Omar Mohammed, K. Hussein, Abdelgawad Ramadan, Goudarzi Mahmoud, M. El-Naggar, Nor Eldein Gaber
Background Pleural effusion can arise as a result of more than 50 recognized causes and the differentiation between benign and malignant origin of the fluid is still a diagnostic challenge. The ability of tumor markers and other biological markers to make better diagnosis of malignant pleural effusion (MPE) remains questionable. Out of these, the calcium-related proteins S100-A8 and S100-A9 (the noncovalent heterodimer calprotectin) were demonstrated in a small amount in malignant not in benign pleural effusion. Objectives This research aimed to assess the diagnostic value of calprotectin in the differentiation between infectious or benign and MPE. Patients and methods Sixty patients were divided into group I: malignant and group II: infectious pleural effusions (which were further divided into group IIA: parapneumonic effusion and group IIB: tuberculous effusion) Quantitative measurement of calprotectin was done using the enzyme-linked immunosorbent assay technique in pleural effusion. Results Pleural calprotectin level in MPEs (229.2±168.6 ng/ml) was significantly lower than its level of infectious pleural effusions (3202.2±1304.8 ng/ml; P<0.001). The cutoff value of calprotectin level for the diagnosis of MPE was less than or equal to 730.5 ng/ml, with 95% confidence interval and the area under the curve was 0.999, the corresponding sensitivity was 96.7 and the specificity was 100% (P<0.001). Conclusion Calprotectin is a valuable biomarker in differentiating malignant from infectious pleural effusion.
{"title":"Diagnostic value of calprotectin in differentiation between benign and malignant pleural effusion","authors":"Omar Mohammed, K. Hussein, Abdelgawad Ramadan, Goudarzi Mahmoud, M. El-Naggar, Nor Eldein Gaber","doi":"10.4103/ejb.ejb_77_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_77_18","url":null,"abstract":"Background Pleural effusion can arise as a result of more than 50 recognized causes and the differentiation between benign and malignant origin of the fluid is still a diagnostic challenge. The ability of tumor markers and other biological markers to make better diagnosis of malignant pleural effusion (MPE) remains questionable. Out of these, the calcium-related proteins S100-A8 and S100-A9 (the noncovalent heterodimer calprotectin) were demonstrated in a small amount in malignant not in benign pleural effusion. Objectives This research aimed to assess the diagnostic value of calprotectin in the differentiation between infectious or benign and MPE. Patients and methods Sixty patients were divided into group I: malignant and group II: infectious pleural effusions (which were further divided into group IIA: parapneumonic effusion and group IIB: tuberculous effusion) Quantitative measurement of calprotectin was done using the enzyme-linked immunosorbent assay technique in pleural effusion. Results Pleural calprotectin level in MPEs (229.2±168.6 ng/ml) was significantly lower than its level of infectious pleural effusions (3202.2±1304.8 ng/ml; P<0.001). The cutoff value of calprotectin level for the diagnosis of MPE was less than or equal to 730.5 ng/ml, with 95% confidence interval and the area under the curve was 0.999, the corresponding sensitivity was 96.7 and the specificity was 100% (P<0.001). Conclusion Calprotectin is a valuable biomarker in differentiating malignant from infectious pleural effusion.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49133463","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}
Background There is growing evidence that tuberculosis (TB) case notifications in men have in many circumstances surpassed those in women. The increase in reported cases among men was often interpreted as the result of barriers to TB diagnosis faced by women in seeking care. Aim To assess Gender differences in patients with pulmonary TB in Abbassia Chest Hospital. Patients and methods This study was carried out between 1 January 2017 and 30 April 2017. Patients were divided into two groups based on Gender difference: males and females. All patients were subjected to history taking, clinical examination, radiological and laboratory investigations, and sputum examination (direct smear and Gene Xpert and sputum culture for relapse TB, treatment failure, default, and suspected smear-negative patients). Pleural aspiration was done for cytological, biochemical, and adenosine deaminase level. Therapy was initiated, and patients were followed up for 6 months. Results The study has been carried out on 126 cases of TB, comprising 98 males and 28 females. The highest prevalence of TB infection among men with respect to different occupations was seen to be manual workers (62%), and among women to be housewives (71.4%). The new cases were 73.5% for males and 89.3% for females. The default was 14.3% for males and 3.6% for females. The frequency of relapse was 10.2% in males and 7.1% in females, whereas cases of treatment failure were found only in males. Male patients were much more compatible with anti-TB treatment. Drug complications were more common in women. In terms of treatment outcome, the rate of cure was higher in males and defaulters in females were more common. Conclusion In our study, the male-to-female ratio of identified patients with TB is higher than the previously reported global figures. Female patients were more likely to be younger, housewives, had longer symptoms duration before diagnosis, were less compatible with anti-TB therapy, and had more drug complications.
{"title":"Gender differences in pulmonary tuberculosis in Abbassia Chest Hospital","authors":"T. Safwat, E. Abdel Fattah, A. Soliman","doi":"10.4103/ejb.ejb_97_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_97_18","url":null,"abstract":"Background There is growing evidence that tuberculosis (TB) case notifications in men have in many circumstances surpassed those in women. The increase in reported cases among men was often interpreted as the result of barriers to TB diagnosis faced by women in seeking care. Aim To assess Gender differences in patients with pulmonary TB in Abbassia Chest Hospital. Patients and methods This study was carried out between 1 January 2017 and 30 April 2017. Patients were divided into two groups based on Gender difference: males and females. All patients were subjected to history taking, clinical examination, radiological and laboratory investigations, and sputum examination (direct smear and Gene Xpert and sputum culture for relapse TB, treatment failure, default, and suspected smear-negative patients). Pleural aspiration was done for cytological, biochemical, and adenosine deaminase level. Therapy was initiated, and patients were followed up for 6 months. Results The study has been carried out on 126 cases of TB, comprising 98 males and 28 females. The highest prevalence of TB infection among men with respect to different occupations was seen to be manual workers (62%), and among women to be housewives (71.4%). The new cases were 73.5% for males and 89.3% for females. The default was 14.3% for males and 3.6% for females. The frequency of relapse was 10.2% in males and 7.1% in females, whereas cases of treatment failure were found only in males. Male patients were much more compatible with anti-TB treatment. Drug complications were more common in women. In terms of treatment outcome, the rate of cure was higher in males and defaulters in females were more common. Conclusion In our study, the male-to-female ratio of identified patients with TB is higher than the previously reported global figures. Female patients were more likely to be younger, housewives, had longer symptoms duration before diagnosis, were less compatible with anti-TB therapy, and had more drug complications.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47995804","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}
Introduction Pleuropulmonary fibroelastosis (PPFE) is a rare type of interstitial lung disease (ILD); however, it may not be as rare as it was described. PPFE has been recognized increasingly worldwide during the past years. Patients and methods The study was held in the Chest Department, Kasr Al-Ainy hospitals, during the period from January 2015 till June 2018. Seventy patients were included and divided into two main groups. Group 1 included 36 cases with PPFE, diagnosed either radiologically alone or combined with histopathological examination of lung biopsy. Group 2 included 34 cases of hypersensitivity pneumonitis (HP) as controls. Group 1 was further subdivided into two subgroups: group A included patients with 19 PPFE without any other pattern of ILD, and group B included 17 cases of PPFE associated with other forms of ILD. Clinical assessment, BMI, and high-resolution computed tomography chest were done. The inner anteroposterior diameter (APD) and transverse diameter (TD) of the chest wall were measured, and the ratio between them was calculated. Results Significant female predominance was observed. Both groups of PPFE presented at earlier age than the HP group. Patients with PPFE had a lower body weight and BMI than HP group. There was a significant reduction in the APD and TD in both groups of PPFE than HP group. Conclusion Thirty-six cases with PPFE presented either alone or in association with other forms of ILD. Significant reduction in their chest wall APD in comparison with TD was observed, giving a characteristic flat shape of the chest. Further evaluation of this phenomena and its explanation is required.
引言胸膜肺弹性纤维病（PPFE）是一种罕见的间质性肺病（ILD）；然而，它可能并不像描述的那样罕见。在过去的几年里，PPFE在世界范围内得到了越来越多的认可。患者和方法该研究于2015年1月至2018年6月在Kasr Al Ainy医院胸科进行。70名患者被纳入并分为两个主要组。第1组包括36例PPFE，单独或结合肺活检组织病理学检查诊断。第2组包括34例超敏性肺炎（HP）作为对照。第1组进一步细分为两个亚组：A组包括19例无任何其他ILD模式的PPFE患者，B组包括17例与其他形式ILD相关的PPFE病例。进行了临床评估、BMI和胸部高分辨率计算机断层扫描。测量胸壁前后内径（APD）和横径（TD），并计算它们之间的比值。结果观察到明显的女性优势。两组PPFE的出现时间均早于HP组。PPFE患者的体重和BMI均低于HP组。PPFE两组的APD和TD均明显低于HP组。结论36例PPFE患者单独或与其他形式的ILD联合出现。与TD相比，他们的胸壁APD显著降低，呈现出典型的胸部扁平形状。需要对这一现象进行进一步的评估和解释。
{"title":"A rare entity of interstitial lung disease, pleuropulmonary fibroelastosis: does it affect the chest wall geometry?","authors":"Y. Akl, M. Ismail, Y. El-Hinnawy, S. Mashhour","doi":"10.4103/ejb.ejb_94_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_94_18","url":null,"abstract":"Introduction Pleuropulmonary fibroelastosis (PPFE) is a rare type of interstitial lung disease (ILD); however, it may not be as rare as it was described. PPFE has been recognized increasingly worldwide during the past years. Patients and methods The study was held in the Chest Department, Kasr Al-Ainy hospitals, during the period from January 2015 till June 2018. Seventy patients were included and divided into two main groups. Group 1 included 36 cases with PPFE, diagnosed either radiologically alone or combined with histopathological examination of lung biopsy. Group 2 included 34 cases of hypersensitivity pneumonitis (HP) as controls. Group 1 was further subdivided into two subgroups: group A included patients with 19 PPFE without any other pattern of ILD, and group B included 17 cases of PPFE associated with other forms of ILD. Clinical assessment, BMI, and high-resolution computed tomography chest were done. The inner anteroposterior diameter (APD) and transverse diameter (TD) of the chest wall were measured, and the ratio between them was calculated. Results Significant female predominance was observed. Both groups of PPFE presented at earlier age than the HP group. Patients with PPFE had a lower body weight and BMI than HP group. There was a significant reduction in the APD and TD in both groups of PPFE than HP group. Conclusion Thirty-six cases with PPFE presented either alone or in association with other forms of ILD. Significant reduction in their chest wall APD in comparison with TD was observed, giving a characteristic flat shape of the chest. Further evaluation of this phenomena and its explanation is required.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45707116","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}
Scabbard trachea is a rare clinical observation, though commonly present in patients with chronic obstructive pulmonary disease. There is coronal narrowing of the intrathoracic part of the trachea resembling a saber sheath. We herein describe a case of scabbard trachea as a sequel of severe chronic obstructive pulmonary disease with the classical computed tomography and bronchoscopy findings.
{"title":"Scabbard trachea","authors":"A. Ray, D. Sindhu","doi":"10.4103/ejb.ejb_92_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_92_18","url":null,"abstract":"Scabbard trachea is a rare clinical observation, though commonly present in patients with chronic obstructive pulmonary disease. There is coronal narrowing of the intrathoracic part of the trachea resembling a saber sheath. We herein describe a case of scabbard trachea as a sequel of severe chronic obstructive pulmonary disease with the classical computed tomography and bronchoscopy findings.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41469265","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}
Background Atypical pneumonia (AP) with its different pathogens comprises a reasonable ratio of community-acquired pneumonia. Mycoplasma pneumoniae (M. pneumoniae) constitutes a known pathogen causing AP with pulmonary and extrapulmonary symptoms that necessitate early diagnosis and treatment. Serology and culture give diagnosis but after few days of infection onset. Aim Study the incidence of M. pneumonia using PCR and relation to clinical symptoms. Settings and design Comprehensive, prospective study. Materials and methods A total of 80 patients with suspected AP were examined for clinical symptoms and signs such as cough, crepitations, arrhythmia and conscious level, and sputum was investigated using PCR for M. pneumoniae. Those with dry cough were subjected to fiberoptic-bronchoscopic bronchoalveolar lavage and the fluid was examined by PCR. Statistical analysis Data were analyzed with the SPSS 22 software package. Results Using the PCR method; M. pneumonia was 42%, mostly by bronchoscopic lavage because of dry cough, with significant correlation to arrhythmia, disturbed consciousness, and positive radiologic infiltrations (74, 65,76%, respectively). Conclusion PCR is considered a highly specific diagnostic method for M. pneumonia. AP incidence is high in our region with special consideration to M. pneumonia as a causative agent with high percentage.
{"title":"Easy and rapid diagnosis of Mycoplasma pneumonia: is it possible?","authors":"R. Elkolaly, Maii Atef Shams Eldeen","doi":"10.4103/ejb.ejb_46_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_46_18","url":null,"abstract":"Background Atypical pneumonia (AP) with its different pathogens comprises a reasonable ratio of community-acquired pneumonia. Mycoplasma pneumoniae (M. pneumoniae) constitutes a known pathogen causing AP with pulmonary and extrapulmonary symptoms that necessitate early diagnosis and treatment. Serology and culture give diagnosis but after few days of infection onset. Aim Study the incidence of M. pneumonia using PCR and relation to clinical symptoms. Settings and design Comprehensive, prospective study. Materials and methods A total of 80 patients with suspected AP were examined for clinical symptoms and signs such as cough, crepitations, arrhythmia and conscious level, and sputum was investigated using PCR for M. pneumoniae. Those with dry cough were subjected to fiberoptic-bronchoscopic bronchoalveolar lavage and the fluid was examined by PCR. Statistical analysis Data were analyzed with the SPSS 22 software package. Results Using the PCR method; M. pneumonia was 42%, mostly by bronchoscopic lavage because of dry cough, with significant correlation to arrhythmia, disturbed consciousness, and positive radiologic infiltrations (74, 65,76%, respectively). Conclusion PCR is considered a highly specific diagnostic method for M. pneumonia. AP incidence is high in our region with special consideration to M. pneumonia as a causative agent with high percentage.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42042841","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}
M. Negm, M. Kamel, O. Mohammad, R. Elsawy, H. Khater
Background Diverse imaging systems can be utilized for the evaluation of chest issues in ICU patients; ultrasound (US) is a decent analytic instrument without exposing the patients to radiation and risk of transfer. Objectives To compare the diagnostic performance of transthoracic US and bedside chest radiography (CXR) for the detection of various pathological abnormalities in fundamentally sick patients, using chest computed tomography as a gold standard. Patients and methods Two hundred and fifty-six patients who were admitted in the Respiratory Care Unit were included in this study. CXR, computed tomography, and transthoracic US were done to all the patients. Six pathological entities were evaluated: pleural effusion, pneumothorax, consolidation, interstitial lung diseases, pulmonary embolism, and neoplasms. Results All patients were evaluated by the three imaging techniques. The sensitivity and specificity of CXR were 42.1, 84.4% for pneumonia 50.0, 90.0% for pleural effusion, 45.5, 90.6% for interstitial syndrome, 50.0, 94.8% for pneumothorax, 60, 100% for pulmonary embolism, and 66, 94% for neoplasm, while the values for chest US were 89.47, 100% for pneumonia, 60, 100% for pulmonary embolism, 100, 100% for pleural effusion, pneumothorax, interstitial syndrome, and neoplasm. Conclusion US examination of the chest is a noninvasive and promising bedside tool in the evaluation of patients in the Respiratory Care Unit.
{"title":"The value of chest ultrasonography applications in the respiratory ICU","authors":"M. Negm, M. Kamel, O. Mohammad, R. Elsawy, H. Khater","doi":"10.4103/ejb.ejb_78_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_78_18","url":null,"abstract":"Background Diverse imaging systems can be utilized for the evaluation of chest issues in ICU patients; ultrasound (US) is a decent analytic instrument without exposing the patients to radiation and risk of transfer. Objectives To compare the diagnostic performance of transthoracic US and bedside chest radiography (CXR) for the detection of various pathological abnormalities in fundamentally sick patients, using chest computed tomography as a gold standard. Patients and methods Two hundred and fifty-six patients who were admitted in the Respiratory Care Unit were included in this study. CXR, computed tomography, and transthoracic US were done to all the patients. Six pathological entities were evaluated: pleural effusion, pneumothorax, consolidation, interstitial lung diseases, pulmonary embolism, and neoplasms. Results All patients were evaluated by the three imaging techniques. The sensitivity and specificity of CXR were 42.1, 84.4% for pneumonia 50.0, 90.0% for pleural effusion, 45.5, 90.6% for interstitial syndrome, 50.0, 94.8% for pneumothorax, 60, 100% for pulmonary embolism, and 66, 94% for neoplasm, while the values for chest US were 89.47, 100% for pneumonia, 60, 100% for pulmonary embolism, 100, 100% for pleural effusion, pneumothorax, interstitial syndrome, and neoplasm. Conclusion US examination of the chest is a noninvasive and promising bedside tool in the evaluation of patients in the Respiratory Care Unit.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47015724","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}
Maha K. Ghanem, H. Makhlouf, A. Hasan, Hebat-allah G. Rashed, H. Khalifa
Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is responsible for a high proportion of morbidity and antibiotic use. This study aimed to identify the causative bacteria, antimicrobial sensitivity, and resistance of hospitalized patients in respiratory ICU owing to AECOPD. Patients and methods This prospective study was performed at Assiut University Hospitals on 50 patients with AECOPD who needed ICU admission. Samples included sputum for staining and culture. Samples were cultured on two bacteriological media (blood and MacConkey’s agars) to detect gram-positive and gram-negative organisms and their sensitivity to different antibiotics. Results Klebsiella pneumoniae was the most frequently detected organism in 29 (58%) patients followed by Pseudomonas aeruginosa in 14 (28%) patients, methicillin resistant Staphylococcus aureus (MRSA) in eight (16%) patients, Acinetobacter baumannii in seven (14%) patients, Proteus spp. and Staphylococcus aureus in five (10%) patients each, and Escherichia coli in three (6%) patients. No growth was reported in three (6%) patients. Among gram-positive organisms, linezolid had the upper hand of efficacy followed by vancomycin and teicoplanin. Gram-negative organisms had high rate or resistance to most tested antibiotics. Frequency of death was more (62.5%) in patients with MRSA. Conclusion K. pneumoniae was the most frequent organism followed by P. aeruginosa, MRSA, and A. baumannii. The isolated bacterial strains were characterized by high resistance rates to the most used antimicrobials. Mortality rate was more among patients with MRSA.
{"title":"Bacteriological profile of critically ill patients with chronic obstructive pulmonary disease in respiratory intensive care unit in Assuit University Hospital","authors":"Maha K. Ghanem, H. Makhlouf, A. Hasan, Hebat-allah G. Rashed, H. Khalifa","doi":"10.4103/ejb.ejb_83_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_83_18","url":null,"abstract":"Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is responsible for a high proportion of morbidity and antibiotic use. This study aimed to identify the causative bacteria, antimicrobial sensitivity, and resistance of hospitalized patients in respiratory ICU owing to AECOPD. Patients and methods This prospective study was performed at Assiut University Hospitals on 50 patients with AECOPD who needed ICU admission. Samples included sputum for staining and culture. Samples were cultured on two bacteriological media (blood and MacConkey’s agars) to detect gram-positive and gram-negative organisms and their sensitivity to different antibiotics. Results Klebsiella pneumoniae was the most frequently detected organism in 29 (58%) patients followed by Pseudomonas aeruginosa in 14 (28%) patients, methicillin resistant Staphylococcus aureus (MRSA) in eight (16%) patients, Acinetobacter baumannii in seven (14%) patients, Proteus spp. and Staphylococcus aureus in five (10%) patients each, and Escherichia coli in three (6%) patients. No growth was reported in three (6%) patients. Among gram-positive organisms, linezolid had the upper hand of efficacy followed by vancomycin and teicoplanin. Gram-negative organisms had high rate or resistance to most tested antibiotics. Frequency of death was more (62.5%) in patients with MRSA. Conclusion K. pneumoniae was the most frequent organism followed by P. aeruginosa, MRSA, and A. baumannii. The isolated bacterial strains were characterized by high resistance rates to the most used antimicrobials. Mortality rate was more among patients with MRSA.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49378186","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}
Introduction In the field of pulmonary medicine, respiratory mechanics and physiology are obviously affected by most pathological lesions and diseases, either primary disease or part of systemic ones. In the era of rheumatoid arthritis (RA), airway abnormality and interstitial lung pneumonia and/or fibrosis are the most common findings that face physicians during the disease course and affect morbidity, survival, and quality of life of patients with RA. Impulse oscillometry (IOS) is a noninvasive technique that needs minimal patient cooperation, which makes it suitable for any age including even children and can be performed by most patients. Aim of the work To describe the respiratory measures done by IOS in patients with RA and to correlate them with those measured by spirometry. Patients and methods A total of 60 patients with RA were recruited in this cross-sectional observational study. They were investigated via pulmonary function assessments, including spirometry and IOS, to measure forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC, and maximal expiratory flow at 25% (MEF 25%) in addition to R5% of predicted, R20% of predicted, R5–20, X5, and area under the curve. Results IOS measures indicated increased airway resistance (R5%, R20%, and R5–20) with decreased lung reactance (X5). Moreover, a positive correlation between disease duration and X5, between X5 and area under the curve and each of FEV1%, FVC%, and MEF 25%, whereas a negative correlation between R5–20 and each of FEV1%, FVC%, and MEF 25%. Conclusion IOS is an easy and rapid maneuver that requires minimal patient cooperation. It can identify lung affection in those who have mild or even normal spirometric changes. It is just a good screening test in patients with RA to detect early pathophysiologic lung changes. However, it needs further investigations to clarify the mechanism of these changes.
{"title":"Impulse oscillometry, an aid or a substitute?","authors":"R. Elkolaly, Salwa Ganna, D. Nada, M. Elnaggar","doi":"10.4103/ejb.ejb_98_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_98_18","url":null,"abstract":"Introduction In the field of pulmonary medicine, respiratory mechanics and physiology are obviously affected by most pathological lesions and diseases, either primary disease or part of systemic ones. In the era of rheumatoid arthritis (RA), airway abnormality and interstitial lung pneumonia and/or fibrosis are the most common findings that face physicians during the disease course and affect morbidity, survival, and quality of life of patients with RA. Impulse oscillometry (IOS) is a noninvasive technique that needs minimal patient cooperation, which makes it suitable for any age including even children and can be performed by most patients. Aim of the work To describe the respiratory measures done by IOS in patients with RA and to correlate them with those measured by spirometry. Patients and methods A total of 60 patients with RA were recruited in this cross-sectional observational study. They were investigated via pulmonary function assessments, including spirometry and IOS, to measure forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC, and maximal expiratory flow at 25% (MEF 25%) in addition to R5% of predicted, R20% of predicted, R5–20, X5, and area under the curve. Results IOS measures indicated increased airway resistance (R5%, R20%, and R5–20) with decreased lung reactance (X5). Moreover, a positive correlation between disease duration and X5, between X5 and area under the curve and each of FEV1%, FVC%, and MEF 25%, whereas a negative correlation between R5–20 and each of FEV1%, FVC%, and MEF 25%. Conclusion IOS is an easy and rapid maneuver that requires minimal patient cooperation. It can identify lung affection in those who have mild or even normal spirometric changes. It is just a good screening test in patients with RA to detect early pathophysiologic lung changes. However, it needs further investigations to clarify the mechanism of these changes.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43431704","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}
Dyspnea is a subjective sensation of difficult or uncomfortable breathing experienced by the patient. The etiology includes myriad causes starting from cardiopulmonary to psychogenic. The evaluation of dyspnea needs to be thorough so as to take into account all possible causes. Vocal cord disorders are a group of conditions uncommonly leading to dyspnea. These patients are usually wrongly labelled as difficult-to-treat asthma and consequently experience significant morbidity. Two cases of vocal cord disorders were presented with dyspnea and initially attributed to pulmonary causes and will be discussed in the present study.
{"title":"Vocal cord disorders: uncommon causes of dyspnea","authors":"A. Ray, S. Biswas","doi":"10.4103/ejb.ejb_70_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_70_18","url":null,"abstract":"Dyspnea is a subjective sensation of difficult or uncomfortable breathing experienced by the patient. The etiology includes myriad causes starting from cardiopulmonary to psychogenic. The evaluation of dyspnea needs to be thorough so as to take into account all possible causes. Vocal cord disorders are a group of conditions uncommonly leading to dyspnea. These patients are usually wrongly labelled as difficult-to-treat asthma and consequently experience significant morbidity. Two cases of vocal cord disorders were presented with dyspnea and initially attributed to pulmonary causes and will be discussed in the present study.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43735170","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}
Background A rapid, highly sensitive, and qualitative diagnostic test will significantly reduce the incidence of tuberculosis (TB). GeneXpert test is the test that is supposed to play this role with those specifications. Objective Our goal was to assess the precision of the GeneXpert test in the diagnosis of pulmonary TB. Patients and methods This cross-sectional analytic study was carried out at Assiut University Hospital in collaboration with Assiut Chest Hospital, Assiut, Egypt. A total of 67 patients of suspected pulmonary TB were included. For microbiological examination, two sputum samples were obtained from each patient within the same day. One sample was collected at Assiut University Hospital and subjected to smear microscopy by Ziehl–Neelsen staining and culture on Lowenstein–Jensen media. The other sample was taken at Assiut Chest Hospital to be processed for GeneXpert Mycobacterium tuberculosis/rifampicin assay. The culture was applied as a confirmatory test to evaluate the Xpert Mycobacterium tuberculosis/rifampicin assay test. Results GeneXpert had 95.9% sensitivity and 94.4% specificity in diagnosing pulmonary TB with the area under the curve of 0.95 and overall diagnostic accuracy of 95.5%. Ziehl–Neelsen examination had 65.3% sensitivity and 100% specificity with the area under the curve of 0.83 and overall diagnostic accuracy of 74.6. For smear-negative, culture-positive cases, GeneXpert showed sensitivity of 94.1%. False-positive GeneXpert for TB was recorded in just one patient. Conclusion The GeneXpert test is accurate in diagnosing pulmonary TB and its greatest benefit is clearly demonstrated in smear-negative TB cases. However, the test is not free from some fallacies, even if they are a few, which draws our attention to the importance of the conventional culture for TB and the clinical correlation.
{"title":"Valuing the use of GeneXpert test as an unconventional approach to diagnose pulmonary tuberculosis","authors":"Amany Omar, A. Elfadl, Y. Ahmed, M. Hosny","doi":"10.4103/ejb.ejb_88_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_88_18","url":null,"abstract":"Background A rapid, highly sensitive, and qualitative diagnostic test will significantly reduce the incidence of tuberculosis (TB). GeneXpert test is the test that is supposed to play this role with those specifications. Objective Our goal was to assess the precision of the GeneXpert test in the diagnosis of pulmonary TB. Patients and methods This cross-sectional analytic study was carried out at Assiut University Hospital in collaboration with Assiut Chest Hospital, Assiut, Egypt. A total of 67 patients of suspected pulmonary TB were included. For microbiological examination, two sputum samples were obtained from each patient within the same day. One sample was collected at Assiut University Hospital and subjected to smear microscopy by Ziehl–Neelsen staining and culture on Lowenstein–Jensen media. The other sample was taken at Assiut Chest Hospital to be processed for GeneXpert Mycobacterium tuberculosis/rifampicin assay. The culture was applied as a confirmatory test to evaluate the Xpert Mycobacterium tuberculosis/rifampicin assay test. Results GeneXpert had 95.9% sensitivity and 94.4% specificity in diagnosing pulmonary TB with the area under the curve of 0.95 and overall diagnostic accuracy of 95.5%. Ziehl–Neelsen examination had 65.3% sensitivity and 100% specificity with the area under the curve of 0.83 and overall diagnostic accuracy of 74.6. For smear-negative, culture-positive cases, GeneXpert showed sensitivity of 94.1%. False-positive GeneXpert for TB was recorded in just one patient. Conclusion The GeneXpert test is accurate in diagnosing pulmonary TB and its greatest benefit is clearly demonstrated in smear-negative TB cases. However, the test is not free from some fallacies, even if they are a few, which draws our attention to the importance of the conventional culture for TB and the clinical correlation.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44971749","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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