Validation and Cardiorespiratory Response of the 1-min Sit-to-Stand Test in Interstitial Lung Disease.
间质性肺疾病 1 min 坐位试验的验证和心肺反应。
- 作者列表："Labrecque PT","Harvey J","Nadreau É","Maltais F","Dion G","Saey D
PURPOSE:To assess the 1STS test-retest reliability and construct validity and its associated cardiorespiratory response in comparison to the 6-minute walk test (6MWT) and symptom-limited cycling cardiopulmonary exercise test (CPET) in people with interstitial lung disease (ILD). METHODS:15 participants with ILD performed two 1STS tests, a 6MWT and a CPET. The three tests were administered on three separate visits and cardiorespiratory parameters were continuously recorded during the tests. RESULTS:The number of repetitions during both 1STS tests was 22 ± 4 and 22 ± 4 (mean difference of 0.53 ± 2.00 repetitions, p=0.32) with an intraclass correlation of 0.937 (95%CI [0.811; 0.979]) and a minimal detectable change of 2.9 repetitions. The number of 1STS repetitions was highly correlated with the 6MWT distance (r = 0.823, p<0.001) and with the peak cycling power output expressed in % predicted values (r = 0.706, p<0.003). Oxygen consumption (V˙O2) peak during the 1STS reached 83% and 78% of V˙O2 peak during 6MWT and CPET, respectively. Peak 1STS heart rate (HR), minute ventilation (V˙E,), V˙O2 values as well nadir SpO2 were achieved during the recovery phase of the test while peak 6MWT and CPET HR, V˙E, V˙O2 and nadir SpO2 always occurred at the end of the test. The three tests elicited a similar fall in SpO2 ranging between 8-12%. Symptom scores after the 1STS were similar to those seen at the end of the 6MWT but lower than those of CPET. CONCLUSION:The 1STS showed excellent test-retest reliability in patients with ILD in whom it elicited a substantial, but submaximal cardiorespiratory response. Our data also support the construct validity of the 1STS to assess functional exercise capacity in patients with ILD and to detect exercise-induced O2 desaturation.
目的: 与 6 分钟步行试验 (6MWT) 相比，评估 1STS 重测信度和结构效度及其相关的心肺反应间质性肺病 (ILD) 患者的症状限制性循环心肺运动试验 (CPET)。 方法: 15 例 ILD 参与者进行了两次 1STS 试验，一次 6MWT，一次 CPET。三次试验分别进行三次访视，试验期间连续记录心肺参数。 结果: 两次 1STS 测试的重复次数分别为 22 ± 4 和 22 ± 4 (0.53 ± 2.00 次重复的平均差异，p = 0.32) 组内相关性为 0.937 (95% CI [0.811; 0.979])，最小可检测变化为 2.9 次重复。1STS 重复次数与 6MWT 距离高度相关 (r = 0.823，p<0.001)，与峰值循环功率输出以 % 预测值表示 (r = 0.706, p<0.003)。1STS 期间的耗氧量 (v O2) 峰值分别达到 6MWT 和 CPET 期间 v O2 峰值的 83% 和 78%。在试验恢复期达到峰值 1STS 心率 (HR) 、分钟通气量 (ve) 、 vo2 值以及最低值 SpO2，而峰值 6MWT 和 CPET HR 、 ve 、试验结束时总是出现血氧饱和度和血氧饱和度最低值。三次测试引起 SpO2 在 8-12% 之间的类似下降。1STS 后的症状评分与 6MWT 结束时的症状评分相似，但低于 CPET。 结论: 1STS 在 ILD 患者中显示出极好的重测信度，在这些患者中，它引起了大量但次最大的心肺反应。我们的数据也支持 1STS 评估 ILD 患者功能运动能力和检测运动诱导的 O2 去饱和的结构有效性。
METHODS:OBJECTIVES:To asses the clinical course in RA-related interstitial lung disease (RA-ILD) patients with and without rituximab (RTX). The influence of other variables was also evaluated. METHODS:A longitudinal multicentre study was conducted in RA diagnosed with ILD from 2007 until 2018 in Madrid. Patients were included in a registry [pNEumology RhEumatology Autoinmune diseases (NEREA)] from the time of ILD diagnosis. The main endpoint was functional respiratory impairment (FI), when there was a decline ≥5% in the predicted forced vital capacity compared with the previous one. Pulmonary function was measured at baseline and in follow-up visits every 6-12 months. The independent variable was therapy with RTX. Covariables included sociodemographic, clinical, radiological and other therapies. Survival techniques were used to estimate the incidence rate (IR) and 95% CI of functional impairment, expressed per 100 patient-semesters. Cox multivariate regression models were run to examine the influence of RTX and other covariates on FI. Results were expressed as the hazard ratio (HR) and CI. RESULTS:A total of 68 patients were included. FI occurred in 42 patients [IR 23.5 (95% CI 19, 29.1)] and 50% of them had FI within 1.75 years of an ILD diagnosis. A multivariate analysis showed that RTX exposure resulted in a lower risk of FI compared with non-exposure [HR 0.51 (95% CI 0.31, 0.85)]. Interstitial pneumonia, glucocorticoids, disease activity and duration also influenced FI. CONCLUSION:RA-ILD patients deteriorate over time, with the median time free of impairment being <2 years. Patients exposed to RTX had a higher probability of remaining free of FI compared with other therapies. Other factors have also been identified. Key words: rheumatoid arthritis, interstitial lung disease, observational study, rituximab and prognosis
METHODS:The safety of anti-programmed cell death 1 (PD-1) antibody for patients with preexisting interstitial lung disease (ILD) remains unknown. The aim of this study was to evaluate the dependence of preexisting ILD on anti-PD-1 antibody-induced pneumonitis in non-small cell lung cancer (NSCLC) patients. We retrospectively reviewed the association of preexisting ILD with the incidence, radiographic pattern, and outcome of pneumonitis in NSCLC patients receiving anti-PD-1 antibody. A total of 331 patients were included in this study. Of these patients, 17 had preexisting ILD. The incidence of pneumonitis was higher among the patients with preexisting ILD than among those without preexisting ILD (29% vs. 10%, P = 0.027). The distributions of the CT appearances at the onset of anti-PD-1 antibody-induced pneumonitis were as follows: for the patients with preexisting ILD, two patients (40%) had diffuse alveolar damage (DAD), one patient each with organizing pneumonia-like (OP), hypersensitivity pneumonitis (HP), and other patterns (20% each); for the patients without preexisting ILD, 19 patients (61%) had OP, 8 (26%) had HP, 3 (10%) had DAD, and 1 (3.2%) had other patterns. The median onset time from the initiation of anti-PD-1 antibody treatment until the development of pneumonitis was 1.3 months (range 0.3–2.1 months) for the patients with preexisting ILD and 2.3 months (range 0.2–14.6 months) for the patients without preexisting ILD. Careful attention to the development of pneumonitis is needed, especially within the first 3 months after the start of anti-PD-1 antibody treatment, when using anti-PD-1 antibody to treat patients with preexisting ILD.
METHODS::Bacteria of the Burkholderia cepacia complex (Bcc) are ubiquitous multidrug resistant organisms and opportunistic pathogens capable of causing life threatening lung infections among cystic fibrosis (CF) patients. No effective therapies are currently available to eradicate Bcc bacteria from CF patients, as these organisms are inherently resistant to the majority of clinically available antimicrobials. An immunoproteomics approach was used to identify Bcc proteins that stimulate the humoral immune response of the CF host, using bacterial cells grown under conditions mimicking the CF lung environment and serum samples from CF patients with a clinical record of Bcc infection. 24 proteins of the Bcc strain B. cenocepacia J2315 were identified as immunoreactive, 19 here reported as immunogenic for the first time. Ten proteins were predicted as extracytoplasmic, 9 of them being conserved in Bcc genomes. The immunogenic Bcc extracytoplasmic proteins are potential targets for development of novel therapeutic strategies and diagnostic tools to protect patients against the onset of chronic Bcc lung infections.