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1.
Medicina (B.Aires) ; 81(5): 715-721, oct. 2021. graf
Article in English | LILACS | ID: biblio-1351042

ABSTRACT

Abstract There are few data regarding the repercussion in the pulmonary function of patients who had severe or critical COVID-19 pneumonia. The objective was to describe these patients´ pulmonary function and establish an association with the severity of the disease (patients with severe or critical pneumonia), the presence of comorbidities, the tomographic involvement and the persistence of dyspnoea. Fifty-five patients were included, 40 (73%) male, media of age 54.9 (11.6) years old and body mass index (BMI) 33.1 (6.09) kg/m2. Fifty (90%) had 1 comorbidity, obesity 67%, arterial hypertension 36%, and diabetes mellitus 35%. Twenty-five (45%) had critical pneumonia. Fifteen (27%) had a spirometric alteration that suggested restriction and 32 (58%) had gas exchange defect. The latter had forced volume capacity (FVC), forced expiratory volume in the first second (FEV1) and carbon monoxide diffusion capacity (DLCO) values significantly lower. Ninety percent presented some degree of involvement in the chest CT scan, ground glass-opacities the most frequent finding. A moderate negative correlation was found between the severity of the tomographic involvement and the DLCO levels. Thirty patients (55%) referred some degree of dyspnoea. Patients with this symptom had DLCO and KCO values below those who did not have dyspnoea: 70.5 vs. 85.1 p = 0.02 and 88 vs. 104 p = 0.02. The presence of abnormal gas exchange is the main characteristic of patients with pulmonary sequelae due to COVID-19. Our study does not show either predictor of evolution towards pulmonary sequelae or an association with the severity of the disease.


Resumen Se conocen pocos datos acerca de la repercusión en la función pulmonar de pacientes que cursaron una neumonía grave o crítica por COVID-19. El objetivo fue describir la función pulmonar de estos pacientes y establecer si existe asociación con la gravedad (neumonía grave o crítica), comorbilidades, compromiso tomográfico y persistencia de disnea. Se incluyeron 55 pacientes, 40 (73%) varones, media de edad 54.9 (11.6) años e índice de masa corporal (IMC) 33.1 (6.09) kg/m2. Cincuenta (90%) tenían una comorbilidad, obesidad 67%, hipertensión arterial 36% y diabetes mellitus 35%. Veinticinco (45%) presentaron neumonía crítica. Se hallaron 15 (27%) con una alteración que sugiere restricción y 32 (58%) presentaron trastorno del intercambio gaseoso. Aquellos con trastorno del intercambio gaseoso, tenían valores de capacidad vital forzada (FVC), volumen espiratorio forzado en el primer segundo (FEV1) y difusión de monóxido de carbono (DLCO) significativamente menores. El 90% tenía algún grado de compromiso en TAC de tórax siendo vidrio esmerilado el hallazgo más frecuente. Se encontró moderada correlación negativa entre gravedad del compromiso tomográfico y nivel de DLCO. A la consulta, 30 (55%) referían algún grado de disnea. Los pacientes con disnea presentaban valores de DLCO y KCO inferiores respecto a los que no referían disnea 70.5 vs. 85.1 p = 0.02 y 88 vs. 104 p = 0.02. La presencia de intercambio anormal de gases es la característica principal de los pacientes con secuelas pulmonares por COVID-19. De nuestro trabajo no surgen predictores para evolución hacia secuela pulmonar ni pudimos asociarlo a la gravedad de la enfermedad.


Subject(s)
Humans , Male , Child , Middle Aged , COVID-19 , Respiratory Function Tests , Forced Expiratory Volume , SARS-CoV-2 , Lung
2.
Medicina (B.Aires) ; 81(2): 301-303, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287286

ABSTRACT

Resumen La proteinosis alveolar pulmonar (PAP) es una enfermedad pulmonar difusa, infrecuente, secundaria a una alteración en la homeostasis del surfactante. Se presenta el caso de una mujer de 69 años que ingresó a sala de internación por disnea progresiva hasta clase funcional III, de tres meses de evolución, asociada a tos no productiva. Se constató insuficiencia respiratoria tipo I. Como hallazgos en tomografía de tórax se evidenció engrosamiento del intersticio pulmonar intra e interlobulillar, opacidades en vidrio esmerilado y áreas con tendencia a la consolidación bilateral. Se realizó biopsia pulmonar con diagnóstico histológico de PAP y se efectuó tratamiento con lavado pulmonar total, logrando mejoría clínica. Se destaca la necesidad de tener presente diagnósticos diferenciales de insuficiencia respiratoria e infiltrados pulmonares en el contexto de la pandemia por COVID-19, incluidas las entidades muy poco prevalentes como lo es la PAP.


Abstract Pulmonary alveolar proteinosis (PAP) is a rare, diffuse pulmonary disease due to abnormal surfactant homeostasis. We present the case of a 69-year-old woman who was admitted to the hospital for progressive dyspnea with marked limitation in activity, and non-productive cough, of three months of evolution. Type I respiratory failure was confirmed. Chest tomography findings were interlobular and intralobular septal thickening, ground glass opacities and bilateral consolidation. Histological diagnosis was made and whole-lung lavage was performed with clinical improvement. We highlight the need to keep in mind differential diagnoses of respiratory failure and pulmonary infiltrates during COVID-19 pandemic, even rare entities such as PAP.


Subject(s)
Humans , Female , Aged , Pulmonary Alveolar Proteinosis/therapy , Pulmonary Alveolar Proteinosis/diagnostic imaging , COVID-19 , Pandemics , SARS-CoV-2 , Lung
3.
Rev. colomb. anestesiol ; 49(2): e500, Apr.-June 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1251502

ABSTRACT

Abstract Introduction Foreign body aspiration (FBA) is a potentially fatal paediatric emergency. Our objective was to highlight the importance of a multidisciplinary approach to difficult/doubtful diagnosis. Case report 34-month-old girl referred for urgent rigid bronchoscopy after suspected metallic blade ingestion (found chewing on it). She had a previous recurrent history of wheezing. The physical examination revealed face/lip wounds, traces of powder on her teeth but no breathing difficulty. The plain X-Ray revealed radiopaque images of the upper pulmonary field and gastric chamber. In the absence of FBA clinical signs but considering a previous history of bronchial hyperresponsiveness, a direct digital radiographic study was performed. There were no images compatible with foreign bodies: the results were interpreted as artefacts and no bronchoscopy was performed. Conclusions A careful pre-anaesthetic evaluation, a high level of suspicion and excellent multidisciplinary communication led to the recognition of false radiologic findings. A conservative approach was followed and invasive procedures in a remote location, with high anaesthetic risk for the paediatric population were avoided.


Resumen Introducción La aspiración de cuerpo extraño (ACE) es una emergencia pediátrica potencialmente fatal. La intención del presente artículo es resaltar la importancia de un abordaje multidisciplinario en caso de un diagnóstico difícil/dudoso. Reporte de caso Se trata de una paciente de 4 meses de edad remitida para broncoscopia rígida de urgencia, luego de la sospecha de ingestión de una hojilla metálica (se encontró a la bebé mordiéndola). La paciente tenía antecedentes de sibilancia. Al examen físico se encontraron heridas en la cara y los labios, rastros de polvo en los dientes, pero no había dificultad respiratoria. El examen de rayos-x mostraba imágenes radio opacas en el cuadrante superior derecho del pulmón y en la cámara gástrica. En virtud de la ausencia de signos clínicos de ACE en una paciente con antecedentes de hiperresponsividad bronquial, se realizó un estudio radiográfico digital. No hubo imágenes compatibles con cuerpos extraños: los resultados se interpretaron como artefactos y no se realizó la broncoscopia. Conclusiones Un cuidadoso examen pre-anestesia, el alto grado de sospecha y una excelente comunicación multidisciplinaria, permitieron el reconocimiento de hallazgos radiológicos falsos. Se siguió un abordaje conservador, evitando así procedimientos invasivos en lugares remotos con alto grado de riesgo para la población pediátrica.


Subject(s)
Humans , Male , Infant , Respiration , Respiratory Sounds , Eating , Emergencies , Foreign Bodies , Wounds and Injuries , X-Rays , Bronchoscopy , Risk , Artifacts , Absenteeism , Lung , Mastication
4.
Arq. bras. med. vet. zootec. (Online) ; 73(3): 583-588, May-June 2021. ilus
Article in English | ID: biblio-1278349

ABSTRACT

The aim of this study was to investigate the occurrence of diseases in free-ranging wild canids that were roadkill on highways in the State of Espírito Santo, Brazil. PCR tests were performed for the detection of Brucella sp., Babesia sp., Rangelia sp., and Hepatozoon sp. in the spleen. Morphological evaluation and identification of parasites was performed in the liver and lung. Twenty specimens of C. thous were necropsied at the Animal Pathology Sector of the Veterinary Hospital of the Universidade Federal do Espírito Santo. Tissue samples were processed for histopathological examination and polymerase chain reaction (PCR) analysis. There was no PCR amplification of genomic DNA sequences of Brucella sp., Babesia sp., Rangelia sp., and Hepatozoon sp. using DNA extracted from the spleen as template. Histologically, lesions associated with parasitism by Platynosomum sp. and Angiostrongylus sp. were observed in the liver and lung, respectively. This is the first report of Platynosomum sp. and Angiostrongylus sp. parasitism in C. thous in the state of Espírito Santo, Brazil. Therefore, this study demonstrated parasitism of crab-eating foxes by Platynosomum sp. and Angiostrongylus sp. Importantly, no evidence of infection with Brucella sp., Babesia sp., Rangelia sp., and Hepatozoon sp. was obtained by PCR analysis.(AU)


O objetivo deste estudo foi investigar a ocorrência de doenças em canídeos silvestres de vida livre que foram atropelados em rodovias no estado do Espírito Santo, Brasil. Testes de PCR foram realizados para a detecção de Brucella sp., Babesia sp., Rangelia sp. e Hepatozoon sp. no baço. A avaliação morfológica e a identificação de parasitas foram realizadaa no fígado e no pulmão. Vinte espécimes de C. thous foram necropsiados no Setor de Patologia Animal do Hospital Veterinário da Universidade Federal do Espírito Santo. Amostras de tecido foram processadas para exame histopatológico e análise de reação em cadeia da polimerase (PCR). Não houve amplificação por PCR das sequências de DNA genômico de Brucella sp., Babesia sp., Rangelia sp. e Hepatozoon sp. usando-se DNA extraído do baço como modelo. Histologicamente, lesões associadas ao parasitismo por Platynosomum sp. e Angiostrongylus sp. foram observadas no fígado e no pulmão, respectivamente. Este é o primeiro relato de Platynosomum sp. e Angiostrongylus sp. parasitismo em C. thous no estado do Espírito Santo, Brasil. Portanto, este estudo demonstrou parasitismo de cachorro-do-mato por Platynosomum sp. e Angiostrongylus sp. É importante detacar que não há evidências de infecção por Brucella sp., Babesia sp., Rangelia sp. e Hepatozoon sp. por análise de PCR.(AU)


Subject(s)
Animals , Babesia/isolation & purification , Brucella/isolation & purification , Canidae/blood , Angiostrongylus/isolation & purification , Autopsy/veterinary , Spleen/virology , Accidents, Traffic , Polymerase Chain Reaction/veterinary , Liver/parasitology , Lung/parasitology , Animals, Wild/blood
5.
Fisioter. Bras ; 22(2): 261-271, Maio 25, 2021.
Article in Portuguese | LILACS | ID: biblio-1284175

ABSTRACT

Introdução: Uma doença altamente infecciosa do trato respiratório, a doença de coronavírus 2019 (COVID-19) pode causar disfunção respiratória, física e psicológica em pacientes. Portanto, a reabilitação pulmonar é crucial para pacientes admitidos e que recebem alta da COVID-19. As sequelas de longo prazo são desconhecidas, mas as evidências de surtos anteriores de CoV demonstram comprometimento da função pulmonar e física, redução da qualidade de vida e sofrimento emocional. Métodos: Trata-se de uma revisão sistemática da literatura realizada através de busca digital em artigos publicados em revistas impressas e eletrônicas, ensaios clínicos, estudos randomizados, revisões sistemáticas, no período compreendido entre os anos de 2003 e 2020. Resultados: Muitos sobreviventes da COVID-19 que necessitam de cuidados críticos podem desenvolver comprometimentos psicológicos, físicos e cognitivos. Conclusão: Existe uma clara necessidade de orientação sobre a reabilitação dos sobreviventes da COVID-19. (AU)


Introduction: A highly infectious disease of the respiratory tract, coronavirus disease 2019 (COVID-19) can cause respiratory, physical, and psychological dysfunction in patients. Therefore, pulmonary rehabilitation is crucial for patients admitted and discharged from COVID-19. The long-term sequelae of COVID-19 are unknown, but evidence of previous CoV outbreaks demonstrates impaired lung and physical function, reduced quality of life and emotional distress. Methods: This is a systematic review of the literature carried out through digital bibliographic search of scientific articles published in printed and electronic journals, clinical trials, randomized studies, systematic reviews, in the period between the years 2003 and 2020. Results: Many survivors of COVID-19 that require critical care can develop psychological, physical, and cognitive impairments. Conclusion: There is a clear need for guidance on the rehabilitation of COVID-19 survivors. (AU)


Subject(s)
Humans , Rehabilitation , Respiratory System , COVID-19 , Coronavirus Infections , Coronavirus , Critical Care , Lung
6.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 67-76, 20210000.
Article in Spanish | LILACS | ID: biblio-1178627

ABSTRACT

Introducción: La Enfermedades Neuromusculares se caracterizan por la pérdida progresiva de la fuerza muscular, la morbi-mortalidad aumenta con la exageración de la debilidad muscular determinando mayor riesgo de complicaciones respiratorias. Es de suma importancia evaluar e interpretar adecuadamente la función pulmonar y ventilatoria para poder realizar intervenciones que pueda prevenir dichas complicaciones. Objetivos: El objetivo del estudio fue reportar el estado funcional respiratorio de un grupo de pacientes con ENM en control ambulatorio y relacionar estos hallazgos con umbrales clínicamente relevantes de complicaciones respiratorias, reforzando intervenciones basadas en opiniones de expertos. Materiales y métodos: Se realizó un estudio Descriptivo-Observacional de corte transversal, donde fueron evaluados en forma ambulatoria, de marzo del 2017 a agosto del 2018, 30 niños y adolescentes con enfermedades neuromusculares. Resultados: El 46% del total de pacientes presenta capacidad tusígena no funcional con alto riesgo de complicaciones. No obstante, sólo el 10% del total de pacientes fueron aptos para realizar adecuadamente estudios de espirometría. Durante las pruebas espirométricas, sólo el 50% de los pacientes logró mantener 6 segundos la espiración. Conclusión: Si bien la espirometría es la principal prueba de función pulmonar y una alta proporción de pacientes presentó alteraciones en su morfología, su realización en estados avanzados de enfermedad fue poco factible. Para detectar umbrales de complicaciones respiratorias graves, la medición del flujo generado durante la tos resultó mejor. Conclusión: Si bien la espirometría es la principal prueba de función pulmonar y una alta proporción de pacientes presentó alteraciones en su morfología, su realización en estados avanzados de enfermedad fue poco factible. Para detectar umbrales de complicaciones respiratorias graves, la medición del flujo generado durante la tos resultó mejor.


Introduction: Neuromuscular Diseases are characterized by the progressive loss of muscle mass, morbidity and mortality increases with the progress of muscle weakness due to the increased risk of respiratory complications, so it is very important to properly evaluate and interpret the measurements of lung functions and ventilation to be able to carry out a specific treatment that can reduce respiratory complications. Objectives: The purpose of this work is to present the results of the measurements of flows, volumes, respiratory capacities and spirometric patterns in outpatients with neuromuscular diseases and to verify their usefulness to detect vital risks. Materials and methods: A cross-sectional Descriptive-Observational study was carried out, where 30 children and adolescents with neuromuscular diseases were evaluated on an outpatient basis, from March 2017 to August 2018. Results: 46% of all patients presented a non-functional cough with a high risk of complications and only 10% of all patients were eligible for spirometry studies. During the spirometric tests, 50% of the patients managed to maintain expiration for 6 seconds. In 70% of the patients, abnormalities in the Flow-Volume curve could be detected. Conclusion: Although spirometry is the main pulmonary function test, its usefulness and efficacy in neuromuscular diseases depends on the findings of specific alterations in the morphology of the flow-volume curve, which in many cases are not possible to distinguish.


Subject(s)
Spirometry , Cough , Lung , Neuromuscular Diseases , Respiratory Function Tests , Measurements, Methods and Theories , Control
8.
Pesqui. vet. bras ; 41: e06669, 2021. tab, ilus
Article in English | ID: biblio-1180872

ABSTRACT

A high prevalence of pneumonic lesions has been reported to affect slaughtered pigs in southern Brazil. In order to identify which microorganisms have been causing those lesions, 30 pig lungs presenting pneumonic gross lesions were collected from five different slaughterhouses, totaling 150 lungs. Samples for bacterial isolation, molecular, histopathologic and immunohistochemistry (IHC) evaluation were taken from each lung. The pneumonic lesion scoring ranged from 1.53 to 2.83. The most frequent histopathological lesions found was the concomitant Influenza A virus (IAV) and Mycoplasma hyopneumoniae infection, corresponding to 55.3% (83/150), and Pasteurella multocida type A was isolated in 54.2% (45/83) of these cases. In 102 samples (68%), there was histopathologic suggestion of involvement of more than one infectious agent. M. hyopneumoniae was the most frequent agent associated with pneumonic lesions, being present in 92.1% (94/102) of the lungs with coinfections, followed by IAV in 89.2% (91/102). Besides the coinfections, IAV lesions were observed also in six samples without another pathogenic microorganism detected. A total of 46 samples with acute and subacute IAV suspected lesions in histopathological examination were assessed for IHC and real time RT-PCR for IAV. A total of 35% (16/46) of them were positive by IHC and 13% (6/46) by real time RT-PCR. Regarding M. hyopneumoniae, 79.3% (119/150) of samples were positive by qPCR and 84.9% (101/119) of them also presented M. hyopneumoniae suspected lesions in the histopathological examination. The results of this study suggest the importance of IAV in respiratory diseases in finishing pigs, even though this virus is more frequently reported in the nursery phase. In addition, our results emphasize the importance of lung coinfections in finishing pigs.(AU)


Lesões sugestivas de pneumonia são frequentemente encontradas em altas prevalências em suínos abatidos no sul do Brasil. Para identificar quais microrganismos causam essas lesões, foram coletados 30 pulmões de suínos com lesão macroscópica sugestiva de pneumonia em cinco frigoríficos diferentes, totalizando 150 pulmões. Amostras para isolamento bacteriano, avaliação molecular, histopatológica e imuno-histoquímica (IHC) foram coletadas de cada pulmão. O escore de lesão pulmonar variou entre 1,53 a 2,83. O achado histopatológico mais observado foi a lesão sugestiva de infecção concomitante pelo vírus Influenza A (IAV) e Mycoplasma (M.) hyopneumoniae, correspondendo a 55,3% (83/150), e em 54,2% (45/83) desses casos Pasteurella (P.) multocida tipo A foi isolado. Em 102 amostras (68%), houve lesão histopatológica sugestiva do envolvimento de mais de um agente infeccioso. M. hyopneumoniae foi o microrganismo mais frequente associado a lesões de pneumonia, estando presente em 92,1% (94/102) dos pulmões com coinfecções, seguido de IAV, que foi encontrado em 89,2% (91/102). Além das coinfecções, lesões de IAV foram observadas em mais seis amostras que não aparentavam envolvimento de outro agente infeccioso. Um total de 46 amostras com suspeita de lesão aguda e subaguda de IAV no exame histopatológico foram avaliadas para IHC e RT-PCR em tempo real para IAV e 35% (16/46) delas foram positivas por IHC e 13% (6/46) foram positivas por RT-PCR em tempo real. Com relação a M. hyopneumoniae, 79,3% (119/150) das amostras foram positivas por qPCR e 84,9% (101/119) delas também apresentaram lesões suspeitas de M. hyopneumoniae no exame histopatológico. Os resultados deste trabalho sugerem a importância do IAV como agente causador de pneumonias em suínos de terminação, embora esse vírus seja mais frequentemente relatado na fase de creche. Além disso, os achados deste trabalho demonstram a presença frequente de coinfecções pulmonares em suínos de terminação.(AU)


Subject(s)
Animals , Influenza A virus , Pneumonia , Swine/injuries , Pasteurella multocida , Infections , Lung , Immunohistochemistry
9.
Article in English | WPRIM | ID: wpr-879311

ABSTRACT

In the era of coronavirus disease 2019 (COVID-19) pandemic, imported COVID-19 cases pose great challenges to many countries. Chest CT examination is considered to be complementary to nucleic acid test for COVID-19 detection and diagnosis. We report the first community infected COVID-19 patient by an imported case in Beijing, which manifested as nodular lesions on chest CT imaging at the early stage. Deep Learning (DL)-based diagnostic systems quantitatively monitored the progress of pulmonary lesions in 6 days and timely made alert for suspected pneumonia, so that prompt medical isolation was taken. The patient was confirmed as COVID-19 case after nucleic acid test, for which the community transmission was prevented timely. The roles of DL-assisted diagnosis in helping radiologists screening suspected COVID cases were discussed.


Subject(s)
Adult , Beijing , COVID-19/diagnostic imaging , COVID-19 Testing/methods , Community-Acquired Infections/diagnostic imaging , Deep Learning , Humans , Lung/diagnostic imaging , Male , Tomography, X-Ray Computed/methods
10.
Article in Chinese | WPRIM | ID: wpr-879287

ABSTRACT

Lung diseases such as lung cancer and COVID-19 seriously endanger human health and life safety, so early screening and diagnosis are particularly important. computed tomography (CT) technology is one of the important ways to screen lung diseases, among which lung parenchyma segmentation based on CT images is the key step in screening lung diseases, and high-quality lung parenchyma segmentation can effectively improve the level of early diagnosis and treatment of lung diseases. Automatic, fast and accurate segmentation of lung parenchyma based on CT images can effectively compensate for the shortcomings of low efficiency and strong subjectivity of manual segmentation, and has become one of the research hotspots in this field. In this paper, the research progress in lung parenchyma segmentation is reviewed based on the related literatures published at domestic and abroad in recent years. The traditional machine learning methods and deep learning methods are compared and analyzed, and the research progress of improving the network structure of deep learning model is emphatically introduced. Some unsolved problems in lung parenchyma segmentation were discussed, and the development prospect was prospected, providing reference for researchers in related fields.


Subject(s)
COVID-19 , Humans , Lung/diagnostic imaging , Machine Learning , SARS-CoV-2 , Tomography, X-Ray Computed
11.
Article in Chinese | WPRIM | ID: wpr-879281

ABSTRACT

Mechanical ventilation is an importmant life-sustaining treatment for patients with acute respiratory distress syndrome. Its clinical outcomes depend on patients' characteristics of lung recruitment. Estimation of lung recruitment characteristics is valuable for the determination of ventilatory maneurvers and ventilator parameters. There is no easily-used, bedside method to assess lung recruitment characteristics. The present paper proposed a method to estimate lung recruitment characteristics from the static pressure-volume curve of lungs. The method was evaluated by comparing with published experimental data. Results of lung recruitment derived from the presented method were in high agreement with the published data, suggesting that the proposed method is capable to estimate lung recruitment characteristics. Since some advanced ventilators are capable to measure the static pressure-volume curve automatedly, the presented method is potential to be used at bedside, and it is helpful for clinicians to individualize ventilatory manuevers and the correpsonding ventilator parameters.


Subject(s)
Humans , Lung , Positive-Pressure Respiration , Respiration, Artificial , Respiratory Distress Syndrome, Newborn , Ventilators, Mechanical
12.
Article in Chinese | WPRIM | ID: wpr-879265

ABSTRACT

The high frequency oscillatory ventilation (HFOV) is characterized with low tidal volume and low mean airway pressure, and can well support the breathing of the patients with respiratory diseases. Since the HFOV was proposed, it has been widely concerned by medical and scientific researchers. About the HFOV, this paper discussed its current research status and prospected its future development in technologies. The research status of ventilation model, mechanisms and ventilation mode were introduced in detail. In the next years, the technologies in developing HFOV will be focused on: to develop the branched high-order nonlinear or volume-depended resistance-inertance-compliance (RIC) ventilation model, to fully understand the mechanisms of HFOV and to achieve the noninvasive HFOV. The development in technologies of HFOV will be beneficial to the patients with respiratory diseases who failed with conventional mechanical ventilation as one of considerable ventilation methods.


Subject(s)
High-Frequency Ventilation , Humans , Lung , Respiration, Artificial , Respiratory Distress Syndrome, Newborn , Tidal Volume
13.
Article in Chinese | WPRIM | ID: wpr-879137

ABSTRACT

The aim of this paper was to investigate the preventive and therapeutic effects of Xiaoer Feike Granules(XEFK) on chronic bronchitis in rats and its mechanism. Except for 10 rats in the blank group, the remaining 50 of the 60 SD rats were used to establish a model of chronic bronchitis induced by LPS. On the 22 nd day, the model rats were randomly divided into 5 groups according to their body weight, and administrated with purified water, Keteling Capsules 0.11 g·kg~(-1), XEFK 3.2, 1.6 and 0.8 g·kg~(-1)(the dosing concentrations were 0.32, 0.16, 0.08 g·mL~(-1), respectively). These rats took the corresponding drug orally once a day, for consecutive 21 days. The rats were anesthetized 1 hour after the last administration, and the lavage bronchus and alveoli were collected. Then, after the fixation of the smear, neutrophils were counted microscopically, and the contents of glutathione peroxidase(GSH-Px), superoxide dismutase(SOD) and malondialdehyde(MDA) in the bronchoalveolar lavage fluid(BALF) were detected by colorimetric method. Flow cytometry was used to detect the content changes of T cell subsets CD4~+, CD8~+, CD4~+/CD8~(+ )in serum. Hemorheology related indexes were detected by automatic hemorheology. Enzyme-linked immunosorbent assay(ELISA) was used to detect the contents of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-2, IL-6 and IL-10 in serum. The expression of TNF-α and IL-10 mRNA in lung was detected by Real-time quantitative PCR(RT-qPCR). HE staining was used to observe the pathological changes in the bronchitis tissues. Compared with the model group, XEFK high and medium dose groups could significantly reduce the contents of neutrophils and MDA in bronchial lavage fluid, and increase the activities of GSH-Px and SOD in BALF, and repair the chronic inflammatory cell infiltration and lymphoid tissue hyperplasia in the bronchial mucosal layer and submucosal layer. The high-dose group could reduce the plasma viscosity of rats, but there was no statistical difference in other hemorheological indexes. CD4~+, CD8~+, CD4~+/CD8~+, IL-2 and IL-10 contents in each dose group were significantly increased, and TNF-α, IL-1β and IL-6 contents were significantly decreased in serum. Each dose group could significantly down-regulate the expression level of TNF-α mRNA in the lung and increase the expression of IL-10 mRNA. XEFK could reduce lipid peroxidation, increase the content of peripheral blood T cell subsets, regulate the release and secretion of inflammatory factors, and repair the morphological and pathological changes of bronchial tissue. Its mechanism might be related to the improvement of inflammatory response and the enhancement of immune function.


Subject(s)
Animals , Bronchitis, Chronic/drug therapy , Drugs, Chinese Herbal/pharmacology , Glutathione Peroxidase , Lipopolysaccharides , Lung , Rats , Rats, Sprague-Dawley , Tumor Necrosis Factor-alpha
14.
Article in Chinese | WPRIM | ID: wpr-878989

ABSTRACT

In this paper, Asarum polysaccharides(AP) were extracted, and its composition was analyzed to study the activity against H1 N1 influenza virus in vitro and its intervention effect on mice with kidney Yang deficiency syndrome. AP was prepared by the strategy of water extraction and alcohol precipitation, the content was determined, and its monosaccharide composition was analyzed. The cell Real-time monitoring system and Reed-Muench model were adopted to evaluate the antiviral activity of AP in vitro. And the mouse model of kidney Yang deficiency syndrome was established in vivo to compare the efficacy of Mahuang Xixin Fuzi Decoction(MXF) and AP. MXF group and AP group were treated with clinical equivalent doses of 1.8 g·kg~(-1)·d~(-1) and 0.077 g·kg~(-1)·d~(-1) respectively, once a day for 6 consecutive days. Real-time PCR was used to detect the relative expression of M gene of H1 N1 influenza virus and cytokines in lung tissue. The content of AP in Asarum was 25.22%, and the protein content was 0.8%. And the monosaccharide composition was identified as L-rhamnose, D-arabinose, D-xylose, D-glucose, D-galactose and D-mannose. TI values of Tamiflu, MXF and AP were 30.00, 8.06 and 10.33, respectively. Three different doses of AP could significantly reduce the concentration of virus in supernatant. Compared with the model mice, lung indexes of MXF group and AP group decreased significantly(P<0.05), and the relative expression of M gene decreased significantly(P<0.05). The relative expressions of IL-10 and IFN-γ were up-regulated to varying degrees, while the relative gene expressions of IL-1β, IL-6 and MCP-1 were down-regulated to different degrees. In addition, AP could significantly enhance the expression of TNF-α(P<0.01). AP had a good anti-influenza virus activity in vitro, and could protect mice with kidney Yang deficiency syndrome by reducing the viral load in lung tissue, decreasing inflammation damage in lung tissue, and regulating the expression of inflammatory cytokines. Compared with the prescription of MXF, AP had a better antiviral activity.


Subject(s)
Animals , Antiviral Agents/therapeutic use , Asarum , Cytokines/genetics , Drugs, Chinese Herbal , Influenza A Virus, H1N1 Subtype , Influenza, Human/genetics , Lung , Mice , Polysaccharides
15.
Article in Chinese | WPRIM | ID: wpr-878723

ABSTRACT

Objective To analyze the CT characteristics of consolidation type of pulmonary cryptococcosis in immunocompetent patients,and thus improve the diagnosis of this disease. Methods A total of 20 cases with consolidation-type pulmonary cryptococcosis confirmed by pathological examinations were studied.Each patient underwent breath-hold multislice spiral CT,and 10 patients underwent contrast enhanced CT.The data including lesion number,lesion distribution,lesion density,performance of enhanced CT scan,accompanying signs,and prognosis were analyzed. Results The occurrence rates of single and multiple lesions were 80.0%(n=16)and 20.0%(n=4),respectively.In all the 16 multiple-lesion patients,the occurrence rate of unilateral lobar distribution was 56.0%(n=9).The 76 measurable lesions mainly presented subpleural distribution(71.1%,n=54)and lower pulmonary distribution(75.0%,n=57).A total of 39 lesions were detected in the 10 patients received contrast enhanced CT,in which 31 lesions(79.5%)showed homogeneous enhancement,34 lesions(87.2%)showed moderate enhancement,and all the lesions manifested angiogram sign.Consolidation lesions were accompanied by many CT signs,of which air bronchogram sign had the occurrence rate of 63.2%(n=48),including types Ⅲ(n =37)and Ⅳ(n=11).Other signs included halo signs(43/76,56.6%),vacuoles or cavities(9/76,11.8%),pleural thickening(14/20,70.0%),and pleural effusion(2/20,10.0%).After treatment,the lesions of 7 patients were basically absorbed and eventually existed in the form of fibrosis. Conclusions The lesions in the immunocompetent patients with consolidation type of pulmonary cryptococcosis usually occur in the lower lobe and close to the pleura,mainly presenting unilateral distribution.The CT angiogram signs,proximal air bronchogram signs,and halo signs are the main features of this disease,which contribute to the diagnosis.


Subject(s)
COVID-19 , Cryptococcosis/diagnostic imaging , Humans , Lung , Lung Diseases, Fungal/diagnostic imaging , Retrospective Studies , Tomography, X-Ray Computed
16.
Article in Chinese | WPRIM | ID: wpr-878722

ABSTRACT

Objective To evaluate the efficacy and risks of autologous blood patch pleurodesis in patients with persistent air leak(PAL)after lung resection. Methods A total of 97 patients with PAL after lung resection in Beijing Shijitan Hospital from October 2014 to October 2019 were retrospectively reviewed,including 53 treated by autologous blood patch pleurodesis and 44 by the conventional way.The therapeutic effect,adverse reactions and complications were analyzed. Results All the patients with PAL were cured with autologous blood patch pleurodesis.Most air leaks(81.1%)ceased within 48 hours after treatment,and the left 18.9% patients got cured after a repeat.The mean tube retention time and the mean in-hospital stay were 8.4 days and 10.0 days in the autologous blood patch pleurodesis group and 13.5 days and 15.3 days in the conventional treatment group.A prolonged drainage time(P=0.00)and in-hospital stay(P=0.00)were observed in the conventional treatment group.No severe complications were observed except two patients developed slight fever and cutaneous emphysema. Conclusion In our experience,the autologous blood patch pleurodesis is an effective way with low risk of adverse reactions in the treatment of PAL.


Subject(s)
Drainage , Humans , Length of Stay , Lung , Pleurodesis , Retrospective Studies
17.
Chinese Journal of Biotechnology ; (12): 646-654, 2021.
Article in Chinese | WPRIM | ID: wpr-878589

ABSTRACT

The high performance liquid chromatography (HPLC) and enzyme-linked immunoassay (ELISA) were used to investigate the changes of collagen and matrix metalloproteinase-1 (MMP-1) in liver, lung and kidney during growth process of mice. The mice from 0 to 18 weeks were used as the research objects. The contents and proportions of hydroxyproline (Hyp), which were used to calculate the collagen contents, in liver, lung and kidney of different weeks were analyzed with HPLC. The contents and activity of MMP-1 in liver, lung and kidney of different weeks were analyzed with ELISA. The results showed that the collagen contents in liver, lung, and kidney were different (Lung(COL)>Kidney(COL)>Liver(COL)), and they all increased first and then decreased with weeks. The collagen contents in liver, lung, and kidney reached the highest level in the ninth (5.52 ng/mg), sixth (54.10 ng/mg) and ninth (19.20 ng/mg) week, respectively. Then it declined slowly from 9 to 18 weeks. The result of ELISA showed that the MMP-1 contents in liver, lung and kidney decreased first and then increased with weeks, and the trend of MMP-1 activity was opposite. It indicated that the increase of collagen contents in the tissues will inhibit the secretion of MMP-1.


Subject(s)
Animals , Collagen , Kidney , Liver , Lung , Matrix Metalloproteinase 1 , Matrix Metalloproteinase 2 , Mice
18.
Chinese Medical Journal ; (24): 757-764, 2021.
Article in English | WPRIM | ID: wpr-878064

ABSTRACT

Chronic obstructive pulmonary disease (COPD) has become the third-leading cause of death worldwide, which is a severe economic burden to the healthcare system. Chronic bronchitis is the most common condition that contributes to COPD, both locally and systemically. Neutrophilic inflammation predominates in the COPD airway wall and lumen. Logically, repression of neutrophilia is an essential fashion to COPD treatment. However, currently available anti-neutrophilic therapies provide little benefit in COPD patients and may have serious side effects. Thus, there is an urgent need to explore an effective and safe anti-neutrophilic approach that might delay progression of the disease. Sialic acid-binding immunoglobulin-like lectin (Siglec)-9 is a member of the Siglec cell surface immunoglobulin family. It is noteworthy that Siglec-9 is highly expressed on human neutrophils and monocytes. Ligation of Siglec-9 by chemical compounds or synthetic ligands induced apoptosis and autophagic-like cell death in human neutrophils. Furthermore, administration of antibody to Siglec-E, mouse functional ortholog of Siglec-9, restrained recruitment and activation of neutrophils in mouse models of airway inflammation in vivo. Given the critical role that neutrophils play in chronic bronchitis and emphysema, targeting Siglec-9 could be beneficial for the treatment of COPD, asthma, fibrosis, and related chronic inflammatory lung diseases.


Subject(s)
Animals , Asthma , Humans , Lung , Mice , N-Acetylneuraminic Acid , Neutrophils , Pulmonary Disease, Chronic Obstructive/drug therapy , Sialic Acid Binding Immunoglobulin-like Lectins
19.
Article in Chinese | WPRIM | ID: wpr-877667

ABSTRACT

OBJECTIVE@#To observe the analgesic effect of auricular point sticking therapy during the perioperative stage in the patients with partial lung resection.@*METHODS@#A total of 92 patients with partial lung resection were randomized into an auricular point group (31 cases, 1 case dropped off), the sham-auricular point group (30 cases) and a medication group (31 cases, 1 case dropped off). The routine medication for analgesia was provided in all of the three groups. In the auricular point group, 1 day before operation, the auricular point sticking therapy was applied at shenmen (TF@*RESULTS@#In 8, 16, 24, 48 h and 72 h after operation, VAS scores in the auricular point group were lower than those in the sham-auricular point group and the medication group separately (@*CONCLUSION@#Auricular point sticking therapy relieves perioperative pain, shortens analgesic time, releases anxious and depressive emotions and reduces postoperative adverse reaction in the patients with partial lung resection. The analgesic mechanism is probably related to the increase of plasma concentration of β-endorphin.


Subject(s)
Acupuncture Points , Acupuncture, Ear , Humans , Lung , Pain , Pain Management
20.
Article in Chinese | WPRIM | ID: wpr-877666

ABSTRACT

OBJECTIVE@#To observe the protective effect of electroacupuncture (EA) at Neiguan (PC 6) on pulmonary function during one-lung ventilation (OLV) in patients with lobectomy, and explore its action mechanism.@*METHODS@#Sixty patients with lobectomy were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with general anesthesia, and OLV was given when surgery began; when the surgery finished, air was removed from the thoracic cavity and two-lung ventilation was performed. On the basis of the treatment in the control group, the patients in the observation group were treated with EA (disperse-dense wave, 2 Hz/100 Hz of frequency) at Neiguan (PC 6) 30 min before anesthesia induction until the end of the surgery. The pulmonary function indexes [arterial partial pressure of oxygen (PaO@*RESULTS@#Compared with T@*CONCLUSION@#EA at Neiguan (PC 6) has protective effects on lung injury induced by OLV after lobectomy, and its mechanism may be related to the improvement of oxidative stress and inflammatory response.


Subject(s)
Anesthesia, General , Electroacupuncture , Humans , Lung , Lung Injury , One-Lung Ventilation
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