Austin journal of pulmonary and respiratory medicine最新文献

{"title":"OrtnerâÂÂs Syndrome as First Clinical Presentation of Severe Pulmonar Arterial Hypertension","authors":"M. Bolaki, M. Fanaridis, E. Pediaditis, I. Mitrouska, D. Georgopoulos","doi":"10.4172/2161-105X.1000387","DOIUrl":"https://doi.org/10.4172/2161-105X.1000387","url":null,"abstract":"A 40 year old female, non-smoker with a past medical history of urticaria and allergic rhinitis presented with hoarseness of voice of 3 months duration without any accompanying symptoms or limitation of daily activities. Direct laryngoscopy identified palsy of the left vocal cord. The magnetic resonance imaging of the chest indicated abnormal signal intensity in the left vocal cord. The thoracic computed tomography revealed only an enlargement of the pulmonary artery, while transthoracic echocardiography estimated systolic pulmonary artery pressure of 75 mmHg. Pulmonary function tests were compatible with pulmonary vascular disease and cardiopulmonary exercise test showed exercise limitation of cardiocirculatory origin (maximum O2 consumption 60% of pred.). Catheterization of the right heart showed precapillary pulmonary hypertension (mean pulmonary artery pressure 40 mmHg) with a positive response to vasoreactivity test. A diagnosis of idiopathic pulmonary arterial hypertension (IPAH) was made, with hoarseness of voice as the only manifestation of the disease. The hoarseness of voice is believed to be the result of the compression of the left recurrent laryngeal nerve between aorta and the dilated pulmonary artery. This is an unusual case of cardiovocal syndrome (or Ortner’s syndrome) in a patient with IPH who had no perception of dyspnea or limitation of daily activities.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"35 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75972524","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":"Metastatic Lung Adenocarcinoma to the Appendix: A Case Report","authors":"C. C. Neto, S. Kato, C. L. Pinto, G. R. Santos, A. Dettino, R. C. S. Prudente","doi":"10.4172/2161-105X.1000386","DOIUrl":"https://doi.org/10.4172/2161-105X.1000386","url":null,"abstract":"There are few reported cases in the literature of metastasis to the appendix. A 44-year-old patient presented with abdominal pain and changes in the bowel pattern. Thoracic and abdominal computed tomography scans evidenced pulmonary and liver nodules. The pulmonary nodule was biopsied and the hematoxylin-and-eosin (HE) stained slides showed an adenocarcinoma. The immunohistochemistry profile demonstrated positivity for CK7 and TTF-1. The patient underwent an appendectomy. HE stained slides also demonstrated adenocarcinoma infiltrating the entire appendix wall along with the epithelial surface with immunohistochemistry study of the appendix neoplasm showing exactly the same results as seen in the first panel.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"42 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88021780","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":"Pattern of Acute Arthritis in Seventeen Patients with Sarcoidosis","authors":"A. Hosseinian-Amiri, M. Aliyali, S. Abedi, A. Sharifpour","doi":"10.11648/j.ajim.20160406.19","DOIUrl":"https://doi.org/10.11648/j.ajim.20160406.19","url":null,"abstract":"Background: Sarcoidosis is a multisystemic disease that most commonly affected organ is lung but other organs such as the liver, skin, eye and musculoskeletal system can be affected (1). The most common rheumatologic findings in sarcoid patients are arthritis that can be acute or chronic but acute form is most common (14). Aim: The aim of this retrospective study was analysis of acute inflammation of joints in 17 patients with sarcoidosis during 2 years from January 2010 to December 2012. Subjects and Methods: This is a retrospective study of sarcoidosis patients with acute onset inflammation in joints during two years from January 2010 to December 2012 that refers to rheumatologic clinic of Mazandaran University of medical sciences. Data were analyzed using the SPSS version 20. Variables analyzed include age, sex, presence of arthritis/periarthritis, the number of involved joints, symmetricity of involvement and kind of arthritis as inflammatory, non inflammatory or septic. Results: At these study 17 sarcoidosis patients with acute onset of joint inflammation refers to our rheumatologic clinic. All of patients were adults between 18 to 52 years old with median age of 36.8 years old. Six patients (35%) were male and eleven patients (65%) were female. Arthritis occurs in 13 patients (76%) and periarthrtis in 10 patients (58%). At 6 patients (35%), arthritis and periarthritis occurs simultaneously. The most commonly involved join was ankle in 10(58%) cases. Another involved joints were knee, wrist and MCPs in 2 patients (12%) for each ones. Mid foot involvements occurs in 3(18%) and MCPs in one (6%) patient. In seven (41%) patients, arthritis were monoarthicular andat anotherseven (41%) of patients arthritis were oligoathicular. Only in 3 (13%) cases, arthritis were polyarthicular. All of arthritis were inflammatory and only in one case septic arthritis occurs. In 9(53%) of patients, arthritis were symmetric and in 8(47%) of cases were asymmetric. Conclusion: Inflammation of joints including arthritis and periarthrtis are important findings in acute sarcoidosis and must be considered in these patients. Lower extremity joint arthritis especially in ankles and in symmetric fashion are common rheumatologic complications of this disease.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"47 1","pages":"148"},"PeriodicalIF":0.0,"publicationDate":"2017-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80741960","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":"Clinical-Radiological, Pathological Profile and Treatment Outcome of Patients with Haemoptysis","authors":"Tinku Joseph, S. Nair, James Pt","doi":"10.4172/2161-105X.1000437","DOIUrl":"https://doi.org/10.4172/2161-105X.1000437","url":null,"abstract":"Background: Haemoptysis is a frequently occurring life threatening situation which can occur in various pulmonary conditions. Managing a case of haemoptysis is often difficult due to a large spectrum of causative factors. The effective control of haemoptysis depends upon identification of the etiology and localization of the site of bleeding. Method: This was a two year cross sectional study of 102 patients who presented with active haemoptysis. Data from these patients was collected for the analyzing the underlying cause, diagnostic modality, treatment approach used and outcome of it in patients suffering from life-threatening haemoptysis. Results: Old Pulmonary tuberculosis, (34.31%), bronchiectasis (25.49%), lung cancer (11.76%), aspergilloma (10.78%) accounted for the most common etiologies of haemoptysis. 12 patients (11.76%), out of 102 had mild haemoptysis, 26 patients (25.49%) had moderate haemoptysis and 64 patients (62.74%) had massive/severe haemoptysis. CT chest was the most sensitive diagnostic test when employed alone, with positive yield of 93.14%. Among study population 61 patients (59.80%) were treated conservatively, 39 patients (38.23%) were treated by bronchial artery embolisation (BAE) and 2 patients underwent surgery for management of recurrent haemoptysis. Most of the patients were treated conservatively, but in case of significant haemoptysis, Bronchial artery embolization was performed than the conservative treatment. Success rate of conservative treatment group on a long term basis was 72.13%, BAE group 89.47%, surgical treatment group was 100%, without any significant statistical significance (p value=0.090). The duration of hospitalization among conservative treatment group was 4.37 days and BAE group was 10.51 days (P-value<0.001). Conclusion: The most common causes of haemoptysis were old pulmonary tuberculosis and bronchiectasis. Emergency bronchial artery embolisation is a better option than medical treatment for immediate cessation of haemoptysis. The successful treatment of haemoptysis requires thorough diagnostic evaluation and close interdisciplinary collaboration among pulmonologists, radiologists, and thoracic surgeons.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"139 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85888894","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":"Indications, Outcome and Complications of Non-Invasive Positive Pressure Ventilation in Acute Respiratory Failure","authors":"A. GosaviRakhi, R. KapseVijaykumar, G. MhaisekarDilip, F. Syed, Luniya Anandkumar Babulal","doi":"10.4172/2161-105X.1000424","DOIUrl":"https://doi.org/10.4172/2161-105X.1000424","url":null,"abstract":"Background: The use of noninvasive positive pressure ventilation (NIPPV) in treating of respiratory failure with diverse etiology is now widely studied. The recent increase in the use of NIPPV in the critical care units has been motivated by the desire to minimize complications of invasive ventilation. The present study was conducted to study the indications, outcome and complications of NIPPV in acute respiratory failure patients. Material and Methods: In this prospective observational study, a total 110 adult patients of respiratory failure and impending respiratory failure due to various diseases attending a tertiary care centre and admitted in intensive respiratory care unit were studied for outcome and complications of NIPPV utilization. Results: The most common indication of NIPPV was exacerbation of COPD 37 (33.63%) followed by post extubation 30 (27.27%), asthma 14 (12.72%), ARDS 9 (8.18%) and pneumonia 10 (9.09%). NIPPV was effective in 88 (80%) and non-effective in 22 (20%). There was significant improvement which also persisted after successful weaning. Common complications observed were dry mouth in 60 (54.54%) patients, facial injury in 21 (19.09%) patients. Discussion: NIPPV can be utilized as an effective modality in the management of ARF due to diverse etiologies. NIPPV was associated with a reduced need for invasive mechanical ventilation and significant outcome and minor complications.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"37 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85923680","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 New Great Imitator","authors":"Esther Nivasch, Ifeanyi U. Anidi","doi":"10.4172/2161-105X.1000423","DOIUrl":"https://doi.org/10.4172/2161-105X.1000423","url":null,"abstract":"Sarcoidosis is a disease of involving the unusual accumulation on inflammatory cells which forms lumps called as granulomas. Though the pathogenesis remains undefined, it has been proposed that an initial CD4+ T cell infiltration is the spark in the inflammatory cascade that results in granulomatous formation in affected organs. In this case report we have described an unusual presentation of sarcoidosis detailing the mutable iterations of this disease.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77683755","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":"Piezo Spirometer: A New Device for the Diagnosis of Pulmonary Failure","authors":"H. Ghasemifard, M. Ghasemifard, M. Ghamari","doi":"10.4172/2161-105X.1000428","DOIUrl":"https://doi.org/10.4172/2161-105X.1000428","url":null,"abstract":"This study offers a cheap and rapid method for the measuring of breath or measuring the size and capacity of the lung. In this innovative method, the respiration flowmeter than other conventional methods with high costs will be done very fast and accurate. In this device, the measurement accuracy and speed will increase dramatically, because of the high-frequency response than other methods. In this paper, the results of design and manufacturing the spirometry device using nanotechnology are discussed, which including synthesis of piezoelectric ceramics PMNPT and the amplifier circuit design.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"97 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85683025","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":"Prevalence of Obstructive Sleep Apnea-Hypopnea in Severe Asthma","authors":"S. Daboussi, A. B. Mansour, S. Mhamedi, Z. Moetemri, C. Aichaouia, M. Khadraoui, R. Cheikh","doi":"10.4172/2161-105X.1000414","DOIUrl":"https://doi.org/10.4172/2161-105X.1000414","url":null,"abstract":"Background: Obstructive sleep apnea syndrome (OSA) and asthma are two common respiratory diseases. An overlap between the two diseases has been widely reported. It is established that OSA may affect control of asthma. This study aims to highlight OSA prevalence in patient with difficult to control asthma and to point out the feature of this overlap syndrome. Methods: We conducted a prospective study including sixty patients with difficult control asthma who had symptoms suggestive of OSA (Epworth scale>10). Based on the findings of the respiratory polygraphy, a comparative analysis of clinical, biologic, lung function testing and therapeutic features was performed. Results: OSA was confirmed in 63.3% of cases, and was severe, moderate and mild in 26%, 61% and 13% of them respectively. Comparison between the OSA and non-OSA arms showed no significant differences in the asthmatic disease features: date of onset, atopy, history of near fatal asthma and medication use. However, OSA patients were older than non OSA patients (54 vs. 45 years old; p=0.05). Furthermore there was a difference in the proportion of males between both arms (50% in OSA vs 23% in non OSA; p=0.05). Gastro-oesophageal reflux disease (GERD) was more common in the OSA group (57.9% vs. 21.7%; p=0.034). There was no significant difference between the two arms regarding obesity, allergic rhinitis and smoking. Conclusion: This study shows that OSA is more prevalent in difficult to control asthma patients. The presence of overlap syndrome was correlated with age, male gender and GERD.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"27 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89905108","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":"Physical Activity Levels and Performance in Italian Adolescents with Cystic Fibrosis: A Multicenter Cross-sectional Study","authors":"C. Cazzarolli, G. Tridello, C. Tartali, I. Meneghelli, M. A. Ciciretti, G. Mamprin, P. Fanzaghi, D. Innocenti, F. Grisorio, S. Tomezzoli, S. Volpi","doi":"10.4172/2161-105X.1000430","DOIUrl":"https://doi.org/10.4172/2161-105X.1000430","url":null,"abstract":"The aim of this study was to compare physical performance in Italian adolescents with different habitual activity levels and to examine its relationship with peripheral muscle strength and quality of life. At regular clinic visits in 5 cystic fibrosis (CF) Centres in Italy, 35 subjects performed spirometry, incremental shuttle walk test (ISWT), one-repetition maximum (1 RM) and completed the Habitual Activity Estimation Scale (HAES). Subjects were divided into two groups, based on activity levels derived from the HAES. More active subjects achieved higher ISWT distance (ISWD) (1040.4 m vs.851.3 m, p=0.2) and described better body image perception (75.7% vs. 66.7% p=0.3) than subjects in the less active group, but these results did not reach a statistical significance. There was no correlation between ISWD, lung function and quality of life, but we observed a moderate correlation between ISWD and upper limb strength (r=0.46). Our data showed that more active subjects did not differ from less- active ones. Further studies should choose alternative tools to assess physical activity levels in order to detect the real engagement in vigorous activities, making it easier to compare and combine results and promote educational intervention.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"44 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77503183","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 Prospective Study of the Safety of Flexible Bronchoscopy under Propofol Sedation in Patients with and without Chronic Obstructive Pulmonary Disease","authors":"M. Solís, Marcos Hernández, C. Durán, R. Dure, S. Quadrelli","doi":"10.4172/2161-105X.1000431","DOIUrl":"https://doi.org/10.4172/2161-105X.1000431","url":null,"abstract":"Background and objective: The British Thoracic Society (BTS) recommends that sedation for fiber-optic bronchoscopy (FOB) should be offered to all patients. This study evaluates the safety of FOB under sedation in patients with COPD.Methods: Is a prospective observational study, with the approval of institutional review board. Sedation was administered by a board-certified anaesthetist. Patients were premedicated (IV) with metoclopramide 10 mg, fentanyl initial dose: 25 μg, midazolam initial dose 2-3 mg. After an initial 50 mg IV propofol, the dose was then carefully titrated according to the ASA physical status classification.Results: The duration of the procedure was not different between the two groups (14.7 ± 3.551 vs. 14.9 ± 3.8 min p=0.695). Serious complications were very infrequent in both groups (2.1 vs. 0.07%, p=0.148). In the group of COPD patients there was no correlation between the lowest SaO2 during the procedure (r=0.03, p=0.518) or the SaO2 at the end of the procedure (r=-0.006, p=0.909) and the baseline FEV1. Neither the presence of a fall in the SaO2 greater than 4 points (HR 0.895, IC 0.452-1.773, p=0.750) nor a SaO2 lower than 90% during the procedure (HR 0.346, IC 0.060-1.918, p=0.233) or the general rate of complications (including desaturation) (HR: 0.627, CI: 0.257-1.529, p=0.305) were predicted by a baseline FEV1 lower than 50%.Conclusions: We conclude that FOB under conscious sedation by a certified anesthesiologist is a safe procedure in patients with COPD with a low incidence of adverse effects.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"20 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82916672","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}