International journal of respiratory and pulmonary medicine最新文献

{"title":"Identification and Molecular Epidemiology of Mycobacterial Isolates in Kayseri/Turkey","authors":"Karauz Murat, Koç A Nedret, A. Altay","doi":"10.23937/2378-3516/1410092","DOIUrl":"https://doi.org/10.23937/2378-3516/1410092","url":null,"abstract":"Background: Early diagnosis and treatment of tuberculosis (TB) patients are the most effective ways to protect society from this disease. The objectives of this study were to evaluate the molecular epidemiology of mycobacterial strains by repetitive sequence PCR (rep-PCR) using the DiversiLab System method at Kayseri in Turkey. Methods: A total of fifteen clinically sample isolated Mycobacterial strains were identified as M. tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM) by the rep-PCR method (bioMerieux), SD (Standard Diagnostics) rapid tests. Genotyping was performed by the rep-PCR method and clonal affinity was researched. Results: Nine of the strains were identified as MTBC and six strains were identified as NTM by the SD rapid test methods. Five of the strains were identified as NTM by the rep-PCR method as two M. scrofulaceum, M. chelonae, M. fortuitum and M. avium complex (MAC). By genotyping with rep-PCR a total of nine clones were identified, which included two main clones (A and B) and seven other clones (C, D, E, F, G, H, I). Conclusions: It was detected that rep-PCR test is useful method and can be used for the molecular epidemiology and for the identification of mycobacterial strains as they are rapid and practical. However, it is necessary to perform new studies for more mycobacterial strains using the methods described herein.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48168161","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":"Supine Sleep during Polysomnography and the Diagnosis of Obstructive Sleep Apnea","authors":"A. Dandan, P. Dettenmeier, J. Chang, J. Espiritu","doi":"10.23937/2378-3516/1410087","DOIUrl":"https://doi.org/10.23937/2378-3516/1410087","url":null,"abstract":"Background: Since the supine position worsens obstructive sleep apnea (OSA) by promoting upper airway collapse, patients may avoid supine sleep in order to mitigate its effects. However, the avoidance of supine sleep during polysomnography (PSG) may result in a missed diagnosis of OSA. This study aims to examine the association between the presence/absence of supine sleep and the diagnosis of OSA during PSG. Methods: This cross-sectional analysis of a prospective cohort study analyzed the demographic, anthropometric, and PSG results in 243 patients who underwent PSG for suspected OSA. The crude and adjusted association between the absence/presence of supine sleep and OSA diagnosis during PSG was determined using Pearson Chi-square testing and binary logistic regression model fitting, respectively. Results: Adult patients suspected of OSA who had no supine sleep during PSG had statistically significant lower odds ratio [crude odds ratio (OR) = 0.26, 95%CI: 0.08, 0.81, p = 0.014] of being diagnosed with OSA compared to those who achieved some supine sleep. This association remained robust despite adjusting for known confounders such as age, BMI, and comorbid coronary heart disease (CHD) [adjusted OR = 0.13, 95%CI: 0.03, 0.48, p = 0.002]. Conclusion: Absence of supine sleep during PSG reduces the odds of an OSA diagnosis, even after adjusting for age, BMI, and CHD. Sleep laboratory policies should consider incorporating protocols that encourage patients to achieve some supine sleep during polysomnography in order to facilitate OSA diagnosis. complete or partial upper airway obstruction during sleep, resulting in respiratory arousals, sleep fragmentation, and/or oxygen desaturation [1]. OSA is the most common sleep-related breathing disorder, affecting 1017% of men and 3-9% of women in the United States [2]. Risk factors include obesity, age, male gender, menopause, wide neck circumference, adenotonsillar hypertrophy, and other craniofacial features that cause pharyngeal narrowing [3,4]. The supine position worsens OSA by promoting posterior displacement of the uvula, soft palate and tongue [5-11]. A case-control study found that sleeping in the supine posture doubled the magnitude of the apnea-hypopnea index (AHI) [7]. Up to 56% of 666 Israeli patients with OSA were found to have positional OSA, defined as a lateral respiratory disturbance index (RDI) less than half of the supine RDI [12]. These Israeli patients with positional OSA not only were, on average, two years younger but also had lower body mass index (BMI), less severe RDI, and better sleep than those with non-positional OSA [12]. A retrospective analysis of 3,813 patients who underwent fullnight polysomnography (PSG) at a sleep disorders center in Turkey reported an estimated 39.9% prevalence of positional OSA [13]. The patients with positional OSA were described to be younger and have less severe OSA compared to those with non-positional OSA [13]. A retrospective study of 326 US Veterans","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47305977","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 Atorvastatin on Right Ventricular Function in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial","authors":"Poorzand Hoorak, Rezaeetalab Fariba, Marvy Masoud Sadeghipour, J. Aida, Afzalaghaei Monavar, J. Majid","doi":"10.23937/2378-3516/1410085","DOIUrl":"https://doi.org/10.23937/2378-3516/1410085","url":null,"abstract":"Objective: Inflammation has an important role in chronic obstructive pulmonary diseases (COPD) and statins are believed to have anti-inflammatory effects beyond low-density lipoprotein cholesterol reduction. This study aimed to assess the effect of statin on the function of the right ventricle and inflammatory markers in COPD patients. Methods: A total of 76 clinically stable COPD patients were included in this randomized, double-blind study. Patients were randomly assigned to receive atorvastatin (40 mg/d) or a placebo over a period of three months. All the patients underwent spirometry, echocardiography, and high-sensitivity C-reactive protein (hsCRP) measurement at baseline and at the end of the study. Right ventricular (RV) systolic function was assessed by echocardiography using the systolic velocity of tricuspid annulus (Sm) and longitudinal strain in the base and mid segments of RV free wall (SRB, SRM). Pulmonary artery pressure (PAP) was estimated by the tricuspid regurgitation gradient. Results: Fifty-five patients (31 in atorvastatin and 24 in the placebo group) completed the course of intervention. Atorvastatin resulted in improvement in RVSB (p = 0.03) and decrease in hsCRP (p = 0.03) compared to placebo group while RV SRM was significantly improved in atorvastatin group (p = 0.01) but this change was not significant between groups (p = 0.44). Conclusion: Statins could improve the prognosis in COPD patients by improving right ventricular hemodynamic.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44417869","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":"An Incidental Case of Pulmonary Amyloidosis","authors":"U. Fatih, Dirol Hulya","doi":"10.23937/2378-3516/1410086","DOIUrl":"https://doi.org/10.23937/2378-3516/1410086","url":null,"abstract":"","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43674835","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":"Visual HRCT Score to Determine Severity and Prognosis of Idiopathic Pulmonary Fibrosis","authors":"Sanchez Ricardo Peris, Fernandez-Fabrellas Estrella, Samper Gustavo Juan, Montanana Maria Luisa Domingo, Vilar Lidia Navarro","doi":"10.23937/2378-3516/1410084","DOIUrl":"https://doi.org/10.23937/2378-3516/1410084","url":null,"abstract":"Introduction: High-resolution computed tomography (HRCT) is an essential technique for the diagnosis and follow-up of idiopathic pulmonary fibrosis (IPF), but it is not routinely used to evaluate severity. A semi-quantitative HRCT score was developed to determine its relation with physiologic variables, to assess severity and fibrosis progression, and to establish prognostic factors. Methods: The HRCTs of 48 newly diagnosed IPF patients were assessed. Reticular pattern, ground-glass opacities, distortion and honeycomb patterns were scored by two independent radiologists to obtain these scores and the Total Score of Fibrosis. Its relation with pulmonary function tests, the 6-minute walking test (6MWT) and air blood gases was evaluated, and with the survival and identification of the worse prognosis factors. The lower HRCT level (everything below the highest point of the right diaphragm) was independently assessed to evaluate differences. Results: The Honeycomb Score (HS) correlated with DLCO% (r = -0.50, p < 0.001) and KCO% (r = -0.55, p < 0.001). The Total Score (TS) correlated with DLCO% (r = -0.55, p < 0.001) and KCO% (r = -0.50, p < 0.001). Final SatO2 in the 6MWT correlated with the TS (r = -0.45, p < 0.01), and desaturation correlated with both HS (r = -0.34, p < 0.05) and TS (r = -0.45, p < 0.01). Survival was 42 (37-48) months. DLCO < 40 (p = 0.005) and the TS of Fibrosis ≥ 20 (p = 0.03) were independent predictors of mortality. In the lower HRCT level assessment HS correlated with DLCO (r = -0.533; p < 0.001), KCO (r = -0.426; p < 0.01) and CPI (r = 0.505; p < 0.001), and also the TS correlated with both DLCO (r = -0.362; p < 0.01) and KCO (r = -0.481; p < 0.001); the HS was an independent mortality factor (p = 0.015) at this level. Conclusions: A semi-quantitative HRCT score is useful for determining severity upon diagnosis and for predicting IPF progression, and it correlates well with physiologic variables. DLCO < 40 and the TS of Fibrosis ≥ 20 were independent mortality predictors. The honeycomb score at lower HRCT levels determined mortality.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43939185","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":"Tuberculosis Diagnosis in Private Independent Laboratories in Kampala- Uganda Implications for TB Control in the City","authors":"D. Lukoye, D. Okello, S. Namatovu, A. Ssebagereka, K Mutesasira, E. Mabumba, M Nandala, P. Suarez","doi":"10.23937/2378-3516/1410081","DOIUrl":"https://doi.org/10.23937/2378-3516/1410081","url":null,"abstract":"Tuberculosis remains the greatest killer globally. Uganda, one of the highest TB burden countries has a rapidly growing private medical sector. Although a large proportion of patients first seek care from the private sector, there is very little if any literature about participation of private independent laboratories in diagnosis of TB. We aimed at assessing this and the extent to which diagnosed TB patients are linked to care. Methods: We conveniently sampled and reviewed records for seven independent private laboratories registered with the ministry of health covering January-June 2015 period. Data was collected on patient demographics, number of sputum samples analyzed in each and those testing positive for TB. We also collected data on where the diagnosed patients were registered for treatment. Results: A total of 33,071 samples were analyzed of which 562 were for sputum. Of these, 271 (48%) were for males, 227 (40%) females and 64 (12%) records missed sex classification. The ≤ 14-year-old contributed only 8 (1.4%) and 301 (54%) of the samples did not have age registered. Four hundred and thirty-six (78%) samples were from private for-profit health units and others were self-referrals. Thirty-four (6%) samples analyzed tested positive of which 21 were not traceable in the unit TB registers. About half of the laboratories were enrolled on the national EQA scheme and about half processed two pre-treatment smears required by the NTLP. Conclusion: Independent private laboratories in Kampala participate in sputum-smear microscopy for TB diagnosis but majority do not follow national guidelines. Majority of the diagnosed patients are not traceable in the known TB care centers. Introduction and Background Tuberculosis is the second greatest killer globally and 95% of the TB deaths do occur in lowand middle-income countries [1]. Uganda, like other developing countries has a large and growing private medical sector. Literature has shown that a large proportion of tuberculosis patients in many high TBburden countries seek care from private health care providers first [2-4]. Kampala city with the highest incidence of TB in Uganda (450-550 TB cases/100,000 population) has reported slow increase in annual TB case notification over the past six years. TB in this city is mainly diagnosed in public and NGO health facilities. It has been observed that private health facilities also participate in TB diagnosis and treatment in this setting, but there is no published data/evidence on participation of independent private laboratories in TB diagnosis. It was assumed that a big number of TB patients are diagnosed in these laboratories and not linked to health facilities that report to RESEARch ARticLE","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47846800","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":"Fibrosing Mediastinitis: A Review of Epidemiology, Diagnosis and Management","authors":"Kuranga Abraham O, Eubank Andrea M, Bowling Mark R","doi":"10.23937/2378-3516/1410079","DOIUrl":"https://doi.org/10.23937/2378-3516/1410079","url":null,"abstract":"Fibrosing Mediastinitis (FM) is a rare complication that has mainly been associated with histoplasmosis infections, however it can also be a complication of granulomatous infiltrative processes, including tuberculosis and sarcoidosis. The results of this condition can lead to significant symptom burden that require a unique approach to its management. We submit a comprehensive review concerning the natural history and management of fibrosing mediastinitis.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48166887","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":"An Asymptomatic Haemorrhagic Pleural Effusion Mimicking Extra-Pulmonary Tuberculosis in a Young Woman with Thoracic Endometriosis Syndrome: A Case Report","authors":"Bataduwaarachchi Vipula R, Jayawardhana Jayani, Weerasinghe Champa, S. Aflah, Constantine Roshana, Gunasekara Kirthi","doi":"10.23937/2378-3516/1410082","DOIUrl":"https://doi.org/10.23937/2378-3516/1410082","url":null,"abstract":"Background: This case discusses the importance of thoroughly investigating a haemorrhagic effusion in a setting where the tuberculosis is endemic. Case report: A young woman presented with an asymptomatic recurrent right sided pleural effusion. Pleural fluid full report showed neutrophilic and haemorrhagic effusion. Adenosine deaminase level in the pleural fluid was elevated and the Mantoux test was positive. Microbiological diagnosis was negative, and she was started on anti-tuberculous therapy on clinical grounds for extrapulmonary tuberculosis. Diagnostic Thoracoscopy revealed characteristic appearance suggestive of thoracic endometriosis which was confirmed by histology. Conclusions: Thoracoscopy is valuable in rapid diagnosis of pleural based diseases such as thoracic endometriosis. It also provides option to drain tuberculous and other complicated effusions completely minimising the chance of later complications. This case discusses the importance of thoroughly investigating a haemorrhagic effusion in a setting where the tuberculosis is endemic.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45865293","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 Case of Primary Pulmonary Artery Intimal Sarcoma","authors":"Yano Chiyo, T. Masaki, M. Keisuke, Naito Yoshiko, Sakazaki Yuki, K. Takuma, Okamoto Masaki, Kawayama Tomotaka, Hoshino Tomoaki, Muto Reiji, Ohshima Koichi, H. Masanori","doi":"10.23937/2378-3516/1410083","DOIUrl":"https://doi.org/10.23937/2378-3516/1410083","url":null,"abstract":"A 28-year-old Japanese woman complained of right chest pain, fever, and cough. Chest radiography revealed consolidation in her right lower lobe with a pleural effusion. She was diagnosed with pneumonia and treated with antibiotics, but her condition did not improve. She was referred to our hospital for evaluation. Contrast-enhanced computed tomography (CT) demonstrated a large saddle filling defect extending into the right pulmonary artery as well as the proximal lower lobe pulmonary artery branch. Massive pulmonary artery thromboembolism was suspected, and early surgical intervention was performed. Myxomatous soft tissue was located in the pulmonary artery trunk. We were unable to remove this tumor. Histologically, the tumor was a malignant spindle cell neoplasm, and was positive for vimentin but negative for CD34, desmin, MDM2 and cytokeratin’s (AE1/AE3). Based on the clinical presentation, radiological findings, and immunohistochemical staining, pulmonary artery intimal sarcoma was diagnosed. Our patient did not agree to more aggressive therapy because there is no established chemotherapy or other aggressive treatment and she desired pregnancy. Unfortunately, regrowth at the surgical margin of right pulmonary artery and multiple lung metastases were detected 3 months after surgery, the patient received chemotherapy with doxorubicin. But we didn’t control the disease activity, next chemotherapeutic agents or challenging therapy such as multi-targeted tyrosine kinase inhibitor will be administrated.","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41651815","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 Comparison between Two Pathophysiologically Different yet Microbiologically Similar Lung Diseases: Cystic Fibrosis and Chronic Obstructive Pulmonary Disease.","authors":"Daniel E Fenker,&nbsp;Cameron T McDaniel,&nbsp;Warunya Panmanee,&nbsp;Ralph J Panos,&nbsp;Eric J Sorscher,&nbsp;Carleen Sabusap,&nbsp;John P Clancy,&nbsp;Daniel J Hassett","doi":"10.23937/2378-3516/1410098","DOIUrl":"10.23937/2378-3516/1410098","url":null,"abstract":"<p><p>Cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) are chronic pulmonary diseases that affect ~70,000 and 251 million individuals worldwide, respectively. Although these two diseases have distinctly different pathophysiologies, both cause chronic respiratory insufficiency that erodes quality of life and causes significant morbidity and eventually death. In both CF and COPD, the respiratory microbiome plays a major contributing role in disease progression and morbidity. Pulmonary pathogens can differ dramatically during various stages of each disease and frequently cause acute worsening of lung function due to disease exacerbation. Despite some similarities, outcome and timing/type of exacerbation can also be quite different between CF and COPD. Given these clinical distinctions, both patients and physicians should be aware of emerging therapeutic options currently being offered or in development for the treatment of lung infections in individuals with CF and COPD. Although interventions are available that prolong life and mitigate morbidity, neither disorder is curable. Both acute and chronic pulmonary infections contribute to an inexorable downward course and may trigger exacerbations, culminating in loss of lung function or respiratory failure. Knowledge of the pulmonary pathogens causing these infections, their clinical presentation, consequences, and management are, therefore, critical. In this review, we compare and contrast CF and COPD, including underlying causes, general outcomes, features of the lung microbiome, and potential treatment strategies.</p>","PeriodicalId":91516,"journal":{"name":"International journal of respiratory and pulmonary medicine","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.23937/2378-3516/1410098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36851640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}