Lung India最新文献

Background: Bronchiectasis is a chronic respiratory condition characterised by abnormal bronchial dilation, often accompanied by inflammation and infection. Tumour necrosis factor-alpha (TNF α) has been implicated in inflammatory processes, and its role in bronchiectasis severity remains underexplored. This study aimed to assess the correlation between serum TNF α levels and bronchiectasis severity using established scoring systems.

Methods: A cross-sectional study was conducted among 96 patients diagnosed with bronchiectasis. Serum TNF α levels were measured and analysed in relation to clinical parameters, radiological features, and severity scores such as FACED and Bronchiectasis Severity Index (BSI). Statistical tests including the Mann-Whitney U-test and Kruskal-Wallis test were used to identify significant associations.

Results: Elevated serum TNF α levels were significantly associated with fever, leukocytosis, recent hospital admissions, and bronchiectasis exacerbations. Patients with multi-lobar involvement and bilateral lung disease exhibited significantly higher TNF α levels (P = 0.01). Pseudomonas colonisation was linked to increased TNF α levels. Severity scoring demonstrated a strong association with TNF α levels, with higher values seen in patients categorised as moderate or severe by FACED and BSI scores.

Conclusion: Serum TNF α levels are a potential biomarker for assessing bronchiectasis severity. Elevated TNF α levels were notably linked to exacerbations, microbial colonisation, and severe disease presentations, underscoring its clinical relevance in guiding prognosis and management strategies.

Postoperative pneumonia (POP) represents a significant complication in lung cancer (LC) patients following lung resection, contributing to poor outcomes. This systematic review and meta-analysis aimed to identify clinical predictors and outcomes of POP in LC. A systematic search was conducted in EBSCOhost, Embase, PubMed/MEDLINE, Scopus, and Web of Science, with screening and reporting following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Meta-analyses were performed in Jamovi 2.3.28, reporting results as odds ratios (OR) or standardised mean differences (SMD). Egger's test and Fail-safe N were used to assess publication bias and evidence robustness (PROSPERO: CRD42024551104). A total of 17 studies encompassing 21,104 LC patients (1,610 with POP and 19,494 without) were included. Reduced FEV1 (SMD: -0.48, 95%CI: [- 0.61, -0.36], P < 0.001) predicted POP. Surgical predictors of POP included VATS (OR: 0.575, 95%CI: [0.448, 0.737], P < 0.001), segmentectomy (OR: 0.459, 95%CI: [0.261, 0.805], P = 0.007), wedge resection (OR: 1.828, 95%CI: [1.189, 2.809], P = 0.006), lobectomy (OR: 0.626, 95%CI: [0.488, 0.803], P < 0.001), bilobectomy (OR: 2.367, 95%CI: [1.408, 3.979], P = 0.001), and pneumonectomy (OR: 1.750, 95%CI: [1.178, 2.600], P = 0.006). Left lung tumours increased POP risk (OR: 1.254, 95%CI: [1.050, 1.499], P = 0.013), while right lung tumours were protective (OR: 0.801, 95%CI: [0.670, 0.975], P = 0.015). POP was associated with longer surgery (SMD: 0.22, 95% CI: [0.11, 0.34], P < 0.001), extended hospitalisation (SMD: 1.19, 95%CI: [1.07, 1.30], P < 0.001), and significantly higher overall mortality OR: 12.12, 95% CI: [5.540, 26.550], P < 0.001). POP in LC patients is influenced by respiratory function, surgical approach, and tumour location, and predicts poor survival, emphasising the need for preventive strategies.

Background: Airway stenting is a complex bronchoscopic intervention that is infrequently performed in children due to limited training opportunities and a lack of appropriate paediatric equipment. We present our institutional data on children (<18 years) who underwent airway stent placement for various tracheobronchial pathologies.

Methods: We conducted a retrospective study of children with notable airway anomalies who underwent stent placement at our institute over a 3.5-year period (January 1, 2020, to June 30, 2023). Data collected included patient age, type and severity of airway obstruction, clinical condition at presentation, type of stent used, complications, outcomes, and follow-up findings.

Results: During the study period, 13 stents were deployed in 12 children with tracheobronchial obstruction. Indications for stenting included severe airway stenosis, airway malacia, stenosis with malacia, and tracheoesophageal fistula (TEF). Stent selection depended on age, lesion location, and device availability. No procedure-related mortalities were noted. The most common complication was granulation tissue formation. After an average 10-month follow-up, 85.7% were clinically stable following stent removal.

Conclusion: Although limited by sample size, our findings support the safety and efficacy of airway stenting in children with tracheobronchial obstruction. Stenting serves as a suitable therapeutic choice when conventional approaches have been unsuccessful or are not suitable. Therefore, it is crucial to establish a robust follow-up system to promptly address any potential complications.

This report highlights an exceptionally rare case of the dirofilariasis presenting with eosinophilic pleural effusion. A previously healthy 44-year-old male presented with a 1-month history of chest pain and cough. Chest computed tomography imaging revealed the right-sided pleural effusion, along with thickening of the parietal pleura. Thoracentesis was performed, yielding an eosinophilic effusion. Bronchoscopy was unremarkable, and microbiological cultures showed no significant findings. A uniporter video-assisted thoracoscopic surgery was conducted, during that a pathological lesion on the parietal pleura was identified and excised in its entirety. Histological analysis of the tissue confirmed an infection caused by the parasitic organism Dirofilaria spp. As complete surgical excision of the parasite is typically curative; no further treatment was necessary. The patient remained asymptomatic during the follow-up period. This case highlights the necessity of considering uncommon etiologist in the differential diagnosis of eosinophilic pleural effusion, especially in patients presenting with persistent or atypical clinical features.

Background: Studies in the past have demonstrated an association between sarcoidosis and pulmonary embolism (PE), but little is known about its impact, especially in young adults. We aim to determine the burden and impact of PE in young adults hospitalized with sarcoidosis.

Methods: This study investigates the prevalence and consequences of PE in young adults aged 18-44 years hospitalized with sarcoidosis using data from the National Inpatient Sample (2016-2020) with relevant International Classification of Diseases (ICD)-10 codes. This study aims to address the primary outcomes of the burden and trends of PE and its associated impact on in-hospital mortality. Additionally, it explores secondary outcomes such as healthcare resource utilization and discharge patterns.

Results: Among 50,385 young adults (median age 37 years) hospitalized with sarcoidosis, 1120 had PE, showing a linear increase from 2% in 2016 to 2.9% (P < 0.001) in 2020. The sarcoidosis-PE+ group, predominantly in young blacks, exhibited a higher prevalence of comorbidities such as obesity, smoking, drug use, peripheral vascular disease, hypothyroidism and prior history of venous thrombus embolism. In contrast, the sarcoidosis-PE- group had a higher prevalence of diabetes (with/without chronic complication), hyperlipidemia and chronic pulmonary disease. Multivariable regression analysis adjusted for all potential sociodemographic and comorbid variables showed higher odds of all-cause mortality (odds ratio [OR]: 2.92, 95% confidence interval [CI]: 1.18-7.24, P < 0.02) in the sarcoidosis-PE+ group as compared to the sarcoidosis-PE- group. The sarcoidosis-PE+ group also had higher hospital costs and length of stay.

Conclusion: The higher odds of in-hospital mortality with an increased length of stay and hospital cost observed in the sarcoidosis-PE+ group highlight the often underreported complications of sarcoidosis, particularly in a younger demographic. The relevance of this study stems from its potential to uncover trends that could lead to improved diagnostic and therapeutic strategies.