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Klinicka Mikrobiologie a Infekcni... Jun 2021The guidelines provide evidence-based recommendations for the management of COVID-19. The clinical manifestations of the disease are described and indication criteria...
The guidelines provide evidence-based recommendations for the management of COVID-19. The clinical manifestations of the disease are described and indication criteria for hospital admission of patients with COVID-19 are listed. Polymerase chain reaction and antigen testing are used in direct diagnostics. Indirect detection of infection by antibodies is currently of limited value. There are a number of hematological and biochemical laboratory test used to diagnose COVID-19. Pathological values of some laboratory parameters are associated with severity of COVID-19. Of the imaging studies, chest X-ray, chest computer tomography and lung ultrasound are used. COVID-19 therapy includes symptomatic and specific therapy (antivirals, immunotherapeutics and anticoagulants) and intensive care in the severe and critical forms of the disease. Remdesivir and favipiravir are available as antiviral agents. Immunotherapeutics include monoclonal antibodies (casirivimab/imdevimab, bamlanivimab/etesevimab), dexamethas one, baricitinib and tocilizumab. Low-molecular-weight heparin is a dominant form of anticoagulant therapy. The guidelines provide specific therapeutic recommendations for each stage of the disease. Antibiotics are recommended only if bacterial superinfection is suspected or demonstrated, which is not common in the early stages of the disease.
Topics: Antiviral Agents; COVID-19; Humans; Lung; SARS-CoV-2; Ultrasonography
PubMed: 34648643
DOI: No ID Found -
Toxicological Sciences : An Official... Jun 2018Exposure to ozone (O3) induces lung injury, pulmonary inflammation, and alters lipid metabolism. During tissue inflammation, specialized pro-resolving lipid mediators...
Exposure to ozone (O3) induces lung injury, pulmonary inflammation, and alters lipid metabolism. During tissue inflammation, specialized pro-resolving lipid mediators (SPMs) facilitate the resolution of inflammation. SPMs regulate the pulmonary immune response during infection and allergic asthma; however, the role of SPMs in O3-induced pulmonary injury and inflammation is unknown. We hypothesize that O3 exposure induces pulmonary inflammation by reducing SPMs. To evaluate this, male C57Bl/6J mice were exposed to filtered air (FA) or 1 ppm O3 for 3 h and necropsied 24 h after exposure. Pulmonary injury/inflammation was determined by bronchoalveolar lavage (BAL) differentials, protein, and lung tissue cytokine expression. SPMs were quantified by liquid chromatography tandem mass spectrometry and SPM receptors leukotriene B4 receptor 1 (BLT-1), formyl peptide receptor 2 (ALX/FPR2), chemokine-like receptor 1 (ChemR23), and SPM-generating enzyme (5-LOX and 12/15-LOX) expression were measured by real time PCR. 24 h post-O3 exposure, BAL PMNs and protein content were significantly increased compared to FA controls. O3-induced lung inflammation was associated with significant decreases in pulmonary SPM precursors (14-HDHA, 17-HDHA), the SPM PDX, and in pulmonary ALX/FPR2, ChemR23, and 12/15-LOX expression. Exogenous administration of 14-HDHA, 17-HDHA, and PDX 1 h prior to O3 exposure rescued pulmonary SPM precursors/SPMs, decreased proinflammatory cytokine and chemokine expression, and decreased BAL macrophages and PMNs. Taken together, these data indicate that O3-mediated SPM reductions may drive O3-induced pulmonary inflammation.
Topics: Animals; Bronchoalveolar Lavage Fluid; Cytokines; Fatty Acids; Gene Expression; Leukotrienes; Lipid Metabolism; Lung; Male; Mice, Inbred C57BL; Ozone; Pneumonia; Prostaglandins
PubMed: 29471542
DOI: 10.1093/toxsci/kfy040 -
Journal of Clinical Monitoring and... Oct 2023Lung ultrasound is widely accepted as a reliable, noninvasive tool for evaluating lung status at the bedside. We assessed the impact of perioperative variables on... (Observational Study)
Observational Study
PURPOSE
Lung ultrasound is widely accepted as a reliable, noninvasive tool for evaluating lung status at the bedside. We assessed the impact of perioperative variables on atelectasis and lung aeration using lung ultrasound, and their correlation with postoperative oxygenation in patients undergoing general anesthesia.
METHODS
This prospective observational study evaluated 93 consecutive patients scheduled to undergo elective non-cardiothoracic surgery under general anesthesia. Lung ultrasound was performed 5 min after admission to the post-anesthesia care unit (PACU). Twelve pulmonary quadrants were selected for each ultrasound examination. The lung ultrasound scores and atelectasis status were calculated. The oxygenation assessment was obtained by arterial blood gas analysis before discharge from the PACU.
RESULTS
Thirty-two patients (34%) had atelectasis in at least one of the 12 evaluated segments, whereas 12 patients (13%) had atelectasis in at least three segments. The proportion of B-lines (≥ 3) and atelectasis in the inferolateral and posterior regions was significantly higher than in other regions. Patients with lung ultrasound scores ≥ 5 had a higher body mass index and lower PaO before discharge from the PACU than those with scores < 5. Patients with atelectasis had higher body mass indices and lung ultrasound scores. The presence of ≥ 2 regions of atelectasis was associated with lower PaO. Using multivariate analysis, body mass index, intraoperative body position, and sex independently correlated with lung ultrasound scores. Age and lung ultrasound scores independently correlated with hypoxemia.
CONCLUSION
Lung ultrasound enables early postoperative evaluation of atelectasis and lung aeration, which are closely associated with postoperative oxygenation.
Topics: Humans; Lung; Pulmonary Atelectasis; Anesthesia, General; Body Mass Index; Postoperative Period
PubMed: 36961634
DOI: 10.1007/s10877-023-00994-7 -
Chinese Medical Journal Feb 2023Exercise, as the cornerstone of pulmonary rehabilitation, is recommended to chronic obstructive pulmonary disease (COPD) patients. The underlying molecular basis and...
BACKGROUND
Exercise, as the cornerstone of pulmonary rehabilitation, is recommended to chronic obstructive pulmonary disease (COPD) patients. The underlying molecular basis and metabolic process were not fully elucidated.
METHODS
Sprague-Dawley rats were classified into five groups: non-COPD/rest ( n = 8), non-COPD/exercise ( n = 7), COPD/rest ( n = 7), COPD/medium exercise ( n = 10), and COPD/intensive exercise ( n = 10). COPD animals were exposed to cigarette smoke and lipopolysaccharide instillation for 90 days, while the non-COPD control animals were exposed to room air. Non-COPD/exercise and COPD/medium exercise animals were trained on a treadmill at a decline of 5° and a speed of 15 m/min while animals in the COPD/intensive exercise group were trained at a decline of 5° and a speed of 18 m/min. After eight weeks of exercise/rest, we used ultrasonography, immunohistochemistry, transmission electron microscopy, oxidative capacity of mitochondria, airflow-assisted desorption electrospray ionization-mass spectrometry imaging (AFADESI-MSI), and transcriptomics analyses to assess rectal femoris (RF).
RESULTS
At the end of 90 days, COPD rats' weight gain was smaller than control by 59.48 ± 15.33 g ( P = 0.0005). The oxidative muscle fibers proportion was lower ( P < 0.0001). At the end of additional eight weeks of exercise/rest, compared to COPD/rest, COPD/medium exercise group showed advantages in weight gain, femoral artery peak flow velocity (Δ58.22 mm/s, 95% CI: 13.85-102.60 mm/s, P = 0.0104), RF diameters (Δ0.16 mm, 95% CI: 0.04-0.28 mm, P = 0.0093), myofibrils diameter (Δ0.06 μm, 95% CI: 0.02-0.10 μm, P = 0.006), oxidative muscle fiber percentage (Δ4.84%, 95% CI: 0.15-9.53%, P = 0.0434), mitochondria oxidative phosphorylate capacity ( P < 0.0001). Biomolecules spatial distribution in situ and bioinformatic analyses of transcriptomics suggested COPD-related alteration in metabolites and gene expression, which can be impacted by exercise.
CONCLUSION
COPD rat model had multi-level structure and function impairment, which can be mitigated by exercise.
Topics: Rats; Animals; Rats, Sprague-Dawley; Pulmonary Disease, Chronic Obstructive; Lung; Mitochondria, Muscle; Metabolome
PubMed: 36752784
DOI: 10.1097/CM9.0000000000002175 -
Annals of Allergy, Asthma & Immunology... Jul 2017Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity.
BACKGROUND
Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity.
OBJECTIVE
To investigate the correlation between anthropometric indices and pulmonary function test results in children without asthma.
METHODS
Children without any respiratory disorders were enrolled in this study. Anthropometric measurements, such as height, weight, neck circumference (NC), and waist circumference, were obtained from the enrollees and body mass index was calculated. Afterward, pulmonary function tests were performed using spirometry.
RESULTS
A total of 178 children (106 boys, 59.5%) with a mean age of 9.7 years were included the study. NC was above the 90th percentile in 65 children. Importantly, pulmonary parameters, such as forced expiratory volume during the first second (FEV) and the ratio of FEV to forced vital capacity (FVC), were lower in subjects with a large NC. Similarly, waist circumference was above the 90th percentile in 67 children, and FEV/FVC was significantly lower in children with a large waist circumference. Moreover, there was a statistically significant negative correlation among FEV, FEV/FVC, and body mass index SD score. Also, multivariable linear regression analysis showed that an NC above the 90th percentile was associated with lower FEV and FEV/FVC values.
CONCLUSION
We identified NC as a novel anthropometric index that is strongly correlated with respiratory functions in children. Therefore, close monitoring of respiratory symptoms, particularly in children with obesity and a large NC, could help with early and prompt determination of respiratory complications of obesity.
Topics: Adolescent; Body Mass Index; Body Weights and Measures; Child; Child, Preschool; Female; Humans; Lung; Male; Neck; Obesity; Respiratory Function Tests
PubMed: 28527867
DOI: 10.1016/j.anai.2017.04.018 -
Chinese Medical Journal Oct 2016Acute respiratory distress syndrome (ARDS) is an acute and lethal clinical syndrome that is characterized by hypoxemic respiratory failure and diffuse alveolar... (Review)
Review
OBJECTIVE
Acute respiratory distress syndrome (ARDS) is an acute and lethal clinical syndrome that is characterized by hypoxemic respiratory failure and diffuse alveolar inflammatory damage. This review aimed to search and discuss the mass spectrometry (MS)-based proteomic studies on different subsets of ARDS patients.
DATA SOURCES
Original research articles were collected from the PubMed database published in English up to December 2015.
STUDY SELECTION
The literature search was done using the term "(acute lung injury OR acute respiratory distress syndrome) AND (proteomics OR proteome OR mass spectrum OR differential in-gel electrophoresis OR two-dimensional polyacrylamide gel electrophoresis)". Related original research articles were included and were carefully analyzed.
RESULTS
Eight original proteomic researches on ARDS patients were found. The common proteomic modalities were two-dimensional (2D) high-performance liquid chromatography-based electronic spray ion-MS/MS and 2D-polyacrylamide gel electrophoresis/differential in-gel electrophoresis-based matrix-assisted laser desorption ionization-time of flight/MS. They compared the proteome between ARDS patients and normal controls and analyzed the dynamic changes of proteome at different ARDS stages or severity. The disturbed proteome in ARDS patients includes plasma acute-phase proteins, inflammatory/immune-associated proteins, and coagulation proteins.
CONCLUSIONS
Although several previous studies have provided some useful information about the lung proteome in ARDS patients and gained several interesting disease-associated biomarkers, clinical proteomic studies in ARDS patients are still in the initial stage. An increased cooperation is still needed to establish a global and faithful database containing disease-specific proteome from the largest ARDS subsets.
Topics: Acute-Phase Proteins; Humans; Lung; Mass Spectrometry; Precision Medicine; Proteomics; Respiratory Distress Syndrome
PubMed: 27647196
DOI: 10.4103/0366-6999.190669 -
The Journal of Thoracic and... Jul 2022
Topics: Humans; Lung; Philosophy; Pneumonectomy
PubMed: 34815093
DOI: 10.1016/j.jtcvs.2021.10.034 -
The Thoracic and Cardiovascular Surgeon Jan 2019Treatment decisions for the management of bronchiectasis include medical treatment, such as antibiotics, chest physiotherapy, and surgical procedures. Here, we aimed to... (Comparative Study)
Comparative Study
BACKGROUND
Treatment decisions for the management of bronchiectasis include medical treatment, such as antibiotics, chest physiotherapy, and surgical procedures. Here, we aimed to review the effect of lung resection on longitudinal growth, clinical course of patients depending on annual exacerbation rates, and pulmonary function tests (PFTs) and compare them with the results of only medically treated children with non-cystic fibrosis (non-CF) bronchiectasis.
METHODS
The medical records of patients with non-CF bronchiectasis were retrospectively analyzed. Patients who underwent lobectomy/segmentectomy/pneumonectomy were categorized as "surgery group" ( = 29). Age- and gender-matched patients who were only medically treated were selected as "medical group" ( = 33). Annual data of patients were included till the end of postoperative second year in the surgery group and third year of medical treatment in the medical group.
RESULTS
Mean baseline height -score was lower in the surgery group, and mean baseline PFT values were all lower in the surgery group than those in the medical group ( < 0.05). In the surgery group, mean values of height -score were -1.68 ± 0.92 at the time of surgery and improved to -1.42 ± 1.22 and -1.34 ± 1.05 in the first and second postoperative years, respectively, and annual intravenous antibiotic requirements decreased significantly ( < 0.05); however, mean body mass index (BMI) -score values and PFT parameters did not change significantly. In the medical group, height -score mean values and PFT parameters showed nonsignificant improvement but annual exacerbation frequency, annual intravenous, and oral antibiotic requirements decreased significantly.
CONCLUSION
Surgical management of non-CF bronchiectasis has no significant effect on BMI -scores, annual exacerbation frequencies, oral antibiotic requirements and lung function tests; but can lead to significant improvement on height -scores and decrease need of annual intravenous antibiotic requirements for acute severe exacerbations despite small number of patients in this study.
Topics: Adolescent; Adolescent Development; Age Factors; Anti-Bacterial Agents; Body Mass Index; Bronchiectasis; Bronchodilator Agents; Child; Child Development; Child, Preschool; Disease Progression; Female; Forced Expiratory Volume; Humans; Lung; Male; Maximal Midexpiratory Flow Rate; Physical Therapy Modalities; Pneumonectomy; Recovery of Function; Retrospective Studies; Risk Factors; Steroids; Time Factors; Treatment Outcome; Vital Capacity
PubMed: 29232734
DOI: 10.1055/s-0037-1608922 -
Revue Des Maladies Respiratoires Apr 2020
Topics: Aged; Bronchogenic Cyst; Diagnosis, Differential; Female; Humans; Lung; Pneumonectomy; Radiography, Thoracic; Tomography, X-Ray Computed
PubMed: 32278509
DOI: 10.1016/j.rmr.2020.01.006 -
PloS One 2021Coronavirus Disease 2019 (COVID-19) is a respiratory viral illness causing pneumonia and systemic disease. Abnormalities in pulmonary function tests (PFT) after COVID-19...
BACKGROUND
Coronavirus Disease 2019 (COVID-19) is a respiratory viral illness causing pneumonia and systemic disease. Abnormalities in pulmonary function tests (PFT) after COVID-19 infection have been described. The determinants of these abnormalities are unclear. We hypothesized that inflammatory biomarkers and CT scan parameters at the time of infection would be associated with abnormal gas transfer at short term follow-up.
METHODS
We retrospectively studied subjects who were hospitalized for COVID-19 pneumonia and discharged. Serum inflammatory biomarkers, CT scan and clinical characteristics were assessed. CT images were evaluated by Functional Respiratory Imaging with automated tissue segmentation algorithms of the lungs and pulmonary vasculature. Volumes of the pulmonary vessels that were ≤5mm (BV5), 5-10mm (BV5_10), and ≥10mm (BV10) in cross sectional area were analyzed. Also the amount of opacification on CT (ground glass opacities). PFT were performed 2-3 months after discharge. The diffusion capacity of carbon monoxide (DLCO) was obtained. We divided subjects into those with a DLCO <80% predicted (Low DLCO) and those with a DLCO ≥80% predicted (Normal DLCO).
RESULTS
38 subjects were included in our cohort. 31 out of 38 (81.6%) subjects had a DLCO<80% predicted. The groups were similar in terms of demographics, body mass index, comorbidities, and smoking status. Hemoglobin, inflammatory biomarkers, spirometry and lung volumes were similar between groups. CT opacification and BV5 were not different between groups, but both Low and Normal DLCO groups had lower BV5 measures compared to healthy controls. BV5_10 and BV10 measures were higher in the Low DLCO group compared to the normal DLCO group. Both BV5_10 and BV10 in the Low DLCO group were greater compared to healthy controls. BV5_10 was independently associated with DLCO<80% in multivariable logistic regression (OR 1.29, 95% CI 1.01, 1.64). BV10 negatively correlated with DLCO% predicted (r = -0.343, p = 0.035).
CONCLUSIONS
Abnormalities in pulmonary vascular volumes at the time of hospitalization are independently associated with a low DLCO at follow-up. There was no relationship between inflammatory biomarkers during hospitalization and DLCO. Pulmonary vascular abnormalities during hospitalization for COVID-19 may serve as a biomarker for abnormal gas transfer after COVID-19 pneumonia.
Topics: Adult; Aged; Biomarkers; COVID-19; Female; Follow-Up Studies; Hospitalization; Humans; Lung; Male; Middle Aged; Retrospective Studies; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 34653196
DOI: 10.1371/journal.pone.0257892