African Journal of Thoracic and Critical Care Medicine最新文献

{"title":"Pulmonary hypertension and the potential of ‘drug’ repurposing: A case for African medicinal plants","authors":"S. Jacobs, MSc MB ChB, MSc C Payne, S. Shaboodien, BSc Hons, T. Kgatla, BSc Pretorius, C. Hons, BSc Jumaar, G. Hons, MSc Maarman, PhD O Sanni, G. Maarman","doi":"10.7196/ajtccm.2024.v30i2.1352","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.1352","url":null,"abstract":"\u0000\u0000\u0000\u0000Pulmonary hypertension (PH) is a haemodynamic disorder in which elevated blood pressure in the pulmonary circulation is caused by abnormal vascular tone. Despite advances in treatment, PH mortality remains high, and drug repurposing has been proposed as a mitigating approach. This article reviews the studies that have investigated drug repurposing as a viable option for PH. We provide an overview of PH and highlight pharmaceutical drugs with repurposing potential, based on limited evidence of their mechanisms of action. Moreover, studies have demonstrated the benefits of medicinal plants in PH, most of which are of Indian or Asian origin. Africa is a rich source of many medicinal plants that have been scientifically proven to counteract myriad pathologies. When perusing these studies, one will notice that some African medicinal plants can counteract the molecular pathways (e.g. proliferation, vasoconstriction, inflammation, oxidative stress and mitochondrial dysfunction) that are also involved in the pathogenesis of PH. We review the actions of these plants with actions applicable to PH and highlight that they could be repurposed as adjunct PH therapies. However, these plants have either never been tested in PH, or there is little evidence of their actions against PH. We therefore encourage caution, as more research is needed to study these plants further in experimental models of PH while acknowledging that the outcomes of such proof- of-concept studies may not always yield promising findings. Regardless, this article aims to stimulate future research that could make timely contributions to the field.\u0000\u0000\u0000\u0000","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for smoking cessation counselling and nicotine with- drawal therapy for hospitalised patients: A smoking point preva- lence study at Groote Schuur Hospital, Cape Town, South Africa","authors":"G. Soin, J. Kok, A. Allie, Q. Bhawoodien, K. Dheda, A. Geragotellis, K. Mulisa, A. Sibi, T. Tarwa, F. Leone, R. Van Zyl-Smit","doi":"10.7196/ajtccm.2024.v30i2.1360","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.1360","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. South Africa has high tobacco-attributable mortality and a smoking prevalence of 32.5% in males and 25.6% in females. There are limited data on smoking prevalence and desire to quit in hospitalised patients, who have limited access to smoking cessation services.\u0000Objectives. To determine smoking prevalence and the extent of nicotine withdrawal symptoms, using a hospital-wide inpatient survey.\u0000Methods. A 1-day point prevalence survey was conducted at Groote Schuur Hospital, Cape Town. All wards except the haematology isolation, active labour and psychiatry lock-up wards were evaluated. Smoking status, withdrawal symptoms and desire to quit were established.\u0000Results. Smoking status was confirmed in 85.8% of inpatients (n=501/584), of whom 31.9% (n=160) were current smokers; 43.5% (n=101/232) of male and 21.9% (n=59/269) of female inpatients were smokers. Documentation and confirmation of smoking status was highest in the maternity wards (100%) and lowest in the surgical wards (79.6%) and intensive care units (70.0%). Smoking prevalence ranged from 47.6% in male surgical patients to 15.2% in maternity patients. Of the smokers, 54.5% reported being motivated to quit, with a median (interquartile range) Fagerström test for nicotine dependence score of 4 (2 - 6), and 31.4% reported moderate to severe cravings to smoke, highest in the surgical wards.\u0000Conclusion. Smoking prevalence was higher in hospitalised patients than in the local general population. Many inpatients were not interested in quitting; however, a third had significant nicotine withdrawal symptoms. All inpatients who are active smokers should be identified and given universal brief smoking cessation advice. Patients with severe withdrawal symptoms should be allowed to smoke outside, and nicotine withdrawal pharmacotherapy should be provided to those who are bedbound or express a desire to stop smoking during the current admission.\u0000\u0000\u0000\u0000","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal necrosis after sandwich immunotherapy and stereotactic body radiotherapy for lung cancer","authors":"S. M. Bennji, B. Jayakrishnan, Z. Al- Hashami, L. Mula-Hussain, R. B. Telugu","doi":"10.7196/ajtccm.2024.v30i2.1620","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.1620","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe lower respiratory tract infections are associated with human adenovirus in hospitalised children in a high HIV prevalence area","authors":"N. Marafungana, FC MB ChB, K. Naidoo, PhD Gounder, MMed Virol Viro, R. Masekela, MMed Paed MB BCh, Cert Pulmonology, PhD Paed","doi":"10.7196/ajtccm.2024.v30i2.1208","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.1208","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. Viral causes of lower respiratory tract infections (LRTIs) are associated with increased mortality in children aged <5 years (U5). Human adenovirus (HAdV) has been associated with severe LRTI; however, its relationship with HIV and malnutrition in South Africa (SA) is not understood.Objectives. To identify the prevalence of and factors associated with HAdV LRTIs in hospitalised U5 childen.\u0000Methods. Clinical and viral data on U5 children hospitalised with severe LRTI from January 2018 to June 2020 at King Edward VIII Hospital, Durban, SA, including results of a multiplex polymerase chain reaction (PCR) panel assay for respiratory viruses, were retrieved from inpatient files and laboratory databases and retrospectively analysed. Standard descriptive statistics and Pearson’s χ2, Fisher’s exact and Mann-Whitney tests were used to determine significant associations with HAdV LRTI.\u0000Results. Among the 206 viral assays analysed (15.6% of all LRTI admissions), HAdV was the most common virus identified. The cohort had a median (interquartile range) age of 5 (2 - 13) months, 47.3% had perinatal HIV exposure, and 34.5% had severe acute malnutrition (SAM). No seasonal pattern with HAdV could be demonstrated. SAM and prematurity were significant risk factors for readmission, and perinatal HIV exposure was a significant risk factor for presence of multiple viruses on analysis of a respiratory specimen. Detection of HAdV was not associated with an increased risk of requiring oxygen or ventilatory support.\u0000Conclusion. HAdV was the most common virus found on analysis of multiplex PCR panel results in children hospitalised with severe LRTI in SA, where high rates of HIV exposure may result in increased susceptibility to viral co-infections. The role of HAdV as a cause of severe LRTI in SA infants, who have high rates of HIV exposure, requires greater scrutiny.\u0000\u0000\u0000\u0000","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the aetiology of lower respiratory tract illness in children","authors":"L. Thaver, H. J. Zar","doi":"10.7196/ajtccm.2024.v30i2.2378","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.2378","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of acute post-intubation respiratory failure.","authors":"L C Costa, J Fernandes, N Príncipe, J A Paiva","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332185","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":"Foreign body aspiration in children: Challenges, insights, and pathways forward","authors":"P. Goussard, E. Eber","doi":"10.7196/ajtccm.2024.v30i2.2380","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.2380","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking cessation for hospitalised inpatients: Butt where do we begin?","authors":"N. Singh, C. F. N. Koegelenberg","doi":"10.7196/ajtccm.2024.v30i2.2379","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.2379","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheobronchial foreign body aspiration in children in Soweto, South Africa: A retrospective descriptive study","authors":"A. Moola, MB BCh, C. Verwey, FC MB ChB, Cert Pulmonology, PhD Paed, Mabaso, K. Mopeli, Z. Dangor","doi":"10.7196/ajtccm.2024.v30i2.1145","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.1145","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. Airway foreign bodies are a common cause of accidental death in children. Tracheobronchial foreign body aspiration (FBA) can result in severe immediate and long-term complications if the foreign body is not identified and removed. Little is known about the burden of tracheobronchial FBA in the Soweto area, south of Johannesburg, South Africa.Objectives. To describe the burden and clinical characteristics of tracheobronchial FBA in hospitalised children in a tertiary-level hospital in Johannesburg.\u0000Methods. This was a retrospective, single-centre, descriptive study of children aged <10 years who presented to Chris Hani Baragwanath Academic Hospital from 1 January 2011 to 31 December 2020. Children with FBA were identified from the paediatric pulmonology and paediatric surgery databases using the relevant International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), codes (T17.4 and T17.5). Clinical and radiological data were extracted from medical records and the databases.Results. Forty-seven children with FBA were identified during the study period. Overall, the incidence of FBA among children aged <10 years of age was 1.42 per 100 000 person-years (95.0% confidence interval 1.04 - 1.88). FBA occurred more commonly in males (66.0%; n=31), and the mean (standard deviation) age at presentation was 68 (28.2) months. Most of the children (42.6%) were in the 7 - <10-year age group, followed by the 5 - <7-year age group (27.7%). Chronic respiratory symptoms were reported in one-third of the children, and a history of witnessed FBA was reported in only 59.6% of cases. Inorganic foreign bodies (n=29; 61.7%) were aspirated more commonly than organic foreign bodies; these included metal objects such as pins or springs (21.3%), toy parts (17.0%), pen or pencil lids/ stoppers (12.8%) and plastic objects (6.4%).Conclusion. Our study highlights the fact that tracheobronchial FBA is prevalent in school-aged children, and public safety campaigns targeted at this age group are warranted. Furthermore, to prevent sequelae, a high index of suspicion in required in children with respiratory symptoms that fail to respond to appropriate therapy.\u0000\u0000\u0000\u0000","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on lung cancer presentation at a high-volume tertiary referral centre in South Africa","authors":"I. Fredericks, E. Irusen, B. Allwood, C. F. N. Koegelenberg","doi":"10.7196/ajtccm.2024.v30i2.1031","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.1031","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. The COVID-19 pandemic had a significant impact on health services globally. Cancer diagnosis and treatment was one of the services most frequently reported to be disrupted. Several international studies showed a marked reduction in the number of new lung cancer cases.Objectives. To assess the impact of the COVID-19 pandemic on lung cancer diagnosis at a high-volume tertiary referral centre in South Africa.\u0000Methods. A retrospective audit was conducted of all patients with primary lung cancer who were presented at the multidisciplinary oncology meeting at Tygerberg Hospital, Cape Town, from January 2018 to December 2021, and the incidence of lung cancer was compared between two cohorts: one prior to and one during the COVID-19 pandemic. We collected data on patient demographics, as well as performance status. A combined panel staged all patients.\u0000Results. During the COVID-19 pandemic there was a relative reduction of 46% in the frequency of lung cancer, from a mean of 25.6 cases per month to 13.9. Patients referred during the COVID-19 pandemic had statistically better performance status (75.0% v. 25.0% with performance status 0 - 2; p=0.01) and were more likely to have adenocarcinoma (49.7% v. 41.1%; p=0.02) than those referred before the pandemic. The proportion of potentially curable lung cancer at presentation (i.e. stages I - IIIA) did not differ between the two cohorts.\u0000Conclusion. The COVID-19 pandemic resulted in a substantial decrease in the number of new lung cancers diagnosed. Patients who were diagnosed with lung cancer during the pandemic had better performance status and were more likely to have adenocarcinoma. No impact on the proportion of potential curable disease was noted.\u0000\u0000\u0000\u0000","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680641","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}