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Ferreira-Cardoso H, Jácome C, Silva S, Amorim A, Redondo MT, Fontoura-Matias J, Vicente-Ferreira M, Vieira-Marques P, Valente J, Almeida R, Fonseca JA, Azevedo I. Lung Auscultation Using the Smartphone-Feasibility Study in Real-World Clinical Practice. SENSORS (BASEL, SWITZERLAND) 2021; 21:4931. [PMID: 34300670 PMCID: PMC8309818 DOI: 10.3390/s21144931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/03/2021] [Accepted: 07/16/2021] [Indexed: 11/17/2022]
Abstract
Conventional lung auscultation is essential in the management of respiratory diseases. However, detecting adventitious sounds outside medical facilities remains challenging. We assessed the feasibility of lung auscultation using the smartphone built-in microphone in real-world clinical practice. We recruited 134 patients (median[interquartile range] 16[11-22.25]y; 54% male; 31% cystic fibrosis, 29% other respiratory diseases, 28% asthma; 12% no respiratory diseases) at the Pediatrics and Pulmonology departments of a tertiary hospital. First, clinicians performed conventional auscultation with analog stethoscopes at 4 locations (trachea, right anterior chest, right and left lung bases), and documented any adventitious sounds. Then, smartphone auscultation was recorded twice in the same four locations. The recordings (n = 1060) were classified by two annotators. Seventy-three percent of recordings had quality (obtained in 92% of the participants), with the quality proportion being higher at the trachea (82%) and in the children's group (75%). Adventitious sounds were present in only 35% of the participants and 14% of the recordings, which may have contributed to the fair agreement between conventional and smartphone auscultation (85%; k = 0.35(95% CI 0.26-0.44)). Our results show that smartphone auscultation was feasible, but further investigation is required to improve its agreement with conventional auscultation.
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Affiliation(s)
| | - Cristina Jácome
- MEDCIDS—Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (R.A.); (J.A.F.)
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
| | - Sónia Silva
- Department of Pediatrics, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal; (S.S.); (J.F.-M.); (M.V.-F.); (I.A.)
| | - Adelina Amorim
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (H.F.-C.); (A.A.)
- Department of Pulmonology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal;
| | - Margarida T. Redondo
- Department of Pulmonology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal;
| | - José Fontoura-Matias
- Department of Pediatrics, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal; (S.S.); (J.F.-M.); (M.V.-F.); (I.A.)
| | - Margarida Vicente-Ferreira
- Department of Pediatrics, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal; (S.S.); (J.F.-M.); (M.V.-F.); (I.A.)
| | - Pedro Vieira-Marques
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
| | - José Valente
- MEDIDA—Serviços em Medicina, Educação, Investigação, Desenvolvimento e Avaliação, LDA, 4200-386 Porto, Portugal;
| | - Rute Almeida
- MEDCIDS—Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (R.A.); (J.A.F.)
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
| | - João Almeida Fonseca
- MEDCIDS—Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (R.A.); (J.A.F.)
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
- MEDIDA—Serviços em Medicina, Educação, Investigação, Desenvolvimento e Avaliação, LDA, 4200-386 Porto, Portugal;
| | - Inês Azevedo
- Department of Pediatrics, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal; (S.S.); (J.F.-M.); (M.V.-F.); (I.A.)
- Department of Obstetrics, Gynecology and Pediatrics, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- EpiUnit, Institute of Public Health, University of Porto, 4050-091 Porto, Portugal
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Eschenhagen P, Schwarz C. [Therapy of cystic fibrosis - new drugs give hope]. Dtsch Med Wochenschr 2020; 145:1486-1489. [PMID: 33022731 DOI: 10.1055/a-1140-3937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
For decades there were only symptom-oriented therapies for the monogenetic disease cystic fibrosis. With the new modulator therapies there are new hopes to better influence the course of the disease, which has its manifestation in several organs such as the lungs, the liver or pancreas.In addition to ivacaftor, lumacaftor/ivacaftor and tezacaftor/ivacaftor, a triple combination with elexacaftor/tezacaftor/ivacaftor was developed. Studies in F508del homozygous and heterozygous patients with cystic fibrosis have resulted in significant clinical improvement and have therefore been approved by the FDA for the first time in the USA.The results are very promising as already after 4 weeks a significant improvement of FEV1 and a significant decrease of the sweat chloride content could be detected. In the USA all patients with at least one F508del mutation can be prescribed the drug. This corresponds to approximately 90 % of all patients with cystic fibrosis and has the potential to change the landscape of cystic fibrosis.
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Affiliation(s)
- Patience Eschenhagen
- Sektion Cystische Fibrose, Christiane Herzog-Zentrum Berlin, Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie m. S. Pneumologie, Immunologie und Intensivmedizin, Campus Rudolf Virchow Klinikum, Berlin
| | - Carsten Schwarz
- Sektion Cystische Fibrose, Christiane Herzog-Zentrum Berlin, Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie m. S. Pneumologie, Immunologie und Intensivmedizin, Campus Rudolf Virchow Klinikum, Berlin
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Shao H, Hua J, Wu Q, Li X, Zhang M, Wang H, Wu J, Xu L, Xie Y, Li L, Chen H. Identification of a Mutation in the Novel Compound Heterozygous CFTR in a Chinese Family with Cystic Fibrosis. Can Respir J 2020; 2020:6507583. [PMID: 32454915 PMCID: PMC7229557 DOI: 10.1155/2020/6507583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 02/05/2023] Open
Abstract
Cystic fibrosis (CF) is one of the most common autosomal recessive disorders among Caucasians of Northern European descent but is uncommon in the Chinese population. Objectives. To elucidate the mutation in the novel compound heterozygous CFTR causing CF in Chinese family. Materials and Methods. Clinical samples were obtained from a Chinese family, the brother and sister with recurrent airway infections, hypoxemia and obstructive ventilatory impairment, sinusitis, clubbed fingers, salty sweat, and nasal polyposis. We performed whole-exome sequencing on the family and validated all potential variants by Sanger sequencing. Results. Next-generation sequencing showed a novel compound heterozygous CFTR mutation (c.400 A > G p.Arg134Gly and c.3484 C > T p.Arg1162 ∗ ) which resulted in CF in the family. Conclusions. As this mutation is consistent with the observed clinical manifestations of CF and no other mutations were detected after scanning the gene sequence, we suggest that their CF phenotypes are caused by the compound heterozygous mutation, c.400 A > G p.Arg134Gly and c.3484 C > T p.Arg1162 ∗ . As c.400 A > G is not currently listed in the Cystic Fibrosis Mutation Database, this information, regarding the CF-causing mutations in two Chinese patients, is of interest.
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Affiliation(s)
- Hongxia Shao
- 1Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin 300350, China
- 2Tianjin Institute of Respiratory Diseases, Tianjin 300350, China
- 3Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin 300350, China
| | - Jingna Hua
- 1Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin 300350, China
- 2Tianjin Institute of Respiratory Diseases, Tianjin 300350, China
- 3Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin 300350, China
| | - Qi Wu
- 1Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin 300350, China
- 2Tianjin Institute of Respiratory Diseases, Tianjin 300350, China
- 3Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin 300350, China
| | - Xiaoge Li
- 4Tianjin Jinnan Xiaozhan Hospital, Tianjin 300353, China
| | - Ming Zhang
- 5Department of Medical Ultrasonics, Haihe Hospital, Tianjin University, Tianjin 300350, China
| | - Herong Wang
- 1Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin 300350, China
- 2Tianjin Institute of Respiratory Diseases, Tianjin 300350, China
| | - Junping Wu
- 2Tianjin Institute of Respiratory Diseases, Tianjin 300350, China
- 3Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin 300350, China
- 6Department of Tuberculosis Medicine, Haihe Hospital, Tianjin University, Tianjin 300350, China
| | - Long Xu
- 7Department of Science and Education, Haihe Hospital, Tianjin University, Tianjin 300350, China
| | - Yi Xie
- 7Department of Science and Education, Haihe Hospital, Tianjin University, Tianjin 300350, China
| | - Li Li
- 1Department of Respiratory Medicine, Haihe Hospital, Tianjin University, Tianjin 300350, China
- 2Tianjin Institute of Respiratory Diseases, Tianjin 300350, China
| | - Huaiyong Chen
- 2Tianjin Institute of Respiratory Diseases, Tianjin 300350, China
- 3Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin 300350, China
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Abstract
Cystic fibrosis (CF) is an inherited incurable multi-organ disease. Improvement in treatment approaches over the last 20 years have led to an increased life expectancy where the number of adult patients has doubled and will continue to increase exponentially. Due to the use of new substances which modulate the basic defect, a substantial improvement in the prognosis can be assumed but the existing healthcare structures in Germany do not meet these rising needs. With more than 50% of patients being adults, there are only very few internal medicine centers available. Only approximately one third of the patients are treated in adult health centers. Adolescence in particular is a very vulnerable phase of the disease, the risk of comorbidities is increased and adherence to the very laborious treatment recommendations is as a rule low. While in many other countries transition programs have been evaluated and implemented for more than 20 years, in Germany there have only been rudimentary approaches to transition. Meanwhile investigations are available on the perceptions of adolescents with respect to coping with the disease and their treatment needs, including the perception of the time when the transition process should begin. Successful transition seems to be performed best in combined pediatric and adult centers, with the back-up of an experienced multidisciplinary team of healthcare providers.
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Affiliation(s)
- D Staab
- Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - C Schwarz
- Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
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Mohseni M, Razzaghmanesh M, Mehr EP, Zare H, Beheshtian M, Najmabadi H. Novel CFTR Mutations in Two Iranian Families with Severe Cystic Fibrosis. IRANIAN BIOMEDICAL JOURNAL 2016; 20:201-6. [PMID: 27017198 PMCID: PMC4983674 DOI: 10.7508/ibj.2016.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 09/14/2015] [Accepted: 11/07/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) is a common autosomal recessive disorder that affects many body systems and is produced by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. CF is also the most frequently inherited disorder in the West. The aim of this study was to detect the mutations in the CFTR gene in two Iranian families with CF. METHODS After DNA extraction using the salting out method, a mutation panel consisting of 35 common mutations was tested by PCR, followed by reverse hybridization Strip Assay. To confirm the mutations, we have also performed Sanger sequencing for all 27 exons, intronic flanking regions, and 5' and 3' UTRs of the CFTR gene. RESULTS Carrier testing in a spouse revealed a novel nonsense mutation in the CFTR gene (c.2777 T>A (p.L926X)) in exon 17 for husband and a previously described heterozygous splice site pathogenic mutation (c.1393-1G>A) in his wife. The other novel compound heterozygous missense mutation (c.3119 T>A (p.L1040H)), which was previously reported as nonsense c.3484C>T (p.R1162X) mutation, was found in exon 19 in patient screening. CONCLUSION Two novel CFTR mutations in exons 17 and 19 are responsible for CF with severe phenotypes in two Iranian families. These two mutations supplement the mutation spectrum of CFTR and may contribute to a better understanding of CFTR protein function.
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Affiliation(s)
- Marzieh Mohseni
- Kariminejad-Najmabadi Pathology and Genetics Center, Tehran, Iran
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Elham Parsi Mehr
- Kariminejad-Najmabadi Pathology and Genetics Center, Tehran, Iran
| | - Hanieh Zare
- Kariminejad-Najmabadi Pathology and Genetics Center, Tehran, Iran
| | - Maryam Beheshtian
- Kariminejad-Najmabadi Pathology and Genetics Center, Tehran, Iran
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hossein Najmabadi
- Kariminejad-Najmabadi Pathology and Genetics Center, Tehran, Iran
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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