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Gonsard A, Mekov E, Barron S, Castellana G, Khurtsidze E, Vontetsianos A, Pennati F, Sivapalan P, Latimer LE, Marillier M, Hui CY, Kaltsakas G, Kolekar S, Vagheggini G, Vicente C, Drummond D, Poberezhets V, Bayat S, Franssen FM, Vogiatzis I, Gille T. ERS International Congress 2023: highlights from the Respiratory Clinical Care and Physiology Assembly. ERJ Open Res 2024; 10:00178-2024. [PMID: 38770003 PMCID: PMC11103686 DOI: 10.1183/23120541.00178-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 05/22/2024] Open
Abstract
It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2023 European Respiratory Society International Congress within the sessions from the five groups of Assembly 1 (Respiratory Clinical Care and Physiology). Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.
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Affiliation(s)
- Apolline Gonsard
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP and Université Paris Cité, Paris, France
- These authors have contributed equally to this work and share first authorship
| | - Evgeni Mekov
- Department of Pulmonary Diseases, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
- These authors have contributed equally to this work and share first authorship
| | - Sarah Barron
- Tallaght University Hospital, Dublin, Ireland
- These authors have contributed equally to this work and share first authorship
| | - Giorgio Castellana
- Istituti Clinici Scientifici Maugeri SpA SB, IRCCS, Institute of Bari, Bari, Italy
- These authors have contributed equally to this work and share first authorship
| | - Elene Khurtsidze
- Alte University, Tbilisi, Georgia
- Clinical Department, Geo Hospitals, Tbilisi, Georgia
- These authors have contributed equally to this work and share first authorship
| | - Angelos Vontetsianos
- 1st Respiratory Medicine Department, “Sotiria” Hospital for Diseases of the Chest, National and Kapodistrian University of Athens Medical School, Athens, Greece
- These authors have contributed equally to this work and share first authorship
| | - Francesca Pennati
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
- These authors have contributed equally to this work and share first authorship
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Department of Medicine, Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- University of Copenhagen, Faculty of Health Sciences, Department of Clinical Medicine, Copenhagen, Denmark
- These authors have contributed equally to this work and share first authorship
| | - Lorna E. Latimer
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, National Institute for Health Research Leicester Biomedical Research Centre – Respiratory, Glenfield Hospital, Leicester, UK
- These authors have contributed equally to this work and share first authorship
| | - Mathieu Marillier
- Université Grenoble Alpes, Inserm, Laboratoire HP2, Grenoble, France
- Laboratory of Clinical Exercise Physiology, Queen's University, Kingston, ON, Canada
- These authors have contributed equally to this work and share first authorship
| | - Chi-Yan Hui
- The University of Edinburgh, Allergy and Respiratory Research Group, Usher Institute, Edinburgh, UK
- These authors have contributed equally to this work and share first authorship
| | - Georgios Kaltsakas
- 1st Respiratory Medicine Department, “Sotiria” Hospital for Diseases of the Chest, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
- Centre of Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Shailesh Kolekar
- University of Copenhagen, Faculty of Health Sciences, Department of Clinical Medicine, Copenhagen, Denmark
- Zealand University Hospital Roskilde, Department of Internal Medicine, Roskilde, Denmark
| | - Guido Vagheggini
- Azienda USL Toscana Nord Ovest, Department of Medical Specialties, Chronic Respiratory Failure Care Pathway, Volterra, Italy
- Fondazione Volterra Ricerche Onlus, Volterra, Italy
| | | | - David Drummond
- Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, AP-HP and Université Paris Cité, Paris, France
- Inserm UMR 1138, HeKA team, Centre de Recherche des Cordeliers, Paris, France
| | - Vitalii Poberezhets
- Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Sam Bayat
- CHU Grenoble Alpes, Service de Pneumologie et de Physiologie, Grenoble, France
- Université Grenoble Alpes, Inserm UA07 STROBE, Grenoble, France
| | - Frits M.E. Franssen
- Maastricht Universitair Medisch Centrum+, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Thomas Gille
- Physiologie et Explorations Fonctionnelles, DMU NARVAL, Hôpitaux Universitaires de Paris Seine-Saint-Denis, AP-HP, Bobigny, France
- Inserm UMR 1272 “Hypoxia & the Lung”, UFR SMBH Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France
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Szabó GV, Szigetváry C, Szabó L, Dembrovszky F, Rottler M, Ocskay K, Madzsar S, Hegyi P, Molnár Z. Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis. Intern Emerg Med 2023; 18:639-653. [PMID: 36310302 PMCID: PMC10017566 DOI: 10.1007/s11739-022-03126-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022]
Abstract
The early, appropriate management of acute onset dyspnea is important but often challenging. The aim of this study was to investigate the effects of the use of Point-of-Care Ultrasound (PoCUS) versus conventional management on clinical outcomes in patients with acute onset dyspnea. The Cochrane Library, MEDLINE, EMBASE and reference lists were searched to identify eligible trials (inception to October 14, 2021). There were no language restrictions. Randomized controlled trials (RCTs), and prospective and retrospective cohort studies that compared PoCUS with conventional diagnostic modalities (controls) in patients with acute onset dyspnea were included. Two independent reviewers extracted data and assessed the risk of bias. Disagreements were resolved by consensus. The primary study outcomes were time to diagnosis, time to treatment, and length of stay (LOS). Secondary outcomes included rate of appropriate treatment, 30-day re-admission rate, and mortality. We included eight RCTs and six observational studies with a total of 5393 participants. Heterogeneity across studies was variable (from low to considerable), with overall low or moderate study quality and low or moderate risk of bias (except one article with serious risk of bias). Time to diagnosis (mean difference [MD], - 63 min; 95% CI, - 115 to - 11 min] and time to treatment (MD, - 27 min; 95% CI - 43 to - 11 min) were significantly shorter in the PoCUS group. In-hospital LOS showed no differences between the two groups, but LOS in the Intensive Care Unit (MD, - 1.27 days; - 1.94 to - 0.61 days) was significantly shorter in the PoCUS group. Patients in the PoCUS group showed significantly higher odds of receiving appropriate therapy compared to controls (odds ratio [OR], 2.31; 95% CI, 1.61-3.32), but there was no significant effect on 30-day re-admission rate and in-hospital or 30-day mortality. Our results indicate that PoCUS use contributes to early diagnosis and better outcomes compared to conventional methods in patients admitted with acute onset dyspnea.
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Affiliation(s)
- Gergő Vilmos Szabó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Emergency Department, Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
- National Ambulance Service, Budapest, Hungary
- Hungarian Air Ambulance Nonprofit Ltd., Budaörs, Hungary
| | - Csenge Szigetváry
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
| | - László Szabó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Fanni Dembrovszky
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Máté Rottler
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Department of Anesthesiology and Intensive Therapy, Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - Klemetina Ocskay
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Stefanie Madzsar
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.
- Department of Anesthesiology and Intensive Therapy, Poznan University, Poznan, Poland.
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Diagnostic test accuracy of imaging modalities for adults with acute pulmonary embolism: A systematic review and meta-analysis. J Med Imaging Radiat Sci 2023; 54:178-194. [PMID: 36456459 DOI: 10.1016/j.jmir.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to evaluate the current literature on diagnostic test accuracy (DTA) of imaging modalities for adults with acute pulmonary embolism (APE). BACKGROUND Medical imaging plays an integral role in evaluating and managing those with APE. Guidance for imaging modality use for APE diagnosis varies due to a lack of clinical standardisation. Despite this, CTPA remains the first-line imaging modality used by clinicians. METHODS A literature search of PubMed, EMBASE, Trove and Mednar databases (2012-2020; English language) was performed. Studies assessing the DTA of imaging modalities for APE diagnosis were included. DTA studies methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2 tool). Results of eligible studies were pooled using random or fixed effects modelling the calculate the pooled DTA of explored imaging modalities for APE. The Higgins I2 test were performed to assess between study heterogeneity. RESULTS 10 Studies, involving 998 participants, were enrolled and pooled using the random effects model. Of the explored modalities, magnetic resonance imaging (MRI), specifically pulmonary MRI and magnetic resonance pulmonary angiography (MRPA) exhibited the highest pooled DTA. Sensitivity, specificity, negative likelihood ratio, positive likelihood ratio and diagnostic odds ratio for MRPA were 0.952 (95% CI, 0.881 to 0.987), 0.857 (95% CI, 0.637 to 0.97), 5.631 (95% CI, 2.163 to 14.659), 0.06 (95% CI, 0.007 to 0.537) and 80.310 (95% CI, 15.607 to 413.25) respectively. Based on the QUADAS-2 criteria, most studies presented low to moderate risk of bias and concern regarding applicability. CONCLUSION The explored ultrasound and MRI protocols which exhibit a lower radiation burden when compared to the current gold standard computed tomography pulmonary angiography (CTPA), have acceptable diagnostic accuracy for APE and can be useful in certain situations.
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