Austin journal of pulmonary and respiratory medicine最新文献

{"title":"Experience of Pleurodesis with a 50% Glucose Solution in Patients with Secondary Pneumothorax: A Case Series","authors":"S. Kajikawa","doi":"10.4172/2161-105X.1000398","DOIUrl":"https://doi.org/10.4172/2161-105X.1000398","url":null,"abstract":"Secondary pneumothorax commonly encountered and it often recurs or becomes a refractory to treatment. \u0000 Pleurodesis is usually selected for initial treatment in community hospitals. Recently, endobronchial intervention using \u0000 the endobronchial Watanabe spigot and endobronchial valve for refractory pneumothorax has become available, but \u0000 these procedures can be performed only at a few institutions with sufficient staff and equipment. \u0000The use of a glucose solution for pleurodesis has been reported as a novel approach to persistent air leakage. \u0000 Pleurodesis with a 50% glucose solution was occasionally empirically performed in community hospitals. However, \u0000 only limited literatures have published. Here, I report the experience of five patients (4 men and 1 woman; 71 years \u0000 to 84 years old), seven times with inoperable secondary pneumothorax who received pleurodesis with a 50% glucose \u0000 solution. In our cases, two of them had pneumoconiosis, one had chronic obstructive lung disease (COPD), one had \u0000 interstitial pneumonia (IP) and one had lung cancer. The procedure successfully stopped air leakage and allowed chest \u0000 tube removal (4 days to 10 days) in three patients without severe complications. Same as previous report, temporary \u0000 hyperglycemia occurred in three patients. Therefore, pleurodesis with a 50% glucose solution suggested possibility \u0000 that a feasible and safe. Despite future large-scale studies should aim to examine the efficacy and tolerance of this \u0000 technique, it would be beneficial to obtain the alternative agent of pleurodesis for patients with inoperable secondary \u0000 pneumothorax and rural hospitals.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"31 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91216840","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":"Morphological Characteristics of a Rat Model of Reexpansion Pulmonary Edema","authors":"S. Otani, T. Yashiro, Y. Sohara, S. Endo","doi":"10.4172/2161-105X.1000396","DOIUrl":"https://doi.org/10.4172/2161-105X.1000396","url":null,"abstract":"Objective: Reexpansion pulmonary edema (RPE) is a severe disorder, and its pathophysiology is not well understood. One proposed mechanism for RPE is that chemical substances such as cytokines increase alveolar permeability. Another possible mechanism is that alveolar distention during reexpansion causes physical damage. To test the hypothesis that sudden alveolar distention damages alveolar cellular structure and identify the underlying cause of RPE, we developed and evaluated the morphological characteristics of a rat RPE model. \u0000Methods: Lung from a rat model of RPE was observed by using live imaging from intravital fluorescence microscopy with fluorescein isothiocyanate labelled albumin as tracer, light microscopy, and electron microscopy (with and without horseradish peroxidase [HRP] as tracer). \u0000Results: Intravital fluorescence microscopy and light microscopy showed that RPE developed almost immediately after lung reexpansion and that blood flow in pulmonary capillaries slowed substantially. In some capillaries, however, blood flow had stopped entirely; in others, anterograde and retrograde flow alternated. Electron microscopy revealed pores in type I pneumocytes and overt fissures in alveolar walls. Electron microscopic observation with HRP revealed that HRP moved from capillaries to the inner surfaces of alveolar epithelia in reexpanded lungs. In addition, diaminobenzidine reaction products from the HRP enzyme reaction were visible in areas with pores. \u0000Conclusions: RPE occurred almost immediately after lung reexpansion. Pores developed in type I pneumocytes in alveolar epithelium. These pores, together with overt fissures in alveolar walls, allowed leakage of plasma components into alveoli. These findings appear to be important features of RPE development.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"3 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73228001","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":"Correlation of the Imaging Findings with Bronchoscopic Findings for the Detection of Endobronchial Lesions: A Systematic Review and Meta-Analysis","authors":"M. Kouvela, S. Kakavas, Christos Karetsos, E. Balis","doi":"10.4172/2161-105X.1000395","DOIUrl":"https://doi.org/10.4172/2161-105X.1000395","url":null,"abstract":"Background: The purpose of this systematic review was to compare the diagnostic accuracy of axial thoracic CT, other imaging techniques and image reconstruction algorithms with the endoscopic findings of Fiberopptic Bronchoscopy (FOB), in patients with newly detected endobronchial lesions. \u0000Methods: A systematic review of the literature for retrospective and prospective studies was performed. Articles considered included patients with endobronchial stenosis that were subjected to axial Computed Tomography of the chest with or without an image reconstruction technique, and Fiberoptic Bronchoscopy. \u0000Results: 10 studies (6 prospective/4 retrospective) that were published in PubMed or CancerLit met the inclusion criteria. A total number of 633 patients were involved in the studies and an additional number of 53 patients were included as controls. All the patients were subjected to Fiberoptic Bronchoscopy (FOB) and imaging of the chest. The meta-analysis showed a high sensitivity for most imaging techniques, comparable with this of Fiberoptic Bronchoscopy, but with a significant Negative Predictive Value. \u0000Conclusion: Even though the imaging techniques are a useful, fast and safe modality for the detection of endobronchial lesions, the high negative predictive value raises a concern on their sufficiency for the exclusion of lung cancer on high risk patients.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"9 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2017-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87444760","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":"Spontaneous Tension Hemothorax in a Young Male with a Nuss Implant","authors":"G. Jacobsen, Bodil Br, S. G. Ellesøe","doi":"10.4172/2161-105X.1000394","DOIUrl":"https://doi.org/10.4172/2161-105X.1000394","url":null,"abstract":"A 19-year-old male presented with upper abdominal pain, shortness of breath and loss of consciousness. X-rays revealed a tension hemothorax and a chest tube was inserted evacuating 2500 ml of blood. Bleeding in the tube ceased after the initial evacuation and the patient was monitored closely and could be discharged in good health on the second day after admission. We hypothesize, that the tension hemothorax was preceded by a spontaneous pneumothorax, which caused a tear in scar tissue following the Nuss procedure five months previously.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"31 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81906792","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":"Trimethoprim-Sulfamethoxazole (TMP-SMX) Induced Severe Systemic Reaction","authors":"Farrukh Abbas, Mehul Patel, K. Abbas, P. Shah, Michael N Gurel","doi":"10.4172/2161-105X.1000393","DOIUrl":"https://doi.org/10.4172/2161-105X.1000393","url":null,"abstract":"Objective: Trimethoprim-Sulfamethoxazole (TMP-SMX) is a relatively commonly prescribed antibiotic. One of the rare but dramatic reactions to TMP-SMX is severe systemic reaction which can mimic sepsis or septic shock and this can be a diagnostic challenge especially in critical care setting. The objective is to raise information about this side effect. Study Selection: The case series includes two patients’ reports. The first patient was 85 year old woman who received TMP-SMX before dental extraction and presented with rash and fever. She met SIRS criteria with leukocytosis, bandemia, lactic acidosis and acute kidney injury. All the infectious work remained negative. She improved with supportive care. She received TMP-SMX again after a few weeks and again presented with similar clinical course. Again the infectious work up remained negative and she improved with supportive care. It was thought that TMP-SMX contributed to this. The second patient was 85 year old man who took TMP-SMX for right leg cellulitis and presented with systemic inflammatory response resembling septic shock. All the infectious work up remained negative. The patient recovered completely with supportive care. TMP-SMX was thought to be responsible for the side effect. Conclusion: TMP-SMX induced systemic reaction resembling anaphylaxis or sepsis is rare. Symptoms are very similar to classic sepsis and septic shock including fever, chills, leukocytosis and hemodynamic instability. This has been described mostly in HIV patients but this may happen in non-HIV patients as well.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"86 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91330097","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":"Predictors of Outcome in Drug Resistant Tuberculosis Patients","authors":"A. Periasamy","doi":"10.4172/2161-105X.1000391","DOIUrl":"https://doi.org/10.4172/2161-105X.1000391","url":null,"abstract":"Introduction: Multi-drug-resistant tuberculosis (MDRTB) is a major public health problem due to longer duration \u0000 of treatment and unfavourable outcome in comparison with sensitive TB. Aim: Registered Drug resistant tuberculosis (DRTB) patients were prospectively followed from 2011-2015. \u0000 Analysis of treatment outcomes was by done by their demographic and clinical data which were hypothesized to be \u0000 outcome predictors. \u0000 Methods: Logistic regression and univariate logistic regression were used upon data of patients registered for \u0000 MDRTB treatment in Trichy district Tamilnadu, India. Totally 63 MDRTB patients were treated from 2011-15. Outcomes \u0000 were reported as success & failure. Success included cured and treatment completed patients and Failure included \u0000 treatment failure, death, defaulted, untraceable cases. SPSS 21 was used. \u0000 Results: Out of total 63 cases, 33 cases had failed outcome and 30 cases had successful outcome. Among \u0000 variables Diabetes, XDRTB suspects, drug abuse & smoking were associated with failed outcome. Sex, age, chest \u0000 x-ray lesion, pre-treatment resistance profile, did not affect the outcome. By logistic regression (enter) method the \u0000 odds of failed outcome were 11.737 with smoking, the odds of failed outcome was 12.43 with XDRTB suspects, and \u0000 the odds of failure with diabetes was 12.61. The P-value of smoking, XDRTB suspect, diabetes obtained was 0.019, \u0000 0.049, and 0.036 respectively. Chi square test showed significant P-value for variables sex, diabetes, XDR suspects, \u0000 smoking and drug abuse, but insignificant P-value for HIV, comorbid illness like renal failure. Similarly, age, chest x-ray \u0000 lesion like cavitary, caseous lesion, did not affect the outcome as per logistic regression analysis. Conclusion: Smoking, PreXDRTB, Diabetes, were factors affecting the outcome of treatment independently \u0000 hence predictors of outcome in MDRTB. The emergence of preXDRTB as independent factor determining the outcome \u0000 is significant emphasizing the earlier switch to XDRTB regimen.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"4 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79015901","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":"Knowledge about Tuberculosis and its Complication among the Patients in a Teaching Hospital","authors":"Fazlu Rehman, M. Raoof, A. Srinivasarao, A. Hasan, M. Qurram","doi":"10.4172/2161-105X.1000390","DOIUrl":"https://doi.org/10.4172/2161-105X.1000390","url":null,"abstract":"Tuberculosis (TB) is an infectious disease which is transmitted by air. This disease damages the lungs and other \u0000 organs in the human body. It is one of the leading causes of morbidity and mortality despite the fact that it can be cured \u0000 with adequate treatment. The entry of multidrug resistant tuberculosis (MDR-TB) or extensively drug resistant (XDRTB) \u0000 is biggest challenges in our effort to control the disease complications. A cross-sectional study was conducted \u0000 to assess TB related knowledge, its complications and control among the patients from the outpatient Pulmonology department of Owaisi Hospital and Research Center- HYD. The research shows that maximum number of patients \u0000 (59%) was unsure about the severe complication of TB whereas patients did not adhere to the treatment and discontinue \u0000 it half-way, this become the prime reasons for the gap between treatment and control, thereby non-adherent treatment \u0000 could have severe consequences of diseases and might lead to death. Knowledge about pulmonary complication and \u0000 duration of treatment has to be emphasized.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"41 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88741505","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":"Inert Cellulose Powder in the Treatment of Seasonal Allergic Rhinitis","authors":"J. Minov, J. Karadžinska-Bislimovska, T. Petrova, K. Vasilevska, S. Stoleski, D. Mijakoski","doi":"10.4172/2161-105X.1000388","DOIUrl":"https://doi.org/10.4172/2161-105X.1000388","url":null,"abstract":"Objective: To assess efficacy and safety of inert cellulose powder (ICP) in the treatment of mild seasonal allergic rhinitis (SAR). Methods: An observational, non-randomized, open study including 74 examinees suffering from mild SAR was conducted. The study subjects were divided in two groups, Group 1 (G1) and Group 2 (G2). The study subjects from G1 were treated 10 days with oral cetirizine and ICP, while the study subjects from G2 were treated 10 days only with oral cetirizine. The treatment outcomes were evaluated after five and 10 days by self-assessment of the symptoms on a five-point scale. Results: In both groups improvement of the symptoms five and 10 days after the treatment was registered. There was significantly higher prevalence of the G1 study subjects in the point 4 (“major relief, casual sneezing”) five days after beginning of the treatment (43.2% vs. 18.9%; P<0.05), as well as in the point 5 (“complete relief, without symptoms”) at the end of the treatment (56.7% vs. 27.0%; P<0.05). A low frequency of adverse effects was registered among examinees of both groups. Conclusion: The results obtained indicated high efficacy and safety of ICP in the treatment of mild SAR.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"19 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82729221","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 Epidemiological Aspects of Tuberculosis Patients in a Tertiary Care Medical College Hospital of Bangladesh","authors":"A. Raza, Muhammad Rafiqul Islam, Mahfujun Nahar, Z. Ahmed","doi":"10.4172/2161-105X.1000389","DOIUrl":"https://doi.org/10.4172/2161-105X.1000389","url":null,"abstract":"Background and Aims: To assess the clinical and socio-demographic characteristics of tuberculosis patients in a \u0000 tertiary care medical college hospital of Bangladesh. \u0000 Methods: An observational study was conducted over a period of one year from September 2015 to August 2016 in \u0000 the Outpatient Department of Jahurul Islam Medical College Hospital and Department of Pathology, Jahurul Islam \u0000 Medical College, Kishoregonj, The inclusion criteria of the study were pulmonary and extra pulmonary tuberculosis cases receiving antitubercular drugs therapy. Primary data from each patient was included in tuberculosis patient \u0000 profile form such as age, gender, educational level, annual income in taka, occupational status and selected social \u0000 habits like smoking, alcohol. Results: Out of 112 patients studied, 50 (44.6%) were male and 62 (55.4%) were female. The majority of patients 69 \u0000 (61.7%) were in the age group of 15-34 years. Annual family income of 78 (69.6%) patients ranged between 36,000- \u0000 1,50,000 taka. In total 112 patients 43 (38.4%) were illiterate and 36 patients (32.2%) were unemployed. 50% of the \u0000 patients were smoker. The most common sites involved in extrapulmonary tuberculosis were the lymph nodes (38.2%) \u0000 followed by the pleura (36.4%). The most common symptoms observed in pulmonary tuberculosis patients were cough \u0000 with expectoration (96.5%) followed by weight loss (80.7%), fever (73.7%) and loss of appetite (54.4%). \u0000 Conclusion: Prevalence of infection was noticed between PTB and EPTB with age and it was more common in \u0000 younger age. However, based on our results TB control programme might usefully target young middle age populations \u0000 for early diagnosis of TB to decrease TB morbidity and mortality.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"31 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75677829","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 Review of the Non Pharmacologic Management of Chronic Obstructive Pulmonary Disease","authors":"J. Akwe, Scott Steinbach, J. Murphy","doi":"10.11648/J.AJIM.20160406.18","DOIUrl":"https://doi.org/10.11648/J.AJIM.20160406.18","url":null,"abstract":"Over the years, the management of chronic obstructive pulmonary disease has evolved, but given the high mortality and morbidity of COPD, much work still needs to be done. To date, none of the existing pharmacological therapies for COPD has been shown conclusively to modify the long-term decline in lung function. Several trials have been completed to evaluate options that can improve patient symptoms and quality of life. Optimal management of COPD requires both pharmacologic and non-pharmacologic interventions. Some of the non-pharmacologic options for the management of COPD like Oxygen therapy have proven reduction in mortality and mortality, and an improvement in the quality of life. Lung transplant is the only treatment that can stop the decline in lung function. Smoking cessation is the non-pharmacologic intervention with the greatest capacity to influence the natural course of COPD. Pulmonary rehabilitation programs are evidence based, multidisciplinary and comprehensive interventions for patients with COPD. These programs involve patient assessment, exercise training, education, nutrition and psychosocial support. Pulmonary rehabilitation programs are designed to reduce symptoms, optimize functional status, increase participation and reduce health care cost through stabilizing or reversing systemic manifestations of the disease. This article discusses the most used non pharmacologic management of COPD and their usefulness in relieving symptoms and improving the quality of life for patients with severe COPD. These treatment options are used in addition to optimal pharmacologic therapy.","PeriodicalId":90449,"journal":{"name":"Austin journal of pulmonary and respiratory medicine","volume":"1 1","pages":"131"},"PeriodicalIF":0.0,"publicationDate":"2017-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88485383","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}