Function Test Results Research Articles

Effectiveness of refined nursing intervention on postoperative recovery and respiratory function in lung cancer patients after thoracic surgery.

To evaluate the effectiveness of refined nursing intervention versus routine nursing care in improving respiratory function and facilitating their recovery in lung cancer patients after thoracic surgery. Total 75 primary lung cancer patients (average age: 55.3 ± 10.8 years) who underwent thoracic surgery at Tangshan People's Hospital from February 2024 to July 2024 were included in the study. According to the different postoperative nursing intervention, patients were randomized into control group (CG) and observational group (OG) for evaluating the effects of refined nursing intervention on pain relief, postoperative recovery and respiratory function. Tidal volume, vital capacity, forced expiratory volume in 1 second, peak expiratory flow, and maximal voluntary ventilation were used to evaluate pulmonary function. The Medical Outcomes Study 36-Item Short-Form Health Survey and Nursing Intensive-Care Satisfaction Scale were administered at the minimum of 30 days of nursing interventions after thoracic surgery to assess quality of life and satisfaction with nursing care respectively. Bivariate correlation analysis and chi-square test (χ2) were used to analyze significant changes by using SPSS (version 27.0). About 61% (n = 46) of the patients were female. Routine nursing care was conducted in both CG and OG patients, while in OG simultaneously received refined nursing care. After a period of nursing intervention, recovery rate of heart and pulmonary was significantly higher than CG (92.31% vs 72.22%, P = .022) with a lower incidence of postoperative complications (12.82% vs 30.56%, P = .049). Pulmonary function test results revealed a significant improvement in OG patients' tidal volume (0.43 ± 0.06 vs 0.39 ± 0.07, P = .014), vital capacity (3.53 ± 0.30 vs 3.34 ± 0.32, P = .020), forced expiratory volume in 1 second (4.67 ± 0.67 vs 4.23 ± 0.58, P = .003), peak expiratory flow (4.76 ± 0.51 vs 4.36 ± 0.51, P = .001) and maximal voluntary ventilation (58.22 ± 7.86 vs 53.70 ± 6.89, P = .010) compared to CG. Postoperative moderate-to-worst pain duration in OG was significantly shortened (4.36 ± 1.56 vs 5.81 ± 1.94, P < .001), while health status value was higher (60.87 ± 5.89 vs 56.53 ± 6.22, P = .003). Moreover, OG expressed higher satisfaction with nursing care compared to CG (P = .002). Patients experienced reduced respiratory function after thoracic surgery. Refined nursing intervention might facilitate patients' postoperative recovery and improve their respiratory function and general well-being, which would be beneficial for achieving patients' satisfaction and promoting positive interaction between patients and multidisciplinary team members.

Effectiveness and safety of elexacaftor/tezacaftor/ivacaftor treatment in children aged 6-11 years with cystic fibrosis in a real-world setting.

Elexacaftor-tezacaftor-ivacaftor (ETI) is a highly effective cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulating therapy for people with CF and at least one F508del variant. However, there is limited data about the safety and efficacy of this therapy in pediatric populations and in real-world settings. This study aimed at evaluating the effectiveness, tolerability, and safety of ETI in children with CF. This was a prospective observational study including all children aged 6-11 years who initiated ETI therapy between October 2022 and March 2023 at the Pediatric CF Center of Milan (Italy). Study outcomes included changes in sweat chloride concentration, FEV1, LCI2.5, body mass index(BMI), tolerance, and safety. Mean changes in study outcomes from baseline through 24 weeks were estimated using mixed-effects regression models. The study included 34 children with CF (median age: 8.3 years). At Week 12, we observed an average decrease in LCI2.5 of 2.3 units (95% confidence interval [CI]: -3.1; -1.5). At Week 24, sweat chloride concentration decreased by 63 mEq/L (95% CI: -69; -58), FEV1 increased by 8.8 percentage point (95% CI: 3.7; 13.9) and BMI increased by 0.15 standard deviation scores (95% CI: 0.04; 0.25). Skin rashes appeared in 6 patients which spontaneously resolved within a few days. One month after treatment initiation, one patient experienced an elevation in liver function test results, which subsequently decreased during follow-up visits without necessitating discontinuation of therapy. Our data indicate that ETI therapy is well tolerated by children with CF and is effective in improving signs of lung function abnormalities from early childhood.

Revised Clinical Practice Guideline of Korean Pancreatobiliary Association for Common Bile Duct Stones: Diagnosis

The diagnosis of common bile duct (CBD) stones is conducted through various imaging tests, endoscopic examinations, and the patient's clinical presentation. In patients with symptomatic gallstone disease, initial tests such as liver function tests, abdominal ultrasound, and abdominal computed tomography can be performed. Based on the results of these initial tests, symptomatic patient with cholelithiasis can be classified into low risk, intermediate risk, and high risk groups. Low risk of choledocholithiasis is characterized by normal liver function test results and absence of CBD dilation on abdominal ultrasound. For patients in this category, additional tests are not necessary unless symptoms indicating CBD stones persist. Intermediate risk of choledocholithiasis is identified by abnormal liver function test results or CBD dilation on abdominal ultrasound. Additional tests such as endoscopic ultrasound or magnetic resonance cholangiopancreatography can be performed. If CBD stones are confirmed in the additional tests, endoscopic retrograde cholangiopancreatography (ERCP) is required. High risk of choledocholithiasis is diagnosed when there is clinical evidence of cholangitis or CBD stones are identified on imaging tests. In such cases, ERCP is recommended for both diagnosis and treatment purposes without the need for further additional tests.

Spirometry Results in Children over Five Years Old with COVID-19 at Least Six Months after Discharge

Introduction: Since it is necessary to detect changes in lung function for the follow-up of the patients with respiratory and functional complications caused by COVID-19, in this study, we decided to examine the results of spirometry in children over 5 years old with Covid-19. Methods: In this cross-sectional study, 52 over-five-year-old children, hospitalized due to COVID-19 for at least six past months, were examined. The participants’ demographic information, respiratory symptoms, underlying diseases, severity of COVID-19 according to WHO, severity of lung involvement in CT scan, type of lung involvement, oxygen saturation at admission as well as FEV1, FVC, and FEV1/FVC were collected and analyzed, the results were analyzed using SPSS version 16 software and t-test and Chi-square tests. Results: Of all investigated patients،, 26 were boys (50%) and 38 (73.1%) were 5-12 years old. The minimum age of the children was 5 years and the maximum was 18 years. The mean age of children was 3.41±10 years. The FEV1/FVC ranged from 61% to 79% in five patients (9.6%) and from 80% to 100% in 47 patients (90.4%). The FEV1 was lower than 80% in 28 and higher than 80% in 24 patients. FEV1/FVC had no significant relationship with the participants’ age, gender, clinical manifestations, and disease severity in terms of pulmonary involvement, but it had a significant association with blood oxygen saturation level (P: 0.001). Conclusion: The changes in pulmonary function tests vary in different months following contamination with COVID-19. In the present study, 9% of the patients, who were examined in the sixth month after infection, had abnormal pulmonary function test results. Based on the findings, the pulmonary function test results had no significant relationship with the patients’ age, gender, and clinical symptoms, while it was significantly associated with their blood oxygen saturation intensity.

Distribution of microvascular endothelial function in different clinical and non-clinical settings in the united states and china

Abstract Background Despite the fact that microvascular (endothelial) dysfunction is associated with various diseases from cardiovascular to kidney, lung, liver, and other medical conditions, it has not been extensively studied in various clinical and non-clinical settings as blood pressure has. Digital Thermal Flowmetry (DTF) of microvascular endothelial function is a new and automated technique based on monitoring fingertip temperature fall and rebound during reactive hyperemia. Here we report distributions of microvascular function across (1) CVD patients, (2) wellness and internal medicine clinics, (3) college students, and (4) community-based healthy volunteers in China. Methods A total of 7,907 endothelial function test results were collected from various settings. Blood pressure and heart rate were measured before the tests. The tests were conducted using FDA-approved automated VENDYS devices (Endothelix Inc., Palo Alto, CA). Adjusted maximum temperature rebound was reported as Vascular Reactivity Index (VRI) and compared across different settings. Results VRI in CVD patients, wellness and internal medicine clinics, college students, and Chinese volunteers were (1.25±0.34) (1.53±0.5) (1.86±0.5) (1.95±0.44.) respectively P&amp;lt;0.01. Age was weakly correlated with VRI with the equation age=-0.01 VRI+2.01 (r=0.17 p&amp;lt;0.001) Conclusions To our knowledge, this is the largest database of finger-based endothelial function testing. VRI showed distinct distributions across various clinical and non-clinical settings with CVD patients exhibiting the lowest and Chinese healthy volunteers the highest values. The VRI trend mimics the statistically expected risk trend with CVD patients having the highest and Chinese healthy volunteers having the lowest CVD events risk.Figure 1.

FREQUENCY OF ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS (ABPA) IN PATIENTS ADMITTED WITH ACUTE EXACERBATION OF ASTHMA IN A TERTIARY CARE HOSPITAL IN KARACHI: A PROSPECTIVE OBSERVATIONAL STUDY

Allergic Bronchopulmonary Aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus species and often complicates the clinical course of asthma, leading to more severe exacerbations and poor disease control. Despite its clinical relevance, the prevalence of ABPA in asthma patients remains under-reported, especially in developing countries like Pakistan. Objective: This study aimed to determine the prevalence of ABPA among patients admitted with acute exacerbations of asthma at a tertiary care hospital in Karachi, Pakistan. Methods: A prospective observational quantitative study was conducted at the Department of Pulmonary Medicine, Aga Khan Hospital University Karachi, Pakistan from January 2023 to December 2023 in Karachi. The study included 150 isolated patients of either gender, aged between 18 and 80 years, with a clinical diagnosis of asthma or those eligible for spirometry. Data collected included demographic details, past medical history, pulmonary function test results, and serological data for ABPA diagnosis. The presence of ABPA was confirmed by elevated serum total IgE concentration, specific IgE to Aspergillus fumigatus, and radiological findings. Statistical analysis was conducted using SPSS, with p-values &lt; 0.05 considered statistically significant. Results: The study revealed an overall prevalence of ABPA in 20% of the 150 patients with acute asthma exacerbations. Serum total IgE concentration was significantly higher in the ABPA group (450 IU/mL) compared to the non-ABPA group (p &lt; 0.05). Additionally, patients with ABPA had significantly lower FEV1 (60% predicted) compared to those without ABPA (p &lt; 0.05). Conclusion: The study highlights a notable prevalence of ABPA among asthma patients experiencing acute exacerbations. This underscores the importance of raising clinical awareness and implementing timely diagnostic strategies for ABPA in asthma management, which could significantly improve patient outcomes.

Thyroid Function in the Time of COVID-19: A Systematic Review of Disease Progression and Vaccination Effect

Objectives: This systematic review sought to address three key questions: (1) what differences in abnormal thyroid function test results are observed between COVID-19 patients and healthy individuals? (2) How does the severity of COVID-19 infection influence the development of thyroid dysfunction? (3) What impact do COVID-19 vaccines have on thyroid function and autoimmune processes? Methods: A literature search was conducted in PubMed, Web of Science, and Scopus from December 2019 to April 2023 to identify studies on thyroid dysfunction in COVID-19 patients without pre-existing thyroid conditions. The search focused on observational and case-control studies. Results: The literature search yielded 329 reports, from which duplicates and unrelated publications were excluded. Ultimately, 21 studies met the inclusion criteria and were selected for review. A second literature search yielded 605 reports, from which 5 studies were selected for inclusion in the systematic review. Conclusions: The findings suggest that SARS-CoV-2 infection can induce transient and reversible thyroid dysfunction, possibly through direct viral effects on the thyroid gland or via indirect immune-mediated mechanisms. Clinicians should be mindful of the potential, albeit rare, thyroid-related adverse effects of COVID-19 vaccines and monitor thyroid function, particularly in high-risk individuals.

Impact of Photon-counting Detector Computed Tomography on a Quantitative Interstitial Lung Disease Machine Learning Model.

Compare the impact of photon-counting detector computed tomography (PCD-CT) to conventional CT on an interstitial lung disease (ILD) quantitative machine learning (QML) model. A QML model analyzed 52 CT exams from patients who underwent same-day conventional and PCD-CT for suspected ILD. Lin's concordance correlation coefficient (CCC) assessed agreement between conventional and PCD-CT QML results. A CCC >0.90 was regarded as excellent, 0.9 to 0.8 as good, and <0.80 as a poor concordance. Spearman rank correlation evaluated the association between pulmonary function test results (PFT) and QML features (reticulation [R], honeycombing [HC], ground glass [GG], interstitial lung disease [ILD], and vessel-related structures [VRS]). Correlations were statistically significant if the 95% CI did not include 0.00 and P value <0.05. Conventional and PCD-CT QML results had good to excellent concordance (CCC ≥0.8) except for total HC (CCC <0.8), likely related to better PCD-CT honeycombing delineation. Overall, compared with conventional CT, PCD-CT had consistently more statistically significant correlation with PFT for HC (9 PCD vs. 2 conventional of 28 total and regional associations), similar correlation for R (20 PCD vs. 18 conventional of 28 associations) and VRS (19 PCD vs. 23 conventional of 28 associations), and less correlation for GG extent (12 PCD vs. 20 conventional associations). There is strong agreement between conventional and PCD-CT QML ILD features except for HC. PCD-CT improved HC but decreased GG extent correlation with PFT. Therefore, even though most quantitative features were not impacted by the newer PCD-CT technology, model adjustment is necessary.

The prevalence of respiratory symptoms and diseases and declined lung function among foundry workers.

Foundry workers are occupationally exposed to a variety of inhalable chemical substances. Occupational exposure to vapors, gases, dusts, and fumes can lead to adverse health effects on the respiratory system and cause chronic respiratory diseases, such as interstitial lung diseases (ILDs), chronic obstructive lung disease (COPD), chronic bronchitis, and emphysema. Research on respiratory symptoms, diseases, and lung function in foundry workers over the past few decades has been limited. The aim of this cross-sectional study was to assess the prevalence of respiratory symptoms and diseases and declined lung function of current foundry workers, ex-foundry workers, and unexposed controls. We assessed respiratory symptoms, diseases, and lung function among 335 current foundry workers, 64 ex-foundry workers, and 161 unexposed controls. The cumulative dust exposure (mg-y) of each participant was calculated, and the median cumulative dust exposure according to the main places of exposure was determined. A higher prevalence of chronic bronchitis, as reported in a questionnaire, was found among current and ex-foundry workers compared to unexposed controls, even after adjusting for pack-years of smoking (p = 0.009). Additionally, cough and wheezing in adulthood without respiratory infection, and chronic rhinitis symptoms were more common among current and ex-foundry workers compared to unexposed controls. These differences remained significant even after adjusting for pack-years of smoking and body mass index (BMI) (p = 0.007 and p < 0.001, respectively). Impaired lung function was more prevalent among both ex-foundry workers (29.7%) and current foundry workers (15.5%) compared to the unexposed controls (8.7%), with the difference remaining significant even after adjusting for the pack-years of smoking and BMI (p = 0.009). According to the questionnaire, the number of physician-diagnosed cases of chronic obstructive pulmonary disease (COPD) or chronic bronchitis was unexpectedly low compared to the indications from the symptom questionnaire and lung function test results, suggesting a potential underdiagnosis. The prevalence of silicosis was low (0.8%) among current and ex-foundry workers. Respiratory symptoms are common among foundry workers. Current and ex-foundry workers exhibited lower lung function in spirometry compared to unexposed controls. There is a potential underdiagnosis of COPD and chronic bronchitis among foundry workers.

Comparison of orexigenic and anorexigenic neuropeptide levels in hyperemesis gravidarum patients with normal pregnant women: A prospective cohort study.

The aim of this study was to determine whether orexigenic neuropeptides, orexin and galanin, and anorexigenic neuropeptides, alpha-melanocyte-stimulating hormone (α-MSH) and cocaine- and amphetamine-regulated transcript (CART), are implicated in hyperemesis gravidarum (HG). Fifty pregnant women who had been diagnosed with HG between April 2022 and February 2023 at the Siirt University Faculty of Medicine Training and Research Hospital (tertiary center) were recruited for this study. An equal number of pregnant women without an HG diagnosis were included in the study as the control group. Participants' age, pregnancy history, medical history, thyroid function test results, complete blood count results, and electrolyte levels were recorded, and their orexin, galanin, α-MSH, and CART serum levels were analyzed using an enzyme-linked immunosorbent assay. No statistically significant differences in orexigenic neuropeptides (orexin and galanin) were observed between the HG and control groups. A statistical difference was found between an anorexigenic neuropeptide (α-MSH) and the control group (P = .012). Based on a receiver operating characteristic analysis, the α-MSH parameter was statistically significant for distinguishing between participants with an HG diagnosis and those without, with a sensitivity of 63.6%, specificity of 65.9%, and cutoff value of 11769.3 pg/mL (P = .012, area under curve: 0.655). Based on the severity classification of ketonuria (ketonuria levels of +1 or +2 were classified as mild, whereas levels of +3 or +4 were classified as moderate to severe), the anorexigenic CART neuropeptide was found to be a statistically significant diagnostic indicator of severe ketonuria (P = .020). α-MSH and CART levels were found to be related in HG patients and in HG patients with severe ketonuria.

Serum Derivatives–Reactive Oxygen Metabolite Levels as a Marker of Clinical Conditions in Patients with Bronchial Asthma, COPD, or Asthma–COPD Overlap: A Prospective Study

Background: Oxidative stress plays an important role in the pathophysiology of bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), and asthma–COPD overlap (ACO), but its relevance has not been fully elucidated. The aim of this study was to measure the levels of oxidative stress and investigate its clinical significance in patients with BA, COPD, or ACO. Methods: We recruited 214 patients between June 2020 and May 2023 (109 patients with BA, 63 with COPD, and 42 with ACO). To assess clinical conditions, we evaluated patient characteristics, results of respiratory function tests and blood tests, and administered several questionnaires. We evaluated oxidative stress using the test for derivatives–reactive oxygen metabolites (d–ROMs) in serum. Results: The d–ROMs levels were significantly higher in patients with COPD or ACO than in patients with BA. There was no difference in serum d–ROMs levels between the COPD and ACO groups. In BA, d–ROMs levels were positively correlated with interleukin (IL)-6, IL-8, serum amyloid A (SAA), and C-reactive protein (CRP) levels; white blood cell (WBC) and neutrophil counts; and St. George’s Respiratory Questionnaire (SGRQ) scores, and they were negatively correlated with forced expiratory volume in 1 s (%FEV1) and asthma control test (ACT) score. In COPD, d–ROMs levels were positively correlated with IL-6, SAA, and CRP levels; WBC, neutrophil, and eosinophil counts; and COPD assessment test (CAT) and SGRQ scores, and they were negatively correlated with forced vital capacity (%FVC), %FEV1, and %FEV1/FVC scores. In ACO, d–ROMs levels were positively correlated with IL-6, SAA, tumor necrosis factor alpha (TNF-α), and CRP levels; and CAT and SGRQ scores, and they were negatively correlated with %FVC and %FEV1 scores. Conclusions: Serum d–ROMs levels may serve as a marker reflecting clinical conditions such as systemic inflammation, symptom severity, and airflow limitation in patients with BA, COPD, and ACO.

Correlation between the etiology of severe hearing loss and endolymphatic hydrops.

This study aimed to investigate correlation between the presence of endolymphatic hydrops(EH) and factors such as causes of hearing loss, patient age, duration of deafness, and results of vestibular function tests. We retrospectively reviewed medical charts of 128 ears of cochlear implantees who were not considered relevant to Meniere's disease. When comparing group with genetic variants of GJB2, SLC26A4, LMX1A and other genetic mutation group, the proportion of vestibular EH and cochlear EH found in group with genetic variants of GJB2, SLC26A4, LMX1A was significantly higher than group with other genetic etiology (p < 0.01) or the group with all the other causes of hearing loss (p < 0.01). The rate of vestibular and cochlear EH detection was higher in younger patients (41.5% and 35.4%) than in older patients (25.4% and 20.6%). A higher ratio of vestibular and cochlear EH was observed in patients with a longer duration of deafness (37.5% and 31.3%) than those with a shorter duration of deafness (29.7% and 25.0%). The group with vestibular EH showed a higher incidence of abnormal findings in the caloric test (42.9%) than the group without vestibular EH (28.2%). Patients with genetic variants of GJB2, SLC26A4, LMX1A, younger patients, those with longer deaf durations showed a higher prevalence of vestibular and cochlear EH, implying EH appears to be formed as a developmental disorder in association with a certain set of genetic variants, rather than a phenotypic marker as a result of severe to profound hearing loss.

6492 Novel compound heterozygous mutations in the SBP2 gene

Abstract Disclosure: H. Jeong: None. Mutations in the selenocysteine insertion sequence binding protein 2 gene (SECISBP2 also known as SBP2) result in a multisystemic disorder. A 4-year-old Korean girl presented with atypical thyroid function test result, characterized by normal TSH 2.13 μIU/mL, decreased T3 0.51 ng/mL, free T3(FT3) 1.71 (pg/mL), and elevated free thyroxine (FT4) 4.28 ng/dL. Additionally, she exhibited short stature below 2 standard deviations and delayed bone age. She has not yet begun speaking, and her waking ability commenced only recently. She conceived twins through natural pregnancy, but tragically, her twin sibling passed away in utero at 8 weeks of gestation.A targeted next-generation sequencing panel revealed compound heterozygous mutation in SBP2 gene (p.Arg120Ter/p.Arg672Ter) and in TPO gene (p.Glu413Gln).Her serum selenium level was relatively low,, easuring at 6.94 ng/dL. She underwent T3 supplementation and received a daily selenium supplement of 20mcg. Subsequently, her thyroid function tests normalized. Presentation: 6/2/2024

Gait speed in older adults: exploring the impact of functional, physical and social factors

Purpose: With age there is a neuromuscular and cognitive decline that impacts on functional ability. One of the most characteristic and easily recognisable signs of this decline is a decrease in usual gait speed. For older adults, gait speed is a non-invasive indicator of health and functional status and is regarded as a vital sign. As it predicts various conditions later in life, measuring usual walking speed is crucial in the clinical setting. Therefore, analysing and determining the association between walking speed and the impact of functional and socio-economic variables may facilitate the prevention of associated health problems and the maintenance of physical function in older adults. This study aims to identify the key factors that influence walking speed in older adults, as well as to examine the influence of socio-economic status on walking speed. Methods: A total of 1253 older adults (89.5% women) with a mean age of 78.1 ± 5.8 voluntarily participated in this descriptive cross-sectional study, which examines the results of functional capacity tests and socioeconomic data in older adults. To assess physical function, SPPB tests (chair stand test, balance tests, gait speed test), manual grip strength, muscle quality index, and power were conducted, in addition to measuring body composition and socioeconomic status. Results: The final regression model showed that gait speed was significantly partially explained (R2=0.35; p&lt;0.01) by the socioeconomic environment, age, balance, and relative power. At the same time, belonging to a higher socio-economic environment is linked to lower relative power (p&lt;0.01; η2=0.07). Conclusions: Exploring the factors that affect walking speed in older adults, this study highlights that age, relative power and balance are significant determinants. These clinical markers provide crucial information for designing personalized and effective interventions to promote healthy aging. Keywords: Frailty, gait speed, elderly, relative power, socioeconomic status.

Correlation of the severity of the clinical presentation of SARS-CoV-2 pneumonia with respiratory function parameters in the post-COVID period.

Since COVID-19 first surfaced in 2019, it has seriously threatened public health. The most prevalent symptoms are respiratory ones. This study aimed to present the correlation between the severity of the clinical presentation of the disease and the results of respiratory function tests conducted within 6 months after hospital discharge. This retrospective study included 99 patients with confirmed SARS-CoV-2 virus infection. Of all patients 24.2% had accentuated bronchovascular pattern, 9.1% had unilateral, and 29.3% had bilateral pneumonia. In comparison, 35.4% patients had diffuse changes, which were described as acute respiratory distress syndrome (ARDS) on computed tomography (CT). Patients with unilateral, bilateral pneumonia or diffuse lung damage had significantly lower forced vital capacity (FVC) values. They were treated with non-invasive mechanical ventilation (NIV) or invasive mechanical ventilation (MV) and had lower FVC values (0.039). A negative, weak correlation existed between CT findings during the infection and Diffusing capacity for carbon monoxide (DLCO) measured after the infection (0.003). A negative, weak correlation was found between oxygen therapy, the use of NIV, and MV findings during the infection with DLCO. A negative correlation was noted between leukocyte values during the infection and forced expiratory volume in the first second (FEV1) and FVC after the infection. Patients with COVID-19 infection who need oxygen support and MV continue to suffer from loss of respiratory function after the resolution of COVID-19 infection. These findings highlight the negative predictive value of pulmonary tests in the long-term follow-up for the development of PC-ILD as well as decreased pulmonary capacity.

Liver Function Test Results Correlate With Spleen Size in Patients With Infectious Mononucleosis.

We aimed to evaluate the efficacy of measuring transaminase levels to determine the resolution of splenomegaly in athletes diagnosed with infectious mononucleosis (IM). Wecollected serial aspartate aminotransferase (AST) and alanine transaminase (ALT) levelsand ultrasound-measured spleen sizes in university athletes who had been diagnosed with IM. Our study included seven university-aged athletes from a single institution. Patients received serial liver function tests (LFT) and splenic ultrasound testing until resolution of symptoms and full return to sport. The effects of AST, ALT, and days from symptom onset were analyzed using multivariable mixed-effects linear regression models. Levels of AST and ALT were significantly correlated with spleen size. For each 10-unit increase in AST and ALT values, spleen size increased by 0.1 cm (p = 0.007) and 0.09 cm (p = 0.008), respectively. Decreasing levels of ALT and AST correlated with a decrease in spleen size. Normalization of AST/ALT values correlated with return of spleen size to baseline. Liver function testing may be useful in the return-to-play decision-making process for athletes with IM.

Outcomes and predictors of progression in progressive pulmonary fibrosis

Background Progressive pulmonary fibrosis (PPF) is a general term for a class of interstitial lung diseases (ILDs) characterized by a progressive fibrosing (PF) phenotype. Patients with PPF have decreased lung function, exercise ability, and quality of life. The purpose of this study was to investigate the clinical characteristics, potential associated factors for disease progression, and survival outcomes of patients in the PPF population. Methods This study retrospectively reviewed the data of patients diagnosed with ILD between January 2011 and December 2022 at The First Affiliated Hospital of Ningbo University. A PF phenotype was defined based on the criteria that were used in the PPF clinical practice guidelines, which led to the identification of 92 patients with a PF phenotype among the 177 patients with fibrotic ILD. Baseline clinical information and laboratory parameters were collected and analysed in our cohort. Results Patients in the PPF group had higher tumour marker levels and lower pulmonary function test results at baseline than did those in the non-PPF group. According to the multivariate logistic regression analysis, age >65 years (OR 2.71, 95% CI 1.26-5.89; p = 0.011), LDH >245 U/L (OR 3.07, 95% CI 1.39-6.78; p = 0.006), CA-153 > 35 U/mL (OR 3.16, 95% CI 1.25-7.97; p = 0.015), FVC <60% predicted (OR 4.82, 95% CI 1.60-14.51; p = 0.005), DLCO <50% predicted (OR 3.21, 95% CI 1.43-7.21; p = 0.005), and the UIP-like pattern on chest HRCT (OR 3.65, 95% CI 1.33-10.07; p = 0.012) were potentially associated with the progression of fibrotic interstitial lung diseases (f-ILDs) to PPF. Furthermore, the PPF group had a poorer survival rate than the non-PPF group (p = 0.0045). According to the multivariate Cox regression analysis, an SPAP ≥ 37 mmHg (HR 2.33, 95% CI 1.09-5.00; p = 0.030) and acute exacerbation (HR 2.88, 95% CI 1.26-6.59; p = 0.012) were identified as significant prognostic factors for mortality in patients with PPFs. Conclusions Patients who were older, had high CA-153 and LDH levels, had poor pulmonary function test results, or had a UIP-like pattern on chest HRCT were more likely to have indications for the progression of f-ILD to PPF. Increased SPAP and AE are independent risk factors for the prognosis of PPF patients, so additional attention should be given to such patients.

Survival and recurrence rates following SBRT or surgery in medically operable Stage I NSCLC

ObjectivesSurgery is the standard of care for early-stage non-small cell lung cancer (NSCLC), with SBRT reserved for patients who are not surgical candidates. We hypothesized overall survival (OS), lung cancer-specific survival (LCSS), progression free survival (PFS), and recurrence rates following SBRT or surgery in medically operable patients with Stage I NSCLC from the Veterans’ Health Care System (VAHS) would be equivalent. Materials and methodsMedically operable patients diagnosed with Stage I NSCLC between 2000–2020 from the VAHS, determined by an FEV1 or DLCO > 60 % of predicted and Charlson comorbidity index (CCI) of 0 or 1, treated with SBRT or surgery were identified. SBRT patients were propensity score matched in a 1:1:1 ratio to those undergoing resection (SBRT:lobectomy:sub-lobar resection). OS, LCSS, and PFS and site of recurrence were determined. Results103 patients were included in each cohort. With a median follow-up of 7.9 years 5-year OS for all patients was 51 % (95 % CI 46–57 %). After propensity score matching, OS (HR 2.08, 1.59), LCSS (HR 2.28, 1.97), and PFS (1.97, 1.45) were significantly worse with SBRT compared to either lobectomy or sub-lobar resection, respectively, (p < 0.05 for each comparison). Regional recurrence was significantly higher following SBRT (15.5 % vs 6.8 % or 4.9 %; p < 0.05), but there was no significant difference in local (28.2 % vs 21.4 % or 21.4 %; p > 0.05) or distant recurrence (10.7 % vs 9.7 % or 13.6 %; p > 0.05) when compared to lobectomy or sub-lobar resection, respectively. ConclusionIn medically operable patients, OS, LCSS, and PFS following either lobectomy or sub-lobar resection were superior to that for SBRT for Stage I NSCLC, likely due in part to higher regional recurrence following SBRT. This suggests that pulmonary function test results and CCI alone are insufficient to define a cohort of medically operable patients suited for SBRT. These data support strategies to overcome regional recurrences seen with SBRT.

Adults who Smoke Should Have Pulmonary Function Testing Before and After Coronary Artery Bypass Grafting (CABG)

Background: Recent research has shown that coronary artery bypass grafting (CABG) has a mortality rate of 0.6–3.0%, making it a popular and generally safe cardiac operation. The purpose of this study is to examine the relationship between sex, age, and diabetes in the early changes in lung volumes measured by pulmonary function tests before and after coronary artery bypass grafting (CABG) in individuals who smoke. Subjects and procedures: Elective coronary artery bypass surgery was the procedure of choice for 200 consecutive patients in this prospective controlled trial. Participants who were not part of the trial were those who were in an emergency or who had a valve operation done alongside a CABG procedure. Based on the data from the operation, the cardiopulmonary bypass time was 98.89 minutes with a standard deviation of 25.14 minutes. The average time for cardiac ischemia was 67.8 minutes with a standard deviation of 26.6 minutes and a range of 25 to 227 minutes. The total time spent in the intensive care unit was 53.54 hours with a standard deviation of 27.98 hours and a range of 4 to 102 hours. Thirteen patients, or 6.5%, were cold, while the remaining patients were warm. Thirteen patients, or 6.5%, used ice slush as a topical cooling method. The results of the pulmonary function tests taken before and after surgery were significantly different. Conclusion: Postoperative obstructive and restrictive breathing problems are associated with cigarette smoking's detrimental effects on pulmonary functioning. Patients with a smoking history who are scheduled for elective revascularization surgery should have their pulmonary status evaluated before surgery, and they should be strongly encouraged to quit smoking as soon as possible before surgery to minimize the risk of respiratory complications after surgery.

Construction of marigold-like ZnIn2S4@Tb-g-C3N4 heterojunction for facilitating photocatalytic degradation of tetracycline and tylosin under simulated solar irradiation

Due to the high biological toxicity and the propensity to induce antibiotic resistance, the treatment of antibiotic wastewater has consistently posed a formidable challenge. The semiconductor photocatalysts can efficiently and completely remove antibiotics from the wastewater to repair the water environment. Therefore, a novel ZnIn2S4/Tb-g-C3N4 (ZIS/TCN) photocatalyst was successfully synthesized in this paper and its ability to efficiently degrade antibiotics has been verified. The optimized 150ZIS/TCN photocatalyst showed excellent photocatalytic performance and stablility toward the degradation of tetracycline (TC) and tylosin (TYL) under sunlight simulated with a xenon lamp. Compared with pristine g-C3N4 and ZnIn2S4, the 150ZIS/TCN exhibited superior degradation performance for TC (TYL)，about 3.2 (2.1) and 1.8 (1.5) times higher than them. Based on density functional theory (DFT) calculations and experimental characterization test results, it was confirmed that the Tb doping effectively regulates the intrinsic electric field and visible light absorption capacity. This study unveils the degradation mechanism of ZIS/TCN photocatalysis and provides an effective pathway for enhancing photocatalytic degradation through rare earth doping.