conclusions: The majority of neonatal morbidity and mortality can be prevented by appropriate interventions
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Williams, E., Ricardo Colasanti, Kasope Wolffs, Paul Thomas, and Ben Hope-Gill. "Classification of Tidal Breathing Airflow Profiles Using Statistical Hierarchal Cluster Analysis in Idiopathic Pulmonary Fibrosis." Medical Sciences 6, no. 3 (September 12, 2018): 75. http://dx.doi.org/10.3390/medsci6030075.
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In idiopathic pulmonary fibrosis (IPF) breathing pattern changes with disease progress. This study aims to determine if unsupervised hierarchal cluster analysis (HCA) can be used to define airflow profile differences in people with and without IPF. This was tested using 31 patients with IPF and 17 matched healthy controls, all of whom had their lung function assessed using spirometry and carbon monoxide CO transfer. A resting tidal breathing (RTB) trace of two minutes duration was collected at the same time. A Euclidian distance technique was used to perform HCA on the airflow data. Four distinct clusters were found, with the majority (18 of 21, 86%) of the severest IPF participants (Stage 2 and 3) being in two clusters. The participants in these clusters exhibited a distinct minute ventilation (p < 0.05), compared to the other two clusters. The respiratory drive was greatest in Cluster 1, which contained many of the IPF participants. Unstructured HCA was successful in recognising different airflow profiles, clustering according to differences in flow rather than time. HCA showed that there is an overlap in tidal airflow profiles between healthy RTB and those with IPF. The further application of HCA in recognising other respiratory disease is discussed.
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Andaç Baltacıoğlu, Nurten. "Latent class analysis for exploring distribution patterns of primary superficial venous insufficiency." Turkish Journal of Thoracic and Cardiovascular Surgery 28, no. 3 (August 28, 2020): 474–79. http://dx.doi.org/10.5606/tgkdc.dergisi.2020.19144.
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Background: This study aims to identify specific segmental distribution patterns of lower extremity chronic venous disease based on latent class analysis of Doppler mapping results. Methods: A total of 1,871 lower extremities of 1,218 treatment-naïve patients (536 males, 682 females; mean age 45.4 years; range, 21 to 87 years) with chronic venous disease referred for Doppler examination between September 2009 and August 2018 were included. Refluxing superficial venous segments of the lower extremities were mapped and recorded in database in 10 distinct anatomic locations as follows: saphenofemoral junction and proximal greater saphenous vein, mid and distal thigh greater saphenous vein, anterior and posterior accessory saphenous veins, proximal and distal calf greater saphenous vein, saphenopopliteal junction and proximal lesser saphenous vein, distal lesser saphenous vein, and intersaphenous veins including Giacomini’s vein. Repeated examinations were excluded. The latent class analysis was applied to identify any possible anatomic distribution patterns of chronic venous disease. Results: Bayesian information criteria revealed three latent class models fit for refluxing segment distribution as follows: 58.2% (n=1,089) were above-the-knee greater saphenous vein segments including saphenofemoral junction (pattern 1); 29.3% (n=548) were below-the-knee greater saphenous vein segments (pattern 2); and 12.5% (n=234) were lesser saphenous vein segments and intersaphenous veins including Giacomini’s vein (pattern 3). There was no age- or sex-specific differences in the chronic venous disease distribution patterns. Conclusion: The latent class analysis, by identifying previously unseen subgroups within the sampled population, provides a new approach to classification of reflux patterns in chronic venous disease. Identification of latent classes may provide understanding of different pathophysiological bases of venous reflux and more optimal planning for interventions.
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Sambataro, Gianluca, Domenico Sambataro, Sebastiano Emanuele Torrisi, Ada Vancheri, Mauro Pavone, Roberta Rosso, Matteo Schisano, et al. "State of the art in interstitial pneumonia with autoimmune features: a systematic review on retrospective studies and suggestions for further advances." European Respiratory Review 27, no. 148 (May 2, 2018): 170139. http://dx.doi.org/10.1183/16000617.0139-2017.
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The term interstitial pneumonia with autoimmune features (IPAF) has been proposed to define patients with interstitial lung disease (ILD) associated with autoimmune signs not classifiable for connective tissue diseases (CTDs). This new definition overcomes previous nomenclatures and provides a uniform structure for prospective studies through specific classification criteria.This work evaluates the characteristics of IPAF patients reported in the literature, to highlight potential limits through a comparative analysis and to suggest better performing classification criteria.Four retrospective studies on the IPAF population have been considered. The study subjects differed in age, sex, smoking habit, ILD pattern and outcomes. Another important difference lies in the diverse items considered in the classification criteria. The retrospective design of the studies and the absence from some of them of a rheumatologist clearly involved in the diagnosis may have influenced the data, but current IPAF criteria seem to include a rather heterogeneous population. To overcome these discrepancies, this review suggests a limitation in the use of single items and the exclusion of extremely specific CTD criteria. This should avoid the definition of IPAF for those diseases at different stages or at early onset. The investigation of a functional or morphological cut-off of pulmonary involvement would be useful.
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Travis, William D., Elisabeth Brambilla, and Gregory J. Riely. "New Pathologic Classification of Lung Cancer: Relevance for Clinical Practice and Clinical Trials." Journal of Clinical Oncology 31, no. 8 (March 10, 2013): 992–1001. http://dx.doi.org/10.1200/jco.2012.46.9270.
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We summarize significant changes in pathologic classification of lung cancer resulting from the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) lung adenocarcinoma classification. The classification was developed by an international core panel of experts representing IASLC, ATS, and ERS with oncologists/pulmonologists, pathologists, radiologists, molecular biologists, and thoracic surgeons. Because 70% of patients with lung cancer present with advanced stages, a new approach to small biopsies and cytology with specific terminology and criteria focused on the need for distinguishing squamous cell carcinoma from adenocarcinoma and on molecular testing for EGFR mutations and ALK rearrangement. Tumors previously classified as non–small-cell carcinoma, not otherwise specified, because of the lack of clear squamous or adenocarcinoma morphology should be classified further by using a limited immunohistochemical workup to preserve tissue for molecular testing. The terms “bronchioloalveolar carcinoma” and “mixed subtype adenocarcinoma” have been discontinued. For resected adenocarcinomas, new concepts of adenocarcinoma in situ and minimally invasive adenocarcinoma define patients who, if they undergo complete resection, will have 100% disease-free survival. Invasive adenocarcinomas are now classified by predominant pattern after using comprehensive histologic subtyping with lepidic, acinar, papillary, and solid patterns; micropapillary is added as a new histologic subtype with poor prognosis. Former mucinous bronchioloalveolar carcinomas are now called “invasive mucinous adenocarcinoma.” Because the lung cancer field is now rapidly evolving with new advances occurring on a frequent basis, particularly in the molecular arena, this classification provides a much needed standard for pathologic diagnosis not only for patient care but also for clinical trials and TNM classification.
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Anetai, Yusuke, Iori Sumida, Yutaka Takahashi, Masashi Yagi, Hirokazu Mizuno, Seiichi Ota, Osamu Suzuki, Keisuke Tamari, Yuji Seo, and Kazuhiko Ogawa. "A concept for classification of optimal breathing pattern for use in radiotherapy tracking, based on respiratory tumor kinematics and minimum jerk analysis." Medical Physics 43, no. 6Part1 (June 1, 2016): 3168–77. http://dx.doi.org/10.1118/1.4951731.
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Novak, Peter. "Cerebral Blood Flow, Heart Rate, and Blood Pressure Patterns during the Tilt Test in Common Orthostatic Syndromes." Neuroscience Journal 2016 (July 12, 2016): 1–20. http://dx.doi.org/10.1155/2016/6127340.
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Objective. The head-up tilt test is widely used for evaluation of orthostatic intolerance. Although orthostatic symptoms usually reflect cerebral hypoperfusion, the cerebral blood flow velocity (CBFv) profile in orthostatic syndromes is not well described. This study evaluated CBFv and cardiovascular patterns associated with the tilt test in common orthostatic syndromes. Methods. This retrospective study analyzed the tilt test of patients with history of orthostatic intolerance. The following signals were recorded: ECG, blood pressure, CBFv using transcranial Doppler, respiratory signals, and end tidal CO2. Results. Data from 744 patients were analyzed. Characteristic pattern associated with a particular orthostatic syndrome can be grouped into abnormalities predominantly affecting blood pressure (orthostatic hypotension, orthostatic hypertension syndrome, vasomotor oscillations, and neurally mediated syncope—cardioinhibitory, vasodepressor, and mixed), cerebral blood flow (orthostatic hypoperfusion syndrome, primary cerebral autoregulatory failure), and heart rate (tachycardia syndromes: postural tachycardia syndrome, paroxysmal sinus tachycardia, and inappropriate sinus tachycardia). Psychogenic pseudosyncope is associated with stable CBFv. Conclusions. The tilt test is useful add-on in diagnosis of several orthostatic syndromes. However diagnostic criteria for several syndromes had to be modified to allow unambiguous pattern classification. CBFv monitoring in addition to blood pressure and heart rate may increase diagnostic yield of the tilt test.
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Schulz, Steffen, Jens Haueisen, Karl-Jürgen Bär, and Voss Andreas. "High-resolution joint symbolic analysis to enhance classification of the cardiorespiratory system in patients with schizophrenia and their relatives." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 373, no. 2034 (February 13, 2015): 20140098. http://dx.doi.org/10.1098/rsta.2014.0098.
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Schizophrenia as a mental illness is one of the most serious in the world. Patients with schizophrenia have an increased cardiac mortality rate, but the reasons for this remain unclear. In addition to other factors, the role of impaired autonomic regulation during acute psychosis has become more evident in different studies applying heart rate (HR) variability analyses. But, until now, respiration and cardiorespiratory regulation, which are important for homeostatic control, have not been considered. In this study, short-term cardiorespiratory couplings (CRCs) of 23 unmedicated patients with paranoid schizophrenia (SZO), 20 of their healthy first-degree relatives (REL) and 20 healthy subjects (CON) matched according to age and sex of SZO and REL were investigated by applying high-resolution joint symbolic dynamics (HRJSD) analysis. We found a significantly ( p <0.0061) altered HR pattern, respiratory pattern and CRCs in SZO and only marginal alterations for the REL group in comparison with the CON group when we applied HRJSD. These results might be an indication of decreased vagal activity within the brainstem, an altered or suppressed interaction of the brainstem and higher regulatory centres, or panic- and anxiety-related changes in the brainstem associated with the acute psychosis of these patients.
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Raidt, Johanna, Julia Wallmeier, Rim Hjeij, Jörg Große Onnebrink, Petra Pennekamp, Niki T. Loges, Heike Olbrich, et al. "Ciliary beat pattern and frequency in genetic variants of primary ciliary dyskinesia." European Respiratory Journal 44, no. 6 (September 3, 2014): 1579–88. http://dx.doi.org/10.1183/09031936.00052014.
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Primary ciliary dyskinesia (PCD) is a rare genetic disorder leading to recurrent respiratory tract infections. High-speed video-microscopy analysis (HVMA) of ciliary beating, currently the first-line diagnostic tool for PCD in most centres, is challenging because recent studies have expanded the spectrum of HVMA findings in PCD from grossly abnormal to very subtle. The objective of this study was to describe the diversity of HVMA findings in genetically confirmed PCD individuals.HVMA was performed as part of the routine work-up of individuals with suspected PCD. Subsequent molecular analysis identified biallelic mutations in the PCD-related genes of 66 individuals. 1072 videos of these subjects were assessed for correlation with the genotype.Biallelic mutations (19 novel) were found in 17 genes: DNAI1, DNAI2, DNAH5, DNAH11, CCDC103, ARMC4, KTU/DNAAF2, LRRC50/DNAAF1, LRRC6, DYX1C1, ZMYND10, CCDC39, CCDC40, CCDC164, HYDIN, RSPH4A and RSPH1. Ciliary beat pattern variations correlated well with the genetic findings, allowing the classification of typical HVMA findings for different genetic groups. In contrast, analysis of ciliary beat frequency did not result in additional diagnostic impact.In conclusion, this study provides detailed knowledge about the diversity of HVMA findings in PCD and may therefore be seen as a guide to the improvement of PCD diagnostics.
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Sebastiani, Marco, Paola Faverio, Andreina Manfredi, Giulia Cassone, Caterina Vacchi, Anna Stainer, Maria Rosa Pozzi, Carlo Salvarani, Alberto Pesci, and Fabrizio Luppi. "Interstitial Pneumonia with Autoimmune Features: Why Rheumatologist-Pulmonologist Collaboration Is Essential." Biomedicines 9, no. 1 (December 26, 2020): 17. http://dx.doi.org/10.3390/biomedicines9010017.
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In 2015 the European Respiratory Society (ERS) and the American Thoracic Society (ATS) “Task Force on Undifferentiated Forms of Connective Tissue Disease-associated Interstitial Lung Disease” proposed classification criteria for a new research category defined as “Interstitial Pneumonia with Autoimmune Features” (IPAF), to uniformly define patients with interstitial lung disease (ILD) and features of autoimmunity, without a definite connective tissue disease. These classification criteria were based on a variable combination of features obtained from three domains: a clinical domain consisting of extra-thoracic features, a serologic domain with specific autoantibodies, and a morphologic domain with imaging patterns, histopathological findings, or multicompartment involvement. Features suggesting a systemic vasculitis were excluded. Since publication of ERS/ATS IPAF research criteria, various retrospective studies have been published focusing on prevalence; clinical, morphological, and serological features; and prognosis of these patients showing a broad heterogeneity in the results. Recently, two prospective, cohort studies were performed, confirming the existence of some peculiarities for this clinical entity and the possible progression of IPAF to a defined connective tissue disease (CTD) in about 15% of cases. Moreover, a non-specific interstitial pneumonia pattern, an anti-nuclear antibody positivity, and a Raynaud phenomenon were the most common findings. In comparison with idiopathic pulmonary fibrosis (IPF), IPAF patients showed a better performance in pulmonary function tests and less necessity of oxygen delivery. However, at this stage of our knowledge, we believe that further prospective studies, possibly derived from multicenter cohorts and through randomized control trials, to further validate the proposed classification criteria are needed.
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Tsao, Ming-Sound, Sophie Marguet, Gwénaël Le Teuff, Sylvie Lantuejoul, Frances A. Shepherd, Lesley Seymour, Robert Kratzke, et al. "Subtype Classification of Lung Adenocarcinoma Predicts Benefit From Adjuvant Chemotherapy in Patients Undergoing Complete Resection." Journal of Clinical Oncology 33, no. 30 (October 20, 2015): 3439–46. http://dx.doi.org/10.1200/jco.2014.58.8335.
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Purpose The classification for invasive lung adenocarcinoma by the International Association for the Study of Lung Cancer, American Thoracic Society, European Respiratory Society, and WHO is based on the predominant histologic pattern—lepidic (LEP), papillary (PAP), acinar (ACN), micropapillary (MIP), or solid (SOL)—present in the tumor. This classification has not been tested in multi-institutional cohorts or clinical trials or tested for its predictive value regarding survival from adjuvant chemotherapy (ACT). Patients and Methods Of 1,766 patients in the IALT, JBR.10, CALGB 9633 (Alliance), and ANITA ACT trials included in the LACE-Bio study, 725 had adenocarcinoma. Histologies were reclassified according to the new classification and then collapsed into three groups (LEP, ACN/PAP, and MIP/SOL). Primary end point was overall survival (OS); secondary end points were disease-free survival (DFS) and specific DFS (SDFS). Hazard ratios (HRs) and 95% CIs were estimated through multivariable Cox models stratified by trial. Prognostic value was estimated in the observation arm and predictive value by a treatment effect interaction with histologic subgroups. Significance level was set at .01 for pooled analysis. Results A total of 575 patients were included in this analysis. OS was not prognostically different between histologic subgroups, but univariable DFS and SDFS were worse for MIP/SOL compared with LEP or ACN/PAP subgroup (P < .01); this remained marginally significant after adjustment. MIP/SOL patients (but not ACN/PAP) derived DFS and SDFS but not OS benefit from ACT (OS: HR, 0.71; 95% CI, 0.51 to 0.99; interaction P = .18; DFS: HR, 0.60; 95% CI, 0.44 to 0.82; interaction P = < .01; and SDFS: HR, 0.59; 95% CI, 0.42 to 0.81; interaction P = .01). Conclusion The new lung adenocarcinoma classification based on predominant histologic pattern was not predictive for ACT benefit for OS, but it seems predictive for disease-specific outcomes.
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Schultz, Kenia, Luiz Carlos D'Aquino, Maria Raquel Soares, Andrea Gimenez, and Carlos Alberto de Castro Pereira. "Lung volumes and airway resistance in patients with a possible restrictive pattern on spirometry." Jornal Brasileiro de Pneumologia 42, no. 5 (October 2016): 341–47. http://dx.doi.org/10.1590/s1806-37562016000000091.
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ABSTRACT Objective: Many patients with proportional reductions in FVC and FEV1 on spirometry show no reduction in TLC. The aim of this study was to evaluate the role that measuring lung volumes and airway resistance plays in the correct classification of patients with a possible restrictive pattern on spirometry. Methods: This was a prospective study involving adults with reduced FVC and FEV1, as well as an FEV1/FV(C) ratio within the predicted range. Restrictive lung disease (RLD) was characterized by TLC below the 5th percentile, as determined by plethysmography. Obstructive lung disease (OLD) was characterized by high specific airway resistance, significant changes in post-bronchodilator FEV1, or an FEF25-75% < 50% of predicted, together with a high RV/TLC ratio. Nonspecific lung disease (NLD) was characterized by TLC within the predicted range and no obstruction. Combined lung disease (CLD) was characterized by reduced TLC and findings indicative of airflow obstruction. Clinical diagnoses were based on clinical suspicion, a respiratory questionnaire, and the review of tests of interest. Results: We included 300 patients in the study, of whom 108 (36%) were diagnosed with RLD. In addition, 120 (40%) and 72 (24%) were diagnosed with OLD/CLD and NLD, respectively. Among the latter, 24 (33%) were clinically diagnosed with OLD. In this sample, 151 patients (50.3%) were obese, and obesity was associated with all patterns of lung disease. Conclusions: Measuring lung volumes and airway resistance is often necessary in order to provide an appropriate characterization of the pattern of lung disease in patients presenting with a spirometry pattern suggestive of restriction. Airflow obstruction is common in such cases.
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Kimura, Jun, and Gail H. Deutsch. "Key Mechanisms of Early Lung Development." Pediatric and Developmental Pathology 10, no. 5 (September 2007): 335–47. http://dx.doi.org/10.2350/07-06-0290.1.
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Lung morphogenesis requires the integration of multiple regulatory factors, which results in a functional air-blood interface required for gas exchange at birth. The respiratory tract is composed of endodermally derived epithelium surrounded by cells of mesodermal origin. Inductive signaling between these 2 tissue compartments plays a critical role in formation and differentiation of the lung, which is mediated by evolutionarily conserved signaling families used reiteratively during lung formation, including the fibroblast growth factor, hedgehog, retinoic acid, bone morphogenetic protein, and Wnt signaling pathways. Cells coordinate their response to these signaling proteins largely through transcription factors, which determine respiratory cell fate and pattern formation via the activation and repression of downstream target genes. Gain- and loss-of-function studies in null mutant and transgenic mice models have greatly facilitated the identification and hierarchical classification of these molecular programs. In this review, we highlight select molecular events that drive key phases of pulmonary development, including specification of a lung cell fate, primary lung bud formation, tracheoesophageal septation, branching morphogenesis, and proximal-distal epithelial patterning. Understanding the genetic pathways that regulate respiratory tract development is essential to provide insight into the pathogenesis of congenital anomalies and to develop innovative strategies to treat inherited and acquired lung disease.
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Saboisky, Julian P., Jane E. Butler, Robert B. Fogel, Janet L. Taylor, John A. Trinder, David P. White, and Simon C. Gandevia. "Tonic and Phasic Respiratory Drives to Human Genioglossus Motoneurons During Breathing." Journal of Neurophysiology 95, no. 4 (April 2006): 2213–21. http://dx.doi.org/10.1152/jn.00940.2005.
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A tongue muscle, the genioglossus (GG), is important in maintaining pharyngeal airway patency. Previous recordings of multiunit electromyogram (EMG) suggest it is activated during inspiration in humans with some tonic activity in expiration. We recorded from populations of single motor units in GG in seven subjects during quiet breathing when awake. Ultrasonography assisted electrode placement. The activity of single units was separated into six classes based on a step-wise analysis of the discharge pattern. Phasic and tonic activities were analyzed statistically with the coefficient of determination ( r2) between discharge frequency and lung volume. Of the 110 motor units, 29% discharged tonically without phasic respiratory modulation (firing rate ∼19 Hz). Further, 16% of units increased their discharge during expiration (expiratory phasic and expiratory tonic units). Only half the units increased their discharge during inspiration (inspiratory phasic and inspiratory tonic units). Units firing tonically with an inspiratory increase had significantly higher discharge rates than those units that only fired phasically (peak rates 25 vs. 16 Hz, respectively). Simultaneous recordings of two or three motor units showed neighboring units with differing respiratory and tonic drives. Our results provide a classification and the first quantitative measures of human GG motor-unit behavior and suggest this activity results from a complex interaction of inspiratory, expiratory, and tonic drives at the hypoglossal motor nucleus. The presence of different drives to GG implies that complex premotor networks can differentially engage human hypoglossal motoneurons during respiration. This is unlike the ordered recruitment of motor units in limb and axial muscles.
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Kuranova, Liudmila B., Dmitrii V. Breusenko, and Maria L. Zakharova. "A meta-analysis of prenatal diagnosis of congenital malformations of the airways." Pediatrician (St. Petersburg) 9, no. 2 (May 15, 2018): 36–40. http://dx.doi.org/10.17816/ped9236-40.
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Congenital malformations of the respiratory tract is an important issue. They cause more than 100 deaths annually in the Russian Federation. The definition and classification of congenital malformations of the respiratory tract are described and developed by Je. A. Cvetkov. The ultrasound is the primal method used in prenatal diagnosis of congenital malformations of the upper respiratory tract. Starting from the age of 17-23 weeks old, the ultrasound shows the following signs: hyperechoic lungs, dilatation of the lower respiratory tract, flattening of the diaphragm. This ultrasound pattern is typical for Congenital High Airway Obstruction Syndrome (CHAOS). If the doctor suspects an identifying of these signs, a follow-up examination is recommended. If the congenital obstruction of the upper respiratory tract is diagnosed during the pregnancy, the childbirth for patients must be performed in the hospital, where it is possible to perform tracheotomy and artificial ventilation of the lungs to the newborn, to operate him with placental support. This type of surgical treatment by the EXIT method (The ex utero intrapartum treatment procedure) is a new stage in neonatal surgery. A meta-analysis of 15 articles in the foreign literature about the detection of CHAOS from 1993 to 2014 was conducted. The analysis includes studies with more than 5 described cases. The statistics of diagnosis and treatment of congenital malformations of the larynx of patients of the ENT clinic of SPbSPMU for the period from 2003 to 2016 with the diagnosis of congenital malformation of the larynx is presented.
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Jardine, David, Leanne Cornel, and Mary Emond. "Gene expression analysis characterizes antemortem stress and has implications for establishing cause of death." Physiological Genomics 43, no. 16 (August 2011): 974–80. http://dx.doi.org/10.1152/physiolgenomics.00062.2011.
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Within the field of forensic pathology, determination of the cause of death depends upon identifying physical changes in the corpse or finding diagnostic laboratory abnormalities. When such perturbations are absent, definitive assignment of a cause of death may be difficult or impossible. An example of such a problem is sudden infant death syndrome (SIDS), a common cause of neonatal mortality that does not produce physical findings or laboratory abnormalities. Although respiratory failure as a cause of SIDS represents the most widely held hypothesis, sudden cardiac death and hyperthermia have also been advanced as possible causes. We hypothesize that each of these physiological stresses would produce a different pattern of premortem gene expression and that these patterns of gene expression would remain evident in tissues collected postmortem. If these patterns were sufficiently distinctive, they could be used to identify the cause of death. Using an infant mouse model, we compared gene expression patterns in liver tissue after sudden death, lethal hyperthermia, and lethal hypoxia. Each of these conditions produced readily distinguishable differences in gene expression patterns. With the K-nearest neighbor classification algorithm, only 10 genes are necessary to correctly classify samples. If the liver tissue was not harvested immediately after death, additional alteration in gene expression patterns resulted; however, these alterations did not affect the group of genes used to classify the samples. Our findings suggest that gene expression analysis from tissues collected postmortem may provide useful clues about certain physiologic stresses that may precede death.
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Slingenbergh, Jan. "Animal Virus Ecology and Evolution Are Shaped by the Virus Host-Body Infiltration and Colonization Pattern." Pathogens 8, no. 2 (May 25, 2019): 72. http://dx.doi.org/10.3390/pathogens8020072.
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The current classification of animal viruses is largely based on the virus molecular world. Less attention is given to why and how virus fitness results from the success of virus transmission. Virus transmission reflects the infection-shedding-transmission dynamics, and with it, the organ system involvement and other, macroscopic dimensions of the host environment. This study describes the transmission ecology of the world main livestock viruses, 36 in total, a mix of RNA, DNA and retroviruses. Following an iterative process, the viruses are virtually ranked in an outer- to inner-body fashion, by organ system, on ecological grounds. Also portrayed are the shifts in virus host tropism and virus genome. The synthesis of the findings reveals a predictive virus evolution framework, based on the outer- to inner-body changes in the interplay of host environment-transmission modes-organ system involvement-host cell infection cycle-virus genome. Outer-body viruses opportunistically respond to the variation in the external environment. For example, respiratory and enteric viruses tend to be associated with poultry and pig mass rearing. Ruminant and equine viruses tend to be more deep-rooted and host-specific, and also establish themselves in the vital inner-body systems. It is concluded that the framework may assist the study of new emerging viruses and pandemic risks.
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Anazawa, Rie, Jiro Terada, Seiichiro Sakao, Ayako Shigeta, Nobuhiro Tanabe, and Koichiro Tatsumi. "Features of radiological and physiological findings in pulmonary capillary hemangiomatosis: an updated pooled analysis of confirmed diagnostic cases." Pulmonary Circulation 9, no. 4 (October 2019): 204589401989669. http://dx.doi.org/10.1177/2045894019896696.
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Pulmonary capillary hemangiomatosis (PCH) is a very rare and refractory disease characterized by capillary angioproliferation. The updated classification of pulmonary hypertension categorizes PCH into a subgroup of pulmonary arterial hypertension (PAH) alongside pulmonary veno-occlusive disease (PVOD). However, the definitive diagnosis of PCH only with noninvasive tools remains difficult. The aim of this study was to elucidate the radiological and physiological characteristics of PCH. We searched for cases of pathologically confirmed PCH in the English literature published between 2000 and 2018. We identified 26 cases among 39 studies. Then, we extracted and evaluated the relevant clinical information in all cases with available data. On chest computed tomography (CT), ground-glass opacities (GGOs) were observed in 92% of the cases, in which poorly defined nodular pattern was the most common (88%). GGOs in a bat-wing distribution were observed in one case. Septal lines and lymph node enlargement were observed less frequently (each 19%, 12%). Seven cases (27%) had overlapping abnormalities. Diffusing capacity of the lung for carbon monoxide (DLCO) was remarkably decreased. Alveolar hemorrhage by histological findings or bronchoalveolar lavage (BAL) was observed in seven cases. The present study showed that the most characteristic findings of CT in PCH was centrilobular GGOs with a poorly defined nodular pattern, and septal lines and lymph node enlargement were seen less frequently. Alveolar hemorrhage detected by BAL and decreased DLCO may also be helpful to recognize the possibility of PCH like PVOD.
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Wilson, D. A., and M. Leon. "Spatial patterns of olfactory bulb single-unit responses to learned olfactory cues in young rats." Journal of Neurophysiology 59, no. 6 (June 1, 1988): 1770–82. http://dx.doi.org/10.1152/jn.1988.59.6.1770.
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1. Neonatal rat pups were classically conditioned to an odor stimulus from postnatal day 1 (PN1) to PN18. Tactile stimulation (stroking) was used as the unconditioned stimulus. On PN19, mitral/tufted cell single-unit responses to the conditioned odor were examined in both conditioned and control pups. Recordings were made from mitral/tufted cells in two regions of the olfactory bulb: 1) an area typically associated with focal [14C]2-deoxyglucose (2-DG) uptake in response to the conditioned odor and 2) an area distant from focal 2-DG uptake to the conditioned odor. Animals were anesthetized with urethane and were naturally respiring during the single-unit recording procedure. 2. Changes in mitral/tufted cell firing rate in response to odors in both bulbar regions and all training groups were classified as either excitatory, suppressive, or no response. This response classification was used to compare response patterns to the conditioned odor between bulbar regions and training groups. 3. Classical conditioning selectively modified the response patterns of mitral/tufted cells to the conditioned odor when those cells were associated with regions of focal 2-DG uptake for that odor. Mitral/tufted cells demonstrated significantly more suppressive and fewer excitatory responses to the conditioned odor than cells in control pups. Response patterns to a novel odor were not similarly modified. 4. Response patterns of mitral/tufted cells distant from the focal region of 2-DG uptake to the conditioned odor were not modified by conditioning compared with control pups. 5. The difference in response pattern between cells in the 2-DG focus and cells distant to the 2-DG focus was apparent within 500 ms of the stimulus onset. Given the respiratory rate of these pups (2 Hz), these data suggest that the modified response pattern occurred on the first inhalation of the learned odor. 6. These data demonstrate that both spatial and temporal patterns of olfactory bulb output neuron activity are used in the coding of olfactory information in the bulb. Furthermore, these spatial/temporal response patterns can be modified by early learning.
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Karampeli, M., K. Thomas, D. Tseronis, M. Aggelakos, D. Kassara, K. Havatza, S. Flouda, et al. "AB1216 INTERSTITIAL PNEUMONIA WITH AUTOIMMUNE FEATURES (IPAF): A SINGLE CENTER, PROSPECTIVE STUDY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1899–900. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2753.
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Background:Interstitial pneumonia with autoimmune features (IPAF)1describes a group of patients with interstitial lung disease and autoimmune features who do not meet the classification criteria for a specific connective tissue disease. Limited data regarding IPAF are available so far.Objectives:To identify the epidemiological and clinical characteristics of patients with IPAF and to observe disease progression, response to treatment and frequency of infections in 1-year follow-up period.Methods:Thirty-nine patients from ‘Attikon’ University Hospital of Athens fulfilling the IPAF criteria were enrolled. Clinical and laboratory findings, comorbidities, medications, pulmonary outcomes assessed with repeated pulmonary function tests (PFTs) and chest HRCT and complications in a 1-year follow-up period were documented for each patient. Univariate models were performed in order to identify determinants of infection and clinically significant difference in PFTs (defined as change of ≥ 10% in FVC and/or ≥ 15% in DLCO).Results:The mean age at the time of IPAF diagnosis was 63.2 (±11) years and 62% of the patients were female. The most common clinical features included in the IPAF criteria were arthritis (82%) and Raynaud’s phenomenon (26%). A morbilliform and/or polymorphic rash of the face, neck and extremities (not included in the IPAF criteria) was noted in 54% of patients. ANA (59%) and anti–Ro (21%) were the most common auto-antibodies. Non-specific Interstitial Pneumonia (NSIP) was the most prevalent radiological pattern (61.5%) as shown in table 1. Treatment comprised corticosteroids and immunosuppressants including hydroxychloroquine, methotrexate, azathioprine, mycophenolate and cyclophosphamide. PFTs following treatment at 6 and 12 months from baseline showed a trend of improvement (Table 2, p> 0.05). At 1 year from baseline, 20.5% of patients showed a clinically significant deterioration while 25% had a clinically significant improvement. Infections were observed in 23.1% of patients during the first semester and in 12.8% during the second semester of the follow-up period. All were respiratory tract infections and two patients (5.1%) required hospitalization. All infections occurred in patients with non-UIP pattern (p=0.02) which might be attributed to higher doses of corticosteroids used in these patients (mean initial prednisolone dose = 27 (±18) mg/d in patients with non-UIP pattern versus 17 (±16) mg/d in patients with UIP pattern, p=0.4).Table 1.Prevalence of HRCT patterns in 39 patients.Radiological patternNo (%)NSIP24 (61,5%)OP2 (5,1%)NSIP with OP overlap2 (5,1%)LIP1 (2,6%)UIP7 (18%)NSIP and UIP3 (7,7%)NSIP: Non-specific Interstitial Pneumonia, OP: Organizing Pneumonia, LIP: Lymphocytic Interstitial Pneumonia, UIP: Usual Interstitial Pneumonia.Table 2.PFTs at baseline, 6 and 12 months.PFTs (% of predicted value ± SD)Baseline6 months12 monthsP valueFVC79% (±19%)82% (±18%)84% (±17%)nsDLCO49% (±16%)52% (±17%)53% (±17%)nsConclusion:Rash is a common feature in IPAF and may be considered for inclusion into IPAF criteria. A trend of improvement in PFTs and a significant risk of respiratory tract infections mainly in the first semester of treatment and in patients with non-UIP radiological pattern were observed. Larger prospective studies are warranted in order to elucidate IPAF’s prognosis and to identify effective management approaches.References:[1]Fischer A, et al. An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features. Eur Respir J 2015; 46: 976-987.Disclosure of Interests:Maria Karampeli: None declared, Konstantinos Thomas: None declared, Dimitrios Tseronis: None declared, Michail Aggelakos: None declared, Dimitra Kassara: None declared, Katerina Havatza: None declared, Sofia Flouda: None declared, Dionysis Nikolopoulos: None declared, Antigoni Pieta: None declared, Vasiliki Tzavara: None declared, Pelagia Katsimbri: None declared, Dimitrios Boumpas Grant/research support from: Unrestricted grant support from various pharmaceutical companies, Theofanis Karageorgas: None declared
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Barrie, J. M., W. J. Freeman, and M. D. Lenhart. "Spatiotemporal analysis of prepyriform, visual, auditory, and somesthetic surface EEGs in trained rabbits." Journal of Neurophysiology 76, no. 1 (July 1, 1996): 520–39. http://dx.doi.org/10.1152/jn.1996.76.1.520.
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1. Spatial ensemble averages were computed for 64 traces of electroencephalograms (EEGs) simultaneously recorded from 8 x 8 arrays over the epidural surfaces of the prepyriform cortex (PPC) and visual, somatic, and auditory cortices. They revealed a common waveform across each array. Examination of the spatial amplitude modulation (AM) of the waveform revealed classifiable spatial pattern in short time segments. The AM patterns varied within trials after presentation of identical conditioned stimuli, and also between trials with differing stimuli. 2. PPC EEGs revealed strong correlates with the respiratory rhythm; neocortical EEGs did not. 3. Time ensemble averaging of the PPC EEG attenuated the oscillatory bursts, indicating that olfactory gamma oscillations (20-80 Hz) were not phase-locked to the times of stimulus delivery but instead to inhalations. Time ensemble averages of neocortical recordings across trials revealed average evoked potentials starting 30-50 ms after the arrival of the stimulus. 4. Average temporal fast Fourier transform (FFT) power spectral densities (PSDs) from pre- and poststimulus PPC EEG segments revealed a peak of gamma activity in olfactory bursts. 5. The logarithm of the average temporal FFT PSDs from pre- and poststimulus neocortical EEG segments, when plotted against log frequency, revealed 1/f-type spectra in both pre- and poststimulus segments for negative/aversive conditioned stimuli (CS-) and positive/rewarding conditioned stimuli (CS+). The alpha'- and beta'-coefficients from the regression of Eq. 2 onto the average PSDs were significantly different between pre- and poststimulus segments, owing to the evoked potentials, but not between CS- and CS+ stimulus segments. 6. Spatiotemporal patterns were invariant over all frequency bins in the 1/f domain (20-100 Hz). Spatiotemporal patterns in the 2- to 20-Hz domain progressively differed from the invariant patterns with decreasing frequency. 7. In the spatial frequency domain, the logarithm of the average spatial FFT power spectra from pre- and poststimulus neocortical EEG segments, when plotted against the log spatial frequency, fell monotonically from the maximum at the lowest spatial frequency, downwardly curving to a linear 1/f spectral domain. This curve in the 1/f spectral domain extended from 0.133 to 0.880 cycles/mm in the PPC and from 0.095 to 0.624 cycles/mm in the neocortices. 8. Methods of FFT and principal component analysis (PCA) EEG decomposition were used to extract the broad-spectrum waveform common to all 64 EEGs from an array. AM patterns for the FFT and PCA components were derived by regression. They were shown by cross-correlation to yield spatial patterns that were equivalent to each other and to AM patterns from calculation of the 64 root-mean-square amplitudes of the segments. 9. Each spatial AM pattern was expressed by a 1 x 64 column vector and a point in 64-space. Similar patterns formed clusters, and dissimilar patterns gave multiple clusters. A statistical test was devised to evaluate dissimilarity by a Euclidean distance metric in 64-space. 10. Significant spatial pattern classification of CS- versus CS+ trials (below the 1% confidence limit for 20 of each) was found in discrete temporal segments of poststimulus data after digital temporal and spatial filter optimization. 11. Varying the analysis window duration from 10 to 500 ms yielded a window length of 120 ms as optimal for pattern classification. A 120-ms window was subsequently stepped across each record in overlapping intervals of 20 ms. Windows in which episodic, significant CS+/CS- differences occurred lasted 50-200 ms and were separated by 100-200 ms in the poststimulus period. 12. Neocortical spatial patterns changed under reinforcement contingency reversal, showing a lack of invariance in respect to stimuli and a dependence on context and learning, as previously found for the olfactory bulb and PPC.
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Larsen, Brandon T., and Thomas V. Colby. "Update for Pathologists on Idiopathic Interstitial Pneumonias." Archives of Pathology & Laboratory Medicine 136, no. 10 (October 1, 2012): 1234–41. http://dx.doi.org/10.5858/arpa.2012-0225-ra.
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Context.—Idiopathic interstitial pneumonias are a subset of diffuse pulmonary interstitial diseases classified by international consensus in 2002 as idiopathic pulmonary fibrosis, nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, respiratory bronchiolitis interstitial lung disease, desquamative interstitial pneumonia, and lymphoid interstitial pneumonia. Each is associated with a characteristic histopathologic pattern. In 2011, updated consensus guidelines were released for diagnosis and management of idiopathic pulmonary fibrosis. The entire group of idiopathic interstitial pneumonias is currently undergoing refinement, with updates expected in a forthcoming consensus classification. Many of these recent and anticipated changes are relevant to pathologists. Objectives.—To review international consensus guidelines for diagnosis of idiopathic pulmonary fibrosis and other idiopathic interstitial pneumonias and to discuss recent and expected future classification updates. Data Sources.—Published peer-reviewed literature and personal experience of the authors. Conclusions.—Diagnosis of idiopathic interstitial pneumonias by multidisciplinary discussion among clinicians, radiologists, and pathologists is now strongly encouraged. Diagnosis of idiopathic pulmonary fibrosis no longer requires surgical lung biopsy; high-resolution computed tomography is an acceptable surrogate. In the context of clinical trials, pathologists are being asked to assign levels of confidence for histologic diagnosis of usual interstitial pneumonia in patients with idiopathic pulmonary fibrosis. Acute exacerbation of idiopathic pulmonary fibrosis is now accepted and should be considered when acute lung injury is superimposed on a background of usual interstitial pneumonia. The updated classification of idiopathic interstitial pneumonias will include a separate category for rare entities, including lymphoid interstitial pneumonia and idiopathic pleuroparenchymal fibroelastosis.
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Young, C. C., M. J. Ho, A. B. Arun, W. M. Chen, W. A. Lai, F. T. Shen, P. D. Rekha, and A. F. Yassin. "Sphingobium olei sp. nov., isolated from oil-contaminated soil." International Journal of Systematic and Evolutionary Microbiology 57, no. 11 (November 1, 2007): 2613–17. http://dx.doi.org/10.1099/ijs.0.65187-0.
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The taxonomic status of a yellow-coloured bacterial isolate from an oil-contaminated soil sample was determined using a polyphasic taxonomic approach. Comparative analysis of 16S rRNA gene sequences showed that the novel isolate formed a distinct phyletic line within the genus Sphingobium. The generic assignment was confirmed by chemotaxonomic data, which revealed: a fatty acid profile that is characteristic of the genus Sphingobium consisting of straight-chain saturated and unsaturated as well as 2-OH fatty acids; a ubiquinone with ten isoprene units (Q-10) as the predominant respiratory quinone; a polar lipid pattern consisting of diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylmonomethylethanolamine, phosphatidylcholine and sphingoglycolipid, and spermidine as the major polyamine component. Genotypic and phenotypic data show that the new isolate merits classification as a representative of a novel species of the genus Sphingobium, for which the name Sphingobium olei sp. nov. is proposed. The type strain is IMMIB HF-1T (=DSM 18999T=CCUG 54329T).
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Nakagiri, Tomoyuki, Noriyoshi Sawabata, Eiichi Morii, Masayoshi Inoue, Yasushi Shintani, Soichiro Funaki, and Meinoshin Okumura. "Evaluation of the new IASLC/ATS/ERS proposed classification of adenocarcinoma based on lepidic pattern in patients with pathological stage IA pulmonary adenocarcinoma." General Thoracic and Cardiovascular Surgery 62, no. 11 (June 3, 2014): 671–77. http://dx.doi.org/10.1007/s11748-014-0429-3.
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Madeira, N., M. Alvarenga Santos, L. Cunha Miranda, S. Clemente, and S. Furtado. "FRI0495 FOLLOW UP OF INTERSTITIAL PNEUMONIA WITH AUTOIMMUNE FEATURES – THE EXPERIENCE OF ONE CENTRE." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 846.3–846. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4395.
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Background:Interstitial Lung Diseases (ILD) may present features suggesting an underlying autoimmune process, which seem to differentiate them from idiopathic interstitial pneumonias, although without fully meeting the classification criteria (CC) for a specific connective tissue disease. Different terms had been used to describe these conditions and, to reach a consensus, the European Respiratory Society/American Thoracic Society proposed the CC for an entity named Interstitial Pneumonia with Autoimmune Features (IPAF). Clinical evolution and prognosis of this entity are still poorly understood.Objectives:To evaluate clinical evolution and prognosis of a population of patients with IPAF.Methods:Retrospective analysis of clinical files of patients followed by the Pulmonology Department since 02/2012 until 06/2019, who met the CC for IPAF, regarding clinical, functional and radiological evolution. Patients were considered to have a progressive phenotype in 24±3 months from their 1stevaluation if they fulfil 1 of the 4 criteria: relative decline in FVC ≥10% predicted; relative decline in FVC ≥5–<10% predicted and worsened respiratory symptoms; relative decline in FVC ≥5–<10% predicted and increased extent of fibrosis on High-resolution Computed Tomography (HRCT); worsened respiratory symptoms and increased extent of fibrosis on HRCT.Results:22 (7.4%) of 296 ILD patients met IPAF CC. 59.0% were female with an age at the 1stevaluation of 66.7±12.4 years. They were all non-smokers (63.6%) or ex-smokers (36.4%). Serologic and morphologic criteria were both present in 21 (95.4%) and clinical criteria in 5 patients (22.7%). Antinuclear antibodies (ANA) were identified in 19, rheumatoid factor in 4, SSA in 3 and anti-Jo-1 in 1 patient. HRCT patterns were identified in 21 patients: 15 nonspecific interstitial pneumonia (NSIP), 5 organizing pneumonia (OP) and 2 lymphocytic interstitial pneumonia (LIP). One NSIP and 1 LIP identified on HRCT were confirmed by histopathology. Three patients had inflammatory arthritis and 2 had Raynaud’s phenomenon. Immunosuppressive therapy was introduced in most cases (18 patients, including systemic corticotherapy in 17, azathioprine in 4, mycophenolate mofetil in 1), azithromycin was prescribed in 2 patients and 3 remained without therapy. Regarding the follow up at 24±3 months from the 1stevaluation (3 patients were excluded due to too recent follow-up), 4 patients (18.2%) had progressive phenotype, 7 (31.8%) had a favourable evolution and 3 (13.6%) patients had died. During a follow-up of 31.1±19.8 months, this number rose to 6 patients (27.3%), all of them died by respiratory cause and had NSIP pattern. No differences were found in age, last FVC, therapy and time of disease evolution between those who died and the others.Conclusion:Our study showed that a small proportion of IPAF patients had a progressive phenotype and the NSIP pattern seemed to be a poor prognosis factor for survival.References:[1]Ito Y, Arita M, Kumagai S, et al. Serological and morphological prognostic factors in patients with interstitial pneumonia with autoimmune features. BMC Pulm Med 2017; 17:111 10.1186/s12890-017-0453-zDisclosure of Interests:None declared
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Rahman, Md Mahfuzur, Muhammad Anwarul Kabir, and Maria Mehjabin. "Pattern of Non-Communicable Diseases among the Admitted Patients in a District Level Hospital of Bangladesh." Bangladesh Heart Journal 34, no. 2 (December 12, 2019): 118–21. http://dx.doi.org/10.3329/bhj.v34i2.44442.
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Background: Non-communicable Diseases (NCD), particularly cardiovascular diseases, cancer, diabetes and chronic respiratory disease, have emerged as the leading threat to mankind worldwide. Likewise in Bangladesh, an increasing trend of incidence of NCDs has been observed and already they have become major public health concern. Hence, we aimed to study the pattern of NCDs among the admitted patients at an Upazila Health Complex (UHC) in Bangladesh.
Methods: In this retrospective study, data of in-hospital patients admitted from January 2018 to June 2018 in UHC, Chhagalnaiya, Feni was analyzed. Data on age, gender, occupation, hospital admission/discharge and diagnosis of disease was obtained from the hospital register. Diseases were categorized into NCD or communicable disease using the World Health Organization’s International Classification of Diseases (ICD) coding system.
Results: 1,367 adult patients with different diseases were admitted into the medical ward over the study period of six months (mean age 57.4 ± 17.9 years; 61.3% male and 38.7% female). There were 904 cases of various NCDs constituting 66.1% of total admissions. The number of cases of NCDs was two times more compared to CDs (ratio 2:1). In all six months, admissions due to NCDs were significantly higher compared to communicable diseases CDs (p = 0.0001). Among the admissions due to NCDs, more than half (51.3%) were aged between 50 to 69 years. In terms of pattern of disease, cardiovascular diseases were the number one cause for hospital admission followed by endocrine disorders.
Conclusion: This study found that the burden of NCDs has increased among the admitted patients in an UHC. These findings could be useful to draw the attention of health authorities to adopt preventive strategies against NCDs even at Upazila level.
Bangladesh Heart Journal 2019; 34(2) : 118-121
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Cattano, Davide, Brian O'connor, Ra'ad Shakir, Francesco Giunta, and Mark Palazzo. "Acute Inflammatory Demyelinating Polyneuropathy and a Unilateral Babinski/Plantar Reflex." Anesthesiology Research and Practice 2008 (2008): 1–3. http://dx.doi.org/10.1155/2008/134958.
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Acquired acute demyelinating peripheral polyneuropathy (AADP) is a general classification of pathologies that could affect secondary the peripheral nervous system. They are characterized by an autoimmune process directed towards myelin. Clinically they are characterized by progressive weakness and mild sensory changes. Acute inflammatory demyelinating polyneuropathy often is referred to as Guillain-Barré syndrome (GBS). GBS is the major cause of acute nontraumatic paralysis in healthy people and it is caused by autoimmune response to viral agents (influenza, coxsackie, Epstein-Barr virus, or cytomegalovirus) or bacterial infective organisms (Campylobacter jejuni, Mycoplasma pneumoniae). A detailed history, with symptoms of progressive usually bilateral weakness, hyporeflexia, with a typical demyelinating EMG pattern supports the diagnosis. Progressive affection of respiratory muscles and autonomic instability coupled with a protracted and unpredictable recovery normally results in the need for ICU management. We present a case report of a patient with a typical GBS presentation but with a unilateral upgoing plantar reflex (Babinski sign). A unifying diagnosis was made and based on a literature search in Pubmed appears to be the first described case of its kind.
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Sari, Putri Nilam. "Assessing Health Risk For Community Adaptation In Urban Heat Island Area Of Padang City." Jurnal Keselamatan Kesehatan Kerja dan Lingkungan 1, no. 1 (December 18, 2020): 12–26. http://dx.doi.org/10.25077/jk3l.1.1.12-26.2020.
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Areas classified as Urban Heat Islands (UHI) have a higher health risk due to climate change. High population activity, increasing population density, and low vegetation cover cause this area to become warmer than its surroundings. From the detection of the spatial pattern, Padang City has nine sub-districts belonging to UHI. In this area, environmental problems often occur due to climate calamities and have an impact on health. Therefore, this study was to determine the classification of public health risks and community adaptation to climate change in urban heat island areas. This research was conducted on 141 households in Koto Tangah sub-district as the large UHI area and highly prone to climate problems. Data collected by questionnaires, observation, and literature study. The risk assessment matrix was used to identify health risk status. The results showed that water pollution, respiratory problems, and diarrheal diseases are classified as high risks. The community needs to adapt to climate change, mainly doing routine physical activities, to increase immunity from many diseases.
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Rodriguez, Erika F., Sanja Dacic, Liron Pantanowitz, Walid E. Khalbuss, and Sara E. Monaco. "Cytopathology of pulmonary adenocarcinoma with a single histological pattern using the proposed International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification." Cancer Cytopathology 123, no. 5 (March 18, 2015): 306–17. http://dx.doi.org/10.1002/cncy.21532.
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A, Yerima, Adamu AA, Bakki B, Amali AO, Muhammad M, and Hassan AA. "CORTICOSTEROIDS USE: A SURVEY ON THE LEVEL OF KNOWLEDGE AND PRESCRIPTION PATTERN OF DOCTORS IN MAIDUGURI, NORTH-EASTERN NIGERIA." Kanem Journal Medical Sciences 15, no. 1 (June 1, 2021): 1–8. http://dx.doi.org/10.36020/kjms.2021.1508.
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Background: Despite the high prescription rates of Corticosteroids (CS), physicians have poor knowledge of the long-term effects and monitoring of CS. Objectives: To evaluate the knowledge of doctors in Maiduguri, Nigeria, on the use, adverse effects, and monitoring of corticosteroids. Methodology: A cross sectional survey involving 248 consenting doctors practicing in Maiduguri between 1st of January and 30th of March, 2020. Results: Of the 248 doctors surveyed, 161 completed the survey (response rate of 64.9%). Mean age was 34±5.6 years with 95 (59%) males. Majority (74.5%) had only MBBS and 125 (77.6%) were practicing in a tertiary setting, 43 (26.7%) and 38 (23.6%) were from Medicine and General Outpatient Department respectively. Seventy-four (50.7%) had been practicing for one to five years. All had prescribed CS before. Duration of practice was not associated with frequency of CS prescription (χ2 = 24.08, p=0.091). Prednisolone was the most commonly prescribed CS (48.4%) while, the oral route was the preferred mode of prescription by 80 (49.7%) respondents. Seventy-three (45.3%) prescribed CS for allergy, respiratory diseases, and dermatological complaints. Most (67.7%) were not aware of the dosage classification of CS but 99 (61.5%) were aware of guidelines for stopping CS during treatment. Majority (92.5%) were aware of multiple adverse effects of CS with 24.2% reporting Cushingoid changes. Seventy-eight (48.4%) routinely assess patients for adverse effects. Only, 4 (2.5%) and 6 (3.7%) of respondents routinely screen for osteoporosis and tuberculosis respectively. Less than 44% and 22% routinely screen for drug-drug interaction and CS complications respectively. Conclusion: There is low level of knowledge regarding the use and monitoring of CS in Maiduguri.
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A, Yerima, Adamu AA, Bakki B, Muhammad M, Amali AO, and Hassan AA AA. "8. CORTICOSTEROIDS USE: A SURVEY ON THE LEVEL OF KNOWLEDGE AND PRESCRIPTION PATTERN OF DOCTORS IN MAIDUGURI, NORTH-EASTERN NIGERIA." Kanem Journal Medical Sciences 15, no. 1 (June 1, 2021): 65–72. http://dx.doi.org/10.36020/kjms.2021.1501.008.
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Background: Despite the high prescription rates of Corticosteroids (CS), physicians have poor knowledge of the long-term effects and monitoring of CS. Objectives: To evaluate the knowledge of doctors in Maiduguri, Nigeria, on the use, adverse effects, and monitoring of corticosteroids. Methodology: A cross sectional survey involving 248 consenting doctors practicing in Maiduguri between 1st of January and 30th of March, 2020. Results: Of the 248 doctors surveyed, 161 completed the survey (response rate of 64.9%). Mean age was 34±5.6 years with 95 (59%) males. Majority (74.5%) had only MBBS and 125 (77.6%) were practicing in a tertiary setting, 43 (26.7%) and 38 (23.6%) were from Medicine and General Outpatient Department respectively. Seventy-four (50.7%) had been practicing for one to five years. All had prescribed CS before. Duration of practice was not associated with frequency of CS prescription (χ2 = 24.08, p=0.091). Prednisolone was the most commonly prescribed CS (48.4%) while, the oral route was the preferred mode of prescription by 80 (49.7%) respondents. Seventy-three (45.3%) prescribed CS for allergy, respiratory diseases, and dermatological complaints. Most (67.7%) were not aware of the dosage classification of CS but 99 (61.5%) were aware of guidelines for stopping CS during treatment. Majority (92.5%) were aware of multiple adverse effects of CS with 24.2% reporting Cushingoid changes. Seventy-eight (48.4%) routinely assess patients for adverse effects. Only, 4 (2.5%) and 6 (3.7%) of respondents routinely screen for osteoporosis and tuberculosis respectively. Less than 44% and 22% routinely screen for drug-drug interaction and CS complications respectively. Conclusion: There is low level of knowledge regarding the use and monitoring of CS in Maiduguri.
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Bourouis, Sami, Abdullah Alharbi, and Nizar Bouguila. "Bayesian Learning of Shifted-Scaled Dirichlet Mixture Models and Its Application to Early COVID-19 Detection in Chest X-ray Images." Journal of Imaging 7, no. 1 (January 10, 2021): 7. http://dx.doi.org/10.3390/jimaging7010007.
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Early diagnosis and assessment of fatal diseases and acute infections on chest X-ray (CXR) imaging may have important therapeutic implications and reduce mortality. In fact, many respiratory diseases have a serious impact on the health and lives of people. However, certain types of infections may include high variations in terms of contrast, size and shape which impose a real challenge on classification process. This paper introduces a new statistical framework to discriminate patients who are either negative or positive for certain kinds of virus and pneumonia. We tackle the current problem via a fully Bayesian approach based on a flexible statistical model named shifted-scaled Dirichlet mixture models (SSDMM). This mixture model is encouraged by its effectiveness and robustness recently obtained in various image processing applications. Unlike frequentist learning methods, our developed Bayesian framework has the advantage of taking into account the uncertainty to accurately estimate the model parameters as well as the ability to solve the problem of overfitting. We investigate here a Markov Chain Monte Carlo (MCMC) estimator, which is a computer–driven sampling method, for learning the developed model. The current work shows excellent results when dealing with the challenging problem of biomedical image classification. Indeed, extensive experiments have been carried out on real datasets and the results prove the merits of our Bayesian framework.
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Bhagavatula, Indira Devi, Dhananjaya I. Bhat, Gopalakrishnan M. Sasidharan, Rakesh Kumar Mishra, Praful Suresh Maste, George C. Vilanilam, and Talakkad N. Sathyaprabha. "Subclinical respiratory dysfunction in chronic cervical cord compression: a pulmonary function test correlation." Neurosurgical Focus 40, no. 6 (June 2016): E3. http://dx.doi.org/10.3171/2016.3.focus1647.
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OBJECTIVE Respiratory abnormalities are well documented in acute spinal cord injury; however, the literature available for respiratory dysfunction in chronic compressive myelopathy (CCM) is limited. Respiratory dysfunction in CCM is often subtle and subclinical. The authors studied the pattern of respiratory dysfunction in patients with chronic cord compression by using spirometry, and the clinical and surgical implications of this dysfunction. In this study they also attempted to address the postoperative respiratory function in these patients. METHODS A prospective study was done in 30 patients in whom cervical CCM due to either cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL) was diagnosed. Thirty age-matched healthy volunteers were recruited as controls. None of the patients included in the study had any symptoms or signs of respiratory dysfunction. After clinical and radiological diagnosis, all patients underwent pulmonary function tests (PFTs) performed using a standardized Spirometry Kit Micro before and after surgery. The data were analyzed using Statistical Software SPSS version 13.0. Comparison between the 2 groups was done using the Student t-test. The Pearson correlation coefficient was used for PFT results and Nurick classification scores. A p value < 0.05 was considered significant. RESULTS Cervical spondylotic myelopathy (prolapsed intervertebral disc) was the predominant cause of compression (n = 21, 70%) followed by OPLL (n = 9, 30%). The average patient age was 45.06 years. Degenerative cervical spine disease has a relatively younger onset in the Indian population. The majority of the patients (n = 28, 93.3%) had compression at or above the C-5 level. Ten patients (33.3%) underwent an anterior approach and discectomy, 11 patients (36.7%) underwent decompressive laminectomy, and the remaining 9 underwent either corpectomy with fusion or laminoplasty. The mean preoperative forced vital capacity (FVC) (65%) of the patients was significantly lower than that of the controls (88%) (p < 0.001). The mean postoperative FVC (73.7%) in the patients showed significant improvement compared with the preoperative values (p = 0.003). The mean postoperative FVC was still significantly lower than the control value (p = 0.002). The mean preoperative forced expiratory volume in 1 second (FEV1) (72%) of the patients was significantly lower than that of the controls (96%) (p < 0.001). The mean postoperative FEV1 (75.3%) in the cases showed no significant improvement compared with the preoperative values (p = 0.212). The mean postoperative FEV1 was still significantly lower than the control value (p < 0.001). The mean postoperative FEV1/FVC was not significantly different from the control value (p = 0.204). The mean postoperative peak expiratory flow rate was significantly lower than the control value (p = 0.01). The mean postoperative maximal voluntary ventilation was still significantly lower than the control value (p < 0.001). On correlating the FVC and Nurick scores using the Pearson correlation coefficient, a negative correlation was found. CONCLUSIONS There is subclinical respiratory dysfunction and significant impairment of various lung capacities in patients with CCM. The FVC showed significant improvement postoperatively. Respiratory function needs to be evaluated and monitored to avoid potential respiratory complications.
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Güler, Emin Çaǧatay, Bülent Sankur, Yasemin P. Kahya, and Sarunas Raudys. "Two-stage classification of respiratory sound patterns." Computers in Biology and Medicine 35, no. 1 (January 2005): 67–83. http://dx.doi.org/10.1016/j.compbiomed.2003.11.001.
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