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Critsinelis A, Lamba H, Chatterjee S, Cheema F, Civitello A, Delgado R, Nair A, Shafii A, Loor G, Rosengart T, Frazier O, Morgan J. Prediction of GIB Using R2 CHA2DS2 VASc Risk Score. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Critsinelis A, Kraus J, Lamba H, Cheema F, Civitello A, Delgado R, Nair A, Shafii A, Loor G, Rosengart T, Frazier O, Morgan J. Gastrointestinal Bleeding Ceases after Heart Transplantation in Patients Bridged on Continuous-Flow LVAD Support. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Critsinelis A, Lamba H, Oberton S, Cheema F, Civitello A, Delgado R, Nair A, Shafii A, Loor G, Rosengart T, Frazier O, Morgan J. INTERMACS Profile Does Not Predict Required Flow Rate of CF-LVAD at Discharge. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Lamba H, Kim M, Hart L, Chou B, Rao C, Chatterjee S, Sattee S, Cheema F, Civitello A, Delgado R, Nair A, Shafii A, Loor G, Rosengart T, Frazier O, Morgan J. Different Risk Factors for Ischemic and Hemorrhagic Stroke on Continuous Flow Left Ventricular Assist Device Support. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Kim M, Lamba H, Miller R, George J, Sattee S, Cheema F, Civitello A, Delgado R, Nair A, Shafii A, Loor G, Rosengart T, Frazier O, Morgan J, Chatterjee S. Predictors and Impact of Vasoplegia after Continuous-Flow Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Horst C, Ruparel M, Dickson J, Quaife S, Hall H, Tisi S, Taylor M, Ahmed A, Shaw P, Burke S, Soo M, Nair A, Devaraj A, Duffy S, Waller J, Navani N, Bhowmik A, Baldwin D, Janes S. Optimising nodule management with data from the Lung Screen Uptake Trial. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30099-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bakewell F, Hodgkiss M, Nair A, Kennedy C, Szolin S, Perumpalath B, Baldwin D, Anwar S. Implementation of the National Optimal Lung Cancer Pathway: the Nottingham experience. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30075-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ruparel M, Dickson J, Quaife S, Sophie T, Hall H, Horst C, Taylor M, Ahmed A, Shaw P, Burke S, Soo M, Nair A, Devaraj A, Duffy S, Waller J, Navani N, Bhowmik A, Baldwin D, Janes S. Results from a prevalence round of LDCT screening for lung cancer in the Lung Screen Uptake Trial. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30100-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nair A, El-Boghdadly K, Ahmad I, Czech AJ. Surface anatomical landmarks or ultrasound for cricoid pressure application - a reply. Anaesthesia 2018; 74:122. [DOI: 10.1111/anae.14524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nair A. Does mannitol contribute to hypotension after parenteral paracetamol administration in critical care? Anaesthesia 2018; 72:130. [PMID: 27988955 DOI: 10.1111/anae.13768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nair S, Ramaswamy S, Nair A. CAN MOCA SCORES PREDICT AMYLOID PET SCAN POSITIVITY? SENSITIVITY AND SPECIFICITY ANALYSES IN A MEMORY CLINIC SAMPLE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nair A, Steinberg WJ, Habib T, Saeed H, Raubenheimer JE. Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa. S Afr Fam Pract (2004) 2018. [DOI: 10.4102/safp.v60i5.4922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Healthcare-associated infections (HCAIs) are a well-known public health threat; however, published data on the endemic burden of HCAIs in sub-Saharan Africa are limited. This study aimed to determine the prevalence of primary bloodstream infection (PBSI), surgical site infection (SSI), lower respiratory tract infection (LRTI) and urinary tract infection (UTI) at Kimberley Hospital Complex (KHC), Northern Cape.Methods: A one-day pointprevalence survey was conducted between February 2016 and March 2016 on all patients admitted to 15 selected wards at KHC. The Standardised Centers for Disease Control and National Nosocomial Infection Surveillance Systems criteria were used.Results: A total of 326 patients were surveyed and the overall HCAI prevalence rate was 7.67%. This included 4.60% SSIs, 1.53% UTIs, 0.92% PBSIs and 0.92% LRTIs. Patients with HCAI stayed a mean of 20.8 days compared with 9.1 days for the remaining patients. Almost 75% (n = 240) of the surveyed patients had one or more recognised risk factors. The most isolated microorganism among the 11 microorganisms isolated was Klebsiella pneumoniae (36.4%). Half (54.5%) of the isolated organisms were resistant to penicillin. At the time of the survey, 42.0% of all the patients were on antimicrobials of which amoxicillin/clavulanic acid was most commonly prescribed (29.9%). Conclusion: The overall HCAI prevalence rate found in KHC is encouraging, but the prevalence of SSI is of concern. Further studies are needed to identify risk factors and target this as an area where preventative interventions can be implemented.
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Lun Y, Xu S, Soska R, Nair A, Frascella M, Garcia A, Ponery A, Feng J, Valle CD, Gotschall R, Do H, Valenzano K, Khanna R. METABOLIC MYOPATHIES II. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nair A, Turner C, Heyman I, Mataix-Cols D, Lovell K, Krebs G, Lang K, Byford S, O’Kearney R. Moderators and predictors of outcomes in telephone delivered compared to face-to-face cognitive behaviour therapy for paediatric obsessive–compulsive disorder: preliminary evidence from a non-inferiority RCT. Cogn Behav Ther 2018; 48:353-368. [DOI: 10.1080/16506073.2018.1513555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nair A, Steinberg WJ, Habib T, Saeed H, Raubenheimer JE. Prevalence of healthcare-associated infection at a tertiary hospital in the Northern Cape Province, South Africa. S Afr Fam Pract (2004) 2018. [DOI: 10.1080/20786190.2018.1487211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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66
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Lee D, Czech AJ, Elriedy M, Nair A, El‐Boghdadly K, Ahmad I. A multicentre prospective cohort study of the accuracy of conventional landmark technique for cricoid localisation using ultrasound scanning. Anaesthesia 2018; 73:1229-1234. [DOI: 10.1111/anae.14399] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2018] [Indexed: 02/04/2023]
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Nair A, Dolan J, Tanner KE, Kerr CM, Jones B, Pollock PJ, Kellett CF. Ultrasound-guided adductor canal block: a cadaver study investigating the effect of a thigh tourniquet. Br J Anaesth 2018; 121:890-898. [PMID: 30236251 DOI: 10.1016/j.bja.2018.04.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/08/2018] [Accepted: 05/16/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Placement of local anaesthetic within the adductor canal using ultrasonography is an alternative to femoral nerve blocks for postoperative pain relief after knee joint replacement surgery. However, the effect of an inflated thigh tourniquet on the distribution of local anaesthetic within the adductor canal is unknown. The aim of this cadaveric study was to compare the distribution of radio-opaque dye within the adductor canal in the presence or absence of an inflated thigh tourniquet. METHODS Bilateral ultrasound-guided adductor canal blocks were performed on the thawed lower limbs of five fresh frozen human cadavers. The left and right lower cadaver limbs were randomised to receive or not receive a thigh tourniquet inflated to 300 mm Hg for 1 h. X-rays with iohexol radio-opaque dye were obtained in four views, and fiducial markers inserted as reference points. Virtual editing technology was used to recreate outlines representing the distribution of the radio-opaque dye and superimpose these on anatomical images. RESULTS Radio-opaque dye was distributed on the medial aspect of the thighs with entire and well circumscribed margins. The majority of the radio-opaque dye was confined within the adductor canal. Superior-inferior dye distribution was 315 mm [95% confidence intervals (CI) 289-342] and 264 mm (95% CI 239-289) in the presence and absence of an inflated thigh tourniquet, respectively (diff 95% CI -80.46 to -22.22, P=0.0081). Image analysis using the recreated radio-opaque outlines suggested that the most proximal point of the radio-opaque dye was 100 mm (95% CI 82-117) or 117 mm (95% CI 62-171) below the inguinal ligament in the presence and absence of an inflated thigh tourniquet, respectively (diff 95% CI -38 to 72, P=0.456). CONCLUSIONS Application and inflation of thigh tourniquets significantly increased the combined superior-inferior dye distribution within the adductor canal of cadaveric limbs. There was insufficient evidence to suggest significant proximal spread of 25 ml of local anaesthetic to involve the motor branches of the femoral nerve. In some patients, the local anaesthetic may reach the popliteal fossa in close approximation to the sciatic nerve.
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Lamba H, Marcano J, Kurihara C, Kawabori M, Sugiura T, Santiago A, Cheema F, Alnajar A, Civatello A, Delgado R, Simpson L, Nair A, Letsou G, Ghanta R, Rosengart T, Frazier O, Morgan J, George J, Chatterjee. S. Extra-Corporeal Membrane Oxygenation (ECMO) as a Bridge to A Long-Term, Implantable Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Dilling D, Nair A, Gries C, Leard L, Fisher A, Johnson S, McCormack F. Use of Sirolimus in Patients with Lymphangioleiomyomatosis (LAM) on Waiting Lists for Lung Transplant (LTX). J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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70
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Santiago A, Lamba H, Alnajar A, Cheema F, Hyak J, Conyer R, Kim M, Chou B, Nair A, Oberton S, Ghanta R, George J, Taimeh Z, Civatello A, Frazier O, Morgan J. Evaluation of the CHADS 2 , CHA 2 DS 2 -VASc, and R 2 CHADS 2 Risk Assessment Scores in Continuous Flow LVADs. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lamba H, Cheema F, Kurihara C, Kawabori M, Sugiura T, Ono M, Loor G, Civitello A, Alnajar A, Delgado R, Simpson L, Nair A, Oberton S, George J, Rosengart T, Cohn W, Frazier O, Morgan J. Outcomes of Continuous Flow Left Ventricular Assist Devices: A Single Institutional 18-Year Experience with Over 850 Devices. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Blum JL, Wong S, Pearson EJ, Nair A, Snipes GJ, Briones N, Baker A, Cropp CD, Carpten JD. Abstract P3-04-02: Molecular analysis of breast cancers from individuals with hereditary cancer syndromes secondary to mutations in BRCA1, BRCA2, ATM, CHEK2, and PALB2. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-04-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Despite a growing understanding of the somatic landscape of breast tumors from BRCA1 and BRCA2 mutation carriers, less is known about breast tumors from carriers of germline mutations in other homologous recombination and DNA repair pathway genes such as ATM, CHEK2, and PALB2.
Methods: We identified 44 clinically annotated breast cancer cases that included carriers of germline mutations in BRCA1 (n=9), BRCA2 (n=9), ATM (n=5), CHEK2 (n=7), and PALB2 (n=6) from the Hereditary Cancer Risk Program at BUMC. Sporadic breast cancers cases (n=8) were also collected. Genomic DNA and RNA were extracted from macro-dissected FFPE tumor sections, adjacent normal FFPE tissue, along with constitutional genomic DNA from blood. Expanded whole exome sequencing (WES) was performed on normal/tumor pairs and RNA-seq from tumors for each case. Bioinformatics analysis was performed using industry standard methods for somatic characterization.
Results: All germline mutations were confirmed by WES. Somatic mutational analysis and copy number profiling from WES revealed the greatest similarities among BRCA1 and CHEK2 carriers. As expected, TP53 mutations were found in 8 of 9 BRCA1 carriers as all were triple negative subtype. We also detected somatic TP53 mutations in tumors from 4 of 7 CHEK2 carriers. Somatic TP53 mutations were found in only 1 of 7 BRCA2 tumors and 1 of 4 PALB2 tumors tested. Furthermore, BRCA1 and CHEK2 tumors showed trends of having higher mutation burden. Analysis of copy number BRCAness demonstrated stronger similarities between BRCA1, ATM, CHEK2, and PALB2 tumors. BRCA2 tumors were unique with fewer events and characterized by specific amplifications including 11q23 (CCND1) and 17q23 (BRIP1). Hierarchical clustering of RNA-seq data revealed strong clustering of BRCA1 tumors compared to all other tumors, predominantly attributed to breast cancer subtype. Furthermore, pathway analysis of genes that distinguish BRCA1 mutation positive versus non-BRCA mutated tumors showed strong correlation to pro-inflammatory and immune pathway signatures.
Conclusions: Molecular analysis of 44 breast cancers from individuals with inherited predisposition to breast cancer via BRCA1, BRCA2, ATM, CHEK2, and PALB2 germline mutations demonstrated strongest somatic similarities between BRCA1 and CHEK2 tumors although all BRCA1 were TNBC and all CHEK2 tumors were ER positive. Marked differential gene expression differences in RNA expression patterns were observed in BRCA1 mutation carriers compared with all other groups analyzed. Our study is among the first to interrogate the profile of non-BRCA mutated hereditary breast cancers.
Citation Format: Blum JL, Wong S, Pearson EJ, Nair A, Snipes GJ, Briones N, Baker A, Cropp CD, Carpten JD. Molecular analysis of breast cancers from individuals with hereditary cancer syndromes secondary to mutations in BRCA1, BRCA2, ATM, CHEK2, and PALB2 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-04-02.
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Venugopal R, Sasidharan A, Nair A, Marigowda V, Kutty B. Exploring sleep stability in long term Vipassana meditators and controls using event related potentials and transcranial alternating current stimulation during sleep. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Magare B, Nair A, Khairnar K. Isolation of bacteriophages from air using vacuum filtration technique: an improved and novel method. J Appl Microbiol 2017; 123:896-902. [PMID: 28766823 DOI: 10.1111/jam.13551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/28/2017] [Accepted: 07/25/2017] [Indexed: 11/28/2022]
Abstract
AIM Development of a simple and economical air sampler for isolation and enrichment of bacteriophages from air samples. METHODS AND RESULTS A vacuum filtration unit with simple modifications was used for isolation of bacteriophages from air sampled in the lavatory. Air was sampled at the rate of 62 l min-1 by bubbling into Mcllvaine buffer for 30 min, which was used as bacteriophage solution for enrichment and plaque assessment against individual hosts. Alternatively, the aforementioned phage solution was enriched using a host consortium before plaque assessment. Phages were isolated in the range of 1-12 PFU per ml by the first method, whereas enrichment with host consortium gave phages around 10- to 1000-folds higher in number. Combining with established enrichment method, an improvement of about 10 times in phage isolation efficiency was attained. CONCLUSIONS The method is very useful for studying the natural bacteriophages of air, requiring only a basic microbiological laboratory setup making it simple and economical. SIGNIFICANCE AND IMPACT OF THE STUDY This study brings out a simple, economical air sampler for assessing air bacteriophages that can be employed by any microbial laboratory. Although various methods are available for studying bacteriophages in water and soil, very limited are available for air. To the best of our knowledge, the method developed in this study is unique in its design and concept for studying bacteriophages in air. The sampler is sterilizable by autoclaving and maintains a healthy rate of airflow provided by conventional vacuum pumps. The use of a nonspecific 'trapping solution' allows for the qualitative and quantitative study of air bacteriophages.
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Moser JB, Mak SM, McNulty WH, Padley S, Nair A, Shah PL, Devaraj A. The influence of inspiratory effort and emphysema on pulmonary nodule volumetry reproducibility. Clin Radiol 2017; 72:925-929. [PMID: 28784319 DOI: 10.1016/j.crad.2017.06.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 06/11/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
Abstract
AIM To evaluate the impact of inspiratory effort and emphysema on reproducibility of pulmonary nodule volumetry. MATERIALS AND METHODS Eighty-eight nodules in 24 patients with emphysema were studied retrospectively. All patients had undergone volumetric inspiratory and end-expiratory thoracic computed tomography (CT) for consideration of bronchoscopic lung volume reduction. Inspiratory and expiratory nodule volumes were measured using commercially available software. Local emphysema extent was established by analysing a segmentation area extended circumferentially around each nodule (quantified as percent of lung with density of -950 HU or less). Lung volumes were established using the same software. Differences in inspiratory and expiratory nodule volumes were illustrated using the Bland-Altman test. The influences of percentage reduction in lung volume at expiration, local emphysema extent, and nodule size on nodule volume variability were tested with multiple linear regression. RESULTS The majority of nodules (59/88 [67%]) showed an increased volume at expiration. Mean difference in nodule volume between expiration and inspiration was +7.5% (95% confidence interval: -24.1, 39.1%). No relationships were demonstrated between nodule volume variability and emphysema extent, degree of expiration, or nodule size. CONCLUSION Expiration causes a modest increase in volumetry-derived nodule volumes; however, the effect is unpredictable. Local emphysema extent had no significant effect on volume variability in the present cohort.
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