Raymond L. Murphy's research while affiliated with Brigham and Women's Hospital and other places
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Publications (21)
Objective. It is generally accepted that crackles are due to sudden opening of airways and that larger airways produce crackles of lower pitch than smaller airways do. As larger airways are likely to open earlier in inspiration than smaller airways and the reverse is likely to be true in expiration, we studied crackle pitch as a function of crackle...
Objective. The phenomenon of pendelluft was described over five decades ago. In patients with regional variations in resistance and elastance, gas moves at the beginning of inspiration out of some alveoli into others. Gas moves in the opposite direction at the end of inspiration. The objective of this study was to apply the method of lung sounds ma...
To determine the variability of crackle pitch and crackle rate during a single automated-auscultation session with a computerized 16-channel lung-sound analyzer.
Forty-nine patients with pneumonia, 52 with congestive heart failure (CHF), and 18 with interstitial pulmonary fibrosis (IPF) performed breathing maneuvers in the following sequence: norma...
A 77-year-old woman presented to the hospital with shortness of breath and fever, 2 months after receiving radiation therapy to the right chest for breast cancer. A diagnosis of radiation pneumonitis was made, and the patient was treated with glucocorticoids. Serial chest radiography revealed irregular opacifications, predominantly in the right hem...
PURPOSE: To determine if time based parameters of lung sounds differed in patients with chronic obstructive lung disease (COPD) as compared to normal subjects and patients with other disorders.
METHODS: A 16-channel lung sound analyzer (Stethographics Model STG1602) was used to collect 20s samples of sound from patients with COPD (n=103), normals (...
PURPOSE: To determine if time based parameters of lung sounds differed in patients with chronic obstructive lung disease (COPD) as compared to normal subjects and patients with other disorders.
METHODS: A 16-channel lung sound analyzer (Stethographics Model STG1602) was used to collect 20s samples of sound from patients with COPD (n=103), normals (...
PURPOSE: The purpose of this investigation was to determine the diagnostic accuracy of the interpretation of waveforms and computerized analyses obtained by a multichannel lung sound analyzer.
METHODS: 54 patients seen at a community teaching hospital were included in this study. Their clinical diagnoses included pneumonia, obstructive lung disease...
Although crackles are frequently heard on auscultation of the chest of patients with common cardiopulmonary disorders, the mechanism of production of these sounds is inadequately understood. The goal of this research was to gain insights into the mechanism of crackle generation by systematic examination of the relationship between inspiratory and e...
PURPOSE: For the purpose of testing different types of protective gear to shield personnel from injury due to explosions on the battlefield, sheep were subjected to mechanically induced injury. We studied lung sounds in these sheep before and after these injuries. Our hypothesis was that abnormal sounds, not present before the injury, would likely...
PURPOSE: The broad, long term objective of this research is to create an algorithm and then a device to detect pneumothorax (PTX) quickly and under a variety of environmental conditions. The goal in this particular study was to investigate differences in the acoustic patterns of patients with pneumothorax as compared to sound patterns in healthy co...
PURPOSE: The goal of this study was to quantify the acoustic changes in pneumothorax (PTX) and hemothorax (HTX).
METHODS: Sequential boluses of air were injected into 2 sedated, ventilated pigs to induce unilateral PTX. Similarly saline was used to simulate HTX. Lung sounds were recorded using a multichannel lung sound analyzer.
RESULTS: When no ad...
PURPOSE: The crackles heard in patients with IPF have been described as distinctive from those in the other conditions commonly associated with crackles. Although there is some objective information to support this claim it has been obtained on only a small number of patients and at few sites on the chest. We used a multichannel lung sound analyzer...
Patients with interstitial pulmonary fibrosis (IPF) often have diffusely abnormal findings on chest radiographs, making it difficult to detect evidence of superimposed congestive heart failure (CHF) or pneumonia. The goal of this study was to determine whether the crackles of IPF differed in their transmission and frequency from crackles of CHF and...
To determine whether objectively detected lung sounds were significantly different in patients with pneumonia than those in asymptomatic subjects, and to quantify the pneumonia findings for teaching purposes.
At a community teaching hospital we used a multi-channel lung sound analyzer to examine a learning sample of 50 patients diagnosed with pneum...
Citations
... The multi-channel stethograph system records the HLT audio from the patient's body for a duration of 20 seconds. Operation errors including improper handling of the system and manual system settings could affect the completeness and accuracy of recorded audio [27]. For example, a bad quality HLT audio whose duration is less than 20 seconds is shown in the time-domain ( Fig. 3(a)). ...
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... This suggests a frequency range of interest for COPD detection. Furthermore, another study evaluated eleven different parameters to diagnose COPD, such as lead and lag time of inspiration at different locations and ratio of inspiratory to expiratory time; the authors concluded that all 11 parameters possessed differences between COPD and healthy patients that were statistically significant, suggesting that further study into these differences should be carried out [159]. ...
Reference: Acoustic Methods for Pulmonary Diagnosis
... COPD patients generally show an abnormal swallowing pattern where they swallow more often and more distinctively (Robinson et al., 2011). Moreover, a study by Vyshedskiy and Murphy (2016) on the acoustic biomarkers of COPD showed that there are measurable differences between the lung sound patterns of COPD patients compared to age matched controls. The breathing difficulties could result in a deviant intensity, a lack of intonation, decreased phonation time for sustained vowels, and a deviant pitch, depending on the compensatory strategy (Constantinescu et al., 2010). ...
... Once the patient recovers spontaneously breathing after surgery, nonuniform transmission of pleural pressure generated by diaphragmatic contraction may cause a phenomenon called pendelluft (4). In the extreme cases such as flail chest, pendelluft volume can be as high as 12.5% of the total volume passing through an airway (5). Although pendelluft could be potentially harmful by introducing local overstretch, tidal recruitment and inflammation, up to now, no traditional technique can track the pendelluft level. ...
... These crackles can be an indication of pneumonia, congestive heart failure and various pulmonary fibrotic diseases (Pramono et al., 2017). Fine crackles have a high pitch, greater than 400 Hz (Vyshedskiy & Murphy, 2012). ...
... Instead, the participants were judged to have good respiratory conditions based on their self-reported absence of underlying pulmonary diseases, recent respiratory symptoms, and no adventitious sounds during bilateral lung auscultation. Pulmonary infectious diseases are generally prone to producing audible crackles in the bilateral lower lungs (Bettencourt et al., 1994;Vyshedskiy et al., 2011), and fake crackles in this study were most common in the bilateral lower lungs. Therefore, the possibility that few patients with mild lung disease were included in this study cannot be ruled out. ...
... Initially, crackles tend to occur in the bases of the lungs and later in the upper zones of the lungs as disease progresses (Sovijärvi et al. 2000b). In addition, fine and coarse crackles may also co-exist in patients with respiratory disorder (Murphy and Vyshedskiy 2010). In healthy people, crackles may sometimes be heard but then eliminated after deep breaths (Bohadana et al. 2014). ...
... Coarse crackles are cau sed by gas passing through an intermittent airway opening and are a feature of secretory diseases such as bronchitis and pneumonia (39). Fine crackles are induced by an inspiratory opening in the small air ways and are associated with interstitial pneumonia, idiopathic pulmonary fibrosis (IPF), and congestive heart failure (40). Stridor is a high-pitched, continuous sound produced by turbulent airflow through a narrowed airway of the upper respiratory tract (37). ...
... For example, lung sounds can be recorded with a di gital stethoscope and then shared (6). Artificial intelligence (AI)-assisted auscultation and digital stethos copes that make use of machine learning (ML) algorithms are changing the clinical role of auscultation (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). ...
... Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with a poor prognosis that affects general wellbeing (Raghu et al. 2011). It is believed that sounds produced within the lungs may provide useful information to help clinicians identify specific diseases (Vyshedskiy et al. 2005;Flietstra et al. 2011;Bohadana et al. 2014). Clinicians have noted the presence of abnormal lung sounds in IPF and reported the presence of 'Velcro-type' or fibrotic crackles as being a characteristic of the disease (ATS 2000;Dempsey 2006;Cottin and Cordier 2012). ...
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