Pub Date : 2020-11-01DOI: 10.1097/CPM.0000000000000380
Jennifer T W Krall, Muhammad Ali, M. Maslonka, A. Pickens, C. Bellinger
Bronchoscopy is an aerosol-generating procedure with important diagnostic and therapeutic indications. However, in the era of the coronavirus disease 2019 (COVID-19) pandemic, airway procedures can put health care providers at an increased risk of exposure and transmission of COVID-19. We have reviewed and summarized guidelines from various societies of respiratory medicine to stratify the indications for bronchoscopy and optimize preprocedural, procedural, and postprocedural preparation. Appropriate measures can help decrease exposure to health care workers when performing this aerosol-generating procedure.
{"title":"Bronchoscopy in the COVID-19 Era","authors":"Jennifer T W Krall, Muhammad Ali, M. Maslonka, A. Pickens, C. Bellinger","doi":"10.1097/CPM.0000000000000380","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000380","url":null,"abstract":"Bronchoscopy is an aerosol-generating procedure with important diagnostic and therapeutic indications. However, in the era of the coronavirus disease 2019 (COVID-19) pandemic, airway procedures can put health care providers at an increased risk of exposure and transmission of COVID-19. We have reviewed and summarized guidelines from various societies of respiratory medicine to stratify the indications for bronchoscopy and optimize preprocedural, procedural, and postprocedural preparation. Appropriate measures can help decrease exposure to health care workers when performing this aerosol-generating procedure.","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":"27 1","pages":"198 - 202"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47600401","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}
Pub Date : 2020-09-01DOI: 10.1097/CPM.0000000000000372
N. Bethuel, L. Edmonds
Upper lobe cavitation carries a broad differential. No review, to our knowledge, includes foreign body in the differential diagnosis. Similarly, reviews of foreign body aspiration do not report lung cavitation. Herein, we report a case of an alert 58-year-old man who presented with sepsis secondary to presumed right upper lobe pneumonia. Computed tomography of the chest was significant for multiple loculated cavitary lesions. Subsequent bronchoscopy revealed a single kernel of popcorn impacted in the bronchus. Our case report highlights the importance of recognizing atypical presentations of foreign body aspiration.
{"title":"“Popcorn” Cavitary Pneumonia: A Case Report","authors":"N. Bethuel, L. Edmonds","doi":"10.1097/CPM.0000000000000372","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000372","url":null,"abstract":"Upper lobe cavitation carries a broad differential. No review, to our knowledge, includes foreign body in the differential diagnosis. Similarly, reviews of foreign body aspiration do not report lung cavitation. Herein, we report a case of an alert 58-year-old man who presented with sepsis secondary to presumed right upper lobe pneumonia. Computed tomography of the chest was significant for multiple loculated cavitary lesions. Subsequent bronchoscopy revealed a single kernel of popcorn impacted in the bronchus. Our case report highlights the importance of recognizing atypical presentations of foreign body aspiration.","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":"27 1","pages":"139 - 140"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41355578","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}
Pub Date : 2020-09-01DOI: 10.1097/CPM.0000000000000379
K. Crane, D. Zappetti
{"title":"How Does the Efficacy and Safety of Triple Inhaled Therapy at 2 Glucocorticoid Doses Compare With 2 Dual Therapies in Moderate-to-Very-Severe COPD?","authors":"K. Crane, D. Zappetti","doi":"10.1097/CPM.0000000000000379","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000379","url":null,"abstract":"","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43878241","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}
Pub Date : 2020-09-01DOI: 10.1097/cpm.0000000000000378
W. Whalen, D. Zappetti
Synopsis: In patients with moderate-to-severe acute respiratory distress syndrome (ARDS), defined as an arterial oxygen partial pressure/ fractional inspired oxygen (PaO2/FiO2) of 200 mmHg or less with a positive end-expiratory pressure (PEEP) of 10 cm H2O or greater and FiO2 > 0.5, administration of dexamethasone within 24 hours of ARDS onset led to more ventilator-free days, and a reduction of all-cause mortality with no difference in adverse events. Source: Villar, J, Ferrando, C, Martínez, D, et al. Dexamethasone treatment for the acute respiratory distress syndrome: a multicenter, randomised controlled trial. Lancet Respir Med. 2020;8:267–276.
{"title":"Dexamethasone in Acute Respiratory Distress Syndrome","authors":"W. Whalen, D. Zappetti","doi":"10.1097/cpm.0000000000000378","DOIUrl":"https://doi.org/10.1097/cpm.0000000000000378","url":null,"abstract":"Synopsis: In patients with moderate-to-severe acute respiratory distress syndrome (ARDS), defined as an arterial oxygen partial pressure/ fractional inspired oxygen (PaO2/FiO2) of 200 mmHg or less with a positive end-expiratory pressure (PEEP) of 10 cm H2O or greater and FiO2 > 0.5, administration of dexamethasone within 24 hours of ARDS onset led to more ventilator-free days, and a reduction of all-cause mortality with no difference in adverse events. Source: Villar, J, Ferrando, C, Martínez, D, et al. Dexamethasone treatment for the acute respiratory distress syndrome: a multicenter, randomised controlled trial. Lancet Respir Med. 2020;8:267–276.","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45106151","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}
Pub Date : 2020-09-01DOI: 10.1097/CPM.0000000000000370
E. Orsini, Cyndee C. Miranda, E. Dasenbrook
Antibiotics form the foundation of comprehensive cystic fibrosis (CF) therapy and are responsible for invaluable gains in life expectancy and quality of life. Although antibiotic stewardship may be perceived to be in conflict with appropriate CF care, there are many potential benefits to antibiotic stewardship in CF. Antimicrobial stewardship teams can provide a collaborative approach to CF care and provide assistance with antibiotic selection, therapeutic drug monitoring, and recommendation of best practices supported by evidenced-based guidelines. The aim of this review is to introduce the rationale for the use of antibiotics in CF care, examine the evidence behind current antibiotic practices, and discuss the potential role of antibiotic stewardship in CF care.
{"title":"Antibiotic Use and Stewardship in Cystic Fibrosis: A Review for Noncystic Fibrosis Providers","authors":"E. Orsini, Cyndee C. Miranda, E. Dasenbrook","doi":"10.1097/CPM.0000000000000370","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000370","url":null,"abstract":"Antibiotics form the foundation of comprehensive cystic fibrosis (CF) therapy and are responsible for invaluable gains in life expectancy and quality of life. Although antibiotic stewardship may be perceived to be in conflict with appropriate CF care, there are many potential benefits to antibiotic stewardship in CF. Antimicrobial stewardship teams can provide a collaborative approach to CF care and provide assistance with antibiotic selection, therapeutic drug monitoring, and recommendation of best practices supported by evidenced-based guidelines. The aim of this review is to introduce the rationale for the use of antibiotics in CF care, examine the evidence behind current antibiotic practices, and discuss the potential role of antibiotic stewardship in CF care.","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":"27 1","pages":"131 - 138"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43330495","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}
Pub Date : 2020-09-01DOI: 10.1097/CPM.0000000000000373
K. Gershner
Lung cancer remains the leading cause of cancer-related deaths worldwide; however, new developments in treatment, specifically immune checkpoint inhibitors, have demonstrated improved progression-free survival. Unfortunately, these medications are not without side effects, including the potentially life-threatening side effect of immune-related pneumonitis. There are a paucity of data with regard to risk factors and diagnostic criteria, leading to a complicated diagnostic dilemma for providers. In addition, guidelines as regards treatment and reinitiation of therapy are sparse at best. Both these factors lead to significant uncertainty in regard to this disease entity. As use of immune checkpoint inhibitors increases, more and more clinicians will be faced with this diagnostic and treatment quandary. Here, we review the current diagnostic and treatment guidelines for immune-related pneumonitis and shed light on future research directions.
{"title":"Immunotherapy-induced Pneumonitis: A Review of Diagnostic Workup and Treatment Guidelines","authors":"K. Gershner","doi":"10.1097/CPM.0000000000000373","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000373","url":null,"abstract":"Lung cancer remains the leading cause of cancer-related deaths worldwide; however, new developments in treatment, specifically immune checkpoint inhibitors, have demonstrated improved progression-free survival. Unfortunately, these medications are not without side effects, including the potentially life-threatening side effect of immune-related pneumonitis. There are a paucity of data with regard to risk factors and diagnostic criteria, leading to a complicated diagnostic dilemma for providers. In addition, guidelines as regards treatment and reinitiation of therapy are sparse at best. Both these factors lead to significant uncertainty in regard to this disease entity. As use of immune checkpoint inhibitors increases, more and more clinicians will be faced with this diagnostic and treatment quandary. Here, we review the current diagnostic and treatment guidelines for immune-related pneumonitis and shed light on future research directions.","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":"27 1","pages":"141 - 147"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48398095","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}
Pub Date : 2020-09-01DOI: 10.1097/CPM.0000000000000374
M. Asgharzadeh, M. R. Valiollahzadeh, Behroz Mahdavi Poor, H. Samadi kafil, V. Asgharzadeh, Ali Vegari, M. Pourostadi, Z. Sanaat, J. Rashedi
SARS-CoV-2 in bats was transmitted to humans by a peridomestic mammal in China and it was transmitted from humans to humans very quickly through coughing and sneezing and is spread all over the world and created coronavirus disease 2019. The disease causes a variety of symptoms in patients and it has killed a significant number of people around the world, especially people with underlying diseases such as heart disease, diabetes, and high blood pressure. Early diagnosis of patients is very important to prevent the transmission of the disease from humans to humans and the spread of the virus. The virus causes abnormal computed tomography scans, lymphopenia, leukopenia, increased C-reactive protein, lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase in a significant number of patients. The standard method for diagnosing SARS-CoV-2 infection is real-time reverse transcriptase polymerase chain reaction with 2 genes RdRp and E being identified together in 1 experiment. Other methods such as cell culture, reverse transcription loop-mediated isothermal amplification, next-generation sequencing, fluorescence in situ hybridization, and antigenic assessment can be used to study and identify the virus. IgG and IgM antibodies against S and N proteins are evaluated to recognize people who have been previously infected with the virus.
{"title":"Laboratory Diagnosis of COVID-19","authors":"M. Asgharzadeh, M. R. Valiollahzadeh, Behroz Mahdavi Poor, H. Samadi kafil, V. Asgharzadeh, Ali Vegari, M. Pourostadi, Z. Sanaat, J. Rashedi","doi":"10.1097/CPM.0000000000000374","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000374","url":null,"abstract":"SARS-CoV-2 in bats was transmitted to humans by a peridomestic mammal in China and it was transmitted from humans to humans very quickly through coughing and sneezing and is spread all over the world and created coronavirus disease 2019. The disease causes a variety of symptoms in patients and it has killed a significant number of people around the world, especially people with underlying diseases such as heart disease, diabetes, and high blood pressure. Early diagnosis of patients is very important to prevent the transmission of the disease from humans to humans and the spread of the virus. The virus causes abnormal computed tomography scans, lymphopenia, leukopenia, increased C-reactive protein, lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase in a significant number of patients. The standard method for diagnosing SARS-CoV-2 infection is real-time reverse transcriptase polymerase chain reaction with 2 genes RdRp and E being identified together in 1 experiment. Other methods such as cell culture, reverse transcription loop-mediated isothermal amplification, next-generation sequencing, fluorescence in situ hybridization, and antigenic assessment can be used to study and identify the virus. IgG and IgM antibodies against S and N proteins are evaluated to recognize people who have been previously infected with the virus.","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":"27 1","pages":"148 - 153"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48443937","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}
Pub Date : 2020-09-01DOI: 10.1097/CPM.0000000000000371
L. Ong
Heart failure (HF) may be associated with pneumonia as HF is one of the most common complications of patients who have a primary diagnosis of pneumonia. Patients who develop HF from pneumonia are associated with higher severity of pneumonia and higher mortality rate. The purpose of this review was to summarize the association between pneumonia and HF with the available literature and discuss the pathophysiology underlying it. Ten studies have been included in this review to support the association between pneumonia and HF. Awareness of this association is essential for clinical management and to improve the outcomes of the patients.
{"title":"The Association Between Pneumonia and Heart failure","authors":"L. Ong","doi":"10.1097/CPM.0000000000000371","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000371","url":null,"abstract":"Heart failure (HF) may be associated with pneumonia as HF is one of the most common complications of patients who have a primary diagnosis of pneumonia. Patients who develop HF from pneumonia are associated with higher severity of pneumonia and higher mortality rate. The purpose of this review was to summarize the association between pneumonia and HF with the available literature and discuss the pathophysiology underlying it. Ten studies have been included in this review to support the association between pneumonia and HF. Awareness of this association is essential for clinical management and to improve the outcomes of the patients.","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":"27 1","pages":"125 - 130"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47864732","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}
Pub Date : 2020-07-01DOI: 10.1097/CPM.0000000000000368
M. H. Pierre-Louis, D. Zapetti
{"title":"Should Every Patient Admitted for a Community-acquired Pneumonia Get Blood Cultures to Detect Bacteremia?","authors":"M. H. Pierre-Louis, D. Zapetti","doi":"10.1097/CPM.0000000000000368","DOIUrl":"https://doi.org/10.1097/CPM.0000000000000368","url":null,"abstract":"","PeriodicalId":10393,"journal":{"name":"Clinical Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/CPM.0000000000000368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46848829","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：