Swanevelder Charlene, Prasad Lila, Chen Kevin YY, Zeng Irene, Corna Nicola, Nguyen Anh, Wong Conroy
{"title":"Intradermal and Subcutaneous Lignocaine for Arterial Blood Gas Sampling: A Randomized Controlled Trial","authors":"Swanevelder Charlene, Prasad Lila, Chen Kevin YY, Zeng Irene, Corna Nicola, Nguyen Anh, Wong Conroy","doi":"10.29328/journal.jprr.1001054","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001054","url":null,"abstract":"Introduction: The use of local anesthesia (LA) prior to arterial blood gas sampling is recommended but is not widely used. We tested the hypothesis that intradermal administration of local anesthesia would be as effective as subcutaneous administration in reducing pain from arterial blood gas sampling. Aims: The primary aim of this study was to evaluate the effect of intradermal and subcutaneous lignocaine on patient-perceived pain during arterial blood gas sampling. The secondary aims were to evaluate if different routes of LA administration had an impact on the difficulty and complications of ABG sampling. Methods: We undertook a randomized, single-blind, placebo-controlled trial in New Zealand. We enrolled patients attending a nurse-led outpatient oxygen clinic who were 18 to 90 years of age and who had an oxygen saturation of 93% or less at rest. Patients were randomly assigned to receive intradermal 1% lignocaine, subcutaneous 1% lignocaine, or subcutaneous normal saline. Patients and nurse assessors were blinded to the treatment allocation. The primary endpoint was a patient-assessed pain score using a graphic rating scale (0-10). Results: 135 patients were randomized (54 patients in the intradermal lignocaine group, 54 patients in the subcutaneous lignocaine group, and 27 in the subcutaneous saline group). The mean patient-assessed pain score for the intradermal lignocaine group was 1.8 (+/- 1.1), which was a relative reduction of 47% (95% C.I. 31%-59%, p < 0.0001) from the mean patient-assessed pain score of 3.4 (+/- 1.1) for the subcutaneous saline group. The mean patient-assessed pain score for the subcutaneous lignocaine group was 2.1 (+/- 1.1), which was also a significant relative reduction of 36% (95% C.I. 17%-51%, p = 0.0001) compared to the subcutaneous saline group. Intradermal lignocaine reduced pain more than subcutaneous lignocaine, with a relative pain reduction difference of 20% (95% CI -4%-49%, p = 0.05). Bruising was more frequent in the subcutaneous lignocaine group (9.3%) than in the intradermal (0%) and saline groups (0%). Conclusion: Intradermal lignocaine is at least as effective as subcutaneous lignocaine for reducing patient-perceived pain from arterial blood gas sampling and results in less bruising.","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":" 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140389218","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}
Friedman Samuel H, Williams Jacob, Hyer Madison, Fox Nicholas, Ramakrishnan Viswanathan, Lammi Matthew R, Steen Virginia D, Argula Rahul G
{"title":"Longitudinal Risk Phenotyping in Incident Systemic Sclerosis-associated Pulmonary Arterial Hypertension (SSc-PAH): An Unsupervised Cluster Analysis of the PHAROS Registry","authors":"Friedman Samuel H, Williams Jacob, Hyer Madison, Fox Nicholas, Ramakrishnan Viswanathan, Lammi Matthew R, Steen Virginia D, Argula Rahul G","doi":"10.29328/journal.jprr.1001053","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001053","url":null,"abstract":"Background: Systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) is characterized by pulmonary arterial remodeling resulting in right ventricular failure and death if untreated. Despite therapeutic advances, there is survival variability within the SSc-PAH population. The aim of this study was to delineate high-risk subgroups of SSc-PAH using readily available clinical parameters. Methods: We analyzed data from the PHAROS database, a prospective observational registry of incident SSc-PAH patients. Latent class modeling was performed based on trends in 6MWD over time. We compared survival between the clusters regarding baseline clinical parameters and changes in these parameters over time. Results: We identified four unique groups within 103 patients meeting our inclusion criteria, based on trajectories of 6MWD. Patients in Cluster 4 exhibited a decline in 6MWD over time and had the worst prognosis with a median survival of 3 years. Patients in Cluster 3, with the lowest baseline 6MWD, were associated with lower median survival (5 years) when compared to Clusters 1 and 2 (> 9 and 7 years, respectively), despite an improvement in 6MWD over time. There were no meaningful changes in SF-36 and WHO functional class between the clusters, but BNP trended higher over time in the higher-risk clusters. Conclusion: We identified high-risk subsets of SSc-PAH characterized by significantly worse survival. Incident SSc-PAH patients with a decline in 6MWD over time or low baseline 6MWD had worse survival when compared to SSc-PAH patients who demonstrated relatively stable or mild reduction in 6MWD over time.","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391900","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 Azithromycin on Lung Function and Pulmonary Exacerbations in Children with Post-infectious Bronchiolitis Obliterans. A Double-blind, Placebo-controlled Trial","authors":"Claudio Castaños, Felix Salin Maximiliano, Luciana Pereyra Carla, Veronica Aguerre, Belen Lucero Maria, Gabriela Bauer, Brenda Zylbersztajn, Leonor Leviled, Hebe González Pena","doi":"10.29328/journal.jprr.1001052","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001052","url":null,"abstract":"Introduction: Acute lower respiratory infection (ALRI) of viral etiology is a frequent consultation in pediatrics. Post-infectious bronchiolitis obliterans (PIBO) is a rare and potentially severe disorder following ALRI, characterized by partial or complete obstruction of the small airways by inflammatory tissue. There is evidence that macrolides reduce morbidity and mortality in diffuse panbronchiolitis, which may have similar inflammatory and obstructive components. We hypothesized that the effect of azithromycin (AZ) may improve lung function and reduce pulmonary exacerbations in PIBO. Methods Study design: A double-blind, randomized, placebo-controlled trial. Patients: We enrolled patients with PIBO followed-up at the Pulmonology department between 5 years to 18 years. Treatment regimen: The patients were randomized to receive active drug or placebo three times a week. Clinical evaluation: Clinical evaluation, pulse oximetry, lung function, and 6-min walk test were performed before and after study initiation and at 1, 3, and 6 months. CT scan and a quality of life questionnaire were performed at the beginning and the end of the Study. Results: 29 patients, 15 in G1 (10 males) and 14 in G2 (7 males) were included. There were no significant differences in FVC, FEV1, TLC, RV, or sGaw between the treatment group and controls. In addition, no significant differences were observed in exacerbations, quality of life questionnaire, or HRCT scan scores. Conclusion: No differences were observed between the groups. Further studies are necessary to allow us to find a better treatment, as azithromycin does not seem to be efficacious.","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"254 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140422020","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 Importance of The Concept of Acute Pneumonia for Choosing the Principles of its Treatment and Results","authors":"Klepikov Igor","doi":"10.29328/journal.jprr.1001051","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001051","url":null,"abstract":"","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"64 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140482542","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":"An Unusual Case of Hydatid Cyst Presenting as Pyopneumothorax","authors":"S. Anand","doi":"10.29328/journal.jprr.1001050","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001050","url":null,"abstract":"","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"78 S345","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139629867","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":"Pathogenesis is the Basis of the Doctrine of Acute Pneumonia and the Principles of its Treatment","authors":"Klepikov Igor","doi":"10.29328/journal.jprr.1001048","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001048","url":null,"abstract":"Modern medicine has achieved phenomenal success in many areas, turning into a visual and tangible reality the embodiment of some phenomena that in previous years could only be read in works of science fiction.","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139262592","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":"Cardiac Tamponade as the Cause of Pulmonary Edema: Case Report","authors":"L. Emidio","doi":"10.29328/journal.jprr.1001046","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001046","url":null,"abstract":"Introduction: Cardiac tamponade is an emergency syndrome that requires fast diagnosis and treatment; otherwise patient follows obstructive shock and cardiac arrest. Case report: A 70-year-old female was brought to the emergency department with hypoxemia. She had a history of progressive dyspnea over the past three weeks. Past medical history includes smoking. On physical examination: tachypnea, hypoxemia (SaO2 89%), jugular venous distention, arterial pressure 220/100 mmHg, heart rate rhythmic of 82 bpm. On pulmonary auscultation: diffuse and bilateral crackles. Lung ultrasound showed a bilateral B line and the echocardiogram demonstrated a pericardial effusion with signs of tamponade. A pericardiocentesis evacuated 620 ml of hemorrhagic fluid and the patient was transferred to the intensive care unit, hemodynamically stable, with SaO2 95%. At the ICU the echocardiogram, showed resolution of the cardiac tamponade and a tumor adhered to the lateral wall of the left ventricle. Chest CT demonstrated: a left lung tumor, infiltrating the pericardial sac. A pericardium biopsy demonstrated undifferentiated carcinoma. Discussion: Cardiac tamponade diagnosis requires a high level of suspicion. Respiratory failure, chest pain, and shock, observed in cardiac tamponade, are also present in different diseases. The most common finding of cardiac tamponade is dyspnea (78% of cases). Our patient had dyspnea due to pulmonary edema, secondary to left ventricle diastolic dysfunction caused by the tamponade. A bedside echocardiogram made the diagnosis of cardiac tamponade and guided the effective pericardiocentesis. Conclusion: Cardiac tamponade must be suspected in all cases of acute dyspnea. Echocardiogram is the method of choice for the diagnosis and for guiding the pericardiocentesis.","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127659399","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":"Lung Abnormalities in Liver Cirrhosis","authors":"Yaman Muli, Mustika Syifa","doi":"10.29328/journal.jprr.1001045","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001045","url":null,"abstract":"This article aims to provide what lung disorders can be caused by liver cirrhosis and also explain the pathophysiology of each etiologies. Regardless of preexisting lung illness, patients suffering from liver cirrhosis, especially decompensated liver cirrhosis can develop distinct pulmonary complications. Liver cirrhosis patients should be assessed for hepatopulmonary syndrome (HPS), portopulmonary hypertension (PoPH), hepatic hydrothorax (HH), and spontaneous bacterial empyema (SBEM) which are the most clinically significant pulmonary consequences, in particular when dyspnea develops in conjunction with hepatic cirrhosis. These entities differ in terms of pathophysiology, clinical characteristics, diagnosis, and suitable treatment options. This emphasizes the need for a specific diagnostic algorithm in liver cirrhosis patients presenting with dyspnea or other pulmonary symptoms. These pulmonary complications might be rare in patients with liver cirrhosis and portal hypertension but these complications might carry significant morbidity and mortality risks and, therefore, strong clinical suspicion is required to make an early accurate diagnosis. There are several medical therapies available for each condition in multiple studies but most of the treatments and procedures don’t have a significant benefit or have short-lived benefits. The only treatment that changes the clinical prognosis of decompensated cirrhosis effectively in the long term is liver transplantation. However, liver transplantation also needs careful consideration as in some cases it might increase the risk of morbidity and mortality.","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131019543","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}
Sarraf Shivmohan, Singapurwala Mustafa, Jain Harshit, Singh Ravendra, Julka Arti
{"title":"Role of Inflammatory Markers in Predicting Severity in COVID-19 Patients at Tertiary Care Hospital, Ujjain (M.P.)","authors":"Sarraf Shivmohan, Singapurwala Mustafa, Jain Harshit, Singh Ravendra, Julka Arti","doi":"10.29328/journal.jprr.1001043","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001043","url":null,"abstract":"Originating from China in 2019, the novel Coronavirus Disease 2019 (COVID-19) pandemic had badly affected most of the world causing immense morbidity and mortality. The disease in moderate to severe cases was characterized by intense inflammation leading to ARDS and hypercoagulable states leading to thrombo-embolism and mortality. Aim: This study aimed to explore the association of inflammatory biomarkers with COVID-19 disease severity in our hospital which became a dedicated COVID hospital during the pandemic.","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"85 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114094479","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 effect of respira inhalation on the oxygen saturation of a patient’s blood (SpO2): A Case Report","authors":"Kadi Hussien O, HK Mohamed, HK Taha","doi":"10.29328/journal.jprr.1001042","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001042","url":null,"abstract":"Introduction: Infection and the accompanying inflammation of the upper and lower respiratory tract, influenza and COVID-19, are among the deadliest diseases in human life in the world. Due to the high emergence of bacterial resistance to antibiotics, we strive to find alternatives to contribute to the treatment by using a new formulation of a mixture of six essential oils in the form of a drop called Respira drops for a therapeutic approach to the upper or lower parts of the respiratory system infection, either by inhalation or sniffing, or by touching it with the body in the form of a skin patch on the head, neck, or chest. The present study suggested that natural essential oils may act as a prophylactic and therapeutic agent in respiratory tract hypoxia, inflammation, and bacterial and viral infection (influenza and COVID-19). Case presentation: A 62-year-old Yemeni man was suffering from acute pneumonia and had used antibiotics his condition improved, but he was suffering from difficulty breathing and stayed on the use of oxygen at home for more than three months, and his SpO2 ranged between 75 to 85 and he also suffered from an abdominal hernia, and he went for a procedure Surgery, and when the SpO2 was measured at 86, the surgery was not completed as a result, so he used Respira drops by inhalation and by steam for twenty-four hours and the next day he went to the hospital and the SpO2 was measured 96 and the operation was performed and he continued using Respira for two weeks three times per day and his condition improved completely. Conclusion: The present case study shows the excellent therapeutic response for Respira drops as inhalation and smiling three times per day increased SpO2 levels which reflect the anti-inflammatory, antimicrobial and anti-viral effects (influenza and COVID-19).","PeriodicalId":398097,"journal":{"name":"Journal of Pulmonology and Respiratory Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127007941","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}