RATHI was introduced as an attempt to further improve the association between anatomical zones and specific breathing activity, both spatially and temporally. This work compares RATHI with clinical pulmonary auscultation (PA) to assess the concordance between both procedures to detect asymmetries in lung sound (LS) intensities. Twelve healthy young males participated in the study and were auscultated by two experts. RATHI consisted in the acquisition of acoustical signals with an array of 5x5 sensors, while experts auscultated and described the intensity of LS heard using the same stethoscope on each sensor's position within the array. Comparisons were established looking for intensity asymmetries between apical vs. basal pulmonary regions and right vs. left hemithorax. By RATHI, most of the subjects showed asymmetries between apical and basal regions higher than 20%, whereas between left and right hemithorax asymmetries higher than 20% occurred only half of the time. RATHI and PA agreed 83 to 100% when apical to base acoustical information was compared, but when left to right asymmetries were considered these figures were about 40 to 50%. We concluded that RATHI has advantages as it gave more detailed and measurable information on LS than clinicians, who could not detect intensity asymmetries mainly below 20%.
Background: Pulmonary involvement in juvenile systemic sclerosis (JSSc) is rare in children and contributes to morbimortality. This study aimed to describe the pulmonary function and clinical, radiologic, and tomographic findings in JSSc. Methods: Patients with JSSc between 5-14 years of age were included. Clinical, functional, and imaging characteristics were assessed. Patients were excluded if they showed lung disease not associated with JSSc: mixed connective tissue disease, overlap syndrome, or acute cardiopulmonary failure at the time of the study. All patients underwent physical examination, electrocardiogram, spirometry, chest X-ray, high-resolution computed tomography (HRCT) of the chest, echocardiography, lung function tests, and the 6-minute walk test (6-MWT). Descriptive statistics were employed for data analysis. Results: We studied 15 patients with the following characteristics: median age, 11 years; median since symptoms onset, 6 years; median since JSSc diagnosis and the finding of pulmonary involvement, 2 years. Lung disease was detected in 73%, interstitial lung disease (ILD) the most common affection (67%); pulmonary hypertension was found in 6.6%. 6-MWT was positive in 26.6%, forced vital capacity (FVC) was abnormal in 26.6%. No pulmonary involvement was found in four patients. Conclusions: The most frequent pulmonary affection in JSSc was ILD. Thus, early JSSc detection and periodic lung monitoring are mandatory to avoid further complications once JSSc is diagnosed.
Respiratory acoustic thoracic imaging (RATHI) permits analysing lung sounds (LS) temporal and spatial distribution, however, a deep understanding of RATHI repeatability associated with the pulmonary function is necessary. As a consequence, in the current work intrasubject variability of RATHI is evaluated at different airflows. For generating RATHIs, LS were acquired at the posterior thoracic surface. The associated image was computed at the inspiratory phases by interpolation through a Hermite function. The acoustic information of eleven subjects was considered at airflows of 1.0, 1.5 and 2.0 L/s. Several RATHIs were generated for each subject according to the number of acquired inspiratory phases. Quadratic mutual information based on Cauchy-Schwartz inequality (I(CS)) was used to evaluate the degree of similitude between intrasubject RATHIs. The results indicated that, for the same subject, I(CS) averaged 0.893, 0.897, and 0.902, for airflows of 1.0, 1.5, and 2 L/s, respectively. In addition, when the airflow was increased, increments in intensity values and in the dispersion of the spatial distribution reflected in RATHI were observed. In conclusion, since the intrasubject variability of RATHI was low for airflows between 1.0 and 2.0 L/s, the pattern of sound distribution during airflow variations is repeatable but differences in sound intensity should be considered.
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