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Archives of Computational Methods in... 2023Airway disease is a major healthcare issue that causes at least 3 million fatalities every year. It is also considered one of the foremost causes of death all around the... (Review)
Review
Airway disease is a major healthcare issue that causes at least 3 million fatalities every year. It is also considered one of the foremost causes of death all around the globe by 2030. Numerous studies have been undertaken to demonstrate the latest advances in artificial intelligence algorithms to assist in identifying and classifying these diseases. This comprehensive review aims to summarise the state-of-the-art machine and deep learning-based systems for detecting airway disorders, envisage the trends of the recent work in this domain, and analyze the difficulties and potential future paths. This systematic literature review includes the study of one hundred fifty-five articles on airway diseases such as cystic fibrosis, emphysema, lung cancer, Mesothelioma, covid-19, pneumoconiosis, asthma, pulmonary edema, tuberculosis, pulmonary embolism as well as highlights the automated learning techniques to predict them. The study concludes with a discussion and challenges about expanding the efficiency and machine and deep learning-assisted airway disease detection applications.
PubMed: 36189431
DOI: 10.1007/s11831-022-09818-4 -
Respiration; International Review of... 2020Spiration Valve System (SVS) is an alternative for patients with severe heterogeneous emphysema; however, data about efficacy from randomized controlled trials (RCT) are... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Spiration Valve System (SVS) is an alternative for patients with severe heterogeneous emphysema; however, data about efficacy from randomized controlled trials (RCT) are unclear.
OBJECTIVES
To explore both efficacy and safety of SVS in patients with severe emphysema and hyperinflation.
METHODS
We included PubMed, EMBASE, Coch-rane database. All searches were performed until August 2019. Only RCTs were included for analysis. Risk of bias was assessed using Cochrane risk of bias tool. A meta-analysis evaluated change in forced expiratory volume in 1 s (FEV1), 6-min walking test (6MWT), residual volume, modified medical research council (mMRC) and Saint George respiratory questionnaire (SGRQ), all-cause mortality, risk of pneumothorax, and risk of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Quality of the evidence was rated using GRADE approach.
RESULTS
Four RCTs including 629 subjects were included. SVS showed an overall change of 0.03 L (-0.07 to 0.13, I2 = 90%) in the in FEV1 (L) and a 2.03% (-2.50 to 6.57, I2 = 96%) in the predicted FEV1 (%) compared to baseline; however, studies without collateral ventilation (CV) showed an improvement of 0.12 L (95% CI 0.09-0.015, I2 = 0%), This subgroup also reported better results in SGRQ -12.27 points (95% CI -15.84 to -8.70, I2 = 0%) and mMRC -0.54 (95% CI -0.74 to -0.33, I2 = 0%). We found no benefit in 6MWT mean difference = 4.56 m (95% CI -21.88 to 31.00, I2 = 73%). Relative risk of mortality was 2.54 (95% CI 0.81-7.96, I2 = 0%), for pneumothorax 3.3 (95% CI 0.61-18.12, I2 = 0%) and AECOPD 1.68 (95% CI 1.04-2.70, I2 = 0%).
CONCLUSION
In patients with severe heterogeneous emphysema and hyperinflation without CV, SVS is an alternative that showed an improvement in pulmonary function, quality of life, and dyspnea score with an acceptable risk profile.
Topics: Humans; Pneumonectomy; Prosthesis Implantation; Pulmonary Emphysema; Severity of Illness Index; Surgical Instruments
PubMed: 31760389
DOI: 10.1159/000504183 -
Chest Mar 2017The indwelling pleural catheter (IPC), which was initially introduced for the management of recurrent malignant effusions, could be a valuable management option for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The indwelling pleural catheter (IPC), which was initially introduced for the management of recurrent malignant effusions, could be a valuable management option for recurrent benign pleural effusion (BPE), replacing chemical pleurodesis. The purpose of this study is to analyze the efficacy and safety of IPC use in the management of refractory nonmalignant effusions.
METHODS
We conducted a systematic review and meta-analysis on the published literature. Retrospective cohort studies, case series, and reports that used IPCs for the management of pleural effusion were included in the study.
RESULTS
Thirteen studies were included in the analysis, with a total of 325 patients. Congestive heart failure (49.8%) was the most common cause of BPE requiring IPC placement. The estimated average rate of spontaneous pleurodesis was 51.3% (95% CI, 37.1%-65.6%). The estimated average rate of all complications was 17.2% (95% CI, 9.8%-24.5%) for the entire group. The estimated average rate of major complications included the following: empyema, 2.3% (95% CI, 0.0%-4.7%); loculation, 2.0% (95% CI, 0.0%-4.7%); dislodgement, 1.3% (95% CI, 0.0%-3.7%); leakage, 1.3% (95% CI, 0.0%-3.5%); and pneumothorax, 1.2% (95% CI, 0.0%-4.1%). The estimated average rate of minor complications included the following: skin infection, 2.7% (95% CI, 0.6%-4.9%); blockage and drainage failure, 1.1% (95% CI, 0.0%-3.5%); subcutaneous emphysema, 1.1% (95% CI, 0.0%-4.0%); and other, 2.5% (95% CI, 0.0%-5.2%). One death was directly related to IPC use.
CONCLUSIONS
IPCs are an effective and viable option in the management of patients with refractory BPE. The quality of evidence to support IPC use for BPE remains low, and high-quality studies such as randomized controlled trials are needed.
Topics: Catheters, Indwelling; Drainage; Empyema, Pleural; Foreign-Body Migration; Humans; Pleural Effusion; Pneumothorax
PubMed: 27845052
DOI: 10.1016/j.chest.2016.10.052 -
Immunology Letters Oct 2019Chronic Obstructive Pulmonary Disease (COPD) is a major cause of death worldwide in which the involvement of autoimmunity has been widely investigated and debated. The...
Chronic Obstructive Pulmonary Disease (COPD) is a major cause of death worldwide in which the involvement of autoimmunity has been widely investigated and debated. The role of autoantibodies in COPD has been extensively researched in recent years. The aim of this systematic review is to assess the association between autoantibodies and COPD and analyse whether autoantibody levels correlate with disease severity and/or phenotype. PubMed, Embase, OpenGrey and the reference lists of articles were searched. The strongest evidence for an association between autoantibodies and COPD lies with anti-endothelial/epithelial cell autoantibodies (7 studies, all positive), rheumatoid factor autoantibodies (4 studies, all positive), anti-cytokeratin autoantibodies (3 studies, all positive), anti-nuclear autoantibodies (8 studies, 7 positive) and anti-collagen autoantibodies (10 studies, 6 positive). This review also identifies several other autoantibodies which had both positive and negative associations with COPD, however the evidence for these was not as strong and/or the number of studies is low, and further research is required. In particular, a clear case can be made for the potential importance of autoantibodies to carbonylated proteins. The relationship between autoantibody levels and disease severity requires further research with only 17/43 studies investigating this; however, 12 of the studies did show a positive association, making it a promising area for future research. There was also not enough evidence available on the relationship between autoantibody levels and disease phenotype to draw any conclusions, with only 2 studies investigating it (1 positive and 1 negative). This review has shown very promising evidence for the association of several autoantibodies in COPD and has identified those autoantibodies which require further research.
Topics: Antibody Specificity; Autoantibodies; Autoantigens; Epithelial Cells; Humans; Pulmonary Disease, Chronic Obstructive
PubMed: 31472176
DOI: 10.1016/j.imlet.2019.08.007 -
BMC Pulmonary Medicine Oct 2023Coronavirus disease 2019 (COVID-19) has posed increasing challenges to global health systems. We aimed to understand the effects of pulmonary air leak (PAL), including... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Coronavirus disease 2019 (COVID-19) has posed increasing challenges to global health systems. We aimed to understand the effects of pulmonary air leak (PAL), including pneumothorax, pneumomediastinum and subcutaneous emphysema, on patients with COVID-19.
METHODS
We searched PubMed, Embase and Web of Science for data and performed a meta-analysis with a random-effects model using Stata 14.0. This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
Thirty-five articles were included in the meta-analysis. The data came from 14 countries and included 3,047 COVID-19 patients with PAL, 11,3679 COVID-19 patients without PAL and 361 non-COVID-19 patients with PAL. We found that the incidence of PAL was much higher in COVID-19 patients than in non-COVID-19 patients (odds ratio (OR) = 6.13, 95% CI: 2.09-18.00). We found that the group of COVID-19 patients with PAL had a longer hospital stay (standardized mean difference (SMD) = 0.79, 95% CI: 0.27-1.30) and intensive care unit (ICU) stay (SMD = 0.51, 95% CI: 0.19-0.83) and comprised more ICU (OR = 15.16, 95% CI: 6.51-35.29) and mechanical ventilation patients (OR = 5.52, 95% CI: 1.69-17.99); furthermore, the mortality rate was also higher (OR = 2.62, 95% CI: 1.80-3.82).
CONCLUSIONS
Patients with lung injuries caused by COVID-19 may develop PAL. COVID-19 patients with PAL require more medical resources, have more serious conditions and have worse clinical outcomes.
PROSPERO REGISTRATION NUMBER
CRD42022365047.
Topics: Humans; COVID-19; Length of Stay; Pneumothorax
PubMed: 37858100
DOI: 10.1186/s12890-023-02710-2 -
Journal of Thoracic Disease Jul 2023Lung volume reduction (LVR) and lung transplantation (LTx) have been used in different populations of chronic obstructive pulmonary disease (COPD) patients. To date,...
BACKGROUND
Lung volume reduction (LVR) and lung transplantation (LTx) have been used in different populations of chronic obstructive pulmonary disease (COPD) patients. To date, comparative study of LVR and LTx has not been performed. We sought to address this gap by pooling the existing evidence in the literature.
METHODS
An electronic search was performed to identify all prospective studies on LVR and LTx published since 2000. Baseline characteristics, perioperative variables, and clinical outcomes were extracted and pooled for meta-analysis.
RESULTS
The analysis included 65 prospective studies comprising 3,671 patients [LTx: 15 studies (n=1,445), LVR: 50 studies (n=2,226)]. Mean age was 60 [95% confidence interval (CI): 58-62] years and comparable between the two groups. Females were 51% (95% CI: 30-71%) in the LTx group 28% (95% CI: 21-36%) in LVR group (P=0.05). Baseline 6-minute walk test (6MWT) and pulmonary function tests were comparable except for the forced expiratory volume in 1 second (FEV1), which was lower in the LTx group [21.8% (95% CI: 16.8-26.7%) 27.3% (95% CI: 25.5-29.2%), P=0.04]. Postoperatively, both groups experienced improved FEV1, however post-LTx FEV1 was significantly higher than post-LVR FEV1 [54.9% (95% CI: 41.4-68.4%) 32.5% (95% CI: 30.1-34.8%), P<0.01]. 6MWT was also improved after both procedures [LTx: 212.9 (95% CI: 119.0-306.9) to 454.4 m (95% CI: 334.7-574.2), P<0.01; LVR: 286 (95% CI: 270.2-301.9) to 409.1 m (95% CI: 392.1-426.0), P<0.01], however, with no significant difference between the groups. Pooled survival over time showed no significant difference between the groups.
CONCLUSIONS
LTx results in better FEV1 but otherwise has comparable outcomes to LVR.
PubMed: 37559607
DOI: 10.21037/jtd-23-63 -
Journal of Thoracic Disease Dec 2017The characteristic and outcomes of lung cancer patients with combined pulmonary fibrosis and emphysema (CPFE) have long been assessed, but results were controversial....
BACKGROUND
The characteristic and outcomes of lung cancer patients with combined pulmonary fibrosis and emphysema (CPFE) have long been assessed, but results were controversial. Therefore, we performed a meta-analysis to assess the clinical features and prognosis of lung cancer patients with CPFE.
METHODS
The databases PubMed, Embase, and Web of Science (updated to October 1, 2017) were searched for eligible studies. Pooled odds ratios (ORs), weighted mean differences (WMD) or hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to evaluate the clinicopathological characteristics, the short-term outcome after operation and long-term survival of lung cancer patients with CPFE compared with lung cancer patients without CPFE (fibrosis, emphysema, and normal).
RESULTS
Thirty original studies with 8,050 patients were included in this meta-analysis. The pooled results indicated that lung cancer patients with CPFE were associated with higher age (MD =3.39; 95% CI: 2.12-4.67, P<0.001), male (OR =8.46; 95% CI: 6.36-11.26, P<0.001), ex- or current smoker (OR =39.65; 95% CI: 15.64-100.5, P<0.001), longer smoking history (MD =15.56; 95% CI: 3.73-27.39, P=0.01), lower DLCO% (MD =-13.82; 95% CI: -21.4 to -6.24, P<0.001), squamous cell carcinoma histology (OR =3.55; 95% CI: 2.49-5.05, P<0.001), the lower lobes (OR =1.92; 95% CI: 1.52-2.43, P<0.001), advanced pathological stage (OR =1.55; 95% CI: 1.22-1.96, P<0.001). Lung cancer patients with CPFE had higher 30-day mortality (OR =4.72, 95% CI: 2.06-10.85, P<0.001), 90-day mortality (OR =5.33; 95% CI: 1.39-20.42, P=0.01), and incidence of postoperative complications (OR =5.25, 95% CI: 2.38-11.57, P<0.001). In addition, the lung cancer patients with CPFE had a poorer OS (HR =2.006, 95% CI: 1.347-2.986, P=0.001) than lung cancer patients without CPFE.
CONCLUSIONS
This meta-analysis demonstrated that lung cancer patients with CPFE have more aggressive clinical characteristic and a poor prognosis, suggesting that lung cancer patients with CPFE should be early detected, treated reasonably and be taken good care of.
PubMed: 29312742
DOI: 10.21037/jtd.2017.12.72 -
BMC Pulmonary Medicine Nov 2016The incidence and prevalence of chronic kidney disease (CKD) continue to rise worldwide. Increasing age, diabetes, hypertension, and cigarette smoking are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The incidence and prevalence of chronic kidney disease (CKD) continue to rise worldwide. Increasing age, diabetes, hypertension, and cigarette smoking are well-recognized risk factors for CKD. Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation leading to airway obstruction and parenchymal lung destruction. Due to some of the common pathogenic mechanisms, COPD has been associated with increased prevalence of CKD.
METHODS
Systematic review of medical literature reporting the incidence and prevalence of CKD in patients with COPD using the Cochrane Collaboration Methodology, and conduct meta-analysis to study the cumulative effect of the eligible studies. We searched Medline via Ovid, PubMed, EMBASE and ISI Web of Science databases from 1950 through May, 2016. We included prospective and retrospective observational studies that reported the prevalence of CKD in patients with COPD.
RESULTS
Our search resulted in 19 eligible studies of which 9 have been included in the meta-analysis. The definition of CKD was uniform across all the studies included in analysis. COPD was found to be associated with CKD in the included epidemiological studies conducted in many countries. Our meta-analysis showed that COPD was found to be associated with a significantly increased prevalence of CKD (Odds Ratio [OR] = 2.20; 95% Confidence Interval [CI] 1.83, 2.65).
STUDY LIMITATIONS
Studies included are observational studies. However, given the nature of our research question there is no possibility to perform a randomized control trial.
CONCLUSIONS
Patients with COPD have increased odds of developing CKD. Future research should investigate the pathophysiological mechanism behind this association, which may lead to better outcomes.
Topics: Humans; Incidence; Odds Ratio; Prevalence; Pulmonary Disease, Chronic Obstructive; Renal Insufficiency, Chronic; Risk Factors
PubMed: 27881110
DOI: 10.1186/s12890-016-0315-0 -
The Cochrane Database of Systematic... Dec 2016Chronic lung disease (CLD) occurs frequently in preterm infants. Bronchodilators have the potential effect of dilating small airways with muscle hypertrophy. Increased... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic lung disease (CLD) occurs frequently in preterm infants. Bronchodilators have the potential effect of dilating small airways with muscle hypertrophy. Increased compliance and tidal volume and decreased pulmonary resistance have been documented with the use of bronchodilators in infants with CLD. Therefore, bronchodilators might have a role in the prevention and treatment of CLD.
OBJECTIVES
To determine the effect of bronchodilators given as prophylaxis or as treatment for CLD on mortality and other complications of preterm birth in infants at risk for or identified as having CLD.
SEARCH METHODS
On 2016 March 7, we used the standard strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 2), MEDLINE (from 1966), Embase (from 1980) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; from 1982). We searched clinical trials databases, conference proceedings and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. We applied no language restrictions.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials involving preterm infants were eligible for inclusion. Initiation of bronchodilator therapy for prevention of CLD had to occur within two weeks of birth. Treatment of patients with CLD had to be initiated before discharge from the neonatal unit. The intervention had to include administration of a bronchodilator by nebulisation, by metered dose inhaler (with or without a spacer device) or by intravenous or oral administration versus placebo or no intervention. Eligible studies had to include at least one of the following predefined clinical outcomes: mortality, CLD, number of days on oxygen, number of days on ventilator, patent ductus arteriosus (PDA), pulmonary interstitial emphysema (PIE), pneumothorax, intraventricular haemorrhage (IVH) of any grade, necrotising enterocolitis (NEC), sepsis and adverse effects of bronchodilators.
DATA COLLECTION AND ANALYSIS
We used the standard method described in the Cochrane Handbook for Systematic Reviews of Interventions (Higgins 2011). Two review authors extracted and assessed all data provided by each study. We reported risk ratio (RR), risk difference (RD) and number needed to treat for an additional beneficial outcome (NNTB) with 95% confidence interval (CI) for dichotomous outcomes and mean difference (MD) for continuous data. We assessed the quality of the evidence by using the GRADE approach.
MAIN RESULTS
For this update, we identified one new randomised controlled trial investigating effects of bronchodilators in preterm infants. This study, which enrolled 73 infants but reported on 52 infants, examined prevention of CLD with the use of aminophylline. According to GRADE, the quality of the evidence was very low. One previously included study enrolled 173 infants to look at prevention of CLD with the use of salbutamol. According to GRADE, the quality of the evidence was moderate. We found no eligible trial that studied the use of bronchodilator therapy for treatment of individuals with CLD. Prophylaxis with salbutamol led to no statistically significant differences in mortality (RR 1.08, 95% CI 0.50 to 2.31; RD 0.01, 95% CI -0.09 to 0.11) nor in CLD (RR 1.03, 95% CI 0.78 to 1.37; RD 0.02, 95% CI -0.13 to 0.17). Results showed no statistically significant differences in other complications associated with CLD nor in preterm birth. Investigators in this study did not comment on side effects due to salbutamol. Prophylaxis with aminophylline led to a significant reduction in CLD at 28 days of life (RR 0.18, 95% CI 0.04 to 0.74; RD -0.35, 95% CI -0.56 to -0.13; NNTB 3, 95% CI 2 to 8) and no significant difference in mortality (RR 3.0, 95% CI 0.33 to 26.99; RD 0.08, 95% CI -0.07 to 0.22), along with a significantly shorter dependency on supplementary oxygen in the aminophylline group compared with the no treatment group (MD -17.75 days, 95% CI -27.56 to -7.94). Tests for heterogeneity were not applicable for any of the analyses, as each meta-analysis included only one study.
AUTHORS' CONCLUSIONS
Data are insufficient for reliable assessment of the use of salbutamol for prevention of CLD. One trial of poor quality reported a reduction in the incidence of CLD and shorter duration of supplementary oxygen with prophylactic aminophylline, but these results must be interpreted with caution. Additional clinical trials are necessary to assess the role of bronchodilator agents in prophylaxis or treatment of CLD. Researchers studying the effects of bronchodilators in preterm infants should include relevant clinical outcomes in addition to pulmonary mechanical outcomes. We identified no trials that studied the use of bronchodilator therapy for treatment of CLD.
Topics: Albuterol; Aminophylline; Beclomethasone; Bronchodilator Agents; Chronic Disease; Drug Therapy, Combination; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Lung Diseases; Randomized Controlled Trials as Topic
PubMed: 27960245
DOI: 10.1002/14651858.CD003214.pub3 -
Annals of Medicine and Surgery (2012) Mar 2022Hydatid disease of the lung, caused by , is an unusual parasitic disease. The aim of the current review for managing pulmonary hydatid cysts by uniportal video-assisted... (Review)
Review
BACKGROUND AND OBJECTIVES
Hydatid disease of the lung, caused by , is an unusual parasitic disease. The aim of the current review for managing pulmonary hydatid cysts by uniportal video-assisted thoracoscopic surgery (u-VATS), and their complications, the size of hydatid cyst, length of hospital stay, surgery time, the rate of conversion from u-VATS to thoracotomy or mini-thoracotomy, follow-up, and outcomes.
METHODS
We conduct the platform searches on the PubMed and Google Scholar electronic databases from inception to January 20, 2022, among patients diagnosed with pulmonary hydatid cyst (PHC) who underwent the u-VATS approach.
RESULTS
This systematic review comprised five studies reporting 85 cases of PHC underwent (u-VATS) approach. Most patients were adults. The most common location of pulmonary hydatid cyst was the right lower lobe followed by the left lower lobe. The average size of PHC was 8.41 cm in all studies. The length of hospital stay was 3.85 days. The duration of operation time based on the means of the included studies was 86.19 min for each patient. Furthermore, the overall complication occurred in 9.35% of patients (n = 11) from 85 cases. The most complication was emphysema and prolonged air leak. The recurrence of pulmonary hydatid cyst did not occur in all studies.
CONCLUSION
The feasibility of the video-assisted thoracoscopic surgery (VATS) approach has been proven globally in terms of reducing the overall complication, shorter chest tube duration, shorter surgery time, reduce postoperative pain, shorter chest tube duration, lower chest tube drainage, and less required to pain killers postoperatively.
PubMed: 35386784
DOI: 10.1016/j.amsu.2022.103474