International journal of respiratory and pulmonary medicine最新文献

{"title":"The HRCT Imaging Findings of the Peripheral Pulmonary Vessels in Patients with Pulmonary Hypertension (PH)","authors":"Kazawa Nobukata, Sugiura Tetsuro","doi":"10.23937/2378-3516/1410187","DOIUrl":"https://doi.org/10.23937/2378-3516/1410187","url":null,"abstract":"Background: To analyze the peripheral pulmonary vessels in patients with pulmonary hypertension (PH) on consecutive HRCT without slice gap and 3D-VR (volume rendering)-CT. Materials and methods: We studied 40 (17-82 mean 45.6-years-old, F/M = 24/16) patients with clinically verified pulmonary hypertension, reviewing the pulmonary angiography, HRCT and 3D-CT. This study includes both idiopathic PAH (n = 20) and secondary PAH (n = 20). The causes were as follows; CTEPH (chronic thrombo-embolic PH) (n = 7), collagen vascular diseases (MCTD1, SjS1, RA1, SLE1), ASD (n = 2), VSD (n = 2), aortic coarctation with PDA (n = 1), liver cirrhosis (n = 1), mitral valve regurgitation (n = 1), single atrium and ventricle (n = 1), and Rendu-Osler-Weber disease (n = 1). Results: The prominence of the pulmonary vasculature and/or tortuosity (n = 16) and dilatation of the central PA (n = 39) with RV hypertrophy were frequently observed. The interlobular septal thickening (n = 18, 45%), and centrilobular (perivascular) ground glass opacities (n = 6, 15%) were clearly depicted on gapless HRCT. PA aneurysmal dilatation and irregular dilatation with arterio-venous fistula were observed in 2 (5%) and 3 cases (7.5%), respectively. Bronchial artery dilatation was observed in 5 cases. RV myocardial muscle hypertrophy was observed in 4 cases (10%). The lymphadenopathy caused mainly by edematous reaction was observed in 9 (22.5%) cases. Conclusion: Besides prominence of the pulmonary vasculature and/or tortuosity of PA, the centrilobular (perivascular) ground glass opacities (n = 6, 15%) reflecting perivascular edema and/or hemorrhage were detected on HRCT. PA aneurysmal dilatation and irregular dilatation with arterio-venous fistula were observed in 2 (5%) and 3 cases (7.5%), respectively in severe PH patients.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46056763","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":"Effectiveness of Extracorporeal Membrane Oxygenation in Adults","authors":"Wright James A","doi":"10.23937/2378-3516/1410185","DOIUrl":"https://doi.org/10.23937/2378-3516/1410185","url":null,"abstract":"Background: With patients for whom it is difficult or near impossible to maintain adequate oxygenation by conventional means, it may become necessary to oxygenate the blood outside the body. One method used with moderate success is the procedure of extracorporeal membrane oxygenation (ECMO). The purpose of this study was to determine the effectiveness of ECMO in adult patients suffering from conditions associated with respiratory failure that is refractory to conventional means of treatment. Methods: A systematic review of available studies was utilized to answer the earlier research questions. Reputable research journals were combed for articles pertaining to ECMO use in adult, pediatric, and neonatal populations and their effectiveness. Included in this study were articles that met the eligibility criteria. Relevant information was summarized and applied to the research questions. Results: Ten Studies were identified for analysis (3 neonatal, 3 pediatric, and 4 adult). Each study showed a benefit in survivability from the use of extracorporeal life support (ECLS) in conditions of respiratory failure that was deemed refractory to conventional means of treatment. The Extracorporeal Life Support Organization (ELSO) registry contained the most comprehensive data, with the neonatal population being the most robust, followed by the pediatric and adult populations respectively. Neonatal indications for ECLS administration were less difficult to reverse than are adult conditions. Conclusion: Though not as effective as the pediatric and neonatal populations, adult ECLS was still determined to have some effectiveness. The indication or diagnosis played a significant role in the utilization and effectiveness of ECLS. Complications associated with the use of ELSC were of great concern for all patient populations. The adult population had a higher incidence of infection, cannula site bleeding, and surgical site bleeding than neonatal and pediatric populations. As the technology continues to evolve and the practice of ECLS use in adults continues to progress and increase, there is a potential to realize increasing effectiveness. ReseARch ARticle","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135877558","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":"Effectiveness of Prone Positioning versus Supine Positioning in Patients Suffering from Refractory ARDS: A Meta-Analysis","authors":"Wright James A","doi":"10.23937/2378-3516/1410184","DOIUrl":"https://doi.org/10.23937/2378-3516/1410184","url":null,"abstract":"Purpose: Prone positioning (PP) was advocated more than 40 years ago as a means of improving the oxygenation status in patients exhibiting acute respiratory failure (ARF) and acute respiratory distress syndrome (ARDS). The purpose of this meta-analysis is to determine if prone positioning (PP) is a more effective way of treating ARDS patients than supine positioning (SP) in patients that are refractory to conventional mechanical ventilation. Design methods: Relevant electronic databases were searched for studies that met appropriate inclusion criteria. Key Medical Subject Headings (MeSH) terms were utilized such as: ARDS, prone positioning, supine positioning, mortality, and ventilator-associated-pneumonia (VAP). The meta-analysis was performed using Review Manager (RevMan) Version 5.4.1 and Microsoft Excel. Any studies relating to COVID-19 were excluded at this time. Results/Expected results: There was no statistically significant difference between PP and SP in terms of mean intensive care unit (ICU) days. PP showed a statistically significant difference over SP for the secondary outcome of mortality. This study indicated that PP had no statistically significant positive effect on VAP cases. Discussion/conclusions: A glaring limitation of this study is the number of cases as only 4 studies were uncovered that met the criteria for acceptance. Lack of study subjects was another limitation and this can be explained partly by the mindset of practitioners. The use PP is a novel approach to treating ARDS. Practitioner education is vital in expediting the change, with COVID-19 seeming to have become a catalyst. As the amount of research, studies, and education increases, this will allow for creation/modification of policies and procedures that will include PP as a first-line treatment in certain cases.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42029470","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":"Factors Associated with the Peak Flow Variation Generated during Forced Manual Hyperinflation Technique","authors":"da Silva Luan Rodrigues, Arantes Ana Paula Felix, Cruvinel Fernando Guimarães, da Silva Renato Canevari Dutra","doi":"10.23937/2378-3516/1410186","DOIUrl":"https://doi.org/10.23937/2378-3516/1410186","url":null,"abstract":"Background: Manual hyperinflation is one of the most used respiratory physiotherapy techniques in critically ill patients and consists of administering a higher volume of gaseous fluid than the patient performed using a self-inflating balloon (AMBU). This technique was developed with the objective of removing bronchial secretion and re-expansion of atelectasis lung areas, thus improving pulmonary compliance and oxygenation in mechanically ventilated patients. Objectives: To demonstrate the peak flow variation generated during the physiotherapeutic technique of abrupt manual hyperinflation in an experimental model according to gender and classification among physiotherapists and physicists. Methods: The analytical and exploratory study included 115 participants, who were instructed to carry out the technique of abrupt manual hyperinflation with the AMBU connected to the device of measuring the peak of three times. Data were analyzed descriptively, according to gender and educational level, Shapiro-Wilk test, t-test and Pearson’s correlation coefficient between the mean PEF, height and age variables. Results: The sample consisted of women (74%) and physiotherapists (75%), with a mean of 22.71 ± 5.75 years of age, 116.74 ± 8.36 cm of height and 322.03 + 45.78 l/min peak flow. There was a significant difference between the genders for mean PEF (P = 0.000), for age (P = 0.002) and for height (P = 0.000) and between the average PEF (P = 0.001) and for the age (P = 0.000). Conclusions: Factors such as male gender, educational level and age were positively influenced by the mean peak expiratory flow generated by the manual hyperinflation technique.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47011658","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":"Methylene Blue Instillation for the Evaluation of Bronchopleural Fistula","authors":"Verbrugghe Lorijn, Driesen Peter","doi":"10.23937/2378-3516/1410183","DOIUrl":"https://doi.org/10.23937/2378-3516/1410183","url":null,"abstract":"A bronchopleural fistula (BPF) is a pathologic communication between a bronchus and the pleural space. BPF has a high morbidity and mortality, therefore a timely diagnosis is of great importance. Methylene Blue has been used for the localization of BPF for decades and although other diagnostic tools are available, it remains favorable because it is widely available, safe and easy to perform. In this case report we would like to stress the ongoing relevance of this diagnostic method by presenting 2 cases in which instillation of Methylene Blue was used in current practice to localize BPF.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49531640","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":"Anti-Inflammatory Effects and Clinical Efficacy of Podo-Whan and Tulobuterol in Mild to Moderate Chronic Obstructive Pulmonary Disease","authors":"Lee Jae-Hoon, J. Sung Hoon, Bae Jun","doi":"10.23937/2378-3516/1410188","DOIUrl":"https://doi.org/10.23937/2378-3516/1410188","url":null,"abstract":"","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68748520","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":"Intravenous Immunoglobulin Therapy for Maintenance Therapy of Interstitial Lung Disease Due to Antisynthetase Syndrome","authors":"Deengar Angad, Mutneja Rahul","doi":"10.23937/2378-3516/1410182","DOIUrl":"https://doi.org/10.23937/2378-3516/1410182","url":null,"abstract":"Antisynthetase syndrome (AS) is a rare autoimmune condition characterized by fever, Raynaud’s phenomenon, hyperkeratosis, inflammatory polyarthritis","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41486360","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":"Laryngeal Foreign Body for 20 days without a Catastrophic EventLaryngeal Foreign Body for 20 days without a Catastrophic Event","authors":"Narang Ved, Giovanni Sambiagio, Natarajan Balaji","doi":"10.23937/2378-3516/1410179","DOIUrl":"https://doi.org/10.23937/2378-3516/1410179","url":null,"abstract":"We present successful management of an unusual foreign body (FB) case in the larynx for 20 days. A 45-year old man presented with complaints of hoarseness of voice and coughing up a few pieces of silver-colored flakes. He had unresolved dyspnoea and wheeze for three weeks and was managed as an asthmatic with partial resolution of symptoms. The patient was alcohol and drug dependent and was under treatment for epilepsy. Fibre-optic laryngeal examination revealed a suspicious object in the Rima glottis. A blister pack measuring 2.6 cm × 2.2 cm was removed under GA. FB larynx is routinely associated with a definitive short history and the need for immediate resuscitation. However, the long period of persistence of FB in the larynx is possible depending upon the position of the FB. A history of aspiration may not be available in patient’s dependent on alcohol, drugs","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68748414","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":"Smear Negative Pulmonary Tuberculosis Is a Distinct Clinical Entity, Not a \"Misdiagnosis Waste Basket\"","authors":"Fawibe Ademola E, Desalu Olufemi O, Agede Olalekan A, Ojuawo Olutobi B, Oloyede Taofeek, Aladesanmi Adeniyi O, Salami Alakija K","doi":"10.23937/2378-3516/1410177","DOIUrl":"https://doi.org/10.23937/2378-3516/1410177","url":null,"abstract":"Background: PTB can mimic many chronic lung diseases resulting in misdiagnosis with serious consequences. Objectives: To appraise all SN PTB patients who were referred to us from lower health facilities after unsuccessful treatment in order to confirm the appropriate diagnosis. Methods: A cross sectional study at the pulmonary section of our hospital. Results: The median age of our patients was 46 with interquartile range of 32 to 54 years. The commonest presenting symptom was difficulty in breathing which was present in almost 90% of them (30 out of 34), cough was present in 24 with sputum production in 22 while haemoptysis was reported in 3. All the 5 patients with malignancy reported chest pain. Sixty eight percent of the patients were referred from Peripheral TB DOT centers and sputum smear tests were done in 82% of them while radiologic tests were done in less than 50% of the patients. The final diagnoses include COPD, malignancy, sarcoidosis, interstitial lung diseases and fungal infection among others. Conclusion: Many lung diseases are misdiagnosed as SN PTB because of similarity in clinical presentation, overreliance on diagnostic test with low TB detection and non adherence to local guidelines. We advocate for WHO-recommended rapid molecular test for all our suspected TB cases and prompt referral of difficult to diagnose cases.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46323325","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":"SARS Cov-2 Infection-Related Persistent Air Leaks Managed By Endobronchial Valves","authors":"Tiwari Mukund, Tangella Nikita, Sreekantan Archana, Patel Killol K","doi":"10.23937/2378-3516/1410180","DOIUrl":"https://doi.org/10.23937/2378-3516/1410180","url":null,"abstract":"Introduction: There have been recently documented reports of pneumothorax and persistent air leaks as complications associated with SARS CoV-2-related ARDS. Alveolar-pleural fistulas and broncho-pleural fistulas can lead to the development of pneumothorax. In more recent times, bronchoscopy-guided interventions, specifically Endobronchial Valves (EBV), have been established to serve as a treatment modality for","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446564","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}