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Use of Lung Volume Recruitment Technique in Patients With Chronic Respiratory Disease Among Brazilian Health Professionals.
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2025-01-10 eCollection Date: 2025-01-01 DOI: 10.1155/pm/4073171
Robert de Melo, Livia Alcantara, Max Sarmet, Nicole L Sheers, David J Berlowitz, Vinicius Maldaner

Background: Lung volume recruitment (LVR) is a stacked-breath assisted inflation technique in which consecutive insufflations are delivered, without exhaling in between, until the maximum tolerable inflation capacity is reached. Although LVR is recommended in some neuromuscular disease guidelines, there is little information detailing when and how allied health professionals (AHPs) prescribe LVR. Objective: This study is aimed at describing the use of LVR in practice across Brazil. Methods: A cross-sectional e-survey (Sep-Nov 2023) explored LVR practices among qualified clinical or home care AHPs in Brazil. It gathered participant data on geographical region, profession, and experience. It delved into LVR specifics: clinical population and indications for use, prescription (frequency, dosage, and interfaces), related side effects, outcomes assessed, and combined therapies. Results were presented descriptively. Results: One hundred two surveys (74 physical therapists (PTs) and 28 speech and language pathologists (SLPs)) from diverse locations were collected. LVR was predominantly prescribed for adults (57%), with the most common diagnosis being amyotrophic lateral sclerosis (84%). Changes in peak cough flow and vital capacity were the most common reasons for LVR prescription. Maximal insufflation capacity was reportedly measured by 58% of PTs and 22% of SLPs. Chest wall soreness and discomfort were the most common side effects, and many respondents did not provide warnings about potential side effects (42% PTs and 50% SLPs). The study highlighted common use of other respiratory therapy devices alongside LVR. Conclusion: LVR is available in routine clinical and home care settings in Brazil. There is a lack of standardization regarding indications, prescription, and outcome measures among PTs and SLPs in Brazil. Clear recommendations and guidelines are needed to standardize these parameters, enabling more objective data and facilitating comparisons between centers.

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引用次数: 0
Research Trends of Artificial Intelligence in Lung Cancer: A Combined Approach of Analysis With Latent Dirichlet Allocation and HJ-Biplot Statistical Methods. 人工智能在肺癌中的研究趋势:潜在Dirichlet分配与HJ-Biplot统计方法的联合分析。
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2024-12-04 eCollection Date: 2024-01-01 DOI: 10.1155/pm/5911646
Javier De La Hoz-M, Karime Montes-Escobar, Viorkis Pérez-Ortiz

Lung cancer (LC) remains one of the leading causes of cancer-related mortality worldwide. With recent technological advances, artificial intelligence (AI) has begun to play a crucial role in improving diagnostic and treatment methods. It is crucial to understand how AI has integrated into LC research and to identify the main areas of focus. The aim of the study was to provide an updated insight into the role of AI in LC research, analyzing evolving topics, geographical distribution, and contributions to journals. The study explores research trends in AI applied to LC through a novel approach combining latent Dirichlet allocation (LDA) topic modeling with the HJ-Biplot statistical technique. A growing interest in AI applications in LC oncology was observed, reflected in a significant increase in publications, especially after 2017, coinciding with the availability of computing resources. Frontiers in Oncology leads in publishing AI-related LC research, reflecting rigorous investigation in the field. Geographically, China and the United States lead in contributions, attributed to significant investment in R&D and corporate sector involvement. LDA analysis highlights key research areas such as pulmonary nodule detection, patient prognosis prediction, and clinical decision support systems, demonstrating the impact of AI in improving LC outcomes. DL and AI emerge as prominent trends, focusing on radiomics and feature selection, promising better decision-making in LC care. The increase in AI-driven research covers various topics, including data analysis methodologies, tumor characterization, and predictive methods, indicating a concerted effort to advance LC research. HJ-Biplot visualization reveals thematic clustering, illustrating temporal and geographical associations and highlighting the influence of high-impact journals and countries with advanced research capabilities. This multivariate approach offers insights into global collaboration dynamics and specialization, emphasizing the evolving role of AI in LC research and diagnosis.

肺癌(LC)仍然是全球癌症相关死亡的主要原因之一。随着近年来的技术进步,人工智能(AI)开始在改善诊断和治疗方法方面发挥关键作用。了解人工智能如何融入LC研究并确定主要关注领域至关重要。这项研究的目的是为人工智能在LC研究中的作用提供最新的见解,分析不断发展的主题、地理分布和对期刊的贡献。本研究通过将潜在狄利克雷分配(latent Dirichlet allocation, LDA)主题建模与HJ-Biplot统计技术相结合的新方法,探讨了人工智能应用于LC的研究趋势。人们对LC肿瘤学中人工智能应用的兴趣日益浓厚,这反映在出版物的显著增加上,特别是在2017年之后,与计算资源的可用性相一致。《肿瘤学前沿》在发表人工智能相关LC研究方面处于领先地位,反映了该领域的严谨研究。从地理上看,中国和美国在贡献方面领先,这归因于在研发方面的大量投资和企业部门的参与。LDA分析强调了肺结节检测、患者预后预测和临床决策支持系统等关键研究领域,展示了人工智能在改善LC预后方面的影响。DL和AI成为突出的趋势,专注于放射组学和特征选择,有望在LC护理中做出更好的决策。人工智能驱动研究的增加涵盖了各种主题,包括数据分析方法、肿瘤表征和预测方法,表明了推进LC研究的一致努力。HJ-Biplot可视化显示专题聚类,说明时间和地理关联,突出高影响力期刊和具有先进研究能力的国家的影响。这种多变量方法提供了对全球协作动态和专业化的见解,强调了人工智能在LC研究和诊断中的不断发展的作用。
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引用次数: 0
Practice Variations in the Diagnosis and Treatment of Pulmonary Embolism. 肺栓塞诊断和治疗的实践差异。
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2024-11-04 eCollection Date: 2024-01-01 DOI: 10.1155/2024/6633148
Devesh Thakkar, Frances Garden, John Nguyen, Brenda Ta, Sikandar Hussaini, Claudia C Dobler

Venous thromboembolism is responsible for a significant burden of disease worldwide. Despite the publication of multiple international guidelines, anecdotal evidence suggests significant clinical variation exists in the diagnostic and management pathways of pulmonary embolism (PE). We conducted a retrospective cohort study using electronic medical records to examine clinical variation in patients admitted to a tertiary referral center in Australia with a diagnosis of PE between November 2018 and January 2020. Three hundred cases met the inclusion criteria; we found variation in rates of compression ultrasonography, acute investigation of the right ventricle, and planning of repeat imaging at specialist follow-up. Guidelines do not address the use of compression ultrasonography in already diagnosed PE, are conflicting in their recommendation for acute investigation of the right ventricle, and recommend repeat imaging only if there are persistent symptoms at the time of specialist follow-up. The variations we found in this study may in part be due to physician preference or due to the paucity of evidence for some of these diagnostic practices. Robust future studies are required to guide the use of these investigations in PE.

静脉血栓栓塞症在全球范围内造成了巨大的疾病负担。尽管发布了多个国际指南,但传闻证据表明,肺栓塞(PE)的诊断和管理路径存在显著的临床差异。我们利用电子病历开展了一项回顾性队列研究,以检查 2018 年 11 月至 2020 年 1 月期间澳大利亚一家三级转诊中心收治的诊断为 PE 的患者的临床差异。300 例病例符合纳入标准;我们发现,在专科随访时,加压超声检查、右心室急性检查和计划重复成像的比例存在差异。指南并未涉及对已确诊的 PE 使用压缩超声波检查的问题,在建议对右心室进行急性检查方面存在冲突,并且仅建议在专科随访时出现持续症状时重复成像。我们在本研究中发现的差异部分可能是由于医生的偏好,也可能是由于其中一些诊断方法缺乏证据。今后需要开展更多的研究,为在 PE 中使用这些检查方法提供指导。
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引用次数: 0
The Impact of COVID-19 Pandemic on Respiratory Syncytial Virus Infection in Children. COVID-19 大流行对儿童呼吸道合胞病毒感染的影响。
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI: 10.1155/2024/2131098
Jose Boris Trigueros Montes, Diego Montes, Andrew Miele, Won Baik-Han, Gagan Gulati, Lily Q Lew

Background/Objective: Respiratory syncytial virus (RSV) is a major cause of bronchiolitis in infants and young children. Bronchiolitis, an acute inflammation of the lower respiratory tract, can lead to pneumonia, respiratory failure, and death. We aimed to compare the incidence and severity of RSV infection in children aged 0-60 months before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: A retrospective chart review was conducted on patients aged 0-60 months who tested positive for RSV between May 1, 2018, and May 31, 2022, in a community hospital in Queens County, New York City, United States. Comparisons were made between seasons 2018-2019 and 2019-2020 as before, and seasons 2020-2021 and 2021-2022 as during the COVID-19 pandemic. Severity of RSV infection was assessed using the Bronchiolitis Severity Score (BSS). Data were analyzed using R software, a p value of < 0.05 was considered statistically significant. Results: The incidence of RSV infection in seasons 2018-2019 and 2019-2020 peaked from mid-October to February, whereas the first season during the COVID-19 pandemic (2020-2021) was truncated with a very low incidence of RSV infection, and season 2021-2022 peaked from September to January, with the highest incidence (37%) and lower frequency of RSV infection at any given point. Patients during the season 2021-2022 were older (H [2, 196.6] = 12.5, p < 0.001, 95% CI = [5.4, 25.6]) and had milder illness (H [2, 187.5] = 7.5, p < 0.01, 95% CI = [2.1, 19.2]). Conclusions: We observed a lower incidence of RSV infection and a lower rate of hospitalization for RSV during the COVID-19 pandemic. The second RSV season during the COVID-19 pandemic began earlier, lasted longer, and had a lower frequency. Older children with milder illnesses were affected most during this season. RSV epidemiology and disease burden were impacted by the COVID-19 pandemic and could have significant ramifications for its prevention and control strategies.

背景/目的:呼吸道合胞病毒(RSV)是导致婴幼儿支气管炎的主要原因。支气管炎是下呼吸道的急性炎症,可导致肺炎、呼吸衰竭和死亡。我们旨在比较 2019 年冠状病毒病(COVID-19)大流行之前和期间 0-60 个月儿童 RSV 感染的发病率和严重程度。研究方法我们对美国纽约市皇后区一家社区医院在2018年5月1日至2022年5月31日期间检测出RSV阳性的0-60个月大的患者进行了回顾性病历审查。将 2018-2019 年和 2019-2020 年这两个季节与之前进行了比较,将 2020-2021 年和 2021-2022 年这两个季节与 COVID-19 大流行期间进行了比较。RSV感染的严重程度采用支气管炎严重程度评分(BSS)进行评估。数据使用 R 软件进行分析,P 值小于 0.05 视为具有统计学意义。结果2018-2019年和2019-2020年两季的RSV感染率在10月中旬至2月达到高峰,而COVID-19大流行期间的第一个季节(2020-2021年)被截断,RSV感染率很低;2021-2022年两季的RSV感染率在9月至1月达到高峰,在任何给定时间点的RSV感染率最高(37%),频率较低。2021-2022 季度的患者年龄较大(H [2, 196.6] = 12.5,P < 0.001,95% CI = [5.4, 25.6]),病情较轻(H [2, 187.5] = 7.5,P < 0.01,95% CI = [2.1, 19.2])。结论我们观察到,在 COVID-19 大流行期间,RSV 感染率较低,RSV 住院率也较低。COVID-19 大流行期间的第二个 RSV 季节开始较早,持续时间较长,频率较低。在这一流行季节,年龄较大、病情较轻的儿童受影响最大。RSV 流行病学和疾病负担受到 COVID-19 大流行的影响,可能对其预防和控制策略产生重大影响。
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引用次数: 0
Dual-Task Performance in Individuals With Chronic Obstructive Pulmonary Disease: A Systematic Review With Meta-Analysis. 慢性阻塞性肺病患者的双任务表现:带 Meta 分析的系统性综述。
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-10 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1230287
Joselyn González Pasten, Jennifer Campos Aguayo, Javiera Aburto, Felipe Araya-Quintanilla, Alejandro Álvarez-Bustos, Juan José Valenzuela-Fuenzalida, Pat G Camp, Walter Sepúlveda-Loyola

Background: Chronic obstructive pulmonary disease (COPD) is characterized by important extrapulmonary alterations that could affect the performance in dual task (DT) (motor and cognitive tasks executed simultaneously), which is defined as DT interference (DTI). Objective: To compare the performance of DT between individuals with COPD and healthy control subjects (HCSs). Methods: The literature search was conducted in seven databases (Medline, Scopus, Web of Science, PEDro, SciELO, LILACS, and Google Scholar) up to December 2023, including studies published in English, Spanish, or Portuguese. Studies with individuals diagnosed with COPD older than 60 years, who were evaluated with any DT assessment, and compared with HCS were included. The quality of the studies was evaluated using the risk of bias in nonrandomized studies of interventions (ROBINS-I). The meta-analysis was performed with JAMOVI software 5.4. The study protocol was registered on PROSPERO (CRD42023435212). Results: From a total of 128 articles, 5 observational studies were selected in this review, involving 252 individuals aged between 60 and 80 years, from France, Italy, Canada, Turkey, and Belgium. Notable DTI was observed in individuals with COPD compared to HCS (standard mean difference [SMD] = 0.91; 95% confidence interval (CI) 0.06-1.75, p = 0.04). Individuals with COPD had impaired gait speed, balance control, muscle strength, and cognitive interference during DT compared to HCS. DT assessment protocols included different combination of motor and cognitive tasks, using functional test, gait analysis, and muscle strength paired with countdown and verbal fluency tasks. Studies presented low (n = 2), moderate (n = 1), and serious (n = 2) overall risk of bias. Conclusion: Older adults diagnosed with COPD exhibited a significant DTI compared to HCSs, which is characterized by poorer physical and cognitive performance during DT execution. These findings highlight the importance of incorporating DT assessments into clinical practice for individuals with COPD.

背景:慢性阻塞性肺疾病(COPD)的特点是重要的肺外改变,可能影响双重任务(DT)(同时执行运动和认知任务)的表现,这被定义为 DT 干扰(DTI)。目的比较慢性阻塞性肺病患者和健康对照受试者(HCSs)的 DT 表现。方法在截至 2023 年 12 月的七个数据库(Medline、Scopus、Web of Science、PEDro、SciELO、LILACS 和 Google Scholar)中进行文献检索,包括以英语、西班牙语或葡萄牙语发表的研究。研究对象包括 60 岁以上确诊为慢性阻塞性肺病的患者,他们接受了任何 DT 评估,并与 HCS 进行了比较。研究质量采用非随机干预研究偏倚风险(ROBINS-I)进行评估。荟萃分析使用 JAMOVI 软件 5.4 进行。研究方案已在 PROSPERO(CRD42023435212)上注册。研究结果本综述从 128 篇文章中选出了 5 项观察性研究,涉及 252 名年龄在 60 至 80 岁之间的患者,他们分别来自法国、意大利、加拿大、土耳其和比利时。与慢性阻塞性肺病患者相比,慢性阻塞性肺病患者的 DTI 显著增加(标准平均差 [SMD] = 0.91;95% 置信区间 (CI) 0.06-1.75,P = 0.04)。与 HCS 相比,慢性阻塞性肺病患者在 DT 过程中的步速、平衡控制、肌肉力量和认知干扰都有所减弱。DT 评估方案包括不同的运动和认知任务组合,使用功能测试、步态分析、肌力与倒计时和语言流畅性任务配对。研究的总体偏倚风险较低(2 项)、中等(1 项)和严重(2 项)。结论与高危人群相比,诊断出慢性阻塞性肺病的老年人表现出明显的 DTI,其特点是在执行 DT 时身体和认知表现较差。这些发现强调了将 DT 评估纳入慢性阻塞性肺病患者临床实践的重要性。
{"title":"Dual-Task Performance in Individuals With Chronic Obstructive Pulmonary Disease: A Systematic Review With Meta-Analysis.","authors":"Joselyn González Pasten, Jennifer Campos Aguayo, Javiera Aburto, Felipe Araya-Quintanilla, Alejandro Álvarez-Bustos, Juan José Valenzuela-Fuenzalida, Pat G Camp, Walter Sepúlveda-Loyola","doi":"10.1155/2024/1230287","DOIUrl":"10.1155/2024/1230287","url":null,"abstract":"<p><p><b>Background:</b> Chronic obstructive pulmonary disease (COPD) is characterized by important extrapulmonary alterations that could affect the performance in dual task (DT) (motor and cognitive tasks executed simultaneously), which is defined as DT interference (DTI). <b>Objective:</b> To compare the performance of DT between individuals with COPD and healthy control subjects (HCSs). <b>Methods:</b> The literature search was conducted in seven databases (Medline, Scopus, Web of Science, PEDro, SciELO, LILACS, and Google Scholar) up to December 2023, including studies published in English, Spanish, or Portuguese. Studies with individuals diagnosed with COPD older than 60 years, who were evaluated with any DT assessment, and compared with HCS were included. The quality of the studies was evaluated using the risk of bias in nonrandomized studies of interventions (ROBINS-I). The meta-analysis was performed with JAMOVI software 5.4. The study protocol was registered on PROSPERO (CRD42023435212). <b>Results:</b> From a total of 128 articles, 5 observational studies were selected in this review, involving 252 individuals aged between 60 and 80 years, from France, Italy, Canada, Turkey, and Belgium. Notable DTI was observed in individuals with COPD compared to HCS (standard mean difference [SMD] = 0.91; 95% confidence interval (CI) 0.06-1.75, <i>p</i> = 0.04). Individuals with COPD had impaired gait speed, balance control, muscle strength, and cognitive interference during DT compared to HCS. DT assessment protocols included different combination of motor and cognitive tasks, using functional test, gait analysis, and muscle strength paired with countdown and verbal fluency tasks. Studies presented low (<i>n</i> = 2), moderate (<i>n</i> = 1), and serious (<i>n</i> = 2) overall risk of bias. <b>Conclusion:</b> Older adults diagnosed with COPD exhibited a significant DTI compared to HCSs, which is characterized by poorer physical and cognitive performance during DT execution. These findings highlight the importance of incorporating DT assessments into clinical practice for individuals with COPD.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"1230287"},"PeriodicalIF":2.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Establishing the Safety and Efficacy of Bedaquiline-Containing Regimen for the Treatment of Drug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. 确定含贝达喹治疗耐药结核病的安全性和有效性:随机临床试验的系统回顾和元分析》。
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2024-08-09 eCollection Date: 2024-01-01 DOI: 10.1155/2024/5542658
Muhammad Candragupta Jihwaprani, Yipeng Sun, Wahyu Choirur Rizky, Idris Sula, Nazmus Saquib

The risks and benefits of bedaquiline (BDQ) for treatment of drug-resistant tuberculosis (DR-TB) have not been firmly established. We aimed to assess the safety and efficacy of BDQ-containing regimens for the treatment of DR-TB as evidenced in available randomized controlled trials (RCTs). In this systematic review and meta-analysis, five databases (i.e., ClinicalTrials.gov, Cochrane CENTRAL, PubMed, ScienceDirect, and SinoMed) were searched. RCTs among DR-TB patients that had a control arm were eligible. The safety endpoints were all-cause mortality and serious adverse effects (SAEs). Efficacy outcomes were sputum culture conversion rate at 8-12 weeks and 24-26 weeks, treatment success, and time to culture conversion. A total of 476 records were screened; 18 met the eligibility criteria. The pooled analysis included 2520 participants (55.8% received BDQ-containing regimens, n = 1408). Pooled safety outcomes showed no significant reduction in all-cause mortality (relative risk [RR] [95%confidence interval (CI)] = 0.94 [0.41-2.20]) or SAEs (RR [95%CI] = 0.91 [0.67-1.23]) in the BDQ-regimen group. Pooled efficacy outcomes showed significantly superior culture conversion rates at 8-12 weeks (RR [95%CI] = 1.35 [1.10-1.65]) and 24-26 weeks (RR [95%CI] = 1.25 [1.15-1.36]), more treatment success (RR [95%CI] = 1.30 [1.17-1.44]), and a 17-day reduction in the time to culture conversion (standardized mean difference [SMD] [95%CI] = -17.46 [-34.82 to -0.11]) in the BDQ-regimen group (reference: non-BDQ regimen). Overall, BDQ regimens showed significant treatment effect against DR-TB but did not reduce mortality or SAEs.

贝达喹啉(BDQ)治疗耐药结核病(DR-TB)的风险和益处尚未得到证实。我们的目的是评估现有随机对照试验(RCT)证明的含贝达喹啉治疗 DR-TB 的安全性和有效性。在本系统综述和荟萃分析中,检索了五个数据库(即 ClinicalTrials.gov、Cochrane CENTRAL、PubMed、ScienceDirect 和 SinoMed)。在 DR-TB 患者中进行的有对照组的 RCT 符合条件。安全性终点为全因死亡率和严重不良反应(SAE)。疗效结局为 8-12 周和 24-26 周的痰培养转换率、治疗成功率和培养转换时间。共筛选出 476 份记录,其中 18 份符合资格标准。汇总分析包括 2520 名参与者(55.8% 接受了含 BDQ 方案,n = 1408)。汇总的安全性结果显示,BDQ方案组的全因死亡率(相对风险[RR][95%置信区间(CI)] = 0.94 [0.41-2.20])或SAE(RR [95%CI] = 0.91 [0.67-1.23])没有显著降低。汇总疗效结果显示,8-12 周(RR [95%CI] = 1.35 [1.10-1.65])和 24-26 周(RR [95%CI] = 1.25 [1.15-1.36])培养转换率明显优于对照组,治疗成功率更高(RR [95%CI] = 1.30 [1.17-1.44]),BDQ方案组(参考:非BDQ方案)的培养转换时间缩短了17天(标准化平均差[SMD] [95%CI] = -17.46 [-34.82 to -0.11])。总体而言,BDQ方案对DR-TB有显著的治疗效果,但并未降低死亡率或SAEs。
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引用次数: 0
Adherence to the ISHLT Protocol for the Referral of Patients with Idiopathic Pulmonary Fibrosis to the Transplantation Center among of Czech Centers for Interstitial Lung Diseases. 捷克肺间质疾病中心间肺移植中心转诊特发性肺纤维化患者遵守 ISHLT 协议的情况。
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2024-06-30 eCollection Date: 2024-01-01 DOI: 10.1155/2024/5918042
Martina Sterclova, Martina Doubkova, Lubica Sykorova, Vladimir Bartos, Monika Zurkova, Vladimira Lostakova, Radka Mokosova, Martina Plackova, Ladislav Lacina, Michaela Cimrova, Radka Bittenglova, Pavlina Lisa, Pavla Musilova, Daniel Dolezal, Jana Psikalova, Petra Ovesna, Martina Koziar Vasakova

There are limited data on referral rates and the number of patients with idiopathic pulmonary fibrosis (IPF) who are eligible for lung transplantation. The aim of the present study was to assess adherence to the consensus of the International Society for Heart and Lung Transplantation (ISHLT) for the referral of patients with IPF among Czech interstitial lung disease (ILD) centers. Czech patients who were diagnosed with IPF between 1999 and 2021 (n = 1584) and who were less than 65 years old at the time of diagnosis were retrospectively selected from the Czech Republic of the European Multipartner Idiopathic Pulmonary Fibrosis Registry (EMPIRE). Nonsmokers and ex-smokers with a body mass index (BMI) of <32 kg/m2 (n = 404) were included for further analyses. Patients with a history of cancer <5 years from the time of IPF diagnosis, patients with alcohol abuse, and patients with an accumulation of vascular comorbidities were excluded. The trajectory of individual patients was verified at the relevant ILD center. From the database of transplant patients (1999-12/2021, n = 541), all patients who underwent transplantation for pulmonary fibrosis (n = 186) were selected, and the diagnosis of IPF was subsequently verified from the patient's medical records (n = 67). A total of 304 IPF patients were eligible for lung transplantation. Ninety-six patients were referred to the transplant center, 50% (n = 49) of whom were referred for lung transplantation. Thirty percent of potentially eligible patients not referred to the transplant center were considered to have too many comorbidities by the reporting physician, 19% of IPF patients denied lung transplantation, and 17% were not referred due to age. Among Czech patients with IPF, there may be a larger pool of potential lung transplant candidates than has been reported to the transplant center to date.

关于转诊率和符合肺移植条件的特发性肺纤维化(IPF)患者人数的数据十分有限。本研究旨在评估捷克间质性肺病(ILD)中心是否遵守国际心肺移植学会(ISHLT)关于IPF患者转诊的共识。研究人员从欧洲多伙伴特发性肺纤维化注册中心(EMPIRE)捷克共和国分中心回顾性筛选出1999年至2021年期间确诊为IPF的捷克患者(n = 1584),这些患者确诊时年龄不到65岁。体重指数(BMI)为 2 的非吸烟者和戒烟者(n = 404)被纳入进一步分析。选择了有癌症病史的患者(n = 541)、所有因肺纤维化而接受移植手术的患者(n = 186),随后从患者的医疗记录中核实了 IPF 的诊断(n = 67)。共有304名IPF患者符合肺移植条件。96名患者被转诊至移植中心,其中50%(n = 49)的患者被转诊进行肺移植手术。在未被转诊至移植中心的潜在合格患者中,有30%的患者被报告医生认为合并症过多,19%的IPF患者拒绝肺移植,17%的患者因年龄原因未被转诊。在捷克的 IPF 患者中,潜在的肺移植候选者人数可能比迄今为止向移植中心报告的人数要多。
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引用次数: 0
Bilothorax: A Case Report and Systematic Literature Review of the Rare Entity. 双气胸:罕见病例的病例报告和系统文献综述。
IF 2 Q3 RESPIRATORY SYSTEM Pub Date : 2024-06-21 eCollection Date: 2024-01-01 DOI: 10.1155/2024/3973056
Roshan Acharya, Smita Kafle, Yub Raj Sedhai, Dhan Bahadur Shrestha, Kevin Walsh, Wasif Elahi Shamsi, Suraj Gyawali, Nikita Acharya, Anthony Lukas Loschner, Edmundo Raul Rubio

Background: Bilothorax is defined as the presence of bile in the pleural space. It is a rare condition, and diagnosis is confirmed with a pleural fluid-to-serum bilirubin ratio of >1.

Methods: The PubMed, Embase, Google Scholar, and CINAHL databases were searched using predetermined Boolean parameters. The systematic literature review was done per PRISMA guidelines. Retrospective studies, case series, case reports, and conference abstracts were included. The patients with reported pleural fluid analyses were pooled for fluid parameter data analysis.

Results: Of 838 articles identified through the inclusion criteria and removing 105 duplicates, 732 articles were screened with abstracts, and 285 were screened for full article review. After this, 123 studies qualified for further detailed review, and of these, 115 were pooled for data analysis. The mean pleural fluid and serum bilirubin levels were 72 mg/dL and 61 mg/dL, respectively, with a mean pleural fluid-to-serum bilirubin ratio of 3.47. In most cases, the bilothorax was reported as a subacute or remote complication of hepatobiliary surgery or procedure, and traumatic injury to the chest or abdomen was the second most common cause. Tube thoracostomy was the main treatment modality (73.83%), followed by serial thoracentesis. Fifty-two patients (51.30%) had associated bronchopleural fistulas. The mortality was considerable, with 18/115 (15.65%) reported death. Most of the patients with mortality had advanced hepatobiliary cancer and were noted to die of complications not related to bilothorax.

Conclusion: Bilothorax should be suspected in patients presenting with pleural effusion following surgical manipulation of hepatobiliary structures or a traumatic injury to the chest. This review is registered with CRD42023438426.

背景:胆气胸是指胸膜腔内出现胆汁。这是一种罕见病,胸腔积液与血清胆红素的比值大于 1 时即可确诊:方法:使用预先确定的布尔参数在 PubMed、Embase、Google Scholar 和 CINAHL 数据库中进行检索。根据 PRISMA 指南进行了系统性文献综述。纳入了回顾性研究、系列病例、病例报告和会议摘要。对有胸腔积液分析报告的患者进行汇总,以进行积液参数数据分析:通过纳入标准确定的 838 篇文章中,去除 105 篇重复文章,筛选出 732 篇文章的摘要,并筛选出 285 篇文章进行全文审阅。之后,123 项研究符合进一步详细审查的条件,其中 115 项研究被集中起来进行数据分析。胸腔积液和血清胆红素的平均水平分别为 72 毫克/分升和 61 毫克/分升,胸腔积液与血清胆红素的平均比值为 3.47。在大多数病例中,胆气胸是肝胆手术或程序的亚急性或远期并发症,胸部或腹部外伤是第二大常见原因。管式胸腔造口术是主要的治疗方式(73.83%),其次是连续胸腔穿刺术。52 名患者(51.30%)伴有支气管胸膜瘘。死亡率相当高,18/115(15.65%)例报告死亡。大多数死亡患者都是肝胆癌晚期患者,他们死于与胆气胸无关的并发症:结论:对肝胆结构进行手术操作或胸部受到外伤后出现胸腔积液的患者应怀疑胆气胸。本评论已注册为 CRD42023438426。
{"title":"Bilothorax: A Case Report and Systematic Literature Review of the Rare Entity.","authors":"Roshan Acharya, Smita Kafle, Yub Raj Sedhai, Dhan Bahadur Shrestha, Kevin Walsh, Wasif Elahi Shamsi, Suraj Gyawali, Nikita Acharya, Anthony Lukas Loschner, Edmundo Raul Rubio","doi":"10.1155/2024/3973056","DOIUrl":"10.1155/2024/3973056","url":null,"abstract":"<p><strong>Background: </strong>Bilothorax is defined as the presence of bile in the pleural space. It is a rare condition, and diagnosis is confirmed with a pleural fluid-to-serum bilirubin ratio of >1.</p><p><strong>Methods: </strong>The PubMed, Embase, Google Scholar, and CINAHL databases were searched using predetermined Boolean parameters. The systematic literature review was done per PRISMA guidelines. Retrospective studies, case series, case reports, and conference abstracts were included. The patients with reported pleural fluid analyses were pooled for fluid parameter data analysis.</p><p><strong>Results: </strong>Of 838 articles identified through the inclusion criteria and removing 105 duplicates, 732 articles were screened with abstracts, and 285 were screened for full article review. After this, 123 studies qualified for further detailed review, and of these, 115 were pooled for data analysis. The mean pleural fluid and serum bilirubin levels were 72 mg/dL and 61 mg/dL, respectively, with a mean pleural fluid-to-serum bilirubin ratio of 3.47. In most cases, the bilothorax was reported as a subacute or remote complication of hepatobiliary surgery or procedure, and traumatic injury to the chest or abdomen was the second most common cause. Tube thoracostomy was the main treatment modality (73.83%), followed by serial thoracentesis. Fifty-two patients (51.30%) had associated bronchopleural fistulas. The mortality was considerable, with 18/115 (15.65%) reported death. Most of the patients with mortality had advanced hepatobiliary cancer and were noted to die of complications not related to bilothorax.</p><p><strong>Conclusion: </strong>Bilothorax should be suspected in patients presenting with pleural effusion following surgical manipulation of hepatobiliary structures or a traumatic injury to the chest. This review is registered with CRD42023438426.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"3973056"},"PeriodicalIF":2.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11213635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and Imaging Characteristics of Smear Negative Pulmonary Tuberculosis Patients: A Comparative Study. 涂片阴性肺结核患者的临床和影像学特征:比较研究
IF 4.3 Q3 RESPIRATORY SYSTEM Pub Date : 2024-03-06 eCollection Date: 2024-01-01 DOI: 10.1155/2024/2182088
Alem Alemayehu, Liya Wassie, Sebsib Neway, Samuel Ayele, Abraham Assefa, Kidist Bobosha, Beyene Petros, Rawleigh Howe

Background: Prevalence surveys in Ethiopia indicate smear negative pulmonary tuberculosis (SNPTB) taking the major share of the overall TB burden. It has also been a diagnostic dilemma worldwide leading to diagnostic delays and difficulty in monitoring treatment outcomes. This study determines and compares the clinical and imaging findings in SNPTB and smear positive PTB (SPPTB). Methodology. A case-control study was conducted on 313 PTB (173 SNPTB) patients. Data and sputum samples were collected from consented patients. Smear microscopy, GeneXpert, and culture analyses were performed on sputum samples. Data were analyzed using Stata version 17; a P value < 0.05 was considered statistically significant.

Results: Of the 173 SNPTB patients, 42% were culture positive with discordances between test results reported by health facilities and Armauer Hansen Research Institute laboratory using concentrated smear microscopy. A previous history of TB and fewer cavitary lesions were significantly associated with SNPTB.

Conclusions: Though overall clinical presentations of SNPTB patients resemble those seen in SPPTB patients, a prior history of TB was strongly associated with SNPTB. Subject to further investigations, the relatively higher discrepancies seen in TB diagnoses reflect the posed diagnostic challenges in SNPTB patients, as a higher proportion of these patients are also seen in Ethiopia.

背景:埃塞俄比亚的发病率调查显示,涂片阴性肺结核(SNPTB)在整个结核病负担中占主要份额。它也一直是世界范围内的诊断难题,导致诊断延误和难以监测治疗效果。本研究确定并比较 SNPTB 和涂片阳性肺结核(SPTB)的临床和影像学结果。研究方法对 313 例 PTB(173 例 SNPTB)患者进行了病例对照研究。从同意的患者处收集数据和痰液样本。对痰样本进行涂片显微镜检查、GeneXpert 和培养分析。数据使用 Stata 17 版进行分析,P 值小于 0.05 为具有统计学意义:在173名SNPTB患者中,42%的患者培养呈阳性,医疗机构和Armauer Hansen研究所实验室使用浓缩涂片显微镜报告的检测结果不一致。既往结核病史和较少的空洞性病变与 SNPTB 有显著相关性:尽管SNPTB患者的总体临床表现与SPPTB患者相似,但既往结核病史与SNPTB密切相关。有待进一步研究的是,结核病诊断中出现的相对较高的差异反映了SNPTB患者在诊断上面临的挑战,因为这些患者在埃塞俄比亚的比例也较高。
{"title":"Clinical and Imaging Characteristics of Smear Negative Pulmonary Tuberculosis Patients: A Comparative Study.","authors":"Alem Alemayehu, Liya Wassie, Sebsib Neway, Samuel Ayele, Abraham Assefa, Kidist Bobosha, Beyene Petros, Rawleigh Howe","doi":"10.1155/2024/2182088","DOIUrl":"10.1155/2024/2182088","url":null,"abstract":"<p><strong>Background: </strong>Prevalence surveys in Ethiopia indicate smear negative pulmonary tuberculosis (SNPTB) taking the major share of the overall TB burden. It has also been a diagnostic dilemma worldwide leading to diagnostic delays and difficulty in monitoring treatment outcomes. This study determines and compares the clinical and imaging findings in SNPTB and smear positive PTB (SPPTB). <i>Methodology</i>. A case-control study was conducted on 313 PTB (173 SNPTB) patients. Data and sputum samples were collected from consented patients. Smear microscopy, GeneXpert, and culture analyses were performed on sputum samples. Data were analyzed using Stata version 17; a <i>P</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 173 SNPTB patients, 42% were culture positive with discordances between test results reported by health facilities and Armauer Hansen Research Institute laboratory using concentrated smear microscopy. A previous history of TB and fewer cavitary lesions were significantly associated with SNPTB.</p><p><strong>Conclusions: </strong>Though overall clinical presentations of SNPTB patients resemble those seen in SPPTB patients, a prior history of TB was strongly associated with SNPTB. Subject to further investigations, the relatively higher discrepancies seen in TB diagnoses reflect the posed diagnostic challenges in SNPTB patients, as a higher proportion of these patients are also seen in Ethiopia.</p>","PeriodicalId":46434,"journal":{"name":"Pulmonary Medicine","volume":"2024 ","pages":"2182088"},"PeriodicalIF":4.3,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Retrospective Cohort Study Evaluating the Safety and Efficacy of Sequential versus Concurrent Intrapleural Instillation of Tissue Plasminogen Activator and DNase for Pleural Infection 一项回顾性队列研究,评估胸膜腔内同时灌注组织浆细胞酶原激活剂和 DNase 治疗胸膜感染的安全性和有效性
IF 4.3 Q3 RESPIRATORY SYSTEM Pub Date : 2023-12-18 DOI: 10.1155/2023/6340851
K. Goh, Wui Mei Chew, J. Ong, C. Leong, Imran Bin Mohamed Noor, D. Anantham, Li Yan Sandra Hui, Mindy Chu Ming Choong, Charlene Jin Yee Liew, Marnie Tamayo Gutierrez, Jane Wong, Ivana Phua, Wen Ting Lim, Qiao Li Tan
Background and Objective. Intrapleural tissue plasminogen activator/deoxyribonuclease (tPA/DNase) is increasingly being used for pleural infections. Compared to sequential instillation of tPA/DNase, concurrent instillation considerably reduces the complexity of the administration process and reduces workload and the number of times the chest drain is accessed. However, it remains unclear if concurrent intrapleural therapy is as efficacious or safe as sequential intrapleural therapy. Methods. We conducted a retrospective review of patients with pleural infection requiring intrapleural therapy at two tertiary referral centres. Results. We included 84 (62.2%) and 51 (37.8%) patients who received sequential and concurrent intrapleural therapy, respectively. Patient demographics and clinical characteristics, including age, RAPID score, and percentage of pleural opacity on radiographs before intrapleural therapy, were similar in both groups. Treatment failure rates (defined by either in-hospital mortality, surgical intervention, or 30-day readmission for pleural infection) were 9.5% and 5.9% with sequential and concurrent intrapleural therapy, respectively ( p = 0.534 ). This translates to a treatment success rate of 90.5% and 94.1% for sequential and concurrent intrapleural therapy, respectively. There was no significant difference in the decrease in percentage of pleural effusion size on chest radiographs (15.1% [IQR 6-35.7] versus 26.6% [IQR 9.9-38.7], p = 0.143 ) between sequential and concurrent therapy, respectively. There were also no significant differences in the rate of pleural bleeding (4.8% versus 9.8%, p = 0.298 ) and chest pain (13.1% versus 9.8%, p = 0.566 ) between sequential and concurrent therapy, respectively. Conclusion. Our study adds to the growing literature on the safety and efficacy of concurrent intrapleural therapy in pleural infection.
背景和目的。胸膜腔内组织纤溶酶原激活剂/脱氧核糖核酸酶(tPA/DNase)越来越多地被用于治疗胸膜感染。与连续灌注 tPA/DNase 相比,同时灌注大大降低了给药过程的复杂性,减少了工作量和胸腔引流管的使用次数。然而,目前还不清楚同期胸膜腔内治疗是否与顺序胸膜腔内治疗一样有效或安全。方法。我们对两家三级转诊中心需要胸膜腔内治疗的胸膜感染患者进行了回顾性研究。结果我们分别纳入了 84 例(62.2%)和 51 例(37.8%)接受序贯胸膜腔内治疗和同期胸膜腔内治疗的患者。两组患者的人口统计学和临床特征(包括年龄、RAPID评分和胸膜腔内治疗前X光片上胸膜不透明的百分比)相似。治疗失败率(定义为院内死亡、手术干预或因胸膜感染而再次入院 30 天)在连续胸膜腔内治疗和同期胸膜腔内治疗中分别为 9.5% 和 5.9% (P = 0.534)。这意味着序贯胸膜腔内疗法和同期胸膜腔内疗法的治疗成功率分别为 90.5% 和 94.1%。序贯疗法和并发疗法在胸片上胸腔积液面积减少的百分比上没有明显差异(15.1% [IQR 6-35.7] 对 26.6% [IQR 9.9-38.7],p = 0.143)。在胸膜出血率(4.8% 对 9.8%,P = 0.298)和胸痛率(13.1% 对 9.8%,P = 0.566)方面,序贯疗法和同期疗法也分别没有明显差异。结论我们的研究为越来越多有关胸膜腔内同时治疗胸膜感染的安全性和有效性的文献增添了新的内容。
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引用次数: 0
期刊
Pulmonary Medicine
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