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Physical activity of patients with bronchiectasis compared with healthy counterparts: A cross-sectional study.

支气管扩张患者与健康对照者的体力活动比较: 一项横断面研究。

  • 影响因子:1.69
  • DOI:10.1016/j.hrtlng.2019.09.004
  • 作者列表:"Cakmak A","Inal-Ince D","Sonbahar-Ulu H","Bozdemir-Ozel C","Ozalp O","Calik-Kutukcu E","Saglam M","Vardar-Yagli N","Arikan H","Selcuk ZT","Coplu L
  • 发表时间:2020-01-01
Abstract

BACKGROUND:A few studies have implied that patients with bronchiectasis have a more inactive lifestyle than healthy counterparts do. The main objective of this study was to compare physical activity (PA) levels subjectively and objectively between patients with bronchiectasis and healthy individuals using an accelerometer and a questionnaire. METHODS:The study included 41 patients with bronchiectasis aged 18-65 years and 35 healthy age- and sex-matched control subjects. The PA level was assessed objectively using a multisensorial PA monitor, the SenseWear Armband (SWA), and subjectively with the International Physical Activity Questionnaire (IPAQ). All participants performed the incremental shuttle walk test (ISWT) for the assessment of exercise capacity. Pulmonary function, dyspnea, severity of bronchiectasis, respiratory and peripheral muscle strength, and quality of life were assessed. RESULTS:The pulmonary function test parameters, respiratory and peripheral muscle strength, exercise capacity, step count, moderate- and vigorous-intensity PA duration were significantly lower in patients with bronchiectasis than in the healthy control group (p < 0.05). Conclusions: Patients with bronchiectasis have a reduced PA level compared with healthy counterparts. The IPAQ (based on the subjective estimation of PA) outcomes differed from the SWA outcomes, reinforcing the necessity for a disease-specific PA questionnaire. IPAQ underestimates the physical activity level compared with objective measurements.

摘要

背景: 一些研究暗示支气管扩张症患者的生活方式比健康对照组更加不活跃。本研究的主要目的是使用加速度计和问卷调查比较支气管扩张症患者和健康人的主观和客观体力活动 (PA) 水平。 方法: 本研究包括 41 例年龄 18-65 岁的支气管扩张患者和 35 例年龄和性别匹配的健康对照者。使用多重感觉 PA 监测仪、 SenseWear 臂带 (SWA) 和主观的国际体力活动问卷 (IPAQ) 客观评估 PA 水平。所有参与者均进行了递增穿梭步行试验 (ISWT),以评估运动能力。评估肺功能、呼吸困难、支气管扩张严重程度、呼吸和外周肌力以及生活质量。 结果: 肺功能测试参数、呼吸和外周肌力、运动能力、台阶数、支气管扩张患者的中、高强度 PA 持续时间显著低于健康对照组 (p <0.05)。 结论: 与健康对照组相比,支气管扩张症患者的 PA 水平降低。IPAQ (基于对 PA 的主观估计) 结果不同于 SWA 结果,加强了疾病特异性 PA 问卷的必要性。与客观测量相比,IPAQ 低估了体力活动水平。

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影响因子:3.18
发表时间:2020-01-13
来源期刊:Surgical Endoscopy
DOI:10.1007/s00464-019-07334-4
作者列表:["Yang, Shun-Mao","Chen, Yi-Chang","Ko, Wei-Chun","Huang, Hsin-Chieh","Yu, Kai-Lun","Ko, Huan-Jang","Huang, Pei-Ming","Chang, Yeun-Chung"]

METHODS:Background Dye localization is a useful method for the resection of unidentifiable small pulmonary lesions. This study compares the transbronchial route with augmented fluoroscopic bronchoscopy (AFB) and conventional transthoracic CT-guided methods for preoperative dye localization in thoracoscopic surgery. Methods Between April 2015 and March 2019, a total of 231 patients with small pulmonary lesions who received preoperative dye localization via AFB or percutaneous CT-guided technique were enrolled in the study. A propensity-matched analysis, incorporating preoperative variables, was used to compare localization and surgical outcomes between the two groups. Results After matching, a total of 90 patients in the AFB group ( N  = 30) and CT-guided group ( N  = 60) were selected for analysis. No significant difference was noted in the demographic data between both the groups. Dye localization was successfully performed in 29 patients (96.7%) and 57 patients (95%) with AFB and CT-guided method, respectively. The localization duration (24.1 ± 8.3 vs. 21.4 ± 12.5 min, p  = 0.297) and equivalent dose of radiation exposure (3.1 ± 1.5 vs. 2.5 ± 2.0 mSv, p  = 0.130) were comparable in both the groups. No major procedure-related complications occurred in either group; however, a higher rate of pneumothorax (0 vs. 16.7%, p  = 0.029) and focal intrapulmonary hemorrhage (3.3 vs. 26.7%, p  = 0.008) was noted in the CT-guided group. Conclusion AFB dye marking is an effective alternative for the preoperative localization of small pulmonary lesions, with a lower risk of procedure-related complications than the conventional CT-guided method.

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影响因子:3.31
发表时间:2020-01-02
DOI:10.1007/s10916-019-1481-4
作者列表:["Matava, Clyde","Pankiv, Evelina","Raisbeck, Sam","Caldeira, Monica","Alam, Fahad"]

METHODS:Background The use of artificial intelligence, including machine learning, is increasing in medicine. Use of machine learning is rising in the prediction of patient outcomes. Machine learning may also be able to enhance and augment anesthesia clinical procedures such as airway management. In this study, we sought to develop a machine learning algorithm that could classify vocal cords and tracheal airway anatomy real-time during video laryngoscopy or bronchoscopy as well as compare the performance of three novel convolutional networks for detecting vocal cords and tracheal rings. Methods Following institutional approval, a clinical dataset of 775 video laryngoscopy and bronchoscopy videos was used. The dataset was divided into two categories for use for training and testing. We used three convolutional neural networks (CNNs): ResNet, Inception and MobileNet. Backpropagation and a mean squared error loss function were used to assess accuracy as well as minimize bias and variance. Following training, we assessed transferability using the generalization error of the CNN, sensitivity and specificity, average confidence error, outliers, overall confidence percentage, and frames per second for live video feeds. After the training was complete, 22 models using 0 to 25,000 steps were generated and compared. Results The overall confidence of classification for the vocal cords and tracheal rings for ResNet, Inception and MobileNet CNNs were as follows: 0.84, 0.78, and 0.64 for vocal cords, respectively, and 0.69, 0.72, 0.54 for tracheal rings, respectively. Transfer learning following additional training resulted in improved accuracy of ResNet and Inception for identifying the vocal cords (with a confidence of 0.96 and 0.93 respectively). The two best performing CNNs, ResNet and Inception, achieved a specificity of 0.985 and 0.971, respectively, and a sensitivity of 0.865 and 0.892, respectively. Inception was able to process the live video feeds at 10 FPS while ResNet processed at 5 FPS. Both were able to pass a feasibility test of identifying vocal cords and tracheal rings in a video feed. Conclusions We report the development and evaluation of a CNN that can identify and classify airway anatomy in real time. This neural network demonstrates high performance. The availability of artificial intelligence may improve airway management and bronchoscopy by helping to identify key anatomy real time. Thus, potentially improving performance and outcomes during these procedures. Further, this technology may theoretically be extended to the settings of airway pathology or airway management in the hands of experienced providers. The researchers in this study are exploring the performance of this neural network in clinical trials.

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影响因子:3.84
发表时间:2020-01-01
来源期刊:Chest
DOI:10.1016/j.chest.2019.06.018
作者列表:["Dhooria S","Chaudhary S","Ram B","Sehgal IS","Muthu V","Prasad KT","Aggarwal AN","Agarwal R"]

METHODS:BACKGROUND:The optimal mode of delivering topical anesthesia during flexible bronchoscopy remains unknown. This article compares the efficacy and safety of nebulized lignocaine, lignocaine oropharyngeal spray, or their combination. METHODS:Consecutive subjects were randomized 1:1:1 to receive nebulized lignocaine (2.5 mL of 4% solution, group A), oropharyngeal spray (10 actuations of 10% lignocaine, group B), or nebulization (2.5 mL, 4% lignocaine) and two actuations of 10% lignocaine spray (group C). The primary outcome was the subject-rated severity of cough according to a visual analog scale. The secondary outcomes included bronchoscopist-rated severity of cough and overall procedural satisfaction on a visual analog scale, total lignocaine dose, subject's willingness to undergo a repeat procedure, adverse reactions to lignocaine, and others. RESULTS:A total of 1,050 subjects (median age, 51 years; 64.8% men) were included. The median (interquartile range) score for subject-rated cough severity was significantly lower in group B compared to group C or group A (4 [1-10] vs 11 [4-24] vs 13 [5-30], respectively; P < .001). The bronchoscopist-rated severity of cough was also the least (P < .001), and the overall satisfaction was highest in group B (P < .001). The cumulative lignocaine dose administered was the least in group B (P < .001). A significantly higher proportion of subjects (P < .001) were willing to undergo a repeat bronchoscopy in group B (73.7%) than in groups A (49.1%) and C (59.4%). No lignocaine-related adverse events were observed. CONCLUSIONS:Ten actuations of 10% lignocaine oropharyngeal spray were superior to nebulized lignocaine or their combination for topical anesthesia during diagnostic flexible bronchoscopy. TRIAL REGISTRY:ClinicalTrials.gov; No.: NCT03109392; URL: www.clinicaltrials.gov.

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