Labram Massawudu, D. Logo, F. Oppong, S. Afari-Asiedu, Zuliehatu Nakobu, L. Baatiema, John Boateng
INTRODUCTION Tobacco use in any form leads to mortality and morbidity of millions of people every year, not only tobacco users but also non-users by inhaling secondhand tobacco smoke. The objective of this study was to assess predictors of cigarette and shisha use in urban and urban slum communities in Accra, Ghana. METHODS A cross-sectional study design was employed, using a quantitative data collection technique over two months, May to June 2017. Logistic regression was used to study the association between demographic characteristics of respondents and cigarette/shisha use, and data were analyzed in STATA. RESULTS The study included 389 respondents from urban (135) and urban slum (254) communities in the capital Accra. The prevalence of ever smoking cigarettes, shisha and electronic cigarettes was 24.9% (95% CI: 20.8–29.5), 34.6% (95% CI: 30.0–39.6) and 15.1% (95% CI: 11.3–19.8), respectively. For current smokers, 13.1% (95% CI: 10.1–16.9) smoked cigarettes, 10.3% (95% CI: 7.6–13.7) smoked shisha, and 19.5% (95% CI: 15.9–23.8) smoked either cigarettes or shisha. Respondents aged 26–35 years (OR=2.22; 95% CI: 1.08–4.56, p=0.029) and those with no employment (OR=2.30; 95% CI: 1.19–4.44, p=0.013) had higher odds of cigarette/shisha use compared to those aged 18–25 years and the employed, respectively. CONCLUSIONS The provision of adequate resources and continued engagement of relevant stakeholders, can strengthen smoke-free law implementation in Ghana and protect citizens from the harmful effects of tobacco use. INTRODUCTION Tobacco remains the single most preventable risk factor that acts against present and future generations, having devastating health, social, environmental and economic consequences through its consumption and exposure1. It is one of the main public health problems killing over 8 million people, with 9 in 10 as a result of direct tobacco use, and 1 in 10 due to exposure to tobacco smoke2. It is a challenge to public health as 8 in 10 of 1.3 billion adult smokers are located in lowand middle-income countries including Ghana. This high level of tobacco consumption and exposure leads to high tobacco-related morbidity and mortality as a result of high level tobacco addiction3 and poverty within the immediate families of the tobacco users due to the diversion of household money from buying basic needs, such as food and shelter, to tobacco purchases4. Tobacco addiction and continuous use also lead to increased healthcare costs as a result of increased tobacco-related disease5. It is well documented that tobacco and tobacco products have no safe level of exposure. Cigarettes are the most commonly used6 tobacco product followed by other types such as waterpipe tobacco (shisha), smokeless tobacco products, cigars, cigarillos, roll-your-own tobacco, pipe tobacco, bidis, and kreteks7. Waterpipe tobacco smoking (hookah, shisha, narghile) use is on the rise and has received attention from public health researchers and practitioners due to
{"title":"Predictors of cigarette and shisha use in Nima and Osu communities, Accra, Ghana: A cross-sectional study","authors":"Labram Massawudu, D. Logo, F. Oppong, S. Afari-Asiedu, Zuliehatu Nakobu, L. Baatiema, John Boateng","doi":"10.18332/pne/143225","DOIUrl":"https://doi.org/10.18332/pne/143225","url":null,"abstract":"INTRODUCTION Tobacco use in any form leads to mortality and morbidity of millions of people every year, not only tobacco users but also non-users by inhaling secondhand tobacco smoke. The objective of this study was to assess predictors of cigarette and shisha use in urban and urban slum communities in Accra, Ghana. METHODS A cross-sectional study design was employed, using a quantitative data collection technique over two months, May to June 2017. Logistic regression was used to study the association between demographic characteristics of respondents and cigarette/shisha use, and data were analyzed in STATA. RESULTS The study included 389 respondents from urban (135) and urban slum (254) communities in the capital Accra. The prevalence of ever smoking cigarettes, shisha and electronic cigarettes was 24.9% (95% CI: 20.8–29.5), 34.6% (95% CI: 30.0–39.6) and 15.1% (95% CI: 11.3–19.8), respectively. For current smokers, 13.1% (95% CI: 10.1–16.9) smoked cigarettes, 10.3% (95% CI: 7.6–13.7) smoked shisha, and 19.5% (95% CI: 15.9–23.8) smoked either cigarettes or shisha. Respondents aged 26–35 years (OR=2.22; 95% CI: 1.08–4.56, p=0.029) and those with no employment (OR=2.30; 95% CI: 1.19–4.44, p=0.013) had higher odds of cigarette/shisha use compared to those aged 18–25 years and the employed, respectively. CONCLUSIONS The provision of adequate resources and continued engagement of relevant stakeholders, can strengthen smoke-free law implementation in Ghana and protect citizens from the harmful effects of tobacco use. INTRODUCTION Tobacco remains the single most preventable risk factor that acts against present and future generations, having devastating health, social, environmental and economic consequences through its consumption and exposure1. It is one of the main public health problems killing over 8 million people, with 9 in 10 as a result of direct tobacco use, and 1 in 10 due to exposure to tobacco smoke2. It is a challenge to public health as 8 in 10 of 1.3 billion adult smokers are located in lowand middle-income countries including Ghana. This high level of tobacco consumption and exposure leads to high tobacco-related morbidity and mortality as a result of high level tobacco addiction3 and poverty within the immediate families of the tobacco users due to the diversion of household money from buying basic needs, such as food and shelter, to tobacco purchases4. Tobacco addiction and continuous use also lead to increased healthcare costs as a result of increased tobacco-related disease5. It is well documented that tobacco and tobacco products have no safe level of exposure. Cigarettes are the most commonly used6 tobacco product followed by other types such as waterpipe tobacco (shisha), smokeless tobacco products, cigars, cigarillos, roll-your-own tobacco, pipe tobacco, bidis, and kreteks7. Waterpipe tobacco smoking (hookah, shisha, narghile) use is on the rise and has received attention from public health researchers and practitioners due to ","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"161 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85380036","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}
Iasonas Dermitzakis, D. Tsavlis, P. Konstantinidou, Charalampos Charalampidis, E. Zagelidou, D. Anestakis
1 Dear Editor, Pneumonia is an inflammatory disease of the lung parenchyma in which alveoli are filled with fluid and blood cells1. This condition is usually caused by viral or bacterial infections of the lung tissue, while it may also be due to aspiration of vomit or food2. Although the most common form of pneumonia is bacterial, lipoid pneumonia (LP) is one of the most difficult to diagnose. The case of a 44-year-old white male with unknown medical history was investigated to determine the exact cause of death. The patient was found dead and transferred to the Forensic Medical Service of Thessaloniki, where an autopsy was performed. A biopsy was done on the deceased’s three key organs (heart, liver and lungs), and the most important finding was related to the lung tissue sample. We observed foci of fibrous connective tissue, swelling in specific areas, regions of hemorrhagic infiltration, plus alveoli and bronchioles destruction due to lipid deposition (Figure 1). These findings led us to consider LP as the cause of death. LP is an infectious disease of the lungs that results from entering fat into the bronchial tree3. There are two types of LP: exogenous and endogenous4. The exogenous LP occurs when the fat particles enter from outside the body and reach the lungs via the nose or mouth5. The endogenous LP occurs in airway obstruction. In this case, fatty particles are released from the cellular breakdown in alveolar walls, and the macrophages, which phagocytose these lipids, fill the lumen of the disconnected airspace6. An ill-defined, pale-yellow area on the lung reflects the gross appearance of LP. At the microscopic scale, foamy macrophages and giant cells are seen in the airways, and the inflammatory response is visible in the parenchyma7. In our cause, a young drug abuser died due to LP. Because of the patient’s unknown medical history, we cannot confidently assume why the young man’s situation led to a manifestation of LP. Nevertheless, we know that the patient was a drug addict, an essential element if we consider recent studies on pulmonary diseases of drug addicts8. The main reason that could lead to this case of LP is overdose. Usually, overdose leads to coma (stage 1, 2 or 3)9. In these stages of coma, aspiration is regularly caused due to lack
{"title":"An interesting case of lipoid pneumonia","authors":"Iasonas Dermitzakis, D. Tsavlis, P. Konstantinidou, Charalampos Charalampidis, E. Zagelidou, D. Anestakis","doi":"10.18332/pne/143226","DOIUrl":"https://doi.org/10.18332/pne/143226","url":null,"abstract":"1 Dear Editor, Pneumonia is an inflammatory disease of the lung parenchyma in which alveoli are filled with fluid and blood cells1. This condition is usually caused by viral or bacterial infections of the lung tissue, while it may also be due to aspiration of vomit or food2. Although the most common form of pneumonia is bacterial, lipoid pneumonia (LP) is one of the most difficult to diagnose. The case of a 44-year-old white male with unknown medical history was investigated to determine the exact cause of death. The patient was found dead and transferred to the Forensic Medical Service of Thessaloniki, where an autopsy was performed. A biopsy was done on the deceased’s three key organs (heart, liver and lungs), and the most important finding was related to the lung tissue sample. We observed foci of fibrous connective tissue, swelling in specific areas, regions of hemorrhagic infiltration, plus alveoli and bronchioles destruction due to lipid deposition (Figure 1). These findings led us to consider LP as the cause of death. LP is an infectious disease of the lungs that results from entering fat into the bronchial tree3. There are two types of LP: exogenous and endogenous4. The exogenous LP occurs when the fat particles enter from outside the body and reach the lungs via the nose or mouth5. The endogenous LP occurs in airway obstruction. In this case, fatty particles are released from the cellular breakdown in alveolar walls, and the macrophages, which phagocytose these lipids, fill the lumen of the disconnected airspace6. An ill-defined, pale-yellow area on the lung reflects the gross appearance of LP. At the microscopic scale, foamy macrophages and giant cells are seen in the airways, and the inflammatory response is visible in the parenchyma7. In our cause, a young drug abuser died due to LP. Because of the patient’s unknown medical history, we cannot confidently assume why the young man’s situation led to a manifestation of LP. Nevertheless, we know that the patient was a drug addict, an essential element if we consider recent studies on pulmonary diseases of drug addicts8. The main reason that could lead to this case of LP is overdose. Usually, overdose leads to coma (stage 1, 2 or 3)9. In these stages of coma, aspiration is regularly caused due to lack","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"54 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88799291","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. Cillóniz, F. Meira, Gerad Dueñas, Julia Gimeno-Miron, Mariana Chumbita, P. Puerta-Alcalde, Nicole García-Poutón, A. Gabarrús, Verónica Rico, António Torres, C. García-Vidal, Á. Soriano
INTRODUCTION COVID-19 disproportionately impacts patients aged >= 80 years, yet few studies have focused on this population. We aimed to investigate the clinical characteristics and outcomes of very elderly patients with COVID-19 across three consecutive waves in Spain. METHODS We retrospectively evaluated very elderly patients admitted with COVID-19 to a university hospital in Barcelona, Spain, across the three first waves. Main outcomes were ICU admission and 30-day mortality. RESULTS From March 2020 to February 2021, 3105 patients diagnosed with COVID-19 were admitted. Of these, 655 (21%) were very elderly patients, 50% were female and median age was 86 (83;89) years. ICU admission and ICU-mortality rates were 11% and 42%, respectively;male sex, respiratory rate >= 25 breaths/min, LDH >= 337.5 U/L and C-reactive protein >= 11.5 mg/dL were significantly associated with ICU admission in the multivariable analysis. Overall, 30-day mortality was 34%. The ICU admission rate was significantly higher during the first wave compared to the third wave (16% vs 8%;p=0.009), whereas no significant differences in 30-day mortality were found between waves (p=0.107). CONCLUSIONS We observed an increase in the percentage of very elderly patients admitted to the ICU during the three first pandemic peaks. ICU admission more likely occurs in very elderly male patients with higher respiratory rate, with elevate LDH and C-reactive protein. Overall, our 30-day mortality rate was lower compared to other series globally.
{"title":"COVID-19 in patients aged 80 years and over during the peaks of the first three pandemic waves at a Spanish tertiary hospital","authors":"C. Cillóniz, F. Meira, Gerad Dueñas, Julia Gimeno-Miron, Mariana Chumbita, P. Puerta-Alcalde, Nicole García-Poutón, A. Gabarrús, Verónica Rico, António Torres, C. García-Vidal, Á. Soriano","doi":"10.18332/pne/143224","DOIUrl":"https://doi.org/10.18332/pne/143224","url":null,"abstract":"INTRODUCTION COVID-19 disproportionately impacts patients aged >= 80 years, yet few studies have focused on this population. We aimed to investigate the clinical characteristics and outcomes of very elderly patients with COVID-19 across three consecutive waves in Spain. METHODS We retrospectively evaluated very elderly patients admitted with COVID-19 to a university hospital in Barcelona, Spain, across the three first waves. Main outcomes were ICU admission and 30-day mortality. RESULTS From March 2020 to February 2021, 3105 patients diagnosed with COVID-19 were admitted. Of these, 655 (21%) were very elderly patients, 50% were female and median age was 86 (83;89) years. ICU admission and ICU-mortality rates were 11% and 42%, respectively;male sex, respiratory rate >= 25 breaths/min, LDH >= 337.5 U/L and C-reactive protein >= 11.5 mg/dL were significantly associated with ICU admission in the multivariable analysis. Overall, 30-day mortality was 34%. The ICU admission rate was significantly higher during the first wave compared to the third wave (16% vs 8%;p=0.009), whereas no significant differences in 30-day mortality were found between waves (p=0.107). CONCLUSIONS We observed an increase in the percentage of very elderly patients admitted to the ICU during the three first pandemic peaks. ICU admission more likely occurs in very elderly male patients with higher respiratory rate, with elevate LDH and C-reactive protein. Overall, our 30-day mortality rate was lower compared to other series globally.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"26 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82634293","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}
D. Moumtzi, Anna Gavriilidou, K. Gasteratos, D. Vlachakis, M. Kakoura
The pathophysiology of pulmonary embolism (PE) and pneumomediastinum (PNM) in COVID-19 patients remain unclear. Studies indicate that the infection of the endothelial cells by the virus perpetuates a storm of cytokines and thrombogenic factors, which cause endothelium injury. We present a unique, to our knowledge, case of a patient aged 56 years with COVID-19 pneumonia who was admitted with dyspnea, desaturation, and fever. His situation was complicated by both PNM and PE. He received appropriate treatment with a therapeutic dose of low molecular weight heparin, and exhibited clinical improvement and resolution of the subcutaneous emphysema. Clinicians should suspect both PE and PNM within the differential diagnosis in cases of COVID-19 patients with pleuritic pain, dyspnea, and respiratory failure, after the tenth day from the onset of symptoms. INTRODUCTION The SARS-CoV-2 pandemic, known as COVID-19, has affected more than 94 million people globally, to date. The risk of thrombosis is increased in these patients. In a United States registry of patients with COVID-19, thrombotic complications occurred in 35.3% of hospitalized critically-ill patients1. However, spontaneous pneumomediastinum (PNM) and subcutaneous emphysema (SE) are rare complications with limited reported cases in the international literature to date2. CASE PRESENTATION A man aged 56 years, ex-smoker with an unremarkable medical background, presented to the Emergency Room with a six-day history of fever and dyspnea. The realtime reverse transcription polymerase chain reaction (RTPCR) for SARS-CoV-2 was positive three days before. On physical examination, he had a low-grade temperature of 37.6°C, tachypnea (RR=35/min) and desaturation (SpO2 88% on FiO2 0.21). The rest of his vital signs were as follows: blood pressure of 130/70 mmHg and heart rate 85 beats per minute. During auscultation, he had crackles at the base of the lungs bilaterally. Chest x-ray showed widespread pulmonary infiltrates (Figure 1a). The baseline laboratory blood tests showed raised inflammatory markers suggestive of acute infection (Table 1). On admission, we used the standard therapy with intravenous azithromycin, and dexamethasone 8 mg/d, subcutaneous prophylactic low molecular weight heparin (LMWH), and supplemental oxygen via nasal cannula (6 L/min). A chest computed tomography (CT) was performed that showed diffuse ground-glass infiltrations in the basal part of the lower lobes (Figure 2a). On the third hospitalization day, intravenous remdesivir was added to the therapeutic scheme following a decrease in the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels (98 IU/L and 112 IU/L, respectively). His condition deteriorated 3 days later with fever up to 38.5°C, gradual increase in oxygen demands, and raised inflammatory markers. A new chest x-ray was ordered on the sixth hospitalization day, which revealed cervical subcutaneous emphysema and radiolucent shades parallel to trachea
{"title":"Pulmonary embolism, spontaneous pneumomediastinum and subcutaneous emphysema in a patient with COVID-19 disease: A case report","authors":"D. Moumtzi, Anna Gavriilidou, K. Gasteratos, D. Vlachakis, M. Kakoura","doi":"10.18332/pne/143223","DOIUrl":"https://doi.org/10.18332/pne/143223","url":null,"abstract":"The pathophysiology of pulmonary embolism (PE) and pneumomediastinum (PNM) in COVID-19 patients remain unclear. Studies indicate that the infection of the endothelial cells by the virus perpetuates a storm of cytokines and thrombogenic factors, which cause endothelium injury. We present a unique, to our knowledge, case of a patient aged 56 years with COVID-19 pneumonia who was admitted with dyspnea, desaturation, and fever. His situation was complicated by both PNM and PE. He received appropriate treatment with a therapeutic dose of low molecular weight heparin, and exhibited clinical improvement and resolution of the subcutaneous emphysema. Clinicians should suspect both PE and PNM within the differential diagnosis in cases of COVID-19 patients with pleuritic pain, dyspnea, and respiratory failure, after the tenth day from the onset of symptoms. INTRODUCTION The SARS-CoV-2 pandemic, known as COVID-19, has affected more than 94 million people globally, to date. The risk of thrombosis is increased in these patients. In a United States registry of patients with COVID-19, thrombotic complications occurred in 35.3% of hospitalized critically-ill patients1. However, spontaneous pneumomediastinum (PNM) and subcutaneous emphysema (SE) are rare complications with limited reported cases in the international literature to date2. CASE PRESENTATION A man aged 56 years, ex-smoker with an unremarkable medical background, presented to the Emergency Room with a six-day history of fever and dyspnea. The realtime reverse transcription polymerase chain reaction (RTPCR) for SARS-CoV-2 was positive three days before. On physical examination, he had a low-grade temperature of 37.6°C, tachypnea (RR=35/min) and desaturation (SpO2 88% on FiO2 0.21). The rest of his vital signs were as follows: blood pressure of 130/70 mmHg and heart rate 85 beats per minute. During auscultation, he had crackles at the base of the lungs bilaterally. Chest x-ray showed widespread pulmonary infiltrates (Figure 1a). The baseline laboratory blood tests showed raised inflammatory markers suggestive of acute infection (Table 1). On admission, we used the standard therapy with intravenous azithromycin, and dexamethasone 8 mg/d, subcutaneous prophylactic low molecular weight heparin (LMWH), and supplemental oxygen via nasal cannula (6 L/min). A chest computed tomography (CT) was performed that showed diffuse ground-glass infiltrations in the basal part of the lower lobes (Figure 2a). On the third hospitalization day, intravenous remdesivir was added to the therapeutic scheme following a decrease in the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels (98 IU/L and 112 IU/L, respectively). His condition deteriorated 3 days later with fever up to 38.5°C, gradual increase in oxygen demands, and raised inflammatory markers. A new chest x-ray was ordered on the sixth hospitalization day, which revealed cervical subcutaneous emphysema and radiolucent shades parallel to trachea ","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"27 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83566096","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 Tuberculosis is a chronic bacterial disease which is caused by mycobacterium and in most cases by mycobacterium tuberculosis. Chest radiography is one of the most basic diagnostic tools in the initial evaluation of the patient for further evaluation and progression of the disease. Hence, this study was performed to investigate the effect of grade smear on the involvement of different lung zones in chest radiography of patients with pulmonary tuberculosis referred to the Zabol tuberculosis center. METHODS A descriptive-analytical study was conducted on all patients with pulmonary tuberculosis referred to the Zabol tuberculosis center in 2020, except patients with immunodeficiency hepatitis and diabetes. Patients with smear grading who did not have chest radiography were excluded. RESULTS The frequency of women in patients with grade 1, 2 and 3 were 73.3%, 50% and 70.6%, respectively, and the frequency of men in grade 1, 2 and 3 were 25.7%, 50% and 29.4%, respectively. There was a significant difference between these two groups. Gender did not show significant difference in terms of smear grade (p=0.192). The frequency of right or left lung involvement or both lungs in patients with grade 1, 2 and 3 was not statistically significant (p=0.306). CONCLUSIONS It seems that there is no relationship between the smear grade and the involvement of different zones in the graph. INTRODUCTION Tuberculosis is a chronic bacterial disease which is caused by a collection of mycobacteria and in most cases by mycobacterium tuberculosis. More than 90% of cases and deaths from tuberculosis occur in developing countries, countries where 75% of the cases occur, in the most economically active age group (15–54 years)1. In these countries, an adult with tuberculosis is not able to work for an average of 3 to 4 months, and therefore lowers by 20– 30% his family’s annual income, while the death of such a person is equal to on average 15 years of family income. It is clear that tuberculosis, in addition to the economic burden, has other indirect negative effects on the quality of life of patients or their families. On the other hand, multidrug resistance, which is the result of poor management of TB treatment, is a serious and growing problem in many countries of the world2. After the initial infection, 90% of people with healthy immunity prevent further proliferation of TB bacilli, causing it to enter the latent phase. The remaining 10% develop tuberculous pneumonia with lymphatic spread at the site of primary implantation or near the umbilical cord, and may present with umbilical lymphadenopathy or with disease in distant sites such as cervical lymphadenopathy, meningitis, pericarditis, or millet distribution3. The basis of the diagnosis of pulmonary tuberculosis is a direct and simple test of patients’ sputum. In the best case scenario, the susceptibility of the patients’ sputum test is examined. Chest radiography should be used as one of the most basic diag
{"title":"The effect of sputum smear grade on the anatomical position of lung involvement: A cross-sectional study","authors":"R. Behzadmehr","doi":"10.18332/pne/140624","DOIUrl":"https://doi.org/10.18332/pne/140624","url":null,"abstract":"INTRODUCTION Tuberculosis is a chronic bacterial disease which is caused by mycobacterium and in most cases by mycobacterium tuberculosis. Chest radiography is one of the most basic diagnostic tools in the initial evaluation of the patient for further evaluation and progression of the disease. Hence, this study was performed to investigate the effect of grade smear on the involvement of different lung zones in chest radiography of patients with pulmonary tuberculosis referred to the Zabol tuberculosis center. METHODS A descriptive-analytical study was conducted on all patients with pulmonary tuberculosis referred to the Zabol tuberculosis center in 2020, except patients with immunodeficiency hepatitis and diabetes. Patients with smear grading who did not have chest radiography were excluded. RESULTS The frequency of women in patients with grade 1, 2 and 3 were 73.3%, 50% and 70.6%, respectively, and the frequency of men in grade 1, 2 and 3 were 25.7%, 50% and 29.4%, respectively. There was a significant difference between these two groups. Gender did not show significant difference in terms of smear grade (p=0.192). The frequency of right or left lung involvement or both lungs in patients with grade 1, 2 and 3 was not statistically significant (p=0.306). CONCLUSIONS It seems that there is no relationship between the smear grade and the involvement of different zones in the graph. INTRODUCTION Tuberculosis is a chronic bacterial disease which is caused by a collection of mycobacteria and in most cases by mycobacterium tuberculosis. More than 90% of cases and deaths from tuberculosis occur in developing countries, countries where 75% of the cases occur, in the most economically active age group (15–54 years)1. In these countries, an adult with tuberculosis is not able to work for an average of 3 to 4 months, and therefore lowers by 20– 30% his family’s annual income, while the death of such a person is equal to on average 15 years of family income. It is clear that tuberculosis, in addition to the economic burden, has other indirect negative effects on the quality of life of patients or their families. On the other hand, multidrug resistance, which is the result of poor management of TB treatment, is a serious and growing problem in many countries of the world2. After the initial infection, 90% of people with healthy immunity prevent further proliferation of TB bacilli, causing it to enter the latent phase. The remaining 10% develop tuberculous pneumonia with lymphatic spread at the site of primary implantation or near the umbilical cord, and may present with umbilical lymphadenopathy or with disease in distant sites such as cervical lymphadenopathy, meningitis, pericarditis, or millet distribution3. The basis of the diagnosis of pulmonary tuberculosis is a direct and simple test of patients’ sputum. In the best case scenario, the susceptibility of the patients’ sputum test is examined. Chest radiography should be used as one of the most basic diag","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"34 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76261263","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}
K. Utpat, U. Desai, Deepthi Laldayal, J. Joshi, R. Bharmal, Jyoti Bacche
1 ABSTRACT INTRODUCTION Spirometry with flow volume loop (FVL) is an easy-to-use bed side test to determine upper airway obstruction (UAO). The study aimed to find the prevalence of UAO and the ability of visual and quantitative criteria to detect UAO. METHODS This was retrospective study conducted for a period of two years at the pulmonary medicine department of a tertiary care center to find the proportion of UAO cases among patients undergoing spirometry, to study the profile of UAO, and to investigated the utility of spirometric indices described for UAO. The demographic data, diagnosis, relevant imaging and bronchoscopy reports of patients were noted. These comprised of Empey’s index, ratio of the flow at the mid-point of the forced expiratory manoeuvre to the flow at the mid-point of the forced inspiratory manoeuvre (FEF50/FIF50), FIF50 <100 L/ min and qualitative features like flattening of inspiratory or expiratory loops, box-shaped loop and oscillations on the loop. RESULTS Mean age of the population was 43 years. Prevalence of UAO was 24 (3.1%). The most common cause of UAO was multinodular goiter (MNG) seen in 10 (39%). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for Empey’s index were 62.5%, 89.4%, 15.7% and 98.6%, respectively. The sensitivity, specificity, PPV and NPV for qualitative criteria of flow volume loop (FVL) visual abnormalities were 95.6%, 99.7%, 91.6% and 99.8%, respectively. The sensitivity, specificity, PPV and NPV of FIF50 <100 L/min were 79.1%, 80.4%, 11.5% and 99.1%, respectively. Variable extrathoracic UAO was seen in 17, variable intrathoracic UAO in 4, while 3 cases had fixed UAO. CONCLUSIONS Spirometry with FVL is a simple and useful screening test for UAO.
{"title":"Role of spirometry with flow volume loop in the\u0000diagnosis of upper airway obstruction: A study from\u0000the pulmonary medicine department of a tertiary care\u0000center","authors":"K. Utpat, U. Desai, Deepthi Laldayal, J. Joshi, R. Bharmal, Jyoti Bacche","doi":"10.18332/pne/142628","DOIUrl":"https://doi.org/10.18332/pne/142628","url":null,"abstract":"1 ABSTRACT INTRODUCTION Spirometry with flow volume loop (FVL) is an easy-to-use bed side test to determine upper airway obstruction (UAO). The study aimed to find the prevalence of UAO and the ability of visual and quantitative criteria to detect UAO. METHODS This was retrospective study conducted for a period of two years at the pulmonary medicine department of a tertiary care center to find the proportion of UAO cases among patients undergoing spirometry, to study the profile of UAO, and to investigated the utility of spirometric indices described for UAO. The demographic data, diagnosis, relevant imaging and bronchoscopy reports of patients were noted. These comprised of Empey’s index, ratio of the flow at the mid-point of the forced expiratory manoeuvre to the flow at the mid-point of the forced inspiratory manoeuvre (FEF50/FIF50), FIF50 <100 L/ min and qualitative features like flattening of inspiratory or expiratory loops, box-shaped loop and oscillations on the loop. RESULTS Mean age of the population was 43 years. Prevalence of UAO was 24 (3.1%). The most common cause of UAO was multinodular goiter (MNG) seen in 10 (39%). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for Empey’s index were 62.5%, 89.4%, 15.7% and 98.6%, respectively. The sensitivity, specificity, PPV and NPV for qualitative criteria of flow volume loop (FVL) visual abnormalities were 95.6%, 99.7%, 91.6% and 99.8%, respectively. The sensitivity, specificity, PPV and NPV of FIF50 <100 L/min were 79.1%, 80.4%, 11.5% and 99.1%, respectively. Variable extrathoracic UAO was seen in 17, variable intrathoracic UAO in 4, while 3 cases had fixed UAO. CONCLUSIONS Spirometry with FVL is a simple and useful screening test for UAO.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"50 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88748828","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}
Maria Tryfon, Efthymia Papadopoulou, Stavros Tryfon
1 Supernumerary or accessory fissures represent the most commonly observed anatomical variation of the lungs both on cadaveric exemplaries and on radiological findings1. Lined by two layers of visceral pleura, an accessory fissure constitutes a cleft that delineates an accessory lobe. It may be missed or misinterpreted in conventional computed tomography (CT), due to inadequate slice thickness, position to the scan plane, or in cases of incomplete fissures. In anatomical studies, accessory fissures are noted at a percentage of 7.5– 35%, whereas in radiologic studies the incidence ranges 8–59%2. Lack of obliteration, which normally occurs in the spaces between bronchopulmonary buds during fetus development, is considered to result in the formation of accessory fissures3. The left minor fissure (Figure 1), an analogue of the right minor fissure, is the second most common accessory fissure and subdivides the upper lobe of the lung into the anterior segment and the lingula, in almost equal sizes (S3/ S4). Thus, the lower part is termed ‘left middle lobe’4. An important anatomic landmark for the distinction of the left minor fissure from other upper lobe fissures is the vessel parallel and inferior to the anterior segmental bronchus of the upper lobe (V3b radiological sign). Accessory fissures of the left upper lobe have been classified into four types on CT imaging4. Type I extends from the anterior chest wall with a lateral convexity almost parallel to the lateral chest wall and merges with the major fissure posteriorly at a right angle, separating either the apicoposterior from the anterior segment of the upper lobe (S1+2/ S3), the anterior segment of the upper lobe from the superior segment of the lingula (S3/S4), or the superior from the inferior segment of the lingula (S4/S5). Type II has a sagittal course with medial convexity and separates the superior from the inferior segment of the lingula (S4/S5). Type III shows anteromedial convexity with an oblique orientation from the anterior chest wall and separates the anterior segment of the upper lobe from the superior segment of the lingula (S3/S4). The patient, presented hereby, has a type IV accessory fissure (Figure 2), which emerges as a transverse and almost straight line parallel to the major fissure (S3/S4).
{"title":"A patient with ‘left middle lung lobe’","authors":"Maria Tryfon, Efthymia Papadopoulou, Stavros Tryfon","doi":"10.18332/pne/142626","DOIUrl":"https://doi.org/10.18332/pne/142626","url":null,"abstract":"1 Supernumerary or accessory fissures represent the most commonly observed anatomical variation of the lungs both on cadaveric exemplaries and on radiological findings1. Lined by two layers of visceral pleura, an accessory fissure constitutes a cleft that delineates an accessory lobe. It may be missed or misinterpreted in conventional computed tomography (CT), due to inadequate slice thickness, position to the scan plane, or in cases of incomplete fissures. In anatomical studies, accessory fissures are noted at a percentage of 7.5– 35%, whereas in radiologic studies the incidence ranges 8–59%2. Lack of obliteration, which normally occurs in the spaces between bronchopulmonary buds during fetus development, is considered to result in the formation of accessory fissures3. The left minor fissure (Figure 1), an analogue of the right minor fissure, is the second most common accessory fissure and subdivides the upper lobe of the lung into the anterior segment and the lingula, in almost equal sizes (S3/ S4). Thus, the lower part is termed ‘left middle lobe’4. An important anatomic landmark for the distinction of the left minor fissure from other upper lobe fissures is the vessel parallel and inferior to the anterior segmental bronchus of the upper lobe (V3b radiological sign). Accessory fissures of the left upper lobe have been classified into four types on CT imaging4. Type I extends from the anterior chest wall with a lateral convexity almost parallel to the lateral chest wall and merges with the major fissure posteriorly at a right angle, separating either the apicoposterior from the anterior segment of the upper lobe (S1+2/ S3), the anterior segment of the upper lobe from the superior segment of the lingula (S3/S4), or the superior from the inferior segment of the lingula (S4/S5). Type II has a sagittal course with medial convexity and separates the superior from the inferior segment of the lingula (S4/S5). Type III shows anteromedial convexity with an oblique orientation from the anterior chest wall and separates the anterior segment of the upper lobe from the superior segment of the lingula (S3/S4). The patient, presented hereby, has a type IV accessory fissure (Figure 2), which emerges as a transverse and almost straight line parallel to the major fissure (S3/S4).","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"4 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85414861","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}
{"title":"Pneumon in 2021: Entering a new e-Era","authors":"K. Kostikas","doi":"10.18332/pne/143259","DOIUrl":"https://doi.org/10.18332/pne/143259","url":null,"abstract":"","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"103 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88999185","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. Boutsikari, A. Christakou, M. Elpidoforou, Ioannis Kopsidas, N. Nikolovienis, D. Kardara, C. C. Boutsikari, C. Triantafyllou
INTRODUCTION In the ongoing coronavirus disease 2019 (COVID-19) pandemic, even though vaccines have been rolled out and the vaccination campaigns in some countries have already been followed by a decline in number and severity of cases, non-pharmaceutical interventions (NPI) are still playing an important role on COVID-19 management (e.g. social distancing) that are imposed by the authorities and require the public's adherence and behavioral adjustment. This study aims to identify factors that affect the general public's attitudes towards the importance of NPI in Greece. METHODS This prevalence study, enrolled 657 adults from the general Greek population in order to assess their beliefs and identify possible factors that influence their perceptions of NPI. All associations were assessed through multivariate logistic regression. RESULTS Overall, Greeks considered NPI important for health protection. The participants who were less likely to consider NPI important were men compared to women (OR=1.64;95% CI: 1.15-2.36, p=0.007), people aged <40 years compared to those >= 40 years (OR=0.48;95% CI: 0.34-0.68, p<0.001), and people who did not choose the Hellenic National Public Health Organization (NPHO) to get informed about COVID-19 compared to other sources (OR=0.65;95% CI: 0.46-0.92, p=0.014). CONCLUSIONS This study profiled Greek people who do and do not consider NPI important, primarily on their demographic characteristics. Focused communicational strategies in certain population subgroups are recommended.
{"title":"Greek population’s perceptions of nonpharmacological interventions towards the first wave of COVID-19 pandemic mitigation: A regressionbased association analysis","authors":"E. Boutsikari, A. Christakou, M. Elpidoforou, Ioannis Kopsidas, N. Nikolovienis, D. Kardara, C. C. Boutsikari, C. Triantafyllou","doi":"10.18332/pne/141592","DOIUrl":"https://doi.org/10.18332/pne/141592","url":null,"abstract":"INTRODUCTION In the ongoing coronavirus disease 2019 (COVID-19) pandemic, even though vaccines have been rolled out and the vaccination campaigns in some countries have already been followed by a decline in number and severity of cases, non-pharmaceutical interventions (NPI) are still playing an important role on COVID-19 management (e.g. social distancing) that are imposed by the authorities and require the public's adherence and behavioral adjustment. This study aims to identify factors that affect the general public's attitudes towards the importance of NPI in Greece. METHODS This prevalence study, enrolled 657 adults from the general Greek population in order to assess their beliefs and identify possible factors that influence their perceptions of NPI. All associations were assessed through multivariate logistic regression. RESULTS Overall, Greeks considered NPI important for health protection. The participants who were less likely to consider NPI important were men compared to women (OR=1.64;95% CI: 1.15-2.36, p=0.007), people aged <40 years compared to those >= 40 years (OR=0.48;95% CI: 0.34-0.68, p<0.001), and people who did not choose the Hellenic National Public Health Organization (NPHO) to get informed about COVID-19 compared to other sources (OR=0.65;95% CI: 0.46-0.92, p=0.014). CONCLUSIONS This study profiled Greek people who do and do not consider NPI important, primarily on their demographic characteristics. Focused communicational strategies in certain population subgroups are recommended.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"GE-18 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84607667","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 SARS-CoV-2 was identified as the causative agent of the COVID-19 pandemic, which has been the focus of extensive research for over a year. Asthmatics were listed as a high-risk group for susceptibility to SARSCoV-2. Several hypotheses have been proposed regarding protective factors in asthmatics, amongst which were the role of biological agents. One such agent is omalizumab, an IgE inhibitor, which is currently the only biological agent available in Malta for the treatment of severe asthma. METHODS This study aims to evaluate the symptomatology and disease course of SARS-CoV-2 in our cohort of severe asthmatic patients on omalizumab that contracted COVID-19. Molecular diagnostic tests (SARSCoV-2 PCR tests taken, if any, and the PCR result) since March 2020 of all adult patients receiving omalizumab for severe allergic asthma in January 2021, were reviewed from I-soft Clinical Manager (R). Demographic data were collected for those patients who were found to be positive. RESULTS Our cohort included 58 patients, of whom 43 had PCR tests. Of these, 7 patients (12%) tested positive during the study period. Results show a male predominance in the cohort, with fever being the commonest symptom, and a mortality of only 1 patient out of 7. CONCLUSIONS From the small number of our severe asthmatic patients infected with SARS-CoV-2 whilst receiving omalizumab, the majority had only mild symptoms, with minimal effect on asthma-related symptoms and hospitalizations, apart from mortality in one patient.
{"title":"COVID-19 in severe asthma treated with omalizumab: The Maltese perspective","authors":"N. Sciberras, C. Gouder, S. Montefort","doi":"10.18332/pne/141591","DOIUrl":"https://doi.org/10.18332/pne/141591","url":null,"abstract":"INTRODUCTION SARS-CoV-2 was identified as the causative agent of the COVID-19 pandemic, which has been the focus of extensive research for over a year. Asthmatics were listed as a high-risk group for susceptibility to SARSCoV-2. Several hypotheses have been proposed regarding protective factors in asthmatics, amongst which were the role of biological agents. One such agent is omalizumab, an IgE inhibitor, which is currently the only biological agent available in Malta for the treatment of severe asthma. METHODS This study aims to evaluate the symptomatology and disease course of SARS-CoV-2 in our cohort of severe asthmatic patients on omalizumab that contracted COVID-19. Molecular diagnostic tests (SARSCoV-2 PCR tests taken, if any, and the PCR result) since March 2020 of all adult patients receiving omalizumab for severe allergic asthma in January 2021, were reviewed from I-soft Clinical Manager (R). Demographic data were collected for those patients who were found to be positive. RESULTS Our cohort included 58 patients, of whom 43 had PCR tests. Of these, 7 patients (12%) tested positive during the study period. Results show a male predominance in the cohort, with fever being the commonest symptom, and a mortality of only 1 patient out of 7. CONCLUSIONS From the small number of our severe asthmatic patients infected with SARS-CoV-2 whilst receiving omalizumab, the majority had only mild symptoms, with minimal effect on asthma-related symptoms and hospitalizations, apart from mortality in one patient.","PeriodicalId":42353,"journal":{"name":"Pneumon","volume":"8 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90014634","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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