International journal of respiratory and pulmonary medicine最新文献

{"title":"Outcomes of Robotic Surgery for Patients with Pulmonary Nontuberculous Mycobacterial Disease","authors":"M. Erin, Basavaraj Ashwin, Cerfolio Robert, Harris Doreen Addrizzo","doi":"10.23937/2378-3516/1410178","DOIUrl":"https://doi.org/10.23937/2378-3516/1410178","url":null,"abstract":"Background: Treatment for patients with pulmonary nontuberculous mycobacterial (NTM) disease includes long, multi-drug, and toxic medication regimens. Surgical resection is an alternative treatment for patients with localized or refractory NTM infection. Robot-assisted operations have not been performed routinely in this population. Methods: A retrospective review was performed on patients with NTM disease that underwent robotic anatomic pulmonary resection at NYU Langone Medical Center between August 2017 and May 2021. Results: A total of 12 patients underwent 13 operations. The majority of patients were female (92%) and white (83%). Mean age at time of surgery was 61 years. The most common indication for surgery was cavitary disease, followed by failure of medical therapy, and hemoptysis. All patients had pre-operative sputum cultures positive for Mycobacterium avium intracellulare . 67% of patients were on IV antibiotics prior to surgery. Lobectomy was the most common operation performed. There were no post-operative deaths. Three patients had a prolonged air leak (> 5 days). There were no post-operative bleeds requiring transfusion, pneumonias, pneumothoraces, or bronchopleural fistulas. None of the patients required an ICU stay and the median length of hospital stay was 1 day. Ten patients were followed for a median follow-up period of 21 months (range 6-48 months). Seven patients have been followed for over a year and are no longer on antibiotic therapy. The remaining three patients had recent surgeries and have de-escalated their medical regimen and are off IV therapy. Interpretation: Surgical resection for patients with complex NTM disease can be performed using minimally invasive, robotic techniques safely and without the need for conversion to open thoracotomy, blood transfusions, or ICU stay. In this small cohort of patients, robotic surgery had a high rate of cure, few post-operative complications, and a short length of hospital stay.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48584802","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 Unusual Occurrence of Leukocytoclastic Vasculitis in Pulmonary Tuberculosis-Case Report","authors":"Prashant Hingolikar Ankita, Mukesh Shah Preet, B. Shah","doi":"10.23937/2378-3516/1410174","DOIUrl":"https://doi.org/10.23937/2378-3516/1410174","url":null,"abstract":"We present a case of 19 year old girl who presented to us with 4 weeks history of anorexia, weight loss and acute onset (3 days) of papular rashes over both lower extremities and swelling and pain in ankle and knee joints. Broncho-alveolar lavage revealed presence of acid fast bacilli and culture showed growth of mycobacterium tuberculosis. Biopsy of the skin lesion revealed evidence of leukocytoclastic vasculitis with negative immunofluorescence. She responded well to antitubercular therapy with short course of steroids. Tuberculosis related cutaneous leukocytoclastic vasculitis is a rare and our case is unique in manifesting this presentation.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44523171","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":"Relationship between Anthropometric Variables and Lung Function Parameters among Apparently Healthy Adults in a Nigerian University","authors":"Nene John Jeneviv, Justina Nwosu Chiamaka, Chinedu Okezue Obinna, Chukwudi Anyachukwu Canice, Okwudili John Davidson, Gloria Mgbeojedo Ukamaka","doi":"10.23937/2378-3516/1410176","DOIUrl":"https://doi.org/10.23937/2378-3516/1410176","url":null,"abstract":"Background: Lung function reportedly differs between ethnic groups in infants, children and adults. More so, a reduction in lung function has health implications that go beyond diagnosable lung disease. As a result, it is imperative to understand the circumstances that can cause variations in lung function. This study investigated the relationship between anthropometric function parameters of adults and should be considered in the interpretation of lung values of apparently healthy individuals.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48336767","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":"Mimicry of EVALI during the Times of Covid-19 Pandemic. Another Preventive Public Health Concerns In Young Adults","authors":"khan Azkia, Siddiqui Nadir, Ejaz Hashim, Lone A. Nazir","doi":"10.23937/2378-3516/1410173","DOIUrl":"https://doi.org/10.23937/2378-3516/1410173","url":null,"abstract":"The global healthcare has been challenged to provide adequate care during COVID 19 pandemic [1]. There is increased public anxiety and knowledge gaps that have created major dilemmas in health care delivery. In this situation a “don’t miss” diagnosis of Covid-19 is unacceptable and there is a trend to suspect respiratory illness as COVID disease unless proved otherwise. We present one of mimics of Covid pneumonia. EVALI (E-cigarettes and vaping associated acute lung injury) is caused by aerosolization of content of E-cigarettes e.g. vitamin E acetate, coconut oil and limonene [2]. COVID-19 is transmitted through respiratory droplets and Aerosols [3]. It is unknown if vaping puts patients at higher risk of respiratory failure if co-infected with COVID-19. Therefore, exposure history in patients with clinical findings of pneumonia-like syndrome is important.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49348567","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":"Free Testosterone Levels in Patients with Covid-19 and its Association with Disease Severity","authors":"Jesus Alan Guardado Vindiola, Gisel Viviana Licón Martínez, Marina Estrada-Rodriguez, Katya Lorena Wilhelmy-Ledesma, Joaquin Córdova Erberk, Álvaro Lozano Castañeda, M. Gaxiola-García, H. Jaramillo-Ramírez","doi":"10.23937/2378-3516/1410170","DOIUrl":"https://doi.org/10.23937/2378-3516/1410170","url":null,"abstract":"","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44521317","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 Patient Outcomes of High Flow versus Low Flow Nasal Oxygen during Outpatient Bronchoscopy under Conscious Sedation at Thoracic Procedure Suite in Lyell McEwin Hospital","authors":"Priyangika Singankutti Mudalige Thanuja Nilushi, Alawami Moayed, Karunarathne Shanka","doi":"10.23937/2378-3516/1410169","DOIUrl":"https://doi.org/10.23937/2378-3516/1410169","url":null,"abstract":"Background and objective: High flow nasal oxygen (HFNO) has been shown to reduce desaturations during flexible bronchoscopy. We evaluated outcomes of HFNO vs . low flow nasal oxygen (LFNO) on intraprocedural hypoxemia, the demand of sedative and reversal medications, post-procedure complications, procedure conversion to general anaesthesia and patient comfort during outpatient standard and EBUS (Endo Bronchial Ultrasound) guided bronchoscopy under conscious sedation. Methods: A Prospective open-label study where the first 42 patients were allocated to LFNO and subsequent 42 patients were allocated to HFNO. Baseline and lowest oxygen saturation, duration of hypoxemia, procedure type, amount of sedative and reversal medications and patient comfort were assessed. Results: Both HFNO and LFNO had similar characteristics at baseline. The odds ratio of being hypoxic (< 90%) was 13.8 times more in the LFNO group (CI 3.55-70.7, p < 0.001) after adjustment for confounders. In addition, the LFNO group had a longer period of desaturation (OR 11.24, CI 3.18-49.78, p < 0.001). There was no statistically significant difference in median lowest peripheral oxygen saturation, the amount of sedative and reversal medications, patient comfort, procedure conversion to general anaesthesia, and post-procedure complications between the two groups. Conclusion: During outpatient standard and EBUS guided bronchoscopy, HFNO is associated with a statistically significant reduction in oxygen desaturation and duration of hypoxemia. However, there was no clinically significant difference in adverse outcomes, or patient comfort between the two groups.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47639235","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":"Sarcoidosis Presenting as a Case of Pulmonary Thrombotic Disease- An Unusual Presentation","authors":"Rasool Muhammad Haseeb ul, Khan Sara Z, Iqbal Pervaiz","doi":"10.23937/2378-3516/1410168","DOIUrl":"https://doi.org/10.23937/2378-3516/1410168","url":null,"abstract":"Sarcoidosis is a chronic inflammatory disease involving multiple organ systems for which the inciting stimulus is unknown. It is characterized by elevated markers of inflammation and disseminated granuloma in the affected organs. Factor V Leiden deficiency has been long associated with an elevated risk of thrombosis, however, it has been observed in the patients having sarcoidosis, a secondary inciting stimulus is required to trigger the thromboembolic phenomenon, as to date only a few cases of Primary thrombosis have been reported in Factor V Leiden deficient patients culminating in an increased incidence of thromboembolic disease. We are presenting a case of a patient presenting with cerebrovascular events and pulmonary embolism, who was diagnosed later diagnosed to have sarcoidosis with an associated Protein S deficiency and factor V Leiden mutation making her predisposed to thromboembolic disease. It has been speculated that steroids as a treatment elevate the risk of thrombosis in such patients instead of the inflammatory process per se. however; this patient experienced a thrombotic episode before the start of medications. Additionally, an anatomical relationship has been reported in the literature between the site of sarcoidosis and the development of thrombosis, but the patient had repeated episodes of cerebrovascular events, despite no evidence of involvement of cranial vasculature or any heart defect, that could cause paradoxical embolization. This case report can help to elicit the relation of sarcoidosis with the increased tendency towards thromboembolic disease. CaSe RePoRt","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48614425","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":"Aquagenic Wrinkling of the Palms: A Potential Sign of Systemic Treatment Response to Elexacaftor-Tezacaftor-Ivacaftor","authors":"Finberg Ariel, Kozak Merrick, Flowers R Hal","doi":"10.23937/2378-3516/1410166","DOIUrl":"https://doi.org/10.23937/2378-3516/1410166","url":null,"abstract":"Cystic Fibrosis is a life altering disease resulting from a mutated gene and ion channel. It is a systemic condition that affects multiple body systems including the skin. Aquagenic wrinkling of the palms (AWP) is the rapid formation of white plaques on the palms after exposure to water and is commonly seen in patients with cystic fibrosis. Numerous theories exist to explain this pathophysiology however no one explanation has been able to characterize it completely. Our patient is a 25-year-old with a past medical history of cystic fibrosis and AWP who was started on Trikafta® (elexacaftor-tezacaftor-ivacaftor). Shortly after she started treatment she observed near total resolution of her AWP. This is the second documented case of this phenomenon and may be a marker for systemic improvement and response to this drug.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41453055","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 Novel Approach to Confirm Endotracheal Tube Depth Using Ultrasound Color Doppler: A Cadaveric Model","authors":"Daube Ariel, P. Leroy, West Erin, N. Lorraine, Chaudoin Lindsey T, Smerling Arthur, Kessler David","doi":"10.23937/2378-3516/1410167","DOIUrl":"https://doi.org/10.23937/2378-3516/1410167","url":null,"abstract":"Objectives: Proper endotracheal tube (ETT) depth must be confirmed immediately after intubation. We developed a novel point-of-care ultrasound examination called the cuff puff (CP) and hypothesized it would accurately confirm appropriate ETT depth in a cadaveric model. CP comprises visualization of cuff inflation using color Doppler sonography. Methods: On a single fresh frozen cadaver, a well-positioned tube was defined as the tip lying between 6.5 cm below the vocal cords and 3 cm above the carina. The ETT was placed at random depths predetermined by an online random number generator while a blinded sonologist visualized the ETT within the trachea in a transverse plane at the level of the suprasternal notch. A positive CP was defined as presence of a focused color Doppler signal during ETT cuff inflation. We compared CP results to bronchoscopy as a gold standard. Two blinded reviewers interpreted CP results on video review and inter-rater agreement was calculated. Results: The sensitivity was 0.44 (0.20-0.70), specificity 0.91 (0.72-0.99), PPV 0.78 (0.40-0.97) and NPV 0.70 (0.51-0.85) for a positive CP representing a well-positioned ETT. The inter-rater agreement between the two blinded reviewers yielded a κ of 0.90 (0.72-1.00) and between each blinded reviewer and the bedside sonologist a κ of 0.90 (0.72-1.00) and 1.00 (1.00-1.00), respectively. Conclusions: In a single cadaver, a positive CP is a reliable and specific sign that the ETT is inserted to an appropriate depth. Further study is needed in live patients.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41858839","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 and Outcomes of Systemic Sclerosis-Associated Interstitial Lung Disease at a Tertiary Level Hospital in KwaZulu Natal, South Africa: A Retrospective Review","authors":"Tanish Salah, N. Kennedy, Vasconcellos K de","doi":"10.23937/2378-3516/1410163","DOIUrl":"https://doi.org/10.23937/2378-3516/1410163","url":null,"abstract":"Background: Interstitial lung disease (ILD) is one of the most serious complications among patients with scleroderma. It is associated with significant morbidity and mortality. Little is known about the epidemiology of scleroderma associated ILD in sub-Saharan Africa. Thus, we aimed to determine the prevalence, clinical characteristics and outcomes of patients with scleroderma -ILD. Methods: A retrospective electronic chart review was conducted of patients with systemic sclerosis seen between January 2010 and December 2016 in the Departments of Pulmonology and Rheumatology at Inkosi Albert Luthuli Central Hospital, Durban, South Africa. Results: A total of 146 patients with systemic sclerosis (SSc) were seen during the study period. Fifty-five had SScassociated ILD, giving a prevalence of 37.6%. The median age was 51 (IQR 41-60) years, 87% of patients were female and 56% were of Indian descent. Dyspnea was the presenting complaint in 47 (85.4%) patients, while 16 (29.1%) presented with cough. ANA was positive in 50 patients (90.9%), antiScl-70 antibodies were positive in 21 (38.2%). Thirty-seven patients (67.3%) received immunosuppressants, with 27 (49.1%) receiving cyclophosphamide as induction therapy, while 18 (32.7%) patients did not receive any specific therapy. Most patient symptoms remained static during the period of observation. UIP was the most common radiological diagnosis Follow-up CT scans were available in 48 (87%) patients, with the majority of patients showing no significant radiological changes between their first and last CT scans. Followup lung function testing showed a statistically significant decrease in median FVC of 0.09l (p = 0.011). Overall 20 (36.4%) patients had a significant decline in FVC, while 7 (12.7%) had an improvement in FVC. Conclusion: ILD is common in systemic sclerosis, affecting 1 in 3 patients with systemic sclerosis in our cohort. Immunosuppressant treatment may arrest or retard the rate of decline of lung function.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49020320","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}