Pulmonary Medicine最新文献

{"title":"Use of Lung Volume Recruitment Technique in Patients With Chronic Respiratory Disease Among Brazilian Health Professionals.","authors":"Robert de Melo, Livia Alcantara, Max Sarmet, Nicole L Sheers, David J Berlowitz, Vinicius Maldaner","doi":"10.1155/pm/4073171","DOIUrl":"10.1155/pm/4073171","url":null,"abstract":"<p><p><b>Background:</b> Lung volume recruitment (LVR) is a stacked-breath assisted inflation technique in which consecutive insufflations are delivered, without exhaling in between, until the maximum tolerable inflation capacity is reached. Although LVR is recommended in some neuromuscular disease guidelines, there is little information detailing when and how allied health professionals (AHPs) prescribe LVR. <b>Objective:</b> This study is aimed at describing the use of LVR in practice across Brazil. <b>Methods:</b> A cross-sectional e-survey (Sep-Nov 2023) explored LVR practices among qualified clinical or home care AHPs in Brazil. It gathered participant data on geographical region, profession, and experience. It delved into LVR specifics: clinical population and indications for use, prescription (frequency, dosage, and interfaces), related side effects, outcomes assessed, and combined therapies. Results were presented descriptively. <b>Results:</b> One hundred two surveys (74 physical therapists (PTs) and 28 speech and language pathologists (SLPs)) from diverse locations were collected. LVR was predominantly prescribed for adults (57%), with the most common diagnosis being amyotrophic lateral sclerosis (84%). Changes in peak cough flow and vital capacity were the most common reasons for LVR prescription. Maximal insufflation capacity was reportedly measured by 58% of PTs and 22% of SLPs. Chest wall soreness and discomfort were the most common side effects, and many respondents did not provide warnings about potential side effects (42% PTs and 50% SLPs). The study highlighted common use of other respiratory therapy devices alongside LVR. <b>Conclusion:</b> LVR is available in routine clinical and home care settings in Brazil. There is a lack of standardization regarding indications, prescription, and outcome measures among PTs and SLPs in Brazil. Clear recommendations and guidelines are needed to standardize these parameters, enabling more objective data and facilitating comparisons between centers.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2025 ","pages":"4073171"},"PeriodicalIF":2.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Trends of Artificial Intelligence in Lung Cancer: A Combined Approach of Analysis With Latent Dirichlet Allocation and HJ-Biplot Statistical Methods.","authors":"Javier De La Hoz-M, Karime Montes-Escobar, Viorkis Pérez-Ortiz","doi":"10.1155/pm/5911646","DOIUrl":"10.1155/pm/5911646","url":null,"abstract":"<p><p>Lung cancer (LC) remains one of the leading causes of cancer-related mortality worldwide. With recent technological advances, artificial intelligence (AI) has begun to play a crucial role in improving diagnostic and treatment methods. It is crucial to understand how AI has integrated into LC research and to identify the main areas of focus. The aim of the study was to provide an updated insight into the role of AI in LC research, analyzing evolving topics, geographical distribution, and contributions to journals. The study explores research trends in AI applied to LC through a novel approach combining latent Dirichlet allocation (LDA) topic modeling with the HJ-Biplot statistical technique. A growing interest in AI applications in LC oncology was observed, reflected in a significant increase in publications, especially after 2017, coinciding with the availability of computing resources. <i>Frontiers in Oncology</i> leads in publishing AI-related LC research, reflecting rigorous investigation in the field. Geographically, China and the United States lead in contributions, attributed to significant investment in R&D and corporate sector involvement. LDA analysis highlights key research areas such as pulmonary nodule detection, patient prognosis prediction, and clinical decision support systems, demonstrating the impact of AI in improving LC outcomes. DL and AI emerge as prominent trends, focusing on radiomics and feature selection, promising better decision-making in LC care. The increase in AI-driven research covers various topics, including data analysis methodologies, tumor characterization, and predictive methods, indicating a concerted effort to advance LC research. HJ-Biplot visualization reveals thematic clustering, illustrating temporal and geographical associations and highlighting the influence of high-impact journals and countries with advanced research capabilities. This multivariate approach offers insights into global collaboration dynamics and specialization, emphasizing the evolving role of AI in LC research and diagnosis.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"5911646"},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice Variations in the Diagnosis and Treatment of Pulmonary Embolism.","authors":"Devesh Thakkar, Frances Garden, John Nguyen, Brenda Ta, Sikandar Hussaini, Claudia C Dobler","doi":"10.1155/2024/6633148","DOIUrl":"https://doi.org/10.1155/2024/6633148","url":null,"abstract":"<p><p>Venous thromboembolism is responsible for a significant burden of disease worldwide. Despite the publication of multiple international guidelines, anecdotal evidence suggests significant clinical variation exists in the diagnostic and management pathways of pulmonary embolism (PE). We conducted a retrospective cohort study using electronic medical records to examine clinical variation in patients admitted to a tertiary referral center in Australia with a diagnosis of PE between November 2018 and January 2020. Three hundred cases met the inclusion criteria; we found variation in rates of compression ultrasonography, acute investigation of the right ventricle, and planning of repeat imaging at specialist follow-up. Guidelines do not address the use of compression ultrasonography in already diagnosed PE, are conflicting in their recommendation for acute investigation of the right ventricle, and recommend repeat imaging only if there are persistent symptoms at the time of specialist follow-up. The variations we found in this study may in part be due to physician preference or due to the paucity of evidence for some of these diagnostic practices. Robust future studies are required to guide the use of these investigations in PE.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"6633148"},"PeriodicalIF":2.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of COVID-19 Pandemic on Respiratory Syncytial Virus Infection in Children.","authors":"Jose Boris Trigueros Montes, Diego Montes, Andrew Miele, Won Baik-Han, Gagan Gulati, Lily Q Lew","doi":"10.1155/2024/2131098","DOIUrl":"10.1155/2024/2131098","url":null,"abstract":"<p><p><b>Background/Objective:</b> Respiratory syncytial virus (RSV) is a major cause of bronchiolitis in infants and young children. Bronchiolitis, an acute inflammation of the lower respiratory tract, can lead to pneumonia, respiratory failure, and death. We aimed to compare the incidence and severity of RSV infection in children aged 0-60 months before and during the coronavirus disease 2019 (COVID-19) pandemic. <b>Methods:</b> A retrospective chart review was conducted on patients aged 0-60 months who tested positive for RSV between May 1, 2018, and May 31, 2022, in a community hospital in Queens County, New York City, United States. Comparisons were made between seasons 2018-2019 and 2019-2020 as before, and seasons 2020-2021 and 2021-2022 as during the COVID-19 pandemic. Severity of RSV infection was assessed using the Bronchiolitis Severity Score (BSS). Data were analyzed using R software, a <i>p</i> value of < 0.05 was considered statistically significant. <b>Results:</b> The incidence of RSV infection in seasons 2018-2019 and 2019-2020 peaked from mid-October to February, whereas the first season during the COVID-19 pandemic (2020-2021) was truncated with a very low incidence of RSV infection, and season 2021-2022 peaked from September to January, with the highest incidence (37%) and lower frequency of RSV infection at any given point. Patients during the season 2021-2022 were older (<i>H</i> [2, 196.6] = 12.5, <i>p</i> < 0.001, 95% <i>CI</i> = [5.4, 25.6]) and had milder illness (<i>H</i> [2, 187.5] = 7.5, <i>p</i> < 0.01, 95% <i>CI</i> = [2.1, 19.2]). <b>Conclusions:</b> We observed a lower incidence of RSV infection and a lower rate of hospitalization for RSV during the COVID-19 pandemic. The second RSV season during the COVID-19 pandemic began earlier, lasted longer, and had a lower frequency. Older children with milder illnesses were affected most during this season. RSV epidemiology and disease burden were impacted by the COVID-19 pandemic and could have significant ramifications for its prevention and control strategies.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"2131098"},"PeriodicalIF":2.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-Task Performance in Individuals With Chronic Obstructive Pulmonary Disease: A Systematic Review With Meta-Analysis.","authors":"Joselyn González Pasten, Jennifer Campos Aguayo, Javiera Aburto, Felipe Araya-Quintanilla, Alejandro Álvarez-Bustos, Juan José Valenzuela-Fuenzalida, Pat G Camp, Walter Sepúlveda-Loyola","doi":"10.1155/2024/1230287","DOIUrl":"10.1155/2024/1230287","url":null,"abstract":"<p><p><b>Background:</b> Chronic obstructive pulmonary disease (COPD) is characterized by important extrapulmonary alterations that could affect the performance in dual task (DT) (motor and cognitive tasks executed simultaneously), which is defined as DT interference (DTI). <b>Objective:</b> To compare the performance of DT between individuals with COPD and healthy control subjects (HCSs). <b>Methods:</b> The literature search was conducted in seven databases (Medline, Scopus, Web of Science, PEDro, SciELO, LILACS, and Google Scholar) up to December 2023, including studies published in English, Spanish, or Portuguese. Studies with individuals diagnosed with COPD older than 60 years, who were evaluated with any DT assessment, and compared with HCS were included. The quality of the studies was evaluated using the risk of bias in nonrandomized studies of interventions (ROBINS-I). The meta-analysis was performed with JAMOVI software 5.4. The study protocol was registered on PROSPERO (CRD42023435212). <b>Results:</b> From a total of 128 articles, 5 observational studies were selected in this review, involving 252 individuals aged between 60 and 80 years, from France, Italy, Canada, Turkey, and Belgium. Notable DTI was observed in individuals with COPD compared to HCS (standard mean difference [SMD] = 0.91; 95% confidence interval (CI) 0.06-1.75, <i>p</i> = 0.04). Individuals with COPD had impaired gait speed, balance control, muscle strength, and cognitive interference during DT compared to HCS. DT assessment protocols included different combination of motor and cognitive tasks, using functional test, gait analysis, and muscle strength paired with countdown and verbal fluency tasks. Studies presented low (<i>n</i> = 2), moderate (<i>n</i> = 1), and serious (<i>n</i> = 2) overall risk of bias. <b>Conclusion:</b> Older adults diagnosed with COPD exhibited a significant DTI compared to HCSs, which is characterized by poorer physical and cognitive performance during DT execution. These findings highlight the importance of incorporating DT assessments into clinical practice for individuals with COPD.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"1230287"},"PeriodicalIF":2.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the Safety and Efficacy of Bedaquiline-Containing Regimen for the Treatment of Drug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Muhammad Candragupta Jihwaprani, Yipeng Sun, Wahyu Choirur Rizky, Idris Sula, Nazmus Saquib","doi":"10.1155/2024/5542658","DOIUrl":"10.1155/2024/5542658","url":null,"abstract":"<p><p>The risks and benefits of bedaquiline (BDQ) for treatment of drug-resistant tuberculosis (DR-TB) have not been firmly established. We aimed to assess the safety and efficacy of BDQ-containing regimens for the treatment of DR-TB as evidenced in available randomized controlled trials (RCTs). In this systematic review and meta-analysis, five databases (i.e., ClinicalTrials.gov, Cochrane CENTRAL, PubMed, ScienceDirect, and SinoMed) were searched. RCTs among DR-TB patients that had a control arm were eligible. The safety endpoints were all-cause mortality and serious adverse effects (SAEs). Efficacy outcomes were sputum culture conversion rate at 8-12 weeks and 24-26 weeks, treatment success, and time to culture conversion. A total of 476 records were screened; 18 met the eligibility criteria. The pooled analysis included 2520 participants (55.8% received BDQ-containing regimens, <i>n</i> = 1408). Pooled safety outcomes showed no significant reduction in all-cause mortality (relative risk [RR] [95%confidence interval (CI)] = 0.94 [0.41-2.20]) or SAEs (RR [95%CI] = 0.91 [0.67-1.23]) in the BDQ-regimen group. Pooled efficacy outcomes showed significantly superior culture conversion rates at 8-12 weeks (RR [95%CI] = 1.35 [1.10-1.65]) and 24-26 weeks (RR [95%CI] = 1.25 [1.15-1.36]), more treatment success (RR [95%CI] = 1.30 [1.17-1.44]), and a 17-day reduction in the time to culture conversion (standardized mean difference [SMD] [95%CI] = -17.46 [-34.82 to -0.11]) in the BDQ-regimen group (reference: non-BDQ regimen). Overall, BDQ regimens showed significant treatment effect against DR-TB but did not reduce mortality or SAEs.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"5542658"},"PeriodicalIF":2.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to the ISHLT Protocol for the Referral of Patients with Idiopathic Pulmonary Fibrosis to the Transplantation Center among of Czech Centers for Interstitial Lung Diseases.","authors":"Martina Sterclova, Martina Doubkova, Lubica Sykorova, Vladimir Bartos, Monika Zurkova, Vladimira Lostakova, Radka Mokosova, Martina Plackova, Ladislav Lacina, Michaela Cimrova, Radka Bittenglova, Pavlina Lisa, Pavla Musilova, Daniel Dolezal, Jana Psikalova, Petra Ovesna, Martina Koziar Vasakova","doi":"10.1155/2024/5918042","DOIUrl":"10.1155/2024/5918042","url":null,"abstract":"<p><p>There are limited data on referral rates and the number of patients with idiopathic pulmonary fibrosis (IPF) who are eligible for lung transplantation. The aim of the present study was to assess adherence to the consensus of the International Society for Heart and Lung Transplantation (ISHLT) for the referral of patients with IPF among Czech interstitial lung disease (ILD) centers. Czech patients who were diagnosed with IPF between 1999 and 2021 (<i>n</i> = 1584) and who were less than 65 years old at the time of diagnosis were retrospectively selected from the Czech Republic of the European Multipartner Idiopathic Pulmonary Fibrosis Registry (EMPIRE). Nonsmokers and ex-smokers with a body mass index (BMI) of <32 kg/m² (<i>n</i> = 404) were included for further analyses. Patients with a history of cancer <5 years from the time of IPF diagnosis, patients with alcohol abuse, and patients with an accumulation of vascular comorbidities were excluded. The trajectory of individual patients was verified at the relevant ILD center. From the database of transplant patients (1999-12/2021, <i>n</i> = 541), all patients who underwent transplantation for pulmonary fibrosis (<i>n</i> = 186) were selected, and the diagnosis of IPF was subsequently verified from the patient's medical records (<i>n</i> = 67). A total of 304 IPF patients were eligible for lung transplantation. Ninety-six patients were referred to the transplant center, 50% (<i>n</i> = 49) of whom were referred for lung transplantation. Thirty percent of potentially eligible patients not referred to the transplant center were considered to have too many comorbidities by the reporting physician, 19% of IPF patients denied lung transplantation, and 17% were not referred due to age. Among Czech patients with IPF, there may be a larger pool of potential lung transplant candidates than has been reported to the transplant center to date.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"5918042"},"PeriodicalIF":2.0,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilothorax: A Case Report and Systematic Literature Review of the Rare Entity.","authors":"Roshan Acharya, Smita Kafle, Yub Raj Sedhai, Dhan Bahadur Shrestha, Kevin Walsh, Wasif Elahi Shamsi, Suraj Gyawali, Nikita Acharya, Anthony Lukas Loschner, Edmundo Raul Rubio","doi":"10.1155/2024/3973056","DOIUrl":"10.1155/2024/3973056","url":null,"abstract":"<p><strong>Background: </strong>Bilothorax is defined as the presence of bile in the pleural space. It is a rare condition, and diagnosis is confirmed with a pleural fluid-to-serum bilirubin ratio of >1.</p><p><strong>Methods: </strong>The PubMed, Embase, Google Scholar, and CINAHL databases were searched using predetermined Boolean parameters. The systematic literature review was done per PRISMA guidelines. Retrospective studies, case series, case reports, and conference abstracts were included. The patients with reported pleural fluid analyses were pooled for fluid parameter data analysis.</p><p><strong>Results: </strong>Of 838 articles identified through the inclusion criteria and removing 105 duplicates, 732 articles were screened with abstracts, and 285 were screened for full article review. After this, 123 studies qualified for further detailed review, and of these, 115 were pooled for data analysis. The mean pleural fluid and serum bilirubin levels were 72 mg/dL and 61 mg/dL, respectively, with a mean pleural fluid-to-serum bilirubin ratio of 3.47. In most cases, the bilothorax was reported as a subacute or remote complication of hepatobiliary surgery or procedure, and traumatic injury to the chest or abdomen was the second most common cause. Tube thoracostomy was the main treatment modality (73.83%), followed by serial thoracentesis. Fifty-two patients (51.30%) had associated bronchopleural fistulas. The mortality was considerable, with 18/115 (15.65%) reported death. Most of the patients with mortality had advanced hepatobiliary cancer and were noted to die of complications not related to bilothorax.</p><p><strong>Conclusion: </strong>Bilothorax should be suspected in patients presenting with pleural effusion following surgical manipulation of hepatobiliary structures or a traumatic injury to the chest. This review is registered with CRD42023438426.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"3973056"},"PeriodicalIF":2.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11213635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Imaging Characteristics of Smear Negative Pulmonary Tuberculosis Patients: A Comparative Study.","authors":"Alem Alemayehu, Liya Wassie, Sebsib Neway, Samuel Ayele, Abraham Assefa, Kidist Bobosha, Beyene Petros, Rawleigh Howe","doi":"10.1155/2024/2182088","DOIUrl":"10.1155/2024/2182088","url":null,"abstract":"<p><strong>Background: </strong>Prevalence surveys in Ethiopia indicate smear negative pulmonary tuberculosis (SNPTB) taking the major share of the overall TB burden. It has also been a diagnostic dilemma worldwide leading to diagnostic delays and difficulty in monitoring treatment outcomes. This study determines and compares the clinical and imaging findings in SNPTB and smear positive PTB (SPPTB). <i>Methodology</i>. A case-control study was conducted on 313 PTB (173 SNPTB) patients. Data and sputum samples were collected from consented patients. Smear microscopy, GeneXpert, and culture analyses were performed on sputum samples. Data were analyzed using Stata version 17; a <i>P</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 173 SNPTB patients, 42% were culture positive with discordances between test results reported by health facilities and Armauer Hansen Research Institute laboratory using concentrated smear microscopy. A previous history of TB and fewer cavitary lesions were significantly associated with SNPTB.</p><p><strong>Conclusions: </strong>Though overall clinical presentations of SNPTB patients resemble those seen in SPPTB patients, a prior history of TB was strongly associated with SNPTB. Subject to further investigations, the relatively higher discrepancies seen in TB diagnoses reflect the posed diagnostic challenges in SNPTB patients, as a higher proportion of these patients are also seen in Ethiopia.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"2182088"},"PeriodicalIF":4.3,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Cohort Study Evaluating the Safety and Efficacy of Sequential versus Concurrent Intrapleural Instillation of Tissue Plasminogen Activator and DNase for Pleural Infection","authors":"K. Goh, Wui Mei Chew, J. Ong, C. Leong, Imran Bin Mohamed Noor, D. Anantham, Li Yan Sandra Hui, Mindy Chu Ming Choong, Charlene Jin Yee Liew, Marnie Tamayo Gutierrez, Jane Wong, Ivana Phua, Wen Ting Lim, Qiao Li Tan","doi":"10.1155/2023/6340851","DOIUrl":"https://doi.org/10.1155/2023/6340851","url":null,"abstract":"Background and Objective. Intrapleural tissue plasminogen activator/deoxyribonuclease (tPA/DNase) is increasingly being used for pleural infections. Compared to sequential instillation of tPA/DNase, concurrent instillation considerably reduces the complexity of the administration process and reduces workload and the number of times the chest drain is accessed. However, it remains unclear if concurrent intrapleural therapy is as efficacious or safe as sequential intrapleural therapy. Methods. We conducted a retrospective review of patients with pleural infection requiring intrapleural therapy at two tertiary referral centres. Results. We included 84 (62.2%) and 51 (37.8%) patients who received sequential and concurrent intrapleural therapy, respectively. Patient demographics and clinical characteristics, including age, RAPID score, and percentage of pleural opacity on radiographs before intrapleural therapy, were similar in both groups. Treatment failure rates (defined by either in-hospital mortality, surgical intervention, or 30-day readmission for pleural infection) were 9.5% and 5.9% with sequential and concurrent intrapleural therapy, respectively (\u0000 \u0000 p\u0000 =\u0000 0.534\u0000 \u0000 ). This translates to a treatment success rate of 90.5% and 94.1% for sequential and concurrent intrapleural therapy, respectively. There was no significant difference in the decrease in percentage of pleural effusion size on chest radiographs (15.1% [IQR 6-35.7] versus 26.6% [IQR 9.9-38.7], \u0000 \u0000 p\u0000 =\u0000 0.143\u0000 \u0000 ) between sequential and concurrent therapy, respectively. There were also no significant differences in the rate of pleural bleeding (4.8% versus 9.8%, \u0000 \u0000 p\u0000 =\u0000 0.298\u0000 \u0000 ) and chest pain (13.1% versus 9.8%, \u0000 \u0000 p\u0000 =\u0000 0.566\u0000 \u0000 ) between sequential and concurrent therapy, respectively. Conclusion. Our study adds to the growing literature on the safety and efficacy of concurrent intrapleural therapy in pleural infection.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":" 41","pages":""},"PeriodicalIF":4.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963554","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}