Pub Date : 2024-09-19DOI: 10.1186/s43168-024-00330-w
Ahmed Al-Husseiny Ali, Hebatallah Hany Assal, Mohamed Said Ismail, Basem Abdelmonem Mashaly, Gihan Saad Abo Elwafa
COVID-19 is a global pandemic that negatively affected the world economy and the health care resources. It is associated with great health impact, mortality, and long-term sequelae. History taking computed tomography of the chest and laboratory investigations including complete blood count, liver and kidney function tests, serum ferritin, C-reactive protein, and D-dimer were done. A total of 246 hospitalized COVID-19 patients were enrolled. Male predominance (67.1% of the total study population) was observed. The mean age was 57.26 ± 14.08 years. Moderate cases comprised 63.8% of the total study population, 22.4% were severe cases, and 13.8% were critical cases. The mortality rate was 8.13% and 6.1% developed venous thromboembolism. Age, smoking, and the presence of previous pulmonary disease were among the most important factors affecting COVID-19 severity. The severity of the disease greatly influences the incidence of venous thromboembolism and the outcome of the disease.
{"title":"Severity, mortality, and incidence of venous thromboembolism in COVID-19 patients","authors":"Ahmed Al-Husseiny Ali, Hebatallah Hany Assal, Mohamed Said Ismail, Basem Abdelmonem Mashaly, Gihan Saad Abo Elwafa","doi":"10.1186/s43168-024-00330-w","DOIUrl":"https://doi.org/10.1186/s43168-024-00330-w","url":null,"abstract":"COVID-19 is a global pandemic that negatively affected the world economy and the health care resources. It is associated with great health impact, mortality, and long-term sequelae. History taking computed tomography of the chest and laboratory investigations including complete blood count, liver and kidney function tests, serum ferritin, C-reactive protein, and D-dimer were done. A total of 246 hospitalized COVID-19 patients were enrolled. Male predominance (67.1% of the total study population) was observed. The mean age was 57.26 ± 14.08 years. Moderate cases comprised 63.8% of the total study population, 22.4% were severe cases, and 13.8% were critical cases. The mortality rate was 8.13% and 6.1% developed venous thromboembolism. Age, smoking, and the presence of previous pulmonary disease were among the most important factors affecting COVID-19 severity. The severity of the disease greatly influences the incidence of venous thromboembolism and the outcome of the disease.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255544","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 : 2024-09-17DOI: 10.1186/s43168-024-00328-4
Dalia Abd El Sattar El Embaby, Fatema AlZahraa Abdellatif Abdullah, Emad Korraa, Heba Shalaby, Eman Abdel-Salam Ibrahim, Wael Emam, Rehab M. Mohammad
Appropriate staging of lung cancer is of paramount importance, as it customizes treatment and predicts prognosis. Both Fludeoxyglucose-18 (FDG) positron emission tomography (PET) combined with contrast computed tomography (CT) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are two widely used diagnostic modalities in the field of staging & diagnosis of lung malignancies, the former depends on image analysis while the later enables real-time sampling of lymph nodes under sonographic guidance. To compare the diagnostic and staging accuracy of convex probe EBUS-TBNA versus FDG – PET/CT as two modalities in diagnosis & mediastinal staging of lung cancer patients. This prospective, observational (daignostic accuracy) research was performed on 40 cases with lung malignancies. All cases were examined via FDG-PET/CT followed by convex probe EBUS-TBNA for diagnosis & staging of concurrent mediastinal lymphadenopathy (MLN). The diagnostic yield of EBUS-TBNA reached 92.5% (37/40) compared to 70% (28/40) for FDG-PET/CT. There was poor agreement between EBUS-TBNA & FDG-PET/CT regarding (MLN) staging (k = 0.043), in 16/40 patients (40%), EBUS MLN staging matched that of FDG-PET/CT, while in 24/40(60%) there were discrepancies between the two diagnostic modalities; 18/40(45%) were up-staged after EBUS while 6/40(15%) were down staged after EBUS. In addition, EBUS-TBNA confirmed occult mediastinal nodal involvement in 9/10 FDG-PET/CT negative scans (N0). The overall diagnostic accuracy of EBUS-TBNA was significantly greater than FDG-PET/CT in staging of lung cancer (97.37% & 70% respectively, p < 0.001). EBUS-TBNA is a minimally invasive procedure that we currently recommend as a first choice for MLN staging. ClinicalTrials.gov, NCT06479798. Registered 26 June 2024—Retrospectively registered, https://clinicaltrials.gov/study/NCT06479798 .
{"title":"Accuracy of convex probe EBUS-TBNA versus FDG-PET/CT imaging in diagnosis and mediastinal staging of lung cancer patients; an Egyptian Experience","authors":"Dalia Abd El Sattar El Embaby, Fatema AlZahraa Abdellatif Abdullah, Emad Korraa, Heba Shalaby, Eman Abdel-Salam Ibrahim, Wael Emam, Rehab M. Mohammad","doi":"10.1186/s43168-024-00328-4","DOIUrl":"https://doi.org/10.1186/s43168-024-00328-4","url":null,"abstract":"Appropriate staging of lung cancer is of paramount importance, as it customizes treatment and predicts prognosis. Both Fludeoxyglucose-18 (FDG) positron emission tomography (PET) combined with contrast computed tomography (CT) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are two widely used diagnostic modalities in the field of staging & diagnosis of lung malignancies, the former depends on image analysis while the later enables real-time sampling of lymph nodes under sonographic guidance. To compare the diagnostic and staging accuracy of convex probe EBUS-TBNA versus FDG – PET/CT as two modalities in diagnosis & mediastinal staging of lung cancer patients. This prospective, observational (daignostic accuracy) research was performed on 40 cases with lung malignancies. All cases were examined via FDG-PET/CT followed by convex probe EBUS-TBNA for diagnosis & staging of concurrent mediastinal lymphadenopathy (MLN). The diagnostic yield of EBUS-TBNA reached 92.5% (37/40) compared to 70% (28/40) for FDG-PET/CT. There was poor agreement between EBUS-TBNA & FDG-PET/CT regarding (MLN) staging (k = 0.043), in 16/40 patients (40%), EBUS MLN staging matched that of FDG-PET/CT, while in 24/40(60%) there were discrepancies between the two diagnostic modalities; 18/40(45%) were up-staged after EBUS while 6/40(15%) were down staged after EBUS. In addition, EBUS-TBNA confirmed occult mediastinal nodal involvement in 9/10 FDG-PET/CT negative scans (N0). The overall diagnostic accuracy of EBUS-TBNA was significantly greater than FDG-PET/CT in staging of lung cancer (97.37% & 70% respectively, p < 0.001). EBUS-TBNA is a minimally invasive procedure that we currently recommend as a first choice for MLN staging. ClinicalTrials.gov, NCT06479798. Registered 26 June 2024—Retrospectively registered, https://clinicaltrials.gov/study/NCT06479798 .","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255545","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 : 2024-09-16DOI: 10.1186/s43168-024-00321-x
Shaimaa Magdy Abou Youssef, Ahmed Abdelsadek Mohamed, Diaa Eldin Abdelazeem Amin, Nashwa Ahmed Amin
Unexpandable lung is a complication by which the lung does not expand to the chest wall with pleural space drainage, which will result in adverse events or intervention failure if not well recognized prior to the intervention. This study aimed to assess the role of pleural manometry and transthoracic ultrasonography in predicting abnormal lung expansion during pleural drainage. This was a prospective observational analytical study involving 50 patients that aims to predict abnormal lung expansion during pleural drainage using pleural manometry and transthoracic ultrasound. Regarding pleural manometry (pleural elastance), all patients in the entrapped lung group (100%) had pleural elastance > 14.5 cmH2o/L, while in the non-entrapped lung group, all patients (100%) had pleural elastance ≤ 14.5 cmH2o/L. Regarding ultrasonography, pleural thickening > 0.5 cm was found in all patients with entrapped lung (100%) and 50% of patients with non-entrapped lung with statistically significant difference. In the entrapped lung group, 20%, 35%, and 45% of patients had simple, complex non-septated, and complex septated pleural effusion, respectively, while in the non-entrapped lung group, 63.35%, 33.33%, and 3.32% of patients had simple, complex non-septated, and complex septated effusion, respectively, with statistically significant difference (p-value 0.0005). Pleural manometry and transthoracic ultrasound can guide decision-making regarding the timing of pleural interventions and management of cases with entrapped lung.
{"title":"Role of pleural manometry and transthoracic ultrasonography to predict entrapped lung","authors":"Shaimaa Magdy Abou Youssef, Ahmed Abdelsadek Mohamed, Diaa Eldin Abdelazeem Amin, Nashwa Ahmed Amin","doi":"10.1186/s43168-024-00321-x","DOIUrl":"https://doi.org/10.1186/s43168-024-00321-x","url":null,"abstract":"Unexpandable lung is a complication by which the lung does not expand to the chest wall with pleural space drainage, which will result in adverse events or intervention failure if not well recognized prior to the intervention. This study aimed to assess the role of pleural manometry and transthoracic ultrasonography in predicting abnormal lung expansion during pleural drainage. This was a prospective observational analytical study involving 50 patients that aims to predict abnormal lung expansion during pleural drainage using pleural manometry and transthoracic ultrasound. Regarding pleural manometry (pleural elastance), all patients in the entrapped lung group (100%) had pleural elastance > 14.5 cmH2o/L, while in the non-entrapped lung group, all patients (100%) had pleural elastance ≤ 14.5 cmH2o/L. Regarding ultrasonography, pleural thickening > 0.5 cm was found in all patients with entrapped lung (100%) and 50% of patients with non-entrapped lung with statistically significant difference. In the entrapped lung group, 20%, 35%, and 45% of patients had simple, complex non-septated, and complex septated pleural effusion, respectively, while in the non-entrapped lung group, 63.35%, 33.33%, and 3.32% of patients had simple, complex non-septated, and complex septated effusion, respectively, with statistically significant difference (p-value 0.0005). Pleural manometry and transthoracic ultrasound can guide decision-making regarding the timing of pleural interventions and management of cases with entrapped lung.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255546","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 : 2024-09-10DOI: 10.1186/s43168-024-00326-6
Alaa Gamal Mashad, Mohamed Farrag, Maryam Ali, Dina Ruby
Noninvasive ventilation (NIV) is frequently employed as a treatment option for acute hypercapnic respiratory failure (AHRF) resulting from chronic obstructive pulmonary disease (COPD). Limited research has substantiated the claims made in recent studies regarding the feasibility of employing high flow nasal cannula (HFNC). Our study assessed the outcome of using HFNC versus NIV for COPD patients with AHRF. Eighty COPD patients with AHRF were confined to the respiratory intensive care unit (RICU) at Ain-Shams University Hospitals from December 2021 to 2023 and subdivided into two groups (40/group), where the first group was placed on NIV while the second group was placed on HFNC. Data during their hospital stay as demographic data, vital data, arterial blood gases, device duration, treatment failure, and mortality were recorded. The majority were males with mean age 63.75 ± 9.05 years along with treatment failure and complications 25%, 12.5.% in NIV versus 45%, and zero% in HFNC, respectively, with longer hospital stay in NIV 10–15 days to 7–10 days in HFNC, and with no difference in mortality rate in both groups. Both modalities NIV and HFNC were effective for treating COPD with AHRF. However, NIV group was significantly superior than HFNC along with apparently faster improvement in ventilatory and respiratory status especially in high CO2 level while less complications and duration of hospital stay in HFNC with no difference in mortality in both groups.
{"title":"Comparing the outcome of using high-flow nasal cannula oxygen therapy versus noninvasive ventilation for chronic obstructive pulmonary disease patients with acute hypercapnic respiratory failure","authors":"Alaa Gamal Mashad, Mohamed Farrag, Maryam Ali, Dina Ruby","doi":"10.1186/s43168-024-00326-6","DOIUrl":"https://doi.org/10.1186/s43168-024-00326-6","url":null,"abstract":"Noninvasive ventilation (NIV) is frequently employed as a treatment option for acute hypercapnic respiratory failure (AHRF) resulting from chronic obstructive pulmonary disease (COPD). Limited research has substantiated the claims made in recent studies regarding the feasibility of employing high flow nasal cannula (HFNC). Our study assessed the outcome of using HFNC versus NIV for COPD patients with AHRF. Eighty COPD patients with AHRF were confined to the respiratory intensive care unit (RICU) at Ain-Shams University Hospitals from December 2021 to 2023 and subdivided into two groups (40/group), where the first group was placed on NIV while the second group was placed on HFNC. Data during their hospital stay as demographic data, vital data, arterial blood gases, device duration, treatment failure, and mortality were recorded. The majority were males with mean age 63.75 ± 9.05 years along with treatment failure and complications 25%, 12.5.% in NIV versus 45%, and zero% in HFNC, respectively, with longer hospital stay in NIV 10–15 days to 7–10 days in HFNC, and with no difference in mortality rate in both groups. Both modalities NIV and HFNC were effective for treating COPD with AHRF. However, NIV group was significantly superior than HFNC along with apparently faster improvement in ventilatory and respiratory status especially in high CO2 level while less complications and duration of hospital stay in HFNC with no difference in mortality in both groups.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142182999","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}
Gastroesophageal reflux disease (GERD) is a frequent digestive illness in North America, causing symptoms and complications. It affects 18.1–27.28% of people and is associated with decreased quality of life. Treatment improves quality of life, but treatment costs are higher. The study aims to assess the role of screening of patients proven to have GERD by upper gastrointestinal endoscope for early detection of interstitial lung diseases. This research was cross-sectional research. The study will be conducted at the Chest Diseases Department of Ain Shams University hospitals. This prospective cross-sectional research will be performed on 90 randomly selected cases diagnosed with GERD by upper gastrointestinal endoscopy. For 1 year. The findings of chest HRCT for enrolled patients are 15 patients (16.7%) showed positive CT findings suggestive of interstitial lung disease, whereas 75 patients (83.3%) had normal CT scans. The most common CT finding was atelectasis reported in nine patients (10%). a statistically significant correlation between age and fibrosis and reticular infiltration, female gender, and reticular infiltration. no statistically significant association between CT findings and each of the chest symptoms and GERD symptoms. CT chest screen of patients diagnosed with GERD by upper gastrointestinal endoscopy plays a favorable role in the early detection of ILD to help in early management and treatment them. In patients diagnosed with GERD by upper gastrointestinal endoscopy, we revealed that: reticular infiltration is more prevalent in female gender. Reticular infiltration and fibrosis increase with older age. Reticular infiltration and atelectasis increase in patients who have a hiatus hernia. Cough, dyspnea, and wheezes increase in older age.
{"title":"The role of screening of patients proved to have gastroesophageal reflux disease by upper gastrointestinal endoscope for early detection of interstitial lung diseases","authors":"Samar Hassan Elsharkawy, Ahmed Mohamed Osman, Asmaa Rashad Abdou Hamed, Ragy Mamdouh Ghaly","doi":"10.1186/s43168-024-00320-y","DOIUrl":"https://doi.org/10.1186/s43168-024-00320-y","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is a frequent digestive illness in North America, causing symptoms and complications. It affects 18.1–27.28% of people and is associated with decreased quality of life. Treatment improves quality of life, but treatment costs are higher. The study aims to assess the role of screening of patients proven to have GERD by upper gastrointestinal endoscope for early detection of interstitial lung diseases. This research was cross-sectional research. The study will be conducted at the Chest Diseases Department of Ain Shams University hospitals. This prospective cross-sectional research will be performed on 90 randomly selected cases diagnosed with GERD by upper gastrointestinal endoscopy. For 1 year. The findings of chest HRCT for enrolled patients are 15 patients (16.7%) showed positive CT findings suggestive of interstitial lung disease, whereas 75 patients (83.3%) had normal CT scans. The most common CT finding was atelectasis reported in nine patients (10%). a statistically significant correlation between age and fibrosis and reticular infiltration, female gender, and reticular infiltration. no statistically significant association between CT findings and each of the chest symptoms and GERD symptoms. CT chest screen of patients diagnosed with GERD by upper gastrointestinal endoscopy plays a favorable role in the early detection of ILD to help in early management and treatment them. In patients diagnosed with GERD by upper gastrointestinal endoscopy, we revealed that: reticular infiltration is more prevalent in female gender. Reticular infiltration and fibrosis increase with older age. Reticular infiltration and atelectasis increase in patients who have a hiatus hernia. Cough, dyspnea, and wheezes increase in older age.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183000","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 : 2024-09-09DOI: 10.1186/s43168-024-00324-8
Mohamed Elsaid Ali Hassan Elfeqy, Hanaa Sami Hamed, Dalia Anas Ibrahim
Pleural effusion is the most prevalent pleural disorder. One third of pleural effusions are caused by lung cancer. Thoracoscopy is regarded as the most reliable diagnostic method for the evaluation of suspected pleural malignancy. To assess visible pleural characteristics of abnormalities and their locations for malignant and benign pathologies as well as to determine the incidence of malignancy in the apparent normal pleura. This was a descriptive, observational, and cross-sectional research that was performed on 36 cases with undiagnosed exudative pleural effusions prepared for medical thoracoscopy and on whom the cytological analysis was inconclusive, at the thoracoscopic Unit Department of Chest Diseases, Faculty of Medicine Zagazig University, from December 2023 to May 2024. The apparent normal pleura and adhesions were significantly greater in benign effusions than in malignant effusions (p = 0.019 and p = 0.04, respectively), while nodular effusion was significantly greater in malignant effusions than in benign effusions (p = 0.003). Bleeding was significantly greater in malignant effusions than in benign effusions (p = 0.019). As regards the thoracoscopic findings, 24 (66.7%) patients showed nodular patterns, 14 (38.9%) patients showed adhesions, and two (5.6%) patients had pus, while six (16.7%) patients had apparent normal pleura. The costal pleura was the most frequently affected site (88.9%) followed by the visceral pleura (55.6%) then the diaphragmatic pleura (38.9%). Medical thoracoscopy (MT), a minimally invasive and a generally safe treatment, enables the interventional pulmonologist to access the pleural cavity directly and obtain pleural samples under direct view helping in predicting the pathology.
{"title":"Correlation between thoracoscopic presentations and pathological patterns in undiagnosed pleural effusion","authors":"Mohamed Elsaid Ali Hassan Elfeqy, Hanaa Sami Hamed, Dalia Anas Ibrahim","doi":"10.1186/s43168-024-00324-8","DOIUrl":"https://doi.org/10.1186/s43168-024-00324-8","url":null,"abstract":"Pleural effusion is the most prevalent pleural disorder. One third of pleural effusions are caused by lung cancer. Thoracoscopy is regarded as the most reliable diagnostic method for the evaluation of suspected pleural malignancy. To assess visible pleural characteristics of abnormalities and their locations for malignant and benign pathologies as well as to determine the incidence of malignancy in the apparent normal pleura. This was a descriptive, observational, and cross-sectional research that was performed on 36 cases with undiagnosed exudative pleural effusions prepared for medical thoracoscopy and on whom the cytological analysis was inconclusive, at the thoracoscopic Unit Department of Chest Diseases, Faculty of Medicine Zagazig University, from December 2023 to May 2024. The apparent normal pleura and adhesions were significantly greater in benign effusions than in malignant effusions (p = 0.019 and p = 0.04, respectively), while nodular effusion was significantly greater in malignant effusions than in benign effusions (p = 0.003). Bleeding was significantly greater in malignant effusions than in benign effusions (p = 0.019). As regards the thoracoscopic findings, 24 (66.7%) patients showed nodular patterns, 14 (38.9%) patients showed adhesions, and two (5.6%) patients had pus, while six (16.7%) patients had apparent normal pleura. The costal pleura was the most frequently affected site (88.9%) followed by the visceral pleura (55.6%) then the diaphragmatic pleura (38.9%). Medical thoracoscopy (MT), a minimally invasive and a generally safe treatment, enables the interventional pulmonologist to access the pleural cavity directly and obtain pleural samples under direct view helping in predicting the pathology.\u0000","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183001","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 : 2024-09-07DOI: 10.1186/s43168-024-00325-7
Mohamed Ahmed Fouad Abdelalim, Mohamed A. Khalil, Ragia Samir Sharshr, Ayman Hassan Abdelzaher
Cardiac symptoms are a characteristic feature of chronic obstructive pulmonary disease (COPD), a disorder with lately achieved recognition as a systemic illness according to established standards. The research’s objective was aimed at investigating the transthoracic echocardiography role in assessing right ventricular (RV) dysfunction among individuals diagnosed with COPD, as well as to examine the potential correlation between blood pro B-type natriuretic peptide (BNP) concentrations + and this diagnostic procedure. Arterial blood gasses, spirometry, echocardiography, and serum pro BNP were done for 80 COPD patients and 20 healthy smokers, and some echocardiographic parameters were correlated with degree of airflow limitation. 77.5% of COPD cases exhibited pulmonary hypertension (PHTN), and on classifying our COPD patients, it was found that 65% of patients in group II had PHTN and 90% of patients in group III had PHTN. Systolic pulmonary artery pressure (SPAP), mean pulmonary arterial pressure (MPAP), right ventricular mid diameter (RVMD), right ventricular basal diameter (RVBD), right ventricular longitudinal diameter (RVLD), right ventricular outflow tract (RVOT) above pulmonary and aortic valve, and tricuspid annular plane systolic excursion (TAPSE) along with RVEF exhibited a significant variance among all groups. A negative correlation was observed among forced expiratory volume (FEV) 1% and (RVMD as well as RVBD) and between Pro BNP and (TAPSE and RVEF). PHTN was found in 77.5% of COPD patients and is negatively correlated with FEV1%. Serum pro BNP level exhibits a negative correlation with FEV1% in stable COPD patients.
心脏症状是慢性阻塞性肺病（COPD）的特征之一，根据既定标准，慢性阻塞性肺病最近被认定为一种全身性疾病。这项研究的目的是调查经胸超声心动图在评估被诊断为慢性阻塞性肺病患者的右心室（RV）功能障碍方面的作用，并研究血液中 B 型钠尿肽（BNP）+ 的浓度与这一诊断程序之间的潜在相关性。研究人员对 80 名慢性阻塞性肺病患者和 20 名健康吸烟者进行了动脉血气、肺活量测定、超声心动图和血清 Pro BNP 检测，并将一些超声心动图参数与气流受限程度相关联。77.5%的慢性阻塞性肺病病例表现为肺动脉高压（PHTN），在对慢性阻塞性肺病患者进行分类时发现，II 组 65% 的患者有 PHTN，III 组 90% 的患者有 PHTN。肺动脉收缩压（SPAP）、平均肺动脉压（MPAP）、右心室中径（RVMD）、右心室基底径（RVBD）、右心室纵径（RVLD）、肺动脉瓣和主动脉瓣上方的右心室流出道（RVOT）、三尖瓣环平面收缩期偏移（TAPSE）以及 RVEF 在所有组别中均存在显著差异。1%的用力呼气容积（FEV）与（RVMD 和 RVBD）之间以及 Pro BNP 与（TAPSE 和 RVEF）之间均呈负相关。77.5%的慢性阻塞性肺病患者发现了 PHTN，它与 FEV1% 呈负相关。在病情稳定的慢性阻塞性肺病患者中，血清 Pro BNP 水平与 FEV1% 呈负相关。
{"title":"The role of transthoracic echocardiography in evaluating right ventricular parameters in chronic obstructive pulmonary disease","authors":"Mohamed Ahmed Fouad Abdelalim, Mohamed A. Khalil, Ragia Samir Sharshr, Ayman Hassan Abdelzaher","doi":"10.1186/s43168-024-00325-7","DOIUrl":"https://doi.org/10.1186/s43168-024-00325-7","url":null,"abstract":"Cardiac symptoms are a characteristic feature of chronic obstructive pulmonary disease (COPD), a disorder with lately achieved recognition as a systemic illness according to established standards. The research’s objective was aimed at investigating the transthoracic echocardiography role in assessing right ventricular (RV) dysfunction among individuals diagnosed with COPD, as well as to examine the potential correlation between blood pro B-type natriuretic peptide (BNP) concentrations + and this diagnostic procedure. Arterial blood gasses, spirometry, echocardiography, and serum pro BNP were done for 80 COPD patients and 20 healthy smokers, and some echocardiographic parameters were correlated with degree of airflow limitation. 77.5% of COPD cases exhibited pulmonary hypertension (PHTN), and on classifying our COPD patients, it was found that 65% of patients in group II had PHTN and 90% of patients in group III had PHTN. Systolic pulmonary artery pressure (SPAP), mean pulmonary arterial pressure (MPAP), right ventricular mid diameter (RVMD), right ventricular basal diameter (RVBD), right ventricular longitudinal diameter (RVLD), right ventricular outflow tract (RVOT) above pulmonary and aortic valve, and tricuspid annular plane systolic excursion (TAPSE) along with RVEF exhibited a significant variance among all groups. A negative correlation was observed among forced expiratory volume (FEV) 1% and (RVMD as well as RVBD) and between Pro BNP and (TAPSE and RVEF). PHTN was found in 77.5% of COPD patients and is negatively correlated with FEV1%. Serum pro BNP level exhibits a negative correlation with FEV1% in stable COPD patients.\u0000","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227739","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 : 2024-09-06DOI: 10.1186/s43168-024-00322-w
Omnya Magdy, Aya AbdelDayem, Ashraf ELMaraghi, Maryam Ali, Fatma Hafez
The endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has revolutionized pulmonology by identifying cancer spread in lung cancer patients. It is now used for diagnosing sarcoidosis, tuberculosis, and lymphoma. Rapid onsite evaluation (ROSE) is a crucial tool for pathologists, assisting in sample adequacy, accuracy, and prompt decision-making. This study aimed to evaluate the efficacy of ROSE in identifying mediastinal lymphadenopathy and lung cancer during EBUS-TBNA and cTBNA. Our research was a prospective study in which we examined sixty cases that were separated into two groups of similar size. The rapid onsite evaluation group and the non-rapid onsite evaluation group were subjected to either Conventional TBNA or endobronchial ultrasound-guided transbronchial needle aspiration. The total diagnostic yield of conventional and endobronchial ultrasound-guided transbronchial needle aspiration in both groups was 83.3% (50/60 cases). Twenty-eight cases (46.7%) were positive for malignancy, 22 cases (36.6%) were positive for benign lesions, and 10 cases (16.6%) were not conclusive. Regarding diagnostic accuracy, it was greater in the rapid onsite evaluation group than in the non-rapid onsite evaluation group (100% in the rapid onsite evaluation group vs. 66.7% in the non-ROSE group). Rapid onsite evaluation during conventional or endobronchial ultrasound-guided transbronchial needle aspiration improves diagnostic accuracy of mediastinal lesions by excluding suspicious or nondiagnostic specimens and can reduce unnecessary punctures or eliminate the need for additional bronchoscopy procedures when reaching preliminary diagnosis.
{"title":"The value of rapid on-site evaluation during conventional and endobronchial ultrasound needle aspiration in the diagnosis of mediastinal lymphadenopathy and lung cancer","authors":"Omnya Magdy, Aya AbdelDayem, Ashraf ELMaraghi, Maryam Ali, Fatma Hafez","doi":"10.1186/s43168-024-00322-w","DOIUrl":"https://doi.org/10.1186/s43168-024-00322-w","url":null,"abstract":"The endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has revolutionized pulmonology by identifying cancer spread in lung cancer patients. It is now used for diagnosing sarcoidosis, tuberculosis, and lymphoma. Rapid onsite evaluation (ROSE) is a crucial tool for pathologists, assisting in sample adequacy, accuracy, and prompt decision-making. This study aimed to evaluate the efficacy of ROSE in identifying mediastinal lymphadenopathy and lung cancer during EBUS-TBNA and cTBNA. Our research was a prospective study in which we examined sixty cases that were separated into two groups of similar size. The rapid onsite evaluation group and the non-rapid onsite evaluation group were subjected to either Conventional TBNA or endobronchial ultrasound-guided transbronchial needle aspiration. The total diagnostic yield of conventional and endobronchial ultrasound-guided transbronchial needle aspiration in both groups was 83.3% (50/60 cases). Twenty-eight cases (46.7%) were positive for malignancy, 22 cases (36.6%) were positive for benign lesions, and 10 cases (16.6%) were not conclusive. Regarding diagnostic accuracy, it was greater in the rapid onsite evaluation group than in the non-rapid onsite evaluation group (100% in the rapid onsite evaluation group vs. 66.7% in the non-ROSE group). Rapid onsite evaluation during conventional or endobronchial ultrasound-guided transbronchial needle aspiration improves diagnostic accuracy of mediastinal lesions by excluding suspicious or nondiagnostic specimens and can reduce unnecessary punctures or eliminate the need for additional bronchoscopy procedures when reaching preliminary diagnosis.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183002","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 : 2024-09-05DOI: 10.1186/s43168-024-00313-x
Eman Mohamed Dahma, Walaa Mowafy El-lawaty, Dalia Ezzat Shaarawy, Mohammed Mahmoud Dawoud, Wafaa Saleh El-Shimy
Chronic obstructive pulmonary disease (COPD) is often ascribed to the disparity that exists between ventilatory loading and diaphragmatic function. The principal factor contributing to this imbalance is the mechanical difficulties brought about by pulmonary hyperinflation. This causes the fiber lengths of the respiratory muscles to be suboptimal, thereby decreasing the tension generated. The frailty of the respiratory musculature is further exacerbated by hypercapnia, acidosis, nutritional deficiency, and steroid therapy. As the principal respiratory muscle, the diaphragm is responsible for 75% of quiescent lung ventilation. Ultrasonography has exhibited substantial promise in evaluating the effectiveness of the diaphragm. The goal of the research was to assess the diaphragmatic function in COPD patients using ultrasonographic examination and to study its correlation with pulmonary function tests. This work was performed on 60 individuals with COPD and 20 healthy volunteers (control group). All the subjects were sequentially examined by chest X-ray and spirometry in one time and then repeated 15–45 min after the first dose of inhalation therapy (salbutamol); then, 6MWT, ABG, and ultrasonography were done for all patients. In COPD patients, diaphragmatic thickness and excursion were substantially reduced in comparison to the control group; these parameters were also significantly correlated with pulmonary function tests. A reduction in diaphragmatic thickness and excursion is observed in patients diagnosed with COPD.
{"title":"Ultrasonographic evaluation of diaphragmatic thickness and movement for assessment of diaphragmatic dysfunction in COPD patients","authors":"Eman Mohamed Dahma, Walaa Mowafy El-lawaty, Dalia Ezzat Shaarawy, Mohammed Mahmoud Dawoud, Wafaa Saleh El-Shimy","doi":"10.1186/s43168-024-00313-x","DOIUrl":"https://doi.org/10.1186/s43168-024-00313-x","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is often ascribed to the disparity that exists between ventilatory loading and diaphragmatic function. The principal factor contributing to this imbalance is the mechanical difficulties brought about by pulmonary hyperinflation. This causes the fiber lengths of the respiratory muscles to be suboptimal, thereby decreasing the tension generated. The frailty of the respiratory musculature is further exacerbated by hypercapnia, acidosis, nutritional deficiency, and steroid therapy. As the principal respiratory muscle, the diaphragm is responsible for 75% of quiescent lung ventilation. Ultrasonography has exhibited substantial promise in evaluating the effectiveness of the diaphragm. The goal of the research was to assess the diaphragmatic function in COPD patients using ultrasonographic examination and to study its correlation with pulmonary function tests. This work was performed on 60 individuals with COPD and 20 healthy volunteers (control group). All the subjects were sequentially examined by chest X-ray and spirometry in one time and then repeated 15–45 min after the first dose of inhalation therapy (salbutamol); then, 6MWT, ABG, and ultrasonography were done for all patients. In COPD patients, diaphragmatic thickness and excursion were substantially reduced in comparison to the control group; these parameters were also significantly correlated with pulmonary function tests. A reduction in diaphragmatic thickness and excursion is observed in patients diagnosed with COPD.","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183003","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 : 2024-09-04DOI: 10.1186/s43168-024-00323-9
Mohamed Hamoda, Amina Abd El-Maksoud, Aida M. Yousef, Dalia Monir Fahmy, Mohamed Tohlob
It has been proposed that prolonged use of anti-inflammatory and anti-fibrotic drugs diminish the probability of development of lung fibrosis. Prolonged low-dose corticosteroid may prevent remodeling of the lung in survivors. Pirfenidone and colchicine may exhibit anti-fibrotic and anti-inflammatory properties as well. This retrospective observational study was conducted at post COVID-19 clinic, Mansoura University Hospitals, during the period between October 2020 and March 2022. This study included 104 patients who had COVID-19 pneumonia confirmed either by RT-PCR or radiologically by CT scan and divided into 3 groups; group A (corticosteroids only) included 33 (31.7%) patients, group B (corticosteroids and colchicine) included 56 (53.8%) patients, and group C (corticosteroids, colchicine, and pirfenidone) included 15 (14.4%) patients. All patients were assessed during follow-up visits in post COVID-19 clinic 1 and 3 months after discharge by evaluation of resting SpO2, spirometry, and radiological assessment. Patients’ data during hospitalization was collected from hospital electronic systems. There was non-statistically significant improvement in FEV1 in group A while there was statistically significant improvement in FEV1 in groups B and C (P value = 0.002 and 0.041, respectively) 1 month and 3 months after discharge. Group B exhibited more statistically significant improvement in FVC as well compared to group C (P value = 0.003 and 0.025, respectively) while group A showed non-statistically significant improvement in FVC. There was a statistically significant decrease in CT severity score in all the groups during follow-up with P value < 0.001 in groups A and B and to less extent less statistically significant decrease in group C comparing the 3 groups to each other. The use of colchicine added to corticosteroids after acute phase of COVID-19 pneumonia resulted in statistically significant improvement regarding functional and radiological changes during follow-up when compared to corticosteroids alone. The addition of pirfenidone (which is a relatively expensive drug) to corticosteroids and colchicine did not add more statistically significant improvement in functional or radiological changes.
{"title":"Radiological and spirometric changes in relation to drugs used in post COVID pulmonary fibrosis in a cohort of COVID-19 survivors","authors":"Mohamed Hamoda, Amina Abd El-Maksoud, Aida M. Yousef, Dalia Monir Fahmy, Mohamed Tohlob","doi":"10.1186/s43168-024-00323-9","DOIUrl":"https://doi.org/10.1186/s43168-024-00323-9","url":null,"abstract":"It has been proposed that prolonged use of anti-inflammatory and anti-fibrotic drugs diminish the probability of development of lung fibrosis. Prolonged low-dose corticosteroid may prevent remodeling of the lung in survivors. Pirfenidone and colchicine may exhibit anti-fibrotic and anti-inflammatory properties as well. This retrospective observational study was conducted at post COVID-19 clinic, Mansoura University Hospitals, during the period between October 2020 and March 2022. This study included 104 patients who had COVID-19 pneumonia confirmed either by RT-PCR or radiologically by CT scan and divided into 3 groups; group A (corticosteroids only) included 33 (31.7%) patients, group B (corticosteroids and colchicine) included 56 (53.8%) patients, and group C (corticosteroids, colchicine, and pirfenidone) included 15 (14.4%) patients. All patients were assessed during follow-up visits in post COVID-19 clinic 1 and 3 months after discharge by evaluation of resting SpO2, spirometry, and radiological assessment. Patients’ data during hospitalization was collected from hospital electronic systems. There was non-statistically significant improvement in FEV1 in group A while there was statistically significant improvement in FEV1 in groups B and C (P value = 0.002 and 0.041, respectively) 1 month and 3 months after discharge. Group B exhibited more statistically significant improvement in FVC as well compared to group C (P value = 0.003 and 0.025, respectively) while group A showed non-statistically significant improvement in FVC. There was a statistically significant decrease in CT severity score in all the groups during follow-up with P value < 0.001 in groups A and B and to less extent less statistically significant decrease in group C comparing the 3 groups to each other. The use of colchicine added to corticosteroids after acute phase of COVID-19 pneumonia resulted in statistically significant improvement regarding functional and radiological changes during follow-up when compared to corticosteroids alone. The addition of pirfenidone (which is a relatively expensive drug) to corticosteroids and colchicine did not add more statistically significant improvement in functional or radiological changes.\u0000","PeriodicalId":22426,"journal":{"name":"The Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183060","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}
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