Adel A. M. Saeed, A. Gomaa, H. Ezzelregal, E. Elbaz
Background Malignant pleural effusion (MPE) is prevalent, and in cases such as aging patients as well as increased long-term survival for metastatic cancers, the number of patients will continue to elevate in the near future. Aim To assess both the diaphragmatic mobility using chest ultrasound and basic echocardiography before and after pleurodesis in patients with MPE. Patients and methods This study included 35 patients with MPE; the diagnosis is based on positive pleural fluid cytology, thoracoscopic biopsy, and fitted for chemical pleurodesis by bleomycin. Baseline chest ultrasound was done to for assess the diaphragmatic mobility and basic echocardiography. Chemical pleurodesis was done through intrapleural injection of 1 IU/kg bleomycin as a sclerosing agent in 100 ml of normal saline. Results Regarding outcome, 17 (48.6%) patients succeeded (defined as absent lung sliding and no reaccumulation of pleural fluid in the lines examined) and 7 (20%) patients failed (known as reaccumulation of pleural fluid and (even with) no presence of lung sliding). There was a statistically substantial decrease in the diaphragmatic excursion (mobility) at 2 weeks and at 2 months after pleurodesis than before. A significant relation was detected between outcome of the studied patients with lung sliding before pleurodesis, whereas there was a substantial increase in pleurodesis success with no presence of lung sliding at 2 weeks and at 2 months after pleurodesis. Conclusion Ultrasound of the diaphragm is an uncomplicated, noninvasive method for estimating the contractile activity of diaphragm. The decrease in the diaphragmatic excursion at 2 weeks and at 2 months after pleurodesis compared with that before pleurodesis can be used as sign to predict pleurodesis success. There is no significant relation between echocardiography measurements and outcome except that normal left ventricle ejection fraction % has a significant relation with increased success outcome.
{"title":"Assessment of diaphragmatic mobility by chest ultrasound and basic echocardiography in patients with malignant pleural effusion undergoing pleurodesis","authors":"Adel A. M. Saeed, A. Gomaa, H. Ezzelregal, E. Elbaz","doi":"10.4103/ecdt.ecdt_75_21","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_75_21","url":null,"abstract":"Background Malignant pleural effusion (MPE) is prevalent, and in cases such as aging patients as well as increased long-term survival for metastatic cancers, the number of patients will continue to elevate in the near future. Aim To assess both the diaphragmatic mobility using chest ultrasound and basic echocardiography before and after pleurodesis in patients with MPE. Patients and methods This study included 35 patients with MPE; the diagnosis is based on positive pleural fluid cytology, thoracoscopic biopsy, and fitted for chemical pleurodesis by bleomycin. Baseline chest ultrasound was done to for assess the diaphragmatic mobility and basic echocardiography. Chemical pleurodesis was done through intrapleural injection of 1 IU/kg bleomycin as a sclerosing agent in 100 ml of normal saline. Results Regarding outcome, 17 (48.6%) patients succeeded (defined as absent lung sliding and no reaccumulation of pleural fluid in the lines examined) and 7 (20%) patients failed (known as reaccumulation of pleural fluid and (even with) no presence of lung sliding). There was a statistically substantial decrease in the diaphragmatic excursion (mobility) at 2 weeks and at 2 months after pleurodesis than before. A significant relation was detected between outcome of the studied patients with lung sliding before pleurodesis, whereas there was a substantial increase in pleurodesis success with no presence of lung sliding at 2 weeks and at 2 months after pleurodesis. Conclusion Ultrasound of the diaphragm is an uncomplicated, noninvasive method for estimating the contractile activity of diaphragm. The decrease in the diaphragmatic excursion at 2 weeks and at 2 months after pleurodesis compared with that before pleurodesis can be used as sign to predict pleurodesis success. There is no significant relation between echocardiography measurements and outcome except that normal left ventricle ejection fraction % has a significant relation with increased success outcome.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"1 1","pages":"514 - 519"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82926939","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}
N. Belloumi, M. Bougacha, I. Bachouch, C. Habouria, F. Chermiti, S. Fenniche
Evans syndrome associates thrombocytopenia, autoimmune hemolytic anemia, and/or neutropenia with a positive direct antihuman globulin test. It is an autoimmune entity. We report here a case of a 71-year-old patient followed up for Evans syndrome, arterial hypertension, diabetes mellitus, and moderate chronic renal failure. He was hospitalized for massive hemoptysis and decline of platelet blood count to under 40 000 cells/mm3. Alveolar hemorrhage was so extended in computed tomography scan. The acute respiratory failure was followed by a systemic shock and then death. This disease has no consensual treatment but some therapies are effective. Preventive management should be considered to avoid cataclysmic complications.
{"title":"Alveolar hemorrhage linked to Evans syndrome","authors":"N. Belloumi, M. Bougacha, I. Bachouch, C. Habouria, F. Chermiti, S. Fenniche","doi":"10.4103/ecdt.ecdt_73_21","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_73_21","url":null,"abstract":"Evans syndrome associates thrombocytopenia, autoimmune hemolytic anemia, and/or neutropenia with a positive direct antihuman globulin test. It is an autoimmune entity. We report here a case of a 71-year-old patient followed up for Evans syndrome, arterial hypertension, diabetes mellitus, and moderate chronic renal failure. He was hospitalized for massive hemoptysis and decline of platelet blood count to under 40 000 cells/mm3. Alveolar hemorrhage was so extended in computed tomography scan. The acute respiratory failure was followed by a systemic shock and then death. This disease has no consensual treatment but some therapies are effective. Preventive management should be considered to avoid cataclysmic complications.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"81 1","pages":"539 - 541"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75842377","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}
Adel A. M. Saeed, Ibraheem Dwidar, E. AbdelFattah, Khaled Elnady, Mustafa Nagdy
Background Idiopathic pulmonary fibrosis (IPF) is known as a particular pattern of persistent gradually developing fibrosing interstitial pneumonia of unspecified cause that takes place mainly in elder adults, is restricted to the lungs, and is correlated with the radiological and/or histopathological pattern of usual interstitial pneumonia. Patients with IPF exhibit characteristic features regarding the respiratory and cardiac muscle function. The lack of an association between diaphragmatic mobility and echocardiography findings of right and left ventricle functions in patients with IPF was unexpected as transthoracic ultrasound (US) and echocardiography are feasible, reproducible, noninvasive, and largely adopted in the clinical practice and in clinical trials. Objective To correlate between diaphragmatic mobility using transthoracic US and ventricular functions using echocardiography in patients with IPF. Patients and methods A prospective case–control study was conducted in which 40 patients with IPF and 10 controls underwent transthoracic US assessment of diaphragmatic excursion and echocardiography study, and then the results were correlated. Results There was a statistically significant decrease in deep breathing excursion, right ventricle functional area change, tricuspid annular plane systolic excursion, and ejection fraction in addition to an increase in pulmonary artery systolic pressure among the study group. Both normal breathing excursion and deep breathing excursion have a positive correlation with right ventricle functional area change and tricuspid annular plane systolic excursion, whereas a negative correlation was seen with age and pulmonary artery systolic pressure in both study and control groups. Conclusions Transthoracic US assessment of diaphragmatic mobility can clearly reflect the right ventricle function in patients with IPF.
{"title":"Correlation between diaphragmatic mobility by transthoracic ultrasound and echocardiography findings in patients with idiopathic pulmonary fibrosis","authors":"Adel A. M. Saeed, Ibraheem Dwidar, E. AbdelFattah, Khaled Elnady, Mustafa Nagdy","doi":"10.4103/ecdt.ecdt_18_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_18_22","url":null,"abstract":"Background Idiopathic pulmonary fibrosis (IPF) is known as a particular pattern of persistent gradually developing fibrosing interstitial pneumonia of unspecified cause that takes place mainly in elder adults, is restricted to the lungs, and is correlated with the radiological and/or histopathological pattern of usual interstitial pneumonia. Patients with IPF exhibit characteristic features regarding the respiratory and cardiac muscle function. The lack of an association between diaphragmatic mobility and echocardiography findings of right and left ventricle functions in patients with IPF was unexpected as transthoracic ultrasound (US) and echocardiography are feasible, reproducible, noninvasive, and largely adopted in the clinical practice and in clinical trials. Objective To correlate between diaphragmatic mobility using transthoracic US and ventricular functions using echocardiography in patients with IPF. Patients and methods A prospective case–control study was conducted in which 40 patients with IPF and 10 controls underwent transthoracic US assessment of diaphragmatic excursion and echocardiography study, and then the results were correlated. Results There was a statistically significant decrease in deep breathing excursion, right ventricle functional area change, tricuspid annular plane systolic excursion, and ejection fraction in addition to an increase in pulmonary artery systolic pressure among the study group. Both normal breathing excursion and deep breathing excursion have a positive correlation with right ventricle functional area change and tricuspid annular plane systolic excursion, whereas a negative correlation was seen with age and pulmonary artery systolic pressure in both study and control groups. Conclusions Transthoracic US assessment of diaphragmatic mobility can clearly reflect the right ventricle function in patients with IPF.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"28 1","pages":"520 - 525"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79781003","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}
H. Assal, A. Shalaby, Samar Farrag, Asmaa Ali, I. Ibrahim, R. Elkaffas, I. Sabry
Background It has recently been shown that the heat shock protein (HSP) is implicated in the pathogenesis of pulmonary fibrosis. The current trial was achieved to detect the relation of HSP-90 in usual interstitial pneumonia (UIP)-associated rheumatoid arthritis (RA). Results Sixty RA patients were studied. Their mean age was 49.63 ± 9.22 years with a mean disease duration of 7.5 (2–14) years. High-resolution computed tomography (HRCT) chest was performed on all patients. Thirty four (56.6%) patients had abnormal radiological findings in CT chest and 26 (43.3%) had normal CT chest findings. In patients with pulmonary involvement by HRCT, the most common abnormality found was small airway disease in 23 (38.3%), followed by UIP in nine (15%), and rheumatoid nodules in two (3.3%) patients. Patients with UIP pattern in HRCT chest has a significant higher level of HSP-90 level in comparison with those with RA-associated small airway disease pattern, P=0.003, and in comparison with other RA patients with no pulmonary involvement by HRCT, P=0.006. Conclusions HSP-90 was significantly elevated in UIP-associated RA and hence studying its inhibition in further studies would have a promising therapeutic role in this subset of patients.
{"title":"Heat shock protein-90: Independent predictor of rheumatoid arthritis-associated usual interstitial pneumonia","authors":"H. Assal, A. Shalaby, Samar Farrag, Asmaa Ali, I. Ibrahim, R. Elkaffas, I. Sabry","doi":"10.4103/ecdt.ecdt_62_21","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_62_21","url":null,"abstract":"Background It has recently been shown that the heat shock protein (HSP) is implicated in the pathogenesis of pulmonary fibrosis. The current trial was achieved to detect the relation of HSP-90 in usual interstitial pneumonia (UIP)-associated rheumatoid arthritis (RA). Results Sixty RA patients were studied. Their mean age was 49.63 ± 9.22 years with a mean disease duration of 7.5 (2–14) years. High-resolution computed tomography (HRCT) chest was performed on all patients. Thirty four (56.6%) patients had abnormal radiological findings in CT chest and 26 (43.3%) had normal CT chest findings. In patients with pulmonary involvement by HRCT, the most common abnormality found was small airway disease in 23 (38.3%), followed by UIP in nine (15%), and rheumatoid nodules in two (3.3%) patients. Patients with UIP pattern in HRCT chest has a significant higher level of HSP-90 level in comparison with those with RA-associated small airway disease pattern, P=0.003, and in comparison with other RA patients with no pulmonary involvement by HRCT, P=0.006. Conclusions HSP-90 was significantly elevated in UIP-associated RA and hence studying its inhibition in further studies would have a promising therapeutic role in this subset of patients.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"26 1","pages":"474 - 480"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80258725","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 Periodic limb movement during sleep (PLMS) could exist with patients diagnosed as obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the most competent therapy for OSA. However, its effect on PLM remains controversial. Aim To evaluate PLMS prevalence in OSA patients and the impact of CPAP titration on PLM outcome. Patients and methods Patients with history suggestive of OSA underwent full attended diagnostic and CPAP titration sleep study. On baseline polysomnography, OSA patients with PLM less than 5 were considered pure OSA and those with periodic limb-movement index more than or equal to 5 were considered combined group. Post-CPAP titration, patients were considered CPAP responders, CPAP persistent, CPAP emergent, or non-PLM group according to response of PLM. Results Out of 100 included OSA patients, the combined group was found in 53 patients. CPAP responder group was reported in 27 patients, while 25 and 24 patients were considered CPAP persistent and CPAP emergent, respectively. CPAP-emergent group showed significantly higher apnea–hypopnea index (AHI) than non-PLM group on baseline polysomnography. On the other hand, AHI was comparable in CPAP-persistent and responder group, despite normalization of AHI in both groups after titration. On multivariate regression analysis, old age was found to be an independent predictor for both persistence and emergence of PLM and higher AHI was an independent predictor in CPAP-emergent group. Conclusion PLMS can coexist with OSA in old-age patients, which may persist after CPAP titration. Elderly patients, especially those with baseline higher AHI, may also present with CPAP-emergent PLMS.
{"title":"Periodic limb movement in sleep before and after continuous positive airway pressure titration in obstructive sleep-apnea patients","authors":"Lamees M. Bakkar, Reham Elmorshedy, S. Farghaly","doi":"10.4103/ecdt.ecdt_27_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_27_22","url":null,"abstract":"Background Periodic limb movement during sleep (PLMS) could exist with patients diagnosed as obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the most competent therapy for OSA. However, its effect on PLM remains controversial. Aim To evaluate PLMS prevalence in OSA patients and the impact of CPAP titration on PLM outcome. Patients and methods Patients with history suggestive of OSA underwent full attended diagnostic and CPAP titration sleep study. On baseline polysomnography, OSA patients with PLM less than 5 were considered pure OSA and those with periodic limb-movement index more than or equal to 5 were considered combined group. Post-CPAP titration, patients were considered CPAP responders, CPAP persistent, CPAP emergent, or non-PLM group according to response of PLM. Results Out of 100 included OSA patients, the combined group was found in 53 patients. CPAP responder group was reported in 27 patients, while 25 and 24 patients were considered CPAP persistent and CPAP emergent, respectively. CPAP-emergent group showed significantly higher apnea–hypopnea index (AHI) than non-PLM group on baseline polysomnography. On the other hand, AHI was comparable in CPAP-persistent and responder group, despite normalization of AHI in both groups after titration. On multivariate regression analysis, old age was found to be an independent predictor for both persistence and emergence of PLM and higher AHI was an independent predictor in CPAP-emergent group. Conclusion PLMS can coexist with OSA in old-age patients, which may persist after CPAP titration. Elderly patients, especially those with baseline higher AHI, may also present with CPAP-emergent PLMS.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"71 1","pages":"507 - 513"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77571118","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. Mousa, M. Elshazly, M. A. Abd El Salam, Salwa Ahmed
Objectives The corona virus SARS-COV-2 has affected millions of people all over the world with much affection and damage to body systems and organs, and still, its long-term effects are debatable. Up till now, a lot of ongoing researches are being conducted to evaluate the deleterious effect of coronavirus disease 2019 (COVID-19) on various systems, including reproduction, however, it is still debatable. Patients and methods Our cohort study included a total of 57 male COVID-19 patients, confirmed positive via nasopharyngeal PCR swab. The aim of the study was to evaluate the correlation between the severity of COVID-19 infection and post-COVID sequelae on male-reproductive functions as regards semen parameters and male-hormone profile at the first and third month after discharge from the hospital. Results Our results have demonstrated highly statistically significant changes in sperm concentration, sperm total, and progressive motility, as well as follicle-stimulating hormone, luteinizing hormone, and E2-hormone levels on the first and third month post-COVID infection with P value less than 0.001. In the same context, there was a statistical significance to testosterone-hormone level with P value 0.003. According to COVID-19 severity, there was a highly significant correlation between the degree of severity and affection of sperm concentration, total, and progressive motility with P value less than 0.001. In contrast, there was no significant correlation between the severity of infection and male-hormone profile. Conclusion The current study revealed a negative influence of COVID-19 infection on semen parameters as well as male-sex hormones (follicle-stimulating hormone, luteinizing hormone, testosterone, and E2) on the first and third month post-COVID infection; however, only semen parameters were affected by the degree of disease severity.
{"title":"Post-coronavirus disease 2019 sequelae on male-reproductive functions: A cohort observational study","authors":"M. Mousa, M. Elshazly, M. A. Abd El Salam, Salwa Ahmed","doi":"10.4103/ecdt.ecdt_15_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_15_22","url":null,"abstract":"Objectives The corona virus SARS-COV-2 has affected millions of people all over the world with much affection and damage to body systems and organs, and still, its long-term effects are debatable. Up till now, a lot of ongoing researches are being conducted to evaluate the deleterious effect of coronavirus disease 2019 (COVID-19) on various systems, including reproduction, however, it is still debatable. Patients and methods Our cohort study included a total of 57 male COVID-19 patients, confirmed positive via nasopharyngeal PCR swab. The aim of the study was to evaluate the correlation between the severity of COVID-19 infection and post-COVID sequelae on male-reproductive functions as regards semen parameters and male-hormone profile at the first and third month after discharge from the hospital. Results Our results have demonstrated highly statistically significant changes in sperm concentration, sperm total, and progressive motility, as well as follicle-stimulating hormone, luteinizing hormone, and E2-hormone levels on the first and third month post-COVID infection with P value less than 0.001. In the same context, there was a statistical significance to testosterone-hormone level with P value 0.003. According to COVID-19 severity, there was a highly significant correlation between the degree of severity and affection of sperm concentration, total, and progressive motility with P value less than 0.001. In contrast, there was no significant correlation between the severity of infection and male-hormone profile. Conclusion The current study revealed a negative influence of COVID-19 infection on semen parameters as well as male-sex hormones (follicle-stimulating hormone, luteinizing hormone, testosterone, and E2) on the first and third month post-COVID infection; however, only semen parameters were affected by the degree of disease severity.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"28 1","pages":"447 - 451"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82582510","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. Mohammad, A. Okab, Enas Sweed, Salwa Mohammed Elsaid, M. Sadek
Background Pulmonary embolism (PE) is a serious condition and has a clinical dilemma in diagnosis. Computed tomography pulmonary angiography (CTPA) is a gold standard in its diagnosis, but MRI has proven a good role in PE diagnosis. Aim The aim of this work was to evaluate the role of noncontrast magnetic resonance pulmonary angiography (MRPA) imaging in diagnosis of acute PE using CTPA as a gold standard. Patients and methods In total, 25 patients with PE confirmed by CTPA were included in this study. All patients underwent computed tomography angiography and noncontrast MRPA on the same day or within three consecutive days. The results were compared and statistically analyzed. Results The mean age of the study group was 46.4 ± 13.5 years. Females represent 60% (15/25) and males represent 40% (10/25). The per-vessel sensitivity of noncontrast MRPA reached to about 100% with specificity 100% at the level of the main trunk, right and left main pulmonary arteries down to segmental arteries. The sensitivity for right subsegmental branches was 25% and left subsegmental branches was 33.3%. Conclusion The noncontrast MRPA has a reasonable sensitivity and specificity in the diagnosis of PE, especially in major branches. So, it can be used as an alternative to the computed tomography angiography, especially when the computed tomography angiography and the use of gadolinium are contraindicated.
{"title":"Role of noncontrast magnetic resonance pulmonary imaging in diagnosis of pulmonary embolism","authors":"O. Mohammad, A. Okab, Enas Sweed, Salwa Mohammed Elsaid, M. Sadek","doi":"10.4103/ecdt.ecdt_62_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_62_22","url":null,"abstract":"Background Pulmonary embolism (PE) is a serious condition and has a clinical dilemma in diagnosis. Computed tomography pulmonary angiography (CTPA) is a gold standard in its diagnosis, but MRI has proven a good role in PE diagnosis. Aim The aim of this work was to evaluate the role of noncontrast magnetic resonance pulmonary angiography (MRPA) imaging in diagnosis of acute PE using CTPA as a gold standard. Patients and methods In total, 25 patients with PE confirmed by CTPA were included in this study. All patients underwent computed tomography angiography and noncontrast MRPA on the same day or within three consecutive days. The results were compared and statistically analyzed. Results The mean age of the study group was 46.4 ± 13.5 years. Females represent 60% (15/25) and males represent 40% (10/25). The per-vessel sensitivity of noncontrast MRPA reached to about 100% with specificity 100% at the level of the main trunk, right and left main pulmonary arteries down to segmental arteries. The sensitivity for right subsegmental branches was 25% and left subsegmental branches was 33.3%. Conclusion The noncontrast MRPA has a reasonable sensitivity and specificity in the diagnosis of PE, especially in major branches. So, it can be used as an alternative to the computed tomography angiography, especially when the computed tomography angiography and the use of gadolinium are contraindicated.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"96 ","pages":"526 - 530"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72417925","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}
F. Ahmadi, Z. Fallah, F. Shadmani, Meisam Allahmoradi, Pegah Salahshoor, Sheler Ahmadi, Kamyar Mansori
Background Asthma is a chronic airway disease characterized by an overreaction of the airways to a wide range of stimuli. Objective To determine the relationship between the incidence and mortality rate of asthma and the levels of PM2.5, ozone, and household air pollution (HAP) from 1990 to 2016 in the world. Materials and methods This ecological study was conducted across 194 countries. The asthma incidence and mortality rates were extracted from IHME Global Burden of Disease databases. Data on average annual population-weighted HAP, PM2.5, and ozone were obtained from the State of Global Air website. A model-based clustering with a finite mixture of matrix-variate normal distributions was used to identify countries with a similar pattern of three air pollution index values. The number of clusters was determined by the Bayesian information criterion, and R software was used for integrated completed likelihood criterion. The random-effects model was applied to evaluate the relationship between asthma incidence in groups and different years by using the SAS software. Results The countries were classified into five clusters in terms of the mean of PM2.5, ozone, and HAP. The incidence rates had a decreasing trend during 1990–2005 and an increasing trend during 2011–2016 in the clusters. The lowest incidence and mortality rates were observed for countries of cluster 3. The highest incidence and mortality rates were observed for countries in clusters 1 and 2, respectively. The incidence and mortality ratio trends experienced an increase in cluster 1 and a decrease in other clusters. Conclusions Depending on the mortality and incidence trends of asthma in countries in each cluster, effective national and international intervention measures are recommended to deal with such pollutants.
{"title":"Relationship between incidence and mortality of asthma with PM2.5, ozone, and household air pollution from 1990 to 2106 in the world: An ecological study","authors":"F. Ahmadi, Z. Fallah, F. Shadmani, Meisam Allahmoradi, Pegah Salahshoor, Sheler Ahmadi, Kamyar Mansori","doi":"10.4103/ecdt.ecdt_5_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_5_22","url":null,"abstract":"Background Asthma is a chronic airway disease characterized by an overreaction of the airways to a wide range of stimuli. Objective To determine the relationship between the incidence and mortality rate of asthma and the levels of PM2.5, ozone, and household air pollution (HAP) from 1990 to 2016 in the world. Materials and methods This ecological study was conducted across 194 countries. The asthma incidence and mortality rates were extracted from IHME Global Burden of Disease databases. Data on average annual population-weighted HAP, PM2.5, and ozone were obtained from the State of Global Air website. A model-based clustering with a finite mixture of matrix-variate normal distributions was used to identify countries with a similar pattern of three air pollution index values. The number of clusters was determined by the Bayesian information criterion, and R software was used for integrated completed likelihood criterion. The random-effects model was applied to evaluate the relationship between asthma incidence in groups and different years by using the SAS software. Results The countries were classified into five clusters in terms of the mean of PM2.5, ozone, and HAP. The incidence rates had a decreasing trend during 1990–2005 and an increasing trend during 2011–2016 in the clusters. The lowest incidence and mortality rates were observed for countries of cluster 3. The highest incidence and mortality rates were observed for countries in clusters 1 and 2, respectively. The incidence and mortality ratio trends experienced an increase in cluster 1 and a decrease in other clusters. Conclusions Depending on the mortality and incidence trends of asthma in countries in each cluster, effective national and international intervention measures are recommended to deal with such pollutants.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"5 1","pages":"457 - 463"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78413106","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 Determination of predictors of coronavirus disease 2019 (COVID-19) severe infection allows early intervention and appropriate treatment of patients at risk, so that we can improve outcome and allow better selection of patients who need hospitalization. Our aim is detection of factors linked to higher rates of complications and death in COVID-19 hospitalized patients. Results The study included 151 patients who were divided into mild, moderate, and severe groups; patients with age more than or equal to 60 were more in the severe category (P=0.001). The severe category had considerably more comorbidities (P=0.001). Patients with more than or equal to two comorbidities were more likely to be in the severe category (P=0.006). Obese patients with BMI more than 30 were substantially more likely to be in the severe category (P=0.004). Cough, fever, dyspnea, and vomiting were the most common presentations. Complications of COVID-19 infection were more likely to be detected in the severe category (P=0.001). In the severe category, lymphopenia, raised neutrophil-to-lymphocyte ratio, C-reactive protein, ferritin, lactate dehydrogenase, and D-dimer were all considerably higher. O2 saturation on admission was significantly lower in the severe group with mean (SD) of 81.23 ± 9.22. Duration of admission was significantly longer in the severe group with a range of 9 (3–27) days. Mortality rate in our study was 7.9% (12 cases); all dead cases were included within the severe group. Conclusion Physicians should consider patients diagnosed as COVID-19 with high ferritin, elevated neutrophil-to-lymphocyte ratio, lymphopenia, obesity, and high D-dimer as risky for severe infection and need hospitalization with intensive care and proper management to decrease complications, mortality, and for proper triage of COVID-19 patients in hospitals.
{"title":"Predictors of severity in coronavirus disease 2019 hospitalized patients","authors":"Shima A. Ahmed, N. Mohammed, K. Alkhayat","doi":"10.4103/ecdt.ecdt_2_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_2_22","url":null,"abstract":"Background Determination of predictors of coronavirus disease 2019 (COVID-19) severe infection allows early intervention and appropriate treatment of patients at risk, so that we can improve outcome and allow better selection of patients who need hospitalization. Our aim is detection of factors linked to higher rates of complications and death in COVID-19 hospitalized patients. Results The study included 151 patients who were divided into mild, moderate, and severe groups; patients with age more than or equal to 60 were more in the severe category (P=0.001). The severe category had considerably more comorbidities (P=0.001). Patients with more than or equal to two comorbidities were more likely to be in the severe category (P=0.006). Obese patients with BMI more than 30 were substantially more likely to be in the severe category (P=0.004). Cough, fever, dyspnea, and vomiting were the most common presentations. Complications of COVID-19 infection were more likely to be detected in the severe category (P=0.001). In the severe category, lymphopenia, raised neutrophil-to-lymphocyte ratio, C-reactive protein, ferritin, lactate dehydrogenase, and D-dimer were all considerably higher. O2 saturation on admission was significantly lower in the severe group with mean (SD) of 81.23 ± 9.22. Duration of admission was significantly longer in the severe group with a range of 9 (3–27) days. Mortality rate in our study was 7.9% (12 cases); all dead cases were included within the severe group. Conclusion Physicians should consider patients diagnosed as COVID-19 with high ferritin, elevated neutrophil-to-lymphocyte ratio, lymphopenia, obesity, and high D-dimer as risky for severe infection and need hospitalization with intensive care and proper management to decrease complications, mortality, and for proper triage of COVID-19 patients in hospitals.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"130 1","pages":"424 - 432"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77489204","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":"Cough: A possible clinical presentation of monkeypox","authors":"Pathum Sooakromdee, V. Wiwanitkit","doi":"10.4103/ecdt.ecdt_73_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_73_22","url":null,"abstract":"","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"96 1","pages":"538 - 538"},"PeriodicalIF":0.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80385104","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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