Effects of Daily Physical Activity on Exercise Capacity in Chronic Obstructive Pulmonary Disease.

Background and Objectives: In adults, 150 to 300 min a week of moderate-intensity physical activity is the recommended daily level to maintain or improve fitness. In subjects with chronic obstructive pulmonary disease (COPD), reductions in daily physical activity (DPA) amounts are related to clinically significant outcomes. In this study, we ascertain whether or not COPD patients, when clustered into active (DPA ≥ 30 min a day, 5 days a week) and inactive (DPA < 30 min a day, 5 days a week), may differ in exercise capacity, as assessed by a cardiopulmonary exercise test (CPET). Materials and Methods: A large sample of clinically stable COPD patients was retrospectively recruited and then underwent spirometry and an incremental ramp protocol 5-15 watts/min CPET. DPA was assessed by a questionnaire. Results: A total of 83 (female 25%, age range 41-85 y) active and 131 (female 31%, age range 49-83 y) inactive participants were enrolled. They were similar in age, sex distribution, body mass index (BMI) and in spirometry. The two groups were significantly different in dyspnea on exertion, as assessed by the modified Medical Research Council (mMRC), and in cardio-metabolic parameters, but not in ventilatory ones, as confirmed by the CPET. Conclusions: COPD patients experiencing physical activity of at least 30 min a day, 5 days a week, showed a greater exercise capacity and an improved cardiovascular response to exercise, when compared to inactive ones. Active and inactive participants did not differ in terms of airflow obstruction severity as well as in dynamic hyperinflation and ventilatory inefficiency during exercise. This study further suggests the benefits of regular physical activity in COPD.

Platypnea-Orthodeoxia Syndrome after SARS-CoV-2 interstitial pneumonia: an overview and an update on our patient.

Platypnea-Orthodeoxia Syndrome (POS) is a clinical entity defined as positional dyspnoea (platypnea) and arterial desaturation (orthodeoxia) that occurs when sitting or standing up and usually resolves by lying down. Up to April 25th 2021, eleven cases of POS after SARS-CoV-2 pneumonia have been reported on Pubmed. Accordingly, SARS-CoV-2 infection may be considered as an emergent cause of POS due to an increase in ventilation/perfusion (V/Q) mismatch. In this article we provide an update on the patient with POS after fibrotic evolution of SARS-CoV-2 interstitial pneumonia, which we previously reported and we discuss the case reports of POS due to SARS-CoV-2 infection.

Streak artefacts in Computed Tomography Urography: Comparative evaluation between two different iodinated contrast media.

INTRODUCTION: The objective of this study was to compare the frequency and entity, in computed tomography (CT) urography, of streak artefacts on the urinary tract generated by two contrast agents with a different iodine concentration and osmolarity. METHODS: Computed tomography scans including an excretory renal phase, performed on adult subjects in the period May-July 2020, were retrospectively evaluated in consensus by three expert radiologists, to detect any streak artefacts located in the urinary tract. Patients were administered either 1.6 mL/kg of Iodixanol 320 mgI/mL or 1.3 mL/kg of Iomeprol 400 mgI/mL. RESULTS: In total, 144 CT scans were analysed, subdivided into two groups administered either Iodixanol (71/144 (49.3%) patients) or Iomeprol (73/144 (50.7%) patients). In 41% cases, no beam hardening artefacts were found; among these, 12/59 (20.3%) patients had received Iodixanol and 47/59 (79.7%) Iomeprol. In the Iodixanol group, the mean contrast density on the renal pelvis was 2565.6 HU and streak artefacts occurred in 59/71 cases (83.1%); in 33/59 (55.9%) cases, the artefacts were marked, and in 26/59 (44.1%) minimal. In the Iomeprol group, the mean contrast density on the renal pelvis was 1666 HU and streak artefacts occurred in 26/73 cases (35.6%); in 7/26 (27%) cases, the artefacts were marked and in 19/26 (73%) minimal. CONCLUSION: The study data demonstrate a significant difference in the attenuation values of iodine urine in the excretory system between the Iodixanol and Iomeprol group. Iodixanol induced a higher frequency and burden of artefacts, compared to Iomeprol.

Platypnea-orthodeoxia after fibrotic evolution of SARS-CoV-2 interstitial pneumonia. A case report.

Platypnea-orthodeoxia syndrome (POS) is a clinical entity characterized by positional dyspnoea (platypnea) and arterial desaturation (orthodeoxia) that occurs when sitting or standing up and usually resolves by lying down. POS may result from some cardiopulmonary disorders or from other miscellaneous aetiologies. We report a case of POS in a patient after fibrotic evolution of SARS-CoV-2 interstitial pneumonia associated with pulmonary embolism. The patient did not have any evidence of an intracardiac/intrapulmonary shunt.