The Egyptian Journal of Bronchology最新文献

{"title":"Incidence of pulmonary hypertension in COPD and its relation to inflammatory marker interleukin-1","authors":"Sherif Ahmed Eissa, Youssef Mohamed Amin Soliman, Tarek Samy Essawy, Mostafa Mohammed Abdelrahman Elsayed, Nashwa Ahmed Amin","doi":"10.1186/s43168-024-00278-x","DOIUrl":"https://doi.org/10.1186/s43168-024-00278-x","url":null,"abstract":"Many COPD patients present with severe PH defined by a pulmonary vascular resistance (PVR) > 5 WU as measured by right heart catheterization (RHC), and inflammation is thought to be contributing strongly to pulmonary vascular remodeling in COPD besides hypoxia. Interleukin-1 (IL-1) is thought to be a major cytokine that may be involved in development of PH in these patients. This study aimed to identify the incidence of PH in COPD and its relation to inflammatory marker IL-1. One-hundred COPD patients underwent echocardiography and serum IL-1 analysis, and patients with high probability of PH underwent pulmonary artery catheterization using Swan-Ganz catheter. The mean serum IL-1 level was 82 pg/ml ± 22 pg/ml (the normal IL-1 serum level is known to be 0:5 pg/mL), 51% of the participants were categorized as having a low probability of PH, 35% was intermediate, and 14% was high. RHC results were as follows: mild combined pre- and postcapillary PH was diagnosed in 14.3% of the patients. Mild precapillary PH was found in 42.9%, making it the most common type. Severe combined pre- and postcapillary PH was noted in 21.4% of the patients. Severe precapillary PH was present in 14.3%. A significant positive correlations were observed between serum IL-1 and tricuspid regurgitation velocity (TRV) (r = 0.409, P < 0.001), estimated systolic pulmonary artery pressure (ESPAP) (r = 0.508, P < 0.001), and mean pulmonary artery pressure (mPAP) (r = 0.410, P = 0.140). Serum IL-1 is a potent predictor of a high probability of PH in COPD patients, and there was significant positive correlation between serum IL-1 and echocardiographic findings and PH probability and RHC findings in COPD patients.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572793","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":"A rare and late complication of lung cancer: bronchial rupture","authors":"Emine Afsin, Özge Koşcu, Furkan Küçük, Muhammed Yavuz Haktanır, Hamza Özer, Hacıali Kılıçgün","doi":"10.1186/s43168-024-00279-w","DOIUrl":"https://doi.org/10.1186/s43168-024-00279-w","url":null,"abstract":"Tracheobronchial injuries generally occur due to iatrogenic or traumatic causes. Although bronchial rupture due to teratoma and germ cell tumors has been reported in the literature, no cases related to lung cancer have been determined. Our case is presented because of the refusal to be examined for the mass in the lung and the detection of bronchial rupture afterward when he presented with massive hemoptysis. A 65-year-old male patient was admitted to the emergency department with the complaint of massive hemoptysis. Six months ago, bronchoscopy was recommended due to the 8 × 7 cm cavitary lesion obliterating the bronchus in the anterior upper lobe of the right lung on chest computed tomography, but the patient refused. The sputum sample, requested 3 times, was negative for acid-resistant bacteria, and no growth was detected in the mycobacterial culture. In the new pulmonary CT angiography, a progressive cavitary lesion invading the right main bronchus, carina, and vena cava superior was observed. Following tranexamic acid treatment and bronchial artery embolization, hemoptysis significantly decreased in the follow-up. In the flexible bronchoscopy performed for diagnostic purposes, the carina was pushed to the left and invaded, and there was damage to the right main bronchus. A biopsy was not performed due to the risk of bleeding, and lavage was performed. Lavage was negative for ARB, there was no growth in the mycobacteria culture, and cytology did not reveal malignant cells. The patient, diagnosed with right main bronchial rupture, was considered inoperable and died 1 month later due to respiratory failure. Examinations should be initiated as soon as malignancy is suspected. When diagnosis and treatment are delayed, complications that would be challenging to intervene may develop.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572791","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":"The association of LPCAT1-rs9728 polymorphism with cord blood IL-10, MIF, and VEGF levels in neonatal respiratory distress syndrome: a case–control study","authors":"Khalid M. Mohany, Ahmed Abdelrasoul Sayed, Osama Mahmoud El-Asheer, Yaser F. Abdel Raheem, Ahmed Mohamed Abbas, Ahmed Mohamed Fawzy, Mona Abd El-Hamid Hassan El-Baz","doi":"10.1186/s43168-024-00273-2","DOIUrl":"https://doi.org/10.1186/s43168-024-00273-2","url":null,"abstract":"Lysophospholipid acyltransferase (LPCAT) is crucial for surfactant biosynthesis. It is encoded by LPCAT genes. We investigated the LPCAT1-rs9728 genotypes in neonatal respiratory distress syndrome (NRDS) cases and their possible association with the cord arterial serum interleukin-10 (IL-10), macrophage migration inhibitory factor (MIF), and vascular endothelial growth factor (VEGF) levels. The study included 160 neonates grouped into G1: 60 healthy neonates and G2: 100 NRDS cases. IL-10, MIF, and VEGF levels were measured by their corresponding kits. The Gene JETTM Whole Blood Genomic DNA Purification Mini Kit was used to extract the DNA from the newborn venous blood. The quantitative real-time polymerase chain reaction was carried out for LPCAT1-rs9728 genotyping. The IL-10 and MIF levels were significantly higher, while VEGF levels were significantly lower in G2 than in G1. The percentages of LPCAT1-rs9728 AA and LPCAT1-rs9728 AG genotypes were significantly higher in G2 than in G1. The IL-10 and MIF levels were significantly higher, while the VEGF levels, birth weight, and APGAR score at 1 and 5 min were significantly lower in neonates with LPCAT1-rs9728 AA genotype than in neonates with LPCAT1-rs9728 AG and LPCAT1-rs9728 GG genotypes and in neonates with LPCAT1-rs9728 AG genotype than in neonates with LPCAT1-rs9728 GG genotype. There is an association between the LPCAT1-rs9728 AA genotype and its A allele and the NRDS development and severity. Further research may provide a better understanding of this association to help future management.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572549","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":"Assessment of hyaluronic acid in COPD patients as a prognostic biomarker","authors":"Marwa Elsayed Elnaggar, Ali Ali Okab, Mohammed Hussein Kamel, Amira Mohammed Noureldin, Doaa Adel Abdelhafez, Maha Mammdouh Osman","doi":"10.1186/s43168-024-00276-z","DOIUrl":"https://doi.org/10.1186/s43168-024-00276-z","url":null,"abstract":"One essential element of the extracellular matrix is hyaluronic acid (HA). It has been claimed that HA and its metabolism are different in the lungs of patients with chronic obstructive pulmonary disease (COPD). The present study investigated the predictive significance of serum level of HA in patients with COPD and monitored changes in its level in these patients because of therapy. HA was assessed in 60 patients with stable COPD (divided into subgroups I and II) and 20 healthy controls and then repeated after 3 and 6 months in COPD patients. Most of the patients were males (63.3%), and their ages ranged from 30 to 90. The serum level of HA was significantly increased in subgroups I and II (269.33 ± 4, 290 ± 4, respectively), compared to the control group (147.5 ± 1) with a significant difference in its level between both (p < 0.0001). The serum level of HA was significantly decreased in both subgroups 3 and 6 months later following adjustment of treatment and associated with improvement in pulmonary function test. There were significant positive correlations between HA and age as well as smoking index. Its level correlated negatively with forced expiratory volume in the first second (FEV1%), forced vital capacity (FVC%), and FEV1/FVC. HA is a useful marker for identifying clinical stability in COPD patients and for follow-up in the efficacy of treatment.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140323902","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":"Blood eosinophil variability in patients presenting with acute exacerbations of COPD within the past year and its correlation with treatment plan","authors":"Samir Mohamed Mahmoud Fahyim, Hesham Atef AbdelHalim, El Shaimaa Sabry Mohammed Hassan","doi":"10.1186/s43168-024-00274-1","DOIUrl":"https://doi.org/10.1186/s43168-024-00274-1","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is an acknowledged contributor to universal fatality and morbidity. Using biomarkers to pinpoint its phenotypes is crucial, enabling individualized treatment and enhancing prognosis. Studying the steadiness of blood eosinophi1s in cases who experienced repeated hospital admissions for acute worsening of COPD during a year and its correlation to the treatment plan. A retrospective cohort study includes 270 COPD male patients with acute exacerbations. The patients were divided into three groups: fluctuating (ranges between ≥ 150 cells/ul and < 150 cells/ul), non-EOS (< 150 cells/ul), and Eosinophil (EOS) (≥ 150 cells/ul). Most patients were in the fluctuating blood EOS group (53.3%). The median length of hospital stay was longer in the fluctuating group (5 days). There was a significant positive correlation between the number of exacerbations and both EOS count and EOS/WBCs. A higher eosinophilic count was associated with an increased risk of eosinophilic exacerbations. Most patients used steroids (higher in the EOS group, 61.6%). Blood eosinophilic count is promising for investigating acute COPD exacerbations. Peripheral blood eosinophilia is a relevant biomarker for directing the management of COPD exacerbations, including steroids.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140313769","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":"Predictors of mortality of hospitalized COVID-19 pneumonia patients in university hospital","authors":"Safa M. Wafy, Marina O. Saman, Mostafa K. Ahmed","doi":"10.1186/s43168-024-00275-0","DOIUrl":"https://doi.org/10.1186/s43168-024-00275-0","url":null,"abstract":"COVID-19 pneumonia is a leading cause for worse outcome of infected patients. Factors associated with mortality in COVID-19 pneumonia vary among studies; identification of most possible factors related to worse outcome might add for management. Consecutive COVID-19 pneumonia patients referred to the Assiut University Hospital, Egypt, from June 2020 to August 2022 were included in our study. All the included patients were followed up from admission until discharge to identify the factors that worsen the outcome. Our cohort study includes two groups: survivors and non-survivors. Clinical, laboratory, and management data of both groups were recorded. Two-hundred and fifty-one confirmed COVID-19 pneumonia patients were included in the study; 147 (58.6%) patients were improved (survivors’ group), and 104 (41.4%) patients were deteriorated and died (non-survivors’ group). Non-survivors’ group had significantly higher MMRC dyspnea scale, pneumonia severity index, CURB-65 score, and baseline respiratory rate. Non-survivors group had significantly lower mean lymphocytes (0.81 ± 0.61 vs. 1.25 ± 0.75; p < 0.001), higher ferritin (1272.45 ± 143.76 vs. 615.84 ± 75.47; p < 0.001), and higher d-dimer (6.65 ± 2.67 vs. 2.78 ± 0.38; p < 0.001), with interestingly significantly higher mean platelet volume (MPV) (10.34 ± 1.64 vs. 10.07 ± 1.93 (fl); p < 0.001). Non-survivors group was frequently admitted to ICU (88 (84.6%) vs. 38 (25.9%); p < 0.001) and had longer duration in ICU than survivors group (9.71 ± 3.36 vs. 5.90 ± 2.34 (days); p < 0.001). The predictors for mortality among patients with COVID-19 pneumonia were old age, high MPV, high CT score, and admission to ICU. Old age, severe lung infiltrate with HRCT, high mean platelet volume, and ICU admission are the main clinical determinants of worse outcome of COVID-19 pneumonia.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140313634","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":"Double-wall sign for differentiation of spontaneous pneumothorax from giant bullous emphysema","authors":"Ramakrishna Narra","doi":"10.1186/s43168-024-00272-3","DOIUrl":"https://doi.org/10.1186/s43168-024-00272-3","url":null,"abstract":"<p>Sir/Madam,</p><p>The patient, a 59-year-old male diagnosed with emphysematous disease and a giant emphysematous bulla, presented with sudden onset grade III shortness of breath. Upon auscultation, diminished breath sounds were detected on the right side of the chest. On admission, the patient’s pulse rate, blood pressure, and peripheral oxygen saturation (SpO2) were 110 beats/min, 150/90 mmHg, and 80%, respectively. Chest computed tomography (CT) revealed giant emphysematous bullae with air outlining both sides of the bulla wall parallel to the chest wall, known as the double-wall sign, indicating secondary pneumothorax and collapsed lungs in the right upper and lower hemithorax. Multiple emphysematous bullae were also observed in both the lungs (Fig. 1a–c). The patient was treated with intercostal tube thoracostomy at the eighth intercostal space.</p><figure><figcaption><b data-test=\"figure-caption-text\">Fig. 1</b></figcaption><picture><source srcset=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs43168-024-00272-3/MediaObjects/43168_2024_272_Fig1_HTML.png?as=webp\" type=\"image/webp\"/><img alt=\"figure 1\" aria-describedby=\"Fig1\" height=\"604\" loading=\"lazy\" src=\"//media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs43168-024-00272-3/MediaObjects/43168_2024_272_Fig1_HTML.png\" width=\"685\"/></picture><p><b>a</b>–<b>c</b> Axial high-resolution computed tomographic images of 59-year-old male patient with severe dyspnea. <b>a</b> Demonstrating double wall sign, with air outlining the wall of the bulla on both the sides and the wall parallel to chest wall suggestive of pneumothorax (white arrow), on right side. <b>b</b> Section taken cranially demonstrating multiple emphysematous bullae with the wall perpendicular to the chest wall and normal adjacent lung tissue in bilateral lungs. <b>c</b> Surface-rendered multiplanar projection reformatted images demonstrating the pneumothorax in right hemithorax compressing the adjacent lung (white arrows). Also, note the rest of the lungs demonstrating bulle with bronchial and vascular markings within</p><span>Full size image</span><svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-chevron-right-small\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></figure><p>Giant emphysematous bullae are characterized by sharply demarcated areas of cystic air lucencies measuring &gt; 1 cm, with a wall thickness of &lt; 1 mm. The presence of one or more bullae occupying at least one-third of the hemithorax on imaging is indicative of giant bullous emphysema. This condition has been referred to by various terms, including vanishing lung syndrome, type 1 bullous disease, bullous pneumopathy, and primary bullous disease of the lung [1, 2]. Weak points in the visceral pleura caused by subpleural blebs, bullae, lung necrosis, and other abnormalities in the connective tissue can lead to alveolar rupture, resulting in secondary spon","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140313771","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":"Vitamin D and the microbiota connection: understanding its potential to improve COPD outcomes","authors":"Asmaa Ali, Liang Wu, Sameh Samir Ali","doi":"10.1186/s43168-024-00271-4","DOIUrl":"https://doi.org/10.1186/s43168-024-00271-4","url":null,"abstract":"The mucosa of the respiratory system is an essential site for local vitamin D synthesis, degradation, and signaling. It modulates the inflammatory and immune response by saving the integrity of the mucosal barrier and killing the invading pathogen through the induction of antimicrobial peptides. The proper functioning of the immune system within the respiratory system is influenced by the complex interactions of numerous immune pathways, including the gut-lung axis. Recent research has indicated that the gut microbiota is vital in developing and progressing chronic inflammatory chest conditions, such as asthma and chronic obstructive pulmonary disease (COPD). Furthermore, the immune-modulating function of vitamin D operates through the gut mucosa; hence, the vitamin D receptor is expressed to regulate the antimicrobial peptide. The potential protective role of vitamin D and its correlation with COPD has garnered significant interest. It is currently under exploration as a possible adjuvant therapy to aid in managing frequent exacerbation of COPD. In this review, we explored the connection between vitamin D and the immune system, as well as its relationship with microbiota. We also summarized some novel mechanisms of action of vitamin D supplementation that can impact disease exacerbation.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140149963","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":"A case series of co-infection in Mycobacterium tuberculosis and other pathogens: insights from nanopore sequencing","authors":"Wei Shu, Wenlong Chen, Lin Yao, Ming Sun, Min Gao, Zanyan Wan, Wei Xie, Yanjuan Lei, Tao Wang","doi":"10.1186/s43168-024-00270-5","DOIUrl":"https://doi.org/10.1186/s43168-024-00270-5","url":null,"abstract":"Tuberculosis (TB) continues to be a major global health burden, and co-infection with other pathogens further complicates the diagnosis and treatment of this infectious disease. The present retrospective study aimed to evaluate the clinical utility of nanopore sequencing in identifying co-infection caused by Mycobacterium tuberculosis (M.tb) and other pathogens. Patients with M.tb co-infection from December 2021 to March 2023 at the Jiangxi Provincial Chest Hospital were retrospectively studied. Data were collected including demographics, symptoms, imaging findings, pathogen diagnosis tests, and treatment history. Pathogen tests involved culture, AFB smear, Xpert MTB/RIF, and nanopore sequencing. The enrolled patients included 20 M.tb cases and three nontuberculous mycobacteria (NTM) cases co-infected with other pathogens. Common clinical symptoms included cough (47.83%), expectoration (34.78%), and asthma (17.39%). Radiological examinations showed typical features of pulmonary tuberculosis, including nodules (73.91%), cord-like shadows (34.78%), cavities (34.78%), and destroyed lung manifestations (17.39%). Nanopore sequencing identified M.tb in a significant majority of the cases (86.96%), outperforming traditional culture tests (39.13%), acid-fast bacilli (AFB) tests (27.27%), and Xpert MTB/RIF (53.84%) tests. Notably, nanopore sequencing revealed that M.tb was frequently co-infected with Candida albicans, Klebsiella pneumoniae, and Mycobacterium abscessus. Three specific cases of co-infection with distinct diagnosis and treatment characteristics were presented in detail. They illustrated the complexity of TB co-infection management and the potential of nanopore sequencing for accurate diagnosis and informing the tailored therapeutic approaches. Nanopore sequencing-based metagenomics method can help clinicians to identify TB co-infection patterns and formulate a rational drug regimen in time.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140098739","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":"Predictive accuracy of years score in diagnosis of pulmonary embolism","authors":"Hussien Fayiad, Heba Moussa, Yara Nosair, Amira Ismail Mostafa","doi":"10.1186/s43168-024-00269-y","DOIUrl":"https://doi.org/10.1186/s43168-024-00269-y","url":null,"abstract":"Pulmonary embolism (PE) is a sudden obstruction of pulmonary arteries usually associated with a high rate of mortality due to acute right ventricular failure. Early diagnosis is of much importance because most patients die within the first hours of presentation. Emergency management is usually highly valuable and right heart failure is potentially reversible. Multidetector computed tomography pulmonary angiography (CTPA) is the best diagnostic imaging modality to document acute pulmonary embolism. Overuse of CTPA increases the unrequired risk of radiation exposure, increasing the risk of malignancy, contrast-related anaphylaxis, and acute kidney injury. To abolish these issues, the simplified score for suspected acute pulmonary embolism using variable D dimer cut-off value in combination with clinical signs can exclude pulmonary embolism safely. To evaluate the predictive accuracy of YEARS score in the diagnosis of pulmonary embolism compared to CTPA that might lead to a decrease in the overuse of CTPA. The study was held at the chest unit in Kasr ElAini hospitals. It included 50 patients, for which full history, examination, calculation of wells score, D-dimer, YEARS score, and CTPA were done. The results showed that the YEARS score succeeded in predicting the presence or the absence of PE in 80% of the 50 enrolled patients in our study. YEARS score has a sensitivity of 90% and specificity of 65%. Patients with zero YEARS score and D-dimer ≥ 1000 ng/ml as well as those with ≥ 1 YEARS score and D-dimer ≥ 500 ng/ml are rendered PE likely by the YEARS algorithm with a sensitivity of 90%. Using years score, we can exclude pulmonary embolism in patients with zero YEARS score and a D-dimer ˂ 1000 ng/ml as well as in patients with ≥ 1 YEARS score and D-dimer ˂ 500 ng/ml with 65% specificity, thus decreasing overuse of CTPA in the diagnosis of PE.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140034721","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}