Pub Date : 2024-07-26DOI: 10.29328/journal.jprr.1001058
Nicholson Mj, Seigo M
Alpha-1 antitrypsin deficiency is a genetic disorder that can lead to chronic obstructive pulmonary disease and emphysema. Although it is the most well-studied genetic risk factor for emphysema, data is still scarce. Traditionally, medical therapy is similar to standard chronic obstructive pulmonary disease patients. Over the past several decades, enzyme augmentation therapy has emerged as a highly utilized alpha-1 antitrypsin-specific therapy. It has become the standard of care for severe alpha-1 antitrypsin deficiency despite unclear effects on a multitude of clinical outcomes. Significant data supports interventional therapies, including lung volume reduction surgery and bronchoscopic lung volume reduction, for chronic obstructive pulmonary disease patients without alpha-1 antitrypsin deficiency. These interventions have less robust data in the treatment of alpha-1 antitrypsin-induced chronic obstructive pulmonary disease. This review will explore the data regarding various treatment options for severe alpha-1 antitrypsin deficiency associated with chronic obstructive pulmonary disease and emphysema.
{"title":"Current Practices for Severe Alpha-1 Antitrypsin Deficiency Associated COPD and Emphysema","authors":"Nicholson Mj, Seigo M","doi":"10.29328/journal.jprr.1001058","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001058","url":null,"abstract":"Alpha-1 antitrypsin deficiency is a genetic disorder that can lead to chronic obstructive pulmonary disease and emphysema. Although it is the most well-studied genetic risk factor for emphysema, data is still scarce. Traditionally, medical therapy is similar to standard chronic obstructive pulmonary disease patients. Over the past several decades, enzyme augmentation therapy has emerged as a highly utilized alpha-1 antitrypsin-specific therapy. It has become the standard of care for severe alpha-1 antitrypsin deficiency despite unclear effects on a multitude of clinical outcomes. Significant data supports interventional therapies, including lung volume reduction surgery and bronchoscopic lung volume reduction, for chronic obstructive pulmonary disease patients without alpha-1 antitrypsin deficiency. These interventions have less robust data in the treatment of alpha-1 antitrypsin-induced chronic obstructive pulmonary disease. This review will explore the data regarding various treatment options for severe alpha-1 antitrypsin deficiency associated with chronic obstructive pulmonary disease and emphysema.","PeriodicalId":477115,"journal":{"name":"Journal of pulmonology and respiratory research","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801087","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}
Pub Date : 2024-07-18DOI: 10.29328/journal.jprr.1001057
Almutairi Noura Mohammed
A case study of a non-COPD (Chronic Obstructive Pulmonary Disease) patient with congenital kyphoscoliosis to see the effect of pulmonary rehabilitation after 36 sessions given for chest disease in Kuwait with signs and symptoms, physical capacity, functional level, and Quality of life.
{"title":"Effect of Pulmonary Rehabilitation on Non-obstructive Disease Congenital Kyphoscoliosis Patient in Kuwait","authors":"Almutairi Noura Mohammed","doi":"10.29328/journal.jprr.1001057","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001057","url":null,"abstract":"A case study of a non-COPD (Chronic Obstructive Pulmonary Disease) patient with congenital kyphoscoliosis to see the effect of pulmonary rehabilitation after 36 sessions given for chest disease in Kuwait with signs and symptoms, physical capacity, functional level, and Quality of life.","PeriodicalId":477115,"journal":{"name":"Journal of pulmonology and respiratory research","volume":" 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141826980","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: Idiopathic intracranial hypertension (IIH or pseudotumor cerebri) has two major morbidities: papilledema with visual loss and disabling headache. Intracranial Venous Hypertension (IVH) is a fundamental mechanism of IIH. Although traditionally considered limiting to the central nervous system, evidence suggests IIH as a systemic disease associated with cardiorespiratory disorders, which has been far less comprehended. Case Report: A 60-year-old female with Chronic Obstructive Pulmonary Disease (COPD) was admitted for dyspnea and developed a coma with a pH of 7.01 and pCO2 of 158 mmHg. She was intubated and had persistent nuchal rigidity, a brief myoclonus episode with a negative electroencephalogram, and negative CT head studies. A Lumbar Puncture (LP) revealed elevated opening pressure (35 cmH2O) with normal Cerebral Spinal Fluid (CSF) studies. Her nuchal rigidity improved after the removal of 40 mL CSF. The ophthalmology examination the next day after her the large volume LP didn’t show visual loss or papilledema. The patient improved clinically and was extubated two days later. Her echocardiogram showed a dilated right ventricle with pulmonary hypertension. The patient was discharged home. Discussion: IIH is different from hypercapnic encephalopathy and characterized by increased intracranial pressure with papilledema, vision loss, and debilitating headache. Hypercapnia-induced increased intracranial venous flow and pulmonary hypertension-caused elevated central venous pressure with consequent outflow resistance lead to IVH. In hypercapnic encephalopathy, the presentation is mostly cognitive changes. In this case, nuchal rigidity with a negative CT head scan triggered the investigation of IIH. Conclusion: A deep understanding of the relationship between COPD and IIH is vital. There is insufficient evidence to recommend routine eye examinations in COPD patients for papilledema and to conduct a pulmonary function test for a newly diagnosed IIH patient. However, we highly suggest a timely ophthalmology exam prior to performing an LP in COPD patients with suspecting IIH to avoid unnecessary procedures and meanwhile improve clinical outcomes.
{"title":"An Interesting Case of COPD Exacerbation Presenting with Mixed Features of Intracranial Hypertension and Hypercapnic Encephalopathy","authors":"Chaoneng Wu, Mendez Gustavo, Gandhi Aaron, Kambhatla Sujata, Siddiqui Furqan, Pasha Amin, Madhavan Ramesh","doi":"10.29328/journal.jprr.1001056","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001056","url":null,"abstract":"Background: Idiopathic intracranial hypertension (IIH or pseudotumor cerebri) has two major morbidities: papilledema with visual loss and disabling headache. Intracranial Venous Hypertension (IVH) is a fundamental mechanism of IIH. Although traditionally considered limiting to the central nervous system, evidence suggests IIH as a systemic disease associated with cardiorespiratory disorders, which has been far less comprehended. Case Report: A 60-year-old female with Chronic Obstructive Pulmonary Disease (COPD) was admitted for dyspnea and developed a coma with a pH of 7.01 and pCO2 of 158 mmHg. She was intubated and had persistent nuchal rigidity, a brief myoclonus episode with a negative electroencephalogram, and negative CT head studies. A Lumbar Puncture (LP) revealed elevated opening pressure (35 cmH2O) with normal Cerebral Spinal Fluid (CSF) studies. Her nuchal rigidity improved after the removal of 40 mL CSF. The ophthalmology examination the next day after her the large volume LP didn’t show visual loss or papilledema. The patient improved clinically and was extubated two days later. Her echocardiogram showed a dilated right ventricle with pulmonary hypertension. The patient was discharged home. Discussion: IIH is different from hypercapnic encephalopathy and characterized by increased intracranial pressure with papilledema, vision loss, and debilitating headache. Hypercapnia-induced increased intracranial venous flow and pulmonary hypertension-caused elevated central venous pressure with consequent outflow resistance lead to IVH. In hypercapnic encephalopathy, the presentation is mostly cognitive changes. In this case, nuchal rigidity with a negative CT head scan triggered the investigation of IIH. Conclusion: A deep understanding of the relationship between COPD and IIH is vital. There is insufficient evidence to recommend routine eye examinations in COPD patients for papilledema and to conduct a pulmonary function test for a newly diagnosed IIH patient. However, we highly suggest a timely ophthalmology exam prior to performing an LP in COPD patients with suspecting IIH to avoid unnecessary procedures and meanwhile improve clinical outcomes.","PeriodicalId":477115,"journal":{"name":"Journal of pulmonology and respiratory research","volume":"25 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684543","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: Changes in lung structures persist in stable Chronic Obstructive Pulmonary Disease (COPD), but their correlation with the clinical picture remains unclear. The purpose of this study was to assess the stable COPD picture via the relationship between exhaled breath condensate (EBC) particle concentration and the Saint George Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and six-minute walking test (6 MWT). Methods: 12 stable COPD and 12 healthy subjects participated in the study. The EBC was collected with Rtube and analyzed using the Accusizer FxNano. Particle concentration was measured and correlated with the findings of the tools used to assess the health status and functional profile of COPD. The results’ analysis was performed with the Spearman’s test and the Mann-Whitney U - test. Results: The COPD group presented a worse picture of health status and functional profile compared to the healthy group. Correlations were observed between components of the SGRQ and CAT. The two groups presented similar levels of EBC particle concentrations, but the number of small particles was higher in COPD subjects. A correlation of the EBC particle concentration with the activity and total score of the SGRQ was only observed in the healthy group. Conclusion: The total particle number was similar in the COPD and healthy groups. A few correlations between the EBC particles and tools used were also observed. The use of EBC particle concentration to monitor COPD status cannot be claimed with confidence because of the small sample size. Further research is necessary, particularly in large-scale groups.
{"title":"Stable COPD Picture through Exhaled Breath Condensate, Questionnaires and Tests. A Proof of Concept Study","authors":"Patsiris Stephanos, Afthinos Andreas, Augouste Ligeri, Valsami Katerina, Dimitras Antonis, Exarchos Themistoklis, Vlamos Panagiotis","doi":"10.29328/journal.jprr.1001049","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001049","url":null,"abstract":"Background: Changes in lung structures persist in stable Chronic Obstructive Pulmonary Disease (COPD), but their correlation with the clinical picture remains unclear. The purpose of this study was to assess the stable COPD picture via the relationship between exhaled breath condensate (EBC) particle concentration and the Saint George Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and six-minute walking test (6 MWT). Methods: 12 stable COPD and 12 healthy subjects participated in the study. The EBC was collected with Rtube and analyzed using the Accusizer FxNano. Particle concentration was measured and correlated with the findings of the tools used to assess the health status and functional profile of COPD. The results’ analysis was performed with the Spearman’s test and the Mann-Whitney U - test. Results: The COPD group presented a worse picture of health status and functional profile compared to the healthy group. Correlations were observed between components of the SGRQ and CAT. The two groups presented similar levels of EBC particle concentrations, but the number of small particles was higher in COPD subjects. A correlation of the EBC particle concentration with the activity and total score of the SGRQ was only observed in the healthy group. Conclusion: The total particle number was similar in the COPD and healthy groups. A few correlations between the EBC particles and tools used were also observed. The use of EBC particle concentration to monitor COPD status cannot be claimed with confidence because of the small sample size. Further research is necessary, particularly in large-scale groups.","PeriodicalId":477115,"journal":{"name":"Journal of pulmonology and respiratory research","volume":"201 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138985230","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}
As the introduction of immune checkpoint inhibitors in the treatment of various cancers is now proven to be already acquired knowledge, so does a new challenge arise for clinicians; the understanding, diagnosis, and management of the rarest adverse effects of immunotherapy. We present a case of type-1 diabetes Mellitus (T1DM) in a patient with non-small cell lung carcinoma (NSCLC) treated with pembrolizumab. Following ten cycles of treatment, our patient was diagnosed with T1DM after being admitted for diabetic ketoacidosis and stayed hospitalized in the ICU. Later, they continued treatment with insulin, having shown disease response to pembrolizumab, and resumed immunotherapy while on insulin. Immunotherapy-induced T1DM can sometimes occur with PD1/PD-L1 blockage therapies. It has a rapid onset, is characterized by insulin deficiency due to the autoimmune destruction of beta-cells, and usually presents itself with diabetic ketoacidosis. Unlike most of the other adverse effects of immunotherapy, glucocorticoids don’t seem to be of therapeutic value, and insulin substitution is required. Regular glucose monitoring can be key to early diagnosis and prevention of hospitalization.
{"title":"Clinical Approach to Immunotherapy-induced Type 1 Diabetes Mellitus: A Case of Pembrolizumab Associated Insulin-dependent Diabetes in a Patient with NSCLC","authors":"Ntertsos Nikolaos, Christantoniou George, Kyrka Krystallia, Pezirkianidou Persefoni, Bikos Vasileios, Konstantina Papadaki, Tsiouda Theodora","doi":"10.29328/journal.jprr.1001047","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001047","url":null,"abstract":"As the introduction of immune checkpoint inhibitors in the treatment of various cancers is now proven to be already acquired knowledge, so does a new challenge arise for clinicians; the understanding, diagnosis, and management of the rarest adverse effects of immunotherapy. We present a case of type-1 diabetes Mellitus (T1DM) in a patient with non-small cell lung carcinoma (NSCLC) treated with pembrolizumab. Following ten cycles of treatment, our patient was diagnosed with T1DM after being admitted for diabetic ketoacidosis and stayed hospitalized in the ICU. Later, they continued treatment with insulin, having shown disease response to pembrolizumab, and resumed immunotherapy while on insulin. Immunotherapy-induced T1DM can sometimes occur with PD1/PD-L1 blockage therapies. It has a rapid onset, is characterized by insulin deficiency due to the autoimmune destruction of beta-cells, and usually presents itself with diabetic ketoacidosis. Unlike most of the other adverse effects of immunotherapy, glucocorticoids don’t seem to be of therapeutic value, and insulin substitution is required. Regular glucose monitoring can be key to early diagnosis and prevention of hospitalization.","PeriodicalId":477115,"journal":{"name":"Journal of pulmonology and respiratory research","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135866763","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}
Pub Date : 2023-05-25DOI: 10.29328/journal.jprr.1001044
Althinyan Albatoul, Mirza Abdulrahman, Aly Sherin, Nouh Thamer, Mahboub Bassam, Salameh Laila, Alkubeyyer Metab, AlSalamah Shada A
Coronavirus disease (COVID-19) is a viral pneumonia that is found in China and has spread globally. Early diagnosis is important for effective and timely treatment. Thus, many ongoing studies attempt to solve key COVID-19 problems such as workload classification, detection, and differentiation from other pneumonia and healthy lungs using different imaging modalities. Researchers have identified some limitations in the deployment of deep learning methods to detect COVID-19, but there are still unmet challenges to be addressed. The use of binary classifiers or building classifiers based on only a few classes is some of the limitations that most of the existing research on the COVID-19 classification problem suffers from. Additionally, most prior studies have focused on model or ensemble models that depend on a flat single-feature imaging modality without using any clinical information or benefiting from the hierarchical structure of pneumonia, which leads to clinical challenges, and evaluated their systems using a small public dataset. Additionally, reliance on diagnostic processes based on CT as the main imaging modality, ignoring chest X-rays. Radiologists, computer scientists, and physicians all need to come to an understanding of these interdisciplinary issues. This article first highlights the challenges of deep learning deployment for COVID-19 detection using a literature review and document analysis. Second, it provides six key recommendations that could assist future researchers in this field in improving the diagnostic process for COVID-19. However, there is a need for a collective effort from all of them to consider the provided recommendations to effectively solve these issues.
{"title":"COVID-19 detection and classification: key AI challenges and recommendations for the way forward","authors":"Althinyan Albatoul, Mirza Abdulrahman, Aly Sherin, Nouh Thamer, Mahboub Bassam, Salameh Laila, Alkubeyyer Metab, AlSalamah Shada A","doi":"10.29328/journal.jprr.1001044","DOIUrl":"https://doi.org/10.29328/journal.jprr.1001044","url":null,"abstract":"Coronavirus disease (COVID-19) is a viral pneumonia that is found in China and has spread globally. Early diagnosis is important for effective and timely treatment. Thus, many ongoing studies attempt to solve key COVID-19 problems such as workload classification, detection, and differentiation from other pneumonia and healthy lungs using different imaging modalities. Researchers have identified some limitations in the deployment of deep learning methods to detect COVID-19, but there are still unmet challenges to be addressed. The use of binary classifiers or building classifiers based on only a few classes is some of the limitations that most of the existing research on the COVID-19 classification problem suffers from. Additionally, most prior studies have focused on model or ensemble models that depend on a flat single-feature imaging modality without using any clinical information or benefiting from the hierarchical structure of pneumonia, which leads to clinical challenges, and evaluated their systems using a small public dataset. Additionally, reliance on diagnostic processes based on CT as the main imaging modality, ignoring chest X-rays. Radiologists, computer scientists, and physicians all need to come to an understanding of these interdisciplinary issues. This article first highlights the challenges of deep learning deployment for COVID-19 detection using a literature review and document analysis. Second, it provides six key recommendations that could assist future researchers in this field in improving the diagnostic process for COVID-19. However, there is a need for a collective effort from all of them to consider the provided recommendations to effectively solve these issues.","PeriodicalId":477115,"journal":{"name":"Journal of pulmonology and respiratory research","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346201","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：