Pulmonary Medicine最新文献_第9页

Guiding Inspiratory Flow: Development of the In-Check DIAL G16, a Tool for Improving Inhaler Technique. 引导吸气流动:改进吸入器技术的一种工具-在检DIAL G16的开发。

IF 4.3

Pulmonary Medicine Pub Date : 2017-01-01 Epub Date: 2017-11-16 DOI: 10.1155/2017/1495867

Mark Jeremy Sanders

{"title":"Guiding Inspiratory Flow: Development of the In-Check DIAL G16, a Tool for Improving Inhaler Technique.","authors":"Mark Jeremy Sanders","doi":"10.1155/2017/1495867","DOIUrl":"https://doi.org/10.1155/2017/1495867","url":null,"abstract":"Portable inhalers are divisible into those that deliver medication by patient triggering (pMDIs: a gentle slow inhalation) and those that use the patient's inspiratory effort as the force for deaggregation and delivery (DPIs: a stronger deeper inspiratory effort). Patient confusion and poor technique are commonplace. The use of training tools has become standard practice, and unique amongst these is an inspiratory flow meter (In-Check) which is able to simulate the resistance characteristics of different inhalers and, thereby, guide the patient to the correct effort. In-Check's origins lie in the 1960s peak expiratory flow meters, the development of the Mini-Wright peak flow meter, and inspiratory flow assessment via the nose during the 1970s-1980s. The current device (In-Check DIAL G16) is the third iteration of the original 1998 training tool, with detailed and ongoing assessments of all common inhaler resistances (including combination and breath-actuated inhaler types) summarised into resistance ranges that are preset within the device. The device works by interpolating one of six ranges with the inspiratory effort. Use of the tool has been shown to be contributory to significant improvements in asthma care and control, and it is being advocated for assessment and training in irreversible lung disease.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1495867","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35749047","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}

引用次数: 53

Tomographic Aspects of Advanced Active Pulmonary Tuberculosis and Evaluation of Sequelae following Treatment. 晚期活动性肺结核的断层扫描和治疗后后遗症的评价。

IF 4.3

Pulmonary Medicine Pub Date : 2017-01-01 Epub Date: 2017-02-05 DOI: 10.1155/2017/9876768

Rafael Barcelos Capone, Domenico Capone, Thiago Mafort, Roberto Mogami, Rosana de Souza Rodrigues, Miriam Menna Barreto, Rogerio Rufino

{"title":"Tomographic Aspects of Advanced Active Pulmonary Tuberculosis and Evaluation of Sequelae following Treatment.","authors":"Rafael Barcelos Capone, Domenico Capone, Thiago Mafort, Roberto Mogami, Rosana de Souza Rodrigues, Miriam Menna Barreto, Rogerio Rufino","doi":"10.1155/2017/9876768","DOIUrl":"https://doi.org/10.1155/2017/9876768","url":null,"abstract":"Objectives. To evaluate tomographic changes in pulmonary tuberculosis (TB), degree of agreement among three radiologists regarding tomographic diagnoses, and sequelae following treatment. Methods. Cross-sectional and descriptive study of 74 TB patients confirmed by sputum culture and chest computed tomography before (CT1) and 6 months after (CT2) drug therapy. Results were performed by three radiologists blinded to clinical and laboratory results. Results. Main findings in CT1 included nodules indicating the presence of a tree-in-bud pattern in 93% of cases, ill-defined nodules in 84% of cases, consolidation in 77% of cases, architectural distortion in 71% of cases, cavitary lesions in 62% of cases, and ground glass opacities in 37% of cases. Airway involvement, characterized by increased thickness and dilatation of the bronchial walls, occurred in 93% of cases. Pleural involvement occurred in 54%. There was an agreement on active TB among the three radiologists in 85% of cases. The results in CT2 indicated the presence of architectural distortion in 91% of cases and cylindrical bronchiectasis in 86%. Conclusions. The study established a tomographic pattern for diagnosis of active TB characterized by the presence of airway nodules, consolidation, architectural distortion, and cavitary lesions, and an almost complete degree of agreement (Kappa) was observed among the radiologists (0.85). CT after treatment assists in defining the cure.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/9876768","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34784035","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}

引用次数: 13

Role of Transbronchial Lung Cryobiopsies in Diffuse Parenchymal Lung Diseases: Interest of a Sequential Approach. 经支气管肺低温活检在弥漫性肺实质疾病中的作用:序贯方法的兴趣。

IF 4.3

Pulmonary Medicine Pub Date : 2017-01-01 Epub Date: 2017-04-20 DOI: 10.1155/2017/6794343

Benjamin Bondue, Thierry Pieters, Patrick Alexander, Paul De Vuyst, Maria Ruiz Patino, Delphine Hoton, Myriam Remmelink, Dimitri Leduc

{"title":"Role of Transbronchial Lung Cryobiopsies in Diffuse Parenchymal Lung Diseases: Interest of a Sequential Approach.","authors":"Benjamin Bondue, Thierry Pieters, Patrick Alexander, Paul De Vuyst, Maria Ruiz Patino, Delphine Hoton, Myriam Remmelink, Dimitri Leduc","doi":"10.1155/2017/6794343","DOIUrl":"https://doi.org/10.1155/2017/6794343","url":null,"abstract":"Background. Transbronchial lung cryobiopsies (TBLCs) are a promising diagnostic tool in the setting of diffuse parenchymal lung diseases (DPLDs). However, no comparison with surgical lung biopsy (SLB) in the same patient is available. Methods. The diagnostic yield and safety data of TBLCs, as well as the result of SLB performed after TBLCs, were analysed in a multicentric Belgian study. A SLB was performed after TBLCs in absence of a definite pathological diagnosis or if a NSIP pattern was observed without related condition identified following multidisciplinary discussion. Results. Between April 2015 and November 2016, 30 patients were included. Frequent complications included pneumothorax (20%) and bleeding (severe 7%, moderate 33%, and mild 53%). There was no mortality. The overall diagnostic yield was 80%. A SLB was performed in six patients (three without definite histological pattern and three with an NSIP). The surgical biopsy changed the pathological diagnosis into a UIP pattern in five patients and confirmed a NSIP pattern in one patient. Conclusion. TBLCs are useful in the diagnostic work-up of DPLDs avoiding a SLB in 80% of the patients. However, surgical biopsies, performed as a second step after TBLCs because of an indefinite diagnosis or a NSIP pattern, provide additional information supporting the interest of a sequential approach in these patients.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/6794343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35003852","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}

引用次数: 24

Guideline-Based Early Detection of Chronic Obstructive Pulmonary Disease in Eight Danish Municipalities: The TOP-KOM Study. 丹麦八个城市基于指南的慢性阻塞性肺病早期检测：TOP-KOM 研究。

IF 4.3

Pulmonary Medicine Pub Date : 2017-01-01 Epub Date: 2017-02-20 DOI: 10.1155/2017/7620397

Ulla Borup Hemmingsen, Margit Stycke, Jens Dollerup, Peter Bo Poulsen

{"title":"Guideline-Based Early Detection of Chronic Obstructive Pulmonary Disease in Eight Danish Municipalities: The TOP-KOM Study.","authors":"Ulla Borup Hemmingsen, Margit Stycke, Jens Dollerup, Peter Bo Poulsen","doi":"10.1155/2017/7620397","DOIUrl":"10.1155/2017/7620397","url":null,"abstract":"Background. Early detection of chronic obstructive pulmonary disease (COPD) and prevention of disease progression are important. Only 40% of COPD cases are diagnosed in Denmark. Recommendations for early case finding have been established. This study investigates early detection of pulmonary obstruction in a Danish municipality setting. Methods. Eight municipalities participated. Citizens fulfilling national case finding recommendations, age ≥35 years, smokers/ex-smokers/relevant occupational exposure, and at least one respiratory symptom, were invited to spirometry. Citizens with indication of pulmonary obstruction, forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) < 0.70, were referred to their general practitioner (GP). Results. 1,499 citizens were examined (53.6% male, mean age 57.2 years). 44.8% were current smokers with 57% planning for smoking cessation. The citizens recorded significant airway symptoms with dyspnea being the most important (71%). The mean FEV1/FVC score was 73.54 (SD 22.84). 456 citizens (30.4%) were found to have indication for pulmonary obstruction and were referred to GP for further diagnosis. Conclusion. Early detection in Danish municipalities proved effective finding nearly 1/3 being pulmonary obstructive. It seems to be of value to have municipalities to perform case finding together with smoking cessation as a primary intervention in COPD management.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34835906","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}

引用次数: 0

Electronic Cigarettes for Curbing the Tobacco-Induced Burden of Noncommunicable Diseases: Evidence Revisited with Emphasis on Challenges in Sub-Saharan Africa 电子烟用于遏制烟草引起的非传染性疾病负担:重新审视证据，重点关注撒哈拉以南非洲的挑战

IF 4.3

Pulmonary Medicine Pub Date : 2016-12-25 DOI: 10.1155/2016/4894352

J. R. Nansseu, J. Bigna

{"title":"Electronic Cigarettes for Curbing the Tobacco-Induced Burden of Noncommunicable Diseases: Evidence Revisited with Emphasis on Challenges in Sub-Saharan Africa","authors":"J. R. Nansseu, J. Bigna","doi":"10.1155/2016/4894352","DOIUrl":"https://doi.org/10.1155/2016/4894352","url":null,"abstract":"Introduction. This review examines whether electronic cigarettes (e-cigs) implementation or vulgarization in sub-Saharan Africa (SSA) could be helpful in curtailing the toll of tobacco smoking in the region. Discussion. There are about 1.3 billion smokers worldwide, with nearly 80% of them living in developing countries where the burden of tobacco-related illnesses and deaths is the heaviest. Studies report that e-cigs may facilitate smoking cessation, reduction, or abstinence and may pose only a small fraction of the risks of traditional tobacco cigarettes; e-cigs may also considerably reduce second-hand smoking. Thereby, implementation of e-cig use could help to substantially reduce the burden driven by tobacco smoking in SSA, in a particular context of lack of regulations and control policies towards this threat. However, the evidence is not clear on whether e-cigs are risk-free, especially if used in the long term. Conclusions. On the whole, if e-cigs were to be introduced in SSA, they should be strictly recommended to current and/or ex-smokers as a method to quit smoking or prevent relapse and never-smokers should be strongly encouraged to avoid using these devices. Bans on sales of e-cigs to youngsters should be legislated, e-cig advertisements prohibited, and their usage continuously controlled and monitored.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2016-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83055656","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}

引用次数: 4

Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis 用于打鼾和阻塞性睡眠呼吸暂停的鼻扩张器(正确呼吸条和NoZovent):系统回顾和荟萃分析

IF 4.3

Pulmonary Medicine Pub Date : 2016-12-13 DOI: 10.1155/2016/4841310

M. Camacho, O. Malu, Y. Kram, G. Nigam, M. Riaz, Sungjin A. Song, Anthony M. Tolisano, C. Kushida

{"title":"Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis","authors":"M. Camacho, O. Malu, Y. Kram, G. Nigam, M. Riaz, Sungjin A. Song, Anthony M. Tolisano, C. Kushida","doi":"10.1155/2016/4841310","DOIUrl":"https://doi.org/10.1155/2016/4841310","url":null,"abstract":"Objective. To systematically review the international literature for studies evaluating internal (NoZovent) and external (Breathe Right Strips) nasal dilators as treatment for obstructive sleep apnea (OSA). Study Design. Systematic review with meta-analysis. Methods. Four databases, including PubMed/MEDLINE, were searched through September 29, 2016. Results. One-hundred twelve studies were screened, fifty-eight studies were reviewed, and fourteen studies met criteria. In 147 patients, the apnea-hypopnea index (AHI) was reported, and there was an improvement from a mean ± standard deviation (M ± SD) of 28.7 ± 24.0 to 27.4 ± 23.3 events/hr, p value 0.64. There was no significant change in AHI, lowest oxygen saturation, or snoring index in OSA patients when using nasal dilators. However, a subanalysis demonstrated a slight reduction in apnea index (AI) with internal nasal dilators (decrease by 4.87 events/hr) versus minimal change for external nasal dilators (increase by 0.64 events/hr). Conclusion. Although nasal dilators have demonstrated improved nasal breathing, they have not shown improvement in obstructive sleep apnea outcomes, with the exception of mild improvement in apnea index when internal nasal dilators were used.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2016-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82293841","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}

引用次数: 27

Protease Inhibitors Extracted from Caesalpinia echinata Lam. Affect Kinin Release during Lung Inflammation 棘荆芥蛋白酶抑制剂的提取。影响肺部炎症时激肽的释放

IF 4.3

Pulmonary Medicine Pub Date : 2016-12-01 DOI: 10.1155/2016/9425807

Ilana Cruz-Silva, V. A. Nunes, A. J. Gozzo, Priscila Praxedes-Garcia, A. Tanaka, K. Shimamoto, M. Araujo

{"title":"Protease Inhibitors Extracted from Caesalpinia echinata Lam. Affect Kinin Release during Lung Inflammation","authors":"Ilana Cruz-Silva, V. A. Nunes, A. J. Gozzo, Priscila Praxedes-Garcia, A. Tanaka, K. Shimamoto, M. Araujo","doi":"10.1155/2016/9425807","DOIUrl":"https://doi.org/10.1155/2016/9425807","url":null,"abstract":"Inflammation is an essential process in many pulmonary diseases in which kinins are generated by protease action on kininogen, a phenomenon that is blocked by protease inhibitors. We evaluated kinin release in an in vivo lung inflammation model in rats, in the presence or absence of CeKI (C. echinata kallikrein inhibitor), a plasma kallikrein, cathepsin G, and proteinase-3 inhibitor, and rCeEI (recombinant C. echinata elastase inhibitor), which inhibits these proteases and also neutrophil elastase. Wistar rats were intravenously treated with buffer (negative control) or inhibitors and, subsequently, lipopolysaccharide was injected into their lungs. Blood, bronchoalveolar lavage fluid (BALF), and lung tissue were collected. In plasma, kinin release was higher in the LPS-treated animals in comparison to CeKI or rCeEI groups. rCeEI-treated animals presented less kinin than CeKI-treated group. Our data suggest that kinins play a pivotal role in lung inflammation and may be generated by different enzymes; however, neutrophil elastase seems to be the most important in the lung tissue context. These results open perspectives for a better understanding of biological process where neutrophil enzymes participate and indicate these plant inhibitors and their recombinant correlates for therapeutic trials involving pulmonary diseases.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89585721","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}

引用次数: 4

Early-Phase Recovery of Cardiorespiratory Measurements after Maximal Cardiopulmonary Exercise Testing in Patients with Chronic Obstructive Pulmonary Disease 慢性阻塞性肺疾病患者最大心肺运动试验后心肺测量的早期恢复

IF 4.3

Pulmonary Medicine Pub Date : 2016-11-27 DOI: 10.1155/2016/9160781

M. Bellefleur, D. Debeaumont, A. Boutry, Marie Netchitailo, A. Cuvelier, J. Muir, C. Tardif, J. Coquart

{"title":"Early-Phase Recovery of Cardiorespiratory Measurements after Maximal Cardiopulmonary Exercise Testing in Patients with Chronic Obstructive Pulmonary Disease","authors":"M. Bellefleur, D. Debeaumont, A. Boutry, Marie Netchitailo, A. Cuvelier, J. Muir, C. Tardif, J. Coquart","doi":"10.1155/2016/9160781","DOIUrl":"https://doi.org/10.1155/2016/9160781","url":null,"abstract":"Background. This study investigated respiratory gas exchanges and heart rate (HR) kinetics during early-phase recovery after a maximal cardiopulmonary exercise test (CPET) in patients with chronic obstructive pulmonary disease (COPD) grouped according to airflow limitation. Methods. Thirty control individuals (control group: CG) and 81 COPD patients (45 with “mild” or “moderate” airflow limitation, COPDI-II, versus 36 with “severe” or “very severe” COPD, COPDIII-IV) performed a maximal CPET. The first 3 min of recovery kinetics was investigated for oxygen uptake (V˙O2), minute ventilation (V˙E), respiratory equivalence, and HR. The time for V˙O2 to reach 25% (T1/4 V˙O2) of peak value was also determined and compared. Results. The V˙O2, V˙E, and HR recovery kinetics were significantly slower in both COPD groups than CG (p < 0.05). Moreover, COPDIII-IV group had significantly higher V˙O2 and V˙E during recovery than COPDI-II group (p < 0.05). T1/4 V˙O2 significantly differed between groups (p < 0.01; 58 ± 18 s in CG, 79 ± 26 s in COPDI-II group, and 121 ± 34 s in COPDIII-IV) and was significantly correlated with forced expiratory volume in one second in COPD patients (p < 0.001, r = 0.53) and with peak power output (p < 0.001, r = 0.59). Conclusion. The COPD groups showed slower kinetics in the early recovery period than CG, and the kinetics varied with severity of airflow obstruction.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2016-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78791784","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}

引用次数: 4

When Women with Cystic Fibrosis Become Mothers: Psychosocial Impact and Adjustments 当患有囊性纤维化的妇女成为母亲:心理社会影响和调整

IF 4.3

Pulmonary Medicine Pub Date : 2016-11-23 DOI: 10.1155/2016/9458980

S. Cammidge, A. Duff, G. Latchford, C. Etherington

{"title":"When Women with Cystic Fibrosis Become Mothers: Psychosocial Impact and Adjustments","authors":"S. Cammidge, A. Duff, G. Latchford, C. Etherington","doi":"10.1155/2016/9458980","DOIUrl":"https://doi.org/10.1155/2016/9458980","url":null,"abstract":"Advances in the treatment and life expectancy of cystic fibrosis (CF) patients mean that motherhood is now a realistic option for many women with CF. This qualitative study explored the psychosocial impact and adjustments made when women with CF become mothers. Women with CF (n = 11) were recruited via an online forum and participated in semistructured telephone interviews about their experiences of becoming a mother. Transcriptions were analysed using Grounded Theory. Analysis revealed three core categories: (i) “Living with CF”: how becoming a mother impacted on health and treatment adherence, requiring a change in support from the CF team, (ii) “Becoming a Mother”: balancing issues common to new mothers with their CF, and (iii) “Pooling Personal Resources”: coping strategies in managing the dual demands of child and CF care. Participants experienced a variety of complex psychosocial processes. Most participants acknowledged an initial negative impact on CF care; however over time they reported successful adaptation to managing dual commitments and that adherence and motivation to stay well had improved. This study highlights the need for preconceptual psychosocial counselling and postpartum adjustment to CF care.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2016-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86178426","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}

引用次数: 14

Diagnosis of Peripheral Lung Lesions via Conventional Flexible Bronchoscopy with Multiplanar CT Planning 常规柔性支气管镜多平面CT规划诊断肺周围性病变

IF 4.3

Pulmonary Medicine Pub Date : 2016-11-13 DOI: 10.1155/2016/5048961

Marianne Anastasia De Roza, Kien Hong Quah, Cheong Kiat Julian Tay, W. Toh, Huihua Li, Ganesh Kalyanasundaram, D. Anantham

{"title":"Diagnosis of Peripheral Lung Lesions via Conventional Flexible Bronchoscopy with Multiplanar CT Planning","authors":"Marianne Anastasia De Roza, Kien Hong Quah, Cheong Kiat Julian Tay, W. Toh, Huihua Li, Ganesh Kalyanasundaram, D. Anantham","doi":"10.1155/2016/5048961","DOIUrl":"https://doi.org/10.1155/2016/5048961","url":null,"abstract":"Background. Conventional flexible bronchoscopy has limited sensitivity in the diagnosis of peripheral lung lesions and is dependent on lesion size. However, advancement of CT imaging offers multiplanar reconstruction facilitating enhanced preprocedure planning. This study aims to report efficacy and safety while considering the impact of patient selection and multiplanar CT planning. Method. Prospective case series of patients with peripheral lung lesions suspected of having lung cancer who underwent flexible bronchoscopy (forceps biopsy and lavage). Endobronchial lesions were excluded. Patients with negative results underwent CT-guided transthoracic needle aspiration, surgical biopsy, or clinical-radiological surveillance to establish the final diagnosis. Results. 226 patients were analysed. The diagnostic yield of bronchoscopy was 80.1% (181/226) with a sensitivity of 84.2% and specificity of 100%. In patients with a positive CT-Bronchus sign, the diagnostic yield was 82.4% compared to 72.8% with negative CT-Bronchus sign (p = 0.116). Diagnostic yield was 84.9% in lesions > 20 mm and 63.0% in lesions ≤ 20 mm (p = 0.001). Six (2.7%) patients had transient hypoxia and 2 (0.9%) had pneumothorax. There were no serious adverse events. Conclusion. Flexible bronchoscopy with appropriate patient selection and preprocedure planning is more efficacious in obtaining a diagnosis in peripheral lung lesions compared to historical data. This trial is registered with ClinicalTrials.gov Identifier: NCT01374542.","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2016-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84775229","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}

引用次数: 12