Lung India最新文献

{"title":"Lung ultrasound score versus HACOR score as a predictor for weaning outcome in patients at high risk for extubation failure.","authors":"M Rathish, M K Renuka, Nvsn Prasant, Baby Sailaja","doi":"10.4103/lungindia.lungindia_583_24","DOIUrl":"10.4103/lungindia.lungindia_583_24","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary complications from mechanical ventilation are a significant concern in intensive care. Reducing the duration of respiratory support is vital to minimize these risks. Extubation, the final step in the weaning process, is critical. Most weaning indices rely on complex ventilatory parameters. This study aimed to evaluate the utility of the heart rate, acidosis, Glasgow Coma Scale, oxygenation, respiratory rate (HACOR) score, and Lung Ultrasound Score (LUS) as predictors of weaning outcomes in the intensive care unit.</p><p><strong>Methods: </strong>This prospective observational study was conducted in the Department of Critical Care Medicine at Sri Ramachandra Institute of Higher Education and Research, involving 100 patients aged 18 years and above. Both the HACOR score and LUS were assessed at the 30th minute during a 60-minute spontaneous breathing trial (SBT).</p><p><strong>Results: </strong>Of the 100 patients, 65 (65%) were successfully weaned, while 35 (35%) experienced weaning failure. The median HACOR score was 3 (interquartile range: 0-3) in the successful group and 6 (IQR: 5-8) in the failed group. The median LUS was 10 (IQR: 8-10) in the successful group and 16 (IQR: 13-16) in the failed group. A HACOR score ≥5 predicted weaning failure with a sensitivity of 87.7%, specificity of 77.1%, and area under the curve of 0.824. The LUS had an area under curve of 0.831, sensitivity of 86.2%, specificity of 80% at a threshold of ≥13 for failure.</p><p><strong>Conclusion: </strong>A HACOR score of ≥5 and a Lung Ultrasound Score of ≥13 are excellent predictors of weaning failure and can be incorporated into ICU weaning strategies.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"211-217"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040914","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":"Human papilloma virus vaccine induced Kikuchi-Fujimoto disease: A case report.","authors":"Benhur Joel Shadrach, Lexmi Priya Raju, Asma Bibi, Kunal Deokar, Priyanka Gaikwad, Jinish Doshi","doi":"10.4103/lungindia.lungindia_557_24","DOIUrl":"10.4103/lungindia.lungindia_557_24","url":null,"abstract":"<p><strong>Abstract: </strong>Cervical lymphadenopathy can be due to numerous causes. The common causes include reactive and infections conditions in children and malignancy in the elderly. Kikuchi-Fujimoto disease (KFD) is a rare cause of cervical lymphadenopathy. As viral vaccines contain viral antigens, they can trigger the development of KFD. The human papillomavirus (HPV) vaccine can trigger KFD. It is important to elicit a history of prior vaccination to identify the trigger in patients with necrotising histiocytic lymphadenitis suspected of having KFD. We hereby report a case of a 16-year-old female who was diagnosed with HPV vaccine induced KFD. Ours is the first case to be reported from India. Histopathology revealed necrotising histiocytic lymphoid hyperplasia and the absence of neutrophils, eosinophils, plasma cells, vessel wall vasculitis, haematoxylin bodies, and Reed-Sternberg cells, and negative aerobic, MTB cultures, anti-nuclear antibodies, clinched the diagnosis of KFD.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"256-259"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054548","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 rare vascular anomaly.","authors":"Manu Chopra, Ritwik Chakrabarty, Saikat Sarkar","doi":"10.4103/lungindia.lungindia_516_24","DOIUrl":"10.4103/lungindia.lungindia_516_24","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"260-261"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989631","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":"Response.","authors":"Anurag Tripathi, Ved Prakash","doi":"10.4103/lungindia.lungindia_142_25","DOIUrl":"10.4103/lungindia.lungindia_142_25","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"277-278"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001107","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 critical appraisal of the clinico-radiological, histopathological and immunohistochemical profile of CT-guided and bronchoscopy-guided biopsies in lung lesions.","authors":"Mukta Pujani, Ruchi Arora Sachdeva, S Zafar Abbas, Charu Agarwal, Minakshi Bhardwaj, Varsha Chauhan, Jyoti Rajpoot, Dipti Sidam, Aniruna Dey","doi":"10.4103/lungindia.lungindia_496_24","DOIUrl":"10.4103/lungindia.lungindia_496_24","url":null,"abstract":"<p><strong>Background: </strong>Lung biopsies are obtained by bronchoscopy or by percutaneous route under image guidance and usually have limited tissue material. It is quite challenging for a pathologist to make an accurate diagnosis of lung cancer using only a limited panel of immunohistochemical markers and mucin stains as well as spare as much tissue for molecular testing.Molecular testing for specific genetic mutations or biomarkers serves as an adjunct for more rational, targeted treatment regimens.</p><p><strong>Methods: </strong>All the consecutive image-guided lung biopsies (both computed tomography [CT] guided and bronchoscopy-guided) for a period of 3 years (2021-2024) were included in the study. The clinicopathological data was compiled from the hospital records, and histopathology and immunohistochemistry (IHC) were analysed critically for all lung carcinomas. Sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy were calculated for IHC markers.</p><p><strong>Results: </strong>There were 127 lung biopsies (117 bronchoscopic and 10 CT-guided biopsies) comprise of adenocarcinoma (30%), squamous cell carcinoma (25.2%), small-cell carcinoma (13.4%) and poorly differentiated carcinoma (6.3%). The concordance between clinico-radiological and pathological diagnosis was 85%. P40 (22/22 cases) and CK5/6 (10/10) were the most sensitive and specific markers for squamous cell carcinoma, while TTF-1 (35/36) and Napsin A (18/22) were the most sensitive IHC markers for adenocarcinoma. The most sensitive markers for small-cell carcinoma lung were synaptophysin (17/17), CD 56, NSE followed by chromogranin A (11/15).</p><p><strong>Conclusion: </strong>Integrating conventional histopathology with IHC results in accurate diagnosis, thereby avoiding a broad diagnosis of non-small-cell lung carcinoma (NSCLC). Subclassification of NSCLC has significant treatment implications, especially for advanced-stage tumours for which chemotherapy or targeted therapy is being considered. The focus should be on the judicious use of IHC based on histological type because of the limited availability of tissues in bronchoscopic and CT-guided biopsy specimens.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"218-224"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001537","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":"Pediatric mediastinal tuberculosis: Exploring the diagnostic precision of endobronchial ultrasound and ancillary investigations.","authors":"Manoj Madhusudan, Priyanka Potti, Kaustubh Mohite, Tejaswi Chandra, J T Srikanta","doi":"10.4103/lungindia.lungindia_288_24","DOIUrl":"10.4103/lungindia.lungindia_288_24","url":null,"abstract":"<p><strong>Background: </strong>Mediastinal Tuberculosis (TB), although a common presentation of TB in children, has a very low rate of microbiological confirmation. This is because of the difficulty in acquiring appropriate tissue samples for microbiological confirmation. Endobronchial ultrasound (EBUS) and esophageal ultrasound with a bronchoscope (EUS-B) offer a safe, effective, and minimally invasive modality of sampling in these children. We present our institutional experience on EBUS/EUSB and the various ancillary investigations for mediastinal TB.</p><p><strong>Methods: </strong>This is a single-center retrospective study among children who underwent EBUS/EUS-B for a mediastinal nodal lesion. The primary objective of the study was to analyze the diagnostic accuracy of histopathology and various microbiological investigations, through EBUS/EUS-B guided TBNA, in the diagnosis of mediastinal TB. The secondary objective was to ascertain the safety of EBUS/EUS-B.</p><p><strong>Results: </strong>A total of 50 children underwent EBUS/EUS-B at our center, of those 26 (17 girls, mean age 11.7 years) were diagnosed with mediastinal TB. Fever was the most common presenting symptom (85%) and only seven children (26%) had a concomitant pulmonary involvement. The diagnostic performance of various investigations was as follows: Acid-fast bacilli (AFB) smear (sensitivity - 86.6%, specificity - 82.9%, NPV-93.5%, PPV - 68.4%), Xpert Ultra (sensitivity -100%, specificity - 68.5%, NPV - 100%, PPV - 57.7%), and cytology (sensitivity - 100%, specificity - 82.9%, NPV - 100%, PPV - 71.4%). A microbiological confirmation was attained in 81% of the children. There were no major complications in any of the procedures.</p><p><strong>Conclusion: </strong>EBUS/EUSB is an effective and safe investigation for the diagnosis of mediastinal TB in children.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"199-203"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001539","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":"Histoplasmosis presenting as fibrosing mediastinitis and superior vena cava obstruction.","authors":"Sagar Poudel, Sanjeev Kumar, Saurabh Mittal, Preyas Sethi, Karan Madan","doi":"10.4103/lungindia.lungindia_485_24","DOIUrl":"10.4103/lungindia.lungindia_485_24","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"264-265"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021935","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":"Pleural fluid refractometry.","authors":"René A Flores-Franco, David R Flores-Aguilar","doi":"10.4103/lungindia.lungindia_30_25","DOIUrl":"10.4103/lungindia.lungindia_30_25","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 3","pages":"268-269"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050339","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":"An uncommon cause of acute hypercapnic respiratory failure managed with endoscopic ultrasound.","authors":"Vishal Raj, Aman Ahuja, Monika Gupta, Dhruva Chaudhry, Pawan Kumar Singh","doi":"10.4103/lungindia.lungindia_423_24","DOIUrl":"10.4103/lungindia.lungindia_423_24","url":null,"abstract":"<p><strong>Abstract: </strong>Mediastinal cysts can occasionally cause severe respiratory symptoms. A 60-year-old female smoker presented with acute hypercapnic respiratory failure. Imaging revealed a posterior mediastinal cyst compressing the trachea. Bronchoscopic ultrasound-guided fine needle aspiration (EUS-B FNA) provided both diagnostic clarity and symptomatic relief. This case underscores the importance of considering mediastinal cysts in differential diagnoses of acute respiratory distress and demonstrates the efficacy of EUS-B FNA for both diagnosis and immediate therapeutic intervention.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"151-154"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516984","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":"Case series of Y shaped self-expanding metallic stents (Y-SEMS) for central airway obstruction - Experience of deployment with 'Single Guide Wire' technique.","authors":"Rajiv Goyal, Manish Kumar Aggarwal, Chetan Nemani, Kedar Hibare, Jeenam Shah, Dhammdeep Kadam, Sagar Raiya, Abhijit Ahuja, Ajay Ravi, Anurag Deshpande, Ramasubramaniam Kottasiamy, Akhilesh Jain, Eshita Shah, Amit Jain, Sankar N Raman, Pankul Mangla, Arushi Chokhani, Avinash Murugan","doi":"10.4103/lungindia.lungindia_482_24","DOIUrl":"10.4103/lungindia.lungindia_482_24","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 2","pages":"166-170"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516994","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}