Pulmonary Medicine最新文献

{"title":"Neutrophil Oxidized-Modified Proteins and Neutrophil Extracellular Traps in Patients with Community-Acquired Pneumonia.","authors":"Vilen Molotov-Luchanskiy,&nbsp;Altynbek Nukhuly,&nbsp;Larissa Muravlyova,&nbsp;Ryszhan Bakirova,&nbsp;Aruna Kossybayeva,&nbsp;Dmitry Klyuyev,&nbsp;Ludmila Demidchik,&nbsp;Irina Beinikova","doi":"10.1155/2020/4897038","DOIUrl":"https://doi.org/10.1155/2020/4897038","url":null,"abstract":"<p><strong>Materials and methods: </strong>51 patients with CAP were divided into 2 groups depending on the severity of the pathological process. The first group (I) consisted of 32 patients with moderate severity of pneumonia. The second group (II) consisted of 19 patients with severe pneumonia. The third group (III), the comparison group, consisted of 14 CAP patients with chronic obstructive pulmonary disease (COPD). The control group consisted of 19 volunteers.</p><p><strong>Results: </strong>Statistically significant increase in the level of carbonyl derivatives (CD) in patients of all study groups relative to the control group was revealed. In the group of patients with moderate severity and severe pneumonia, also in CAP patients with COPD, the level of CD exceeded the control group. There was no statistically significant difference in the level of advanced oxidation protein products (AOPP) and myeloperoxidase (MPO) in blood neutrophils between the studied groups.</p><p><strong>Conclusion: </strong>Results indicate an oxidative imbalance in neutrophils and contribute to the worsening of the course of the disease.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4897038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38453475","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 Effect of Smoking on COVID-19 Symptom Severity: Systematic Review and Meta-Analysis.","authors":"Askin Gülsen,&nbsp;Burcu Arpinar Yigitbas,&nbsp;Berat Uslu,&nbsp;Daniel Drömann,&nbsp;Oguz Kilinc","doi":"10.1155/2020/7590207","DOIUrl":"https://doi.org/10.1155/2020/7590207","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SAR2-COV-2) and was first identified in Wuhan, China, in December of 2019, but quickly spread to the rest of the world, causing a pandemic. While some studies have found no link between smoking status and severe COVID-19, others demonstrated a significant one. The present study aimed to determine the relationship between smoking and clinical COVID-19 severity via a systematic meta-analysis approach.</p><p><strong>Methods: </strong>We searched the Google Scholar, PubMed, Scopus, Web of Science, and Embase databases to identify clinical studies suitable for inclusion in this meta-analysis. Studies reporting smoking status and comparing nonsevere and severe patients were included. Nonsevere cases were described as mild, common type, nonintensive care unit (ICU) treatment, survivors, and severe cases as critical, need for ICU, refractory, and nonsurvivors.</p><p><strong>Results: </strong>A total of 16 articles detailing 11322 COVID-19 patients were included. Our meta-analysis revealed a relationship between a history of smoking and severe COVID-19 cases (OR = 2.17; 95% CI: 1.37-3.46; <i>P</i> < .001). Additionally, we found an association between the current smoking status and severe COVID-19 (OR = 1.51; 95% CI: 1.12-2.05; <i>P</i> < .008). In 10.7% (978/9067) of nonsmokers, COVID-19 was severe, while in active smokers, severe COVID-19 occurred in 21.2% (65/305) of cases.</p><p><strong>Conclusion: </strong>Active smoking and a history of smoking are clearly associated with severe COVID-19. The SARS-COV-2 epidemic should serve as an impetus for patients and those at risk to maintain good health practices and discontinue smoking. The trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) CRD42020180173.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7590207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38409453","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":"Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies.","authors":"Ademola S Ojo, Simon A Balogun, Oyeronke T Williams, Olusegun S Ojo","doi":"10.1155/2020/6175964","DOIUrl":"10.1155/2020/6175964","url":null,"abstract":"<p><p>Although pulmonary fibrosis can occur in the absence of a clear-cut inciting agent, and without a clinically clear initial acute inflammatory phase, it is more commonly associated with severe lung injury. This may be due to respiratory infections, chronic granulomatous diseases, medications, and connective tissue disorders. Pulmonary fibrosis is associated with permanent pulmonary architectural distortion and irreversible lung dysfunction. Available clinical, radiographic, and autopsy data has indicated that pulmonary fibrosis is central to severe acute respiratory distress syndrome (SARS) and MERS pathology, and current evidence suggests that pulmonary fibrosis could also complicate infection by SARS-CoV-2. The aim of this review is to explore the current literature on the pathogenesis of lung injury in COVID-19 infection. We evaluate the evidence in support of the putative risk factors for the development of lung fibrosis in the disease and propose risk mitigation strategies. We conclude that, from the available literature, the predictors of pulmonary fibrosis in COVID-19 infection are advanced age, illness severity, length of ICU stay and mechanical ventilation, smoking and chronic alcoholism. With no proven effective targeted therapy against pulmonary fibrosis, risk reduction measures should be directed at limiting the severity of the disease and protecting the lungs from other incidental injuries.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38313256","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":"Epidemiology of COVID-19 and Predictors of Recovery in the Republic of Korea.","authors":"Ashis Kumar Das,&nbsp;Saji Saraswathy Gopalan","doi":"10.1155/2020/7291698","DOIUrl":"https://doi.org/10.1155/2020/7291698","url":null,"abstract":"<p><strong>Background: </strong>The recent COVID-19 pandemic has emerged as a threat to global health. Though current evidence on the epidemiology of the disease is emerging, very little is known about the predictors of recovery.</p><p><strong>Objectives: </strong>To describe the epidemiology of confirmed COVID-19 patients in the Republic of Korea and identify predictors of recovery.</p><p><strong>Materials and methods: </strong>Using publicly available data for confirmed COVID-19 cases from the Korea Centers for Disease Control and Prevention from January 20, 2020, to April 30, 2020, we undertook descriptive analyses of cases stratified by sex, age group, place of exposure, date of confirmation, and province. Correlation was tested among all predictors (sex, age group, place of exposure, and province) with Pearson's correlation coefficient. Associations between recovery from COVID-19 and predictors were estimated using a multivariable logistic regression model.</p><p><strong>Results: </strong>Majority of the confirmed cases were females (56%), 20-29 age group (24.3%), and primarily from three provinces-Gyeongsangbuk-do (36.9%), Gyeonggi-do (20.5%), and Seoul (17.1%). The case fatality ratio was 2.1%, and 41.6% cases recovered. Older patients, patients from provinces such as Daegu, Gyeonggi-do, Gyeongsangbuk-do, Jeju-do, Jeollabuk-do, and Jeollanam-do, and those contracting the disease from healthcare settings had lower recovery.</p><p><strong>Conclusions: </strong>Our study adds to the very limited evidence base on potential predictors of recovery among confirmed COVID-19 cases. We call additional research to explore the predictors of recovery and support development of policies to protect the vulnerable patient groups.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7291698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38247838","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":"Assessment of Asthma Control and Quality of Life among Asthmatic Patients Attending Armed Forces Referral and Teaching Hospital, Addis Ababa, Ethiopia.","authors":"Tesfalidet Gebremeskel Zeru,&nbsp;Ephrem Engidawork,&nbsp;Alemseged Beyene Berha","doi":"10.1155/2020/5389780","DOIUrl":"https://doi.org/10.1155/2020/5389780","url":null,"abstract":"<p><strong>Background: </strong>The primary goal of asthma management is to achieve good asthma control. However, poor patient-physician communication, unavailability of appropriate medications, and lack of long-term goals have made asthma control difficult in developing countries. Poor assessment of asthma control and quality of life is a major cause of suboptimal asthma treatment worldwide, and information regarding this issue is scanty in developing countries like Ethiopia. This study thus attempted to assess the level of asthma control and quality of life in asthmatic patients attending Armed Forces Referral and Teaching Hospital.</p><p><strong>Methods: </strong>A cross-sectional study comprising 184 physician-diagnosed asthmatic patients was conducted using interview, chart review, and prescription assessment. Asthma control was assessed using Asthma Control Test, while asthma quality of life was assessed using Mini-Asthma Quality of Life Questionnaire (mini-AQLQ). Spearman's rank correlation analysis was performed to understand the relationship between mean mini-AQLQ score and asthma control. Receiver operating characteristic curve analysis was performed to establish cut-off values for mini-AQLQ.</p><p><strong>Results: </strong>Asthma was uncontrolled in 67.9% subjects. There was a strong correlation between asthma control and quality of life (rs = 0.772; <i>P</i> < 0.01). A cut-off value for the quality of life was established at 4.97. Majority of the patients were taking two or three antiasthmatic drugs. Oral tablet and inhaler short-acting beta agonists (SABA) were the frequently combined drugs. Uncontrolled asthma was associated with middle-aged adults (adjusted odds ratio (AOR) = 6.31; 95% CI: 2.06, 19.3; <i>P</i> = 0.001), male gender (AOR = 0.38; 95% CI: 0.15, 0.98; <i>P</i> = 0.044), married (AOR = 0.24; 95% CI: 0.08, 0.78; <i>P</i> = 0.017), comorbidities (AOR = 0.23; 95% CI: 0.09, 0.61; <i>P</i> = 0.003), and oral SABA use (AOR = 0.22; 95% CI: 0.09, 0.59; <i>P</i> = 0.003). Male gender (AOR = 0.36; 95% CI: 0.16, 0.84; <i>P</i> = 0.018), intermittent asthma (AOR = 0.18; 95% CI: 0.04, 0.86; <i>P</i> = 0.032), use of oral corticosteroids (AOR = 0.22; 95% CI: 0.06, 0.73; <i>P</i> = 0.013), and SABA (AOR = 0.39; 95% CI: 0.17, 0.89; <i>P</i> = 0.026) were found to have a significant association with poor asthma-related quality of life.</p><p><strong>Conclusion: </strong>The findings collectively indicate asthma remains poorly controlled in a large proportion of asthma patients in the study setting. Moreover, quality of life appears to be directly related to asthma control. Healthcare providers should therefore focus on asthma education with an integrated treatment plan to improve asthma control and quality of life.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5389780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38269531","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":"Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations.","authors":"Zsófia Lázár,&nbsp;Alpár Horváth,&nbsp;Gábor Tomisa,&nbsp;Lilla Tamási,&nbsp;Veronika Müller","doi":"10.1155/2020/6164343","DOIUrl":"https://doi.org/10.1155/2020/6164343","url":null,"abstract":"<p><strong>Purpose: </strong>The health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) is worsened by frequent exacerbations, and it can be affected by the concomitant presence of bronchial asthma (asthma-COPD overlap (ACO)). The impacts of clinical factors associated with HRQL have not been compared in patients with COPD and ACO experiencing exacerbations. <i>Patients and Methods</i>. Patients with COPD (<i>N</i> =705) and ACO (<i>N</i> =148) belonging to C and D groups according to GOLD 2017 were recruited in stable condition. Demographic and clinical data were collected, spirometry was performed, and patients rated the intensity of respiratory symptoms during the previous week. The COPD Assessment Test (CAT) and the EQ-5D 3 level version (dimensions and visual analogue scale (VAS)) were used to assess disease-specific and generic HRQL, respectively. Fisher's exact test, <i>χ</i> ² test, ANOVA, and Pearson correlation were used for analysis (mean ± SD). Multiple linear regression was applied to identify variables related to CAT and EQ-5D VAS scores.</p><p><strong>Results: </strong>The CAT and EQ-5D VAS scores showed similarly low HRQL in COPD and ACO (20.7 ± 6.7 vs. 21.1 ± 6.3 (<i>p</i> = 0.52) and 56.2 ± 17.8 vs. 53.7 ± 18.2 (<i>p</i> = 0.11)). There was a weak correlation between CAT and EQ-5D VAS scores (COPD: <i>r</i> = -0.345, <i>p</i> < 0.001; ACO: <i>r</i> = -0.245, <i>p</i> = 0.003). More patients with COPD had problems related to anxiety/depression in EQ-5D (63.7% vs. 55.4%, <i>p</i> = 0.06). Pack-years exerted a negative effect on HRQL measures both in ACO and COPD. Low HRQL in COPD was associated with female gender, dyspnea, cough, gastroesophageal reflux disease, and arrhythmia, while in ACO, it was related to arrhythmia, hypertension, and cough, but less to dyspnea.</p><p><strong>Conclusions: </strong>Patients with COPD and ACO experiencing exacerbations have low quality of life, which is influenced by smoking history, symptoms, and comorbidities. These findings have important implications for the development of therapeutic strategies to improve the health status of patients with these conditions.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6164343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38267327","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":"Noninvasive Neurally Adjusted Ventilator Assist Ventilation in the Postoperative Period Produces Better Patient-Ventilator Synchrony but Not Comfort.","authors":"L O Harnisch,&nbsp;U Olgemoeller,&nbsp;J Mann,&nbsp;M Quintel,&nbsp;O Moerer","doi":"10.1155/2020/4705042","DOIUrl":"https://doi.org/10.1155/2020/4705042","url":null,"abstract":"Background Noninvasive neurally adjusted ventilatory assist (NAVA) has been shown to improve patient-ventilator interaction in many settings. There is still scarce data with regard to postoperative patients indicated for noninvasive ventilation (NIV) which this study elates. The purpose of this trial was to evaluate postoperative patients for synchrony and comfort in noninvasive pressure support ventilation (NIV-PSV) vs. NIV-NAVA. Methods Twenty-two subjects received either NIV-NAVA or NIV-PSV in an object-blind, prospective, randomized, crossover fashion (observational trial). We evaluated blood gases and ventilator tracings throughout as well as comfort of ventilation at the end of each ventilation phase. Results There was an effective reduction in ventilator delays (p < 0.001) and negative pressure duration in NIV-NAVA as compared to NIV-PSV (p < 0.001). Although we used optimized settings in NIV-PSV, explaining the overall low incidence of asynchrony, NIV-NAVA led to reductions in the NeuroSync-index (p < 0.001) and all types of asynchrony except for double triggering that was significantly more frequent in NIV-NAVA vs. NIV-PSV (p = 0.02); ineffective efforts were reduced to zero by use of NIV-NAVA. In our population of previously lung-healthy subjects, we did not find differences in blood gases and patient comfort between the two modes. Conclusion In the postoperative setting, NIV-NAVA is well suitable for use and effective in reducing asynchronies as well as a surrogate for work of breathing. Although increased synchrony was not transferred into an increased comfort, there was an advantage with regard to patient-ventilator interaction. The trial was registered at the German clinical Trials Register (DRKS no.: DRKS00005408).","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4705042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38144992","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":"Patient Delay in Initiating Tuberculosis Treatment and Associated Factors in Oromia Special Zone, Amhara Region.","authors":"Muhammed Abdu,&nbsp;Awraris Balchut,&nbsp;Eshetu Girma,&nbsp;Wondwosen Mebratu","doi":"10.1155/2020/6726798","DOIUrl":"https://doi.org/10.1155/2020/6726798","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is a major global public health problem. The disease is a leading cause of morbidity and mortality in Ethiopia. Early identification of cases and commencement of effective chemotherapy is an effective method to control the spread of tuberculosis. Delay in diagnosis and starting tuberculosis treatment increases severity, risk of mortality, and transmission of the disease in the community.</p><p><strong>Objective: </strong>The purpose of this study is to assess the magnitude of patient delay in initiating tuberculosis treatment and its associated factors among tuberculosis patients in health facilities of Oromia Special Zone, Ethiopia.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted in Oromia Special Zone. Data were collected using pretested questionnaires from patients with tuberculosis who are on treatment during the study period. The simple random sampling method was used to select health facilities and study participants. Data were entered using Epi Info version 7.2 and analyzed by SPSS version 23. Bivariate and multivariate logistic regression analyses were used to see the significance of association between the outcome and independent variables. A <i>P</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Three hundred and eighty-seven tuberculosis patients aged 18 years and above enrolled in the study. Among these, 223 (57.6%) were males, 194 (50.1%) were married, and 206 (53.2%) lived in rural areas. The mean age of respondents was 35 years. The median patient delay was 35 (IQR = 30) days, and 54.4% of patients seek their first consultation after 21 days. Patients who have a basic schooling level (AOR = 0.45, 95% CI: 0.23, 0.89) compared with the college/university level, long distance greater than 10 km (AOR = 3.23, 95% CI: 1.97, 5.42), seeking treatment from informal source and private drug stores (AOR = 3.01, 95% CI: 1.52, 5.95), extrapulmonary tuberculosis (AOR = 2.30, 95% CI: 1.26, 4.23), and poor knowledge about tuberculosis (AOR = 1.58, 95% CI: 1.01, 2.49) were associated factors that predict patient delay. <i>Conclusion and Recommendation</i>. A significant proportion of tuberculosis patients delayed to seek treatment. Health promotion and education involving different stake holders will make the community create awareness about tuberculosis that could help reduce delays in initiating tuberculosis treatment.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6726798","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38078153","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":"Predictive Value of Pleural Cytology in the Diagnosis of Complicated Parapneumonic Effusions and Empyema Thoracis.","authors":"John Ferguson,&nbsp;Michal Kazimir,&nbsp;Michael Gailey,&nbsp;Frank Moore,&nbsp;Earl Schott","doi":"10.1155/2020/7175451","DOIUrl":"https://doi.org/10.1155/2020/7175451","url":null,"abstract":"<p><strong>Introduction: </strong>Complicated parapneumonic effusions (CPE) are distinguished from uncomplicated parapneumonic effusions (UPE) by the ability to resolve without drainage. Determinants include pleural pH, pleural glucose, and pleural LDH, along with microbiologic cultures. Inflammation mediated by neutrophil chemotactic cytokines leads to fibrinous loculation of an effusion, and the degree of this inflammation may lead to a CPE. One role of the pathologist is to evaluate for the presence of malignancy in a pleural effusion; however, the ability of the pathologist to distinguish a CPE from UPE has not been evaluated.</p><p><strong>Materials and methods: </strong>A single-center retrospective study was performed on pleural cytology specimens from 137 patients diagnosed with a parapneumonic effusion or empyema over a five-year interval. Pleural cytology was characterized as either uncomplicated or complicated by two pathologists based on cellular composition and the presence or absence of fibrinous exudate in the fluid. Cohen's kappa was calculated for interobserver agreement. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cytologic diagnoses were calculated. Determinants of cytologic accuracy were assessed using Wilcoxon rank sum test, unpaired <i>t</i>-test, and logistic regression.</p><p><strong>Results: </strong>Kappa interobserver agreement between pathologists was 0.753. Pleural fluid cytology sensitivity, specificity, PPV, and NPV for CPE/empyema were 76.0%, 95% CI [65.0, 84.9]; 50%, 95% CI [29.1, 70.9]; 83.3%, 95% CI [76.7, 88.4]; and 38.7%, 95% CI [26.5, 52.5], respectively. The presence of pleural bacteria, elevated pleural LDH, and reduced pleural pH were nonsignificant determinants of cytologic accuracy. Logistic regression was significant for the presence of pleural bacteria (<i>p</i> = 0.03) in determining a successful cytologic diagnosis.</p><p><strong>Conclusion: </strong>Pleural cytology adds little value to traditional markers of distinguishing a UPE from CPE. Inflammation on pleural fluid cytology is suggestive of empyema or the presence of pleural fluid bacteria.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7175451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38027333","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":"Comment on \"Comparison of Diaphragmatic Stretch Technique and Manual Diaphragm Release Technique on Diaphragmatic Excursion in Chronic Obstructive Pulmonary Disease: A Randomized Crossover Trial\".","authors":"Bruno Bordoni","doi":"10.1155/2020/7437019","DOIUrl":"https://doi.org/10.1155/2020/7437019","url":null,"abstract":"","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2020-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7437019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38027334","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}