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Leung DH, Ye W, Schwarzenberg SJ, Freeman AJ, Palermo JJ, Weymann A, Alonso EM, Karnsakul WW, Murray KF, Stoll JM, Huang S, Karmazyn B, Masand P, Magee JC, Alazraki AL, Towbin AJ, Nicholas JL, Green N, Otto RK, Siegel MJ, Ling SC, Navarro OM, Harned RK, Narkewicz MR, Molleston JP. Long-term follow-up and liver outcomes in children with cystic fibrosis and nodular liver on ultrasound in a multi-center study. J Cyst Fibros 2022; 22:248-255. [PMID: 35985930 DOI: 10.1016/j.jcf.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/30/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Nodular liver (NOD) in cystic fibrosis (CF) suggests advanced CF liver disease (aCFLD); little is known about progression of liver disease (LD) after detection of sonographic NOD. METHODS Clinical, laboratory, and ultrasound (US) data from Prediction by Ultrasound of the Risk of Hepatic Cirrhosis in CFLD Study participants with NOD at screening or follow-up were compared with normal (NL). Linear mixed effects models were used for risk factors for LD progression and Kaplan-Meier estimator for time-to-event. RESULTS 54 children with NOD (22 screening, 32 follow-up) and 112 NL were evaluated. Baseline (BL) and trajectory of forced expiratory volume, forced vital capacity, height/BMI z-scores were similar in NOD vs NL. Platelets were lower in NOD at BL (250 vs 331×103/microL; p < 0.001) and decreased by 8600/year vs 2500 in NL. Mean AST to Platelet Ratio Index (1.1 vs 0.4; p < 0.001), Fibrosis-4 Index (0.4 vs 0.2, p < 0.001), and spleen size z-score (SSZ) [1.5 vs 0.02; p < 0.001] were higher in NOD at BL; SSZ increased by 0.5 unit/year in NOD vs 0.1 unit/year in NL. Median liver stiffness (LSM) by transient elastography was higher in NOD (8.2 kPa, IQR 6-11.8) vs NL (5.3, 4.2-7, p < 0.0001). Over 6.3 years follow-up (1.3-10.3), 6 NOD had esophageal varices (cumulative incidence in 10 years: 20%; 95% CI: 0.0%, 40.0%), 2 had variceal bleeding, and 2 underwent liver transplantation; none had ascites or hepatic encephalopathy. No NL experienced liver-related events. CONCLUSIONS NOD developed clinically evident portal hypertension faster than NL without worse growth or lung disease.
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Key Words
- ALT, alanine aminotransferase
- APRI, aspartate aminotransferase to platelet ratio index
- AST, aminotransferase
- CAP, continuous attenuation parameter
- CFRD, cystic-fibrosis-related diabetes
- CFTR, cystic fibrosis transmembrane regulator
- Cirrhosis
- Cystic fibrosis liver disease
- FEV1, forced expiratory volume in one second
- FIB4, fibrosis index based on four factors
- FVC, forced vital capacity
- GGT, gamma-glutamyl transferase
- IGT, impaired glucose tolerance
- INR, international normalized ratio
- LSM, liver stiffness measurement
- NL, normal
- NOD, nodular
- PELD, pediatric end-stage liver disease
- PUSH, prediction by ultrasound of the risk of hepatic cirrhosis
- US, ultrasound
- Ultrasound
- VCTE, vibration controlled transient elastography
- WBC, white blood cell count
- abbreviations: CF, cystic fibrosis
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Affiliation(s)
- Daniel H Leung
- Department of Pediatrics, Baylor College of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital, 6621 Fannin St, CCC 1010.00, Houston, TX 77030, USA
| | - Wen Ye
- Department of Biostatistics, University of Michigan, 1420 Washington Heights, M4073 SPH II, Ann Arbor, MI 48109, USA
| | - Sarah J Schwarzenberg
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Minnesota, 2450 Riverside Save S AO-201, Minneapolis, MN 55454, USA
| | - A Jay Freeman
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Healthcare of Atlanta, Emory University, 2015 Uppergate Drive, NE, Atlanta, GA 30322, USA
| | - Joseph J Palermo
- Department of Pediatrics, Division of Gastroenterology, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 2010, Cincinnati, OH 45229, USA
| | - Alexander Weymann
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH 43205, USA
| | - Estella M Alonso
- Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue, Box 57, Chicago, IL 60611, USA
| | - Wikrom W Karnsakul
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Johns Hopkins University School of Medicine, 600 N Wolfe Street, CMSC-2, Baltimore, MD 21287, USA
| | - Karen F Murray
- Pediatric Institute and Cleveland Clinic Children's, Cleveland Clinic, 8950 Euclid Avenue, R3, Cleveland, OH 44195, USA
| | - Janis M Stoll
- Department of Pediatrics, Division of Gastroenterology, Pediatric Hepatology and Nutrition, Washington University School of Medicine in St. Louis, One Children's Place, Suite 8116, St. Louis, MO 63110, USA
| | - Suiyuan Huang
- Department of Biostatistics, University of Michigan, 1420 Washington Heights, M4073 SPH II, Ann Arbor, MI 48109, USA
| | - Boaz Karmazyn
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd, Rm 0663, Indianapolis, IN 46202, USA
| | - Prakash Masand
- Department of Pediatrics, Baylor College of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital, 6621 Fannin St, CCC 1010.00, Houston, TX 77030, USA
| | - John C Magee
- Department of Surgery, University of Michigan School of Medicine, 1500 E Medical Center Drive, UH South Rm 6689, Ann Arbor, MI 48109, USA
| | - Adina L Alazraki
- Department of Radiology, Children's Healthcare of Atlanta, Emory University, 1405 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Alexander J Towbin
- Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman Street, PO Box 670761, Cincinnati, OH 45267, USA
| | - Jennifer L Nicholas
- Department of Radiology, Division of Pediatric Imaging, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Nicole Green
- Department of Pediatrics, Division of Gastroenterology and Hepatology, Seattle Children's Hospital, 4800 Sand Point Way NE, PO Box 5371, Seattle, WA 98105, USA
| | - Randolph K Otto
- Department of Radiology, Seattle Children's Hospital, 4800 Sand Point Way NE, MA.7.220, Seattle, WA 98105, USA
| | - Marilyn J Siegel
- Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Blvd, St. Louis, MO 63110, USA
| | - Simon C Ling
- Department of Paediatrics, Division of Gastroenterology, Hepatology and Nutrition, University of Toronto, 555 University Ave ON, Toronto, M5G 1X8, Canada
| | - Oscar M Navarro
- Department of Diagnostic Imaging, Division of Pediatric Imaging, University of Toronto, 263 McCaul St 4th floor, Toronto, ON M5T 1W7, Canada
| | - Roger K Harned
- Department of Radiology-Diagnostics, University of Colorado School of Medicine, 13123 East 16th Avenue, B125, Aurora, CO 80045, USA
| | - Michael R Narkewicz
- Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, B290, Aurora, CO 80045, USA
| | - Jean P Molleston
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Riley Hospital for Children at IU Health, Indiana University School of Medicine, 705 Riley Hospital Drive, ROC 4210, Indianapolis, IN 46202, USA.
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Nap-van der Vlist MM, Houtveen J, Dalmeijer GW, Grootenhuis MA, van der Ent CK, van Grotel M, Swart JF, van Montfrans JM, van de Putte EM, Nijhof SL. Internet and smartphone-based ecological momentary assessment and personalized advice (PROfeel) in adolescents with chronic conditions: A feasibility study. Internet Interv 2021; 25:100395. [PMID: 34026566 DOI: 10.1016/j.invent.2021.100395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 03/09/2021] [Accepted: 04/12/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Growing up with a chronic disease comes with challenges, such as coping with fatigue. Many adolescents are severely fatigued, though its associated factors exhibit considerable interpersonal and longitudinal variation. We assessed whether PROfeel, a combination of a smartphone-based ecological momentary assessment (EMA) method using the internet, followed by a face-to-face dialogue and personalized advice for improvement of symptoms or tailor treatment based on a dynamic network analysis report, was feasible and useful. STUDY DESIGN Feasibility study in fatigued outpatient adolescents 12-18 years of age with cystic fibrosis, autoimmune disease, post-cancer treatment, or with medically unexplained fatigue. Participants were assessed at baseline to personalize EMA questions. EMA was conducted via smartphone notifications five times per day for approximately six weeks. Hereby, data was collected via the internet. The EMA results were translated into a personalized report, discussed with the participant, and subsequently translated into a personalized advice. Afterwards, semi-structured interviews on feasibility and usefulness were held. RESULTS Fifty-seven adolescents were assessed (mean age 16.2 y ± 1.6, 16% male). Adolescents deemed the smartphone-based EMA feasible, with the app being used for an average of 49 days. Forty-two percent of the notifications were answered and 85% of the participants would recommend the app to other adolescents. The personalized report was deemed useful and comprehensible and 95% recognized themselves in the personalized report, with 64% rating improved insight in their symptoms and subsequent steps towards an approach to reduce one's fatigue as good or very good. CONCLUSIONS PROfeel was found to be highly feasible and useful for fatigued adolescents with a chronic condition. This innovative method has clinical relevance through bringing a patient's daily life into the clinical conversation.
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Signes-Costa J, Núñez-Gil IJ, Soriano JB, Arroyo-Espliguero R, Eid CM, Romero R, Uribarri A, Fernández-Rozas I, Aguado MG, Becerra-Muñoz VM, Huang J, Pepe M, Cerrato E, Raposeiras S, Gonzalez A, Franco-Leon F, Wang L, Alfonso E, Ugo F, García-Prieto JF, Feltes G, Abumayyaleh M, Espejo-Paeres C, Jativa J, Masjuan AL, Macaya C, Carbonell Asíns JA, Estrada V. Prevalence and 30-Day Mortality in Hospitalized Patients With Covid-19 and Prior Lung Diseases. Arch Bronconeumol 2021; 57:13-20. [PMID: 34629634 PMCID: PMC7744014 DOI: 10.1016/j.arbres.2020.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Patients with pre-existing respiratory diseases in the setting of COVID-19 may have a greater risk of severe complications and even death. METHODS A retrospective, multicenter, cohort study with 5847 COVID-19 patients admitted to hospitals. Patients were separated in two groups, with/without previous lung disease. Evaluation of factors associated with survival and secondary composite end-point such as ICU admission and respiratory support, were explored. RESULTS 1,271 patients (22%) had a previous lung disease, mostly COPD. All-cause mortality occurred in 376 patients with lung disease (29.5%) and in 819 patients without (17.9%) (p < 0.001). Kaplan-Meier curves showed that patients with lung diseases had a worse 30-day survival (HR = 1.78; 95%C.I. 1.58-2.01; p < 0.001) and COPD had almost 40% mortality. Multivariable Cox regression showed that prior lung disease remained a risk factor for mortality (HR, 1.21; 95%C.I. 1.02-1.44; p = 0.02). Variables independently associated with all-cause mortality risk in patients with lung diseases were oxygen saturation less than 92% on admission (HR, 4.35; 95% CI 3.08-6.15) and elevated D-dimer (HR, 1.84; 95% CI 1.27-2.67). Age younger than 60 years (HR 0.37; 95% CI 0.21-0.65) was associated with decreased risk of death. CONCLUSIONS Previous lung disease is a risk factor for mortality in patients with COVID-19. Older age, male gender, home oxygen therapy, and respiratory failure on admission were associated with an increased mortality. Efforts must be done to identify respiratory patients to set measures to improve their clinical outcomes.
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Key Words
- 30-Day mortality
- ACE2, angiotensin converting enzyme II
- CI, confidence interval
- COPD
- COPD, chronic obstructive pulmonary disease
- COVID-19
- COVID-19, 2019 novel coronavirus
- CQ/HCQ, chloroquine/hydroxychloroquine
- FEV1, forced expiratory volume in one second
- HFNC, high flow nasal cannula
- HOPE-COVID-19, Health Outcome Predictive Evaluation for COVID-19
- HR, hazard ratio
- ICS, inhaled corticosteroids
- ICU, intensive care unit
- ILD, interstitial lung disease
- IQR, interquartile range
- MERS, middle east respiratory syndrome
- Prognosis
- RT-PCR, real time reverse transcriptase-polymerase chain reaction
- Respiratory diseases
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- STROBE, strengthening the reporting of observational studies in epidemiology
- WHO, World Health Organization
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Affiliation(s)
- Jaime Signes-Costa
- Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain
| | - Iván J Núñez-Gil
- Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Joan B Soriano
- Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - Charbel Maroun Eid
- Hospital Universitario La Paz, Instituto de Investigacion, Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | | | - Aitor Uribarri
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Víctor Manuel Becerra-Muñoz
- Unidad de Gestión Clínica Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERCV, Málaga, Spain
| | - Jia Huang
- The Second People's Hospital of Shenzhen, Shenzhen, China
| | - Martino Pepe
- Azienda ospedaliero-universitaria consorziale policlinico di Bari, Italy
| | - Enrico Cerrato
- San Luigi Gonzaga University Hospital, Rivoli, Turin, Italy
| | | | - Adelina Gonzalez
- Hospital Universitario Infanta Sofia, San Sebastián de los Reyes, Madrid, Spain
| | | | - Lin Wang
- Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Alfonso
- Instituto de Cardiología y Cirugía Cardiovascular, Havana, Cuba
| | | | | | | | - Mohammad Abumayyaleh
- First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
| | | | - Jorge Jativa
- Hospital de Especialidades de las Fuerzas Armadas N1, Quito, Ecuador
| | | | - Carlos Macaya
- Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | - Vicente Estrada
- Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Hino T, Hata A, Hida T, Yamada Y, Ueyama M, Araki T, Kamitani T, Nishino M, Kurosaki A, Jinzaki M, Ishigami K, Honda H, Hatabu H, Kudoh S. Projected lung areas using dynamic X-ray (DXR). Eur J Radiol Open 2020; 7:100263. [PMID: 32953949 PMCID: PMC7486627 DOI: 10.1016/j.ejro.2020.100263] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/31/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022] Open
Abstract
The right projected lung area (PLA) was significantly larger than left one. PLA had correlation with height, weight, BMI, vital capacity (VC), and forced expiratory volume in one second (FEV1). Multivariate analysis showed that body mass index (BMI), sex and VC were considered independent correlation factors, respectively.
Background Dynamic X-ray (DXR) provides images of multiple phases of breath with less radiation exposure than CT. The exact images at end-inspiratory or end-expiratory phases can be chosen accurately. Purpose To investigate the correlation of the projected lung area (PLA) by dynamic chest X-ray with pulmonary functions. Material and Methods One hundred sixty-two healthy volunteers who received medical check-ups for health screening were included in this study. All subjects underwent DXR in both posteroanterior (PA) and lateral views and pulmonary function tests on the same day. All the volunteers took several tidal breaths before one forced breath as instructed. The outlines of lungs were contoured manually on the workstation with reference to the motion of diaphragm and the graph of pixel values. The PLAs were calculated automatically, and correlations with pulmonary functions and demographic data were analyzed statistically. Results The PLAs have correlation with physical characteristics, including height, weight and BMI, and pulmonary functions such as vital capacity (VC) and forced expiratory volume in one second (FEV1). VC and FEV1 revealed moderate correlation with the PLAs of PA view in forced inspiratory phase (VC: right, r = 0.65; left, r = 0.69. FEV1: right, r = 0.54; left, r = 0.59). Multivariate analysis showed that body mass index (BMI), sex and VC were considered independent correlation factors, respectively. Conclusion PLA showed statistically significant correlation with pulmonary functions. Our results indicate DXR has a possibility to serve as an alternate method for pulmonary function tests in subjects requiring contact inhibition including patients with suspected or confirmed covid-19.
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Key Words
- %FEV1, percent predicted FEV1
- %VC, percent vital capacity
- BMI, body mass index
- COPD, chronic obstructive pulmonary disease
- Chest radiograph
- DXR, dynamic X-ray
- FEV1%, forced expiratory volume percent in one second divided by FVC
- FEV1, forced expiratory volume in one second
- FPD, flat-panel detector
- FVC, forced vital capacity
- Health screening cohort
- IPF, idiopathic pulmonary fibrosis
- PA, posteroanterior
- PFTs, pulmonary function tests
- PLA, projected lung area
- Projected lung area
- Pulmonary function
- TLC, total lung capacity
- TV, tidal volume
- VC, vital capacity
- dynamic X-ray
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Affiliation(s)
- Takuya Hino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA
- Corresponding author at: Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
| | - Akinori Hata
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA
| | - Tomoyuki Hida
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Yoshitake Yamada
- Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Masako Ueyama
- Department of Health Care, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan
| | - Tetsuro Araki
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA
| | - Takeshi Kamitani
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Mizuki Nishino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA
| | - Atsuko Kurosaki
- Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Boston, MA, USA
| | - Shoji Kudoh
- Japan Anti-Tuberculosis Association, 1-3-12 Kanda-Misakicho, Chiyoda-ku, Tokyo, Japan
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Eckrich J, Hinkel J, Fischl A, Herrmann E, Holtappels G, Bachert C, Zielen S. Nasal IgE in subjects with allergic and non-allergic rhinitis. World Allergy Organ J 2020; 13:100129. [PMID: 32612737 PMCID: PMC7322186 DOI: 10.1016/j.waojou.2020.100129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 01/15/2023] Open
Abstract
Purpose The prevalence of "ocal allergic rhinitis" within individuals suffering from perennial rhinitis remains uncertain, and patients usually are diagnosed with non-allergic rhinitis. The aim of this study was to evaluate the prevalence of a potential "local allergic rhinitis" in subjects suffering from non-allergic rhinitis in a non-selected group of young students. Methods 131 students (age 25.0 ± 5.1 years) with a possible allergic rhinitis and 25 non-allergic controls without rhinitis symptoms (age 22.0 ± 2.0 years) were recruited by public postings. 97 of 131 students with rhinitis were tested positive (≥3 mm) to prick testing with 17 frequent allergens at visit 1. Twenty-four 24 subjects with a house dust mite allergy, 21 subjects with a non-allergic rhinitis, and 18 non-allergic controls were further investigated at visit 2. Blood samples were taken, and nasal secretion was examined. In addition, all groups performed a nasal provocation test with house dust mite (HDM). Results In serum and nasal secretion, total IgE and house dust mite specific IgE significantly differed between HDM positive subjects and controls. However, no differences between non-allergic subjects and control subjects were quantifiable. Neither a nasal provocation test nor a nasal IgE to HDM allergens showed a measurable positive response in any of the non-allergic rhinitis subjects as well as the healthy controls, whilst being positive in 13 subjects with HDM allergy. Conclusions Nasal IgE is present in subjects with HDM allergy, but not in non-allergic rhinitis. In the investigated non-selected population, exclusive local production of IgE is absent. By implication, therefore, our findings challenge the emerging concept of local allergic rhinitis.Study identifier at ClinicalTrials.gov: NCT02810535.
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Key Words
- AR, allergic rhinitis
- AR + HDM, allergic rhinitis with house dust mite allergy
- Allergic rhinitis
- D1, Dermatophagoides pteronyssinus
- D2, Dermatophagoides farinae
- FEV1, forced expiratory volume in one second
- FVC, forced vital capacity
- GCP, Good Clinical Practice
- HDM, house dust mite
- House dust mite allergy
- ISAAC, International Study of Asthma and Allergies in Childhood questionnaire
- LAR, local allergic rhinitis
- Local IgE
- Local allergic rhinitis
- NARES, non-allergic rhinitis with eosinophilia-syndrome
- NPT, nasal provocation tests
- Non-allergic-rhinitis
- PNIF, peak nasal inspiratory flow
- RAST, Radioallergosorbent Test
- SD, standard deviation
- SPT, skin prick test
- sIgE, allergen-specific IgE
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Affiliation(s)
- Jonas Eckrich
- Department of Otolaryngology, Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Julia Hinkel
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt, Germany
| | - Anna Fischl
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University, Frankfurt, Germany
| | | | - Claus Bachert
- Upper Airways Research Laboratory, Ghent University, B-9000 Ghent, Belgium
| | - Stefan Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University, Frankfurt, Germany
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Feijen J, Seys SF, Steelant B, Bullens DM, Dupont LJ, García-Cruz M, Jimenez-Chobillón A, Larenas-Linnemann D, Van Gerven L, Fokkens WJ, Agache I, Hellings PW. Prevalence and triggers of self-reported nasal hyperreactivity in adults with asthma. World Allergy Organ J 2020; 13:100132. [PMID: 32642023 PMCID: PMC7334478 DOI: 10.1016/j.waojou.2020.100132] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Nasal hyperreactivity (NHR) is a common feature of various rhinitis subtypes and represents a novel phenotype of rhinitis. It is being reported in two-thirds of adult rhinitis patients irrespective of the atopic status. Data on the prevalence of NHR in patients with asthma are lacking, as well as the nature of evoking triggers. METHODS Postal questionnaires were distributed to an unselected group of asthmatic patients in Leuven (Belgium, n = 190) and completed by 114 patients. In Mexico City (Mexico) and Brasov (Romania), respectively, 97 out of 110 and 80 out of 100 asthmatic patients attending the outpatient clinic completed the questionnaire. Non-asthmatic volunteers were recruited amongst university and hospital co-workers in Leuven (n = 53). The presence of self-reported NHR, the type of triggers evoking nasal and bronchial symptoms, medication use, self-reported allergy, and environmental factors were evaluated. RESULTS Overall, 69% of asthma patients reported NHR, with 32% having more than 4 triggers evoking NHR. These triggers included mainly exposure to temperature and humidity changes, cigarette smoke, and strong odours. A higher prevalence of NHR was detected in allergic compared to non-allergic asthma patients (73% vs. 53% p < 0.01). The prevalence of NHR correlated with asthma severity, ranging from 63% (VAS ≤3) to 81% (VAS ≥7). BHR was found more frequently in patients with NHR compared to without NHR (89% vs. 53%, p < 0.0001). CONCLUSION NHR represents a clinical phenotype of upper airway disease affecting over two-thirds of asthma patients and correlates with asthma severity. Targeting NHR in patients with asthma is often overlooked and should be reinforced in the future to achieve better symptom control.
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Affiliation(s)
- Jef Feijen
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Belgium
| | - Sven F. Seys
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Brecht Steelant
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Dominique M.A. Bullens
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
- Clinical Division of Pediatrics, University Hospitals Leuven, Belgium
| | - Lieven J. Dupont
- Department of Respiratory Medicine, University Hospitals Leuven, Belgium
| | - Maria García-Cruz
- Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | | | | | - Laura Van Gerven
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Belgium
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
| | - Ioana Agache
- Department of Fundamental, Prophylactic and Clinical Disciplines, Transylvania University of Brasov, Romania
| | - Peter W. Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Belgium
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands
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Oguonu T, Obumneme-Anyim IN, Eze JN, Ayuk AC, Okoli CV, Ndu IK. Prevalence and determinants of airflow limitation in urban and rural children exposed to cooking fuels in South-East Nigeria. Paediatr Int Child Health 2018. [PMID: 29542392 DOI: 10.1080/20469047.2018.1445506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background Biofuels and other cooking fuels are used in households in low- and middle-income countries. Aim To investigate the impact of cooking fuels on lung function in children in urban and rural households in South-East Nigeria. Methods The multi-stage sampling method was used to enroll children exposed to cooking fuel in the communities. Lung function values FEV1, FVC and the FEV1/FVC ratio, were measured with ndd EasyOneR spirometer. Airflow limitation was determined with FEV1/FVC Z-score values at -1.64 as the lower limit of normal (LLN5). The Global Lung Function Initiative 2012 software was used to calculate the lung function indices. Results The median age (range) of the 912 children enrolled was 10.6 years (6-18). Altogether, 468 (51.6%) children lived in rural areas. Seven hundred and thirty-seven (80.7%) were directly exposed to cooking fuels (418/737, 56.5% in rural areas). Wood and kerosene were the dominant fuels in rural and urban households. The respective mean Z-scores of the exposed children in rural and urban were zFEV1 -0.62, FVC -0.21, FEV1/FVC -0.83 and zFEV1 -0.57, zFVC -0.14, FEV1/FVC -0.75. Few (5.2%, 38/737) of the children had airflow limitation. Most of them (60.5%, 25/38) lived in the rural community; the lowest FEV1/FVC Z-scores were those of exposed to a combination of fuels. Conclusion Exposure to cooking fuels affects lung function in children with airway limitation in a small proportion, Control measures are advocated to reduce the morbidity related to cooking fuels exposure.
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Key Words
- ANOVA, analysis of variance
- ATS/ERS, American Thoracic Society and European Respiratory Society
- Airflow limitation
- BMI, body mass index
- DALY, disability-adjusted life years
- FER, forced expiratory ratio
- FEV1, forced expiratory volume in one second
- FEV1/FVC, forced expiratory volume in one second and forced vital capacity
- FEV6, forced expiratory volume in 6 s
- FVC, forced vital capacity
- GLI, global lung function initiative
- HAP, household air pollution
- IQR, interquartile ratio
- LLN, lower limit of normal
- LMS, Lambda–Mu–Sigma
- LPG, liquefied petroleum gas
- MA, Massachusetts
- NHANES III, Third National Health and Nutrition Examination Survey
- NHREC, Nigeria Health Research and Ethics Committee
- Nigeria
- PM, particulate matter
- SD, standard deviation
- SEC, socio-economic class
- SPSS, Statistical Package for Social Sciences
- WHO, World Health Organization
- children
- cooking fuel exposure
- lung function
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Affiliation(s)
- Tagbo Oguonu
- a Department of Paediatrics , University of Nigeria Teaching Hospital , Enugu State , Nigeria
| | - Ijeoma N Obumneme-Anyim
- a Department of Paediatrics , University of Nigeria Teaching Hospital , Enugu State , Nigeria
| | - Joy N Eze
- a Department of Paediatrics , University of Nigeria Teaching Hospital , Enugu State , Nigeria
| | - Adaeze C Ayuk
- a Department of Paediatrics , University of Nigeria Teaching Hospital , Enugu State , Nigeria.,b Paediatric Pulmonology firm , Red Cross War Memorial Children's Hospital , Cape Town , South Africa
| | - Chinyere V Okoli
- a Department of Paediatrics , University of Nigeria Teaching Hospital , Enugu State , Nigeria.,c Department of Paediatrics , Nyanya General Hospital , Abuja , Nigeria
| | - Ikenna K Ndu
- a Department of Paediatrics , University of Nigeria Teaching Hospital , Enugu State , Nigeria.,d Department of Paediatrics , Enugu State University of Science and Technology , Enugu , Nigeria
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8
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Koshak A, Koshak E, Heinrich M. Medicinal benefits of Nigella sativa in bronchial asthma: A literature review. Saudi Pharm J 2017; 25:1130-1136. [PMID: 30166900 PMCID: PMC6111118 DOI: 10.1016/j.jsps.2017.07.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 07/09/2017] [Indexed: 02/06/2023] Open
Abstract
Nigella sativa L. (NS) seeds, known as black seed, is a spice and a traditional herbal medicine used in various diseases including bronchial asthma. This review aimed to assess the studies supporting the medicinal use of NS in asthma and to highlight future research priorities. Various medical databases were searched for the effects of NS and its active secondary metabolites in asthma inflammation and outcomes. There were fourteen preclinical studies describing multiple effects of NS in animal or cellular models of asthma including bronchodilation, anti-histaminic, anti-inflammatory, anti-leukotrienes and immunomodulatory effects. Furthermore, seven clinical studies showed improvements in different asthma outcomes including symptoms, pulmonary function and laboratory parameters. However, often these studies are small and used ill-defined preparations. In conclusion, NS could be therapeutically beneficial in alleviating airway inflammation and the control of asthma symptoms, but the evidence remains scanty and is often based on poorly characterised preparations. Accordingly, well-designed large clinical studies using chemically well characterised NS preparation are required.
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Key Words
- ACT, Asthma Control Test
- Asthma
- Black seed
- Clinical studies
- FEV1, forced expiratory volume in one second
- FeNO, fractional exhaled nitric oxide
- GINA, Global Initiative for Asthma
- IL, Interleukin
- IgE, Immunoglobulin E
- NS, Nigella sativa L.
- Nigella sativa
- RDBCT, Randomised Double-Blinded Clinical Trial
- RDBPCT, Randomised Double-Blinded Placebo-Controlled Clinical Trial
- RSBPCT, Randomised Single-Blinded Placebo-Controlled Clinical Trial
- Th1, Type 1 T helper (Th1) cells
- Th2, Type 2 T helper (Th2) cells
- Traditional medicine
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Affiliation(s)
- Abdulrahman Koshak
- Research Cluster Biodiversity and Medicines, UCL School of Pharmacy, University College London, London, UK.,Department of Natural Products & Alternative Medicine, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Emad Koshak
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Michael Heinrich
- Research Cluster Biodiversity and Medicines, UCL School of Pharmacy, University College London, London, UK
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Ito S, Araya J, Kurita Y, Kobayashi K, Takasaka N, Yoshida M, Hara H, Minagawa S, Wakui H, Fujii S, Kojima J, Shimizu K, Numata T, Kawaishi M, Odaka M, Morikawa T, Harada T, Nishimura SL, Kaneko Y, Nakayama K, Kuwano K. PARK2-mediated mitophagy is involved in regulation of HBEC senescence in COPD pathogenesis. Autophagy 2016; 11:547-59. [PMID: 25714760 PMCID: PMC4502689 DOI: 10.1080/15548627.2015.1017190] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cigarette smoke (CS)-induced mitochondrial damage with increased reactive oxygen species (ROS) production has been implicated in COPD pathogenesis by accelerating senescence. Mitophagy may play a pivotal role for removal of CS-induced damaged mitochondria, and the PINK1 (PTEN-induced putative kinase 1)-PARK2 pathway has been proposed as a crucial mechanism for mitophagic degradation. Therefore, we sought to investigate to determine if PINK1-PARK2-mediated mitophagy is involved in the regulation of CS extract (CSE)-induced cell senescence and in COPD pathogenesis. Mitochondrial damage, ROS production, and cell senescence were evaluated in primary human bronchial epithelial cells (HBEC). Mitophagy was assessed in BEAS-2B cells stably expressing EGFP-LC3B, using confocal microscopy to measure colocalization between TOMM20-stained mitochondria and EGFP-LC3B dots as a representation of autophagosome formation. To elucidate the involvement of PINK1 and PARK2 in mitophagy, knockdown and overexpression experiments were performed. PINK1 and PARK2 protein levels in lungs from patients were evaluated by means of lung homogenate and immunohistochemistry. We demonstrated that CSE-induced mitochondrial damage was accompanied by increased ROS production and HBEC senescence. CSE-induced mitophagy was inhibited by PINK1 and PARK2 knockdown, resulting in enhanced mitochondrial ROS production and cellular senescence in HBEC. Evaluation of protein levels demonstrated decreased PARK2 in COPD lungs compared with non-COPD lungs. These results suggest that PINK1-PARK2 pathway-mediated mitophagy plays a key regulatory role in CSE-induced mitochondrial ROS production and cellular senescence in HBEC. Reduced PARK2 expression levels in COPD lung suggest that insufficient mitophagy is a part of the pathogenic sequence of COPD.
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Key Words
- Baf A1, bafilomycin A1
- COPD
- COPD, chronic obstructive pulmonary disease
- CS, cigarette smoke
- CSE, cigarette smoke extract
- EM, electron microscopy
- FEV1, forced expiratory volume in one second
- FVC, forced vital capacity
- HBEC, human bronchial epithelial cell
- MAP1LC3/LC3, microtubule-associated protein 1 light chain 3
- NAC, N-acetylcysteine
- PARK2
- PCD, programmed cell death
- PINK1, PTEN-induced putative kinase 1
- ROS
- ROS, reactive oxygen species
- SA-β-Gal, senescence-associated β-galactosidase
- TLR, toll-like receptor
- WB, western blotting
- mitophagy
- senescence
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Affiliation(s)
- Saburo Ito
- a Division of Respiratory Diseases; Department of Internal Medicine ; Jikei University School of Medicine ; Tokyo , Japan
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10
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Sæverud HA, Borchsenius F, Mellem H, Finstad P, Skjønsberg OH. The obstructive siblings: Relapsing polychondritis without chondritis? Respir Med Case Rep 2013; 10:4-6. [PMID: 26029500 PMCID: PMC3920352 DOI: 10.1016/j.rmcr.2013.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/25/2013] [Accepted: 04/26/2013] [Indexed: 11/02/2022] Open
Abstract
Progressive narrowing of the central airways due to diffuse inflammation is a potential life-threatening condition. A number of diseases have been described as possible causes. We present two siblings with severe central airway obstruction. Despite considerable efforts we have not been able to match the clinical appearance of our patients with the diagnostic criteria of any of the disease entities known to cause this condition.
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Key Words
- ACE, angiotensin converting enzyme
- ANA, anti-nuclear antibody
- ANCA, anti-neutrophil cytoplasmic antibody
- CMV, cytomegalovirus
- CRP, C-reactive protein
- CT, computer tomography
- DLCO, diffusing capacity of the lung for carbon monoxide
- FEV1, forced expiratory volume in one second
- FVC, forced vital capacity
- GP, general practitioner
- Obstruction
- Polychondritis
- RF, rheumatoid factor
- RPC, relapsing polychondritis
- Siblings
- TLC, total lung capacity
- WG, Wegener's granulomatosis
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Affiliation(s)
- Haavard A Sæverud
- Dept. of Pulmonary Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, 0407 Oslo, Norway
| | - F Borchsenius
- Dept. of Pulmonary Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, 0407 Oslo, Norway
| | - H Mellem
- Dept. of Pulmonary Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, 0407 Oslo, Norway
| | - P Finstad
- Dept. of Pulmonary Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, 0407 Oslo, Norway
| | - Ole H Skjønsberg
- Dept. of Pulmonary Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, 0407 Oslo, Norway
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