African Journal of Thoracic and Critical Care Medicine最新文献

{"title":"Pulmonary hypertension in adults completing tuberculosis treatment.","authors":"B W Allwood, S Manie, M Stolbrink, L Hunter, S Matthee, G Meintjes, S L Amosun, A Pecoraro, G Walzl, E Irusen","doi":"10.7196/AJTCCM.2023.v29i3.676","DOIUrl":"https://doi.org/10.7196/AJTCCM.2023.v29i3.676","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) after tuberculosis (TB) is typically not included among the chronic lung diseases causing PH (group 3 PH), with few data available to support the inclusion.</p><p><strong>Objectives: </strong>To determine the prevalence of PH in an adult population completing TB treatment.</p><p><strong>Methods: </strong>This single-centre, cross-sectional study only included patients with their first documented episode of TB, and who were in the second half of treatment or had recently completed treatment. PH was assessed using transthoracic echocardiography. Questionnaires were completed, and spirometry and a 6-minute walk test were performed.</p><p><strong>Results: </strong>One hundred patients were enrolled, with a mean age of 37.1 years, of whom 58% were male and 46% HIV positive. The median time since initiation of TB treatment was 22 weeks. The mean (standard deviation) measured right ventricular systolic pressure (RVSP) was 23.6 (6.24) mmHg. One participant had PH (defined as RVSP ≥40 mmHg; 95% confidence interval (CI) 0.0 - 3.0) and a further 3 had possible PH (RVSP ≥35 and <40 mmHg), with a combined PH prevalence of 4% (95% CI 0.2 - 7.8). Airflow obstruction on spirometry was found in 13.3% of 98 patients, while 25.5% had a reduced forced vital capacity. There was no association between RVSP or PH/possible PH and sex, age, HIV status, systemic hypertension, spirometry measurements or 6-minute walking distance. Smoking status was associated with RVSP, but not with the presence of PH/possible PH.</p><p><strong>Conclusion: </strong>There was a significant prevalence of PH in this preliminary study of predominantly young patients completing treatment for a first episode of TB. Larger and more detailed studies are warranted.</p><p><strong>Study synopsis: </strong><b>What the study adds.</b> Of 100 adult patients with their first episode of tuberculosis (TB) who underwent echocardiograms near the end of treatment completion to determine the prevalence of pulmonary hypertension (PH), 1 (1%) had PH and a further 3 (3%) had possible PH. There was no association between sex, age, HIV status, lung function or 6-minute walking distance and the presence of PH. The study adds to the growing awareness of the association of TB with pulmonary vascular disease. It shows that even in a young population with a first episode of TB treated in an ambulatory setting, there is a significant prevalence of PH on treatment completion.<b>Implications of the findings.</b> Given that 10.6 million people acquire TB annually, the absolute global burden of cases with PH is likely to be high, but is underappreciated to date. Further work is urgently needed in this field.</p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10642409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650519","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 WT1-positive pleural neoplasm. Is it always a mesothelioma?: Diagnostic pitfall of WT1 immunohistochemistry in pleural neoplasm.","authors":"G Gaggero, D Taietti, M Concardi, M Mora","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 3","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464313","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 cool new kid on the block: Lung cryobiopsy.","authors":"A Esmail, K Dheda","doi":"10.7196/AJTCCM.2023.v29i3.1494","DOIUrl":"10.7196/AJTCCM.2023.v29i3.1494","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10642397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650522","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":"Abnormal chest radiograph in an asymptomatic young man - what is the differential diagnosis?","authors":"T H A Zobair,&nbsp;N Singh,&nbsp;M A S Alameen,&nbsp;Q Said-Hartley,&nbsp;M Lephoi,&nbsp;R I Raine","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 1","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/8a/AJTCCM-29-1-955.PMC10561714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219957","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":"Chest radiographic interpretation - an essential competency for Africa.","authors":"Elvis Irusen","doi":"10.7196/AJTCCM.2023.v29i1.892","DOIUrl":"10.7196/AJTCCM.2023.v29i1.892","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/9b/AJTCCM-29-1-892.PMC10355186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840802","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":"Motor neuron disease presenting with acute hypercapnic respiratory failure.","authors":"H Moola,&nbsp;A Govind,&nbsp;J R Eloff,&nbsp;A van Blydenstein","doi":"10.7196/AJTCCM.2023.v29i1.573","DOIUrl":"10.7196/AJTCCM.2023.v29i1.573","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/86/AJTCCM-29-1-573.PMC10354874.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840808","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":"Tracheo-oesophageal fistula in a case of organophosphate poisoning.","authors":"S M Khaladkar,&nbsp;S Goyal,&nbsp;S S Vinay Kumar Parripati,&nbsp;V Gupta,&nbsp;S Goyal","doi":"10.7196/AJTCCM.2023.v29i1.267","DOIUrl":"10.7196/AJTCCM.2023.v29i1.267","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/4f/AJTCCM-29-1-267.PMC10354871.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840809","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":"Critical care for patients with potentially fatal haematological disorders.","authors":"Richard van Zyl-Smit","doi":"10.7196/AJTCCM.2023.v29i1.891","DOIUrl":"10.7196/AJTCCM.2023.v29i1.891","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/99/AJTCCM-29-1-891.PMC10355185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227099","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":"Shisha use amongst students.","authors":"A Goolam Mahomed","doi":"10.7196/AJTCCM.2023.v29i1.893","DOIUrl":"10.7196/AJTCCM.2023.v29i1.893","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/9a/AJTCCM-29-1-893.PMC10105901.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9382952","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":"Outcomes of patients with haematological malignancies and febrile neutropenia at the Universitas Academic Hospital multidisciplinary intensive care unit, Free State Province, South Africa.","authors":"C D S Martins,&nbsp;S D Maasdorp","doi":"10.7196/AJTCCM.2023.v29i1.263","DOIUrl":"https://doi.org/10.7196/AJTCCM.2023.v29i1.263","url":null,"abstract":"<p><strong>Background: </strong>Mortality rates in patients with haematological malignancies who required intensive care unit (ICU) admission have in the past been high. More recently, however, improved outcomes for critically ill haematological patients have been reported.</p><p><strong>Objectives: </strong>To determine outcomes, average length of ICU stay, and factors associated with mortality in patients with haematological malignancies and neutropenic fever in the multidisciplinary ICU (MICU) at Universitas Academic Hospital (UAH), Bloemfontein, Free State Province, South Africa.</p><p><strong>Methods: </strong>We conducted a retrospective review of medical and laboratory records of all patients admitted to the UAH MICU with haematological malignancies and febrile neutropenia between 2010 and 2019.</p><p><strong>Results: </strong>A total of 182 patients with haematological malignancies were admitted to the MICU between 1 January 2010 and 31 December 2019, of whom 51 (28.0%) fulfilled the inclusion criteria for the study. The median age was 33 years, and 29 patients (56.9%) were female. Most patients had either acute myeloid leukaemia (n=22; 43.1%) or acute lymphocytic leukaemia (n=16; 31.4%), while B-cell lymphoma (n=12; 23.5%) and multiple myeloma (n=1; 2%) were less frequent. The median length of stay in the ICU was 3 days. ICU mortality was 76.5% and hospital mortality 82.4%. Factors associated with mortality included septic shock, vasoactive agent use and mechanical ventilation.</p><p><strong>Conclusion: </strong>Patients with haematological malignancies and febrile neutropenia in the UAH MICU have high ICU and hospital mortality rates. More needs to be done with regard to timeous management of patients with haematological malignancies and septic shock in our setting to improve survival.</p><p><strong>Study synopsis: </strong>This is the first study to report on ICU mortality of adult patients with haematological malignancies and neutropenic sepsis in a tertiary hospital ICU in the Free State. These patients had a high mortality rate. <b>What the study adds.</b> Our study shows that septic shock, vasoactive agent use and mechanical ventilation were associated with increased ICU mortality.<b>Implications of the findings.</b> Strict adherence to infection prevention and control measures in haematology wards is required. Early recognition and treatment of sepsis before it progresses to septic shock is important. ICUs must be designed so that isolation cubicles are readily available to prevent cross-infection of patients.</p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/04/AJTCCM-29-1-263.PMC10354873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227101","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}