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Curcumin improves step 4 asthma treatment: placebo-controlled, single blind study 姜黄素改善第4步哮喘治疗:安慰剂对照,单盲研究
Pub Date : 2019-05-01 DOI: 10.30881/PRMIJ.00010
E. Jusufovic, M. Košnik, N. Arifhodzic, J. Nurkić, M. Al‐Ahmad, Azra Jusufovic, Dženan Halilović, R. Sejdinović
Background: Despite multistep efforts, many asthma patients remain symptomatic. Anti-inflammatory activities of curcumin are shown. Aim of the study was to analyse the impact of curcumin add-on therapy on inflammatory parameters, lung function, disease control and quality of life in asthma patients. Subjects and methods: Three-months lasting study was done on 150 non-smokers with asthma, that were treated with stable, moderate dose of inhaled glucocorticoids (IGK) and divided into three groups (n=50 each): curcumin group (receiving curcumin 500 mg per os twice daily), placebo group (receiving placebo tablets) and control (non-intervention) group. Sputum eosinophils (sEo), blood eosinophils (bEo), high sensitive C-reactive protein (hsCRP), predicted forced expiratory volume in first second (FEV1%), Asthma Control Test (ACT) and mini Asthma Quality of Life Questionnaire (mAQLQ) were compared before and after study, as well as between groups. Results: Before study, all followed parameters were similar between groups. After study, FEV1%, ACT and AQLQ were improved in all groups, but these improvements were more prominent in curcumin group than in placebo and control. Additionally curcumin group only showed improvement in sEo, bEo and hsCRP. Furthermore, curcumin group showed more frequent clinically significant improvement in ACT score (change>3) and in mAQLQ score (change≥0.5) when compared to placebo and control. On the other side, after study FEV1%, ACT, mAQLQ, hsCRP, sEo and bEo were similarly distributed among placebo and control group. Conclusion: This is the first placebo controlled and single-blind study to suggest that add-on therapy with curcumin could improve lung function, disease control and quality of life in moderate partially controlled asthma. Future studies may benefit from a larger sample size, longer study duration, double blind design, different dose of curcumin and/or improvements in oral bioavailability.
背景:尽管采取了多步骤的努力,许多哮喘患者仍然有症状。显示姜黄素的抗炎活性。本研究的目的是分析姜黄素辅助治疗对哮喘患者炎症参数、肺功能、疾病控制和生活质量的影响。研究对象和方法:对150例不吸烟的哮喘患者进行了为期3个月的研究,这些患者接受稳定、中等剂量的吸入糖皮质激素(IGK)治疗,分为三组(n=50):姜黄素组(每天两次接受姜黄素500毫克)、安慰剂组(接受安慰剂片)和对照组(不干预)。比较研究前后及组间痰嗜酸性粒细胞(sEo)、血嗜酸性粒细胞(bEo)、高敏c反应蛋白(hsCRP)、预测第一秒用力呼气量(FEV1%)、哮喘控制试验(ACT)、哮喘生活质量问卷(mAQLQ)。结果:研究前,各组间随访参数基本一致。研究结束后,各组FEV1%、ACT和AQLQ均有改善,但姜黄素组改善效果较安慰剂组和对照组更为显著。姜黄素组仅改善了sEo、bEo和hsCRP。此外,与安慰剂和对照组相比,姜黄素组在ACT评分(变化bb0.3)和mAQLQ评分(变化≥0.5)方面表现出更频繁的临床显著改善。另一方面,研究结束后,FEV1%、ACT、maqql、hsCRP、sEo、bEo在安慰剂组和对照组的分布相似。结论:这是第一个安慰剂对照和单盲研究,表明姜黄素附加治疗可以改善中度部分控制哮喘患者的肺功能、疾病控制和生活质量。未来的研究可能受益于更大的样本量、更长的研究时间、双盲设计、不同剂量的姜黄素和/或口服生物利用度的改善。
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引用次数: 3
Pulmonary spindle cell carcinoma: case report and literature review 肺梭形细胞癌1例报告及文献复习
Pub Date : 2019-03-12 DOI: 10.30881/PRMIJ.00009
Alexis Eduardo Higareda Basilio, Cecilio Omar Ceballos Zuñiga, Federico Isaac Hernandez Rocha, S. Ham
Spindle cell carcinoma is a rare and malignant variety of squamous cell carcinoma. It is a tumor that is constituted by a double cell proliferation: a carcinomatous sarcomatous epithelial cells of spindle cells and another sarcomatous of spindle cells. It can affect any part of the body; however, it is more commonly found in upper airway and digestive tract. It affects men more frequently between the sixth and seventh decade of life. It has an aggressive behavior with a tendency of recurrence. Alcohol and tobacco have been identified as the most important risk factors. The histopathological diagnosis is complicated and it is often necessary to resort to immunohistochemical techniques and the use of the electron microscope. Given the infrequent strain, it is considered important to publish the information collected from a case in our environment to compare it with what is currently described in the literature. Pulmonary and Respiratory Medicine International Journal Submit your Article | www.ologypress.com/submit-article Ology Press Citation: Basilio AEH, Zuñiga COC, Rocha FIH, et al. Pulmonary spindle cell carcinoma: case report and literature review. Pulm Resp Med Int J. (2019);2(1):1-3. DOI: 10.30881/prmij.00009 2 of 18,340 uL, with neutrophils of 17,550 uL (95.7%), lymphocytes 460 uL (2.5%) monocytes 290 uL ( 1.6%), eosinophils of 0%, and basophils of 40 uL (0.2%). This is why third-generation cephalosporin and macrolide are initiated for suspected community-acquired pneumonia with pleural effusion. The following approach was to perform a contrast computed tomography of the thorax, which reported a tumor with central necrosis in the right hemithorax of 3.5 inches x 4.3 inches, infiltrating the right pulmonary bronchus from its origin in the main carina, with peripheral enhancement, practically collapsing the right hemithorax in its entirety, with left hemithorax without evident alterations, and mediastinum with retraction towards affected hemithorax as well as infiltration to fat, presence of adenopathies reporting 1.1 inches as the largest diameter located sub-carinal. The esophagus showed a loss of fat separation interface in the middle third, which is why it is considered infiltration of the same. Bone tissues showed only degenerative changes and soft tissues with hypotrophy. The department of diagnostic radiology suggested the diagnosis of bronchogenic cancer, possibly of large cells, thus requiring histopathological confirmation. Macrolide was suspended and clindamycin was initiated for probable post obstructive pneumonia. During his hospital stay prior to his bronchoscopy, the patient was found to have a transcutaneous oxygen measurement of 89% without supplementary oxygen, which improved with the administration of supplementary oxygen by nasal tips at 0.5 L/min. Continuing with the same symptomatology, the patient was stable. A bronchoscopy was performed with diagnostic cryobiopsy, showing extrinsic compression of the middle third of th
梭形细胞癌是一种罕见的恶性鳞状细胞癌。它是一种由双细胞增殖构成的肿瘤:一种是梭形细胞上皮细胞的癌性肉瘤,另一种是梭形细胞的肉瘤。它可以影响身体的任何部位;然而,它更常见于上呼吸道和消化道。男性在60岁到70岁之间更容易患此病。它具有攻击行为并有复发倾向。酒精和烟草已被确定为最重要的危险因素。组织病理学诊断是复杂的,往往需要求助于免疫组织化学技术和电子显微镜的使用。鉴于罕见的菌株,在我们的环境中公布从病例收集的信息并将其与目前文献中描述的信息进行比较是很重要的。提交你的文章| www.ologypress.com/submit-article Ology出版社引文:Basilio AEH, Zuñiga COC, Rocha FIH等。肺梭形细胞癌1例报告及文献复习。中华医学杂志(2019);2(1):1-3。DOI: 10.30881 / prmij。其中中性粒细胞17550 uL(95.7%),淋巴细胞460 uL(2.5%),单核细胞290 uL(1.6%),嗜酸性粒细胞0%,嗜碱性粒细胞40 uL(0.2%)。这就是为什么第三代头孢菌素和大环内酯开始用于怀疑社区获得性肺炎合并胸腔积液。接下来的方法是对胸部进行计算机断层扫描,结果显示右半胸有3.5英寸x 4.3英寸的中心坏死肿瘤,从其起源的主隆胸浸润到右肺支气管,周围增强,几乎整个右半胸塌陷,左半胸无明显改变,纵隔向受影响的半胸缩回,并浸润到脂肪中。存在最大直径1.1英寸的腺病,位于隆突下。食道中间三分之一处脂肪分离界面丢失,考虑为浸润性。骨组织仅表现为退行性改变,软组织萎缩。诊断放射科建议诊断为支气管源性癌,可能为大细胞癌,因此需要组织病理学证实。停用大环内酯并开始使用克林霉素治疗可能的阻塞性肺炎。在支气管镜检查前住院期间,发现患者在没有补充氧的情况下经皮氧测量为89%,在以0.5 L/min的鼻尖补充氧后改善。在相同的症状下,患者病情稳定。经支气管镜检查,诊断性冷冻活检显示气管中三分之一处外源性压迫,右侧主支气管100%阻塞并延伸至主隆突,中间支气管通透,持续存在大叶支气管阻塞和基底干部分再通。因此,送支气管灌洗进行培养和细胞学检查,以及细胞学和免疫组织化学活检。作物报告阴性,病理报告显示梭细胞恶性肿瘤与梭形细胞癌一致,细胞角蛋白AE1 / AE3局部阳性,TTF阴性,P63阴性(图2-4)。图1 A)胸部冠状位ct扫描,纵隔窗B)胸部ct扫描轴向切片,纵隔窗C)胸部ct扫描轴向切片,肺窗图2 P63免疫组化表达阴性。图3 TTF-1免疫组化表达阴性。图4细胞角蛋白AE1/AE3阳性。
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引用次数: 1
Skeletal Tuberculosis- Review of Literature and Few case reports 骨结核-文献回顾和少数病例报告
Pub Date : 2018-11-29 DOI: 10.30881/PRMIJ.00008
Dr. C. Sumalata, Dr. Arundhathi
Extrapulmonary tuberculosis forms 15% of total tuberculosis in India. Skeletal tuberculosis which constitutes bone and joint tuberculosis, results from haematogenous spread from a pulmonary or other visceral or lymph node focus. Tuberculosis osteomyelitis was described by Nelatoo (1837); histologic morphology was given by Rokitansky (1884); tuberculosis nodule in a joint was seen by Koster (1869); and synovial tuberculosis by Volkmann (1879). Case No. 1: A case of Shoulder joint Tuberculosis which was relatively rare, was diagnosed in a middle aged farmer after taking proper history of pain and inability to move. He was investigated appropriately with radiological images and the case eventually responded to the anti-tuberculosis treatment. Case No. 2: A case of rib osteomyelitis was diagnosed when the young lady had only a complaint of pain in lower chest right side. The diagnosis of TB was reached after she had empyema and the same pus was tested for TB DNA. The decrease in pain and relieve of symptoms noticed after the initiation of treatment with Anti tuberculous treatment. She had surgical intervention for the same. Case No. 3 A young lady complained of pain and swelling in left wrist for a long duration. MRI showed bone marrow oedema in distal row of carpal bones with loss of articular cartilage and small erosion noted in trapezoid, base of metacarpal and capitates and base of third metacarpal joint. The diagnosis of tuberculosis was supported with Immunoglobulin Releasing Assay (IGRA) which was positive. Anti tuberculous drugs were given, and she responded well. Case No. 4 A middle aged man who was suffering from low back ache from 3 years had been diagnosed as Potts spine at L5 –S1 with the help of MRI spine. He was started with Anti tuberculosis drugs and he responded well. All the cases were also worked up for primary pulmonary involvement.
在印度,肺外结核占肺结核总数的15%。骨性结核构成骨和关节结核,由肺或其他内脏或淋巴结病灶的血源性扩散引起。结核性骨髓炎由Nelatoo(1837)描述;Rokitansky(1884)给出了组织学形态学;Koster(1869)发现关节结核结节;以及Volkmann(1879)的滑膜结核。病例1:一个相对罕见的肩关节结核病例,被诊断为中年农民,经过适当的疼痛和不能移动的历史。对他进行了适当的放射图像调查,该病例最终对抗结核治疗有反应。病例2:一例肋骨骨髓炎被诊断时,年轻的女士只有一个疼痛的投诉下胸部右侧。在她出现脓胸后,诊断为结核病,并对相同的脓液进行了结核病DNA检测。抗结核治疗开始后疼痛减轻,症状缓解。她也做过手术。病例3一位年轻女士主诉左腕长时间疼痛和肿胀。MRI显示远端腕骨骨髓水肿伴关节软骨缺失,跖骨、掌骨基部、头跖骨和第三掌关节基部有少量糜烂。免疫球蛋白释放试验(IGRA)结果为阳性,支持结核病的诊断。给予抗结核药物治疗,效果良好。病例4:一名中年男性,腰痛3年,经脊柱MRI诊断为L5 -S1部位Potts脊柱。他开始服用抗结核药物,效果很好。所有病例均被诊断为原发性肺部受累。
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引用次数: 1
Severe Bronchial Asthma in the era of biological treatments 生物治疗时代的重症支气管哮喘
Pub Date : 2018-11-13 DOI: 10.30881/PRMIJ.00007
Eleni Manoloudi, P. Steiropoulos
Severe bronchial asthma is a chronic heterogeneous disease that requires a combination of therapies in order to be sufficiently controlled. A significant number of patients, however, do not achieve adequate control, leading to frequent exacerbations, impaired quality of life and increased health care costs. In recent years, several biological agents for severe asthma treatment have been introduced in the market or are under development. Although, biological treatment regimens for severe asthma are increasing our perspective about future asthma approach for specific asthma phenotypes and endotypes, still certain issues are raised concerning their appropriate use in line with everyday clinical practice. Pulmonary and Respiratory Medicine International Journal Submit your Article | www.ologypress.com/submit-article Ology Press Citation: Manoloudi E, Steiropoulos P. Severe Bronchial Asthma in the era of biological treatments. Pulm Resp Med Int J. (2018);1(1):6-9. 7 Anti-immunoglobulin E More than 50% of patients with poorly controlled asthma have allergic immunoglobulin E (IgE)-mediated asthma.10 IgE has a crucial upstream role in the inflammatory cascade of allergy and allergic asthma.6 Omalizumab is the only biological anti-IgE agent currently approved for humans.10 It was approved by the FDA in 2003 and by the European Union in 2005 as add-on treatment for patients aged >12 years with severe persistent allergic asthma who have serum total IgE levels 30-700 IU/mL.10 It is a recombinant DNA derived humanized IgG1 monoclonal antibody, which was originally constructed as a murine antibody selectively binding to human IgE.11 It has two main mechanisms of action: 1) it binds exclusively to circulating IgE in the blood and interstitial space and promotes its depletion and 2) it inhibits IgE binding to high-affinity (FcoRI) or low-affinity receptors (FcoRII) on basophils, mast cells and dendritic cells.10 As a result, it hinders the release of inflammatory mediators from mast cells reducing the recruitment of inflammatory cells, especially eosinophils, into the airways.11 As reported in clinical trials, omalizumab contributes to reduction in exacerbation rates, fewer emergency department visits and asthma related hospitalizations, better asthma symptom control, reduction in ICS or oral CS dose and improvement in asthma-related quality of life (QoL).6
严重支气管哮喘是一种慢性异质性疾病,需要综合治疗才能得到充分控制。然而,相当多的病人没有得到适当的控制,导致病情频繁恶化,生活质量受损,保健费用增加。近年来,几种用于治疗严重哮喘的生物制剂已经上市或正在开发中。尽管严重哮喘的生物治疗方案增加了我们对未来特定哮喘表型和内源性哮喘治疗方法的看法,但在日常临床实践中,它们的适当使用仍然存在一些问题。《肺与呼吸医学国际期刊》投稿丨www.ologypress.com/submit-article Ology Press引文:Manoloudi E, Steiropoulos P.重度支气管哮喘生物治疗时代。中华临床医学杂志(2018);1(1):6-9。10 .抗免疫球蛋白E在控制不良的哮喘患者中,超过50%为过敏性免疫球蛋白E (IgE)介导的哮喘IgE在过敏和过敏性哮喘的炎症级联反应中起着至关重要的上游作用Omalizumab是目前唯一被批准用于人类的生物抗ige药物2003年获FDA批准,2005年获欧盟批准,作为12岁以上血清总IgE水平为30-700 IU/ ml的严重持续性过敏性哮喘患者的附加治疗它是一种重组DNA衍生的人源化IgG1单克隆抗体,最初是作为一种选择性结合人IgE.11的小鼠抗体构建的它有两种主要的作用机制:1)它只结合血液和间质空间中的循环IgE并促进其耗竭;2)它抑制IgE与嗜碱性细胞、肥大细胞和树突状细胞上的高亲和受体(FcoRI)或低亲和受体(FcoRII)的结合因此,它阻碍肥大细胞释放炎症介质,减少炎症细胞,特别是嗜酸性粒细胞进入气道的募集据临床试验报道,omalizumab有助于降低急性发作率,减少急诊就诊和哮喘相关住院,更好地控制哮喘症状,减少ICS或口服CS剂量,改善哮喘相关生活质量(QoL) 6
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引用次数: 0
Video-Assisted Thoracoscopic Surgery versus open approach for systematic mediastinal lymph node dissection as surgical staging in major pulmonary resections for lung cancer 视频胸腔镜手术与开放入路系统纵隔淋巴结清扫作为肺癌大肺切除术的手术分期
Pub Date : 2018-09-28 DOI: 10.30881/PRMIJ.00006
J. L. Fernández, R. M. Balsalobre, H. Goicoechea, I. C. Vázquez, Paloma Rofso Raboso, A. D. L. Fuente
Introduction Oncological pulmonary resection should include ipsilateral hilar and mediastinal systematic lymphatic dissection allowing adequate pathological staging. Video-Assisted Thoracoscopic Surgery (VATS) has been proposed as an appropriate surgical procedure for treatment of early-stage lung cancer patients. This study aims to compare VATS versus Thoracotomy lymph node dissection in patients who underwent pulmonary resection for lung cancer. Methods This is a retrospective analysis of prospectively collected data from 585 patients operated at La Princesa University Hospital in Madrid (Spain) from December 2007 to January 2018. All included patients underwent complete major pulmonary resection, lobectomy or bilobectomy, and mediastinal lymph node dissection. Patients were divided in two groups, VATS group with 290 patients and thoracotomy group (TT) with 295 patients. Results The number of lymph nodes resected in each group did not present significant differences. VATS-group was 13.4 and TT-group was 14.1. We did not appreciate any significant difference regarding the identification of positive hilar lymphadenopathies in VATS-group versus TT-group, 36 and 41 patients respectively. However, we observed differences in patients with mediastinal lymph node metastasis (N2 disease). 34 cases (11.7%) in VATS-group and 28 cases (9.5%) in the TT-group. Lymphadenectomy 2R and 4R stations was equivalent in both groups and did not show any statistically significant difference. In the same way, there was no difference in the number of lymph nodes for levels 7R and 8R. Hilar lymphadenectomy (10R and 11R) was performed in both procedures in an equivalent manner obtaining 3.4 lymphadenopathies in VATS-group and 3.3 lymphadenopathies in TT-group. Regarding lymphadenectomy on the left side, we did not observe any difference between both groups at 5L or 6L levels. Otherwise, subcarinal lymphadenectomy on the left side showed differences when this was performed by VATS in comparison to open surgery. 3.2 lymph nodes in the VATS-group versus 4.9 lymph nodes in TT-group. This difference was statistically significant (p < 0.01). There was no difference in at the level of 8L and 9L stations. Hilar lymphadenectomy at 10L and 11L levels was superior in VATS-group, 4.4 lymphadenopathies, respect to TT-group, 3.1 lymph nodes. This difference was statistically significant (p <0. 01). Conclusions VATS seems to be at least equivalent to thoracotomy for pulmonary major resections in terms of oncological and staging criteria.
肿瘤肺切除术应包括同侧肺门和纵隔系统性淋巴清扫,以便进行适当的病理分期。视频胸腔镜手术(VATS)被认为是治疗早期肺癌患者的一种合适的手术方法。本研究旨在比较VATS与开胸淋巴结清扫在肺癌肺切除术患者中的应用。方法回顾性分析2007年12月至2018年1月在西班牙马德里公主大学医院接受手术的585例患者的前瞻性数据。所有纳入的患者都进行了完整的大肺切除术、肺叶切除术或胆管切除术和纵隔淋巴结清扫。患者分为两组,VATS组290例,开胸组295例。结果两组间淋巴结切除数无显著性差异。vats组为13.4,tt组为14.1。我们没有发现vats组与tt组在鉴别门淋巴病变阳性方面有任何显著差异,分别为36例和41例。然而,我们观察到纵隔淋巴结转移(N2疾病)患者的差异。vats组34例(11.7%),tt组28例(9.5%)。两组淋巴结切除2R和4R站相等,无统计学差异。同样,7R和8R水平的淋巴结数量也没有差异。两种手术均行肝门淋巴结切除术(10R和11R),结果相同,vats组3.4个淋巴结病变,tt组3.3个淋巴结病变。对于左侧淋巴结切除术,我们在5L或6L水平上没有观察到两组之间的差异。另外,与开放手术相比,VATS行左侧隆突下淋巴结切除术表现出差异。vats组有3.2个淋巴结,tt组有4.9个淋巴结。差异有统计学意义(p < 0.01)。在8L和9L站点水平上无差异。10L和11L水平的肝门淋巴结切除术在vats组有优势,4.4个淋巴结病变,相对于tt组,3.1个淋巴结。差异有统计学意义(p <0)。01). 结论VATS在肿瘤和分期标准上至少与开胸肺大切除术相当。
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引用次数: 0
It is a bile! 这是胆汁!
Pub Date : 2018-08-01 DOI: 10.30881/PRMIJ.00005
A. Fayed, Mona Hassan
Bilothorax is a rare reported complication of hepatobiliary tree manipulation and can cause a great threat for life. We reported in this case a benign course of this problem without detection of obvious communication between peritoneal and pleural spaces and without peritonitis.
胆道胸是一种罕见的肝胆树操作并发症,可造成严重的生命威胁。我们报告了这个病例的良性过程,没有发现腹膜和胸膜间隙之间的明显联系,也没有腹膜炎。
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引用次数: 0
Gorham-Stout disease with thoracic, vertebral and pleural involvement: case report and literature review Gorham-Stout病伴胸、椎和胸膜受累:病例报告及文献复习
Pub Date : 1900-01-01 DOI: 10.30881/prmij.00011
F. H. Hernández Rocha, Alexis Eduardo Higareda Basilio, Cecilio Omar Ceballos Zuñiga
Gorham-Stout disease, pathology with vascular proliferation, angiomatosis and bone lymphangiomatosis that causes progressive osteolysis and loss of bone mass. Thoracic, pulmonary or pleural affection leads to a compromised respiratory function that can lead to a fatal outcome. The mandibular involvement may lead to the development of obstructive sleep apnea. The etiopathogenesis is currently unknown and occurs sporadically. Since the description of the pathology in 1838, there have been documented more than 200 cases in the literature being 50 of these in pediatric population. We report the case of a 13-year-old patient with Gorham-Stout disease with thoracic, vertebral and pleural involvement.
Gorham-Stout病,病理表现为血管增生、血管瘤病和骨淋巴管瘤病,导致进行性骨溶解和骨量丢失。胸、肺或胸膜病变会导致呼吸功能受损,从而导致致命的后果。下颌受累可导致阻塞性睡眠呼吸暂停的发展。其发病机制目前尚不清楚,偶尔发生。自1838年病理描述以来,文献中记录了200多例,其中50例为儿科病例。我们报告一例13岁的Gorham-Stout病伴胸、椎和胸膜受累的病例。
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引用次数: 0
期刊
Pulmonary and Respiratory Medicine International Journal
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