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Jeong, Yoon Jeong, Gyu Seong Kim, Yeon Gyu Jeong e Hyun Im Moon. "Can Pulmonary Function Testing Predict the Functional Outcomes of Poststroke Patients?" American Journal of Physical Medicine & Rehabilitation 99, n. 12 (23 giugno 2020): 1145–49. http://dx.doi.org/10.1097/phm.0000000000001507.
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Varon, Joseph, Sushen Bhalla e Daniel Martini. "Long-Haul COVID-19: Imaging or Functional Testing?" Current Respiratory Medicine Reviews 18, n. 3 (agosto 2022): 159–60. http://dx.doi.org/10.2174/1573398x1803220810153544.
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Yeh, Mei-Ling, Hsing-Hsia Chen, Yu-Chien Liao e Wei-Yu Liao. "Testing the functional status model in patients with chronic obstructive pulmonary disease". Journal of Advanced Nursing 48, n. 4 (novembre 2004): 342–50. http://dx.doi.org/10.1111/j.1365-2648.2004.03203.x.
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Valieva, Z. S., Z. H. Dadacheva, T. V. Martynyuk, N. M. Danilov, M. A. Saidova e I. Ye Chazova. "CLINICAL CASE: THERAPY WITH SILDENAFIL IN THE TREATMENT OF IDIOPATHIC PULMONARY HYPERTENSION". Eurasian heart journal, n. 4 (30 dicembre 2015): 40–47. http://dx.doi.org/10.38109/2225-1685-2015-4-40-47.
Testo completoAbstract (sommario):
The patient with the verified diagnosis of idiopathic pulmonary hypertension, negative acute vasoreactivity testing by RHC, functional class III (WHO) was treated by phosphodiesterase type 5 inhibitor sildenafil. After one year there was achieved the significant improvement of the functional and hemodynamic status.
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Copelan., Edward A. "Predicitve Value of Pretransplant Testing." Blood 104, n. 11 (16 novembre 2004): 1144. http://dx.doi.org/10.1182/blood.v104.11.1144.1144.
Testo completoAbstract (sommario):
Abstract Routine evaluation prior to stem cell transplantation generally includes assessment of left ventricular ejection fraction (EF), pulmonary function, renal function, liver function, and functional status. Patients in whom compromised organ function is detected, are often deemed ineligible for myeloablative transplantation. However, the predictive value of specific pretransplant tests is not well documented, and has not been critically analyzed in patients receiving busulfan-based preparative regimens. We analyzed the prognostic value of the pretransplant evaluation performed in 1035 consecutive patients who underwent autologous (n=444) or allogeneic (n=591) transplantation with busulfan-based regimens between 2/84 and 12/03 for acute (250) or chronic leukemia (198), myelodysplasia (50), multiple myeloma (88), or Hodgkin’s (139) or non-Hodgkin’s lymphoma (303). Ages ranged from 4–75 (median 41). BuCy was given to 477 and BuCyVP16 to 558 individuals. Ninety three patients had EF < 50%, 61 had DLCO < 65%, 103 had elevated creatine, 130 had elevated tranaminases or bilirubin, and 116 had Karnofsky scores < 80%. For the entire group, multivariable analysis demonstrated only Karnofsky score < 80% (P < .001) and elevated LFTs (P=.04) to have significant adverse prognostic influence on survival. Karnofsky score was significant in patients undergoing autologous (P <.001) or allogenic (P <.001) transplantation. Neither EF nor DLCO were predictive of poor outcome for the overall group (P >.2), nor for the autologous or allogeneic transplant groups. However in patients undergoing transplants from unrelated donors (n=119) DLCO < 65% was a significant adverse prognostic factor (P=.004). There was no association of compromised cardiac or pulmonary function with cardiac or pulmonary failure as a primary cause of death. This study suggests that moderately compromised organ function, particularly cardiopulmonary limitations which might not be clinically apparent, are of limited value in prediction of transplant outcome. Direct clinical assessment, including functional status are of much greater value in prediction of outcome. It is hoped that this investigation will stimulate larger studies of pretransplant predictors of outcome with attention to their relevance to specific preparative regimens, sources of stem cells, and other treatment variables.
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Pele, Irina, e Florin-Dumitru Mihălțan. "Cardiopulmonary exercise testing in thoracic surgery". Pneumologia 69, n. 1 (27 luglio 2020): 3–10. http://dx.doi.org/10.2478/pneum-2020-0001.
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AbstractThe assessment of functional capacity is a significant part of the preoperative evaluation of patients proposed for both thoracic and abdominal surgery. The cardiopulmonary exercise test (CPET) is the most comprehensive exercise test currently used. It provides an objective assessment of the patient's training level and an individualised risk profile for complications and guides the perioperative care. This article provides a brief description of the roles of CPET in thoracic surgery. Guidelines recommend it for perioperative assessments because of its prognostic value, its utility in the postoperative period and in pulmonary rehabilitation programmes.
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Fogarty, Colin B., e Dylan S. Small. "Equivalence testing for functional data with an application to comparing pulmonary function devices". Annals of Applied Statistics 8, n. 4 (dicembre 2014): 2002–26. http://dx.doi.org/10.1214/14-aoas763.
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Day, Ronald W. "Acute vasodilator testing following Fontan palliation: an opportunity to guide precision care?" Cardiology in the Young 30, n. 6 (22 maggio 2020): 829–33. http://dx.doi.org/10.1017/s1047951120001110.
Testo completoAbstract (sommario):
AbstractBackground:Pulmonary vasodilators improve the functional capacity of some patients with pulmonary arterial hypertension. However, pulmonary vasodilators frequently fail to improve unequivocal endpoints of efficacy in patients with lower pulmonary arterial pressures who have been palliated with a Fontan procedure.Objective:Haemodynamic measurements and the results of acute vasodilator testing in a subset of patients were reviewed to determine whether some patients acutely respond more favourably to sildenafil and might be candidates for precision care with a phosphodiesterase V inhibitor long term.Materials and Methods:Heart catheterisation was performed in 11 patients with a Fontan procedure. Haemodynamic measurements were performed before and after treatment with intravenous sildenafil (mean 0.14, range 0.05–0.20 mg/kg). Results (mean ± standard deviation) were compared by paired and unpaired t-tests to identify statistically significant changes.Results:Sildenafil was acutely associated with changes in mean pulmonary arterial pressure, transpulmonary gradient, indexed blood flow, and indexed vascular resistance. Changes in mean pulmonary arterial pressure were greater for patients with a mean pulmonary arterial pressure greater than 14 mmHg compared to patients with a lower mean pulmonary arterial pressure. Changes in transpulmonary gradient were greater for patients with a transpulmonary gradient greater than 5 mmHg compared to patients with a lower transpulmonary gradient.Conclusion:Sildenafil acutely decreases mean pulmonary arterial pressure and transpulmonary gradient and causes greater acute changes in patients with higher mean pulmonary arterial pressures and transpulmonary gradients. Haemodynamic measurements and vasodilator testing might help to guide precision care following Fontan palliation.
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Youssef, Amir A., Shereen A. Machaly, Mohammed E. El-Dosoky e Nermeen M. El-Maghraby. "Respiratory symptoms in rheumatoid arthritis: relation to pulmonary abnormalities detected by high-resolution CT and pulmonary functional testing". Rheumatology International 32, n. 7 (3 aprile 2011): 1985–95. http://dx.doi.org/10.1007/s00296-011-1905-z.
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Raheja, Suraj, Hassan Nemeh, Celeste Williams, Cristina Tita, Yelena Selektor, Themistokles Chamogeorgiakis e David Lanfear. "Pulmonary Function Testing and Outcomes after Left Ventricular Assist Device Implantation". Heart Surgery Forum 22, n. 3 (8 maggio 2019): E202—E206. http://dx.doi.org/10.1532/hsf.2299.
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Background: Pulmonary function testing (PFT) is often done during workup prior to left ventricular assist devices (LVAD), but its utility for predicting outcomes and changes in pulmonary function post-LVAD is not well established. We assessed the association of baseline PFT metrics with outcomes after LVAD, and quantified the changes in PFTs post-LVAD.
Methods and results: A retrospective study of 178 patients receiving continuous flow LVADs was conducted. A total of 129 subjects had baseline PFT data and 54 of these had repeat tests after LVAD. We collected PFT data (FEV1, FVC, FEV1/FVC ratios, and DLCO) at baseline and post-LVAD, and tested the association with survival, right heart failure, quality of life (Kansas City Cardiomyopathy Questionnaire [KCCQ]) and functional capacity (six-minute walking distance [6MWD]). Proportional hazards and linear regressions determined relationships between baseline PFT data and survival time and functional outcomes, respectively. Paired t-tests compared pre- and post- LVAD PFT variables. There was no association of baseline PFT parameters with survival time post-LVAD (all P > .2), nor the incidence of perioperative RV failure (all P > .15). There were no significant associations of the baseline PFT metrics with the change in KCCQ or 6MWD. There were statistically significant declines in FEV1, FEV1/FVC ratio, and DLCO after LVAD (P < .05).
Conclusion: In this single center study, there was no relationship between baseline PFTs and post-LVAD outcomes, and PFT parameters often worsened after LVAD. Further studies are needed to determine whether PFTs are useful in this setting, and what, if any, impact LVAD therapy has on pulmonary function.
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Ruigrok, Dieuwertje, Natalia J. Braams, Esther J. Nossent, Peter I. Bonta, Anco Boonstra, Rutger J. Lely, Frederikus A. Klok et al. "Dynamic vascular changes in chronic thromboembolic pulmonary hypertension after pulmonary endarterectomy". Pulmonary Circulation 10, n. 4 (ottobre 2020): 204589402090788. http://dx.doi.org/10.1177/2045894020907883.
Testo completoAbstract (sommario):
Residual pulmonary hypertension is an important sequela after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Recurrent thrombosis or embolism could be a contributor to this residual pulmonary hypertension but the potential extent of its role is unknown in part because data on incidence are lacking. We aimed to analyze the incidence of new intravascular abnormalities after pulmonary endarterectomy and determine hemodynamic and functional implications. A total of 33 chronic thromboembolic pulmonary hypertension patients underwent routine CT pulmonary angiography before and six months after pulmonary endarterectomy, together with right heart catheterization and exercise testing. New vascular lesions were defined as (1) a normal pulmonary artery before pulmonary endarterectomy and containing a thrombus, web, or early tapering six months after pulmonary endarterectomy or (2) a pulmonary artery already containing thrombus, web, or early tapering at baseline, but increasing six months after pulmonary endarterectomy. Nine of 33 (27%) chronic thromboembolic pulmonary hypertension patients showed new vascular lesions on CT pulmonary angiography six months after pulmonary endarterectomy. In a subgroup of patients undergoing CT pulmonary angiography 18 months after pulmonary endarterectomy, no further changes in lesions were noted. Hemodynamic and functional outcomes were not different between patients with and without new vascular lesions. New vascular lesions are common after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension; currently their origin, dynamics, and long-term consequences remain unknown.
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Martyniuk, T. V., I. E. Chazova e S. N. Nakonechnikov. "Pulmonary hypertension: current issues of diagnosis and treatment". Eurasian heart journal, n. 1 (30 marzo 2011): 6–12. http://dx.doi.org/10.38109/2225-1685-2011-1-6-12.
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Pulmonary hypertension (PH) is the group of diseases characterized by progressive increase of pulmonary vascular resistance leading to right heart failure and premature death of patients. This review represents the modern clinical and functional classifications, diagnostic algorithm with four main steps. The 1st step -PH suspicion- includes the analysis of clinical symptoms, physical examination, screening and occasional findings. The 2nd step - PH diagnosis verification- requires some instrumental methods performance, such as ECG, transthoracic echo, chest X-ray, right heart catheterization with acute pharmacological testing. The 3rd step means clinical class determination on the basis of lung function tests, ventilation-perfusion scan, CT and angiopulmonography. The 4th step task is PH type clarification (lab and functional testing, abdomen ultrasound). The PH treatment has always been a real challenge for physicians. Traditional therapy with calcium channel blockers, anticoagulants diuretics, oxygen often fails to help the patients effectively, to prolong their life, to improve its quality. Lately, on increasing of the number of randomized controlled studies in this field, the situation has been changed greatly. In the clinical practice there used the drugs for the treatment of pulmonary arterial hypertension-endothelin receptors antagonists, prostanoids, phosphodiesterase type 5 inhibitors.
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Rafferty, Anthony, Bernard Donne, Patrick Kiely e Neil Fleming. "Functional deficits in post-operative adolescent idiopathic scoliosis". Physiotherapy Practice and Research 41, n. 2 (11 gennaio 2021): 133–41. http://dx.doi.org/10.3233/ppr-190365.
Testo completoAbstract (sommario):
BACKGROUND: Little or no research currently exists investigating musculoskeletal strength, joint flexibility and cardiopulmonary capacity post-operative adolescent idiopathic scoliosis (AIS) patients. PURPOSE: To explore if AIS patients following spinal fusion surgery have deficiencies in strength, endurance joint flexibility and pulmonary capacity (>12-month post-operative) compared to a matched sample of the general population. METHODS: This retrospective case control study; AIS group (n = 20) and control group (n = 20) matched for gender, age and anthropometrics. Participants underwent standardised tests to establish pulmonary capacity via spirometry, upper and lower limb strength via manual muscle testing, upper and lower limb endurance via press-up and wall squat tests and joint flexibility via manual goniometry. Within session reliability and reproducibility of variables were assessed. RESULTS: No significant differences between AIS and control cohorts were identified for mass (57.1±9.0 vs. 62.8±9.0kg), height (164.7±6.3 vs. 165.6±6.0cm) or BMI (21.2±4.0 vs. 22.9±2.7). Pulmonary and musculoskeletal deficiencies in the AIS cohort were identified, including significantly lower forced vital capacity (FVC; 2.6±0.5 vs. 3.3±0.5L, P < 0.001) and forced expiratory volume in 1 second (FEV1, 2.8±0.6 vs. 3.3±0.5L, P < 0.001); restrictions in shoulder flexion (P < 0.01) and internal rotation (P < 0.001) weaker bilateral pinch grip (P < 0.01) and bilateral hip adductor strength (P < 0.01). CONCLUSION: The results highlight that AIS patients still have major pulmonary and musculoskeletal impairments over a year after spinal fusion surgery. Clinicians should consider periodic assessment of pulmonary and musculoskeletal function with comparison to these age-matched reference values in order to improve the post-operative rehabilitation process.
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Ferrazza, A. M., D. Martolini, G. Valli e P. Palange. "Cardiopulmonary Exercise Testing in the Functional and Prognostic Evaluation of Patients with Pulmonary Diseases". Respiration 77, n. 1 (2009): 3–17. http://dx.doi.org/10.1159/000186694.
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Saynor, Zoe L., Mathieu Gruet, Melitta A. McNarry, Brenda Button, Lisa Morrison, Marlies Wagner, Abbey Sawyer, Helge Hebestreit, Thomas Radtke e Don S. Urquhart. "Guidance and standard operating procedures for functional exercise testing in cystic fibrosis". European Respiratory Review 32, n. 169 (9 agosto 2023): 230029. http://dx.doi.org/10.1183/16000617.0029-2023.
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Regular exercise testing is recommended for all people with cystic fibrosis (PwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in PwCF and has led to the development of novel exercise tests which may be applied to PwCF. This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for PwCF. Importantly, this document also highlights previously used tests that are no longer suggested for PwCF and areas where research is mandated. This collaboration, on behalf of the European Cystic Fibrosis Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of PwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated.
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Oliveira, Rudolf K. F., Mariana Faria-Urbina, Bradley A. Maron, Mario Santos, Aaron B. Waxman e David M. Systrom. "Functional impact of exercise pulmonary hypertension in patients with borderline resting pulmonary arterial pressure". Pulmonary Circulation 7, n. 3 (8 giugno 2017): 654–65. http://dx.doi.org/10.1177/2045893217709025.
Testo completoAbstract (sommario):
Borderline resting mean pulmonary arterial pressure (mPAP) is associated with adverse outcomes and affects the exercise pulmonary vascular response. However, the pathophysiological mechanisms underlying exertional intolerance in borderline mPAP remain incompletely characterized. In the current study, we sought to evaluate the prevalence and functional impact of exercise pulmonary hypertension (ePH) across a spectrum of resting mPAP’s in consecutive patients with contemporary resting right heart catheterization (RHC) and invasive cardiopulmonary exercise testing. Patients with resting mPAP <25 mmHg and pulmonary arterial wedge pressure ≤15 mmHg (n = 312) were stratified by mPAP < 13, 13–16, 17–20, and 21–24 mmHg. Those with ePH (n = 35) were compared with resting precapillary pulmonary hypertension (rPH; n = 16) and to those with normal hemodynamics (non-PH; n = 224). ePH prevalence was 6%, 8%, and 27% for resting mPAP 13–16, 17–20, and 21–24 mmHg, respectively. Within each of these resting mPAP epochs, ePH negatively impacted exercise capacity compared with non-PH (peak oxygen uptake 70 ± 16% versus 92 ± 19% predicted, P < 0.01; 72 ± 13% versus 86 ± 17% predicted, P < 0.05; and 64 ± 15% versus 82 ± 19% predicted, P < 0.001, respectively). Overall, ePH and rPH had similar functional limitation (peak oxygen uptake 67 ± 15% versus 68 ± 17% predicted, P > 0.05) and similar underlying mechanisms of exercise intolerance compared with non-PH (peak oxygen delivery 1868 ± 599 mL/min versus 1756 ± 720 mL/min versus 2482 ± 875 mL/min, respectively; P < 0.05), associated with chronotropic incompetence, increased right ventricular afterload and signs of right ventricular/pulmonary vascular uncoupling. In conclusion, ePH is most frequently found in borderline mPAP, reducing exercise capacity in a manner similar to rPH. When borderline mPAP is identified at RHC, evaluation of the pulmonary circulation under the stress of exercise is warranted.
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Powell, Adam W., Wayne A. Mays, Sandra K. Knecht e Clifford Chin. "Pulmonary effects on exercise testing in tetralogy of Fallot patients repaired with a transannular patch". Cardiology in the Young 29, n. 2 (26 novembre 2018): 133–39. http://dx.doi.org/10.1017/s1047951118001920.
Testo completoAbstract (sommario):
AbstractBackgroundA transannular patch is often used in the contemporary surgical repair of tetralogy of Fallot. This can lead to significant pulmonary insufficiency and increased right ventricular volumes and ultimately pulmonary valve replacement. Cardiopulmonary exercise testing is used to assess exercise capacity in tetralogy of Fallot patients before pulmonary valve replacement. There is only few published literatures on how lung function affects functional capacity in tetralogy of Fallot patients repaired with a transannular patch.MethodsA retrospective chart review was done from 2015 to 2017 on patients with tetralogy of Fallot who underwent maximal effort cardiopulmonary exercise testing with cycle ergometry and with concurrent pulmonary function testing. Tetralogy of Fallot patients repaired with a transannular patch without pulmonary valve replacement were compared with age, gender, and size-matched normal controls.ResultsIn the tetralogy of Fallot group, 24 out of 57 patients underwent primary repair with a transannular patch. When compared to the normal controls, they demonstrated abnormal predicted forced expiratory volume in one second (79 ± 23.1% versus 90.7 ± 14.1%, p<0.05), predicted maximal voluntary ventilation (74 ± 18% versus 90.5 ± 16.2%, p<0.05) while having low-normal predicted forced vital capacity (80.5 ± 17.2% versus 90.2 ± 12.4%, p<0.05) and normal breathing reserve percentage (50.3 ± 11.3% versus 47.5 ± 17.3%, p = 0.52). Cardiopulmonary exercise testing abnormalities included significantly lower percent predicted oxygen consumption (63.2 ± 12.2% versus 87 ± 12.1%, p<0.05), maximal heart rate (171.8 ± 18.9 versus 184.6 ± 13.6, p<0.05), and percent predicted maximum workload (61.7 ± 15.9% versus 88.3 ± 21.5%, p<0.05).ConclusionsTetralogy of Fallot patients repaired with a transannular patch can have abnormal pulmonary function testing with poor exercise capacity in addition to chronotropic incompetence and impaired muscular power.
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Szász, Zsuzsánna Ágnes, Enikő Székely-Vass, Gyopár Horváth e Mădălina Hozoi. "Chalk-induced Lung Fibrosis — Case Report". Journal of Interdisciplinary Medicine 2, n. 4 (1 dicembre 2017): 357–61. http://dx.doi.org/10.1515/jim-2017-0089.
Testo completoAbstract (sommario):
Abstract Introduction: Our article underlines the importance of a good professional anamnesis, knowing all the chemical components with which the patient had been exposed to during her active life as a teacher. Case presentation: A 64-year-old female patient, teacher for 27 years, who had been retired for six years, presented cough with white phlegm and shortness of breath occurring during physical exertion, diffuse thoracic pain, and fatigue. Several lung functional tests were performed, which established the diagnosis of irreversible minor mixed ventilatory dysfunction. In order to establish the etiology of the patient’s symptoms, multiple clinical, laboratory, imaging, and functional investigations were performed including a chest radiograph, pulmonary functional testing, bronchial reversibility testing, a thoracic CT scan, fibrobronchoscopy, alveolar-capillary diffusion capacity measurement, otorhinolaryngology examination, thyroid ultrasound, as well as a cardiological consult. Finally, a positive diagnosis was established: bronchial hyperreactivity syndrome, chalk dust-induced diffuse pulmonary fibrosis. Conclusion: An essential part of clinical practice is a proper anamnesis, including detailed information on the professional history and exposure, as well as the composition of the dust/particles with which the patient had been in contact with.
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Yarovoy, Sergey Y., Irina E. Chazova, Yuri G. Matchin e Nikolay M. Danilov. "Parameters of acute vasoreactivity testing after balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension". Systemic Hypertension 17, n. 3 (28 ottobre 2020): 53–58. http://dx.doi.org/10.26442/2075082x.2020.3.200418.
Testo completoAbstract (sommario):
Aim.To study the effect of balloon pulmonary angioplasty (BPA) on the changes of pulmonary artery pressure, cardiac output and structural parameters of pulmonary arteries after acute vasoreactivity testing (AVT) in inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH).
Materials and methods.The prospective study included 22 patients with inoperable CTEPH. 11 patients underwent intravascular ultrasound (IVUS) of the pulmonary arteries. The assessment of clinical and hemodynamic parameters, vasoreactivity, structural parameters of the pulmonary arteries according to IVUS data was performed at 2 visits before the first BPA and after a series of BPA.
Results.The patients underwent 2.31.4 stages of BPA. The follow up was 160 (85; 248) days. Positive changes after a series of BPA were revealed in clinical (functional class, distance in the 6-minute walk test, level of brain natriuretic peptide) and hemodynamic (systolic and mean pulmonary artery pressure, right atrium pressure, etc.) parameters. The results of the AVT after BPA demonstrated a decrease in the portion of non-responders from 63.6 to 55.5%, and a group of responders (16.7%) has appeared. According to IVUS before and after AVT, the response to iloprost administration was observed basically in branches of subsegmental pulmonary arteries and initially corresponded to the process of vasodilation. However, after a series of BPA there was noted a paradoxical reaction in the middle section after the AVT a decrease in the vessel lumen and an increase in the thickness and area of the vessel wall. This effect is probably associated with the response to the test at the level of the microvasculature, as in pulmonary arterial hypertension before the onset of its pronounced structural changes. The data obtained confirm the reverse remodeling of the pulmonary vessels and the restoration of vasoreactivity after a series of BPA.
Conclusion.BPA improves clinical and hemodynamic parameters, as well as pulmonary vasoreactivity, in inoperable patients with CTEPH. AVT may be included in the recommendations for the examination of patients with CTEPH to assess the effectiveness of BPA and determine the disease prognosis.
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Warheit, D. B., M. A. Hartsky e M. S. Stefaniak. "Comparative physiology of rodent pulmonary macrophages: in vitro functional responses". Journal of Applied Physiology 64, n. 5 (1 maggio 1988): 1953–59. http://dx.doi.org/10.1152/jappl.1988.64.5.1953.
Testo completoAbstract (sommario):
Since toxicological testing of inhaled materials frequently requires utilization of several species, we have investigated pulmonary macrophage (PM) functional responses and compared the rat model with other rodents. Two strains of rats, three strains of mice, and one strain each of hamster and guinea pig were used in this study. The numbers of recovered cells by bronchoalveolar lavage generally correlated with animal body weight. The one exception was the Syrian Golden hamster from which increased numbers of macrophages were recovered. Cellular differential data obtained from lavaged cytocentrifuge preparations demonstrated that PM's account for greater than 97% of recoverable free lung cells for all species except the guinea pig, which contains a resident population of eosinophils. Cell morphology studies indicated that hamster PM exhibited the highest proportion of ruffled PM and demonstrated the highest phagocytic activity, whereas mouse PM phagocytic activity was significantly reduced compared with the other three species. In addition, chemotaxis studies showed that rat PM migrated best to zymosan-activated, complement-dependent chemoattractants, whereas hamster PM demonstrated an enhanced chemotactic response to N-formyl peptides. The results of these studies suggest that the rat may be the most efficient species for clearing inhaled particles, whereas hamsters and guinea pigs may best respond to bacteria.
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Boon, Gudula J. A. M., Menno V. Huisman e Frederikus A. Klok. "Determinants and Management of the Post–Pulmonary Embolism Syndrome". Seminars in Respiratory and Critical Care Medicine 42, n. 02 (6 febbraio 2021): 299–307. http://dx.doi.org/10.1055/s-0041-1722964.
Testo completoAbstract (sommario):
AbstractAcute pulmonary embolism (PE) is not only a serious and potentially life-threatening disease in the acute phase, in recent years it has become evident that it may also have a major impact on a patient's daily life in the long run. Persistent dyspnea and impaired functional status are common, occurring in up to 50% of PE survivors, and have been termed the post-PE syndrome (PPES). Chronic thromboembolic pulmonary hypertension is the most feared cause of post-PE dyspnea. When pulmonary hypertension is ruled out, cardiopulmonary exercise testing can play a central role in investigating the potential causes of persistent symptoms, including chronic thromboembolic pulmonary disease or other cardiopulmonary conditions. Alternatively, it is important to realize that post-PE cardiac impairment or post-PE functional limitations, including deconditioning, are present in a large proportion of patients. Health-related quality of life is strongly influenced by PPES, which emphasizes the importance of persistent limitations after an episode of acute PE. In this review, physiological determinants and the diagnostic management of persistent dyspnea after acute PE are elucidated.
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Gawlitza, Joshua, Timo Sturm, Kai Spohrer, Thomas Henzler, Ibrahim Akin, Stefan Schönberg, Martin Borggrefe, Holger Haubenreisser e Frederik Trinkmann. "Predicting Pulmonary Function Testing from Quantified Computed Tomography Using Machine Learning Algorithms in Patients with COPD". Diagnostics 9, n. 1 (21 marzo 2019): 33. http://dx.doi.org/10.3390/diagnostics9010033.
Testo completoAbstract (sommario):
Introduction: Quantitative computed tomography (qCT) is an emergent technique for diagnostics and research in patients with chronic obstructive pulmonary disease (COPD). qCT parameters demonstrate a correlation with pulmonary function tests and symptoms. However, qCT only provides anatomical, not functional, information. We evaluated five distinct, partial-machine learning-based mathematical models to predict lung function parameters from qCT values in comparison with pulmonary function tests. Methods: 75 patients with diagnosed COPD underwent body plethysmography and a dose-optimized qCT examination on a third-generation, dual-source CT with inspiration and expiration. Delta values (inspiration—expiration) were calculated afterwards. Four parameters were quantified: mean lung density, lung volume low-attenuated volume, and full width at half maximum. Five models were evaluated for best prediction: average prediction, median prediction, k-nearest neighbours (kNN), gradient boosting, and multilayer perceptron. Results: The lowest mean relative error (MRE) was calculated for the kNN model with 16%. Similar low MREs were found for polynomial regression as well as gradient boosting-based prediction. Other models led to higher MREs and thereby worse predictive performance. Beyond the sole MRE, distinct differences in prediction performance, dependent on the initial dataset (expiration, inspiration, delta), were found. Conclusion: Different, partially machine learning-based models allow the prediction of lung function values from static qCT parameters within a reasonable margin of error. Therefore, qCT parameters may contain more information than we currently utilize and can potentially augment standard functional lung testing.
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Gille, Thomas, e Pierantonio Laveneziana. "Cardiopulmonary exercise testing in interstitial lung diseases and the value of ventilatory efficiency". European Respiratory Review 30, n. 162 (30 novembre 2021): 200355. http://dx.doi.org/10.1183/16000617.0355-2020.
Testo completoAbstract (sommario):
Interstitial lung diseases (ILDs) are diverse parenchymal pulmonary disorders, primarily characterised by alveolar and interstitial inflammation and/or fibrosis, and sharing pathophysiological similarities. Thus, patients generally harbour common respiratory symptoms, lung function abnormalities and modified exercise adaptation. The most usual and disabling complaint is exertional dyspnoea, frequently responsible for premature exercise interruption. Cardiopulmonary exercise testing (CPET) is increasingly used for the clinical assessment of patients with ILD. This is because exercise performance or dyspnoea on exertion cannot reliably be predicted by resting pulmonary function tests. CPET, therefore, provides an accurate evaluation of functional capacity on an individual basis. CPET can unmask anomalies in the integrated functions of the respiratory, cardiovascular, metabolic, peripheral muscle and neurosensory systems in ILDs. CPET uniquely provides an evaluation of all above aspects and can help clinicians shape ILD patient management. Preliminary evidence suggests that CPET may also generate valuable prognostic information in ILDs and can be used to shed light on the presence of associated pulmonary hypertension. This review aims to provide comprehensive and updated evidence concerning the clinical utility of CPET in ILD patients, with particular focus on the physiological and clinical value of ventilatory efficiency (V˙E/V˙CO2).
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Leo, Fabian, Dag Wormanns e Christian Grohé. "COVID-19 aus Sicht der Pneumologie – Langzeitfolgen und Implikationen für die pneumologische Nachsorge". DMW - Deutsche Medizinische Wochenschrift 145, n. 15 (luglio 2020): 1086–92. http://dx.doi.org/10.1055/a-1164-4040.
Testo completoAbstract (sommario):
AbstractThe long-term sequelae of COVID-19 on are not yet predictable. Radiological and histopathological data on COVID-19 and observational studies after the SARS-CoV-1 pandemic 2003/2004 suggest that in a proportion of COVID-19 patients, functional limitations due to pulmonary fibrosis and other patterns of lung damage may persist. Systematic follow-up, based on prudent pulmonary function testing, is warranted for the correct diagnosis, graduation and treatment of the underlying pathology at an early stage. This review summarizes the potential spectrum of Post-COVID-19 pulmonary disease patterns and provides recommendations for the follow-up care of COVID-19 patients in the field of respiratory medicine.
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Ari Rifqi, Muhammad, Sri Endang Anjarwani e Ari Hernawan. "Analysis of Automation Testing Using Repeato for Functional Testing of the Yess Nutrition Application Based on Flutter". E3S Web of Conferences 465 (2023): 02036. http://dx.doi.org/10.1051/e3sconf/202346502036.
Testo completoAbstract (sommario):
Automated testing has the advantage of executing test cases faster than manual testing and has a higher accuracy rate because it can detect more defects in the application. Automated testing is also effective for regression testing performed when there is a fix or update, to ensure that the fix does not cause new bugs to appear in the system. Therefore, automated testing becomes essential to replace manual testing. Automated testing involves the use of testing tools or frameworks that can reduce the time required in the testing process. This paper reviews Repeato software as an automatic testing tool, where Repeato works based on Computer vision. Experiments were conducted to see the test steps and results of the application display rendering time using the Repeato tool. The advantage of Repeato lies in its ability to automate visualbased testing, which can save the time and effort required in manual testing. However, as is the case with other testing tools, Repeato also has its limitations and drawbacks. Repeatos may not be able to recognize visual elements that are very complex or have arbitrary patterns. Repeato can conduct two rounds of tests on the Yess Nutrition application within 216 seconds, which is equivalent to 3.6 minutes.
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Chushkin, Mikhail Ivanovich, e Oleg Nikolayevich Ots. "Impaired pulmonary function after treatment for tuberculosis: the end of the disease?" Jornal Brasileiro de Pneumologia 43, n. 1 (febbraio 2017): 38–43. http://dx.doi.org/10.1590/s1806-37562016000000053.
Testo completoAbstract (sommario):
ABSTRACT Objective: To evaluate the prevalence of pulmonary function abnormalities and to investigate the factors affecting lung function in patients treated for pulmonary tuberculosis. Methods: A total of 214 consecutive patients (132 men and 82 women; 20-82 years of age), treated for pulmonary tuberculosis and followed at a local dispensary, underwent spirometry and plethysmography at least one year after treatment. Results: Pulmonary impairment was present in 102 (47.7%) of the 214 patients evaluated. The most common functional alteration was obstructive lung disease (seen in 34.6%). Of the 214 patients, 60 (28.0%) showed reduced pulmonary function (FEV1 below the lower limit of normal). Risk factors for reduced pulmonary function were having had culture-positive pulmonary tuberculosis in the past, being over 50 years of age, having recurrent tuberculosis, and having a lower level of education. Conclusions: Nearly half of all tuberculosis patients evolve to impaired pulmonary function. That underscores the need for pulmonary function testing after the end of treatment.
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Valenzuela, Ignacio, Katerina Zapletalova, Marnel Greyling, Yannick Regin, Andre Gie, David Basurto, Jan Deprest e Johannes van der Merwe. "Fetal Growth Restriction Impairs Lung Function and Neurodevelopment in an Early Preterm Rabbit Model". Biomedicines 11, n. 1 (5 gennaio 2023): 139. http://dx.doi.org/10.3390/biomedicines11010139.
Testo completoAbstract (sommario):
We previously reported the multi-system sequelae of fetal growth restriction, induced by placental underperfusion, in near-term born rabbits, in the immediate neonatal period and up to pre-adolescence. Herein, we describe the pulmonary and neurodevelopmental consequences of FGR in rabbits born preterm. We hypothesize that FGR has an additional detrimental effect on prematurity in both pulmonary function and neurodevelopment. FGR was induced at gestational day (GD) 25 by placental underperfusion, accomplished by partial uteroplacental vessel ligation in one uterine horn. Rabbits were delivered by cesarean section at GD 29, and placentas were harvested for histology. Neonates underwent neurobehavioral or pulmonary functional assessment at postnatal day 1, followed by brain or lung harvesting, respectively. The neurodevelopmental assessment included neurobehavioral testing and multiregional quantification of cell density and apoptosis in the brain. Lung assessment included functional testing, alveolar morphometry, and airway histology. FGR was associated with higher perinatal mortality, lower birth and placental weight, and a similar brain-to-body weight ratio compared to controls. Placental underperfusion decreased labyrinth and junction zone volumes in FGR placentas. FGR impaired pulmonary function, depicted by higher parenchymal resistance, damping, and elastance. Alveolar morphometry and airway smooth muscle content were comparable between groups. Neurobehavioral tests showed motoric and sensorial impairment in FGR rabbits. In FGR brains, cell density was globally reduced, with higher apoptosis in selected areas. In conclusion, in preterm-born rabbits, placental underperfusion leads to higher mortality, FGR, and impaired lung and brain development in early assessment. This study complements previous findings of placental, pulmonary, and neurodevelopmental impairment in near-term born rabbits in this model.
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Caicedo, Lina, Rachel Hopper, Humberto Garcia Aguilar, Dunbar Ivy, Dora Haag, Jeff Fineman, Tillman Humpl et al. "Acute vasoreactivity testing in pediatric idiopathic pulmonary arterial hypertension: an international survey on current practice". Pulmonary Circulation 9, n. 4 (ottobre 2019): 204589401985753. http://dx.doi.org/10.1177/2045894019857533.
Testo completoAbstract (sommario):
The aim of this study was to determine practice patterns and inter-institutional variability in how acute vasoreactivity testing (AVT) is performed and interpreted in pediatrics throughout the world. A survey was offered to physicians affiliated with the Pediatric & Congenital Heart Disease Taskforce of the Pulmonary Vascular Research Institute (PVRI), the Pediatric Pulmonary Hypertension Network (PPHNET), or the Spanish Registry for Pediatric Pulmonary Hypertension (REHIPED), from February to December 2016. The survey requested data about the site-specific protocol for AVT and subsequent management of pediatric patients with idiopathic pulmonary arterial hypertension (IPAH) or heritable PAH (HPAH). Twenty-eight centers from 13 countries answered the survey. AVT is performed in most centers using inhaled nitric oxide (iNO). Sitbon criteria was used in 39% of the centers, Barst criteria in 43%, and other criteria in 18%. First-line therapy for positive AVT responders in functional class (FC) I/II was calcium channel blocker (CCB) in 89%, but only in 68% as monotherapy. Most centers (71%) re-evaluated AVT-positive patients hemodynamics after 6–12 months; 29% of centers re-evaluated based only on clinical criteria. Most centers (64%) considered a good response as remaining in FC I or II, with near normalization of pulmonary arterial pressure and pulmonary vascular resistance, but a stable FC I/II alone was sufficient criteria in 25% of sites. Protocols and diagnostic criteria for AVT, and therapeutic approaches during follow-up, were highly variable across the world. Reported clinical practice is not fully congruent with current guidelines, suggesting the need for additional studies that better define the prognostic value of AVT for pediatric IPAH patients.
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Dougherty, Cynthia M., Bonnie G. Steele e Jim Hunziker. "Testing an Intervention to Improve Functional Capability in Advanced Cardiopulmonary Illness". Journal of Cardiopulmonary Rehabilitation and Prevention 31, n. 1 (2011): 35–41. http://dx.doi.org/10.1097/hcr.0b013e3181f1fd77.
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Vieira, Ana Karine, Cristina Gonçalves Alvim, Maria Cristina Marquez Carneiro e Cássio da Cunha Ibiapina. "Pulmonary function in children and adolescents with sickle cell disease: have we paid proper attention to this problem?" Jornal Brasileiro de Pneumologia 42, n. 6 (dicembre 2016): 409–15. http://dx.doi.org/10.1590/s1806-37562016000000057.
Testo completoAbstract (sommario):
ABSTRACT Objective: To evaluate pulmonary function and functional capacity in children and adolescents with sickle cell disease. Methods: This was a cross-sectional study involving 70 children and adolescents (8-15 years of age) with sickle cell disease who underwent pulmonary function tests (spirometry) and functional capacity testing (six-minute walk test). The results of the pulmonary function tests were compared with variables related to the severity of sickle cell disease and history of asthma and of acute chest syndrome. Results: Of the 64 patients who underwent spirometry, 15 (23.4%) showed abnormal results: restrictive lung disease, in 8 (12.5%); and obstructive lung disease, in 7 (10.9%). Of the 69 patients who underwent the six-minute walk test, 18 (26.1%) showed abnormal results regarding the six-minute walk distance as a percentage of the predicted value for age, and there was a ≥ 3% decrease in SpO2 in 36 patients (52.2%). Abnormal pulmonary function was not significantly associated with any of the other variables studied, except for hypoxemia and restrictive lung disease. Conclusions: In this sample of children and adolescents with sickle cell disease, there was a significant prevalence of abnormal pulmonary function. The high prevalence of respiratory disorders suggests the need for a closer look at the lung function of this population, in childhood and thereafter.
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Sagaydak, O. V., N. M. Danilov, Yu G. Matchin, T. V. Martynyuk e I. E. Chazova. ""Grey zone" of vasoreactivity during acute vasodilator testing in patients with pulmonary hypertension". Systemic Hypertension 13, n. 2 (15 giugno 2016): 73–76. http://dx.doi.org/10.26442/sg29146.
Testo completoAbstract (sommario):
Aim - to analyze functional status and hemodynamic changes in patients who demonstrate vasoreactivity but doesn’t reach the criteria of "positive respond" ("grey zone") and to compare this data with "responders" and "true non-responders". Material and methods. We enrolled 159 patients with pulmonary hypertension. Right heart catheterization with acute vasodilator testing was performed in all cases. Depending on hemodynamic respond during acute vasoreactivity testing patients were divided in to three groups: "responders", "true non-responders" and patients in the "grey zone". The following parameters were analyzed in all included patients: basic clinical parameters, hemodynamic changes, right ventricle size, right atrium area, 6-minute walking test distance and time to clinical worsening. Results. In our study it was shown that patients of "grey zone" had several clinical and hemodynamic parameters that differ significantly from patients "responders" and "true non-responders". Patients in the "grey zone" also have the longest time to clinical worsening.
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Powell, Adam W., Wayne A. Mays e Clifford Chin. "Functional Capacity Is Affected by Younger Age of Repair in Tetralogy of Fallot Patients But Not by Era of Repair". World Journal for Pediatric and Congenital Heart Surgery 10, n. 6 (novembre 2019): 715–21. http://dx.doi.org/10.1177/2150135119878034.
Testo completoAbstract (sommario):
Background:Cardiopulmonary exercise testing is widely used to assess functional capacity in patients with tetralogy of Fallot after surgical repair. Little is known regarding the impact of age at the time of primary complete repair and surgical era effect on exercise capacity.Methods:A retrospective, single-center chart review was done from 1976 to 2016 on pediatric patients with tetralogy of Fallot who underwent cardiopulmonary exercise testing with cycle ergometry utilizing the James protocol and were then sorted by repair before/after 1990 and by age of complete repair before/after one year. Exclusion criteria included submaximal tests, incomplete data, previous pulmonary valve replacement, and surgery prior to complete repair (ie, Blalock-Taussig shunt placement).Results:When comparing the groups who underwent primary complete repair before (N = 39) and after (N = 26) one year of age, the younger group demonstrated a higher percentage of predicted peak oxygen consumption ([Formula: see text] o2peak; 83.1% ± 11.8% vs 73.1% ± 16.1%; P = .005) despite having worse pulmonary insufficiency at the time of exercise testing. There were no differences in heart rate and blood pressure response. Age of repair was independently associated with [Formula: see text] o2peak. Data were statistically similar to the study eras (repair before 1990, N = 23; repair after 1990, N = 65): percentage of predicted [Formula: see text] o2peak (81.4% ± 13.6% vs 79.1% ± 14.4%, P = .5), maximal systolic blood pressure (155.1 ± 22.4 mm Hg vs 153.9 ± 17 mm Hg, P = .8), and percentage of predicted maximal heart rate (89.8% ± 9% vs 92% ± 7.1%, P = .3).Conclusions:Older age at primary repair appears to negatively impact [Formula: see text] o2peak; however, era effect does not appear to influence cardiopulmonary exercise testing outcomes.
33
Mathai, Stephen C. "A Rare Opportunity in a Rare Disease". Advances in Pulmonary Hypertension 16, n. 4 (1 gennaio 2018): 175–78. http://dx.doi.org/10.21693/1933-088x-16.4.175.
Testo completoAbstract (sommario):
Pulmonary hypertension (PH) is a chronic disease of the pulmonary vasculature, characterized by vessel remodeling that leads to increased pulmonary vascular resistance, right ventricular failure, and ultimately, death. While PH is somewhat simply defined as a mean pulmonary artery pressure (mPAP) on right heart catheterization (RHC) of greater than or equal to 25 mm Hg, the clinical, pathobiologic, and physiologic manifestations of the disease, and its subsequent impact on an individual patient, vary greatly. For example, while PH is defined by an elevated mPAP, current guidelines classify PH into 5 major categories, each with numerous subcategories based on clinical and physiologic features.1 Accordingly, proper classification of an individual patient requires an extensive evaluation that includes pulmonary function testing, submaximal exercise testing, several imaging studies, overnight oximetry, echocardiography, and ultimately, RHC. PH, regardless of etiology, imparts significant burden on patients, causing severe functional limitations and negatively impacting survival. Historically, in the era prior to the availability of specific pulmonary vasodilator therapies to treat patients with the rarest form of PH, pulmonary arterial hypertension, median survival was around 2 years.2 With the advent of targeted medical therapies over the past 30 years, the median survival has improved to more than 7 years.3 However, with these advances in therapies and the expanding availability of lung transplantation for most forms of PH, the complexity of care for patients with this disease has increased exponentially.
34
Weatherald, Jason, David Montani, Mitja Jevnikar, Xavier Jaïs, Laurent Savale e Marc Humbert. "Screening for pulmonary arterial hypertension in systemic sclerosis". European Respiratory Review 28, n. 153 (31 luglio 2019): 190023. http://dx.doi.org/10.1183/16000617.0023-2019.
Testo completoAbstract (sommario):
Pulmonary arterial hypertension (PAH) is a dreaded complication of systemic sclerosis (SSc) that occurs in ∼10% of patients. Most individuals present with severe symptoms, significant functional impairment and severe haemodynamics at diagnosis, and survival after PAH diagnosis is poor. Therefore, early diagnosis through systematic screening of asymptomatic patients has the potential to identify PAH at an early stage. Current evidence suggests that early diagnosis and treatment of PAH in patients with SSc may lead to better clinical outcomes. Annual screening may include echocardiography, but this can miss some patients due to suboptimal visualisation or insufficient tricuspid regurgitation. Other options for screening include the DETECT algorithm or the use of a combination of pulmonary function testing (forced vital capacity/diffusing capacity of the lung for carbon monoxide ratio) and N-terminal-pro-brain natriuretic peptide levels. Symptomatic patients, those with an elevated tricuspid regurgitation velocity on echocardiogram with or without secondary echocardiographic features of PAH, and those who screen positive on the DETECT or other pulmonary function test algorithms should undergo right heart catheterisation. Exercise echocardiography or cardiopulmonary exercise testing, nailfold capillaroscopy and molecular biomarkers are promising but, as yet, unproven potential options. Future screening studies should employ systematic catheterisation to define the true predictive values for PAH.
35
Samaranayake, Chinthaka Bhagya, John Upham, Khoa Tran, Luke S. Howard, Sean Nguyen, Myo Lwin, James Anderson et al. "Right ventricular functional recovery assessment with stress echocardiography and cardiopulmonary exercise testing after pulmonary embolism: a pilot prospective multicentre study". BMJ Open Respiratory Research 10, n. 1 (luglio 2023): e001637. http://dx.doi.org/10.1136/bmjresp-2023-001637.
Testo completoAbstract (sommario):
BackgroundData on right ventricular (RV) exercise adaptation following acute intermediate and high-risk pulmonary embolism (PE) remain limited. This study aimed to evaluate the symptom burden, RV functional recovery during exercise and cardiopulmonary exercise parameters in survivors of intermediate and high-risk acute PE.MethodsWe prospectively recruited patients following acute intermediate and high-risk PE at four sites in Australia and UK. Study assessments included stress echocardiography, cardiopulmonary exercise testing (CPET) and ventilation–perfusion (VQ) scan at 3 months follow-up.ResultsThirty patients were recruited and 24 (median age: 55 years, IQR: 22) completed follow-up. Reduced peak oxygen consumption (VO2) and workload was seen in 75.0% (n=18), with a persistent high symptom burden (mean PEmb-QoL Questionnaire 48.4±21.5 and emPHasis-10 score 22.4±8.8) reported at follow-up. All had improvement in RV-focused resting echocardiographic parameters. RV systolic dysfunction and RV to pulmonary artery (PA) uncoupling assessed by stress echocardiography was seen in 29.2% (n=7) patients and associated with increased ventilatory inefficiency (V̇E/V̇CO2slope 47.6 vs 32.4, p=0.03), peak exercise oxygen desaturation (93.2% vs 98.4%, p=0.01) and reduced peak oxygen pulse (p=0.036) compared with controls. Five out of seven patients with RV–PA uncoupling demonstrated persistent bilateral perfusion defects on VQ scintigraphy consistent with chronic thromboembolic pulmonary vascular disease.ConclusionIn our cohort, impaired RV adaptation on exercise was seen in almost one-third of patients. Combined stress echocardiography and CPET may enable more accurate phenotyping of patients with persistent symptoms following acute PE to allow timely detection of long-term complications.
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Amăricăi, Elena, Oana Suciu, Roxana Ramona Onofrei, Roxana Steliana Miclăuș, Radu Emil Iacob, Liliana Caţan, Călin Marius Popoiu, Simona Cerbu e Eugen Boia. "Respiratory function, functional capacity, and physical activity behaviours in children and adolescents with scoliosis". Journal of International Medical Research 48, n. 4 (31 dicembre 2019): 030006051989509. http://dx.doi.org/10.1177/0300060519895093.
Testo completoAbstract (sommario):
Objectives To assess pulmonary function and functional capacity in children and adolescents with mild or moderate idiopathic scoliosis who were included in a rehabilitation programme, and to observe some of their physical activity behaviours. Methods Forty children (aged 9–17 years) with mild or moderate idiopathic scoliosis (patients) and 40 sex- and age-matched healthy controls were included in the study. Physical activity behaviours (hours of time spent at a desk and at a computer, hours of competitive and non-competitive practice of exercise per week) were recorded. Patients were assessed before beginning rehabilitation and 12 weeks after an exercised-based programme by spirometry and functional capacity testing (6-minute walk test). Results All respiratory and functional capacity parameters were significantly increased after physical therapy compared with before beginning physical therapy in patients. However, there were still differences between patients and controls in all assessed parameters after therapy. Children and adolescents who were diagnosed with scoliosis spent a longer time at a computer, and had reduced regular and competitive physical exercise compared with controls. Conclusions In children and adolescents with mild/moderate idiopathic scoliosis, pulmonary parameters and functional capacity are improved after 12 weeks of supervised physical therapy.
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van der Feen, Diederik E., Beatrijs Bartelds, Rudolf A. de Boer e Rolf M. F. Berger. "Assessment of reversibility in pulmonary arterial hypertension and congenital heart disease". Heart 105, n. 4 (22 novembre 2018): 276–82. http://dx.doi.org/10.1136/heartjnl-2018-314025.
Testo completoAbstract (sommario):
Pulmonary arterial hypertension (PAH) in congenital heart disease (CHD) can be reversed by early shunt closure, but this potential is lost beyond a certain point of no return. Therefore, it is crucial to accurately assess the reversibility of this progressive pulmonary arteriopathy in an early stage. Reversibility assessment is currently based on a combination of clinical symptoms and haemodynamic variables such as pulmonary vascular resistance. These measures, however, are of limited predictive value and leave many patients in the grey zone. This review provides a concise overview of the mechanisms involved in flow-dependent progression of PAH in CHD and evaluates existing and future alternatives to more directly investigate the stage of the pulmonary arteriopathy. Structural quantification of the pulmonary arterial tree using fractal branching algorithms, functional imaging with intravascular ultrasound, nuclear imaging, putative new blood biomarkers, genetic testing and the potential for transcriptomic analysis of circulating endothelial cells and educated platelets are being reviewed.
38
&NA;. "Development and Testing of the Modified Version of the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M)". Journal of Cardiopulmonary Rehabilitation 19, n. 1 (gennaio 1999): 64. http://dx.doi.org/10.1097/00008483-199901000-00013.
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Puranik, R., V. T. Tsang, A. Broadley, J. Nordmeyer, P. Lurz, N. Muthialu, G. Derrick et al. "Functional outcomes after the Ross (pulmonary autograft) procedure assessed with magnetic resonance imaging and cardiopulmonary exercise testing". Heart 96, n. 4 (18 giugno 2009): 304–8. http://dx.doi.org/10.1136/hrt.2009.172965.
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Lareau, Suzanne C., Paula M. Meek e Philip J. Roos. "Development and testing of the modified version of the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M)". Heart & Lung 27, n. 3 (maggio 1998): 159–68. http://dx.doi.org/10.1016/s0147-9563(98)90003-6.
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Fidler, L., K. J. Keen, Z. Touma e S. Mittoo. "Impact of pulmonary disease on patient-reported outcomes and patient-performed functional testing in systemic lupus erythematosus". Lupus 25, n. 9 (3 febbraio 2016): 1004–11. http://dx.doi.org/10.1177/0961203316630818.
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Feshchenko, Y. I., e M. O. Polianska. "METHODS OF PULMONARY FUNCTION TESTING IN THE DIAGNOSIS AND MONITORING OF CHRONIC OBSTRUCTIVE LUNG DISEASE (SPIROMETRY, BODYPLETHISMOGRAPHY, DLCO) ACCORDING UPDATED GOLD-2024". Ukrainian Pulmonology Journal 32, n. 1 (2024): 24–31. http://dx.doi.org/10.31215/2306-4927-2024-32-1-24-31.
Testo completoAbstract (sommario):
Pulmonary function testing (PFT) is an integral component in the diagnosis of broncho-obstructive diseases. Spirometry is a mandatory method of pulmonary research, and chronic obstructive pulmonary disease (COPD) is the only respiratory nosology, the diagnosis of which is based on a change in functional indicators, which are measured precisely with the help of spirometry. With the help of spirometry, only the obstructive type of PFT violations can be clearly determined. But one can also suspect restrictive and mixed (presence of both restrictions and obstruction) types. To diagnose these disorders, an indicator of Total Lung Capacity (TLC) is required, which cannot be determined by spirometry, as it consists of TLC and Residual Lung Volume (RES), which is also not determined by spirometry. More complex and less widespread methods of investigation can determine these missing indicators: bodyplethysmography — it is a method of a wider study of lung volumes and capacities and makes it possible to measure general and specific bronchial resistance (Rtot, sRaw). It is not an indispensable condition for confirming obstructive disorders, but it can be useful for identifying underlying diseases and their functional consequences — an increase in TLC, RV or RV/TLC above the upper limit of normal variability allows to suspect the presence of emphysema, severe bronchial asthma, and also to assess the severity hyperinflation. Another important study for a more complete assessment of PFT — diffusion capacity of the lungs for carbon monoxide (DLCO); performed after forced spirometry (determination of FVC, VC) or bodyplethysmography (VC) and determination of the structure of static volumes. It is used in patients with restrictive and obstructive diseases, for the diagnosis of emphysema or pulmonary fibrosis. With the help of this study, the diffusion capacity of the lungs (DLCO) and the alveolar volume (Va) are determined. The article presents the results of research in which these methods were used and provides justification for their application. Conclusion. Different methods of PFT are important and complement each other in clinical practice Key words: chronic obstructive pulmonary disease, diagnosis, spirometry, bodyplethysmography, diffusion capacity of the lungs, Global initiative chronic obstructive pulmonary disease (GOLD).
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Зилов, V. Zilov, Черныш, I. Chernysh, Василенко, A. Vasilenko, Фролков e V. Frolkov. "Monitoring of the Functional State of Patients on the Magnitude of Testing Voltage in the Reference Point". Journal of New Medical Technologies 22, n. 4 (15 novembre 2015): 139–43. http://dx.doi.org/10.12737/17039.
Testo completoAbstract (sommario):
Reference principle of electropuncture diagnostics is based on prior determining the individual
testing voltage using the “reference” point with subsequent measurement of the currents in the acupuncture
points. This approach improves the accuracy of estimation of functional states in comparison with other
methods of electropuncture diagnostics and provides the necessary personalization of diagnostic procedures.
Based on analyzing and summarizing the experience of the clinical use of electropuncture diagnostics
ʺBioreperʺ, its new features are revealed. It is found that the magnitude of testing voltage in a reference point
is a non‐specific indicator of the level of health and the degree of distress the body. It is shown that the measurement
of testing voltage in the reference point allows to monitoring the functional status of patients, to
identifying the severity of pathological changes in the body and to assessing their dynamics during treatment
and rehabilitation. The close correlation between the magnitude of testing voltage and the severity of
pathogenesis reactions of cardiovascular disease, broncho‐pulmonary, digestive and musculoskeletal systems
was revealed. This phenomenon has been confirmed in animal studies (dogs) with the pathology of the stomach, pancreas and gall bladder. It is also found a direct correlation between the magnitude of testing
voltage in the reference point and the severity of pain.
44
Westhoff, Michael, Patric Litterst e Ralf Ewert. "Cardiopulmonary Exercise Testing in Combined Pulmonary Fibrosis and Emphysema". Respiration 100, n. 5 (2021): 395–403. http://dx.doi.org/10.1159/000513848.
Testo completoAbstract (sommario):
<b><i>Background:</i></b> Combined pulmonary fibrosis and emphysema (CPFE) is a distinct entity among fibrosing lung diseases with a high risk for lung cancer and pulmonary hypertension (PH). Notably, concomitant PH was identified as a negative prognostic indicator that could help with early diagnosis to provide important information regarding prognosis. <b><i>Objectives:</i></b> The current study aimed to determine whether cardiopulmonary exercise testing (CPET) can be helpful in differentiating patients having CPFE with and without PH. <b><i>Methods:</i></b> Patients diagnosed with CPFE in 2 German cities (Hemer and Greifswald) over a period of 10 years were included herein. CPET parameters, such as peak oxygen uptake (peak VO<sub>2</sub>), functional dead space ventilation (<i>V</i><sub>Df</sub>/<i>V</i><sub>T</sub>), alveolar-arterial oxygen difference (AaDO<sub>2</sub>), arterial-end-tidal CO<sub>2</sub> difference [P(a-ET)CO<sub>2</sub>] at peak exercise, and the minute ventilation-carbon dioxide production relationship (VE/VCO<sub>2</sub> slope), were compared between patients with and without PH. <b><i>Results:</i></b> A total of 41 patients with CPET (22 with PH, 19 without PH) were analyzed. Right heart catheterization was performed in 15 of 41 patients without clinically relevant complications. Significant differences in peak VO<sub>2</sub> (861 ± 190 vs. 1,397 ± 439 mL), VO<sub>2</sub>/kg body weight/min (10.8 ± 2.6 vs. 17.4 ± 5.2 mL), peak AaDO<sub>2</sub> (72.3 ± 7.3 vs. 46.3 ± 14.2 mm Hg), VE/VCO<sub>2</sub> slope (70.1 ± 31.5 vs. 39.6 ± 9.6), and peak P(a-ET)tCO<sub>2</sub> (13.9 ± 3.5 vs. 8.1 ± 3.6 mm Hg) were observed between patients with and without PH (<i>p</i> < 0.001). Patients with PH had significantly higher <i>V</i><sub>Df</sub>/<i>V</i><sub>T</sub> at rest, <i>V</i><sub>T1</sub>, and at peak exercise (65.6 ± 16.8% vs. 47.2 ± 11.6%; <i>p</i> < 0.001) than those without PH. A cutoff value of 44 for VE/VCO<sub>2</sub> slope had a sensitivity and specificity of 94.7 and 72.7%, while a cutoff value of 11 mm Hg for P(a-ET)CO<sub>2</sub> in combination with peak AaDO<sub>2</sub> >60 mm Hg had a specificity and sensitivity of 95.5 and 84.2%, respectively. Combining peak AaDO<sub>2</sub> >60 mm Hg with peak VO<sub>2</sub>/body weight/min <16.5 mL/kg/min provided a sensitivity and specificity of 100 and 95.5%, respectively. <b><i>Conclusion:</i></b> This study provided initial data on CPET among patients having CPFE with and without PH. CPET can help noninvasively detect PH and identify patients at risk. AaDO<sub>2</sub> at peak exercise, VE/VCO<sub>2</sub> slope, peak P(a-ET)CO<sub>2</sub>, and peak VO<sub>2</sub> were parameters that had high sensitivity and, when combined, high specificity.
45
Chernyak, A. V., N. A. Karchevskaya, O. I. Savushkina, M. Kh Mustafina, E. A. Sinitsyn, E. N. Kalmanova, M. V. Samsonova, E. A. Zaryanova e K. A. Zykov. "Functional changes in the respiratory system after COVID-19-associated lung injury". PULMONOLOGIYA 32, n. 4 (16 agosto 2022): 558–67. http://dx.doi.org/10.18093/0869-0189-2022-32-4-558-567.
Testo completoAbstract (sommario):
Since the beginning of the pandemic, COVID-19 (COronaVIrus Disease-2019) has been viewed as a respiratory disease with characteristic symptoms including cough, shortness of breath, and difficulty breathing. However, some patients still have respiratory complaints and post-inflammatory changes in the lung tissue according to high-resolution computed tomography of the chest organs (CT scan) even after discharge from the hospital.The aim. To assess the functional changes in the respiratory system in patients who had COVID-19-associated lung injury using a comprehensive testing of the respiratory function (spirometry, body plethysmography and diffusion test) in the first 6 months after discharge from the hospital.Methods. The study included 434 patients (252 men and 182 women, aged 20 to 79 years), who were divided into 3 groups depending on the time interval between discharge from the hospital and the respiratory function test: Group 1 – 15 – 45 days; Group 2 – 46 – 93 days; Group 3 – 94 – 183 days. All patients underwent a comprehensive testing of respiratory function.Results. The average pulmonary ventilation indicators remained within the normal range both in the general group and in separate groups. A decrease in DLCO was found in most patients: in 53% of people in the general group, in 54, 54 and 51% of cases in Groups 1, 2 and 3, respectively. Restrictive ventilation disorders (reduction of TLC below the lower limit of normal (LLN)) were detected in 29 % of people in the general group, 33, 27 and 26% in Groups 1, 2 and 3, respectively. Obstructive ventilation disorders (decrease in FEV1/FVC below LLN) were detected in 2 % in the general group, and in 3, 1 and 1% in groups 1, 2 and 3, respectively. Statistically significant correlations were found between the maximum volume of lung tissue damage in the acute period of COVID-19, the age of the patients, and the respiratory function indicators.Conclusion. The pulmonary ventilation indicators normalized within 6 months after COVID-19, while a decrease in lung diffusion capacity persisted in most patients and required further active follow-up.
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Degani-Costa, Luiza H., Barbara Levarge, Subba R. Digumarthy, Aaron S. Eisman, R. Scott Harris e Gregory D. Lewis. "Pulmonary vascular response patterns during exercise in interstitial lung disease". European Respiratory Journal 46, n. 3 (14 maggio 2015): 738–49. http://dx.doi.org/10.1183/09031936.00191014.
Testo completoAbstract (sommario):
When overt pulmonary hypertension arises in interstitial lung disease (ILD), it contributes to exercise intolerance. We sought to determine the functional significance of abnormal pulmonary arterial pressure (PAP) responses to exercise in ILD.27 ILD patients and 11 age-matched controls underwent invasive cardiopulmonary exercise testing (iCPET). Mean PAP (mPAP) was indexed to cardiac output (Q´T) during exercise, with a mPAP–Q´Tslope ≥3 mmHg·min·L−1defined as an abnormal pulmonary vascular response.All control subjects had mPAP–Q´Tslopes <3 mmHg·min·L−1(mean±sem1.5±0.1 mmHg·min·L−1). 15 ILD patients had mPAP–Q´Tslopes ≥3 mmHg·min·L−1(4.1±0.2 mmHg·min·L−1) and were labelled as having ILD plus pulmonary vascular dysfunction (PVD). Subjects without pulmonary hypertension and with mPAP–Q´Tslopes <3 mmHg·min·L−1(1.9±0. 2 mmHg·min·L−1) were labelled as ILD minus PVD (n=12). ILD+PVD and ILD−PVD patients did not differ in terms of age, sex, body mass index, pulmonary function testing or degree of exercise oxygen desaturation. Peak oxygen consumption was lower in ILD+PVD than in ILD−PVD (13.0±0.9versus17±1.1 mL·kg−1·min−1, p=0.012) and controls (19.8±1.7 mL·kg−1·min−1, p=0.003). ILD+PVD patients had increased dead space volume (VD)/tidal volume (VT) and minute ventilation/carbon dioxide production at the anaerobic threshold.In ILD, mPAP–Q´Tslope ≥3 mmHg·min·L−1is associated with lower peak oxygen consumption, increasedVD/VTand inefficient ventilation. While noninvasive parameters were unable to predict those with abnormal pulmonary vascular responses to exercise, iCPET-derived mPAP–Q´Tslope may aid in identifying physiologically significant, early pulmonary vascular disease in ILD.
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Surman, T., J. Abrahams, J. Edwards, M. Worthington e J. Beltrame. "The Functional Limits of the Aneurysmal Aortic Root: A Unique Pressure Testing Apparatus". Heart, Lung and Circulation 32 (giugno 2023): S55. http://dx.doi.org/10.1016/j.hlc.2023.04.155.
Testo completo
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Chernyak, A. V., M. Kh Mustafina, Zh K. Naumenko, E. N. Kalmanova e K. A. Zykov. "Dynamics of functional changes in the respiratory system after COVID-19-associated lung injury at one year after hospital discharge". PULMONOLOGIYA 33, n. 5 (5 settembre 2023): 611–21. http://dx.doi.org/10.18093/0869-0189-2023-33-5-611-621.
Testo completoAbstract (sommario):
Morphological examination reveals microcirculation disorders in combination with small areas of lung damage in the long term after COVID-19. Therefore, the function of the respiratory system should be assessed after COVID-19. Aim of this study was to evaluate the dynamics of respiratory dysfunction in patients with COVID-19-associated lung injury using a complex examination of lung function (spirometry, body plethysmography, and lung diffusion testing) one year after hospital discharge. Methods. 60 patients (38 men/22 women, aged 39 to 80 years) with a diagnosis of “COVID-19-associated interstitial process in the lungs” were examined. Lung function (spirometry, body plethysmography, and lung diffusion capacity testing) was examined in all patients twice, at 1 – 6 months (visit 1) and at 12 – 24 months (visit 2) after hospital discharge. Results. At visit 1, 60% of patients had restrictive pulmonary ventilation disorders. Obstructive ventilation disorders were detected in only 1 patient. Decreased lung diffusion capacity (D CO corr.) was found in 78% of patients. At visit 2, obstructive disorders were detected in 1 patient, and the frequency of restrictive ventilation disorders was 29%. Decreased DLCO corr. was noted in 57% of cases. The parameters of pulmonary ventilation and pulmonary gas exchange function differed significantly between visits. Significant correlations were found between changes in the functional parameters of the respiratory system and disorders identified at visit 1 after hospital discharge. Conclusion. Thus, there is a decrease in the lung diffusion capacity and the rate of restrictive ventilation disorders even one year after severe COVID-19-associated lung injury. However, our results suggest a marked improvement in respiratory system function over time.
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Zapata, Karina A. "Supervised Deep Breathing Exercises Improve Functional Aerobic Capacity in Patients with Severe Spinal Deformity". Journal of the Pediatric Orthopaedic Society of North America 4, n. 2 (1 maggio 2022): 1–6. http://dx.doi.org/10.55275/jposna-2022-0029.
Testo completoAbstract (sommario):
Background: Our institution has traditionally treated children with severe spine deformity using halo gravity traction (HGT) to improve curve magnitude and increase flexibility. Local Problem: Assessing the non-radiographic benefits of HGT such as pulmonary function, is difficult. Pulmonary function is commonly reflected by pulmonary function testing (PFT) which is dependent on MAXIMAL patient effort. Six-minute walk test (6MWT) reflects functional exercise capacity. Specific Aims: This quality initiative (QI) was performed to evaluate the addition of supervised deep breathing exercises (DBE) utilizing an incentive spirometer (IS) to supervised physical therapy exercise in patients with severe spinal deformity that require HGT. Methodology: A QI core team was established with the aim of improving the pulmonary function aspect of our HGT program. The team consisted of 1 orthopaedic surgeon, 1 quality improvement program manager, 2 physical therapists (PTs), and 1 respiratory therapist (RT). The QI core team met every 4 to 6 weeks to discuss patients and processes. Intervention: RTs supervised HGT patients performing DBE 4 times per day, and asked families to independently perform DBE 4 additional times per day. PTs performed the six-minute walk tests (6MWT). A pulse oximeter was used to monitor oxygen saturation levels. RTs performed the PFTs. The 6MWT and PFTs were performed prior to halo application, and every 2 weeks while in HGT treatment. Results: The intervention HGT patients who received supervised DBE (n=14) demonstrated significantly improved 6MWT scores from 1440±546 feet pre-halo to 1663±398 feet pre-surgery (p=0.02). A historic cohort of HGT patients who did not receive supervised DBE (n=10) demonstrated no significant changes in 6MWT scores at 1493±391 feet pre-halo and 1477±406 feet pre-surgery. Averaged forced vital capacity worsened 4±10% and average forced expire volume in one second worsened 1±8%. Conclusions: Children in HGT undergoing supervised DBE and physical therapy demonstrate improved functional aerobic capacity according to the 6MWT despite no improvement in pulmonary function tests.
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Segrera, Sergio A., Laurie Lawler, Alexander R. Opotowsky, David Systrom e Aaron B. Waxman. "Open label study of ambrisentan in patients with exercise pulmonary hypertension". Pulmonary Circulation 7, n. 2 (12 maggio 2017): 531–38. http://dx.doi.org/10.1177/2045893217709024.
Testo completoAbstract (sommario):
A growing body of evidence suggests that exercise pulmonary hypertension (ePH) is an early form of pulmonary arterial hypertension (PAH). Identifying the disease at an early, potentially more responsive phase, and initiating treatment may improve functional status and prevent progression to severe forms of PAH. This was a single-center, open-label six-month treatment trial to evaluate the effect of ambrisentan on pulmonary hemodynamics and exercise capacity in ePH utilizing invasive cardiopulmonary exercise testing (iCPET). After six months of treatment with ambrisentan, patients repeated iCPET; exercise capacity, symptoms, and pulmonary hemodynamics were reassessed. Twenty-two of 30 patients completed the treatment phase and repeat iCPET. After six months of treatment there was a significant decline in peak exercise mPAP (−5.2 ± 5.6 mmHg, P = 0.001), TPG (−7.1 ± 8.0 mmHg, P = 0.001), PVR (−0.9 ± 0.7 Woods units, P = 0.0002), and Ca-vO2 (−1.8 ± 2.3 mL/dL, P = 0.0002), with significant increases in peak PCWP (+2.9 ± 5.6 mmHg, P = 0.02), PVC (+0.8 ± 1.4 mL/mmHg, P = 0.03), and CO (+2.3 ± 1.4 L/min, P = 0.0001). A trend toward increased VO2max (+4.4 ± 2.6% predicted, P = 0.07) was observed. In addition, there were improvements in 6MWD and WHO FC after 24 weeks. Our findings suggest that treatment of ePH with ambrisentan results in improved pulmonary hemodynamics and functional status over a six-month period. Treatment of ePH may prevent the progression of vascular remodeling and development of established PAH.