Journal of Bronchology & Interventional Pulmonology最新文献

{"title":"Cytological Diagnosis of Pulmonary Hydatid disease by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Cyst Fluid.","authors":"Pinakjyoti Das, Prajwala Gupta, Desh Deepak","doi":"10.1097/LBR.0000000000000932","DOIUrl":"10.1097/LBR.0000000000000932","url":null,"abstract":"occasions diagnostic difficulties can arise with perivascular epithelioid cell tumors and alveolar sarcoma. Although this tumor type was initially described as benign and slow growing, with no tendency to recur, it has occasionally been shown to be malignant. The diagnosis of malignancy requires meeting at least 3 of the Fanburg-Smith criteria.10,11 None of the cases in our series could be considered malignant according to these criteria. However, respiratory GCTs can cause respiratory symptoms of type hemoptysis, cough, or dyspnea, which coupled with the fact that this tumor type lacks well-defined limits, can suggest a clinical diagnosis of malignancy (Table 1). In principle, the treatment for GCTs is not surgical, although the tumor size and certain pulmonary involvement could make surgery advisable. In this case, the surgery should be conservative. If the tumor is smaller than 8 mm, endoscopic resection is feasible. In the case of multiple lesions, clinical follow-up using imaging techniques and bronchoscopy are advisable. In our series, we opted for clinical follow-up for 2 patients, endoscopic polypectomy in 1 of them. In the 2 remaining patients, it was interpreted clinically that the tumor could be malignant and, therefore, proceeded to pulmonary bilobectomy. No complications resulting from the disease or surgery were detected in the follow-up period of at least 10 years. In summary, respiratory GCTs are benign neoplasms with a clear association with tobacco use and can arise as the consequence of chronic irritation of the bronchial nerves and whose treatment should be a clinical follow-up or endoscopic or surgical resection depending on tumor size, symptoms, and obstructive complications.","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"392-397"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9548525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchoscopic Management of Hemoptysis Caused by Airway Erosion From Vascular Coils.","authors":"Hussain Ahmed Raza, Mohummad H R Raja, Jefferson H Chambers, Chakravarthy B Reddy, Majid Shafiq","doi":"10.1097/LBR.0000000000000919","DOIUrl":"10.1097/LBR.0000000000000919","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"384-387"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9603424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pleural Disease in Acute COVID-19 Pneumonia: A Single Center Retrospective Cohort Study.","authors":"Kai Swenson,&nbsp;Juan P Uribe,&nbsp;Alvaro Ayala,&nbsp;Mihir Parikh,&nbsp;Chenchen Zhang,&nbsp;Alichia Paton,&nbsp;Molly Trachtenberg,&nbsp;Adnan Majid","doi":"10.1097/LBR.0000000000000896","DOIUrl":"10.1097/LBR.0000000000000896","url":null,"abstract":"<p><strong>Background: </strong>Pleural diseases encompass pleural effusion and pneumothorax (PTX), both of which were uncommon in coronavirus disease of 2019 (COVID-19). We aimed to describe the frequency, characteristics, and main outcomes of these conditions in patients with COVID-19 pneumonia.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis of inpatients with COVID-19 pneumonia between January 1, 2020 and January 1, 2022, at Beth Israel Deaconess Medical Center in Boston, Massachusetts.</p><p><strong>Results: </strong>Among 4419 inpatients with COVID-19 pneumonia, 109 (2.5%) had concurrent pleural disease. Ninety-four (2.1%) had pleural effusion (50% seen on admission) and 15 (0.3%) had PTX, both with higher rates of underlying conditions such as heart failure, liver disease, kidney disease, and malignancy. A total of 28 (30%) pleural effusions were drained resulting in 32% being exudative, 43% pseudoexudative, and 25% transudative. Regarding PTX, 5 (33%) were spontaneous and 10 (67%) were due to barotrauma while on mechanical ventilation. We found that the presence of underlying lung disease was not associated with an increased risk of developing PTX. In addition, patients with pleural disease had a higher incidence of severe or critical illness as represented by intensive care unit admission and intubation, longer hospital and intensive care unit stay, and a higher mortality rate as compared with patients without the pleural disease.</p><p><strong>Conclusion: </strong>Pleural effusions and pneumothoraces are infrequent findings in patients admitted due to COVID-19 pneumonia, worsened outcomes in these patients likely reflect an interplay between the severity of inflammation and parenchymal injury due to COVID-19 disease and underlying comorbidities.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"363-367"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chartis-guided Endobronchial Valves Placement for Persistent Air Leak.","authors":"Mohamed Omballi,&nbsp;Zaid Noori,&nbsp;Regina V Alanis,&nbsp;Robert Lukken Imel,&nbsp;Fayez Kheir","doi":"10.1097/LBR.0000000000000914","DOIUrl":"10.1097/LBR.0000000000000914","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"398-400"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10831768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Practices Supporting Rigid Bronchoscopy-An International Survey.","authors":"Ismael Matus,&nbsp;Shannon Wilton,&nbsp;Elliot Ho,&nbsp;Haroon Raja,&nbsp;Lei Feng,&nbsp;Septimiu Murgu,&nbsp;Mona Sarkiss","doi":"10.1097/LBR.0000000000000881","DOIUrl":"10.1097/LBR.0000000000000881","url":null,"abstract":"<p><strong>Background: </strong>There are no guidelines for anesthesia or staff support needed during rigid bronchoscopy (RB). Identifying current practice patterns for RB pertinent to anesthesia, multidisciplinary teams, and algorithms of intra and post-procedural care may inform best practice recommendations.</p><p><strong>Methods: </strong>Thirty-three-question survey created obtaining practice patterns for RB, disseminated via email to the members of the American Association of Bronchology and Interventional Pulmonology and the American College of Chest Physicians Interventional Chest Diagnostic Procedures Network.</p><p><strong>Results: </strong>One hundred seventy-five clinicians participated. Presence of a dedicated interventional pulmonology (IP) suite correlated with having a dedicated multidisciplinary RB team ( P =0.0001) and predicted higher likelihood of implementing team-based algorithms for managing complications (39.4% vs. 23.5%, P =0.024). A dedicated anesthesiology team was associated with the increased use of high-frequency jet ventilation ( P =0.0033), higher likelihood of laryngeal mask airway use post-RB extubation ( P =0.0249), and perceived lower rates of postprocedural anesthesia adverse effects ( P =0.0170). Although total intravenous anesthesia was the most used technique during RB (94.29%), significant variability in the modes of ventilation and administration of muscle relaxants was reported. Higher comfort levels in performing RB are reported for both anesthesiologists ( P =0.0074) and interventional pulmonologists ( P =0.05) with the presence of dedicated anesthesia and RB supportive teams, respectively.</p><p><strong>Conclusion: </strong>Interventional bronchoscopists value dedicated services supporting RB. Multidisciplinary dedicated RB teams are more likely to implement protocols guiding management of intraprocedural complications. There are no preferred modes of ventilation during RB. These findings may guide future research on RB practices.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"328-334"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40664616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional Pulmonologists and Advanced Bronchoscopists in 2022 America: Who We Are and How Much We Earn.","authors":"Sonali Sethi,&nbsp;Septimiu Murgu","doi":"10.1097/LBR.0000000000000939","DOIUrl":"https://doi.org/10.1097/LBR.0000000000000939","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"30 4","pages":"315-317"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient With Metastatic Airway Calcification and Hypercalcemia Due to Secondary Hyperparathyroidism.","authors":"Fabiana Diaz-Churion,&nbsp;Alejandra Yu Lee-Mateus,&nbsp;Haares Mirzan,&nbsp;Andras Khoor,&nbsp;David Abia-Trujillo,&nbsp;Sebastian Fernandez-Bussy","doi":"10.1097/LBR.0000000000000921","DOIUrl":"10.1097/LBR.0000000000000921","url":null,"abstract":"","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"387-390"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Yield of Cone-beam-Derived Augmented Fluoroscopy and Ultrathin Bronchoscopy Versus Conventional Navigational Bronchoscopy Techniques.","authors":"David M DiBardino, Roger Y Kim, Yulei Cao, Michelle Andronov, Anthony R Lanfranco, Andrew R Haas, Anil Vachani, Kevin C Ma, Christoph T Hutchinson","doi":"10.1097/LBR.0000000000000883","DOIUrl":"10.1097/LBR.0000000000000883","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary nodules suspicious for lung cancer are frequently diagnosed. Evaluating and optimizing the diagnostic yield of lung nodule biopsy is critical as innovation in bronchoscopy continues to progress.</p><p><strong>Methods: </strong>This is a retrospective cohort study. Consecutive patients undergoing guided bronchoscopy for suspicious pulmonary nodule(s) between February 2020 and July 2021 were included. The cone-beam computed tomography (CBCT)+ radial endobronchial ultrasound (r-EBUS) group had their procedure using CBCT-derived augmented fluoroscopy along with r-EBUS. The CBCT+ ultrathin bronchoscope (UTB)+r-EBUS group had the same procedure but with the use of an ultrathin bronchoscope. The r-EBUS group underwent r-EBUS guidance without CBCT or augmented fluoroscopy. We used multivariable logistic regression to compare diagnostic yield, adjusting for confounding variables.</p><p><strong>Results: </strong>A total of 116 patients were included. The median pulmonary lesion diameter was 19.5 mm (interquartile range, 15.0 to 27.5 mm), and 91 (78.4%) were in the peripheral half of the lung. Thirty patients (25.9%) underwent CBCT+UTB, 27 (23.3%) CBCT, and 59 (50.9%) r-EBUS alone with unadjusted diagnostic yields of 86.7%, 70.4%, and 42.4%, respectively ( P <0.001). The adjusted diagnostic yields were 85.0% (95% CI, 68.6% to 100%), 68.3% (95% CI, 50.1% to 86.6%), and 44.5% (95% CI, 31.0% to 58.0%), respectively. There was significantly more virtual navigational bronchoscopy use in the r-EBUS group (45.8%) compared with the CBCT+UTB (13.3%) and CBCT (18.5%) groups, respectively. CBCT procedures required dose area product radiation doses of 7602.5 µGym 2 .</p><p><strong>Conclusion: </strong>Compared with the r-EBUS group, CBCT + UTB + r-EBUS was associated with higher navigational success, fewer nondiagnostic biopsy results, and a higher diagnostic yield. CBCT procedures are associated with a considerable radiation dose.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"335-345"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/e6/lbr-30-335.PMC10538603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40577581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Narrow-band Imaging Bronchoscopy in the Diagnosis of Endobronchial Sarcoidosis.","authors":"Sahajal Dhooria,&nbsp;Inderpaul Singh Sehgal,&nbsp;Amanjit Bal,&nbsp;Valliappan Muthu,&nbsp;Kuruswamy Thurai Prasad,&nbsp;Nalini Gupta,&nbsp;Babu Ram,&nbsp;Ashutosh N Aggarwal,&nbsp;Ritesh Agarwal","doi":"10.1097/LBR.0000000000000885","DOIUrl":"10.1097/LBR.0000000000000885","url":null,"abstract":"<p><strong>Background: </strong>There are few reports on the utility of bronchoscopic narrow-band imaging (NBI) for visualizing endobronchial abnormalities in sarcoidosis. Our primary objective was to compare the sensitivity of finding endobronchial abnormality using NBI versus white light bronchoscopy (WLB) in patients with sarcoidosis. The secondary aim was to evaluate the sensitivity of NBI in diagnosing endobronchial sarcoidosis against a reference standard of positive endobronchial biopsy (EBB).</p><p><strong>Methods: </strong>We retrospectively included subjects with sarcoidosis, where we sequentially recorded WLB and NBI videos to visualize the endobronchial mucosa. We collected data on the demographic findings, sarcoidosis stage, and the histopathological findings of transbronchial needle aspiration, EBB, and transbronchial lung biopsy. Three experienced bronchoscopists viewed the video recordings and noted the abnormalities of the airway mucosa separately on WLB and NBI.</p><p><strong>Results: </strong>We included 28 subjects (mean age, 42.9 y; 53.6% men; 14 each, stages 1 and 2) with a final diagnosis of sarcoidosis. Granulomas were detected on EBB in 11 (39.3%) subjects. We identified endobronchial nodules in 10 and 15 subjects on WLB and NBI. The sensitivity of finding endobronchial abnormality using WLB and NBI was 35.7% (10/28) and 53.6% (15/28), respectively (χ 2 =1.77, df=1, P =0.18). The sensitivity of NBI in diagnosing endobronchial sarcoidosis against a positive EBB was 63.6% (7/11 subjects). There was excellent agreement (Κ=0.86) for detecting nodules on NBI among the 3 observers.</p><p><strong>Conclusion: </strong>NBI might allow the identification of additional abnormalities not detected on WLB in sarcoidosis. Larger studies are required to confirm our observations.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"346-353"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40624135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an Electronic Medical Record-Based Recognition Tool for the Identification of Incidental Pulmonary Nodules.","authors":"Amit K Mahajan,&nbsp;Nancy Collar,&nbsp;Mahwish Bari,&nbsp;Abe Nader,&nbsp;Frances Muldowney,&nbsp;Priya P Patel,&nbsp;Michael J Weyant,&nbsp;Glenn G Druckenbrod,&nbsp;Patrick Oliverio,&nbsp;John Moynihan,&nbsp;John F Deeken","doi":"10.1097/LBR.0000000000000905","DOIUrl":"10.1097/LBR.0000000000000905","url":null,"abstract":"<p><strong>Background: </strong>Incidental pulmonary nodules (IPNs) are lung nodules detected on imaging studies performed for an unrelated reason. Approximately 1.6 million IPNs are detected in the United States every year. Unfortunately, close to 1.1 million (69%) of these IPNs are not managed with appropriate follow-up care. The goal of this study was to assess the utility of a noncommercial electronic medical record (EMR)-based IPN keyword recognition program in identifying IPNs and the ability of lung navigators to communicate these findings to patients.</p><p><strong>Methods: </strong>This is a observational, implementation study aimed identify IPNs using an EMR-based protocol and to relay results of findings to patients. The patient population included patients 16 and older undergoing computed tomography (CT) chest, CT chest/abdomen, CT angiogram chest, CT chest/abdomen/pelvis, and chest radiography through the radiology department within a large community tertiary medical campus between June 2019 and August 2020. EPIC EMR were queried using criteria designed to find IPNs. A lung navigator reviewed these cases and sorted them into categories based on their size and risk status. After identification of risk factors, actions were taken to directly communicate results to patients.</p><p><strong>Results: </strong>Seven hundred and fifty-three patients were found to have true IPNs without a history of active malignancy involving the lung. On the basis of radiographic measurements, 60% of the nodules identified were <6 mm, 17% were between 6 and 8 mm, 22% were >8 mm, and 12% were deemed nodular opacities. Lung navigators were able to contact a total of 637 (87%) individuals with IPNs and results were directly communicated. Of the 637 patients identified to have an IPN, a total of 12 (2%) cancers were diagnosed.</p><p><strong>Conclusion: </strong>We have here demonstrated that the development of an EMR-based keyword recognition platform for the identification of IPNs is a useful and successful tool for communication of IPN findings to patients using lung navigators.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":" ","pages":"373-378"},"PeriodicalIF":3.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10636983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}