Pneumologia最新文献

{"title":"Clinical and laboratory correlations in patients with cystic fibrosis and Pseudomonas aeruginosa infection: The experience of a regional centre.","authors":"Roxna Smădeanu,&nbsp;Simona Moşescu,&nbsp;Carmen Zăpucioiu,&nbsp;Dumitru Orăşeanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pseudomonas aeruginosa (Pa) is the most important pathogen affecting the prognosis of patients with cystic fibrosis (CF). Distinguishing the correlations associated with PA infection may change the way in which investigation and therapeutic plans are approached. This study aims to evaluate the correlations between various factors such as age at diagnosis, nutritional status, homozygous status of delF508 mutation, the number of exacerbations per year, imagistic modifications, the presence of chronic infection with Staphylococcus aureus, serum levels of total immunoglobulins G (IgG) and gammaglobulins and ventilation parameters - forced vital capacity (FVC) and one-second forced expired volume (FEV1) and their association with Pa infection.</p><p><strong>Methods: </strong>The associations between the analyzed parameters have been made by logistic regression; the comparisons between means of continuous variables were performed using Studen t-test; the variables distribution was tested using chi-square-test; and correlations between variables were assessed using Pearson coefficient.</p><p><strong>Results: </strong>The mean age at the acquisition of Pa was 5.26 (±5.3 years). Of the 50 patients included in the study, 21 acquired the Pa infection having the median age of primo-infection of 3 years. The study identified a greater number of exacerbations per year in those infected with Pa (2.71 compared to 1.38 exacerbations per year; p=0.002); the increase of radiological score with 1 unit associated with an increased risk of infection with Pa (OR 1.31; 95% CI 1.10-1.56;p=0.002), the mean Brasfield radiologic score is lower for uninfected children (6.9 vs. 11 points, p=0.001); increasing the degree of bronchiectasis associated with Pa infection (OR 3.75;CI 1.77-7.96;p=0.001); gammaglobulin (15.91 vs. 19.42%;p=0.01) or immunoglobulin G values (IgG) (9.8 vs. 11.9 g/L;p=0.05) were higher for those infected.</p><p><strong>Conclusions: </strong>The increased number of exacerbations per year, the severity of imagistic modifications, and IgG and gammaglobulin values are associated with Pa infection. Tracking these parameters guides the therapeutic conduct.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 4","pages":"201-6"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35917403","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":"Air pollution and respiratory diseases – a problematic risk factor.","authors":"Florin Mihălţan,&nbsp;Oana Deleanu,&nbsp;Roxana Nemeș,&nbsp;Ruxandra Ulmeanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pollution was a neglected factor for years in all the research that took in the viewfinder was examined in the risk factors in of respiratory diseases. Considering the concerns of politicians, scientists, doctors, which have intensified upgraded especially after the last climate “summit”, “summit” climatological we found it necessary to have a review of the effects of pollution, pathogenic mechanisms of interaction, and some diseases strongly influenced by pollutants such as COPD, asthma, bronchialand bronchial and lung cancer.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"122-5"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35916009","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":"New treatments in idiopathic pulmonary fibrosis.","authors":"Irina Strâmbu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis is a chronic fibrotic pulmonary disease of unknown origin, with an unfavourable prognosis, leading to death by respiratory failure in most patients within 3-5 years ofdiagnosis. Several drugs were studied for the treatment of this disease, and most of them were not able to stop the relentless evolution of the disease (warfarin, corticosteroids in combination with azathioprine, N-acetylcysteine, ambrisentan, bosentan, sildenafil, antiacids). Two novel drugs, pirfenidone and nintedanib, proved effective in reducing lung function decline, improving the patient’s quality of life, and increasing the patient’s probability of survival. These drugs were approved by international health authorities for use in the treatment of IPF patients. The paper refers also to the status of IPF patients in Romania, where epidemiological data are not known, and where the disease is most likely severely underdiagnosed. Patients are typically diagnosed late, and are therefore in advanced stages of the disease. A proactive attitude, in favour of identification and early diagnosis of IPF patients is highly needed in order to offer to these patients the opportunity of treatment, improved survival, and a better quality of life.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"127-32"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35916010","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 experience surrounding bronchoscopy.","authors":"Richard Bodington,&nbsp;Salim Meghjee,&nbsp;Muthu Thirumaran,&nbsp;Shoaib Faruqi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fiberoptic bronchoscopy (FOB) is a commonly performed procedure in thoracic medicine associated with significant discomfort, which greatly impacts patient satisfaction with the procedure. The UK DoH and BTS stress the benefits of collecting and reviewing patient experiences of a service and how this information should shape service provision.\u0000 In this current study we assess a number of tolerance and satisfaction related factors in 108 consecutive patients undergoing FOB. We demonstrate a highly significant\u0000 relationship between patient reported comfort and complete amnesia of FOB. We fail to demonstrate a relationship between patient reported comfort during FOB and the bronchoscopist’s assessment of tolerance.\u0000 We also suggest a relationship between poorer patient reported comfort and a lower WHO performance status. The identification of factors associated with satisfaction with FOB will allow creation of strategies to improve patient experience and lead to better outcomes.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"134-7"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35916015","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":"Atrial fibrillation in an asthmatic patient with albuterol-induced lactic acidosis.","authors":"Alan Reyes-Mondragon,&nbsp;Guillermo Delgado-García,&nbsp;Adán Pacheco-Cantú,&nbsp;Nancy Contreras-Garza,&nbsp;Dionicio Ángel Galarza-Delgado,&nbsp;Julio González-Aguirre","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Asthma is a highly prevalent chronic respiratory disease\u0000affecting millions of people worldwide. Short-acting\u0000beta 2-agonists induce bronchodilation and usually are\u0000prescribed as a rescue medication. They are recognized\u0000as a cause of hyperlactatemia and, less frequently,\u0000lactic acidosis. Short-acting beta 2-agonists are also\u0000known for their potentially adverse cardiovascular\u0000effects, such as atrial fibrillation. Differential diagnosis\u0000and subsequent treatment of the latter entity are\u0000important due to the adverse prognosis related to it. In\u0000this case report, we describe the unusual association\u0000between albuterol-induced lactic acidosis and atrial\u0000fibrillation in a patient with an asthma exacerbation.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"150-1"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35917975","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":"Medical Errors - a new focus on proficiency and efficacy in medicine. What we learned at the First European Conference on Diagnostic Errors.","authors":"Radu Crișan-Dabija,&nbsp;Traian Mihăescu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"120-1"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35916008","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":"Outpatient pleuroscopy: Report of an experience in a referral hospital.","authors":"Arda Kiani,&nbsp;Abolghasem Daneshvar Kakhaki,&nbsp;Ali Khalili,&nbsp;Mahsa Pourabdolah Tootkaboni,&nbsp;Mitra Sadat Rezaie,&nbsp;Atefeh Abedini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pleuroscopy is a safe diagnostic procedure for evaluation of\u0000pleural diseases, with minimum complications. This procedure\u0000has been recently conducted on outpatient basis. Results\u0000support its safety, especially in busy referral hospitals. We\u0000aimed to report our experience on performing outpatient\u0000pleuroscopy at Masih Daneshvari hospital; Tehran, Iran. All\u0000eligible patients referred to Masih Daneshvari Hospital for\u0000pleuroscopy between May 2015 and May 2016 were enrolled.\u0000Air evacuation was conducted in operating room though\u0000a thin Nelaton catheter attached to low pressure suction.\u0000Compression dressing using Vaseline gauze was done after air\u0000leak terminated. Patients were discharged if first chest x-ray\u0000was negative for pneumothorax and were advised to stay in\u0000touch and return 12 hours later for second chest radiograph.\u0000Baseline characteristics, radiographic and pathologic reports\u0000were reviewed. Outpatient pleuroscopy was conducted on\u000010 patients. Average procedure time was 22±9 minutes. All\u0000patients were discharged after 4 hours. Eight of the patients\u0000remained free of complications after 12 hours, and 2 patients\u0000presented with pneumothorax (both who had massive\u0000pleural effusion) and were successfully managed by our\u0000team. Considering pathologic diagnosis, pleural tuberculosis\u0000was as common diagnosis as malignancy in our patients (4\u0000patients), adenocarcinoma was the most malignancy reported\u0000(3 out of 4 patients). Chronic nonspecific inflammation was\u0000reported by our pathologist in 2 cases. Outpatient pleuroscopy\u0000can be conducted safely and effectively, reducing the\u0000number of unnecessary hospitalizations in a referral center.\u0000Closed follow up, patient education and proper patient\u0000selection are necessary for minimizing complications.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"142-5"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35917973","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":"Hepatopulmonary syndrome: an unusual cause of dyspnea in the pulmonology ward - case presentation.","authors":"Anca Macri,&nbsp;Florica Negru,&nbsp;Radu Stoica,&nbsp;Alexandra Diaconu,&nbsp;Mariana Barbu,&nbsp;Dan Spataru","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatopulmonary syndrome is one of the possible\u0000complications of chronic liver disease, defined clinically\u0000by impaired oxygenation. The underlying cause of the\u0000respiratory failure is the presence of intrapulmonary\u0000shunting, as a result of abnormal vascular dilatations\u0000in the lungs. We report the case of 52-year-old male, exsmoker,\u0000with a history of pulmonary TB and also of heavy\u0000drinking, who was admitted to the pulmonology ward\u0000for dyspnea at rest and limb cyanosis. His clinical exam\u0000was suggestive of liver cirrhosis, with signs of pneumonia,\u0000but also chronic lung disease. Variations in SaO2 with\u0000posture were noted: platypnea and orthodeoxia.\u0000Arterial gas assessment revealed severe hypoxemia,\u0000only partially corrected by high-flow oxygen therapy,\u0000while plethysmography showed only a mild obstructive\u0000syndrome, but with severely impaired alveolar-capillary\u0000diffusion. The suspicion of a hepatopulmonary syndrome\u0000was raised and a contrast echocardiography confirmed the\u0000diagnosis by revealing the presence of an intrapulmonary\u0000shunt. Although it is believed to be a fairly common\u0000complication of chronic liver disease, it is possible for a case\u0000of hepatopulmonary syndrome to be admitted solely for\u0000respiratory symptoms. The patient’s poor socio-economic\u0000status is the main reason for both the lack of proper followup\u0000for his liver disease and the limited therapeutic options.\u0000Keywords: Hepatopulmonary syndrome, liver cirrhosis,\u0000respiratory failure, contrast echocardiography</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"156-8"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35917977","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":"Anemia in COPD.","authors":"Alexandru Corlateanu,&nbsp;Serghei Covantev,&nbsp;Alexander G Mathioudakis,&nbsp;Victor Botnaru","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"168"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35917400","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":"Chylothorax and chylous ascites due to Mycobacterium tuberculosis in an AIDS patient whose PCR tested negative.","authors":"Ángel Del Cueto-Aguilera,&nbsp;Héctor Raúl Ibarra-Sifuentes,&nbsp;Guillermo Delgado-García,&nbsp;Alexandro Atilano-Díaz,&nbsp;Dionicio Ángel Galarza-Delgado","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mycobacterium tuberculosis as a cause of both\u0000chylothorax and chylous ascites is extremely rare. A\u000046-year-old non-adherent woman with AIDS and\u0000pulmonary tuberculosis presented to our clinic with\u0000dyspnea, pleuritic chest and abdominal pain. Chest x-ray\u0000demonstrated a left pleural effusion. Contrast-enhanced\u0000CT showed free abdominal fluid. Thoracentesis revealed\u0000a chylothorax, and paracentesis a chylous ascites. AFB\u0000staining and PCR for M. tuberculosis (GeneXpert MTB/\u0000RIF Assay) were both negative. Malignant cells cytology\u0000also tested negative. Tuberculosis could account for\u0000both chylothorax and chylousascites, as she clinically\u0000improved when antituberculous drugs were resumed.\u0000Even when PCR tested negative, M. tuberculosis should\u0000be included in the differential diagnosis because\u0000of its therapeutic and prognostic implications.\u0000Keywords: Chylothorax, chylous ascites,\u0000Mycobacterium tuberculosis, acquired\u0000immunodeficiency syndrom, antituberculous drugs.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"65 3","pages":"161-3"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35917978","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}