首页 > 最新文献

African Journal of Thoracic and Critical Care Medicine最新文献

英文 中文
A case of septic pulmonary embolism associated with hand sepsis in an immunocompetent host 一例免疫功能正常者手部败血症并发脓毒性肺栓塞病例
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.1014
T. Zobair, I. Sihlahla, D. B. Arnolds, R. I. Raine, G. Calligaro
-
-
{"title":"A case of septic pulmonary embolism associated with hand sepsis in an immunocompetent host","authors":"T. Zobair, I. Sihlahla, D. B. Arnolds, R. I. Raine, G. Calligaro","doi":"10.7196/ajtccm.2024.v30i2.1014","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i2.1014","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677944","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}
引用次数: 0
3-Tesla cardiac magnetic resonance imaging in primary dilated cardiomyopathy 原发性扩张型心肌病的 3-Tesla 心脏磁共振成像
Q3 Medicine Pub Date : 2024-04-04 DOI: 10.7196/ajtccm.2024.v30i1.844
T. Kalekar, A. Gupta, M. Kumar
Background. Cardiac magnetic resonance imaging (CMR) is an excellent non-invasive imaging tool in the assessment of patients with dilated cardiomyopathy (DCM). Few studies have analysed the findings in primary (idiopathic) DCM.Objectives. To study the CMR features in primary DCM.Methods. We conducted a descriptive observational study on 20 adult patients with suspected or confirmed primary DCM. Each patient underwent a dedicated 3-Tesla CMR scan, and the findings were evaluated.Results. Seventeen patients had systolic dysfunction with a reduced ejection fraction and elevated end-diastolic volume, 19 patients had contractile dysfunction in the form of global left ventricular hypokinesia, 13 patients showed no abnormal delayed contrast enhancement with gadolinium administration, and 7 patients showed abnormal late gadolinium enhancement patterns.Conclusion. In patients with primary DCM, CMR is a powerful diagnostic tool that can definitively establish the diagnosis, assess the severity of the disease, predict the risk of future adverse cardiovascular outcomes, check for complications, and assist in future follow-ups.   
背景。心脏磁共振成像(CMR)是评估扩张型心肌病(DCM)患者的绝佳无创成像工具。很少有研究对原发性(特发性)DCM 进行分析。研究原发性 DCM 的 CMR 特征。我们对 20 名疑似或确诊原发性 DCM 的成年患者进行了描述性观察研究。每位患者都接受了专门的 3-Tesla CMR 扫描,并对扫描结果进行了评估。17例患者出现收缩功能障碍,射血分数降低,舒张末期容积增大;19例患者出现收缩功能障碍,表现为左心室整体运动功能减退;13例患者在使用钆剂后未出现异常延迟对比增强,7例患者出现异常晚期钆剂增强模式。对于原发性 DCM 患者,CMR 是一种强大的诊断工具,可以明确诊断、评估疾病的严重程度、预测未来心血管不良后果的风险、检查并发症并协助未来的随访。
{"title":"3-Tesla cardiac magnetic resonance imaging in primary dilated cardiomyopathy","authors":"T. Kalekar, A. Gupta, M. Kumar","doi":"10.7196/ajtccm.2024.v30i1.844","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i1.844","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. Cardiac magnetic resonance imaging (CMR) is an excellent non-invasive imaging tool in the assessment of patients with dilated cardiomyopathy (DCM). Few studies have analysed the findings in primary (idiopathic) DCM.\u0000Objectives. To study the CMR features in primary DCM.\u0000Methods. We conducted a descriptive observational study on 20 adult patients with suspected or confirmed primary DCM. Each patient underwent a dedicated 3-Tesla CMR scan, and the findings were evaluated.\u0000Results. Seventeen patients had systolic dysfunction with a reduced ejection fraction and elevated end-diastolic volume, 19 patients had contractile dysfunction in the form of global left ventricular hypokinesia, 13 patients showed no abnormal delayed contrast enhancement with gadolinium administration, and 7 patients showed abnormal late gadolinium enhancement patterns.\u0000Conclusion. In patients with primary DCM, CMR is a powerful diagnostic tool that can definitively establish the diagnosis, assess the severity of the disease, predict the risk of future adverse cardiovascular outcomes, check for complications, and assist in future follow-ups.\u0000\u0000\u0000\u0000\u0000 \u0000 \u0000 ","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140745648","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}
引用次数: 0
High-flow nasal oxygen therapy outside the intensive care unit 重症监护室外的高流量鼻氧疗法
Q3 Medicine Pub Date : 2024-04-04 DOI: 10.7196/ajtccm.2024.v30i1.151
S. Maasdorp
-
-
{"title":"High-flow nasal oxygen therapy outside the intensive care unit","authors":"S. Maasdorp","doi":"10.7196/ajtccm.2024.v30i1.151","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i1.151","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140741965","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}
引用次数: 0
What potentially treatable opportunistic mould could be the cause of the patients' breathlessness? 患者呼吸困难的原因可能是什么?
Q3 Medicine Pub Date : 2024-04-04 eCollection Date: 2024-01-01
S Brunke, L D Hunter, A T Mnguni
{"title":"What potentially treatable opportunistic mould could be the cause of the patients' breathlessness?","authors":"S Brunke, L D Hunter, A T Mnguni","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960916","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
The significance of monitoring respiratory sample cultures and polymerase chain reaction tests for detecting bacterial pathogens in severely and critically ill patients with COVID-19 监测呼吸道样本培养和聚合酶链反应测试对检测 COVID-19 重症和危重病人细菌病原体的意义
Q3 Medicine Pub Date : 2024-04-04 DOI: 10.7196/ajtccm.2024.v30i1.1293
D. Strelkova, V. Kuleshov, E. Burmistrova, I. Sychev, Y. Savochkina, D. Danilov, S. Yatsyshina, E. Glushchenko, M. Elkina, N. Ananicheva, A. Yasneva, S. Topolyanskaya, S. Rachina
Background. Bacterial superinfection is one of the most common and potentially lethal complications in severely and critically ill patients with COVID-19.Objectives. To determine the colonisation time frame and the spectrum of potential bacterial pathogens in respiratory samples from patients with severe and critical COVID-19, using routine culture and polymerase chain reaction (PCR) tests.Methods. A prospective observational study was conducted on patients aged ≥18 years with confirmed severe and critical COVID-19 who were admitted to or transferred to the intensive care unit (ICU). Respiratory samples were collected for microbial culture and PCR testing within the first 2 days after ICU admission/transfer, between days 3 and 6, and after 7 days of ICU stay.Results. A total of 82 patients, with a median (interquartile range) age of 74.5 (67.3 - 81.0) years and a median Charlson comorbidity index of 4 (3 - 5), were enrolled in the study. Colonisation with any pathogen was observed in 67% of patients, after a median of 4 (2 - 6) days in the ICU. On days 0 - 2 of the ICU stay, micro-organisms were detected in 18% of patients, with Klebsiella pneumoniae (without acquired antibiotic resistance) and methicillin-susceptible Staphylococcus aureus being most frequently identified. Later, Acinetobacter baumannii and carbapenem-resistant K. pneumoniae became the predominant micro-organisms, identified in nearly half of the patients. In 74% of the samples, the results of microbial culture and PCR tests were identical. In 17%, PCR revealed bacterial pathogens not identified by culture.Conclusion. Our study confirms that colonisation of the respiratory tract occurs early in the course of ICU stay. Superinfections are predominantly caused by multidrug-resistant Gram-negative bacteria.
背景。细菌超级感染是COVID-19重症和危重症患者最常见且可能致命的并发症之一。通过常规培养和聚合酶链反应(PCR)检测,确定重症和危重 COVID-19 患者呼吸道样本中的定植时限和潜在细菌病原体谱。这项前瞻性观察研究的对象是年龄≥18岁、确诊为重症和危重COVID-19、入住或转入重症监护室(ICU)的患者。在入住或转入重症监护病房后的头两天、第3至第6天以及入住重症监护病房7天后,采集呼吸道样本进行微生物培养和PCR检测。共有 82 名患者参与了研究,中位数(四分位数间距)年龄为 74.5(67.3 - 81.0)岁,中位数夏尔森合并症指数为 4(3 - 5)。67%的患者在重症监护室住院中位数为 4(2 - 6)天后,发现有病原体定植。在重症监护室住院的第 0 - 2 天,18% 的患者检测到微生物,其中最常发现的是肺炎克雷伯菌(无获得性抗生素耐药性)和甲氧西林敏感金黄色葡萄球菌。随后,鲍曼不动杆菌和耐碳青霉烯类的肺炎克雷伯菌成为主要微生物,在近一半的患者中被发现。在 74% 的样本中,微生物培养和 PCR 检测的结果相同。在 17% 的样本中,PCR 检测发现了培养未鉴定出的细菌病原体。我们的研究证实,呼吸道定植发生在重症监护病房的早期。超级感染主要由耐多药革兰氏阴性菌引起。
{"title":"The significance of monitoring respiratory sample cultures and polymerase chain reaction tests for detecting bacterial pathogens in severely and critically ill patients with COVID-19","authors":"D. Strelkova, V. Kuleshov, E. Burmistrova, I. Sychev, Y. Savochkina, D. Danilov, S. Yatsyshina, E. Glushchenko, M. Elkina, N. Ananicheva, A. Yasneva, S. Topolyanskaya, S. Rachina","doi":"10.7196/ajtccm.2024.v30i1.1293","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i1.1293","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. Bacterial superinfection is one of the most common and potentially lethal complications in severely and critically ill patients with COVID-19.\u0000Objectives. To determine the colonisation time frame and the spectrum of potential bacterial pathogens in respiratory samples from patients with severe and critical COVID-19, using routine culture and polymerase chain reaction (PCR) tests.\u0000Methods. A prospective observational study was conducted on patients aged ≥18 years with confirmed severe and critical COVID-19 who were admitted to or transferred to the intensive care unit (ICU). Respiratory samples were collected for microbial culture and PCR testing within the first 2 days after ICU admission/transfer, between days 3 and 6, and after 7 days of ICU stay.\u0000Results. A total of 82 patients, with a median (interquartile range) age of 74.5 (67.3 - 81.0) years and a median Charlson comorbidity index of 4 (3 - 5), were enrolled in the study. Colonisation with any pathogen was observed in 67% of patients, after a median of 4 (2 - 6) days in the ICU. On days 0 - 2 of the ICU stay, micro-organisms were detected in 18% of patients, with Klebsiella pneumoniae (without acquired antibiotic resistance) and methicillin-susceptible Staphylococcus aureus being most frequently identified. Later, Acinetobacter baumannii and carbapenem-resistant K. pneumoniae became the predominant micro-organisms, identified in nearly half of the patients. In 74% of the samples, the results of microbial culture and PCR tests were identical. In 17%, PCR revealed bacterial pathogens not identified by culture.\u0000Conclusion. Our study confirms that colonisation of the respiratory tract occurs early in the course of ICU stay. Superinfections are predominantly caused by multidrug-resistant Gram-negative bacteria.\u0000\u0000\u0000\u0000","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140744792","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}
引用次数: 0
Rupture of the sinus of Valsalva with fistulous connection with the cardiac chambers: A report of 2 cases 与心腔有瘘管连接的瓦萨尔瓦窦破裂:2 个病例的报告
Q3 Medicine Pub Date : 2024-04-04 DOI: 10.7196/ajtccm.2024.v30i1.919
MD T Kalekar, MD V Rangankar, MD S Dhirawani, Radiodiagnosis Junior Resident, MD N Soman, MD T Singh, Junior Resident
-
-
{"title":"Rupture of the sinus of Valsalva with fistulous connection with the cardiac chambers: A report of 2 cases","authors":"MD T Kalekar, MD V Rangankar, MD S Dhirawani, Radiodiagnosis Junior Resident, MD N Soman, MD T Singh, Junior Resident","doi":"10.7196/ajtccm.2024.v30i1.919","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i1.919","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140741743","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}
引用次数: 0
A rare costovertebral malformation in a Kenyan infant 肯尼亚一名婴儿罕见的肋椎畸形
Q3 Medicine Pub Date : 2024-04-04 DOI: 10.7196/ajtccm.2024.v30i1.984
A. Irungu, R. Patil, M. Awori, A. Metto
-
-
{"title":"A rare costovertebral malformation in a Kenyan infant","authors":"A. Irungu, R. Patil, M. Awori, A. Metto","doi":"10.7196/ajtccm.2024.v30i1.984","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i1.984","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140743987","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}
引用次数: 0
High-flow nasal oxygen in resource-constrained, non-intensive, high-care wards for COVID-19 acute hypoxaemic respiratory failure: Comparing outcomes of the first v. third waves at a tertiary centre in South Africa 在资源紧张的非重症监护病房中使用高流量鼻氧治疗 COVID-19 急性低氧血症呼吸衰竭:比较南非一家三级医疗中心的第一波与第三波治疗结果
Q3 Medicine Pub Date : 2024-04-04 DOI: 10.7196/ajtccm.2024.v30i1.1151
G. Audley, P. Raubenheimer, G. Symons, M. Mendelson, G. Meintjes, N. A. B. Ntusi, S. Wasserman, S. Dlamini, K. Dheda, R. van Zyl-Smit, G. Calligaro
Background. High-flow nasal oxygen (HFNO) is an accepted treatment for severe COVID-19-related acute hypoxaemic respiratory failure (AHRF).Objectives. To determine whether treatment outcomes at Groote Schuur Hospital, Cape Town, South Africa, during the third COVID-19 wave would be affected by increased institutional experience and capacity for HNFO and more restrictive admission criteria for respiratory high-care wards and intensive care units.Methods. We included consecutive patients with COVID-19-related AHRF treated with HFNO during the first and third COVID-19 waves. The primary endpoint was comparison of HFNO failure (composite of the need for intubation or death while on HFNO) between waves.Results. A total of 744 patients were included: 343 in the first COVID-19 wave and 401 in the third. Patients treated with HFNO in the first wave were older (median (interquartile range) age 53 (46 - 61) years v. 47 (40 - 56) years; p<0.001), and had higher prevalences of diabetes (46.9% v. 36.9%; p=0.006), hypertension (51.0% v. 35.2%; p<0.001), obesity (33.5% v. 26.2%; p=0.029) and HIV infection (12.5% v. 5.5%; p<0.001). The partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio at HFNO initiation and the ratio of oxygen saturation/FiO2 to respiratory rate within 6 hours (ROX-6 score) after HFNO commencement were lower in the first wave compared with the third (median 57.9 (47.3 - 74.3) mmHg v. 64.3 (51.2 - 79.0) mmHg; p=0.005 and 3.19 (2.37 - 3.77) v. 3.43 (2.93 - 4.00); p<0.001, respectively). The likelihood of HFNO failure (57.1% v. 59.6%; p=0.498) and mortality (46.9% v. 52.1%; p=0.159) did not differ significantly between the first and third waves.Conclusion. Despite differences in patient characteristics, circulating viral variant and institutional experience with HFNO, treatment outcomes were very similar in the first and third COVID-19 waves. We conclude that once AHRF is established in COVID-19 pneumonia, the comorbidity profile and HFNO provider experience do not appear to affect outcome.
背景。高流量鼻氧(HFNO)是治疗与 COVID-19 相关的严重急性低氧血症呼吸衰竭(AHRF)的公认疗法。目的:确定南非开普敦格罗特舒尔医院在 COVID-19 第三次浪潮期间的治疗效果是否会受到机构高流量鼻氧治疗经验和能力的增加以及呼吸科重症监护病房和重症监护病房更严格的入院标准的影响。我们纳入了在 COVID-19 第一波和第三波期间接受高频硝化治疗的 COVID-19 相关 AHRF 连续患者。主要终点是比较不同阶段的高频硝化失败率(高频硝化治疗期间需要插管或死亡的综合结果)。共纳入 744 名患者:共纳入 744 名患者:第一轮 COVID-19 纳入 343 名,第三轮纳入 401 名。第一波接受高频溶氧治疗的患者年龄较大(中位数(四分位数间距)年龄为 53 (46 - 61) 岁对 47 (40 - 56) 岁;p<0.001),糖尿病(46.9% 对 36.9%;p=0.006)、高血压(51.0% 对 35.2%;p<0.001)、肥胖(33.5% 对 26.2%;p=0.029)和 HIV 感染(12.5% 对 5.5%;p<0.001)的发病率较高。与第三波相比,第一波患者在开始高频硝化氧治疗时的动脉血氧分压与吸入氧分压(PaO2/FiO2)比值以及高频硝化氧治疗开始后 6 小时内的血氧饱和度/FiO2 与呼吸频率(ROX-6 评分)比值较低(中位数为 57.9 (47.3 - 74.3) mmHg v. 64.3 (51.2 - 79.0) mmHg; p=0.005 和 3.19 (2.37 - 3.77) v. 3.43 (2.93 - 4.00); p<0.001)。第一波和第三波的高频逆转录病毒失败可能性(57.1% 对 59.6%;P=0.498)和死亡率(46.9% 对 52.1%;P=0.159)没有显著差异。尽管患者特征、循环病毒变异体和机构的 HFNO 经验存在差异,但第一轮和第三轮 COVID-19 的治疗结果非常相似。我们的结论是,一旦 COVID-19 肺炎确定为 AHRF,合并症特征和高频硝化甘油提供者的经验似乎不会影响治疗效果。
{"title":"High-flow nasal oxygen in resource-constrained, non-intensive, high-care wards for COVID-19 acute hypoxaemic respiratory failure: Comparing outcomes of the first v. third waves at a tertiary centre in South Africa","authors":"G. Audley, P. Raubenheimer, G. Symons, M. Mendelson, G. Meintjes, N. A. B. Ntusi, S. Wasserman, S. Dlamini, K. Dheda, R. van Zyl-Smit, G. Calligaro","doi":"10.7196/ajtccm.2024.v30i1.1151","DOIUrl":"https://doi.org/10.7196/ajtccm.2024.v30i1.1151","url":null,"abstract":"\u0000\u0000\u0000\u0000Background. High-flow nasal oxygen (HFNO) is an accepted treatment for severe COVID-19-related acute hypoxaemic respiratory failure (AHRF).\u0000Objectives. To determine whether treatment outcomes at Groote Schuur Hospital, Cape Town, South Africa, during the third COVID-19 wave would be affected by increased institutional experience and capacity for HNFO and more restrictive admission criteria for respiratory high-care wards and intensive care units.\u0000Methods. We included consecutive patients with COVID-19-related AHRF treated with HFNO during the first and third COVID-19 waves. The primary endpoint was comparison of HFNO failure (composite of the need for intubation or death while on HFNO) between waves.\u0000Results. A total of 744 patients were included: 343 in the first COVID-19 wave and 401 in the third. Patients treated with HFNO in the first wave were older (median (interquartile range) age 53 (46 - 61) years v. 47 (40 - 56) years; p<0.001), and had higher prevalences of diabetes (46.9% v. 36.9%; p=0.006), hypertension (51.0% v. 35.2%; p<0.001), obesity (33.5% v. 26.2%; p=0.029) and HIV infection (12.5% v. 5.5%; p<0.001). The partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio at HFNO initiation and the ratio of oxygen saturation/FiO2 to respiratory rate within 6 hours (ROX-6 score) after HFNO commencement were lower in the first wave compared with the third (median 57.9 (47.3 - 74.3) mmHg v. 64.3 (51.2 - 79.0) mmHg; p=0.005 and 3.19 (2.37 - 3.77) v. 3.43 (2.93 - 4.00); p<0.001, respectively). The likelihood of HFNO failure (57.1% v. 59.6%; p=0.498) and mortality (46.9% v. 52.1%; p=0.159) did not differ significantly between the first and third waves.\u0000Conclusion. Despite differences in patient characteristics, circulating viral variant and institutional experience with HFNO, treatment outcomes were very similar in the first and third COVID-19 waves. We conclude that once AHRF is established in COVID-19 pneumonia, the comorbidity profile and HFNO provider experience do not appear to affect outcome.\u0000\u0000\u0000\u0000","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140743012","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}
引用次数: 0
Pulmonary alveolar proteinosis diagnosis after re‐evaluation for chronic cough unresponsive to empirical antituberculosis therapy 对经验性抗结核治疗无效的慢性咳嗽重新评估后诊断出肺泡蛋白病
Q3 Medicine Pub Date : 2023-11-29 DOI: 10.7196/ajtccm.2023.v29i4.1186
N. Ndlovu, H. Ghammo, M. Tau, B. Thomas, T. Fathuse, C. Ekpebegh, T. Dubula
This study extends the reports of PAP in SA, in this case a 29-year- old HIV-negative black African woman with no history of smoking. Patients with respiratory symptoms who are microbiologically negative for TB should be carefully evaluated for an alternative diagnosis.
本研究扩展了有关南澳大利亚 PAP 的报告,本病例中的患者是一名 29 岁的 HIV 阴性非洲黑人妇女,无吸烟史。对有呼吸道症状但结核病微生物学检测阴性的患者应进行仔细评估,以确定其他诊断。
{"title":"Pulmonary alveolar proteinosis diagnosis after re‐evaluation for chronic cough unresponsive to empirical antituberculosis therapy","authors":"N. Ndlovu, H. Ghammo, M. Tau, B. Thomas, T. Fathuse, C. Ekpebegh, T. Dubula","doi":"10.7196/ajtccm.2023.v29i4.1186","DOIUrl":"https://doi.org/10.7196/ajtccm.2023.v29i4.1186","url":null,"abstract":"This study extends the reports of PAP in SA, in this case a 29-year- old HIV-negative black African woman with no history of smoking. Patients with respiratory symptoms who are microbiologically negative for TB should be carefully evaluated for an alternative diagnosis.","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139212481","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}
引用次数: 0
Pleural fluid residue as a diagnostic tool for cytology-negative malignant pleural effusion: A proof-of-concept study 将胸腔积液残留物作为细胞学阴性恶性胸腔积液的诊断工具:概念验证研究
Q3 Medicine Pub Date : 2023-11-29 DOI: 10.7196/ajtccm.2023.v29i4.1149
L. E. Nyanti, Mrcpi N-C Huan, Y. Ramarmurty, Mrcp T Renganathan, Abdul Aziz, J. L. Low, T. Rosli, S. Letcheminan, G. Lansing, Sivaraman Kannan
Pleural fluid residue, or macroscopic tissue, circulating freely in the pleural fluid obtained through direct filtration, may carry diagnostic histopathological information. We aimed to determine the histopathological concordance of pleural fluid residue in diagnosing TPE and MPE, compared with conventional pleural biopsy. This was a prospective cohort study of consecutive inpatients with cytology-negative exudative effusion who underwent pleuroscopy and had their initial suctioned pleural fluid filtered for residue samples. Pleural fluid residue demonstrated malignant cells in four out of seven cases of pleural biopsy-confirmed malignancy. Pleural fluid residue has comparable cytomorphology but reduced cellularity compared with pleural biopsy. No tuberculous histological features were present in the pleural fluid residue samples. In this preliminary study pleural fluid residue provided histopathological information for malignant pleural effusion, but no incremental diagnostic information for tuberculous effusion. However larger and more definitive studies are required to clarify these findings, and to explore the utility and suitability of pleural fluid residue for mutational analysis.
胸腔积液残留物或通过直接过滤获得的胸腔积液中自由循环的大块组织可能具有组织病理学诊断信息。我们旨在确定胸腔积液残留物在诊断 TPE 和 MPE 时与传统胸膜活检的组织病理学一致性。这是一项前瞻性队列研究,研究对象是细胞学阴性的渗出性胸腔积液的连续住院患者,他们都接受了胸腔镜检查,并对最初抽吸的胸腔积液进行了过滤,以获取残留样本。在七例胸膜活检证实为恶性肿瘤的病例中,有四例的胸腔积液残留物显示出恶性细胞。与胸膜活检相比,胸腔积液残留物的细胞形态相似,但细胞数量减少。胸腔积液残留样本中没有结核组织学特征。在这项初步研究中,胸腔积液残留物提供了恶性胸腔积液的组织病理学信息,但没有增加结核性积液的诊断信息。不过,要澄清这些发现,并探索胸腔积液残留物用于突变分析的实用性和适宜性,还需要进行更大规模和更明确的研究。
{"title":"Pleural fluid residue as a diagnostic tool for cytology-negative malignant pleural effusion: A proof-of-concept study","authors":"L. E. Nyanti, Mrcpi N-C Huan, Y. Ramarmurty, Mrcp T Renganathan, Abdul Aziz, J. L. Low, T. Rosli, S. Letcheminan, G. Lansing, Sivaraman Kannan","doi":"10.7196/ajtccm.2023.v29i4.1149","DOIUrl":"https://doi.org/10.7196/ajtccm.2023.v29i4.1149","url":null,"abstract":"Pleural fluid residue, or macroscopic tissue, circulating freely in the pleural fluid obtained through direct filtration, may carry diagnostic histopathological information. We aimed to determine the histopathological concordance of pleural fluid residue in diagnosing TPE and MPE, compared with conventional pleural biopsy. This was a prospective cohort study of consecutive inpatients with cytology-negative exudative effusion who underwent pleuroscopy and had their initial suctioned pleural fluid filtered for residue samples. Pleural fluid residue demonstrated malignant cells in four out of seven cases of pleural biopsy-confirmed malignancy. Pleural fluid residue has comparable cytomorphology but reduced cellularity compared with pleural biopsy. No tuberculous histological features were present in the pleural fluid residue samples. In this preliminary study pleural fluid residue provided histopathological information for malignant pleural effusion, but no incremental diagnostic information for tuberculous effusion. However larger and more definitive studies are required to clarify these findings, and to explore the utility and suitability of pleural fluid residue for mutational analysis.","PeriodicalId":52847,"journal":{"name":"African Journal of Thoracic and Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139214085","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}
引用次数: 0
期刊
African Journal of Thoracic and Critical Care Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1