Journal of lung health and diseases最新文献

{"title":"Barotrauma in COVID-19 Patients","authors":"M. Abdallat, M. Khalil, Ghayth Alawwa, R. Kothuru, Charles La Punzina","doi":"10.29245/2689-999x/2020/2.1163","DOIUrl":"https://doi.org/10.29245/2689-999x/2020/2.1163","url":null,"abstract":"Results: 25 patients developed evidence of barotrauma on Chest Xray or Computed tomography (CT) with a mean age of 60.1 at the time of diagnosis, 12 (48%) developed severe ARDS with PaO2/FiO2 ratio of <100. 14 (56%) patients developed pneumothorax, 7 had evidence of subcutaneous emphysema and 6 developed pneumomediastinum. More barotrauma occured in the first day of ventilation than any other day, the median time between mechanical ventilation and development of barotrauma is 3.5 days.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76097925","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":"COVID-19 Pneumonia in Bilateral Lung Transplant Recipient: Case Report","authors":"J. Mezquida, A. Bellorín, A. Ortega, G. Francisco","doi":"10.29245/2689-999x/2020/2.1164","DOIUrl":"https://doi.org/10.29245/2689-999x/2020/2.1164","url":null,"abstract":"The clinical course of Coronavirus disease 2019 (covid-19) in lung transplant recipients remains unknown. We present the fatal clinical course of a 63-year-old double lung transplant recipient with severe Covid-19 pneumonia. She had stable graft function before Covid-19 infection. Despite all the supportive care and treatment graft injury progressed, causing patient death. Therefore, the prognosis in lung transplant recipients with Covid-19 infection is not optimistic. CAse RePORt *Corresponding author: Juan Pablo Reig Mezquida, MD, Lung Transplant Unit, Hospital Universitario la Fe, Valencia, Spain, Tel: +0034665116403 Check for updates bilateral lung transplant due to end-stage emphysema. On admission, she was in poor general condition, diarrhea, fever, hypoxemia and tachypnea. Her laboratory results showed impaired renal function with creatinine of 2.45 mg/dL, lymphopenia of 0.06 × 103/μL (5%), C-reactive protein (CRP) of 110.3 mg/L, Procalcitonin of 1.06 ng/mL, D-dimer of 2,571 ng/ml. At that moment, calcineurin inhibitor was replaced by low dose mTOR inhibitor Everolimus. Methylprednisolone was increased to 1 mg/kg and meropenem was started. Prophylactic doses of enoxaparin, hydroxychloroquine (200 mg daily) and Azithromycin 500 mg/24 h were prescribed. During the first 24 h, the patient clinically improved, but on the third day her laboratory test showed a CRP of 203 mg/L, the interleukin-6 (IL-6) levels increased to 308.9 pg/mL, and D-dimer value raised to 60,479 ng/ml. The CT-scan reported extensive ground-glass opacities, affecting the middle lobe, lingula, and lower lobes, with consolidation areas and small left pleural effusion (Figure 1). Everolimus blood levels were 1.8 ng/mL. A single dose of anti-IL-6 antibody Tocilizumab was administered (400 mg IV) and the patient remained respiratory stable and with sustained diuresis. On day 5 of admission, she developed a clinical deterioration, with pO2 of 46 mmHg, and was transferred to the Intensive Care Unit (ICU) where high-flow oxygen therapy was started (FiO2 of 100%, 60 L/min). At this moment, renal function continued worsening, associated with lower T-cell count, and procalcitonin raised to 9.92 ng/mL. ImmunoIntroduction The current pandemic of Coronavirus Disease 2019 (COVID-19) has raised great alarm worldwide, but its impact on transplant patients is unknown, especially in lung transplant recipients. The immunosuppressive maintenance therapy, leads to suppose that the course of this disease could be severe [1]. Spain has a National Transplant Organization which coordinates more than 100 lung transplants per year, and gives support to transplant patients as at-risk population to COVID-19 infection. We report the fatal clinical course of a lung transplant recipient.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77007187","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":"Disseminated BCG-osis and the Importance of Performing Post-Mortem Examinations","authors":"Paul Lilburn, P. Bazin, A. Beveridge, E. Goeman, H. Goldberg","doi":"10.29245/2689-999x/2020/2.1161","DOIUrl":"https://doi.org/10.29245/2689-999x/2020/2.1161","url":null,"abstract":"Paul Andrew Lilburn1,2*, Patrick Bazin2, Alexander Beveridge2, Emma Goeman3, Hazel Goldberg1,3,4,5 1Prince of Wales Hospital, Barker Street, Randwick, Sydney, NSW, 2031, Australia 2St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia 3Royal Prince Alfred, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia 4Sydney Hospital, 8 Macquarie Street, Sydney, NSW, 2000, Australia 5St George Hospital, Kogarah, NSW 2017, Australia","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74420941","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":"Ventilator-Associated Pneumonia and In-Hospital Mortality: Which Risk Factors may predict In-Hospital Mortality in Such Patients?","authors":"A. Sadigov, Irada Mamedova, Kamran Mammmadov","doi":"10.29245/2689-999x/2019/4.1157","DOIUrl":"https://doi.org/10.29245/2689-999x/2019/4.1157","url":null,"abstract":"Methods: This retrospective study was carried out from February 2014 to January 2019. One hundred twenty one adults patients with VAP maintained on mechanical ventilation for more than 48 h in our ICU department were enrolled in the study. VAP was diagnosed as new persistent pulmonary infiltrates on chest radiographs and a least two of following: (1) Fever of ≥38.3C (2) leukocytosis of ≥ 12.000/mm3 and (3) purulent tracheobronchial secretions. Endotracheal aspirate (ETA) samples and blood samples of suspected case were collected and processed as per standard protocols.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89918953","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 Social and Behavior Change Communication Framework for Addressing Delays to Appropriate TB Care and Treatment","authors":"H. Almossawi, Colleen F Longacre, Y. Pillay, N. Kak, C. Chase, Southwest Africa, blockquote","doi":"10.29245/2689-999x/2019/4.1156","DOIUrl":"https://doi.org/10.29245/2689-999x/2019/4.1156","url":null,"abstract":"Social and behavior change (SBC) communication strategies and interventions have been used to successfully promote positive health behaviors and health outcomes, yet there is little evidence in the published literature on SBC frameworks for tuberculosis (TB) care and treatment. In this article, we outline a high-level generalized framework for the development, deployment, and evaluation of SBC communication strategies in high TB burden settings and how it could be employed to address TB treatment delays. The framework describes the contextual factors that will impact the design of a program, the spheres of influence, and details some of the outcomes to be achieved within each sphere that will lead to improved knowledge and substantive changes in behaviors at each prescribed level of the system. Improved design and delivery of SBC interventions can assist countries in meeting the Sustainable Development and Global End TB goals of reduced TB incidence, increased TB cure rates, reduced TB deaths, prevention of catastrophic out-of-pocket costs for TB care, and integration of health systems for patient-centered care.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81942808","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":"Tuberculous Meningitis in Children in Russia: Diagnostic Features and Clinical Observations","authors":"L. Klochkova, M. Lozovskaya, E. Vasilyeva, Yu.A Yarovaya","doi":"10.29245/2689-999x/2019/4.1159","DOIUrl":"https://doi.org/10.29245/2689-999x/2019/4.1159","url":null,"abstract":"Results and Discussion: The number of cases of tuberculous meningitis in children in Russia decreased from 51 to 13 per year from 2000 to 2016. In St. Petersburg, from 2005 to 2016 there were 7 registered cases; 4 died, 3 survived. Predisposing factors of development of tuberculous meningitis were young age, presence of tuberculosis in the family, absence of BCG vaccination, and unfavorable social conditions. Three out of 7 children infected with HIV developed tuberculosis. However, a low frequency of cases has led to absence of phthisis vigilance, delayed diagnosis and deaths. Two illustrative cases are presented from clinical practice.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80109899","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":"Universal Health Coverage - Inclusion of TB in National Health Insurance Programs and Recommendations for Expansion of Coverage of TB Services in LMICs","authors":"H. Almossawi, N. Kak, Y. Pillay, R. Matji, S. Joshi, C. Chase, Pretoria, S. Africa., blockquote","doi":"10.29245/2689-999X/2019/3.1158","DOIUrl":"https://doi.org/10.29245/2689-999X/2019/3.1158","url":null,"abstract":"Background: Increasingly lower- and middle-income countries have moved towards the adoption of National Health Insurance (NHI) models as a means to support sustainable financing for Universal Health Care. National Health Insurance in the form of government-led, publicly supported and/or centrally managed insurance programs in various forms have been introduced in countries such as Brazil, Cambodia, China, Rwanda, Mexico, South Africa, and Thailand and have demonstrated important successes. The impact of these insurance programs on the use of tuberculosis (TB) services and outcomes is unclear. \u0000Objectives: This assessment examines how TB is included (or neglected) in the service delivery package in NHI programs and how effectively NHI programs interact with National TB Programs (NTP) and other TB control stakeholders to plan, implement, and measure TB service use. This assessment aims to analyze the extent to which several NHI programs currently in place or in development in high-burden TB countries have integrated TB services. It synthesizes the findings of assessments in four countries - Thailand, Peru, Philippines, and India - which have adopted publicly supported health insurance programs. \u0000Results: The four case studies demonstrate that the integration of TB services with national health insurance can have a positive effect on access to services and their quality. On the other hand, each of the models assessed impose different types of restrictions which can limit the utilization of services. Some restrictions are planned and are part of the design of the insurance model. Others, however, are indirect or unintended consequences of implementation. As it relates to TB, the findings of the assessment have highlighted the need to carefully examine the impact of restrictions in terms of access and use of TB services. In Thailand, the case study found that long wait times at facilities discouraged patients from obtaining services through national health insurance. In the Philippines, the case study found that many patients perceive that they will have to pay direct and indirect costs for TB services in the public sector and prefer instead to seek treatment in the private sector, including pharmacies, to reduce costs. The primary goal of publicly-supported health insurance programs is to improve access to care for a vulnerable segment of the population and, especially as it relates to TB, have the potential to play an important role in improving public health. However, specific objectives for health insurance programs are not typically defined in terms of disease objectives. In countries with significant burdens of key diseases like TB which threaten to jeopardize overall population health (as well as long term growth and development), specific considerations should be made to ensure that the NHI program is designed to be a driving force for controlling the epidemic. The decision to develop and adopt a publicly-supported insurance model should ideal","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"126 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77572990","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":"Commentary: Is Sustainability an Option While Implementing Programs to end TB by 2030?","authors":"Colleen F Longacre, Hala Jassim AlMossawi sup, Yogan Pillay sup, Neeraj Kak sup, Usa Chevy Chase, Gauteng South Africa Pretoria, blockquote","doi":"10.29245/2689-999X/2019/3.1154","DOIUrl":"https://doi.org/10.29245/2689-999X/2019/3.1154","url":null,"abstract":"© 2019 Kak N. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. Over the past year, the global tuberculosis (TB) community has rallied around the laudable and ambitious goal of ending TB within a generation. In September 2018, the United Nations General Assembly (UNGA) held its first ever High-Level Meeting (UNHLM) on TB. The resulting UN resolution1 reaffirmed its commitment to end the global TB epidemic by 2030 in line with the Sustainable Development Goals (SDGs) target.2 Drawing on the global efforts to end TB, including United States Agency for International Development (USAID)’s Global Accelerator to End TB and support from the Global Fund, excellent opportunities for joint and synergistic efforts are possible, including expansion of universal health coverage (UHC), engaging the private sector and civil societies, ensuring equity and respect for human rights, establishment of an innovative approach to strategic information within and beyond health, strengthening of health systems with integrated service delivery, pursuit of sustainable financing, and promotion of research across the spectrum, among others. Published to coincide with World TB Day 2019, the Lancet Commission report on TB3 provides a roadmap for achieving a world free of TB by 2045. However, to achieve this goal, both reports acknowledge the need for a massive increase in financial investment. The UNHLM report calls for global investment for TB to increase from its current level of $6-7 billion USD to $13 billion USD by 2022, while the Lancet Commission report estimates that an additional expenditure of $5 billion USD annually over the next two decades is needed.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78911826","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":"Review of Paediatric Deep Neck Space Infection","authors":"S. Mungul, S. Maharaj, Johannesburg., S. Africa., blockquote","doi":"10.29245/2689-999X/2019/3.1152","DOIUrl":"https://doi.org/10.29245/2689-999X/2019/3.1152","url":null,"abstract":"Pediatric deep neck space infection is an important entity that often requires hospitalisation for antimicrobial therapy. There is a higher pattern of drug resistance in lower income countries such as South Africa. Resource limitations, poor access to healthcare, nutritional deficiencies and immune deficiency necessitate appropriate antimicrobial use as resistance may have a greater socioeconomic impact relative to higher income countries.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88616321","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":"Rifampicin Bioavailability in Fixed-Dose Combinations for Tuberculosis Treatment: Evidence and Policy Actions","authors":"P. Sadaphal, K. Chakraborty, Hala Jassim-AlMossawi, Y. Pillay, G. Roscigno, A. Kaul, N. Kak, R. Matji, L. Mvusi, A. Destefano, Maryland, Pretoria, S. Africa., Geneva, Switzerland, Tulsa, Ok, blockquote","doi":"10.29245/2689-999X/2019/3.1155","DOIUrl":"https://doi.org/10.29245/2689-999X/2019/3.1155","url":null,"abstract":"Purpose: The pharmacokinetics (PK) of anti-tuberculosis drugs, including their bioavailability (BA), significantly impacts the efficacy and effectiveness of tuberculosis (TB) treatment regimens. Rifampicin, one of the most important drugs in the treatment of drug-sensitive tuberculosis, has been used increasingly in fixed-dose combinations (FDCs). This paper reviews and analyzes available data on BA and PK of rifampicin with a focus on FDCs, from published studies and reports. \u0000Methods: Using PubMed as the primary database, Cochrane and other relevant databases, a systematic review of literature was conducted to identify studies on the bioavailability and efficacy of rifampicin in FDCs versus single drug formulations. A number of keywords including “bioavailability”, “rifampicin”, “fixed dose combinations”, and “pharmacokinetics” were used in various combinations. The search covered the period 1980 to 2016. Priority was given to articles on rifampicin bioavailability in fixed dose combinations used in the program setting, and human studies that used the World Health Organization (WHO) approved BA/PK protocol and sample size (≥22 patients). \u0000Findings: More than 450 original peer-reviewed articles, reviews and reports, were assessed for this analysis. Eleven papers, which included data from high-TB-burden countries (South Africa, India, and China), raised significant concerns about rifampicin bioavailability within FDCs; the authors of the studies discussed multiple factors associated with low bioavailability, including drug formulation and quality, storage environment, patient factors, and concomitant diseases. \u0000Implications: Recent studies and reviews point to the problem of low bioavailability of rifampicin in fixed dose combinations. However, in the field, it remains a hidden or unrecognized factor leading to poor treatment outcomes. It is difficult to study the issue thoroughly unless there is awareness among TB program personnel of its existence, and adequate laboratory and research support is available to national tuberculosis programs (NTPs). In stemming the tide of tuberculosis multi-drug resistance (MDR) and extensive drug resistance (XDR), it is paramount to ensure that rifampicin bioavailability is adequate in FDCs, and to detect and address any deviation from recommended target ranges. There is a need for strategies to minimize the undesirable clinical effects of reduced rifampicin bioavailability in FDCs, and for effective utilization of quality-assured drugs within NTPs programs; these can help NTPs support effective case management in line with the international TB care standards, while taking into consideration the factors affecting drug absorption and therapeutic concentration.","PeriodicalId":92410,"journal":{"name":"Journal of lung health and diseases","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82460252","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}