African Journal of Thoracic and Critical Care Medicine最新文献

{"title":"Respiratory technologists in the frontlines against COVID-19.","authors":"S D Maasdorp,&nbsp;M Pretorius,&nbsp;P Pienaar,&nbsp;E Rosslee,&nbsp;A Alexander,&nbsp;A van der Linde,&nbsp;C van Rooyen","doi":"10.7196/AJTCCM.2022.v28i2.210","DOIUrl":"https://doi.org/10.7196/AJTCCM.2022.v28i2.210","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic overwhelmed healthcare resources globally, but especially those of resource-limited countries. Strategies to supplement the number of healthcare workers attending COVID-19 patients had to be implemented. Several institutions used non-respiratory clinicians to work in COVID-19 wards. At Universitas Academic Hospital (UAH), Bloemfontein, South Africa, respiratory technologists were requested to assist with managing the oxygen supportive care of patients with severe COVID-19 and respiratory failure.</p><p><strong>Objectives: </strong>To highlight the contribution that respiratory technologists made in the management of severe COVID-19 pneumonia patients by describing the baseline characteristics and mortality of patients with COVID-19, whose oxygen supportive care was managed primarily by respiratory technologists at UAH.</p><p><strong>Methods: </strong>This was a retrospective study. The investigators extracted data from the hospital files of all adult patients admitted with severe COVID-19 to UAH and where respiratory technologists were involved in their care between 1 January and 31 December 2020.</p><p><strong>Results: </strong>A total of 781 patients were admitted to UAH, of whom 106 fulfilled the inclusion criteria. The majority of the patients were female (n=68; 64.1%), and the median age (interquartile range (IQR)) was 59.5 (51 - 68) years. Hypertension (n=69; 65.1%) and diabetes mellitus (n=39; 36.8%) were the most frequent comorbidities. At the time of admission, the median oxygen saturation was 92% and the median respiratory rate oxygenation (ROX) index was 3.2. The median length of stay was 7 days and the mortality was 41.5%.</p><p><strong>Conclusion: </strong>The clinical characteristics and mortality of patients whose oxygen support was managed by respiratory technologists were similar to those in previously reported studies from resource-limited settings. Respiratory technologists can form a valuable addition to the front-line team when clinicians and nurses are faced with overwhelming patient numbers in subsequent COVID-19 surges and where the mainstay of treatment is oxygen supportive care.</p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/c3/AJTCCM-28-2-210.PMC9366451.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40414674","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 comparison of lung cancer in HIV-positive and HIV-negative populations.","authors":"R Berman,&nbsp;A van Blydenstein,&nbsp;A Graham","doi":"10.7196/AJTCCM.2022.v28i2.162","DOIUrl":"https://doi.org/10.7196/AJTCCM.2022.v28i2.162","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is the most common cancer worldwide and is the greatest contributor to malignancy-associated deaths. Human immunodeficiency virus (HIV) is an epidemic in many developing countries and South Africa carries the largest burden of this disease in the world. With the introduction of antiretroviral therapy (ART), acquired immune deficiency syndrome (AIDS)-defining malignancies (ADMs) are on the decline and non-AIDS-defining malignancies (NADMs) are becoming more common, with lung cancer being the most common among these.</p><p><strong>Objectives: </strong>To describe and compare a cohort of HIV-positive lung cancer patients and a cohort of HIV-negative lung cancer patients.</p><p><strong>Methods: </strong>A retrospective study of 188 patients with histologically confirmed bronchogenic carcinoma was conducted. Smoking history, cancer sub-type, cancer stage, HIV parameters and demographic data were collected.</p><p><strong>Results: </strong>There were 31 (16.94%) HIV-positive patients. They presented at a younger age (53.94 years) than the HIV-negative group (61.64 years) (p=0.0001). Adenocarcinoma was the most common sub-type in the HIV-negative cohort while squamous cell carcinoma was slightly more common in the HIV-positive cohort. Both groups predominantly presented with locally advanced or metastatic disease.</p><p><strong>Conclusion: </strong>HIV-positive patients present at a younger age than HIV-negative patients and both groups show a male-predominant pattern.</p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/f6/AJTCCM-28-2-162.PMC9366453.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713965","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 presentation of multi-organ hydatid disease: Case report and review of the literature.","authors":"I Ntatamala,&nbsp;S Adams","doi":"10.7196/AJTCCM.2022.v28i2.178","DOIUrl":"https://doi.org/10.7196/AJTCCM.2022.v28i2.178","url":null,"abstract":"<p><p>Hydatid disease involving multiple organs is rare in clinical practice. The most commonly affected organs in adults include the liver and lungs. We report a case of a 54-year-old woman who presented to our hospital with multiple cystic lesions in the liver, lung and spleen. The case highlights the need to have a high index of suspicion for hydatid disease in endemic areas in patients with this clinical presentation.</p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/43/AJTCCM-28-2-178.PMC9396231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33443590","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":"Updated WHO definitions for tuberculosis outcomes: Simplified, unified and future-proofed.","authors":"J A M Stadler","doi":"10.7196/AJTCCM.2022.v28i2.224","DOIUrl":"10.7196/AJTCCM.2022.v28i2.224","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/05/AJTCCM-28-2-224.PMC9339140.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578969","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":"COVID-19 brought out the best and worst of us.","authors":"Richard van Zyl-Smit","doi":"10.7196/AJTCCM.2022.v28i2.260","DOIUrl":"10.7196/AJTCCM.2022.v28i2.260","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/29/AJTCCM-28-2-260.PMC9347900.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696993","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":"Lung cancer in people living with HIV: a different kettle of fish?","authors":"R Bhikoo, C F N Koegelenberg","doi":"10.7196/AJTCCM.2022.v28i2.245","DOIUrl":"10.7196/AJTCCM.2022.v28i2.245","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/89/AJTCCM-28-2-245.PMC9339138.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578967","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":"Position statement on endoscopic lung volume reduction in South Africa: 2022 update.","authors":"C F N Koegelenberg,&nbsp;R N van Zyl-Smit,&nbsp;K Dheda,&nbsp;B W Allwood,&nbsp;M J Vorster,&nbsp;D Plekker,&nbsp;D-J Slebos,&nbsp;K Klooster,&nbsp;P L Shah,&nbsp;F J F Herth","doi":"10.7196/AJTCCM.2022.v28i2.249","DOIUrl":"https://doi.org/10.7196/AJTCCM.2022.v28i2.249","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) remains one of the most common causes of morbidity and mortality in South Africa. Endoscopic lung volume reduction (ELVR) was first proposed by the South African Thoracic Society (SATS) for the treatment of advanced emphysema in 2015. Since the original statement was published, there has been a growing body of evidence that a certain well-defined sub-group of patients with advanced emphysema may benefit from ELVR, to the point where the current Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines and the United Kingdom National Institute for Health and Care Excellence (NICE) advocate the use of endoscopic valves based on level A evidence. Patients aged 40 - 75 years with severe dyspnoea (COPD Assessment Test score ≥10) despite maximal medical therapy and pulmonary rehabilitation, with forced expiratory volume in one second (FEV₁) 20 - 50%, hyperinflation with residual volume (RV) >175% or RV/total lung capacity (TLC) >55% and a six-minute walking distance (6MWD) of 100 - 450 m (post-rehabilitation) should be referred for evaluation for ELVR, provided no contraindications (e.g. severe pulmonary hypertension) are present. Further evaluation should focus on the extent of parenchymal tissue destruction on high-resolution computed tomography (HRCT) of the lungs and interlobar collateral ventilation (CV) to identify a potential target lobe. Commercially available radiology software packages and/or an endobronchial catheter system can aid in this assessment. The aim of this statement is to provide the South African medical practitioner and healthcare funders with an overview of the practical aspects and current evidence for the judicious use of the valves and other ELVR modalities which may become available in the country.</p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/82/AJTCCM-28-2-249.PMC9315962.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578970","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":"Central venous catheter-related infection - back to basics.","authors":"Mervyn Mer","doi":"10.7196/AJTCCM.2022.v28i1.244","DOIUrl":"10.7196/AJTCCM.2022.v28i1.244","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46558266","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 breath of relief: High-flow nasal oxygen in a resource-limited setting.","authors":"L Kühn, A Esmail, S Oelofse, K Dheda","doi":"10.7196/AJTCCM.2022.v28i1.223","DOIUrl":"10.7196/AJTCCM.2022.v28i1.223","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48471638","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":"Modern techniques for staging lung cancer - improved precision but too late for too many.","authors":"R I Raine","doi":"10.7196/AJTCCM.2022.v28i1.209","DOIUrl":"10.7196/AJTCCM.2022.v28i1.209","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49638366","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}