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Glick DR, Brown CH, Li L, Gucer P, Gaitens JM, McDiarmid MA, Hines SE. Performance of Impulse Oscillometry in Identifying Restrictive Lung Defects in a Veteran Cohort. Open Respir Med J 2024; 18:e18743064304109. [PMID: 39130647 PMCID: PMC11311798 DOI: 10.2174/0118743064304109240611054726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 08/13/2024] Open
Abstract
Background Impulse oscillometry (IOs) is a technique used to evaluate lung function that uses sound waves imposed over tidal breathing to characterize the airways and lung parenchyma. IOs has been particularly useful in the identification of obstructive lung defects. The present analysis seeks to explore the use of IOs in the identification of restrictive lung physiology among a group of Gulf War I veterans exposed to depleted uranium (DU). Methods A total of 36 out of a dynamic 85-veteran cohort attended in-person surveillance visits in 2019 and completed both IOs and PFTs. Performance on IOs was evaluated in a cross-sectional analysis of the group overall and in those identified as having restrictive lung defects defined by either spirometry (FEV1/FVC ≥ LLN and FVC < LLN) or lung volumes (TLC < LLN). Results A total of 6 individuals were identified as having restriction (4 based on spirometry alone and an additional 2 by lung volumes). When restriction was present, IOs values of both resistance and reactance were significantly more abnormal. Conclusion In the assessment of lung function, IOs may be advantageous over PFTs because it is faster to perform and effort-independent. Although little is known about the utility of IOs in identifying restrictive lung physiology, our results support its use.
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Affiliation(s)
- Danielle R Glick
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
- Department of Veterans Affairs Medical Center, Baltimore, MD, United States
| | - Clayton H Brown
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Lan Li
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Patricia Gucer
- Department of Veterans Affairs Medical Center, Baltimore, MD, United States
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Joanna M Gaitens
- Department of Veterans Affairs Medical Center, Baltimore, MD, United States
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Melissa A McDiarmid
- Department of Veterans Affairs Medical Center, Baltimore, MD, United States
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Stella E Hines
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
- Department of Veterans Affairs Medical Center, Baltimore, MD, United States
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, Baltimore, MD, United States
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McDiarmid MA, Hines S, Cloeren M, Gucer P, Condon M, Oliver M, Roth T, Lewin-Smith MR, Strathmann F, Velez-Quinones MA, Gaitens JM. The Department of Veterans' Affairs Depleted Uranium Cohort in the Time of COVID-19: Translating a Traditional Surveillance Protocol to a Telehealth Platform. J Occup Environ Med 2023; 65:670-676. [PMID: 37167933 PMCID: PMC10417219 DOI: 10.1097/jom.0000000000002875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE In 2021, 37 members of a cohort of depleted uranium-exposed Gulf War I veterans were evaluated using a protocol tailored to accommodate COVID-19 safety practices on a telehealth platform. METHODS Individual elements of the legacy protocol were reviewed for urgency and feasibility of inclusion in a modified, telehealth platform. RESULTS The redesigned protocol included a participant readiness for telehealth assessment, nurse and physician telehealth visits, collection of usual health questionnaires, and urine collections for exposure monitoring for uranium and other fragment-related metal measures. CONCLUSIONS Despite some limitations in scope, the telehealth platform permitted a visual "visit" with surveillance participants who expressed a high comfort level with the format. The telehealth platform has apparent utility for occupational surveillance and should be explored as a standard approach for surveillance outside of public health emergencies.
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Li Y, Yang GM, Zhao YB, Li BC. Wounding characteristics and treatment principle of ground anti-armored vehicle ammunition against armored crew. Chin J Traumatol 2023:S1008-1275(23)00019-6. [PMID: 36990837 DOI: 10.1016/j.cjtee.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
The wound mechanism, injury characteristics and treatment principle of anti-armored vehicle ammunition against armored crew in the past 20 years are summarized in this paper. Shock vibration, metal jet, depleted uranium aerosol and post armor breaking effect are the main factors for wounding armored crew. Their prominent characteristics are severe injury, high incidence of bone fracture, high rate of depleted uranium injury, and high incidence of multiple/combined injuries. During the treatment, attention must be paid on that the space of armored vehicle is limited, and the casualties should be moved outside of the cabin for comprehensive treatment. Especially, the management of depleted uranium injury and burn/inhalation injury are more important than other injuries for the armored wounds.
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Affiliation(s)
- Yue Li
- Neurosurgery Department, Xijing 986 Hospital, Fourth Military Medical University, Xi'an, 710054, China
| | - Guang-Ming Yang
- Research Department of Field Research Institute, Army Medical University, Chongqing, 400042, China
| | - Yong-Bo Zhao
- Neurosurgery Department, Xijing 986 Hospital, Fourth Military Medical University, Xi'an, 710054, China
| | - Bing-Cang Li
- Research Department of Field Research Institute, Army Medical University, Chongqing, 400042, China.
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