The aim of the study was to evaluate the types of left ventricular (LV) rotation depending on the nature of feeding during the first year of life in oneto five-year-old children born with very low and extremely low body weight.Material and Methods. The study included 88 children aged one to five years, born deeply premature with very low and extremely low body weight. The comparison group consisted of 46 healthy children of the same age, born full-term. TheLV mechanics was studied based on the assessment ofLV rotation at the levels of the mitral valve, papillary muscles, and apex andLV twist using two-dimensional echocardiography and two-dimensional speckle-tracking strain imaging.Results. Differences between the types ofLV twist and the nature of feeding during the first year of life in oneto five-year-old children born with very low and extremely low body weight were identified. In children with natural feeding, the first (“adult”) type ofLV twist was registered in 75% of cases; the fourth type ofLV twist was detected in 12.5% of cases. In children with bottle-feeding during the first year of life, the “adult” type ofLV twist was registered in 34.38% of cases; fourth type ofLV twist was detected in 40.63% of children born deeply premature. In children with mixed feeding during the first year of life, the ratio ofLV twist types was as follows: 40.63% of patients had the first “adult” type; “child” types were present in 18.75% and 18.75% of children, respectively; fourth type of twist was detected in 21.88%.
The aim of this study was to evaluate changes in lung ventilation and lung diffusing capacity (DLCO) of cystic fibrosis (CF) patients during 1 year after lung transplantation. Methods. Complex lung function was monitored in CF patients underwent bilateral lung transplantation in 2012 – 2016. Results. CF patients (n = 12; mean age, 26.4 ± 4.4 years) were included in the study. Median follow-up after the lung transplantation was 19 (12–57) months. Consistent improvement in lung function parameters and DLCO was observed in 3 months after lung transplantation and maintained during 1 year. The ratio of forced expiratory volume in 1 sec to forced vital capacity was higher the normal level and the bronchial resistance was lower the cut-off values, i.e. the patients did not have bronchial obstruction. The total lung capacity (TLC) decreased to normal according to the anthropometric characteristics of the recipient. Meanwhile, change in the TLC structure, such as non-significant reduction in the vital capacity (VC) together with increase in the functional residual capacity (FRC), residual volume (RV) and RV/TLC ratio, have been developed. Consistent increase in FRC and RV could be explained by changes in the shape and the elasticity of the chest wall after the surgery. DLCO also improved, but was still slightly decreased. Conclusion. The lung function and DLCO improved in a year after bilateral lung transplantation in CF patients. Effects of different factors on postoperative lung function parameters need to be further investigated.
1 -ФГБУ «НИИ пульмонологии» ФМБА России: 105077, Москва, ул. 11 я Парковая, 32, корп. 4; 2 -ГБОУ ДПО «Российская медицинская академия последипломного образования» Минздрава России: 123995, Москва, ул. Баррикадная, 2 / 1; 3 -ГБОУ ВПО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России: 117997, Москва, ул. Островитянова, 1 РезюмеЦель. Выявление у работников промышленного предприятия факторов риска хронических неинфекционных заболеваний (ХНИЗ) и ранняя диагностика хронической обструктивной болезни легких (ХОБЛ). Материалы и методы. В рамках программы проекта «Мо бильная кардиореспираторная и метаболическая лаборатория» (МКРМЛ) проведен аудит здоровья работников (n = 194) промышлен ного предприятия в возрасте от 31 до 62 лет. Результаты и обсуждение. По результатам обследования показана высокая распространен ность таких факторов риска ХНИЗ, как табакокурение (активные курильщики -45 %, экс курильщики -31 %), индекс массы тела ≥ 30 кг / м 2 (у 37 %), повышение уровня общего холестерина в капиллярной крови (у 34 %), эндотелиальная дисфункция (у 57 % обсле дованных). При этом показатели сосудистой биомеханики находились в корреляционной взаимосвязи с состоянием бронхиальной про водимости, величиной системного давления, а также с концентрацией СО в выдыхаемом воздухе. При проведении спирометрии обструктивные нарушения были выявлены у 56 % обследованных, из них ХОБЛ диагностирована у 13 %. У 3 % работников в возрасте от 39 до 43 лет при расчете нижней границы нормы значения отношения объема форсированного выдоха за 1 ю секунду / форсирован ной жизненной емкости легких (возраст, пол) были ниже порогового значения, что требует дополнительного обследования и динами ческого наблюдения для исключения ХОБЛ. Заключение. Приближение медицинской помощи непосредственно к рабочему месту ра ботников промышленных предприятий с использованием МКРМЛ является наиболее эффективным инструментом диагностики ХНИЗ и факторов их риска, что позволяет персонифицировать рекомендации по снижению факторов риска, дополнительно обследовать боль ного и назначить базисную терапию на ранней стадии заболевания. SummaryThe aim of this study was to determine risk factors of chronic non infectious diseases and early diagnosis of cardiovascular, respiratory and endocrine functional disorders in industrial workers using a mobile cardiorespiratory and metabolic laboratory. Methods. This was a prospective non compar ative observational study in a non selected population. All participants underwent the following measurements: weight and height, wrist and thigh circumferences, pulse oxymetry, exhaled nitric oxide (NO) and exhaled carbon monooxide (CO), spirometry before and after bronchodilator inhala tion, electrocardiogram, arterial stiffness and endothelial dysfunction, blood glucose and blood total cholesterol. Indirect calorimetry with energy expenditure calculation was used in several patients. Validated questionnaires were also used. Results. The study involved 194 industrial workers. High prevalence of r...
Федеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства: 115682, Москва, Ореховый бульвар, 28; 2-Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени Д.Д.Плетнева Департамента здравоохранения города Москвы»: 105077, Москва, ул. 11-я Парковая, 32; 3-Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М.Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет): 119991, Москва, ул. Трубецкая, 8, стр. 2 Информация об авторах Черняк Александр Владимирович-к. м. н., заведующий лабораторией функциональных и ультразвуковых методов исследования Федерального государственного бюджетного учреждения «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентства России, врач функциональной диагностики отделения функциональной и ультразвуковой диагностики Государственного бюджетного учреждения здравоохранения города Москвы «Городская клиническая больница имени Д.Д.Плетнева Департамента здравоохранения города Москвы»; SPIN-код: 9328-6440; тел.:
The article describes a clinical case demonstrating the results of the lungs ultrasound examination in the COVID-19 patient during the acute period of the disease and early recovery period.
The aim of the study was to evaluate prevalence and age-dependence of bronchial hyperresponsiveness (BHR) in cross country skiers. Methods. Twenty-nine cross-country skiers (14 males, 15 females aged 18 to 30 years; average age, 23.9 ± 3.4 years) were involved in the study. All athletes underwent pulmonary function tests (spirometry before and after inhalation of 400 μg of salbutamol, body plethysmography, diffusion test). Then, methacholine challenge test was performed. Results. In skiers, lung function data were higher compared to the reference vаlues calculated in accordance with the ECSC equations, 1993. Bronchial reversibility was found in 4 athletes (14%). Methacholine provocative concentration causing a 20% fall in FEV1 (PC20) was > 4 mg/ml in 9 skiers (31%). Significant relationships were found between the atheltes’ age and BHR. Conclusion. Cross-country skiers have a high prevalence of BHR to methacholine. BHR increases with age.
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