Validation of a predictive survival model in Italian patients with cystic fibrosis

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Effect of heliox on heart rate kinetics and dynamic hyperinflation during high-intensity exercise in COPD

Respiratory mechanical abnormalities in patients with chronic obstructive pulmonary disease (COPD) may impair cardiodynamic responses and slow down heart rate (HR) kinetics compared with normal resulting in reduced convective oxygen delivery during exercise. We reasoned that heliox breathing (79% helium-21% oxygen) and the attendant reduction of operating lung volumes should accelerate HR kinetics in the transition from rest to high-intensity exercise. Eleven male ambulatory patients with clinically stable COPD undertook constant work-rate cycle testing at 80% of each individuals' maximum work capacity while breathing room air (RA) or heliox (HX), randomly. Mean response time (MRT) for HR and dynamic end-expiratory lung volume (EELV) were measured. Resting EELV was not affected by HX breathing, while exercise EELV decreased significantly by 0.23 L at isotime during HX breathing compared with RA. During FIX breathing, MRT for HR significantly accelerated (p = 0.002) by an average of 20 s (i.e., 17%). Speeded MRT for HR correlated with indices of reduced lung hyperinflation, such as EELV at isotime (r = 0.88, p = 0.03), and with improved exercise endurance time (r = -0.64, p = 0.03). The results confirm that HX-induced reduction of dynamic lung hyperinflation is associated with consistent improvement in indices of cardio-circulatory function such as HR kinetics in the rest-to-exercise transition in COPD patients

In-hospital and long-term all-cause mortality in 75 years and older hospitalized patients with and without COVID-19

backgrounds and purpose. . In-hospital older patients have a high mortality and a higher risk of severe COVID-19 outcomes. however, it is unclear whether COVID-19 infection further increases the already-high mortality risk. this study aimed to assess whether COVID-19 could impact in-hospital and post-discharge mortality in older individuals. methods. . we compared in-hospital and up to 240 days after hospital discharge all-cause mortality in hospitalized 75 years and older patients with and without COVID-19. one-to-one propensity score allocated study participants into two balanced groups (n = 69 for both). notably, this study was carried out in 2020, when COVID-19 vaccination was not available yet. results. . COVID-19 patients died more frequently within 30 days of hospital admission than non-COVID patients (36.2 vs 18.8%, respectively; p = 0.018). In contrast, the 240-day post-discharge mortality rate did not differ between groups (42.0 vs 47.8%, respectively; p = 0.304). after controlling for clinical covariates, we found that 30-day all cause-mortality was significantly and independently associated with COVID-19 infection (HR = 2.284, 95% CI = 1.068-4.883, p = 0.033) whereas 240-day all-cause mortality was not significantly associated with the infection (HR = 1.525, 95% CI = 0.869-2.678, p = 0.141). conclusions. . our results confirm that COVID-19 significantly increases the mortality risk of patients aged 75 or older during hospitalization. however, we found no substantial difference in post-discharge mortality risk between COVID-19 and non-COVID-19 patients. we suggest that continued monitoring of COVID-19 patients after discharge remains crucial to understand the breadth and severity of the long-term effects of SARS-CoV-2 infection, particularly as currently the number of COVID-19 unvaccinated individuals is still high

Effect of camptocormia on lung volumes in Parkinson's disease

Camptocormia is defined as an abnormal flexion of the thoracolumbar spine of 45 degrees, or more, that typically increases during walking or standing and completely disappears in the supine position. Camptocormia may occur in patients with Parkinson's disease; when it does, it is usually associated with greater disease severity. Respiratory complications, which may be secondary to abnormal chest function, are one of the most frequent causes of death in patients with Parkinson's disease. No data on lung volumes are available for Parkinson's disease patients with camptocormia. The aim of this study was to evaluate the effect of camptocormia on lung function. Eleven patients with Parkinson's disease and camptocormia and ten age-matched healthy subjects underwent lung spirometry (in the standing position, inclining the trunk forward at approx. 45 degrees and supine) measurement of arterial oxygen-hemoglobin saturation and heart rate. We found that Parkinson's disease with camptocormia is not associated with major clinical changes in lung volumes. (C) 2013 Elsevier B.V. All rights reserved

Effect of acetazolamide on post-NIV metabolic alkalosis in acute exacerbated COPD patients

Non-invasive ventilation (NIV) is an effective treatment in patients with acute exacerbation of COPD (AECOPD). However, it may induce post-hypercapnic metabolic alkalosis (MA). This study aims to evaluate the effect of acetazolamide (ACET) in AECOPD patients treated with NIV

Complication detection in MRI guided cardiac ablation: Atrial wall damage and hepatic oedema

Magnetic resonance imaging is a novel imaging technique for guiding electrophysiology based ablation operations for atrial flutter and typical atrial fibrillation. When compared to standard electrophysiology ablation, this innovative method allows for better outcomes. Intra-procedural imaging is important for following the catheter in real time throughout the ablation operation while also seeing cardiac architecture and determining whether the ablation is being completed appropriately utilizing oedema sequences. At the same time, intra-procedural imaging allows immediate visualization of any complications of the procedure. We describe a case of a 67 year old male underwent an isthmus-cavo-tricuspid magnetic resonance-guided thermoablation procedure for atrial flutter episodes. During the procedure we noted an atypical focal thinning of the right atrial wall at the isthmus cava-tricuspidal zone. The post-procedural Black Blood T2 STIR showed an area of hyperintensity at the hepatic dome and glissonian capsule, which was consistent with intraparenchymal hepatic oedema, in close proximity to the atrial finding. Given the opportunity to direct monitoring of adjacent tissues, we aim to highlight with our case the ability of magnetic resonance-guided cardiac ablation to immediately detect peri-procedural complications in the ablative treatment of atrial fibrillation