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A systematic review of studies examining the rate of lung function decline in patients with cystic fibrosis

Harun SN, Wainwright C, Klein K, Hennig S

Paediatr Respir Rev, 2016 Sep;20:55-66.
PMID: 27259460 DOI: 10.1016/j.prrv.2016.03.002

A systematic review was performed (i) to describe the reported overall rate of progression of CF lung disease quantified as FEV1%predicted decline with age, (ii) to summarise identified influencing risk factors and (iii) to review methods used to analyse CF lung disease progression data. A search of publications providing FEV1%predicted values over age was conducted in PUBMED and EMBASE. Baseline and rate of FEV1%predicted decline were summarised overall and by identified risk factors. Thirty-nine studies were included and reported variable linear rates of lung function decline in patients with CF. The overall weighted mean FEV1%predicted over age was graphically summarised and showed a nonlinear, time-variant decline of lung function. Compared to their peers, Pseudomonas aeruginosa infection and pancreatic insufficiency were most commonly associated with lower baseline and more rapid FEV1%predicted declines respectively. Considering nonlinear models and drop-out in lung disease progression, analysis is lacking and more studies are warranted.

Matched MeSH terms: Lung/physiopathology*
Fulltext Recurrent lung cavities and endobronchial nodules in an adolescent male

Fauzi MA, Fadilah SA, Bahariah K

Med J Malaysia, 2007 Mar;62(1):66-7.
PMID: 17682575 MyJurnal

Multiple lung cavitations and endobronchial nodules are rare presentations of newly diagnosed and recurrent Hodgkin's disease. The clinical and radiological features can be confused with pulmonary tuberculosis, which can be difficult to exclude in endemic areas. However, the presence of endobronchial nodules point, towards Hodgkin's disease. Differential diagnosis is aided by the fact that these lesions usually respond promptly to specific therapy. We present a case of an adolescent male who had constitutional and pulmonary symptoms associated with pulmonary cavities and endobronchial nodules subsequently confirmed to be Hodgkin's disease.

Matched MeSH terms: Lung/physiopathology*
Fulltext Clinical phenotypes of COPD and health-related quality of life: a cross-sectional study

Chai CS, Liam CK, Pang YK, Ng DL, Tan SB, Wong TS, et al.

Int J Chron Obstruct Pulmon Dis, 2019 03 01;14:565-573.
PMID: 30880946 DOI: 10.2147/COPD.S196109

Introduction: The Spanish COPD guideline (GesEPOC) classifies COPD into four clinical phenotypes based on the exacerbation frequency and dominant clinical manifestations. In this study, we compared the disease-specific health-related quality of life (HRQoL) of patients with different clinical phenotypes.
Methods: This was a cross-sectional study of patients with COPD attending the respiratory medicine clinic of University of Malaya Medical Centre from 1 June 2017 to 31 May 2018. Disease-specific HRQoL was assessed by using the COPD Assessment Test (CAT) and St George's Respiratory Questionnaire for COPD (SGRQ-c).
Results: Of 189 patients, 28.6% were of non-exacerbator phenotype (NON-AE), 18.5% were of exacerbator with emphysema phenotype (AE NON-CB), 39.7% were of exacerbator with chronic bronchitis phenotype (AE CB), and 13.2% had asthma-COPD overlap syndrome phenotype (ACOS). The total CAT and SGRQ-c scores were significantly different between the clinical phenotypes (P<0.001). Patients who were AE CB had significantly higher total CAT score than those with ACOS (P=0.033), AE NON-CB (P=0.001), and NON-AE (P<0.001). Concerning SGRQ-c, patients who were AE CB also had a significantly higher total score than those with AE NON-CB (P=0.001) and NON-AE (P<0.001). However, the total SGRQ-c score of AE CB patients was only marginally higher than those who had ACOS (P=0.187). There was a significant difference in the score of each CAT item (except CAT 7) and SGRQ-c components between clinical phenotypes, with AE CB patients recording the highest score in each of them.
Conclusion: Patients who were AE CB had significantly poorer HRQoL than other clinical phenotypes and recorded the worst score in each of the CAT items and SGRQ-c components. Therefore, AE CB patients may warrant a different treatment approach that focuses on the exacerbation and chronic bronchitis components.

Matched MeSH terms: Lung/physiopathology*
Fulltext PET/CT in nononcological lung diseases: current applications and future perspectives

Capitanio S, Nordin AJ, Noraini AR, Rossetti C

Eur Respir Rev, 2016 Sep;25(141):247-58.
PMID: 27581824 DOI: 10.1183/16000617.0051-2016

Positron emission tomography (PET) combined with computed tomography (CT) is an established diagnostic modality that has become an essential imaging tool in oncological practice. However, thanks to its noninvasive nature and its capability to provide physiological information, the main applications of this technique have significantly expanded.(18)F-labelled fluorodeoxyglucose (FDG) is the most commonly used radiopharmaceutical for PET scanning and demonstrates metabolic activity in various tissues. Since activated inflammatory cells, like malignant cells, predominantly metabolise glucose as a source of energy and increase expression of glucose transporters when activated, FDG-PET/CT can be successfully used to detect and monitor a variety of lung diseases, such as infections and several inflammatory conditions.The added value of FDG-PET/CT as a molecular imaging technique relies on its capability to identify disease in very early stages, long before the appearance of structural changes detectable by conventional imaging. Furthermore, by detecting the active phase of infectious or inflammatory processes, disease progression and treatment efficacy can be monitored.This review will focus on the clinical use of FDG-PET/CT in nonmalignant pulmonary diseases.

Matched MeSH terms: Lung/physiopathology
Effects of indoor air pollution on lung function of primary school children in Kuala Lumpur

Azizi BH, Henry RL

Pediatr Pulmonol, 1990;9(1):24-9.
PMID: 2388776

In a cross-sectional study of 7-12 year-old primary school children in Kuala Lumpur city, lung function was assessed by spirometric and peak expiratory flow measurements. Spirometric and peak expiratory flow measurements were successfully performed in 1,214 and 1,414 children, respectively. As expected, the main predictors of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and peak expiratory flow rate (PEFR) were standing height, weight, age, and sex. In addition, lung function values of Chinese and Malays were generally higher than those of Indians. In multiple regression models which included host and environmental factors, asthma was associated with significant decreases in FEV1, FEF25-75, and PEFR. However, family history of chest illness, history of allergies, low paternal education, and hospitalization during the neonatal period were not independent predictors of lung function. Children sharing rooms with adult smokers had significantly lower levels of FEF25-75. Exposures to wood or kerosene stoves were, but to mosquito repellents were not, associated with decreased lung function.

Matched MeSH terms: Lung/physiopathology*
Sarcoidosis in Singapore: epidemiology, clinical presentation and ethnic differences

Anantham D, Ong SJ, Chuah KL, Fook-Chong S, Hsu A, Eng P

Respirology, 2007 May;12(3):355-60.
PMID: 17539838

The aim of this study is to better understand the epidemiological and clinical features of patients with sarcoidosis in Singapore and to ascertain if ethnic differences exist.

Matched MeSH terms: Lung/physiopathology
Fulltext Optimised genetic algorithm-extreme learning machine approach for automatic COVID-19 detection

Albadr MAA, Tiun S, Ayob M, Al-Dhief FT, Omar K, Hamzah FA

PLoS One, 2020;15(12):e0242899.
PMID: 33320858 DOI: 10.1371/journal.pone.0242899

The coronavirus disease (COVID-19), is an ongoing global pandemic caused by severe acute respiratory syndrome. Chest Computed Tomography (CT) is an effective method for detecting lung illnesses, including COVID-19. However, the CT scan is expensive and time-consuming. Therefore, this work focus on detecting COVID-19 using chest X-ray images because it is widely available, faster, and cheaper than CT scan. Many machine learning approaches such as Deep Learning, Neural Network, and Support Vector Machine; have used X-ray for detecting the COVID-19. Although the performance of those approaches is acceptable in terms of accuracy, however, they require high computational time and more memory space. Therefore, this work employs an Optimised Genetic Algorithm-Extreme Learning Machine (OGA-ELM) with three selection criteria (i.e., random, K-tournament, and roulette wheel) to detect COVID-19 using X-ray images. The most crucial strength factors of the Extreme Learning Machine (ELM) are: (i) high capability of the ELM in avoiding overfitting; (ii) its usability on binary and multi-type classifiers; and (iii) ELM could work as a kernel-based support vector machine with a structure of a neural network. These advantages make the ELM efficient in achieving an excellent learning performance. ELMs have successfully been applied in many domains, including medical domains such as breast cancer detection, pathological brain detection, and ductal carcinoma in situ detection, but not yet tested on detecting COVID-19. Hence, this work aims to identify the effectiveness of employing OGA-ELM in detecting COVID-19 using chest X-ray images. In order to reduce the dimensionality of a histogram oriented gradient features, we use principal component analysis. The performance of OGA-ELM is evaluated on a benchmark dataset containing 188 chest X-ray images with two classes: a healthy and a COVID-19 infected. The experimental result shows that the OGA-ELM achieves 100.00% accuracy with fast computation time. This demonstrates that OGA-ELM is an efficient method for COVID-19 detecting using chest X-ray images.

Matched MeSH terms: Lung/physiopathology
Fulltext Does the duration of smoking cessation have an impact on hospital admission and health-related quality of life amongst COPD patients?

Abu Hassan H, Abd Aziz N, Hassan Y, Hassan F

Int J Chron Obstruct Pulmon Dis, 2014;9:493-8.
PMID: 24868154 DOI: 10.2147/COPD.S56637

BACKGROUND: Lack of awareness among ex-smokers on the benefits of sustaining smoking cessation may be the main cause of their smoking relapse. This study explored health-related quality of life (HRQoL) and hospital admission amongst chronic obstructive pulmonary disease (COPD) patients according to the duration of smoking cessation.
MATERIALS AND METHODS: This study recruited COPD patients from a chest clinic who agreed to participate in a medication therapy-adherence program from January to June 2013. They were interviewed during their visits to obtain information regarding their smoking history and HRQoL. They were divided into three groups according to smoking status (sustained quitters, quit ≥5 years; quitters, quit <5 years; and smokers, smoking at least one cigarette/day). The effects of the duration of cessation on HRQoL and hospital admission were analyzed using a multinomial logistic model.
RESULTS: A total of 117 participants with moderate COPD met the inclusion criteria, who were comprised of 41 sustained quitters, 40 quitters, and 36 smokers. Several features were similar across the groups. Most of them were married elderly men (aged >64 years) with low-to-middle level of education, who smoked more than 33 cigarettes per day and had high levels of adherence to the medication regimen. The results showed that sustained quitters were less likely to have respiratory symptoms (cough, phlegm and dyspnea) than smokers (odds ratio 0.02, confidence interval 0-0.12; P<0.001). The hospital admission rate per year was increased in quitters compared to smokers (odds ratio 4.5, confidence interval 1.91-10.59; P<0.005).
CONCLUSION: A longer duration of quitting smoking will increase the benefits to COPD patients, even if they experience increased episodic respiratory symptoms in the early period of the cessation. Thus, the findings of this study show the benefits of early smoking cessation.
KEYWORDS: HRQoL; chronic obstructive pulmonary disease (COPD); hospital admission and hospital stay
Study site: Chest Clinic, Hospital Melaka, Malaysia

Matched MeSH terms: Lung/physiopathology*