Austin journal of pulmonary and respiratory medicine最新文献

{"title":"Spindle Cell Carcinoma of the Lung: Benefits of Immunohistochemical Studies","authors":"W. Feki, W. Ketata, S. Charfi, N. Bahloul, I. Yangui, S. Kammoun","doi":"10.4172/2161-105X.1000449","DOIUrl":"https://doi.org/10.4172/2161-105X.1000449","url":null,"abstract":"Sarcomatoid carcinoma is a rare histologic type of non-small cell lung cancers (NSCLC) which represents only 0.3 to 3% of primitive lung cancers. \u0000In 2004, the World Health Organization (WHO) defined in its classification a new entity, sarcomatoid carcinoma, as “any proliferation that can offer permanently epithelial-mesenchymal morphological transition.” \u0000The term sarcomatoid carcinoma is generic; it includes various entities such as spindle cell carcinomas which are without well-known clinical and immunohistochemical features. \u0000We report the case of a 53-year-old smoker patient, with a history of bullous emphysema discovered 8 years ago and who was hospitalized for exploration of a large pleuro parenchymal mass. The functional signs were dyspnea and alteration of the condition. Percutaneous Computed Tomography (CT) guided biopsy of the mass concluded to a pulmonary spindle cell carcinoma. Staging revealed adrenal nodule with mesenteric and peritoneal invasions. The patient died two months after diagnosis despite an attempt of chemotherapy based on carboplatin/docetaxel.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"28 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80438529","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":"Endoscopic Airway Findings in Infants with Obstructive Sleep Apnea","authors":"A. Bandyopadhyay, Heather N Muston, J. Slaven, Hasnaa E. Jalou, W. Engle, Ameet S DaftaryMS","doi":"10.4172/2161-105X.1000448","DOIUrl":"https://doi.org/10.4172/2161-105X.1000448","url":null,"abstract":"Objectives: This study describes the un-sedated endoscopic airway findings in infants with obstructive sleep apnea confirmed by polysomnography (PSG). Methods: A retrospective chart review was performed on infants who had undergone both a documented airway endoscopy and PSG from 2006 to 2015 at our center. Demographics, comorbidities, findings of airway endoscopy and findings on PSG were extracted from the electronic medical record. Regression analyses were performed to determine the relationship between AHI, endoscopic airway findings and gestational age. Results: We identified 39 patients with PSG in room air and confirmed obstructive sleep apnea (Apnea Hypopnea Index (AHI) >1/hour) who had undergone unsedated airway endoscopy. The median gestational age at time of PSG was 40 weeks and for endoscopy was 40 weeks. Median AHI on PSG was 17.2/hour. Laryngomalacia [87.2%], pharyngomalacia [33.3%] and tracheomalacia [10.3%] were the three most prevalent findings on endoscopy. Surgically correctable fixed airway obstruction was uncommon. Prevalence of pharyngomalacia decreased with increased gestational maturity (p=0.05). As the postmenstrual age at PSG completion increased, there was a trend towards a decline of the AHI (p=0.087). Twenty-two (56.4%) patients had a follow up PSG performed. Using paired t test, there was a significant decrease in AHI (Δ13.41: -40.9, 15.8, 15.8) from 23.4/hour (1.3-62) to 10.0/hour (0-32), despite no interim surgical intervention. Conclusions: Dynamic airway collapse, including laryngomalacia and pharyngomalacia, were the most common findings in obstructive sleep apnea during infancy. The decreased prevalence of pharyngomalcia and trend towards improvement of AHI with time suggests airway immaturity contributes to obstructive sleep apnea observed during infancy and improves with age.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"203 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77611838","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":"Interest of Myocutaneous Plasty after Extended Sternal Resection","authors":"A. Ayed, A. Hentati, W. Abid, I. Ghorbel, K. Nouri","doi":"10.4172/2161-105X.1000447","DOIUrl":"https://doi.org/10.4172/2161-105X.1000447","url":null,"abstract":"Background: Thoracic wall reconstruction is commonly performed by using muscle flaps or prosthetic materials. We try through this article to show the possibility of myoplasty in extended thoracic wall resections.Case report: A 33-year-old woman had been treated by chemo-radiotherapy, for undifferentiated carcinoma of the nasopharyngeal type. The CT-scan completed by magnetic resonance showed a 10 cm sternal mass centered by the manubriosternal articulation with an infiltration of left and right second sternocostal joints and intercostal muscles. The diagnosis of a single sternal metastasis of nasopharyngeal carcinoma was established. \u0000After the resection of anterior arc of right ribs (from the first to the third), resection of internal right clavicle edge, transverse sternotomy above xiphoid process, resection of anterior arc of left ribs (from the first to the third), resection of internal left clavicle edge, sternal tumor and sternal body were removed en-bloc without a 2 cm residual extension which was marked by metallic clips. A myocutaneous plasty using pectoralis major and pectoralis minor muscles covered the chest wall defect after the release of the pectoralis major from its humeral attachment. \u0000The postoperative course was uneventful. Residual tumor was treated by radiotherapy with no disease recurrence sign for 3 years later.Conclusion: The choice of muscle to use depends on the location and the extent of the defect to be repaired. The knowledge of the anatomy of the muscles is essential to obtain a good quality flap.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"23 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89422725","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 Effect of Low Altitude on the Performance of Lung Function in Alaghwar Region, Dead Sea, Jordan","authors":"N. Alnawaiseh, F. El-Gamal","doi":"10.4172/2161-105X.1000445","DOIUrl":"https://doi.org/10.4172/2161-105X.1000445","url":null,"abstract":"Background: Alaghwar region is the lowest area in the world inhabited by permanent population at the level of the Dead Sea area, which is -420 m (-1,378 ft) below sea level. The reduced barometric pressure, density of air and the degree of acclimatization are associated with the low altitude. These factors are essential for the evaluation of a lung function tests at different altitudes. Objectives: The main aim of this study was to assess the effect of this unique feature of very low altitude (LA) on the performance of lung function. Methods: A comparative cross sectional design was chosen as the epidemiological design, and the standard cluster sampling technique was used to select the study population. Study was conducted on 1493 subjects (319 exposed to LA, and 1174 living at HA). Data were collected using predesigned questionnaire on personal and sociodemographic characteristics and smoking habit; as well as measurements of forced spirometry [time-volume curve and flow volume curve), and anthropometric measurements, using standard techniques and equipment. The data was analyzed using SPSS software (IBM, version 22), and multiple regression statistical subroutine, was used. Level of significance for the present study was 0.05. Results: After allowing for the effect of age, height, gender and smoking habit, people residing in low altitude area had significantly higher lung function indices compared to those residing at high altitude areas. Smoking was found to have significant negative effect on the different indices of lung function mainly of obstructive type. Conclusions: The increased barometric pressure, decreased density of air and the degree of acclimatization have shown an increment in most pulmonary function indices at low altitude. Basically high altitude may play a role in altering ventilatory function. However, additional factors like smoking should be considered.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"149 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88010104","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":"Finding Out the Possibilities of Improving OPD Services","authors":"Heenatimulla Sdk, Deepthi Wkc, N. Samarawickrama, Wijesinghe Ak, M. Mru","doi":"10.4172/2161-105X.1000443","DOIUrl":"https://doi.org/10.4172/2161-105X.1000443","url":null,"abstract":"Introduction: National Hospital for Respiratory Diseases (NHRD) at Welisara is the Premier tertiary care hospital in Sri Lanka for respiratory diseases. No studies have been done in its OPD set up to collect data which could have been invaluable for future planning and implementation. This study was done to gather such vital information in view of improving services rendered by NHRD OPD. Few parameters like socio-demographic details, distance to the hospital, cost for the visit, having a referral letter given by a doctor, number of persons accompanied the patient and reasons to visit NHRD were studied.Methodology: This was a descriptive cross sectional study of patients who attended OPD of NHRD. Interviewer administered questionnaire was given to randomly selected 420 patients who were above 18 years of age and who were on their first visit to the hospital.Results: Majority of patients were less educated and were coming from a low socio-economic background. Both sexes presented equally to the OPD. 68% of patients were coming from within 20 km of distance from the hospital and for 62%, the cost for the visit was found to be 200 rupees or less. Only for 7% of people, NHRD was the nearest hospital. 95% of patients has presented with respiratory related conditions while only 2% had a referral letter with them. Most of the patients (around 80%) were accompanied by 2 or 3 persons. More than 70% visited NHRD due to its reputation as the leading hospital in the country for respiratory diseases.Conclusion: Middle aged less educated people with a low socio-economic status were the people who mostly visited the NHRD OPD. Most had respiratory system related presenting complaints. This is of significance and should be considered in giving health education to these patients. Majority of the patients resided close by to the hospital and their cost for the visit roughly showed similarities to the distances they travel. Though most patients visit NHRD after using nearby health facilities, lack of a proper referral system and accompained too many people can worsen the overcrowding at OPD. Strengthening the usage of nearby healthcare facilities can reduce this as NHRD was found to be the nearest hospital for very few of this population. Most common reason for visiting NHRD OPD was the reputation NHRD has gained as the leading hospital of the country for Respiratory disease, which should be conserved.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"383 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83464880","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":"Sudden Death in Middle Aged Woman with Invasive Pulmonary Aspergillosis","authors":"A. Fayed","doi":"10.4172/2161-105X.1000441","DOIUrl":"https://doi.org/10.4172/2161-105X.1000441","url":null,"abstract":"A 45-year-old Saudi female with history of SLE on hydroxychloroquine 400 mg daily and prednisolone 5 mg daily Presented to ER by epigastric pain, diarrhoea 3 motions per day and generalized body aches associated with infrequent cough for past 2 days not preceded by flu symptoms without contact to sick people for last month, without history of recent travel and without contact to animals.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"5 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76002656","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":"Assessment of Hemodynamic Changes during Mechanical and Spontaneous Ventilation by Variations in Pulse Oximetry Waveform in Critically Ill Patients Undergoing Hemodialysis: A Pilot Study to Evaluate Reliability of a Noninvasive Technique","authors":"K. Stern, R. Pillai, Shadman Chowdhury, A. Baydur","doi":"10.4172/2161-105X.1000479","DOIUrl":"https://doi.org/10.4172/2161-105X.1000479","url":null,"abstract":"","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73094464","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":"Life-Threatening Massive Hemoptysis: A Unique Option Using Customized Endobronchial Silicone Blocker","authors":"A. Singla, P. Yadav, Priya Bajaj, H. Venkateshappa, C. Loknath, Mehta Rm","doi":"10.4172/2161-105X.1000468","DOIUrl":"https://doi.org/10.4172/2161-105X.1000468","url":null,"abstract":"Airway bleeding with massive hemoptysis (MH) has a high morbidity and mortality. With rapid deterioration, conventional methods such as bronchial artery embolization or surgery are not possible, and unconventional methods are described. We describe a situation of airway bleed leading to MH of left main bronchial origin, where emergent placement of a customized endobronchial silicone blocker (CESB) was done to contain bleeding. We propose the CESB as a useful modality in life-threatening MH, when conventional options are not feasible. *Corresponding author: Ravindra M. Mehta, Department of Pulmonary Medicine, Apollo Hospitals, Bangalore, India, Tel: +91-9980910645; E-mail: ravihetal@gmail.com Received August 23, 2018; Accepted August 28, 2018; Published September 04, 2018 Citation: Singla A, Yadav P, Bajaj P, Venkateshappa H, Loknath C, et al. (2018) Life-Threatening Massive Hemoptysis: A Unique Option Using Customized Endobronchial Silicone Blocker. J Pulm Respir Med 8: 468. doi: 10.4172/2161-105X.1000468 Copyright: ©2018 Singla A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77796623","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":"Swallowing Muscle Dysfunction and Residual Factor of Dysphagia with Community- Acquired Pneumonia in the Elderly","authors":"Y. Sakai, T. Yamaga, Shuhei Yamamoto, Masayoshi Ohira, Y. Yokokawa, T. Sakamoto, M. Kikuchi, Y. Yoshimura","doi":"10.4172/2161-105X.1000462","DOIUrl":"https://doi.org/10.4172/2161-105X.1000462","url":null,"abstract":"Objectives: This study aimed to elucidate the characteristics of swallowing function, including swallowing muscle activity, and the residual factors of dysphagia in elderly patients with community-acquired pneumonia (CAP). Study design: A total of 163 subjects were included in the study. The subjects were classified into an oral intake independent group (severe aspiration), which comprises subjects who have a total fiberoptic endoscopic evaluation of swallowing (FEES) score of seven or more, and an oral intake restriction group (no aspiration or mild aspiration), which comprises subjects who have a total FEES score of less than seven. These two groups were compared, and the residual factors of dysphagia were analyzed. Results: Significant differences between the two groups were found in the repetitive saliva swallowing test, geriatric nutritional risk index, pneumonia severity, swallowing muscle activity, and respiratory rate fasting period. Multivariate logistic regression analysis revealed that the duration of swallowing muscle activity (OR 15.7, 95% CI 1.29 to 19.66; P=0.031) and respiratory rate (OR 1.22, 95% CI 1.03 to 1.58; P=0.026) were the residual factors of dysphagia in elderly people with CAP. Conclusions: This study highlighted the importance of an early approach that focuses on swallowing function and respiratory rate in the rehabilitation of elderly people with dysphagia and CAP. The results for the residual factors of dysphagia provide new evidence in the field of rehabilitation and will help reduce hospitalization and readmission for pneumonia.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"28 3 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87998250","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":"Neurological Consequences Stemming From Pulmonary Alveolar Proteinosis and Opportunistic Infections","authors":"B. Kirshner, T. Franco, R. Dean","doi":"10.4172/2161-105X.1000459","DOIUrl":"https://doi.org/10.4172/2161-105X.1000459","url":null,"abstract":"Pulmonary alveolar proteinosis (PAP) is a rare lung disease in which macrophage dysfunction causes a nonproductive cough and progressive dyspnea. However, mortality in roughly 20% of these patients is due to opportunistic infections by fungal pathogens, Nocardia spp, and mycobacteria. In this case, we discuss a 52-year-old African American male who presented with a month-long history of progressively worsening dyspnea and frequent nonproductive cough. The patient’s medical history was significant for a diagnosis of cavitary pneumonia one year ago. He was treated for community acquired pneumonia. A week later, the patient presented back to the emergency room with seizures and an altered mental status with a lesion appearing on head CT. The brain lesion was removed and tested positive for Nocardia. However, the diagnosis of PAP was not considered at that time. This case is significant because PAP should be considered as a differential when a patient presents with dyspnea, cough, and opportunistic infection. If the patient was diagnosed with PAP at his initial visit, the Nocardia infection could have been found and treated conservatively before it progressed to seizures and an emergent surgery.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"27 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83081874","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}