The Experts below are selected from a list of 6525 Experts worldwide ranked by ideXlab platform
Philipp Latzin - One of the best experts on this subject based on the ideXlab platform.
-
Single-breath washout tests to assess Small Airway Disease in COPD.
Chest, 2016Co-Authors: Lucas Boeck, Philipp Latzin, Anna Gensmer, Sylvia Nyilas, Bram Stieltjes, Michael Tamm, Daiana StolzAbstract:Background Current functional assessments do not allow a reliable assessment of Small Airways, which are a major site of Disease in COPD. Single-breath washout (SBW) tests are feasible and reproducible methods for evaluating Small Airway Disease. Their relevance in COPD remains unknown. Methods We performed a cross-sectional study in 65 patients with moderate to severe COPD. Phase III slope of nitrogen (SIII N2 ) and double tracer gas (SIII DTG ) SBW tests were used as a measure of ventilation inhomogeneity. The association of both markers with established physiological and clinical features of COPD was assessed. Results Ventilation inhomogeneity as measured by SIII N2 and SIII DTG was increased in patients with COPD compared with healthy subjects ( P P N2 was associated with FEV 1 predicted, residual volume (RV)/total lung capacity (TLC) and diffusing capacity of the lung for carbon monoxide (D lco) (all P N2 was related to dyspnea, exercise-induced desaturation, and exercise capacity ( P = .001, P P = .047, respectively). SIII DTG was associated with TLC, D lco, and cough ( P P = .001, and P = .009, respectively). In multivariate regression models, we demonstrated that these associations are largely independent of FEV 1 and mostly stronger than associations with FEV 1 . In contrast, FEV 1 was superior in predicting emphysema severity. Conclusions SIII N2 and SIII DTG , two fast and clinically applicable measures of Small Airway Disease, reflect different physiological and clinical aspects of COPD, largely independent of spirometry. Trial Registry ISRCTN99586989, Ethics committee Beider Basel (approval number 295/07)
-
tidal volume single breath washout of two tracer gases a practical and promising lung function test
PLOS ONE, 2011Co-Authors: Florian Singer, Georgette Stern, Per E Gustafsson, Thomas Riedel, Oliver Fuchs, Cindy Thamrin, Urs Frey, Philipp LatzinAbstract:Small Airway Disease frequently occurs in chronic lung Diseases and may cause ventilation inhomogeneity (VI), which can be assessed by washout tests of inert tracer gas. Using two tracer gases with unequal molar mass (MM) and diffusivity increases specificity for VI in different lung zones. Currently washout tests are underutilised due to the time and effort required for measurements. The aim of this study was to develop and validate a simple technique for a new tidal single breath washout test (SBW) of sulfur hexafluoride (SF(6)) and helium (He) using an ultrasonic flowmeter (USFM).
Margarida Dias - One of the best experts on this subject based on the ideXlab platform.
-
Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia: A Clinical Case.
European journal of case reports in internal medicine, 2020Co-Authors: Adelaide Alves, Ana Barroso, Margarida DiasAbstract:Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare pulmonary condition characterized by diffuse proliferation of neuroendocrine cells in the epithelium of the bronchial wall. DIPNECH may be easily missed in daily clinical practice and diagnosis is often delayed, which may impair prognosis since this condition is considered a pre-invasive lesion for lung carcinoid tumours. We report a clinical case of DIPNECH in order to discuss the diagnostic and therapeutic approach for this entity, the management of which is not yet well established in the literature. LEARNING POINTS DIPNECH is a poorly understood lung condition characterized histologically by diffuse proliferation of pulmonary neuroendocrine cells in the bronchial wall, clinically by obstructive respiratory symptoms and radiologically by Small Airway Disease features and pulmonary nodules.DIPNECH is considered to be a preneoplastic lesion within the spectrum of pulmonary neuroendocrine tumours.Treatment is usually guided by the symptoms and prognosis is highly variable.
Surya P. Bhatt - One of the best experts on this subject based on the ideXlab platform.
-
clinical significance of bronchodilator responsiveness evaluated by forced vital capacity in copd spiromics cohort analysis
International Journal of Chronic Obstructive Pulmonary Disease, 2019Co-Authors: Igor Z Barjaktarevic, Surya P. Bhatt, Russell G Buhr, Xiaoyan Wang, David Couper, Wayne H Anderson, Richard E Kanner, Robert Paine, Nirav R Bhakta, Mehrdad ArjomandiAbstract:Author(s): Barjaktarevic, Igor Z; Buhr, Russell G; Wang, Xiaoyan; Hu, Scott; Couper, David; Anderson, Wayne; Kanner, Richard E; Paine Iii, Robert; Bhatt, Surya P; Bhakta, Nirav R; Arjomandi, Mehrdad; Kaner, Robert J; Pirozzi, Cheryl S; Curtis, Jeffrey L; O'Neal, Wanda K; Woodruff, Prescott G; Han, MeiLan K; Martinez, Fernando J; Hansel, Nadia; Wells, James Michael; Ortega, Victor E; Hoffman, Eric A; Doerschuk, Claire M; Kim, Victor; Dransfield, Mark T; Drummond, M Bradley; Bowler, Russell; Criner, Gerard; Christenson, Stephanie A; Ronish, Bonnie; Peters, Stephen P; Krishnan, Jerry A; Tashkin, Donald P; Cooper, Christopher B; NHLBI SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) | Abstract: Objective:Bronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronchodilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume. Methods:We analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models. Results:A majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced Disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and Small Airway Disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1. Conclusion:With advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of Small Airway Disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD. Clinical trials registration:ClinicalTrials.gov: NCT01969344T4.
-
clinical significance of bronchodilator responsiveness evaluated by forced vital capacity in copd spiromics cohort analysis
International Journal of Chronic Obstructive Pulmonary Disease, 2019Co-Authors: Igor Z Barjaktarevic, Surya P. Bhatt, Russell G Buhr, Xiaoyan Wang, Scott Hu, David Couper, Wayne H Anderson, Richard E Kanner, Robert Paine, Nirav R BhaktaAbstract:Objective: Bronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronchodilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume. Methods: We analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models. Results: A majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced Disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and Small Airway Disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1. Conclusion: With advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of Small Airway Disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD. Clinical trials registration: ClinicalTrials.gov: NCT01969344T4.
-
Association between functional Small Airway Disease and FEV1 decline in chronic obstructive pulmonary Disease
American journal of respiratory and critical care medicine, 2016Co-Authors: Surya P. Bhatt, Xavier Soler, Xin Wang, Susan Murray, Antonio Anzueto, Terri H. Beaty, Aladin M. Boriek, Richard Casaburi, Gerard J. Criner, Alejandro A. DiazAbstract:Rationale: The Small conducting Airways are the major site of airflow obstruction in chronic obstructive pulmonary Disease and may precede emphysema development.Objectives: We hypothesized a novel computed tomography (CT) biomarker of Small Airway Disease predicts FEV1 decline.Methods: We analyzed 1,508 current and former smokers from COPDGene with linear regression to assess predictors of change in FEV1 (ml/yr) over 5 years. Separate models for subjects without and with airflow obstruction were generated using baseline clinical and physiologic predictors in addition to two novel CT metrics created by parametric response mapping (PRM), a technique pairing inspiratory and expiratory CT images to define emphysema (PRMemph) and functional Small Airways Disease (PRMfSAD), a measure of nonemphysematous air trapping.Measurements and Main Results: Mean (SD) rate of FEV1 decline in ml/yr for GOLD (Global Initiative for Chronic Obstructive Lung Disease) 0–4 was as follows: 41.8 (47.7), 53.8 (57.1), 45.6 (61.1), 31...
Eric J. Stern - One of the best experts on this subject based on the ideXlab platform.
-
Imaging of Small Airway Disease (SAD)
Radiologic clinics of North America, 2009Co-Authors: Sudhakar Pipavath, Eric J. SternAbstract:This article comprehensively reviews and illustrates the imaging features of Small Airway Diseases. The authors discuss the imaging findings of Small Airway Diseases in general and how to differentiate them from other findings that can be confused with Small Airway Diseases. The authors also discuss the features that aid in diagnosing specific Diseases that affect the Small Airways.
-
Small-Airway Diseases of the lungs : findings at expiratory CT
AJR. American journal of roentgenology, 1994Co-Authors: Eric J. Stern, M S FrankAbstract:CT performed in patients during suspended full expiration has recently been used to reveal a major physiologic consequence of Airway Diseases, particularly Diseases of those Smaller Airways beyond the segmental branches: air trapping. Lung regions that retain air during exhalation (air trapping) remain more lucent than normal lung regions do. Detection of air trapping can provide clues to an otherwise unsuspected or underappreciated Small-Airway Disease.
Nirav R Bhakta - One of the best experts on this subject based on the ideXlab platform.
-
clinical significance of bronchodilator responsiveness evaluated by forced vital capacity in copd spiromics cohort analysis
International Journal of Chronic Obstructive Pulmonary Disease, 2019Co-Authors: Igor Z Barjaktarevic, Surya P. Bhatt, Russell G Buhr, Xiaoyan Wang, Scott Hu, David Couper, Wayne H Anderson, Richard E Kanner, Robert Paine, Nirav R BhaktaAbstract:Objective: Bronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronchodilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume. Methods: We analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models. Results: A majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced Disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and Small Airway Disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1. Conclusion: With advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of Small Airway Disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD. Clinical trials registration: ClinicalTrials.gov: NCT01969344T4.
-
clinical significance of bronchodilator responsiveness evaluated by forced vital capacity in copd spiromics cohort analysis
International Journal of Chronic Obstructive Pulmonary Disease, 2019Co-Authors: Igor Z Barjaktarevic, Surya P. Bhatt, Russell G Buhr, Xiaoyan Wang, David Couper, Wayne H Anderson, Richard E Kanner, Robert Paine, Nirav R Bhakta, Mehrdad ArjomandiAbstract:Author(s): Barjaktarevic, Igor Z; Buhr, Russell G; Wang, Xiaoyan; Hu, Scott; Couper, David; Anderson, Wayne; Kanner, Richard E; Paine Iii, Robert; Bhatt, Surya P; Bhakta, Nirav R; Arjomandi, Mehrdad; Kaner, Robert J; Pirozzi, Cheryl S; Curtis, Jeffrey L; O'Neal, Wanda K; Woodruff, Prescott G; Han, MeiLan K; Martinez, Fernando J; Hansel, Nadia; Wells, James Michael; Ortega, Victor E; Hoffman, Eric A; Doerschuk, Claire M; Kim, Victor; Dransfield, Mark T; Drummond, M Bradley; Bowler, Russell; Criner, Gerard; Christenson, Stephanie A; Ronish, Bonnie; Peters, Stephen P; Krishnan, Jerry A; Tashkin, Donald P; Cooper, Christopher B; NHLBI SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) | Abstract: Objective:Bronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronchodilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume. Methods:We analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models. Results:A majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced Disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and Small Airway Disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1. Conclusion:With advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of Small Airway Disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD. Clinical trials registration:ClinicalTrials.gov: NCT01969344T4.