Egyptian Journal of Bronchology最新文献

{"title":"Does vitamin D deficiency worsen the clinical and functional parameters of stable chronic obstructive pulmonary disease patients?","authors":"Esmat Abd Elnaby, Samah Abd Elnaiem, A. Mostafa, D. Sabry, Mohamed Haswa","doi":"10.4103/ejb.ejb_44_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_44_19","url":null,"abstract":"Introduction There is not much data about the effect of deficient vitamin D on stable chronic obstructive pulmonary disease (COPD) patients and its relation to the disease severity. Objective The aim was to measure the serum level of 25-hydroxy (OH) vitamin D in stable COPD patients, and to assess its relation to COPD severity and functional parameters. Patients and methods A prospective study that was carried out at Chest Department, Kasr El-Aini Hospital, Cairo University. It was carried out on 70 male individuals: 50 stable COPD patients and 20 healthy individuals. All persons were subjected to history taking, clinical examination, 6 min walk test (6MWT), spirometry, and measurement of 25(OH) vitamin D serum level. Results Our results showed a deficiency of vitamin D in 37 (74%) of the COPD patients. It showed a significant lower level of 25(OH) vitamin D in COPD cases who were severe and very severe, compared with those who were mild and moderate ones (P=0.017). There was also a positive significant correlation between vitamin D level and 6 min walk distance, basal oxygen saturation, post-6MWT oxygen saturation, and forced expiratory volume in the first second predicted, and an inverse correlation with basal heart rate and post-6MWT heart rate. Conclusion The study highlights the value of measurement of vitamin D level in COPD, as a potential therapeutic agent. Vitamin D serum level showed low values in COPD cases compared with healthy ones and was correlated significantly to forced expiratory volume in the first second predicted.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"584 - 590"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44490021","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":"Clinical outcome of weaning in mechanically ventilated patients with chronic obstructive pulmonary disease","authors":"S. Sayed, K. Ahmed, S. Kinawy, Islam G. Sayed","doi":"10.4103/ejb.ejb_9_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_9_19","url":null,"abstract":"Background Chronic obstructive pulmonary disease (COPD) represents a significant reason for mortality and morbidity worldwide that induces a high socioeconomic burden, with exacerbations necessitating mechanical ventilation representing a major aspect of illness management. Many patients with COPD frequently presented with troubles in the liberation from mechanical ventilation. The aim of the current study was to verify the validity of the weaning categorization that is classified according to the difficulty and length of the weaning procedure in mechanically ventilated patients with COPD and its effect on the different clinical and mortality outcome variables. Patients and methods A total of 102 patients with COPD who achieved the weaning criteria were classified according to the length and difficulty of weaning procedure into simple weaning group (n=60, 58.8%) and nonsimple weaning group (which include difficult and prolonged weaning categories) (n=42, 42.2%). The outcome measures are the length of mechanical ventilation, the duration of ICU stay, and lastly the mortality rate. Results Regarding baseline data recorded at admission, no significant difference between both weaning groups was found apart from Acute Physiology and Chronic Health Evaluation score II. The nonsimple weaning group had considerably higher duration of invasive mechanical ventilation, length of ICU stays, and lastly the mortality rate, in comparison with the simple weaning group. Conclusion Weaning categorization according to the length and the difficulty of the weaning procedure may be used as a suitable predictor of outcome in severe COPD exacerbation with the requirement for invasive mechanical ventilation.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"484 - 488"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46601718","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":"Airway inflammatory biomarkers in different asthma phenotypes","authors":"A. Osman, A. Elsaid","doi":"10.4103/ejb.ejb_38_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_38_19","url":null,"abstract":"Background Asthma is a diverse disease with various phenotypes. Correlation of clinical asthma phenotypes with their underlying inflammatory biomarkers could help tailor asthma management and in turn improve the patient’s outcome. Aim of the study To validate the clinical classification of asthma phenotypes and to portray cough-predominant asthma phenotype and wheezy phenotype in accordance with their related inflammatory biomarkers. Patients and methods This is a case–control study comprising 50 patients with cough-predominant asthma phenotype and 50 patients with wheezy asthma phenotype, together with 50 healthy controls. Serum interleukin-10 (IL-10), transforming growth factor-beta 1 (TGF-β1), and total serum immunoglobulin E (IgE) levels were assessed using immunoassay techniques. Results The asthmatic children showed a significant increase of eosinophilic percentage, total serum IgE, and TGF-β1, when compared with the control group, whereas they showed a significant decrease of serum IL-10 when compared with the control group. As regards the clinical characteristics of both phenotypes, the prevalence of associated allergic rhinitis and atopic dermatitis in patients with cough-predominant asthma was significantly higher compared with the wheezy group. As regards laboratory biomarkers, total serum IgE was significantly elevated in cough-predominant asthma phenotype compared to wheezy phenotype. No significant differences were found between both phenotypes regarding serum TGF-β1 and IL-10. Conclusion Cough-predominant asthma phenotype is characterized by prominent atopic features (allergic manifestations and elevated total IgE). However, cough-predominant asthma and wheezy asthma phenotypes were similar regarding serum TGF-β1 and IL-10.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"580 - 583"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47072845","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":"Functional and radiological characteristics of asthma combined chronic obstructive pulmonary disease overlap","authors":"Hamada Fayed, Yasen Abd-Elkareem, Wassem Samaha, Maher Abdalshakour","doi":"10.4103/ejb.ejb_14_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_14_19","url":null,"abstract":"Background Persons with asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) are a crucial but poorly characterized group. In spite of the numbers of patients with ACO have increased, there is minimal confirmed evidence regarding diagnostic features and choices of treatment. So, the aim of this study was to identify the physiological and radiological characteristics of patients with ACO. Patients and methods This study was performed on 200 patients classified into 38 patients diagnosed as having asthma, 132 patients diagnosed as having COPD, and 30 patients diagnosed as having ACO, who were chosen based on clinical features. All patients underwent pulmonary function tests, and multislice computed tomography imaging. Results The mean age of our study population was 61 years. The mean age in COPD group was higher compared with asthma and ACO groups (63.9±7.8 vs. 44.84±12.2 and 56.7±8, respectively), with a predominance of males in COPD and females in asthma, with a higher smoking index in patients with COPD than those with ACO and asthma (47.05±37.7, 13.53±2.2, and 2.47±1.46, respectively). Measurements of forced expiratory volume in 1 s (FEV1) by liters before bronchodilator therapy is greater in patients with asthma than ACO and COPD groups (1.89±0.42, 1.52±0.39, and 1.35±0.4, respectively), with highly significant difference (P<0.001). With airway reversibility, it is also greater in patients with asthma than ACO and COPD groups (2.85±0.49, 1.99±0.47, and 1.41±0.39, respectively), with a highly significant difference (P<0.001). Airway internal diameter of patients with COPD is greater than ACO and asthma groups (4.03±0.3, 3.92±0.17, and 2.82±0.31, respectively), with a highly significant difference (P<0.001). On the contrary, airway external diameter of patients with COPD is greater than asthma and ACO groups, with a highly significant difference (P<0.001). Airway wall thickness of patients with asthma is greater than ACO and COPD groups, with a highly statistical difference (P<0.001). There is no relation between thickness of airway wall and airway obstruction, expressed as FEV1 %predicted, in patients with asthma and COPD. This study results confirmed the correlation between the thickness of airway wall and airway obstruction, expressed as FEV1 %predicted, in patients with ACO. Conclusion Bronchial wall thickness measured by chest high resolution computed tomography (HRCT) is increased in patients with asthma than those with ACO and COPD, with a high statistical significance.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"596 - 604"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43235785","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":"Pulmonary rehabilitation outcome in chronic obstructive pulmonary disease patients with a different body composition","authors":"Laila A Alsharaway","doi":"10.4103/ejb.ejb_33_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_33_19","url":null,"abstract":"Context Change in body composition is commonly present in chronic obstructive pulmonary disease (COPD) patients. Aim The aim of this study was to investigate the effects of pulmonary rehabilitation program (PRP) on COPD patients who have a different body composition. Materials and methods In this study, we measure;Deg;BM;Deg;I and fat-free mass index (FFMI) using a single-frequency bioelectrical impedance analysis apparatus to classify patients into three categories: Group 1 nonmuscle depleted;Deg;BM;Deg;I greater than or equal to 21 kg/m2 and FFMI greater than or equal to 16. Group 2 muscle depleted;Deg;BM;Deg;I greater than or equal to 21 kg/m2 and FFMI less than 16 in men or FFMI less than 15 in women. Group 3 muscle depleted with cachexia;Deg;BM;Deg;I less than 21 kg/m2 and FFMI less than 16 in men or FFMI less than 15 in women. PRP outcomes were assessed by the improvement in pulmonary function severity, exercise capacity by 6-min walk test, dyspnea score by modified-British Medical Research Council, and health status by combined assessment test score and arterial blood gas improvements. Results Forty-four patients with FFMI were measured by bioelectrical impedance analysis. The patients were mainly elderly men (N=35; 79%), who have a mean age of 65 years with different global initiative obstructive lung disease stage I–IV. In the nonmuscle depleted group, there were statistically significant improvements in the mean values of FFMI (kg/m2) while in the muscle depleted group there were improvements as regards the mean values of dyspnea score by modified-British Medical Research Council; in the cachectic group there were statistically significant improvements in the mean values of BMI (kg/m2), forced expiratory volume in the first second (FEV1), forced expiratory volume in first second divided by forced vital capacity ratio, combined assessment test score after PRP. Conclusions A comprehensive PRP outcome change in COPD patients with different body compositions.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"616 - 622"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45901568","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":"Study of upper airway inflammation in patients with obstructive sleep apnea–hypopnea syndrome","authors":"E. Mohamed, A. Baess, Yasser Eldowik","doi":"10.4103/ejb.ejb_27_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_27_19","url":null,"abstract":"Background Pharyngeal lavage was reported as a novel technique for noninvasive assessment of inflammation of the pharynx. Aim To study upper airway inflammation in patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) and its correlation with systemic inflammation. Patients and methods A total of 36 patients with known OSAHS, admitted to the Chest Department, Alexandria Main University Hospital (group I), and 15 healthy volunteers (group II) were enrolled into the study. Informed consent was taken from all participants. The two groups underwent complete history taking, assessment of BMI, measurement of serum C-reactive protein (CRP), overnight polysomnography, and oropharyngeal lavage (OPL) analysis. Results In group I, the most prevalent cell type of OPL was lymphocytes followed by neutrophils. Compared with control group (group II), the most prevalent cell type in OPL was macrophages followed by epithelial cells. Regarding the OPL differential cell count which denotes local pharyngeal inflammation, there was a statistically significant difference between both groups (P<0.001). Similarly, CRP, a marker of systemic inflammation, showed a significant statistical difference between both groups (P<0.001). Strikingly, there was no statistically significant correlation between CRP and apnea–hypopnea index (P=0.604). Snoring, apnea–hypopnea index, and other sleep parameters correlated significantly with lymphocytic predominance in OPL (P<0.001), whereas CRP correlates significantly with neutrophils and eosinophil’s in OPL (P<0.001 and P=0.015, respectively). Conclusion Our study had provided a novel vision into the pathophysiology of OSAHS in emphasizing the existence of upper airway lymphocytic inflammation. OPL is a simple, applicable, and easy noninvasive procedure for assessment of upper airway inflammation.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"754 - 759"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45102314","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":"Tuberculosis in Upper and Lower Egypt before and after directly observed treatment short-course strategy: a multi-governorate study","authors":"M. Negm, A. Allam, T. goda, M. Elawady","doi":"10.4103/ejb.ejb_47_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_47_19","url":null,"abstract":"Background Tuberculosis (TB) is a major problem in developing countries. TB in Egypt is considered an important public health problem. Egypt is ranked among the mid-level incidence countries. Objective To evaluate TB status in 19 governorates and to compare the TB situation in Upper and Lower Egypt over 20 years from 1992 to 2012 before and after the application of directly observed treatment short-course strategy (DOTS). Patients and methods This is a retrospective study involving record review. The registered data were collected from TB registration units in the 19 governorates. Results The highest percentage of TB cases was in the age group 15–30 years. Infection was higher in males than females and in rural areas more than urban areas. Pulmonary TB and smear positivity at diagnosis, second, third, and fifth month were higher in Lower Egypt. Treatment after failure or relapse was significantly higher in Upper Egypt, whereas default rate, failure rate, and death rate were significantly higher in Lower Egypt. Regarding treatment outcome, cure, complete treatment, and transfer out were significantly increased after DOTS than before. Failure, default, and death were significantly reduced after DOTS than before DOTS. Upper Egypt included higher incidence rates of TB, new adult smear-positive cases, new extrapulmonary TB cases, and sputum conversion rate at the end of the initial phase of treatment. Cure rate and treatment success rate were significantly higher among patients of Upper Egypt, whereas transfer out rate and retreatment failure rate were significantly higher among Lower Egypt patients. Conclusion TB is still a health problem in Egypt, with pulmonary TB more in Lower Egypt, whereas extrapulmonary more in Upper Egypt, but after the introduction of DOTS, there is a significant increase in cure and success rate, with markers of success being more in Upper Egypt.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"722 - 729"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47686051","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":"Effect of incentive spirometer exercise on pulmonary functions in children with spastic cerebral palsy","authors":"M. Elseify, D. Ramadan, S. Ishak","doi":"10.4103/ejb.ejb_53_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_53_19","url":null,"abstract":"Background Spastic cerebral palsy (CP) patients have lower pulmonary functions than normal healthy individuals as they usually have decreased chest wall mobility, deviation of optimal chest wall structure, and weak respiratory muscles. Purpose The aim was to study the effect of incentive spirometer exercise (ISE) on spirometry pulmonary function in children with spastic CP. Materials and methods Fifty spastic CP patients were randomly divided into two groups: the study group consisted of 30 patients and the control group consisted of 20 patients. Both groups were following and doing physiotherapy in the National Institute of Neuromotor System, the study group added incentive spirometer exercise to their physiotherapy program. We assessed forced expiratory volume at first second (FEV1%), the forced vital capacity (FVC %), FEV1/FVC ratio, and maximal mid-expiratory flow before and after 4 weeks of exercise and lastly after another 4 weeks of exercise. Results The authors found significant improvements in FEV1%, FVC %, and maximal mid-expiratory flow in the study group, but not in the control group. Conclusion The authors support the use of ISE for improving pulmonary functions in children with spastic CP.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"716 - 721"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46020816","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":"Pattern of chest diseases among addicts in Poison Control Center of Ain Shams University Hospitals","authors":"Ayah Abdeldayem, M. Sakr, N. Osman, Maryam Abd El Kader, Sherehan EL Abd El-Aaty","doi":"10.4103/ejb.ejb_60_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_60_19","url":null,"abstract":"Background Drug addiction results in serious pulmonary complications. Thoracic complications of drug addiction vary depending on the type and the route of administration of the drug that has been abused. Aim To study the pattern of chest diseases among addicts in Poison Control Center of Ain Shams University Hospitals. Patients and methods A total of 200 addict patients were selected from Poison Control Center of Ain Shams University Hospitals in the duration between June 2016 and June 2018. All patients with pulmonary complications referred to Abbasia Chest Hospital were included. Results A total of 200 addict patients were enrolled in this study. Of them, 100 addicts with drug overdose with no pulmonary complications were excluded, and the other 100 patients were included, comprising 99 males and only one female, with mean age of 39.91±10.75 years. Overall, 63% of drug addicts were cannabis addicts, 27.0% were opiate addicts, 8.0% were polysubstance abusers, and 2.0% were alcohol addicts. Pulmonary tuberculosis was the most common pulmonary complication of all drug addicts. There was a statistically significant correlation between the type of drug addiction and the pulmonary complications. Pulmonary tuberculosis was the most common among cannabis addicts as well as polysubstance abusers. Parenchymal lung diseases (pneumonia and lung abscess) were the most common among opiate and intravenous drug addicts. There was no significant difference between different types of drugs and outcomes of the patients. Mortality represented 3.0% of all drug addicts. Conclusion Many pulmonary complications are associated with drug addiction. Achievement of early diagnosis and treatment can be obtained by proper counseling and therapeutic programs.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"704 - 709"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47763072","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":"Spontaneous resolution of persistent lymphadenitis: a case of Kikuchi–Fujimoto disease","authors":"D. Ramachandran, Rajesh Venkitakrishnan, Jolsana Augustine, Melcy Cleetus","doi":"10.4103/ejb.ejb_26_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_26_19","url":null,"abstract":"Cervical lymphadenopathy is common in all age groups. Persistently enlarged cervical lymph nodes often pose a diagnostic challenge and necessitate focused clinical evaluation with targeted investigations. Pathological examination of excised node yields conclusive answer in the vast majority of cases with unsettled diagnosis. We present a case of a young man with persistent posterior cervical lymphadenopathy which on excision biopsy turned out to be Kikuchi–Fujimoto disease. With watchful follow-up, he had a self-limiting clinical course in the next few months.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":"13 1","pages":"778 - 780"},"PeriodicalIF":1.3,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44280870","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}