F. Sampsonas, Markela Antonogiannaki, S. Vittorakis, C. Kyriakopoulos, Stelios Boutlas, A. Boutou, P. Ntolios, N. Tzanakis
Preoperative evaluation prior to thoracic surgery aims to assess the risk associated with the planned surgical intervention and thus to aid the selection of the appropriate plan of anaesthesia and of perioperative care that will provide optimal patient safety. Risk factors for the occurrence of perioperative and postoperative complications can be classified as patient-related and procedure-related. Among others, they include age, increased body weight, the presence of comorbidities such as chronic respiratory diseases, smoking history, site of surgery, duration of anaesthesia
{"title":"Preoperative evaluation of the respiratory system: A narrative review based on Hellenic Thoracic Society guidelines","authors":"F. Sampsonas, Markela Antonogiannaki, S. Vittorakis, C. Kyriakopoulos, Stelios Boutlas, A. Boutou, P. Ntolios, N. Tzanakis","doi":"10.18332/pne/163183","DOIUrl":"https://doi.org/10.18332/pne/163183","url":null,"abstract":"Preoperative evaluation prior to thoracic surgery aims to assess the risk associated with the planned surgical intervention and thus to aid the selection of the appropriate plan of anaesthesia and of perioperative care that will provide optimal patient safety. Risk factors for the occurrence of perioperative and postoperative complications can be classified as patient-related and procedure-related. Among others, they include age, increased body weight, the presence of comorbidities such as chronic respiratory diseases, smoking history, site of surgery, duration of anaesthesia","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90794623","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}
E. Malakounidou, P. Tsiri, E. Theochari, E. Koulousousa, T. Karampitsakos, A. Tzouvelekis
Frequently identified bacteria
常见的细菌
{"title":"Lower respiratory tract infections treatment recommendations: An overview","authors":"E. Malakounidou, P. Tsiri, E. Theochari, E. Koulousousa, T. Karampitsakos, A. Tzouvelekis","doi":"10.18332/pne/163184","DOIUrl":"https://doi.org/10.18332/pne/163184","url":null,"abstract":"Frequently identified bacteria","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74350041","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}
C. Costa, Bárbara Leal, Daniela Ester Ribeiro, Maria Manuel Flores, Paula Rocha, Lília Andrade
, through the question: ‘How long after waking up do you smoke your first cigarette?’ with responses 1st cigarette in the first 30 minutes of the day (severe), 1st cigarette between the first 30 to 60 minutes of the day (moderate), and 1st cigarette after the first 60 minutes of the day (mild). We interpreted as motivation for smoking cessation the positive and simultaneous answer to two questions: ‘Have you made any attempt to quit smoking in the last year?’ and ‘Do you intend to quit smoking within one month?’. The model of Prochaska and Di Clemente 10 describes five stages of change in smoking cessation: pre-contemplation, ABSTRACT INTRODUCTION Children’s exposure to parental tobacco smoke is a public health concern. Guiding parents towards smoking cessation plays a key role in protecting the child’s health. This study aims to evaluate parents’ smoking habits and their availability for a smoking cessation intervention in the context of a pediatric consultation or hospitalization. METHODS This was a prospective study conducted between January 2020 and October 2021 in a level two hospital in the central region of Portugal. Parents of all children hospitalized or seen in a pediatric consultation unit during this period were approached consecutively and fulfilled an anonymous survey about their smoking habits, nicotine dependence and motivation to quit smoking. RESULTS A total of 133 questionnaires were evaluated, 39 from hospitalization and 94 from consultation. Smoking exposure was 39.8% in the study sample. Among smoking parents, 57% of parents at inpatient and 23% at outpatient consultation were probably in the preparation phase for smoking cessation. CONCLUSIONS Pediatric hospitalization and outpatient consultation may be excellent opportunities for the implementation of measures to raise awareness and intervene in parental smoking cessation.
{"title":"Pediatric observation as an opportunity for parental smoking cessation","authors":"C. Costa, Bárbara Leal, Daniela Ester Ribeiro, Maria Manuel Flores, Paula Rocha, Lília Andrade","doi":"10.18332/pne/163067","DOIUrl":"https://doi.org/10.18332/pne/163067","url":null,"abstract":", through the question: ‘How long after waking up do you smoke your first cigarette?’ with responses 1st cigarette in the first 30 minutes of the day (severe), 1st cigarette between the first 30 to 60 minutes of the day (moderate), and 1st cigarette after the first 60 minutes of the day (mild). We interpreted as motivation for smoking cessation the positive and simultaneous answer to two questions: ‘Have you made any attempt to quit smoking in the last year?’ and ‘Do you intend to quit smoking within one month?’. The model of Prochaska and Di Clemente 10 describes five stages of change in smoking cessation: pre-contemplation, ABSTRACT INTRODUCTION Children’s exposure to parental tobacco smoke is a public health concern. Guiding parents towards smoking cessation plays a key role in protecting the child’s health. This study aims to evaluate parents’ smoking habits and their availability for a smoking cessation intervention in the context of a pediatric consultation or hospitalization. METHODS This was a prospective study conducted between January 2020 and October 2021 in a level two hospital in the central region of Portugal. Parents of all children hospitalized or seen in a pediatric consultation unit during this period were approached consecutively and fulfilled an anonymous survey about their smoking habits, nicotine dependence and motivation to quit smoking. RESULTS A total of 133 questionnaires were evaluated, 39 from hospitalization and 94 from consultation. Smoking exposure was 39.8% in the study sample. Among smoking parents, 57% of parents at inpatient and 23% at outpatient consultation were probably in the preparation phase for smoking cessation. CONCLUSIONS Pediatric hospitalization and outpatient consultation may be excellent opportunities for the implementation of measures to raise awareness and intervene in parental smoking cessation.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77693820","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}
O. Papaioannou, T. Karampitsakos, P. Tsiri, Vagia Karageorgou, A. Papaioannou, M. Kallieri, M. Blizou, Stefanos Lampadakis, M. Sfika, Antonios Krouskos, Vasilis Papavasileiou, Franceska Strakosha, Kalliopi-Theoni Vandorou, Pavlos Siozos, Marina Moustaka Christodoulou, Georgia Kontonasiou, V. Apollonatou, E. Antonogiannaki, C. Kyriakopoulos, C. Aggelopoulou, C. Chronis, K. Kostikas, E. Koukaki, Z. Sotiropoulou, A. Athanasopoulou, P. Bakakos, Pinelopi Sxini, Emmanouil Alevrakis, Sotirios Poupos, Evangelia Xondrou, Dionisios Tsoukalas, Alexia Chronaiou, G. Tsoukalas, S. Koukidou, G. Hillas, K. Dimakou, K. Roukas, Ifigenia Nakou, D. Chloros, E. Fouka, S. Papiris, S. Loukides, A. Tzouvelekis
INTRODUCTION Epidemiological data from hospitalized patients with COVID-19 during the fourth and fifth waves of the pandemic have been published worldwide. METHODS This registry was an observational, prospective study conducted in seven reference hospitals across Greece. Maximum FiO 2 during hospitalization and Charlson comorbidity index (CCI) on admission were correlated with disease severity, as well as radiological features, parameters of complete blood count, and d-dimer. RESULTS A total of 1019 patients were included in the analysis; 55.1% and 57.2% of patients were males and never smokers, respectively, with median age of 67 years (95% CI: 65.7–69.0). Patients with increased extent of consolidation and ground glass opacities in chest CT (>10–25%) exhibited more advanced disease compared to the low extent group (<10%) as indicated by both CCI on admission (3; 95% CI: 2–3 vs 2; 95% CI: 1–2, p=0.0002) and MaxFiO 2 (0.40; 95% CI: 0.35–0.40 vs 0.28; 95% CI: 0.24–0.28, p<0.0001). Patients with high neutrophil to lymphocyte ratio (≥4.42) exhibited more severe disease as indicated by significantly increased CCI on admission (4; 95% CI: 3 to 4 vs 3; 95% CI: 2–3, p<0.0001) and MaxFiO 2 (0.35; 95% CI: 0.35–0.4 vs 0.28; 95% CI: 0.28–0.28, p<0.0001). Patients with elevated d-dimer (≥0.74 μg/mL) displayed also advanced disease compared to the low d-dimer group (<0.74 μg/mL), as assessed by both CCI on admission (4; 95% CI: 4–4 vs 2; 95% CI: 2–2, p<0.0001) and MaxFiO 2 (0.38; 95% CI: 0.35–0.40 vs 0.28; 95% CI: 0.28–0.28, p<0.0001). CONCLUSIONS We present the first observational study across Greece during the fourth and fifth waves of the COVID-19 pandemic. Extent of opacities in chest CT, neutrophil to lymphocyte ratio and d-dimer may represent reliable disease prognostic factors leading to timely therapeutic interventions.
{"title":"Epidemiological characteristics, clinical features\u0000and outcomes of patients with COVID-19 admitted\u0000to seven reference centers across Greece: An\u0000observational study during the fourth and fifth waves\u0000of the COVID-19 pandemic","authors":"O. Papaioannou, T. Karampitsakos, P. Tsiri, Vagia Karageorgou, A. Papaioannou, M. Kallieri, M. Blizou, Stefanos Lampadakis, M. Sfika, Antonios Krouskos, Vasilis Papavasileiou, Franceska Strakosha, Kalliopi-Theoni Vandorou, Pavlos Siozos, Marina Moustaka Christodoulou, Georgia Kontonasiou, V. Apollonatou, E. Antonogiannaki, C. Kyriakopoulos, C. Aggelopoulou, C. Chronis, K. Kostikas, E. Koukaki, Z. Sotiropoulou, A. Athanasopoulou, P. Bakakos, Pinelopi Sxini, Emmanouil Alevrakis, Sotirios Poupos, Evangelia Xondrou, Dionisios Tsoukalas, Alexia Chronaiou, G. Tsoukalas, S. Koukidou, G. Hillas, K. Dimakou, K. Roukas, Ifigenia Nakou, D. Chloros, E. Fouka, S. Papiris, S. Loukides, A. Tzouvelekis","doi":"10.18332/pne/163036","DOIUrl":"https://doi.org/10.18332/pne/163036","url":null,"abstract":"INTRODUCTION Epidemiological data from hospitalized patients with COVID-19 during the fourth and fifth waves of the pandemic have been published worldwide. METHODS This registry was an observational, prospective study conducted in seven reference hospitals across Greece. Maximum FiO 2 during hospitalization and Charlson comorbidity index (CCI) on admission were correlated with disease severity, as well as radiological features, parameters of complete blood count, and d-dimer. RESULTS A total of 1019 patients were included in the analysis; 55.1% and 57.2% of patients were males and never smokers, respectively, with median age of 67 years (95% CI: 65.7–69.0). Patients with increased extent of consolidation and ground glass opacities in chest CT (>10–25%) exhibited more advanced disease compared to the low extent group (<10%) as indicated by both CCI on admission (3; 95% CI: 2–3 vs 2; 95% CI: 1–2, p=0.0002) and MaxFiO 2 (0.40; 95% CI: 0.35–0.40 vs 0.28; 95% CI: 0.24–0.28, p<0.0001). Patients with high neutrophil to lymphocyte ratio (≥4.42) exhibited more severe disease as indicated by significantly increased CCI on admission (4; 95% CI: 3 to 4 vs 3; 95% CI: 2–3, p<0.0001) and MaxFiO 2 (0.35; 95% CI: 0.35–0.4 vs 0.28; 95% CI: 0.28–0.28, p<0.0001). Patients with elevated d-dimer (≥0.74 μg/mL) displayed also advanced disease compared to the low d-dimer group (<0.74 μg/mL), as assessed by both CCI on admission (4; 95% CI: 4–4 vs 2; 95% CI: 2–2, p<0.0001) and MaxFiO 2 (0.38; 95% CI: 0.35–0.40 vs 0.28; 95% CI: 0.28–0.28, p<0.0001). CONCLUSIONS We present the first observational study across Greece during the fourth and fifth waves of the COVID-19 pandemic. Extent of opacities in chest CT, neutrophil to lymphocyte ratio and d-dimer may represent reliable disease prognostic factors leading to timely therapeutic interventions.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75085660","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}
1. Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733-748. doi:10.1164/rccm.201308-1483ST CrossRef Google Scholar
1. Travis WD, Costabel U, Hansell DM等。美国胸科学会/欧洲呼吸学会官方声明:特发性间质性肺炎国际多学科分类的最新进展。[J]中华呼吸与急救杂志，2013;18(6):733-748。doi: 10.1164 / rccm。201308-1483ST交叉检索谷歌学术
{"title":"What is new in the treatment of interstitial lung diseases","authors":"Vasilina Sotiropoulou, Thodoris Karampitsakos, Matthaios Katsaras, Ourania Papaioannou, Panagiota Tsiri, Fotios Sampsonas, Argyrios Tzouvelekis","doi":"10.18332/pne/161867","DOIUrl":"https://doi.org/10.18332/pne/161867","url":null,"abstract":"1. Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733-748. doi:10.1164/rccm.201308-1483ST CrossRef Google Scholar","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295904","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}
E. Koukaki, Z. Sotiropoulou, A. Vontetsianos, S. Zaneli, A. Bakakos, S. Ampelioti, A. Kyriakoudi, A. Papaioannou, A. Koutsoukou, N. Rovina
other hand, it is known that COPD patients are at high risk of mortality from respiratory infections, such as influenza and community acquired pneumonia (CAP) 9,10 . However, the prevalence of COPD among COVID-19 patients was lower than expected 11 . This paradox can be explained by the fact that COPD patients, similarly to patients with other respiratory or smoking-associated conditions, have ABSTRACT INTRODUCTION Asthma and chronic obstructive pulmonary disease (COPD) are the commonest respiratory diseases. The aim of the present study is to describe the clinical characteristics and outcomes of critically ill COVID-19 patients with obstructive pulmonary disease. METHODS We conducted an observational study of severe COVID-19 patients admitted to the intensive care unit of the 1st Respiratory Medicine Department of the University of Athens at Sotiria Hospital, Greece, from 27 August 2020 to 10 November 2021. RESULTS Among 297 patients, 24 (8.1%) had a previous diagnosis of asthma and 18 (6.1%) of COPD. Compared to patients without obstructive disease, asthmatics were younger, suffered from less severe disease on admission, and experienced similar adverse events and outcomes. None of the asthmatics had symptoms suggestive of exacerbation during their hospitalization. In contrast, COPD patients were older, with more severe disease, had more comorbidities, required more frequently mechanical ventilation, and continuous renal replacement therapy. Finally, mortality in COPD patients was greater. CONCLUSIONS Although asthmatic patients with severe COVID-19 do not seem to differ from the non-asthmatics regarding disease course and outcomes, COVID-19 patients with COPD are at increased risk of poor outcomes.
{"title":"Critically ill COVID-19 patients with obstructive\u0000pulmonary diseases: Characteristics, risk factors and\u0000outcome","authors":"E. Koukaki, Z. Sotiropoulou, A. Vontetsianos, S. Zaneli, A. Bakakos, S. Ampelioti, A. Kyriakoudi, A. Papaioannou, A. Koutsoukou, N. Rovina","doi":"10.18332/pne/161858","DOIUrl":"https://doi.org/10.18332/pne/161858","url":null,"abstract":"other hand, it is known that COPD patients are at high risk of mortality from respiratory infections, such as influenza and community acquired pneumonia (CAP) 9,10 . However, the prevalence of COPD among COVID-19 patients was lower than expected 11 . This paradox can be explained by the fact that COPD patients, similarly to patients with other respiratory or smoking-associated conditions, have ABSTRACT INTRODUCTION Asthma and chronic obstructive pulmonary disease (COPD) are the commonest respiratory diseases. The aim of the present study is to describe the clinical characteristics and outcomes of critically ill COVID-19 patients with obstructive pulmonary disease. METHODS We conducted an observational study of severe COVID-19 patients admitted to the intensive care unit of the 1st Respiratory Medicine Department of the University of Athens at Sotiria Hospital, Greece, from 27 August 2020 to 10 November 2021. RESULTS Among 297 patients, 24 (8.1%) had a previous diagnosis of asthma and 18 (6.1%) of COPD. Compared to patients without obstructive disease, asthmatics were younger, suffered from less severe disease on admission, and experienced similar adverse events and outcomes. None of the asthmatics had symptoms suggestive of exacerbation during their hospitalization. In contrast, COPD patients were older, with more severe disease, had more comorbidities, required more frequently mechanical ventilation, and continuous renal replacement therapy. Finally, mortality in COPD patients was greater. CONCLUSIONS Although asthmatic patients with severe COVID-19 do not seem to differ from the non-asthmatics regarding disease course and outcomes, COVID-19 patients with COPD are at increased risk of poor outcomes.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73794182","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}
Demet Turan, E. Chousein, E. Tanrıverdi, Mustafa Çörtük, B. Yıldırım, T. Şeker, M. Özgül, E. Çetinkaya
complication rate was reported as 16% and the mortality rate as 1.1%. The most common complication after the procedure is fever 9 . Studies are still needed to optimize and standardize the procedure. There are few studies on this subject 11 . This study aimed to evaluate ABSTRACT INTRODUCTION Pulmonary alveolar proteinosis (PAP) is a rare syndrome that causes hypoxemic respiratory failure characterized by accumulation of lipoproteinous material in the alveoli. Whole lung lavage (WLL) is still the standard treatment which is based on the physical removal of the material with saline fluid. This study was aimed to evaluate the technical aspects of WLL procedures and postoperative complications in our unit. METHODS The study is a single-center retrospective study. A total of 83 WLLs performed on 21 PAP patients were evaluated. Saline was infused repetitively through the double-lumen intubation tube leading to the target lung in reverse Trendelenburg position and drained in the Trendelenburg position until the drained fluid became clear. Liquid deficits, complications and intensive care follow-up were recorded. RESULTS In all, 21 patients with a mean age of 38.2 ± 9.8 years underwent WLLs. The median number of procedures per patient was 2, the mean amount of fluid infused through the airways was 11.8 ± 4.3 L, while liquid deficit was 550 mL. Complications such as oxygen desaturation, arrhythmia, bronchospasm, epilepsy secondary to intracranial hemorrhage, pneumonia, and transient neuropathy were observed in 9 procedures; 59 (71.1%) procedures were followed by supplemental oxygen, 17 (20.5%) NIMV and 7 (8.4%) IMV support. The median residual liquid in the supplemental oxygen group was 485.19 ± 387 mL, 646.19 ± 652 mL in NIMV and 14009 ± 1419 mL (p<0.001) in the IMV (invasive mechanical ventilation) group.
并发症发生率为16%，死亡率为1.1%。手术后最常见的并发症是发烧。仍需进行研究以优化和规范这一程序。关于这个问题的研究很少。肺泡蛋白沉积症(PAP)是一种罕见的低氧性呼吸衰竭综合征，其特征是肺泡内脂蛋白物质的积累。全肺灌洗(WLL)仍然是标准的治疗方法，它是基于生理盐水的物理清除物质。本研究的目的是评估我们单位WLL手术的技术方面和术后并发症。方法本研究为单中心回顾性研究。21例PAP患者共行83例wll。生理盐水通过双腔插管以反Trendelenburg位反复输注至靶肺，并以Trendelenburg位排出，直至排出的液体清透。记录患者液体不足、并发症及重症监护随访情况。结果共有21例患者接受了wls，平均年龄为38.2±9.8岁。每例患者中位手术数为2例，平均经气道输注液体量为11.8±4.3 L，液体亏缺550 mL。9例出现氧不饱和、心律失常、支气管痉挛、颅内出血继发性癫痫、肺炎、一过性神经病变等并发症;59例(71.1%)采用补充氧，17例(20.5%)采用NIMV支持，7例(8.4%)采用IMV支持。补氧组中位残液为485.19±387 mL, NIMV组为646.19±652 mL, IMV组为14009±1419 mL (p<0.001)。
{"title":"Amount of liquid deficit in whole lung lavage predicts the need for mechanical ventilation","authors":"Demet Turan, E. Chousein, E. Tanrıverdi, Mustafa Çörtük, B. Yıldırım, T. Şeker, M. Özgül, E. Çetinkaya","doi":"10.18332/pne/161857","DOIUrl":"https://doi.org/10.18332/pne/161857","url":null,"abstract":"complication rate was reported as 16% and the mortality rate as 1.1%. The most common complication after the procedure is fever 9 . Studies are still needed to optimize and standardize the procedure. There are few studies on this subject 11 . This study aimed to evaluate ABSTRACT INTRODUCTION Pulmonary alveolar proteinosis (PAP) is a rare syndrome that causes hypoxemic respiratory failure characterized by accumulation of lipoproteinous material in the alveoli. Whole lung lavage (WLL) is still the standard treatment which is based on the physical removal of the material with saline fluid. This study was aimed to evaluate the technical aspects of WLL procedures and postoperative complications in our unit. METHODS The study is a single-center retrospective study. A total of 83 WLLs performed on 21 PAP patients were evaluated. Saline was infused repetitively through the double-lumen intubation tube leading to the target lung in reverse Trendelenburg position and drained in the Trendelenburg position until the drained fluid became clear. Liquid deficits, complications and intensive care follow-up were recorded. RESULTS In all, 21 patients with a mean age of 38.2 ± 9.8 years underwent WLLs. The median number of procedures per patient was 2, the mean amount of fluid infused through the airways was 11.8 ± 4.3 L, while liquid deficit was 550 mL. Complications such as oxygen desaturation, arrhythmia, bronchospasm, epilepsy secondary to intracranial hemorrhage, pneumonia, and transient neuropathy were observed in 9 procedures; 59 (71.1%) procedures were followed by supplemental oxygen, 17 (20.5%) NIMV and 7 (8.4%) IMV support. The median residual liquid in the supplemental oxygen group was 485.19 ± 387 mL, 646.19 ± 652 mL in NIMV and 14009 ± 1419 mL (p<0.001) in the IMV (invasive mechanical ventilation) group.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84887521","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}
Vasileios Issaris, K. Kotsifas, V. Lazarou, Natalia Giosdekou, Georgios Poupouzas, N. Athanasiou, G. Giannikos, S. Kompogiorgas, G. Milas, E. Balis
A 68-year-old female presented to the emergency department with shortness of breath and right sided pleuritic chest pain. Chest computed tomography (CT) revealed pleural effusion occupying the right hemithorax. Thoracentesis showed a black-coloured pleural effusion. Fine needle biopsy of the pleura and bronchoscopic biopsy revealed lung adenocarcinoma with epidermal growth factor receptor (EGFR) L858R mutation. This case report describes a patient with an extremely rare case of pleural effusion
{"title":"Black pleural effusion in a patient with EGFR-positive lung adenocarcinoma","authors":"Vasileios Issaris, K. Kotsifas, V. Lazarou, Natalia Giosdekou, Georgios Poupouzas, N. Athanasiou, G. Giannikos, S. Kompogiorgas, G. Milas, E. Balis","doi":"10.18332/pne/161745","DOIUrl":"https://doi.org/10.18332/pne/161745","url":null,"abstract":"A 68-year-old female presented to the emergency department with shortness of breath and right sided pleuritic chest pain. Chest computed tomography (CT) revealed pleural effusion occupying the right hemithorax. Thoracentesis showed a black-coloured pleural effusion. Fine needle biopsy of the pleura and bronchoscopic biopsy revealed lung adenocarcinoma with epidermal growth factor receptor (EGFR) L858R mutation. This case report describes a patient with an extremely rare case of pleural effusion","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80536981","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. Kipourou, I. Tsanaktsidis, K. Koutroumanidis, Maro Varsami, I. Tsifountoudis, K. Katsoulis
1 Thorax Magnetic Resonance Imaging (MRI) is not routinely used in clinical practice for characterization of lung lesions, as presence of air in the lungs results in considerable reduction of the MRI diagnostic accuracy. We present a case of a 69-year-old patient, bedridden for the past year due to hemorrhagic stroke, who was transferred to the Emergency Department, due to breathlessness and productive cough. Microbiological exams revealed anemia (Hb: 9.9 g/dL), moderately elevated C-Reactive Protein (CRP) value (4.33 mg/dL, with normal values <0.5 mg/dL) and procalcitonin (PCT) value within normal range (0.03 ng/mL, with normal values <0.05 ng/mL). Blood and urine cultures were negative. The patient had a smoking history of 35 pack-years. CT imaging revealed a large lesion of the right upper lobe (Figure 1). The patient underwent CT guided FNA of the lesion twice, without findings suggestive of a definite diagnosis. A chest MRI was then conducted (Figure 2), revealing diffusion restriction in the diffusion-weighted imaging (DWI) of the upper right lobe lesion. Empiric treatment with amoxicillin-clavulanic acid 1 g × 3 was initiated, resulting in gradual increase of body weight and diminution of
胸腔磁共振成像(MRI)在临床实践中并未常规用于肺病变的表征，因为肺中存在空气会导致MRI诊断准确性大大降低。我们提出一个病例69岁的病人，卧床去年因出血性中风，谁被转移到急诊科，由于呼吸困难和生产性咳嗽。微生物检查显示贫血(Hb: 9.9 g/dL)， c -反应蛋白(CRP)值中度升高(4.33 mg/dL，正常值<0.5 mg/dL)，降钙素原(PCT)值在正常范围内(0.03 ng/mL，正常值<0.05 ng/mL)。血和尿培养均为阴性。患者有35包年的吸烟史。CT成像显示右上叶大病变(图1)。患者在CT引导下对病变进行了两次FNA检查，未见明确诊断。然后进行胸部MRI(图2)，在右上叶病变的弥散加权成像(DWI)中显示扩散受限。开始阿莫西林-克拉维酸1 g × 3经验治疗，体重逐渐增加，血压下降
{"title":"Thorax MRI contribution to the differential diagnosis of pulmonary lesions","authors":"M. Kipourou, I. Tsanaktsidis, K. Koutroumanidis, Maro Varsami, I. Tsifountoudis, K. Katsoulis","doi":"10.18332/pne/160040","DOIUrl":"https://doi.org/10.18332/pne/160040","url":null,"abstract":"1 Thorax Magnetic Resonance Imaging (MRI) is not routinely used in clinical practice for characterization of lung lesions, as presence of air in the lungs results in considerable reduction of the MRI diagnostic accuracy. We present a case of a 69-year-old patient, bedridden for the past year due to hemorrhagic stroke, who was transferred to the Emergency Department, due to breathlessness and productive cough. Microbiological exams revealed anemia (Hb: 9.9 g/dL), moderately elevated C-Reactive Protein (CRP) value (4.33 mg/dL, with normal values <0.5 mg/dL) and procalcitonin (PCT) value within normal range (0.03 ng/mL, with normal values <0.05 ng/mL). Blood and urine cultures were negative. The patient had a smoking history of 35 pack-years. CT imaging revealed a large lesion of the right upper lobe (Figure 1). The patient underwent CT guided FNA of the lesion twice, without findings suggestive of a definite diagnosis. A chest MRI was then conducted (Figure 2), revealing diffusion restriction in the diffusion-weighted imaging (DWI) of the upper right lobe lesion. Empiric treatment with amoxicillin-clavulanic acid 1 g × 3 was initiated, resulting in gradual increase of body weight and diminution of","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72716128","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}
Georgia Athanasopoulou, G. Zakynthinos, K. Eleftheriou, Effrosyni Dima, C. Magkou, P. Katsaounou, I. Kalomenidis
any drug use that could provoke lung fibrosis. The laboratory tests were positive for ΑΝΑ, anti-Ro52, and anti-ENA. Then, the diagnosis of systemic lupus erythematosus (SLE) was made and the patient was treated with a high dose of corticosteroids and Rituximab. It should be noted that after hospital discharge, the patient did not receive the suggested treatment regularly. Over the past two years, the patient reports multiple hospitalizations for shortness of breath with unclear diagnosis and treatment. Upon admission to our department, his temperature was 37 o C, his respiratory rate was 32/min, his blood pressure was 110/80 mmHg, his heart rate was 105/ min, and the SpO2=89% while breathing room air. Lung ABSTRACT We present the case of a 28-year-old African man with multiple hospitalizations during the past two years due to worsening shortness of breath. The initial work-up revealed recurrent pulmonary embolism and interstitial lung disease (ILD). The diagnosis of primary Sjogren syndrome was established and a lung biopsy demonstrated cellular non-specific interstitial pneumonia (NSIP). Proper treatment of NSIP was partially effective and respiratory failure persisted, implying additional pathology to NSIP. Further evaluation revealed pulmonary hypertension that required treatment with pulmonary vasodilators.
{"title":"Interstitial lung disease and primary Sjogren syndrome: A case report","authors":"Georgia Athanasopoulou, G. Zakynthinos, K. Eleftheriou, Effrosyni Dima, C. Magkou, P. Katsaounou, I. Kalomenidis","doi":"10.18332/pne/161143","DOIUrl":"https://doi.org/10.18332/pne/161143","url":null,"abstract":"any drug use that could provoke lung fibrosis. The laboratory tests were positive for ΑΝΑ, anti-Ro52, and anti-ENA. Then, the diagnosis of systemic lupus erythematosus (SLE) was made and the patient was treated with a high dose of corticosteroids and Rituximab. It should be noted that after hospital discharge, the patient did not receive the suggested treatment regularly. Over the past two years, the patient reports multiple hospitalizations for shortness of breath with unclear diagnosis and treatment. Upon admission to our department, his temperature was 37 o C, his respiratory rate was 32/min, his blood pressure was 110/80 mmHg, his heart rate was 105/ min, and the SpO2=89% while breathing room air. Lung ABSTRACT We present the case of a 28-year-old African man with multiple hospitalizations during the past two years due to worsening shortness of breath. The initial work-up revealed recurrent pulmonary embolism and interstitial lung disease (ILD). The diagnosis of primary Sjogren syndrome was established and a lung biopsy demonstrated cellular non-specific interstitial pneumonia (NSIP). Proper treatment of NSIP was partially effective and respiratory failure persisted, implying additional pathology to NSIP. Further evaluation revealed pulmonary hypertension that required treatment with pulmonary vasodilators.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84351941","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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