Austin journal of pulmonary and respiratory medicine最新文献

{"title":"Alveolar Hemorrhage Associated with Rivaroxaban: A Case Series","authors":"H. Laird-Fick, Brian Grondahl, M. Benedict, Anas Riehani","doi":"10.4172/2161-105X.1000405","DOIUrl":"https://doi.org/10.4172/2161-105X.1000405","url":null,"abstract":"Background: We present 4 cases of alveolar hemorrhage in patients receiving rivaroxaban. While bleeding is a common complication of rivaroxaban therapy reported by multiple case reports in the literature, this complication is not frequently reported. There were two cases of alveolar hemorrhage related to rivaroxaban found in our literature search. Alveolar hemorrhage is a potentially fatal complication and must be promptly recognized. \u0000Case Presentation: The electronic medical record was reviewed for patients with alveolar hemorrhage syndromes admitted to our hospital between July 1, 2014 and June 30, 2015. This data was cross referenced for patients received anticoagulant medications. \u0000Our series of patients included one patient with underlying Antiphospholipid Syndrome (APS) and systemic lupus erythematous, another patient with pulmonary malignancy and distant lung resection, a third patient with lymphangioleiomyomatosis, and a fourth patient with myelodysplastic syndrome. Rivaroxaban accounted for 13.6% of all cases of clinically significant pulmonary hemorrhage and drug related pulmonary hemorrhage accounted for half of cases. The rate of alveolar hemorrhage associated with Rivaroxaban in our institution was about 3 cases in 1000. \u0000Conclusions: We identified four cases of rivaroxaban associated alveolar hemorrhage. We encourage cautious use of rivaroxaban in patients with underlying lung conditions or factors that predispose to alveolar hemorrhage. Further research to clarify the risk of diffuse alveolar hemorrhage (DAH) in at-risk patients receiving oral anticoagulants is recommended.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"30 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90036395","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":"Evaluation of the Maximal Respiratory Pressure in Children and Adolescentswith Asthma between 7 and 14 Years Old","authors":"Patrícia Helena Medeiros Cézar de Oliveira Rodrigues, M. March, Regina Kátia Cerqueira Ribeiro, C. Sant´Anna","doi":"10.4172/2161-105X.1000404","DOIUrl":"https://doi.org/10.4172/2161-105X.1000404","url":null,"abstract":"Objectives: To evaluate the respiratory muscle strength among children (<10 years old) and adolescents with asthma. \u0000Methods: This is a cross-sectional, retrospective study, among children and adolescents (7 years to 14 years of age) with asthma. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) [in cmH2O] were measured through digital manometer. The variables evaluated were: gender, age, BMI (body mass index), severity of asthma, use of inhaled corticosteroid (IC). \u0000Results: A total of 48 individuals were studied. MIP values were according: a) normal weight=69.5 ± 22.6; overweight=81.6 ± 25.4 (p<0.088); b) use of inhaled corticosteroid=70.5 ± 23.0; no use=25.1 ± 86.3 (p<0.045). MEP values according: a) ages 7-9 years=78.8 ± 19.4; 10-14 years=68.1 ± 22.7 (p<0.097); b) normal weight=66.1 ± 18.9; overweight=80.3 ± 23.3 (p<0.024); c) use of inhaled corticosteroid=68.3 ± 18.3; no use=83.1 ± 27.5 (p<0.036); d) with bronchiectasis=61.8 ± 19.2; without bronchiectasis=83.1 ± 27.5 (p<0.069). \u0000Conclusions: Patients who used inhaled corticosteroid had MIP and MEP lower than the others; patients with normal BMI tended to have lower MEP than the overweight group and lower MIP in the group of normal weight. There was a tendency of adolescents to present lower MEP than children.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"21 2-4","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91472579","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":"Respiratory management of the newborn with an omphalocele","authors":"J. Baerg, Arul S. Thirumoorthi, A. Hopper","doi":"10.5772/63735","DOIUrl":"https://doi.org/10.5772/63735","url":null,"abstract":"Despite advances in neonatal care, infants with omphalocele have a mortality rate ranging between 5% and 25%. Respiratory insufficiency is a common clinical chal‐ lenge and an independent predictor of mortality in these infants. The causes of respiratory failure are diverse and are not well understood. This chapter discusses the unique aspects of respiratory management in omphalocele infants. The authors have chosen references in this chapter with appropriate sample size, variable comparisons, regression analyses, and documented median follow-up times. Omphalocele is rare; therefore, the case reports of chapter references have important information. Omphalocele infants are sometimes born with inadequate lung volume to support survival. Prenatal predictors of pulmonary hypoplasia are discussed in the context of fetal magnetic resonance imaging (MRI) and postnatal clinical-radiologic correlation studies. Two recent retrospective articles explain the unique aspects of pulmonary hypertension in omphalocele infants and distinguish it from pulmonary hypoplasia. The avoidance of abdominal compartment syndrome at the time of omphalocele closure is discussed. Clinical strategies that improve the respiratory care of these infants, based on Specific definitions and diagnoses, may reduce the high mortality rate. lung the role of the influence of (GERD),","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75325292","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":"Epidemiological Factors and Preventable Tuberculosis Transmission in a Hospital Setting in Malaysia","authors":"Thana Sehgaran Shanmugam, Nyanamalar Sivapalan, N. Parthiban, Tha Shanmuga Sundari Thana Sehgaran, P. Subramanian","doi":"10.11648/J.AJPRM.20170202.13","DOIUrl":"https://doi.org/10.11648/J.AJPRM.20170202.13","url":null,"abstract":"Tuberculosis (TB) is a public health challenge in Malaysia. Delay in diagnosing and treating TB patients are associated with TB transmission. These treatment delays can be reduced by identifying and managing the contributing epidemiological factors. This study measured the magnitude of the delays in TB treatment in terms of patient delay, medical visit delay and treatment initiation delay. In addition, it aims to identify epidemiological factors contributing to these delays, the disease severity and positive sputum smear outcome. This is a cross sectional study of TB patients in a district hospital and the outcomes were computed in terms of percentage, survival curve, odds ratio and confidence interval. The patient delay, medical visit delay and initiation of treatment delay are 73%, 53% and 14% respectively. Patient delay is reduced to 50% after 28 days and is eliminated after 1120 days. Malay patients and patients without family history of TB have higher risk of experiencing all three delays. Non-Malays, males, patients with family history of TB and patients with TB contact have been related to higher risk of severe form of TB and positive smear. TB transmission can be reduced by managing the epidemiological factors identified in TB control measures.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"7 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2017-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73381164","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":"Anesthesia for a Patient with Severe Pulmonary Hypertension Undergoing Laparoscopic Cholecystectomy: A Case Report","authors":"Yilu Zhou, Hongfei Chen, Hao Zhang, Mingxing Li, Jiayue Guo, Qingxiu Wang","doi":"10.4172/2161-105X.1000403","DOIUrl":"https://doi.org/10.4172/2161-105X.1000403","url":null,"abstract":"Pulmonary hypertension (PH) is a haemodynamic and pathophysiological condition defined as an increase in \u0000 mean pulmonary arterial pressure (PAP) ≥ 25 mmHg at rest as assessed by right heart catheterization. We report \u0000 a patient with severe pulmonary hypertension after repair of ventricular septal defect. The patient underwent \u0000 laparoscopic cholecystectomy. The purpose of this case was to discuss the perioperative management of a patient \u0000 with severe pulmonary hypertension who underwent laparoscopic cholecystectomy which could provide a reference \u0000 for the management of these patients in the perioperative period.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"8 2","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91440519","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":"Unique Approach to Diagnosing and Treating Congenital Bronchial Atresia (CBA): A Case Series","authors":"A. Mahajan, Rod A Rahimi, Paul, erlaan, Erik Folch, S. Gangadharan, A. Majid","doi":"10.4172/2161-105X.1000402","DOIUrl":"https://doi.org/10.4172/2161-105X.1000402","url":null,"abstract":"Congenital bronchial atresia (CBA) is a rare airway anomaly resulting in termination of a bronchus into a blind \u0000 pouch with associated mucoid impaction and segmental hyperinflation. The etiology of CBA is related to vascular \u0000 insufficiency to the bronchial bud during embryologic development. Controversy exists regarding the best approach \u0000 to treatment for CBA and relating symptoms to the presence of these anomalies can be challenging. This case series \u0000 describes three patients with varying approaches to diagnosis and treatment of CBA.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"117 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79435793","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 Global Usability Score: A Novel Comprehensive Tool for Assessing, Ranking, and Compare Usability of Inhalers in Patients Requiring Airway Treatments","authors":"W. DalNegroRoberto, Turco Paola, M. Povero","doi":"10.4172/2161-105X.1000401","DOIUrl":"https://doi.org/10.4172/2161-105X.1000401","url":null,"abstract":"Introduction: The inhalation route is the best choice for respiratory drug delivery, but benefits to patients are \u0000 strictly related to the proper use of inhalers. The role of patients’ view point (such as: their intuitivity, preference, \u0000 acceptance, and satisfaction) were extensively investigated, even if other factors, unrelated to their personal beliefs, \u0000 can further affect inhaler usability. \u0000Aim: to define a specific tool for easily assessing, ranking, and comparing the real usability of whatever inhaler by \u0000 a single, comprehensive score, also based on objective measurements. \u0000Methods: A specific, anonymous questionnaire was validated. The Questionnaire consists of four main sections \u0000 (Introductory; Assessing Track; Global Score calculation, Patient’s personal data). Questions are twenty-seven, \u0000 all scored: twenty-two addressed to the patient, and five to the expert nurse, who has to conduct the independent \u0000 assessments. The sum of the eight sub-scores of the Assessing Track will represent the final Global Usability Score- \u0000 GUS, which ranges 0-50 points for each inhaler; higher the GUS value, higher the real usability will be. \u0000Results: the comprehension of all questions at their first reading was >97% in the final version of the GUS \u0000 Questionnaire, for both patients and nurses participating to the questionnaire development. \u0000Discussion: usability of inhalers is a complex and multifaceted issue. When assessing usability, it should be taken \u0000 into account that the role of patients’ beliefs differently integrates the role of other objective determinants which are \u0000 unrelated to the sole patients’ viewpoint. Terms like intuitivity, preference, acceptability, or satisfaction should not be \u0000 used as synonyms for usability, because too related to the patients’ subjectivity only. \u0000Conclusions: the Global Usability Score represents the first comprehensive score for assessing, ranking, and \u0000 comparing objectively the contribution of all main components of inhaler usability, and then provide an effective and \u0000 motivated standard of choice.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"63 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84684790","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":"Video-Assisted Thoracoscopic Surgery for Several Diseases of Thoracic Surgery in 1412 Patients","authors":"Un-Chol Kwon, Hyon-Jong Kim, Hwan-Su Riu, K. Ju, Un Song, Gee-Yong Ri, Il-Su Jo","doi":"10.11648/J.AJPRM.20170202.12","DOIUrl":"https://doi.org/10.11648/J.AJPRM.20170202.12","url":null,"abstract":"Bauckground: Video-Assisted Thoracoscopic Surgery (VATS) is applied in the almost diseases of Thoracic Surgery in the world, and became a standard approach that the patients enthusiastically hope, because VATS can reduce the invasion of operation, the duration of hospitalization and aesthetically satisfy in all patients. We retrospectively reviewed our recent experience with VATS to define its role in the context of current surgical practice. Method: Between January 1999 and December 2015, 1209 patients at Pyongyang medical college hospital, Kim Il Sung university with Hyperhidrosis, kakidrosis, Raynaud’s disease, pleurisy in 1 st stage and pneumothorax were treated with the use of VATS. 203 patients with pleurisy in 2 nd , 3 rd stage and pneumothorax, empyema, haemothorax, lung cancer, mediastinal tumor, lung tuberculoma, lung cystoma and esophageal cancer were treated with MITS (Mini-Invasion Thoracoscopic Surgery). Result: VATS was successful in achieving satisfied effects in the patients with hyperhidrosis, empyema, pneumothorax, mediastinal tumor, lung tuberculoma, lung cystoma and esophageal cancer. In 42 patients with kakidrosis VATS failed to treat and symptom recurred. In one patient with pleurisy died postoperatively, two patient experienced empyema. Conclusions: In our experience the operation approach with the use of VATS was safe and effective in the surgical treatment of several thoracic diseases. The rate of complication is low and the level of pain is acceptable without long-term sequelae.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"2 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2017-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88873119","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":"Conventional vs. Liquid Based Cytology in Fine Needle Aspirates of Lung and Mediastinal Masses","authors":"Garima Singh, P. Agarwal, M. Goel, Madhu Kumar, D. Singh","doi":"10.4172/2161-105X.1000400","DOIUrl":"https://doi.org/10.4172/2161-105X.1000400","url":null,"abstract":"Background: Lung cancer most common worldwide cancer, early diagnosis makes effective treatment in lung \u0000 cancer. Liquid Based Cytology (LBC) for non-gynae specimens has gained popularity over conventional Cytology (CS) \u0000 during last one decade because of increased sensitivity and specificity. \u0000Aim and objectives: To assess the diagnostic utility of LBC versus CS in fine needle aspirates of lung and \u0000 mediastinal mass lesions. Compare cyto-morphological parameters in terms of adequacy, interpretation, concordance \u0000 and diagnostic efficiency. \u0000Materials and Methods: Eighty -two cases suspected of lung or mediastinal mass lesions underwent imagine \u0000 guided Transbronchial Needle aspiration (TBNA) or Trans Thoracic Needle aspiration (TTFNA). Fine needle passes \u0000 were made for both conventional and LBC smears. All smears were examined and diagnosis was correlated in each \u0000 case with histopathology as gold standard for final diagnosis. Results: Histopathology of 82 cases, 21 were non \u0000 -neoplastic and 61 were malignant respectively.34 cases of adenocarcinoma, 15 cases of squamous cell carcinoma, \u0000 5 cases of adenosquamous cell carcinoma, 4 cases of small cell carcinoma, 1 cases of poorly differentiated 1 case of \u0000 carcinoid and 1 cases of germ cell tumor. LBC were diagnosed 17 non -neoplastic and 54 were malignant respectively. \u0000 25 cases of adenocarcinoma, 11 cases of squamous cell carcinoma, 5 cases of adenosquamous cell carcinoma and \u0000 3 cases of small cell carcinoma, CS was diagnosed 4 non -neoplastic and 37 were malignant respectively. 24 cases \u0000 of adenocarcinoma, 7 cases of squamous cell carcinoma, 4 cases of adenosquamous cell carcinoma and 2 cases of \u0000 small cell carcinoma. \u0000Conclusion: Concordance of LBC with histopathology was found in higher proportion (72%) as compared to \u0000 conventional smear (48.8%) (p=0.004), because percentage of adequacy for LBC (85.37%) was higher as compared \u0000 to CS (56.1%) (P<0.001). The assessment of all the morphological parameters were predominantly equal in both \u0000 methods except in few cases.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"110 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85764085","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":"Effect of Smoking in Cognition","authors":"Karishma Rajbh, P. ari, Ey, P. DipeshRaj, Ay, N. Sapkota, Anish Dhami, Akshay Sarraf, eep Shrestha, D. Kc","doi":"10.4172/2161-105X.1000399","DOIUrl":"https://doi.org/10.4172/2161-105X.1000399","url":null,"abstract":"Introduction: Smokers claim that smoking increases their concentration, alertness, and overall mental \u0000 performance. On the contrary, evidences point at gradual cognitive deterioration in smokers. Montreal cognitive \u0000 assessment (MoCA) assesses even mild cognitive impairment. \u0000Objective: To determine and compare the cognitive status in smokers and healthy controls. \u0000Method and Materials: A cross-sectional comparative study was done in 46 apparently healthy male healthscience \u0000 students (23 smokers and 23 nonsmokers) at Pulmonary Function Lab in the Department of Basic and Clinical \u0000 Physiology, BPKIHS. Pulmonary function tests (PFT) were measured. For cognition assessment MoCA, which is \u0000 a set of close ended questionnaire was used. To assess smoking status and MoCA score, Mann Whitney U test \u0000 was employed and data are expressed in median and IQR. Fisher’s Exact Chi-square Test was applied to observe \u0000 association between smoking and cognition. Level of significance was p<0.05. \u0000Results: All PFT variables, compared between smokers and non-smokers yielded non-significant differences (VC: \u0000 3.97 (3.53-4.76) vs. 4.26 (3.83-4.66) p=0.709; FEV1: 3.81 (3.47-4.71) vs. 4.17 (3.58-4.44) p=0.775; FEV1/FVC: 98.09 \u0000 (95.72-99.09) vs. 95.3 (92.5-98.2) p=0.202). The comparison of MoCA score between the two groups (26(25-27) vs. \u0000 27(26-28) p=0.192 as well as the association between smoking and cognition was non-significant. \u0000Conclusion: Young healthy smokers without any pulmonary function abnormalities had cognition state similar to \u0000 non-smokers. Therefore, there is no association of smoking on cognition in apparently healthy young adults.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"417 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74983228","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}