Lung India最新文献

Introduction: Lung ultrasound is emerging as a rapid, simple and safe alternative for diagnosing pneumonia since it has a higher sensitivity than X-rays and lower radiation exposure than computerized tomography. This is a prospective observational study done at a tertiary care centre in Chennai to study the diagnostic utility of lung ultrasound in pneumonia.

Methods: Children aged 1 month to 12 years who were admitted to the hospital with complaints of cough, fever and/or breathing difficulty and on examination had tachypnea and/or chest indrawing were included in the study. All children underwent chest X-rays which was a standard hospital protocol. At admission, an independent investigator who was blinded to the clinical and radiological features of the child performed lung ultrasound. In all children, the final diagnosis of pneumonia was made by another independent expert paediatrician on the basis of the clinical features and chest X-ray. The test characteristics of ultrasound and chest X-ray were compared against this gold standard of physician-diagnosed pneumonia.

Results: Out of the 252 children studied, 225 (89.3%) had pneumonia while the rest 27 (10.7%) had other diagnoses. Among the 225 children with pneumonia, 223 (99.1%) were detected by ultrasound while 157 (69.8%) were detected by chest X-ray. All the test characteristics such as sensitivity, specificity, positive and negative predictive values of ultrasound were higher than those of chest X-ray. The sensitivity and specificity of ultrasound to diagnose pneumonia were 99.11% and 81.48%, respectively, while the sensitivity and specificity of X-ray for the same were 69.77% and 74.07%, respectively. Overall diagnostic accuracy for chest ultrasonography was 97.22% (94.36% to 98.88%), whereas for chest radiography, it was found to be 70.24% (64.18% to 75.81%).While both modalities were able to diagnose pneumonia significantly, ultrasound had better strength of association (Cramer's V value = 0.849) than X-ray to the final diagnosis.

Conclusion: Lung ultrasound can be employed as a point-of-care investigation to diagnose pneumonia in suspected cases and can even replace chest X-ray in such circumstances.

Abstract: Prolonged air leak (PAL) represents the most commonly encountered complication following pulmonary resection. This review aims to show the role of autologous blood pleurodesis (ABPP) in the management of PAL. A search was conducted on the Web of Science, PubMed, MEDLINE, and Google Scholar for English-language articles until September 15, 2023, with titles containing the related phrase "autologous blood patch pleurodesis (ABPP), and prolonged air leaks." Included studies comprised four randomised controlled trials, ten cohort studies, a case series, and nine case reports from various countries. Patients undergoing ABPP had a mean age of 52.7 years. Autologous blood volumes for pleurodesis varied (50 mL to 250 mL). Approximately 73.8% of cases responded to ABPP in 1 to 30 days (mean 3.75 days), and in-hospital complications were infrequent (3.9%). Follow-up durations post pleurodesis were up to 20 months. The evidence presented in this systematic review supports the role of ABPP as an effective and safe intervention for managing PAL, particularly after pulmonary resection.

Background: Persistent dyspnoea and pulmonary function impairment are common after coronavirus disease 2019 (COVID-19). However, long-term outcomes beyond 2 years of infection are unknown.

Methods: In this single-center study, we observed the trend of self-reported dyspnoea and pulmonary functions among subjects attending a post-COVID clinic in India after 2 years of COVID-19 illness. Using logistic regression, we explored the clinico-demographic factors associated with persistent dyspnoea and impaired lung functions beyond 2 years.

Results: Among 231 included subjects (68.8% male) with a mean [standard deviation (SD)] age of 44.8 (13.2) years, 119 (51.5%) had recovered from moderate-to-severe COVID-19. The median [inter-quartile range (IQR)] time intervals from COVID-19 diagnosis (T0) to clinical enrolment (T1) and final follow-up (T2) were 3.3 (1.9-5.5) months and 29.5 (27.2-32.2) months, respectively. Between T1 and T2, the prevalence of self-reported dyspnoea remained stable in the whole cohort (39.4% vs. 36.4%, P = 0.26) but declined in the sub-group with moderate-to-severe COVID-19 (63% vs. 54.6%, P = 0.03). Persistent dyspnoea at T2 was associated with female sex (P = 0.007), moderate-to-severe COVID-19 (P < 0.001), and infection during the delta wave (P < 0.001). At T2, impairment in forced vital capacity (FVC) was seen in 48.1% subjects. Persistently impaired FVC was associated with older age (P value = 0.047), female sex (P value <0.001), and infection during the delta wave (P value = 0.02).

Conclusion: Persistent self-reported dyspnoea and impaired pulmonary functions were common in COVID-19 survivors beyond 2 years of infection. Female sex and infection during the delta wave were associated with long-term impairments.

Background: In settings with high burden of extrapulmonary tuberculosis, the use of various diagnostic modalities can result in superior and quick diagnosis leading to prompt initiation of treatment.

Objective: This study assessed the diagnostic performance of the fine-needle aspiration cytology (FNAC), Ziehl-Neelsen (ZN) stain, fluorescence microscopy (FM) and cartridge-based nucleic acid amplification test (CBNAAT) in patients with suspected tuberculous lymphadenitis (TBLN).

Methods: This cross-sectional studyodes, who underwent FNAC. The FNAC samples were subjected to cytomorphological examinati involved 255 patients clinically suspected of TBLN with palpable lymph non, ZN stain, FM and CBNAAT. The diagnostic performance of each modality was compared with CBNAAT, and combined performance was determined. The diagnostic performance of CBNAAT was determined by comparing it with composite reference standard.

Results: Of 255 patients, 148 (58.04%) showed features of TBLN on FNAC. The presence of epithelioid cell granulomas with caseous necrosis (67.57%) was the predominant cytomorphological pattern. On ZN stain, FM and CBNAAT, 31 (20.95%), 63 (42.57%) and 100 (67.57%) patients were found to be positive for TBLN, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of CBNAAT was 58.59%, 91.83%, 92% and 58.06%, respectively. Finally, the combination of ZN stain, FM and CBNAAT led to the detection of 88.51% patients with TBLN.

Conclusion: Combined use of ZN stain, FM and CBNAAT leads to superior and swift diagnosis of patients with clinically suspected TBLN.

Abstract: Recurrent pulmonary infections starting from childhood often prompt evaluation for primary immunodeficiency disorders (PIDs). Hyper IgE syndrome (HIES) is a less common PID characterised by recurrent skin and pulmonary infections associated with elevated IgE levels. Staphylococcal infections are more commonly seen in these individuals, resulting in structural lung abnormalities such as pneumatoceles and bronchiectasis. The associated non-immunologic features (characteristic facies, retained primary dentition, scoliosis, osteopenia, and hyperextensible joints) should raise suspicion of this syndrome. We present four cases of HIES and review the pulmonary manifestations in this disease as reported in the Indian literature.