Journal of Pulmonology Research & Reports最新文献

{"title":"“Timbre” Pilot Study Conducted Using Training & Validation Data Provisioned by UCSF R2D2 for Screening of Pulmonary Tuberculosis Using Cough (Acoustic Sounds), Clinical & Demographic Inputs","authors":"R. Pathri, Shekhar Jha","doi":"10.47363/jprr/2023(5)144","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)144","url":null,"abstract":"TimBre from Docturnal offers multidirectional screening of Lung Ailments – Pulmonary Tuberculosis, Pneumonia, Covid19 & COPD. Detailed studies of TimBre in the past used third party Microphone Array that focused on a XY arrangement that provided high fidelity cough sounds with an average length of >5 seconds and real-time demographic data such as Height, Weight, BMI [1]. In the current study, cough sounds were harvested from 7 different countries (India, Vietnam, Philippines, Uganda, Tanzania, Madagascar, SA) using Mobile Phones from different manufacturers & recorded solicited coughs in a clinic for a duration of 0.5 seconds. A plethora of demographic and clinical variables were provided of which a subset was used by TimBre algorithm. Most importantly, the .WAV files were recorded in a single channel at a sampling rate of 44.1kHz & 16 bits. The study details two approaches wherein the first method was to concatenate all the 0.5 second WAV files based on a timestamp provided for each StudyID in the training & scoring set while the second method involved using the 0.5 second snippets as-is in both training and validation sets without any concatenation. The first approach on the TEST set yielded a sensitivity and specificity (table-1) of 68.6% and 71.7% respectively with an AUC of 0.75 while the second approach yielded a sensitivity & specificity (table-2) of 75.41% and 68.30% respectively with an AUC of 0.78 as reported by UCSF R2D2 team. Both the approaches used a combination of Clinical, Demographic and Spectral Variables. Some additional variables included were derived (BMI) & excluded (Spectral) based on the feature importance scores. The ML model performed better in the second approach and we anticipate it to improve further once an additional 714,922 .WAV files harvested as Longitudinal coughs shall be appended to the training set as a part of a subsequent pilot study","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research & Reports","volume":"246 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116711508","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":"Differentiating Productive and Nonproductive Cough using Cough Acoustics & Machine Learning","authors":"R. Pathri, Shekhar Jha","doi":"10.47363/jprr/2023(5)138","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)138","url":null,"abstract":"A wet cough by definition is when the cough brings about mucous in the phlegm due an irritant or an inflammation in the Lungs. Every cough regardless of it being wet or dry brings about phlegm and the degree of mucous varies and is much more in quantity in cases of a wet cough & can be used to determine the extent of SOB (shortness of breath), dyspnea due to excessive mucous. This is not always the case in that there are instances where the dry cough subjects may also experience dyspnea that can be attributed to other underlying & related conditions. From an acoustics perspective, a dry cough is usually something like a bland and hacking sound that is followed by an irritation in the Lungs while wet cough has a certain tonality to it whether it is crackling or a rattling sound. Tonality here can be measured using Spectral Flatness & other spectral variables that provide explainability are kurtosis, spectral centroid and spectral skewness. While this is not an exhaustive list, there are other variables that or of importance. Mucous is agnostic to whether it is a bacterial or viral infection but with Pneumonia, there are some indicators with sticky mucous with a bacterial infection Vs viral. However, an indicator of dyspnea induced by phlegm and whether it can differentiate between a bacterial and a viral Pneumonia is an important use case, the later in this context. Wet cough with wheezing caught at an early stage can determine an underlying Emphysema condition [1]. Emphysema: Types, Symptoms, Causes, Diagnosis, Treatment (health.com) or other forms of COPD such as chronic Bronchitis. Cystic Fibrosis has a certain type of mucous that if screened early can be priceless. The shortness of breath caused due to excessive mucus in the Phlegm, if it can rule out Lung Cancer as a screening modality are other areas where the applicability of wet cough can be useful. While the applications are many, in this paper we discuss the AI/ML methods on the acoustics of the “wetness or dryness” of a cough which provides an additional biomarker under the primary biomarker, “cough” in the field of acoustic epidemiology","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research & Reports","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126705059","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":"Supratherapeutic International Normalized Ratio on Rivaroxaban and the Mechanisms behind it: A Systematic Review","authors":"Angela Khidhir DO MSc","doi":"10.47363/jprr/2023(5)140","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)140","url":null,"abstract":"Leonard Palatnic DO, Usman Najam DO University at Buffalo Jacobs School of Medicine and Biomedical Sciences, USA","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research & Reports","volume":"6 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120942189","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":"Limb Salvage after Covid-19 Related Major Arterial Thrombosis in an 81 -Year Lady with Critical Limb Ischemia: A Case Report","authors":"A. Khalil","doi":"10.47363/jprr/2023(5)141","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)141","url":null,"abstract":"Hypercoagulable state and thromboembolic events are common extra-pulmonary complications of COVID-19 that are increasingly reported in the literature. Unfortunately unlike VTE, no remarkable data are available on arterial thrombosis in SARS-CoV2 infected patients, and despite the use of anticoagulant and antiplatelet therapies, severe arterial thrombotic complications are observed. The objective of this case study is to share our experience about COVID-19 related peripheral arterial thrombosis and highlight the management plan of the resulting CLI in an elderly patient. It is a case report of an 81- year lady that developed fever, vomiting, and bone aches for 3 days before being transferred to the fever hospital with gastrointestinal upset, where she was admitted to normal ward and the diagnosis of COVID-19 was confirmed by RT-PCR. The patient improved and discharged to home after one week, 5 days later she started to complain of painful right foot then the pain involved the whole leg later on with fixed color changes and coldness, however, the diagnosis of acute ischemia was missed for one week more until the patient came to our department, and arterial duplex revealed extensive thrombosis of the SFA, popliteal and tibial arteries with CLI (ABI was<0.4). The patient was prepared for prompt vascular intervention and surgical embolectomy was performed via combined popliteal and femoral approaches. A long, thick, more gelatinous and darker thrombus was retrieved both proximally and distally. The limb was saved with fairly good distal runoff. Unfortunately, one week after the operation the patient slipped and developed fracture neck femur of the same limb, and she was operated on one month later. The patient had uneventful postoperative course, and such lucky 81years lady kept a viable well-functioning limb and could walk again. In conclusion, the key points of our case study include vigilant consideration of the arterial thrombosis in COVID-19 infected patients, routine monitoring of D-dimer levels with initiation of full-dose anticoagulation if levels elevated by six times the upper limit of normal, as well as prompt diagnosis of ALI, and urgent surgical revascularization to save the limb.","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research &amp; Reports","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127582701","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":"Monoresistance to Rifampicin: An Uncharted Territory in The Management of Drug-Resistant Tuberculosis","authors":"Amit Sharma","doi":"10.47363/jprr/2023(5)142","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)142","url":null,"abstract":"Tuberculosis (TB) disease caused by the bacilli Mycobacterium tuberculosis (MTB) is a chronic disease, mostly involving the lungs but can also involve other parts of the body, which if left untreated may lead to severe illness which can be fatal. Worldwide, TB is the 13th leading cause of death. TB occurs in every part of the world but its distribution is heterogenous. As per WHO global TB report, the biggest quantum of cases occurs in the South and South-Eastern Asian region (46%). Africa contributes to 23% with Western pacific taking 18% of the burden of TB [1].","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research &amp; Reports","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134438484","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":"Energy Alterations in Patients with Chronic Cough","authors":"H. W. L.","doi":"10.47363/jprr/2023(5)139","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)139","url":null,"abstract":"Chronic cough is an important symptom that has a major cause of gastroesophageal reflux, and asthma but there are multiple factors involved. In traditional Chinese medicine, problems in the Lungs can be caused by energy alterations in other organs. The purpose of this study is to demonstrate that patients with chronic cough have energy deficiency inside the five internal massive organs mainly in the Kidney, leading to problems in the Lungs. Also, there is the necessity to prevent the exposition to external pathogenic factors, such as Cold and Wind, and Cold from foods that can lead to cough. Methods: one case report of 42 years-old female patients with a chronic cough for more than 4 months that improves when she lay down and worse when she is upside. She went to a variety of medical doctors that did not find any problem in her laboratory exams. She went to my clinic and I asked about her daily eating habits she likes to use oranges recently but she does not have a desire to drink water. The maximum amount she drinks is 1 liter per day. I measured the energy of her five internal massive organs (Liver, Heart, Spleen, Lungs, and Kidney) through the radiesthesia procedure using a Wood pendulum. Results: all internal massive organs were in the lowest level of energy. I asked her to avoid the ingestion of orange and Cold water and begin to treat her using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, and systemic acupuncture and began to replenish the energy of the internal organs’ energy using highly diluted medications according to the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications. It was also advised the patient increase the water intake to at least 3 liters per day. The patient improved from her cough condition and she is having a normal life since the first ten days of treatment. The conclusion of this study is to demonstrate that patients with chronic cough have energy deficiency inside the five internal massive organs and invasion of external pathogenic factors through the environment and from wrong eating habits and the rebalancing of these energies using auricular acupuncture and replenishing the internal organs energy using highly diluted medications according to the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications is of paramount importance to treat the cause and not just treating the symptoms.","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research &amp; Reports","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126665349","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":"Auricle Myxoma, Evidence from the Clinic to Cardiovascular Emergency Surgery, Triad: Cardiac, Systemic, Embolic","authors":"Sánchez Crespo VJ, Tapia Valverde A M","doi":"10.47363/jprr/2023(5)135","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)135","url":null,"abstract":"Cardiac tumors are infrequent, primary tumors, such as atrial myxoma, are estimated at 000017 to 0.13% of all cardiac neoplasms, postmortem records, n relation to its frequency, it is more than the other primary ones, in 67% the left atrial myxoma, 23% in the right atrium and less frequent the biaurals left. age group from 30 to 60 years, more in the female sex, in the childhood is more related to alterations in skin lentiginosis, nevi as Carney.autosomica dominant síndrome. In genetic studies, alterations in the PRKAR1A gene on chromosome 17 are found. We present the case of a patient with a request for pre-surgical evaluation, urological prolapse of the bladder, with systemic manifestations, weight loss, chronic anemic syndrome treated with vitamins and trace elements, by a private physician, without remission. It is worth mentioning that the physical and cardiovascular examination revealed semiotic onygomatic seizures of Duroziez in the mitral area, with auscultatory changes in the left lateral decubitus position, for which reason I propose the diagnosis of mitral valvular heart disease vs atrial myxoma, with 2 elements of clinical judgment of the classic triad of myxoma, in the performance of the transcutaneous echocardiogram, a cardiac mass was observed, at the level of the left atrium, spherical, of 5.5 cmt diameter, hyperechogenic. Great mobility in cycles cardiac, prolapse of the mitral valve in diastole with stenosis, the emergency consultation was made to cardiovascular surgery in a hospital of greater complexity, a procedure with complete excision of the tumor of approx 12 cmt by 5.5 cmt diameter, with satisfactory evolution of the patient","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research &amp; Reports","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129395827","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 of Mucormycosis with Covid-19 with a Conservative Medical Management, a Rare Management Approach","authors":"Muna Mareh, Mohammad Abu-Jeyyab","doi":"10.47363/jprr/2023(5)134","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)134","url":null,"abstract":"Mucormycosis is an infection caused by fungi belonging to the order Mucorales. It has been reported in many patients following COVID-19 infection, particularly in those with Diabetes Mellitus and in those treated with steroids. The most common type in patients with diabetes, rhino-orbito-cerebral mucormycosis, is associated with various neurological complications. In this report, we describe the case of a 71-year-old female with diabetes and hypertension, who presented one week after recovering from Covid-19 infection, with symptoms of severe headache and, right eye ptosis, ophthalmoplegia and decreasing visual aquity. Brain CT scan showed features of maxillary sinusitis. Nasal biopsy and cultures revealed mucormycosis. She was managed with Amphotericin-B with improvement in headache and persistence of eye complications. Three months after discharge, she presented to the emergency department complaining of left-sided weakness. Brain MRI showed an acute ischemic infarction with totally occluded right internal carotid artery, progressive boney destruction of the right maxillary sinuses, and inflammation of the right orbit and cavernous sinus. As she refused surgical debridement, she was admitted and managed conservatively with Amphotericin-B.","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research &amp; Reports","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131109405","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":"Efficacy & Safety of Omalizumab in Indian Adult Patients with Severe Allergic Asthma: A Retrospective Observational Study","authors":"A. Khanna, D. Talwar","doi":"10.47363/jprr/2023(5)137","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)137","url":null,"abstract":"Background: We designed the present study to understand the characteristics of patients who initiate Omalizumab in a real-world setting and understand the long-term outcomes of Omalizumab in India. Methods: This was a retrospective, observational, cohort study using the data from health records of a tertiary care center (June 2018 and May 2020) in north India. We included patients aged 18 years or over with IgE mediated asthma (IgE levels 30-1500 IU/ml) who were prescribed omalizumab therapy at MCRD Severe Asthma Clinic for a minimum duration of 16 weeks. Patients were evaluated at 16 weeks (±2 weeks) and 52 weeks(±4 weeks). Exacerbations, hospitalizations/emergency visits, medications, asthma control test (ACT) score, and lung function before/after initiation with omalizumab therapy were assessed. Results: A total of 101 patients were included in the study. The mean age of patients was 61.1 years, with only 24.8% patients aged less than 50 years The number of exacerbations per year significantly improved (p <0.001) from a mean baseline of 6.34±2.04 to 1.52±0.99 at 16 weeks, 2.81±1.63 at 52 weeks. We observed a significant improvement(p<0.001) in ACT score, frequency of OCS bursts, and FEV1 at 16 weeks and 52 weeks. There were statistically significant improvements(p<0.001) in hospitalizations/ER visits per year and reductions in mean ICS dosage and mean number of medications prescribed for asthma daily. Conclusion: Omalizumab led to improved asthma control, lung function, and QoL and allowed a reduction in the dosage of medications for asthma. The improvement was observed irrespective of age and biomarker levels.","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research &amp; Reports","volume":"165 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123774416","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":"Clinico-Radiological Profile of Patients with Connective Tissue Disease (CTD) Associated Interstitial Lung Disease (ILD) At a Tertiary Care Center in India","authors":"A. Khanna, Amit Jose","doi":"10.47363/jprr/2023(5)136","DOIUrl":"https://doi.org/10.47363/jprr/2023(5)136","url":null,"abstract":"Interstitial lung diseases (ILDs) are a group of heterogenous disorders characterized by varying degree of fibrosis in lung [1]. Work-up for connective tissue diseases (CTDs) is an important component of evaluation of a patient with ILD. CTDs affect connective tissue in various organs resulting from poorly controlled autoimmune responses, and associated inflammation. Overall ILD has been documented in up-to 15% of patients with CTD, with rates as high as 26% in Systemic Sclerosis (SS) [2]. Lung involvement contributes to mortality in CTDs, and the management of ILDs depends on the presence and severity of underlying CTDs. Hence it is necessary to understand the clinical presentation of CTD-ILDs","PeriodicalId":229002,"journal":{"name":"Journal of Pulmonology Research &amp; Reports","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123352019","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}