Our study analyzed the main manifestations of tuberculous pleurisy (TBP) in children under medical thoracoscopy (MT). This article aimed to explore the clinical application value of MT in the diagnosis and treatment of TBP in children. In our study, we selected 23 TBP patients diagnosed in our hospital. We analyzed the clinical data and thoracoscopic morphology of these patients. At the same time, we also observed the pathological manifestations, acid-fast staining, and treatment effects of the patient’s diseased tissue under MT. The MT clinical findings of TBP patients include pleural hyperemia and edema, miliary nodules, scattered or more white nodules, simple pleural adhesion, wrapped pleural effusion, massive cellulose exudation, yellow-white caseous necrosis, pleural hyperplasia and hyperplasia, and mixed pleural necrosis. The positive rate of pleural biopsy was 73.91% and that of acid-fast staining was 34.78%. The main pathologic types of these patients were tuberculous granulomatous lesions (16 cases), caseous necrosis (5 cases), and fibrinous exudative, multinucleated giant cell and other inflammatory cell infiltration lesions (13 cases). The average time of diagnosis of the 23 patients was 8.32 days (5.0–16.0 days), and they were transferred to specialized hospitals for treatment after diagnosis. The mean time of chest drainage was 3.0–5.0 days after treatment. The average time for their body temperature to return to normal was 3.31 days (2.0–5.0 days). Thoracoscopic lesions of TBP in children are varied. The use of MT is not only helpful for the early diagnosis and treatment of TBP. It also protects and improves lung function. Therefore, the use of MT has high clinical value.
{"title":"Morphological manifestation of tuberculous pleurisy in children under medical thoracoscope and diagnostic value","authors":"Qian Li, Xiaodi Tang, Xiuli Yan","doi":"10.4103/atm.atm_2_24","DOIUrl":"https://doi.org/10.4103/atm.atm_2_24","url":null,"abstract":"\u0000 \u0000 \u0000 Our study analyzed the main manifestations of tuberculous pleurisy (TBP) in children under medical thoracoscopy (MT). This article aimed to explore the clinical application value of MT in the diagnosis and treatment of TBP in children.\u0000 \u0000 \u0000 \u0000 In our study, we selected 23 TBP patients diagnosed in our hospital. We analyzed the clinical data and thoracoscopic morphology of these patients. At the same time, we also observed the pathological manifestations, acid-fast staining, and treatment effects of the patient’s diseased tissue under MT.\u0000 \u0000 \u0000 \u0000 The MT clinical findings of TBP patients include pleural hyperemia and edema, miliary nodules, scattered or more white nodules, simple pleural adhesion, wrapped pleural effusion, massive cellulose exudation, yellow-white caseous necrosis, pleural hyperplasia and hyperplasia, and mixed pleural necrosis. The positive rate of pleural biopsy was 73.91% and that of acid-fast staining was 34.78%. The main pathologic types of these patients were tuberculous granulomatous lesions (16 cases), caseous necrosis (5 cases), and fibrinous exudative, multinucleated giant cell and other inflammatory cell infiltration lesions (13 cases). The average time of diagnosis of the 23 patients was 8.32 days (5.0–16.0 days), and they were transferred to specialized hospitals for treatment after diagnosis. The mean time of chest drainage was 3.0–5.0 days after treatment. The average time for their body temperature to return to normal was 3.31 days (2.0–5.0 days).\u0000 \u0000 \u0000 \u0000 Thoracoscopic lesions of TBP in children are varied. The use of MT is not only helpful for the early diagnosis and treatment of TBP. It also protects and improves lung function. Therefore, the use of MT has high clinical value.\u0000","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704435","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}
Electronic cigarettes (e-cigarettes) are often advertised as a safer alternative to traditional smoking. However, recent data suggest they may not be as safe as previously believed. This study aims to evaluate the genotoxicity and mutagenicity of e-cigarette liquids. We randomly selected eight varieties of e-cigarette liquids from the local market in Jeddah, Saudi Arabia. We evaluated their genotoxicity using the Genotoxicity SOS-Chromo Test™ Kit. In this investigation, a rat liver S9 fraction was utilized to emulate liver metabolic function to measure any chemical substance’s mutagenic potential. The SOS-Chromo Test was performed by recording the β-galactosidase and alkaline phosphatase activity with and without the metabolic activation enzyme (S-9). All samples, except for the first two dilutions of sample 2, were nongenotoxic in the absence of the S9 activation enzyme, according to the genotoxicity analysis. However, when tested in the presence of the S9 enzyme, samples 2, 4, and 7 exhibited mutagenic activity at varying concentrations. Contrary to common belief, e-cigarettes are not safe. The present investigation confirms the presence of both toxicants and carcinogens in some e-cigarette liquids. This exposure could increase users’ risk of various health complications.
{"title":"Genotoxicity and mutagenicity assessment of electronic cigarette liquids","authors":"H. Al-Otaibi, A. Baqasi, H. Alhadrami","doi":"10.4103/atm.atm_59_24","DOIUrl":"https://doi.org/10.4103/atm.atm_59_24","url":null,"abstract":"\u0000 \u0000 \u0000 Electronic cigarettes (e-cigarettes) are often advertised as a safer alternative to traditional smoking. However, recent data suggest they may not be as safe as previously believed. This study aims to evaluate the genotoxicity and mutagenicity of e-cigarette liquids.\u0000 \u0000 \u0000 \u0000 We randomly selected eight varieties of e-cigarette liquids from the local market in Jeddah, Saudi Arabia. We evaluated their genotoxicity using the Genotoxicity SOS-Chromo Test™ Kit. In this investigation, a rat liver S9 fraction was utilized to emulate liver metabolic function to measure any chemical substance’s mutagenic potential. The SOS-Chromo Test was performed by recording the β-galactosidase and alkaline phosphatase activity with and without the metabolic activation enzyme (S-9).\u0000 \u0000 \u0000 \u0000 All samples, except for the first two dilutions of sample 2, were nongenotoxic in the absence of the S9 activation enzyme, according to the genotoxicity analysis. However, when tested in the presence of the S9 enzyme, samples 2, 4, and 7 exhibited mutagenic activity at varying concentrations.\u0000 \u0000 \u0000 \u0000 Contrary to common belief, e-cigarettes are not safe. The present investigation confirms the presence of both toxicants and carcinogens in some e-cigarette liquids. This exposure could increase users’ risk of various health complications.\u0000","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"41 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704764","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}
For Muslims all across the world, the desire to participate in the religious rites of the Hajj (pilgrimage to Mecca) which stands as one of the five pillars of Islam is a heartfelt longing. It stands for the pinnacle of devotion and spiritual gratification, luring followers to the most sacred city in Islam for a life-changing journey of faith, comradery, and submission to Allah. Muslims hold Mecca in the highest regard; it is a source of endless inspiration and devotion throughout their lives, as seen by their desire to undertake the Hajj and Umrah. The pilgrimage encompasses a series of synchronized rituals and acts of worship, each holding its unique spiritual meaning, and serve as a powerful testament to the universal nature of Islamic teachings. These rituals have a significant impact on Muslims’ mental and spiritual well-being. Hajj elicits a spectrum of feelings; creates unity, humility, and thankfulness; and encourages self-reflection as well as personal development. It also instills a sense of spiritual fulfillment. Hajj transcends personal boundaries, strengthening a pilgrim’s sense of connection to the larger Muslim community that rejuvenates their hearts and souls toward the teaching of Islam. Hence, it is imperative to explore in depth this transformative journey, illuminating the mental, emotional, and spiritual dimensions that bind Muslims across the globe.
{"title":"Beyond borders: Exploring the mental, emotional, and spiritual significance of Hajj","authors":"A. Alzeer, Jude Abuzinadah","doi":"10.4103/atm.atm_72_24","DOIUrl":"https://doi.org/10.4103/atm.atm_72_24","url":null,"abstract":"\u0000 For Muslims all across the world, the desire to participate in the religious rites of the Hajj (pilgrimage to Mecca) which stands as one of the five pillars of Islam is a heartfelt longing. It stands for the pinnacle of devotion and spiritual gratification, luring followers to the most sacred city in Islam for a life-changing journey of faith, comradery, and submission to Allah. Muslims hold Mecca in the highest regard; it is a source of endless inspiration and devotion throughout their lives, as seen by their desire to undertake the Hajj and Umrah. The pilgrimage encompasses a series of synchronized rituals and acts of worship, each holding its unique spiritual meaning, and serve as a powerful testament to the universal nature of Islamic teachings. These rituals have a significant impact on Muslims’ mental and spiritual well-being. Hajj elicits a spectrum of feelings; creates unity, humility, and thankfulness; and encourages self-reflection as well as personal development. It also instills a sense of spiritual fulfillment. Hajj transcends personal boundaries, strengthening a pilgrim’s sense of connection to the larger Muslim community that rejuvenates their hearts and souls toward the teaching of Islam. Hence, it is imperative to explore in depth this transformative journey, illuminating the mental, emotional, and spiritual dimensions that bind Muslims across the globe.","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"15 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700918","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 S. Alharbi, M. Al-Hindi, Mansour M. Alqwaiee, Abdullah Al-Shamrani, Saleh Alharbi, Abdullah Yousef, Aisha Alshammary, A. Miqdad, Yazan S. Said, A. Alnemri, Turki S Alahmadi, Ali Husein Almudeer
Respiratory syncytial virus (RSV) is the major cause of bronchiolitis among children under 5 years of age worldwide, accounting for a prevalence of 25%–88% in Saudi Arabia. Although no effective treatment for the virus exists, passive immunoprophylaxis reduced RSV hospitalizations in high-risk children. With recent advances in immunization, the Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention panel screened recent relevant international guidelines, locally published data, and expert consensus to update guidelines for RSV prevention, taking into consideration the resources, timing, varying health profiles, and RSV burden in Saudi Arabia. The panel updated its recommendations to include immunization of infants, mothers, and older adults. Practical guidelines were prepared to facilitate the administration of the short-acting and newly developed long-acting RSV monoclonal antibodies (mAb) during the regular follow-ups of high-risk infants in specialized clinics. In addition, long-acting mAb was highlighted as all-infant protection in the routine immunization calendar.
{"title":"Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention 2024 updated consensus on the prevention of respiratory syncytial virus","authors":"Adel S. Alharbi, M. Al-Hindi, Mansour M. Alqwaiee, Abdullah Al-Shamrani, Saleh Alharbi, Abdullah Yousef, Aisha Alshammary, A. Miqdad, Yazan S. Said, A. Alnemri, Turki S Alahmadi, Ali Husein Almudeer","doi":"10.4103/atm.atm_69_24","DOIUrl":"https://doi.org/10.4103/atm.atm_69_24","url":null,"abstract":"\u0000 Respiratory syncytial virus (RSV) is the major cause of bronchiolitis among children under 5 years of age worldwide, accounting for a prevalence of 25%–88% in Saudi Arabia. Although no effective treatment for the virus exists, passive immunoprophylaxis reduced RSV hospitalizations in high-risk children. With recent advances in immunization, the Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention panel screened recent relevant international guidelines, locally published data, and expert consensus to update guidelines for RSV prevention, taking into consideration the resources, timing, varying health profiles, and RSV burden in Saudi Arabia. The panel updated its recommendations to include immunization of infants, mothers, and older adults. Practical guidelines were prepared to facilitate the administration of the short-acting and newly developed long-acting RSV monoclonal antibodies (mAb) during the regular follow-ups of high-risk infants in specialized clinics. In addition, long-acting mAb was highlighted as all-infant protection in the routine immunization calendar.","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"2 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693652","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. Alghamdi, Elaf A. Alshammari, Afnan A. Alsahli, Alanoud A Abuhaimed, Bader Y. Alyousef, Fatmah Othman, Tamer A. Abusido, Hamad Alkhalaf
The aim of the study was to assess adherence to asthma controller therapy and factors that influence asthma control and to determine the association between asthma knowledge of the caregiver and asthma control among admitted children with asthma. A cross-sectional study was conducted between November 2022 and May 2023 in a tertiary care hospital. Children with a diagnosis of asthma aged 2–14 years, who were admitted to the hospital with an exacerbation of asthma were identified. Caregivers of the admitted children were interviewed using the Asthma Knowledge Questionnaire and Pediatric Inhaler Adherence Questionnaire. Demographic and clinical data were described using descriptive analyses, where mean and standard deviation were used for normally distributed continuous variables, median and interquartile range (IQR), if otherwise. A P < 0.05 was set as a cutoff for statistical significance. A total of 144 caregivers completed the survey. Median score for parents’ knowledge of asthma was 64%, with an IQR of 59–67. Both mother’s and father’s educational levels were associated with a good level of knowledge: odds ratio (OR) = 2.48, 95% confidence interval (CI) = 1.1–5.6, and OR = 5.33, 95% CI = 2.23–12.7, respectively. Median adherence to metered dose inhaler (MDI) was 4 (IQR = 2–6). Children who had been admitted to the general ward in the last 6 months were three times more likely to be nonadherent to MDI (OR = 3.03, 95% CI = 1.18–7.82). Forty-three percent of children who were nonadherent to MDI were less likely to have their asthma controlled (OR = 0.43, 95% CI = 0.17–1.06). This study revealed that a low level of knowledge among caregivers of asthma patients is linked to inadequate adherence to asthma controller therapy. As medication adherence is crucial for achieving desirable asthma control and improving the quality of life for this population, efforts need to be made to enhance the knowledge level of parents of children with asthma.
{"title":"The adherence to asthma medication for hospitalized children with asthma: A cross-sectional study in a tertiary hospital in Riyadh, Saudi Arabia","authors":"N. Alghamdi, Elaf A. Alshammari, Afnan A. Alsahli, Alanoud A Abuhaimed, Bader Y. Alyousef, Fatmah Othman, Tamer A. Abusido, Hamad Alkhalaf","doi":"10.4103/atm.atm_24_24","DOIUrl":"https://doi.org/10.4103/atm.atm_24_24","url":null,"abstract":"\u0000 \u0000 \u0000 The aim of the study was to assess adherence to asthma controller therapy and factors that influence asthma control and to determine the association between asthma knowledge of the caregiver and asthma control among admitted children with asthma.\u0000 \u0000 \u0000 \u0000 A cross-sectional study was conducted between November 2022 and May 2023 in a tertiary care hospital. Children with a diagnosis of asthma aged 2–14 years, who were admitted to the hospital with an exacerbation of asthma were identified.\u0000 \u0000 \u0000 \u0000 Caregivers of the admitted children were interviewed using the Asthma Knowledge Questionnaire and Pediatric Inhaler Adherence Questionnaire.\u0000 \u0000 \u0000 \u0000 Demographic and clinical data were described using descriptive analyses, where mean and standard deviation were used for normally distributed continuous variables, median and interquartile range (IQR), if otherwise. A P < 0.05 was set as a cutoff for statistical significance.\u0000 \u0000 \u0000 \u0000 A total of 144 caregivers completed the survey. Median score for parents’ knowledge of asthma was 64%, with an IQR of 59–67. Both mother’s and father’s educational levels were associated with a good level of knowledge: odds ratio (OR) = 2.48, 95% confidence interval (CI) = 1.1–5.6, and OR = 5.33, 95% CI = 2.23–12.7, respectively. Median adherence to metered dose inhaler (MDI) was 4 (IQR = 2–6). Children who had been admitted to the general ward in the last 6 months were three times more likely to be nonadherent to MDI (OR = 3.03, 95% CI = 1.18–7.82). Forty-three percent of children who were nonadherent to MDI were less likely to have their asthma controlled (OR = 0.43, 95% CI = 0.17–1.06).\u0000 \u0000 \u0000 \u0000 This study revealed that a low level of knowledge among caregivers of asthma patients is linked to inadequate adherence to asthma controller therapy. As medication adherence is crucial for achieving desirable asthma control and improving the quality of life for this population, efforts need to be made to enhance the knowledge level of parents of children with asthma.\u0000","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"105 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714393","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}
Abdulkarim M Alkadrou, Waleed N. Saleh, Huda M. Alzamel, Abdelrahman A. Ahmed
Middle lobe torsion (MLT) is an unusual complication in lung surgery that is usually associated with upper lobe lobectomy and rarely develops postlower lobectomy. In the case of MLT, urgent surgical intervention is required to decrease the risk of mortality and morbidity, and diagnosis is challenging due to the nonspecific symptoms of MLT. In this article, we present a case of a recurring lung abscess treated by the right lower lobectomy, complicated by the right MLT and to our knowledge MLT consider rarest complication postright lower lobectomy.
{"title":"A very rare case of the right middle lobe torsion postlower lobectomy due to chronic lung abscess","authors":"Abdulkarim M Alkadrou, Waleed N. Saleh, Huda M. Alzamel, Abdelrahman A. Ahmed","doi":"10.4103/atm.atm_292_23","DOIUrl":"https://doi.org/10.4103/atm.atm_292_23","url":null,"abstract":"\u0000 Middle lobe torsion (MLT) is an unusual complication in lung surgery that is usually associated with upper lobe lobectomy and rarely develops postlower lobectomy. In the case of MLT, urgent surgical intervention is required to decrease the risk of mortality and morbidity, and diagnosis is challenging due to the nonspecific symptoms of MLT. In this article, we present a case of a recurring lung abscess treated by the right lower lobectomy, complicated by the right MLT and to our knowledge MLT consider rarest complication postright lower lobectomy.","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"30 S1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703202","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}
W. Hajjar, Sundus W. Hajjar, Sami A. Alnassar, Ahmad W. Hajjar
An interosseous ganglion cyst is a very rare entity, found mostly in skeletally mature patients, particularly in long bones such as the tibia and femur. However, we are the first to report here an unusual case of interosseous ganglion cyst of the upper ribs in a young female patient, which she had an unpredicted presentation of cough and hemoptysis and a large painful lump over the anterior left upper chest. The radiological and pathological workup confirmed the presence of a benign interosseous ganglion cyst arising from the left first rib, invading the second rib and the apex of the left lung. The patient has been treated successfully by surgical resection of this rib cyst. However, we could not find any reported cases in the current literature of an interosseous ganglion cyst pathology arising in the ribs with a similar presentation of cough and hemoptysis.
{"title":"Interosseous ganglion cyst of the ribs with unusual presentation of hemoptysis","authors":"W. Hajjar, Sundus W. Hajjar, Sami A. Alnassar, Ahmad W. Hajjar","doi":"10.4103/atm.atm_297_23","DOIUrl":"https://doi.org/10.4103/atm.atm_297_23","url":null,"abstract":"\u0000 An interosseous ganglion cyst is a very rare entity, found mostly in skeletally mature patients, particularly in long bones such as the tibia and femur. However, we are the first to report here an unusual case of interosseous ganglion cyst of the upper ribs in a young female patient, which she had an unpredicted presentation of cough and hemoptysis and a large painful lump over the anterior left upper chest. The radiological and pathological workup confirmed the presence of a benign interosseous ganglion cyst arising from the left first rib, invading the second rib and the apex of the left lung. The patient has been treated successfully by surgical resection of this rib cyst. However, we could not find any reported cases in the current literature of an interosseous ganglion cyst pathology arising in the ribs with a similar presentation of cough and hemoptysis.","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"62 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699014","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}
The aim of the study was to analyze the clinical data of patients with chronic obstructive pulmonary disease and obstructive sleep apnea overlap syndrome (OS) during hospitalization and to evaluate the risk factors of patients treated with Non-Invasive Ventilation (NIV). Demographic and clinical data of patients with confirmed OS during hospitalization were retrospectively collected. The patients were divided into two groups according to whether noninvasive ventilator was used during hospitalization, including OS treated with NIV (244 cases) and OS without NIV (239 cases). The t-test, χ 2 test, and Kaplan–Meier curve were used to compare the two groups, and multiple logistic regression was used to analyze the risk factors of NIV in patients with OS. Compared with the OS group without NIV, the pulmonary hypertension, lymphocyte count, and left ventricular ejection fraction% of OS patients with NIV were lower, whereas PCO2, uric acid, C-reactive protein, procalcitonin, and N-terminal pro-B-type natriuretic peptide were higher, with statistical differences (P < 0.05). During hospitalization and follow-up, OS patients with NIV had a longer hospital stay (P < 0.001), and there was no significant difference in the rate of readmission within 28 days. The logistic regression analysis showed that the history of diuretic use, previous history of noninvasive ventilator use, and ischemic heart disease were independent risk factors for NIV treatment in OS patients during hospitalization. Patients with OS undergoing NIV during hospitalization exhibited more severe overall illness and had prolonged hospital stays compared to OS patients not receiving NIV. History of diuretic use, history of NIV use, and ischemic heart disease are independent risk factors for NIV treatment in OS patients during hospitalization.
该研究旨在分析慢性阻塞性肺病和阻塞性睡眠呼吸暂停重叠综合征（OS）患者住院期间的临床数据，并评估患者接受无创通气（NIV）治疗的风险因素。 研究人员回顾性收集了住院期间确诊为睡眠呼吸暂停综合征的患者的人口统计学和临床数据。根据住院期间是否使用无创呼吸机将患者分为两组，包括使用无创呼吸机治疗的 OS（244 例）和未使用无创呼吸机治疗的 OS（239 例）。采用 t 检验、χ 2 检验和 Kaplan-Meier 曲线对两组患者进行比较，并采用多元 Logistic 回归分析 OS 患者使用无创呼吸机的风险因素。 与无NIV的OS组相比，有NIV的OS患者肺动脉高压、淋巴细胞计数、左室射血分数%较低，而PCO2、尿酸、C反应蛋白、降钙素原、N末端前B型钠尿肽较高，差异有统计学意义（P＜0.05）。在住院和随访期间，使用 NIV 的 OS 患者住院时间更长（P < 0.001），28 天内再入院率无显著差异。逻辑回归分析显示，利尿剂使用史、既往无创呼吸机使用史和缺血性心脏病是 OS 患者住院期间接受 NIV 治疗的独立风险因素。 与未接受无创呼吸机治疗的 OS 患者相比，住院期间接受无创呼吸机治疗的 OS 患者总体病情更严重，住院时间更长。使用利尿剂史、使用 NIV 史和缺血性心脏病是 OS 患者住院期间接受 NIV 治疗的独立风险因素。
{"title":"Risk factors analysis of noninvasive positive pressure ventilation in inpatients with overlapping syndrome of chronic obstructive pulmonary disease combined with obstructive sleep apnea","authors":"Wenjing Liu, Fang Ding, Hong-feng Guo, JieMei Li, Wei Guo, Jing Wang, Zhaobo Cui","doi":"10.4103/atm.atm_305_23","DOIUrl":"https://doi.org/10.4103/atm.atm_305_23","url":null,"abstract":"\u0000 \u0000 \u0000 The aim of the study was to analyze the clinical data of patients with chronic obstructive pulmonary disease and obstructive sleep apnea overlap syndrome (OS) during hospitalization and to evaluate the risk factors of patients treated with Non-Invasive Ventilation (NIV).\u0000 \u0000 \u0000 \u0000 Demographic and clinical data of patients with confirmed OS during hospitalization were retrospectively collected. The patients were divided into two groups according to whether noninvasive ventilator was used during hospitalization, including OS treated with NIV (244 cases) and OS without NIV (239 cases). The t-test, χ\u0000 2 test, and Kaplan–Meier curve were used to compare the two groups, and multiple logistic regression was used to analyze the risk factors of NIV in patients with OS.\u0000 \u0000 \u0000 \u0000 Compared with the OS group without NIV, the pulmonary hypertension, lymphocyte count, and left ventricular ejection fraction% of OS patients with NIV were lower, whereas PCO2, uric acid, C-reactive protein, procalcitonin, and N-terminal pro-B-type natriuretic peptide were higher, with statistical differences (P < 0.05). During hospitalization and follow-up, OS patients with NIV had a longer hospital stay (P < 0.001), and there was no significant difference in the rate of readmission within 28 days. The logistic regression analysis showed that the history of diuretic use, previous history of noninvasive ventilator use, and ischemic heart disease were independent risk factors for NIV treatment in OS patients during hospitalization.\u0000 \u0000 \u0000 \u0000 Patients with OS undergoing NIV during hospitalization exhibited more severe overall illness and had prolonged hospital stays compared to OS patients not receiving NIV. History of diuretic use, history of NIV use, and ischemic heart disease are independent risk factors for NIV treatment in OS patients during hospitalization.\u0000","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"79 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701222","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. Al-Dorzi, Sadeem Atham, Faten Khayat, Jullanar Alkhunein, Bushra T. Alharbi, Norah Alageel, Mohamed Tlayjeh, H. Tlayjeh, Y. Arabi
The prognosis of patients with lung cancer admitted to the intensive care unit (ICU) is often perceived as poor. We described the characteristics, management, and outcomes of critically ill patients with lung cancer and determined the predictors of mortality. We retrospectively studied patients with lung cancer who were admitted to the ICU of a tertiary care hospital between 1999 and 2021 for the reasons other than routine postoperative care. We noted their characteristics, ICU management, and outcomes. We performed the multivariable logistic regression analysis to determine the predictors of hospital mortality. In the 23-year period, 306 patients with lung cancer were admitted to the ICU (median age = 63.0 years, 68.3% males, 45.6% with moderate/severe functional disability, most had advanced lung cancer, and median Acute Physiology and Chronic Health Evaluation II score = 24.0). Life support measures included invasive mechanical ventilation (47.1%), vasopressors (34.0%), and new renal replacement therapy (8.8%). Do-Not-Resuscitate orders were implemented during ICU stay in 30.1%. The hospital mortality was 43.8% with a significantly lower rate in patients admitted after 2015 (28.0%). The predictors of mortality were moderate/severe baseline disability (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.22, 5.78), advanced lung cancer (OR 8.36, 95% CI 1.81, 38.58), lactate level (OR 1.45, 95% CI 1.12, 1.88, invasive mechanical ventilation (OR 10.92, 95% CI 4.98, 23.95), and admission period after 2015 (OR 0.37, 95% CI 0.16, 0.85). The mortality rates in patients with lung cancer admitted to the ICU during a 23-year period decreased after 2015. Functional disability, advanced lung cancer stage, vasopressor use, and invasive mechanical ventilation predicted mortality.
重症监护室（ICU）收治的肺癌患者预后通常较差。我们描述了肺癌重症患者的特征、管理和预后，并确定了死亡率的预测因素。 我们对 1999 年至 2021 年间因常规术后护理以外的原因入住一家三级医院重症监护室的肺癌患者进行了回顾性研究。我们记录了他们的特征、重症监护室的管理和结果。我们进行了多变量逻辑回归分析，以确定住院死亡率的预测因素。 在这23年中，有306名肺癌患者住进了重症监护室（中位年龄=63.0岁，68.3%为男性，45.6%有中度/重度功能障碍，大多数为晚期肺癌，急性生理学和慢性健康评估II中位评分=24.0分）。生命支持措施包括有创机械通气（47.1%）、血管加压（34.0%）和新的肾脏替代疗法（8.8%）。30.1%的患者在入住重症监护室期间执行了 "禁止复苏 "指令。住院死亡率为43.8%，2015年后入院的患者死亡率明显降低（28.0%）。预测死亡率的因素包括中度/重度基线残疾（比值比 [OR] 2.65，95% 置信区间 [CI] 1.22，5.78）、晚期肺癌（OR 8.36，95% CI 1.81，38.58）、乳酸水平（OR 1.45，95% CI 1.12，1.88）、有创机械通气（OR 10.92，95% CI 4.98，23.95）和 2015 年后入院（OR 0.37，95% CI 0.16，0.85）。 在23年间，入住重症监护室的肺癌患者死亡率在2015年后有所下降。功能障碍、肺癌晚期、使用血管加压剂和有创机械通气可预测死亡率。
{"title":"Characteristics, management, and outcomes of patients with lung cancer admitted to a tertiary care intensive care unit over more than 20 years","authors":"H. Al-Dorzi, Sadeem Atham, Faten Khayat, Jullanar Alkhunein, Bushra T. Alharbi, Norah Alageel, Mohamed Tlayjeh, H. Tlayjeh, Y. Arabi","doi":"10.4103/atm.atm_287_23","DOIUrl":"https://doi.org/10.4103/atm.atm_287_23","url":null,"abstract":"\u0000 \u0000 \u0000 The prognosis of patients with lung cancer admitted to the intensive care unit (ICU) is often perceived as poor. We described the characteristics, management, and outcomes of critically ill patients with lung cancer and determined the predictors of mortality.\u0000 \u0000 \u0000 \u0000 We retrospectively studied patients with lung cancer who were admitted to the ICU of a tertiary care hospital between 1999 and 2021 for the reasons other than routine postoperative care. We noted their characteristics, ICU management, and outcomes. We performed the multivariable logistic regression analysis to determine the predictors of hospital mortality.\u0000 \u0000 \u0000 \u0000 In the 23-year period, 306 patients with lung cancer were admitted to the ICU (median age = 63.0 years, 68.3% males, 45.6% with moderate/severe functional disability, most had advanced lung cancer, and median Acute Physiology and Chronic Health Evaluation II score = 24.0). Life support measures included invasive mechanical ventilation (47.1%), vasopressors (34.0%), and new renal replacement therapy (8.8%). Do-Not-Resuscitate orders were implemented during ICU stay in 30.1%. The hospital mortality was 43.8% with a significantly lower rate in patients admitted after 2015 (28.0%). The predictors of mortality were moderate/severe baseline disability (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.22, 5.78), advanced lung cancer (OR 8.36, 95% CI 1.81, 38.58), lactate level (OR 1.45, 95% CI 1.12, 1.88, invasive mechanical ventilation (OR 10.92, 95% CI 4.98, 23.95), and admission period after 2015 (OR 0.37, 95% CI 0.16, 0.85).\u0000 \u0000 \u0000 \u0000 The mortality rates in patients with lung cancer admitted to the ICU during a 23-year period decreased after 2015. Functional disability, advanced lung cancer stage, vasopressor use, and invasive mechanical ventilation predicted mortality.\u0000","PeriodicalId":505641,"journal":{"name":"Annals of Thoracic Medicine","volume":"48 s14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688814","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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