Y. Kobashi, K. Mouri, Y. Obase, Shigeki Kato, M. Oka
Objectives: We analyzed the clinical characteristics of patients with pulmonary mycobacterial disease diagnosed as coincidental pulmonary infection due to Mycobacterium species. Materials and Methods: One hundred sixty patients satisfied the diagnostic criteria of nontuberculous mycobacterial disease proposed by American Thoracic Society during the last seven years. Six patients (3.8%) were coincidental pulmonary infection due to two Mycobacterium species. We investigated the background, laboratory findings, microbiological findings, radiological findings, treatment and prognosis. Results: There were six patients, 3 males and 3 females, with a mean age of 71.7 years. The causative microorganisms of coincidental pulmonary infection consisted of Mycobacterium avium + Mycobacterium intracellulare in two patients, Mycobacterium avium + Mycobacterium kansasii in one, Mycobacterium intracellulare + Mycobacterium chelonae in one, Mycobacterium intracellulare + Mycobacterium abscessus in one, and Mycobacterium intracellulare + Mycobacterium tuberculosis in one. Regarding the radiological findings, the distribution of the lesion was frequently shown in both the right middle and left lingula lobes, but the extent of the lesion was limited within the unilateral lung field. Centrilobular small nodules with bronchiectasis were recognized in all patients and cavities or infiltration shadows were recognized in half of them on chest computed tomography. A definite diagnosis was obtained by bronchoalveolar lavage fluid in four patients and expectorated sputum in two. Combined chemotherapy was performed for two patients and that for pulmonary tuberculosis in one. Conclusions: Coincidental pulmonary infection due to Mycobactterium species occurred at a low percentage. Although most patients were elderly with underlying disease and clinical features were compatible with pulmonary Mycobacterium avium complex disease, the prognosis was comparatively good with and without treatment.
{"title":"Clinical Analysis of Pulmonary Nontuberculous Mycobacterial Disease Diagnosed as Coincidental Pulmonary Infection Due to Mycobacterium Species","authors":"Y. Kobashi, K. Mouri, Y. Obase, Shigeki Kato, M. Oka","doi":"10.4236/OJRD.2013.32016","DOIUrl":"https://doi.org/10.4236/OJRD.2013.32016","url":null,"abstract":"Objectives: We analyzed the clinical characteristics of patients with pulmonary mycobacterial disease diagnosed as coincidental pulmonary infection due to Mycobacterium species. Materials and Methods: One hundred sixty patients satisfied the diagnostic criteria of nontuberculous mycobacterial disease proposed by American Thoracic Society during the last seven years. Six patients (3.8%) were coincidental pulmonary infection due to two Mycobacterium species. We investigated the background, laboratory findings, microbiological findings, radiological findings, treatment and prognosis. Results: There were six patients, 3 males and 3 females, with a mean age of 71.7 years. The causative microorganisms of coincidental pulmonary infection consisted of Mycobacterium avium + Mycobacterium intracellulare in two patients, Mycobacterium avium + Mycobacterium kansasii in one, Mycobacterium intracellulare + Mycobacterium chelonae in one, Mycobacterium intracellulare + Mycobacterium abscessus in one, and Mycobacterium intracellulare + Mycobacterium tuberculosis in one. Regarding the radiological findings, the distribution of the lesion was frequently shown in both the right middle and left lingula lobes, but the extent of the lesion was limited within the unilateral lung field. Centrilobular small nodules with bronchiectasis were recognized in all patients and cavities or infiltration shadows were recognized in half of them on chest computed tomography. A definite diagnosis was obtained by bronchoalveolar lavage fluid in four patients and expectorated sputum in two. Combined chemotherapy was performed for two patients and that for pulmonary tuberculosis in one. Conclusions: Coincidental pulmonary infection due to Mycobactterium species occurred at a low percentage. Although most patients were elderly with underlying disease and clinical features were compatible with pulmonary Mycobacterium avium complex disease, the prognosis was comparatively good with and without treatment.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"110 1","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2013-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582988","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}
A. A. E. Halim, A. Attia, Taysser Zytoun, H. Salah
Ventilator-associated pneumonia (VAP) is a complication in as many as 28% of patients who receive mechanical ventilation. Studies have consistently shown that a delay in diagnosis and treatment increases the mortality risk. The aim of this work was to clarify the role of the serum procalcitonin (PCT) in the diagnosis and the prognosis of ventilator associated pneumonia. Methods: Forty two VAP patients, 20 non VAP-ICU (on mechanical ventilation) admitted patients and 20 healthy control subjects of similar age and sex were included in the study. PCT levels in serum samples were measured in all subjects. Results: There was a highly statistically significant difference (p value < 0.001) between VAP patients on one side and non VAP-ICU patients and healthy control subjects on the other side regarding the mean values of PCT. Also, the mean values of PCT were statistically significantly higher (p < 0.001) among died VAP group than the survivor VAP group. There was a statistically positive correlation (p < 0.01) between mortality prediction scores (APACHE II (R = 0.449), CRIP (R = 0.403) and SOFA (R = 0.437)) and initial PCT serum levels. Conclusions: This study found that the increased PCT serum level is an important diagnostic tool for VAP and the PCT serum levels can predict the outcome of VAP patients. We recommend other larger studies to augment our findings.
{"title":"The Diagnostic and Prognostic Value of Serum Procalcitonin among Ventilator Associated Pneumonia Patients","authors":"A. A. E. Halim, A. Attia, Taysser Zytoun, H. Salah","doi":"10.4236/OJRD.2013.32012","DOIUrl":"https://doi.org/10.4236/OJRD.2013.32012","url":null,"abstract":"Ventilator-associated pneumonia (VAP) is a complication in as many as 28% of patients who receive mechanical ventilation. Studies have consistently shown that a delay in diagnosis and treatment increases the mortality risk. The aim of this work was to clarify the role of the serum procalcitonin (PCT) in the diagnosis and the prognosis of ventilator associated pneumonia. Methods: Forty two VAP patients, 20 non VAP-ICU (on mechanical ventilation) admitted patients and 20 healthy control subjects of similar age and sex were included in the study. PCT levels in serum samples were measured in all subjects. Results: There was a highly statistically significant difference (p value < 0.001) between VAP patients on one side and non VAP-ICU patients and healthy control subjects on the other side regarding the mean values of PCT. Also, the mean values of PCT were statistically significantly higher (p < 0.001) among died VAP group than the survivor VAP group. There was a statistically positive correlation (p < 0.01) between mortality prediction scores (APACHE II (R = 0.449), CRIP (R = 0.403) and SOFA (R = 0.437)) and initial PCT serum levels. Conclusions: This study found that the increased PCT serum level is an important diagnostic tool for VAP and the PCT serum levels can predict the outcome of VAP patients. We recommend other larger studies to augment our findings.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"3 1","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2013-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582182","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}
Asra Z. Ahmed, J. Thliveris, A. Shaw, M. Sowa, J. Gilchrist, J. Scott
Smoking during pregnancy is a major source of fetal exposure to numerous harmful agents present in tobacco smoke. Lung development involves complex biochemical processes resulting in dramatic changes which continue even after birth. In addition to type I cells which form the blood-air barrier, type II alveolar epithelial (AE) cells have important and diverse functions related to immunological protection and stabilization of the alveolus through synthesis and secretion of the pulmonary surfactant. Apoptosis or programmed cells death is an important physiological process during lung embryogenesis and for the proper maintenance of homeostasis. Caspases are proteases that play important roles in regulating apoptosis. Caspase-3 is the key executioner caspase in the cascade of events leading to cell death by apoptosis. We explored the hypothesis that cigarette smoke extract (CSE) induces apoptosis in fetal rat lung type II AE cells by activation of caspase-3. To analyze these factors, isolated fetal rat lung type II AE cells were used. The cells were exposed to different concentrations of CSE (5%, 10% or 15%) (v/v) for 60 min. The results of the present study showed that CSE induced apoptosis in fetal rat lung type II AE cells with a significant increase (p < 0.05) in caspase-3 activity and decrease in cell proliferation at CSE concentrations of 10% and 15% (v/v). These observations indicate that cigarette smoke extract induces apoptosis by activation of caspase-3 in fetal rat lung type II AE cells in a dose-dependent manner and may potentially alter the regulated development of the lung and the appearance of the surfactant-producing type II alveolar cells which are critical for the establishment of adequate gas exchange at birth.
{"title":"Cigarette Smoke Induces Apoptosis by Activation of Caspase-3 in Isolated Fetal Rat Lung Type II Alveolar Ep-ithelial Cells in Vitro","authors":"Asra Z. Ahmed, J. Thliveris, A. Shaw, M. Sowa, J. Gilchrist, J. Scott","doi":"10.4236/OJRD.2013.31002","DOIUrl":"https://doi.org/10.4236/OJRD.2013.31002","url":null,"abstract":"Smoking during pregnancy is a major source of fetal exposure to numerous harmful agents present in tobacco smoke. Lung development involves complex biochemical processes resulting in dramatic changes which continue even after birth. In addition to type I cells which form the blood-air barrier, type II alveolar epithelial (AE) cells have important and diverse functions related to immunological protection and stabilization of the alveolus through synthesis and secretion of the pulmonary surfactant. Apoptosis or programmed cells death is an important physiological process during lung embryogenesis and for the proper maintenance of homeostasis. Caspases are proteases that play important roles in regulating apoptosis. Caspase-3 is the key executioner caspase in the cascade of events leading to cell death by apoptosis. We explored the hypothesis that cigarette smoke extract (CSE) induces apoptosis in fetal rat lung type II AE cells by activation of caspase-3. To analyze these factors, isolated fetal rat lung type II AE cells were used. The cells were exposed to different concentrations of CSE (5%, 10% or 15%) (v/v) for 60 min. The results of the present study showed that CSE induced apoptosis in fetal rat lung type II AE cells with a significant increase (p < 0.05) in caspase-3 activity and decrease in cell proliferation at CSE concentrations of 10% and 15% (v/v). These observations indicate that cigarette smoke extract induces apoptosis by activation of caspase-3 in fetal rat lung type II AE cells in a dose-dependent manner and may potentially alter the regulated development of the lung and the appearance of the surfactant-producing type II alveolar cells which are critical for the establishment of adequate gas exchange at birth.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"03 1","pages":"4-12"},"PeriodicalIF":0.0,"publicationDate":"2013-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4236/OJRD.2013.31002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582346","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. Matsuoka, Y. Matsumoto, K. Kimura, M. Koyama, T. Uzu, Yasuko Koma, Kensuke Fukumitsu, Yoshitaka Kasai, N. Nakashima, D. Masuya, Harukazu Yoshimatsu, Y. Suzuki
Introduction: Several studies have suggested that decreased FEV1 is associated with cardiovascular risk in COPD patients. Objective: To identify the prevalence of undiagnosed peripheral artery disease (PAD) and the relationship between leg atherosclerosis and clinical indices, which predict COPD mortality in Japanese COPD patients. Methods: We performed a cross-sectional study in 51 COPD patients and 51 age-matched, healthy control smokers. We measured ankle-brachial index (ABI) as a marker of atherosclerosis of the legs, pulmonary function, body mass index, modified Medical Research Council (MMRC) dyspnea scale, and smoking pack-years. We also calculated the ADO index (Age, Dyspnea, and Obstruction), an established predictor of mortality in COPD patients. Co-morbidities including diabetes mellitus, hypertension, and hypercholesterolemia were identified from blood laboratory tests and medical records. Results: Five subjects (9.8%) had an ABI < 0.9. ABI was significantly lower in the COPD patients than in the healthy control smokers (p < 0.05). The prevalence of PAD was marginally higher in COPD patients than in control smokers (p = 0.09), with the prevalence of ABI < 1.0 being significantly higher in COPD patients than in control smokers (p = 0.04). In the COPD patients, ABI showed significant correlations with age (p = 0.006), FEV1 (p = 0.004), smoking pack-years (p = 0.047), MMRC dyspnea scale (p = 0.0005), SaO2 (p = 0.001), and ADO index (p < 0.001). Multiple linear regression modeling showed the factors associated independently with ABI were age, FEV1, smoking pack-years, MMRC dyspnea scale, and SaO2. Conclusion: The risk of leg atherosclerosis in Japanese COPD patients is higher than in smokers without COPD. Leg atherosclerosis in COPD patients is associated with clinical indices that predict COPD mortality.
{"title":"Leg Atherosclerosis in Japanese COPD Patients: Prevalence of Undiagnosed Peripheral Artery Disease and Association between Leg Atherosclerosis and Clinical Indices","authors":"H. Matsuoka, Y. Matsumoto, K. Kimura, M. Koyama, T. Uzu, Yasuko Koma, Kensuke Fukumitsu, Yoshitaka Kasai, N. Nakashima, D. Masuya, Harukazu Yoshimatsu, Y. Suzuki","doi":"10.4236/OJRD.2013.31005","DOIUrl":"https://doi.org/10.4236/OJRD.2013.31005","url":null,"abstract":"Introduction: Several studies have suggested that decreased FEV1 is associated with cardiovascular risk in COPD patients. Objective: To identify the prevalence of undiagnosed peripheral artery disease (PAD) and the relationship between leg atherosclerosis and clinical indices, which predict COPD mortality in Japanese COPD patients. Methods: We performed a cross-sectional study in 51 COPD patients and 51 age-matched, healthy control smokers. We measured ankle-brachial index (ABI) as a marker of atherosclerosis of the legs, pulmonary function, body mass index, modified Medical Research Council (MMRC) dyspnea scale, and smoking pack-years. We also calculated the ADO index (Age, Dyspnea, and Obstruction), an established predictor of mortality in COPD patients. Co-morbidities including diabetes mellitus, hypertension, and hypercholesterolemia were identified from blood laboratory tests and medical records. Results: Five subjects (9.8%) had an ABI < 0.9. ABI was significantly lower in the COPD patients than in the healthy control smokers (p < 0.05). The prevalence of PAD was marginally higher in COPD patients than in control smokers (p = 0.09), with the prevalence of ABI < 1.0 being significantly higher in COPD patients than in control smokers (p = 0.04). In the COPD patients, ABI showed significant correlations with age (p = 0.006), FEV1 (p = 0.004), smoking pack-years (p = 0.047), MMRC dyspnea scale (p = 0.0005), SaO2 (p = 0.001), and ADO index (p < 0.001). Multiple linear regression modeling showed the factors associated independently with ABI were age, FEV1, smoking pack-years, MMRC dyspnea scale, and SaO2. Conclusion: The risk of leg atherosclerosis in Japanese COPD patients is higher than in smokers without COPD. Leg atherosclerosis in COPD patients is associated with clinical indices that predict COPD mortality.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"03 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2013-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582427","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}
F. Messan, M. Lawani, B. Akplogan, P. Dansou, D. Mama, Rodrigue Hounkponou, Rodrigue A. Dagnitché
Background: In African cities, chronic exposure to pollutants is the most common public health problem faced daily by motorcycle taxi drivers. In Benin, studies conducted on motorcycle drivers, have shown the presence of nitrogen oxides, carbon monoxide, sulfur dioxide, volatile organic compounds and particulate matter in ambient air, which may affect lung function. Aims: This study aims to diagnose potential respiratory problems among 48 motorcycle taxi drivers (47.02 ± 8.75 years) compared to a control group made up of 52 people (46.38 ± 8.81 years) in Porto-Novo, Benin. Methods: A questionnaire, two exploration pulmonary function tests and two 6-minute walk tests were used to identify symptoms and changes in respiratory variables that reveal the existence of bronchospasm. Results: The frequency of respiratory symptoms noted among motorcycle taxi drivers is higher than that recorded among members of the control group. We observed that motorcycle drivers at rest and after physical effort have significantly lower respiratory variables (FVC, FEV1, PEF, FEF25-75, FEF50 and FEF25) (p < 0.05) than those recoded in control group. Conclusion: It can therefore be concluded that, because of the relatively long duration of exposure among motorcycle taxi drivers, the inhalation of automobile pollutants, may cause respiratory problems in this population.
{"title":"Bronchospasm Diagnosis in Motorcycle Taxi Drivers Exposed to Automotive Pollutants in Porto-Novo *","authors":"F. Messan, M. Lawani, B. Akplogan, P. Dansou, D. Mama, Rodrigue Hounkponou, Rodrigue A. Dagnitché","doi":"10.4236/OJRD.2013.31003","DOIUrl":"https://doi.org/10.4236/OJRD.2013.31003","url":null,"abstract":"Background: In African cities, chronic exposure to pollutants is the most common public health problem faced daily by motorcycle taxi drivers. In Benin, studies conducted on motorcycle drivers, have shown the presence of nitrogen oxides, carbon monoxide, sulfur dioxide, volatile organic compounds and particulate matter in ambient air, which may affect lung function. Aims: This study aims to diagnose potential respiratory problems among 48 motorcycle taxi drivers (47.02 ± 8.75 years) compared to a control group made up of 52 people (46.38 ± 8.81 years) in Porto-Novo, Benin. Methods: A questionnaire, two exploration pulmonary function tests and two 6-minute walk tests were used to identify symptoms and changes in respiratory variables that reveal the existence of bronchospasm. Results: The frequency of respiratory symptoms noted among motorcycle taxi drivers is higher than that recorded among members of the control group. We observed that motorcycle drivers at rest and after physical effort have significantly lower respiratory variables (FVC, FEV1, PEF, FEF25-75, FEF50 and FEF25) (p < 0.05) than those recoded in control group. Conclusion: It can therefore be concluded that, because of the relatively long duration of exposure among motorcycle taxi drivers, the inhalation of automobile pollutants, may cause respiratory problems in this population.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"03 1","pages":"13-20"},"PeriodicalIF":0.0,"publicationDate":"2013-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582422","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}
In patients who undergo prolonged endotracheal intubation, tracheostomy is performed to prevent the tracheal and laryngeal trauma which may be caused by the intubation tube. In this report, a patient who was intubated after a cerebrovascular embolism and required a tracheostomy for 6 months due to decannulation problems is presented. The patient subsequently developed a tracheomalacia. A stent was inserted and seen to provide functional support. Upon removal of the stent, the tracheomalacia improved. Although surgical therapy is claimed to provide higher success rate, stenting may also be a viable option for the management of tracheomalacia and improve the quality of life in patients with good general condition.
{"title":"Stenting for the Management of Posttracheostomy Tracheomalacia: Case Report","authors":"D. Ozkan, Hurkal Tugce, Sener Sibel, Ece Ferah","doi":"10.4236/OJRD.2013.31001","DOIUrl":"https://doi.org/10.4236/OJRD.2013.31001","url":null,"abstract":"In patients who undergo prolonged endotracheal intubation, \u0000tracheostomy is performed to prevent the tracheal and laryngeal \u0000trauma which may be caused by the intubation tube. In this report, a patient \u0000who was intubated after a cerebrovascular embolism and required a \u0000tracheostomy for 6 months due to decannulation problems is presented. The patient \u0000subsequently developed a tracheomalacia. A stent was inserted and seen to \u0000provide functional support. Upon removal of the stent, the tracheomalacia \u0000improved. Although surgical therapy is claimed to provide higher success rate, \u0000stenting may also be a viable option for the management of tracheomalacia and \u0000improve the quality of life in patients with good general condition.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"03 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2013-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582208","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}
Thymomas are rare and usually slowly growing tumors, originating from the epithelial layer of the thymus. Prognosis depends on the extent of invasion of adjacent tissues whereby multimodality treatment including surgery with or without adjuvant chemoradiotherapy is the preferred approach for locally advanced thymomas. For metastatic thymomas, only few chemotherapeutic options are available. We report 2 cases of patients with metastatic thymic malignancies with a dramatic response on pemetrexed treatment. The choice for this antifolate therapy is based upon a small series. Because metastatic thymic neoplasm is a rare disease, large randomised trials are not feasible. Case reports on the treatment of these malignancies are very important and can provide readers with the opportunity to deal with rare dis- eases.
{"title":"Unexpected Dramatic Response of Pretreated Invasive Thymic Malignancies on Pemetrexed-Case Report and Review of Current Treatment Modalities","authors":"P. Raman, V. Surmont","doi":"10.4236/OJRD.2012.24016","DOIUrl":"https://doi.org/10.4236/OJRD.2012.24016","url":null,"abstract":"Thymomas are rare and usually slowly growing tumors, originating from the epithelial layer of the thymus. Prognosis depends on the extent of invasion of adjacent tissues whereby multimodality treatment including surgery with or without adjuvant chemoradiotherapy is the preferred approach for locally advanced thymomas. For metastatic thymomas, only few chemotherapeutic options are available. We report 2 cases of patients with metastatic thymic malignancies with a dramatic response on pemetrexed treatment. The choice for this antifolate therapy is based upon a small series. Because metastatic thymic neoplasm is a rare disease, large randomised trials are not feasible. Case reports on the treatment of these malignancies are very important and can provide readers with the opportunity to deal with rare dis- eases.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"37 1","pages":"107-115"},"PeriodicalIF":0.0,"publicationDate":"2012-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582154","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}
G. Mlinarić‐Galinović, D. Forčić, J. Ivančić-Jelečki, Gordana Vojnović, J. Bozikov, R. Welliver
Objective: The biennial epidemic pattern of respiratory syncytial virus (RSV) circulation in Croatia has been preserved and could not be related to climatic factors and the predominant RSV subtypes. The possibility that the circulation of different RSV genotypes affect the outbreak cycle in children in Croatia (Zagreb region) over a period of 3 consecutive years was explored in the paper. Methods: The study group consisted of inpatients, aged 0 - 10 years, who were hospitalized with acute respiratory tract infections caused by RSV, in Zagreb, over the period from 1 January 2006 to 31 December 2008. The virus was identified in the nasopharyngeal secretion using direct immunofluorescence method. The virus subtype and genotype was determined by real-time PCR and sequence analysis, respectively. Results: RSV infections identified in 731 children. RSV subtype A caused 399 infections, and subtype B 332. Two subtype A genotypes (NA1 and GA5) and three subtype B genotypes (BA7, BA9 and BA10) were found. During persistent RSV biennial cycles namely four succeeding outbreaks, the new genotype from the previous smaller outbreak persevered into the upcoming larger outbreak. Conclusion: Our molecular-epidemiology study of RSV subtypes and genotypes during calendar months demonstrates that the biennial RSV cycle cannot be fully explained by the dynamic of the predominant circulating genotype of RSV. Other unknown factors account for the biennial cycle of RSV epidemics in Croatia.
{"title":"Do Circulating RSV-Genotypes Affect Established Biennial Epidemic Periodicity in Zagreb Region?","authors":"G. Mlinarić‐Galinović, D. Forčić, J. Ivančić-Jelečki, Gordana Vojnović, J. Bozikov, R. Welliver","doi":"10.4236/OJRD.2012.24013","DOIUrl":"https://doi.org/10.4236/OJRD.2012.24013","url":null,"abstract":"Objective: The biennial epidemic pattern of respiratory syncytial virus (RSV) circulation in Croatia has been preserved and could not be related to climatic factors and the predominant RSV subtypes. The possibility that the circulation of different RSV genotypes affect the outbreak cycle in children in Croatia (Zagreb region) over a period of 3 consecutive years was explored in the paper. Methods: The study group consisted of inpatients, aged 0 - 10 years, who were hospitalized with acute respiratory tract infections caused by RSV, in Zagreb, over the period from 1 January 2006 to 31 December 2008. The virus was identified in the nasopharyngeal secretion using direct immunofluorescence method. The virus subtype and genotype was determined by real-time PCR and sequence analysis, respectively. Results: RSV infections identified in 731 children. RSV subtype A caused 399 infections, and subtype B 332. Two subtype A genotypes (NA1 and GA5) and three subtype B genotypes (BA7, BA9 and BA10) were found. During persistent RSV biennial cycles namely four succeeding outbreaks, the new genotype from the previous smaller outbreak persevered into the upcoming larger outbreak. Conclusion: Our molecular-epidemiology study of RSV subtypes and genotypes during calendar months demonstrates that the biennial RSV cycle cannot be fully explained by the dynamic of the predominant circulating genotype of RSV. Other unknown factors account for the biennial cycle of RSV epidemics in Croatia.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"2 1","pages":"91-94"},"PeriodicalIF":0.0,"publicationDate":"2012-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582094","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}
Backgrounds: In Chronic Obstructive Pulmonary Disease (COPD) a multi factorial effort limitation becomes pro- gressively relevant as the disease progresses in the consecutive stages. It is measured by both six minutes walking test (6MWT) and maximal cardiopulmonary incremental test (CPET). Aim: It is important to assess in each stage of dis-ease the metabolic load during 6MWT referring to the outcome of CPET and to ascertain whether there is a significant rela- tionship between the measures obtained by CPET and 6MWT. Methods: Four group of fifteen patients affected by COPD in stage I to IV underwent 6MWT and maximal CPET in the same day and results were compared to a group of healthy people. Airflow obstruction was measured by whole body plethysmography, blood gases by gas analysis, maxi- mal oxygen consumption and metabolic parameters by ergometer, lactic acid levels by analyzer. Results: Maximal oxygen consumption (V’O2max) and 6MWT are progressively impaired and related (V’O2max = 1.25 ? 0.26, 1.152 ? 0.4, 1.03 ? 0.44, .85 ? 0.2 l/m; 6MWD = 452 ? 84, 446 ? 82, 381 ? 165, 200 ? 100 respectively in GOLD I to IV stage). Oxygen consumption (V’O2) during 6MWT becomes stable after 3 - 4 minutes and reached at the end of the test close to those measured at de-compensated metabolic acidosis anaerobic threshold (TDMA) (85 ± 0.4 l/m vs. 9 ? 0.4 l/m) in stage I to III, while in COPD there is no difference between V’O2max and V’O2 during 6MWT (0.85 ? 0.2 vs. 0.8 ? 0.23 l/m). 6MWT is more suitable to determine oxygen desaturation than CPET (dSaO2 ?4 ± 2% vs. ?2 ± 1%). 6MWD, the workload performed in 6MWT and V’O2max are significantly related. Conclusion: 6MWT looks as a suitable sub maximal test related CPET. Metabolic requirements under 6MWT are close to TDMA and are obtained in a suitable, self paced, usual exercise, close to everyday experience and thus related to activity daily levels. As the disease worsens the differences between V’O2 during 6MWT and V’O2max wane.
{"title":"Metabolic Requirements during Six Minutes Walking Tests in Patients Affected by Chronic Obstructive Pulmonary Disease in Different Stages","authors":"G. Valerio, Pierluigi Bracciale, Fábio Valério","doi":"10.4236/OJRD.2012.24012","DOIUrl":"https://doi.org/10.4236/OJRD.2012.24012","url":null,"abstract":"Backgrounds: In Chronic Obstructive Pulmonary Disease (COPD) a multi factorial effort limitation becomes pro- gressively relevant as the disease progresses in the consecutive stages. It is measured by both six minutes walking test (6MWT) and maximal cardiopulmonary incremental test (CPET). Aim: It is important to assess in each stage of dis-ease the metabolic load during 6MWT referring to the outcome of CPET and to ascertain whether there is a significant rela- tionship between the measures obtained by CPET and 6MWT. Methods: Four group of fifteen patients affected by COPD in stage I to IV underwent 6MWT and maximal CPET in the same day and results were compared to a group of healthy people. Airflow obstruction was measured by whole body plethysmography, blood gases by gas analysis, maxi- mal oxygen consumption and metabolic parameters by ergometer, lactic acid levels by analyzer. Results: Maximal oxygen consumption (V’O2max) and 6MWT are progressively impaired and related (V’O2max = 1.25 ? 0.26, 1.152 ? 0.4, 1.03 ? 0.44, .85 ? 0.2 l/m; 6MWD = 452 ? 84, 446 ? 82, 381 ? 165, 200 ? 100 respectively in GOLD I to IV stage). Oxygen consumption (V’O2) during 6MWT becomes stable after 3 - 4 minutes and reached at the end of the test close to those measured at de-compensated metabolic acidosis anaerobic threshold (TDMA) (85 ± 0.4 l/m vs. 9 ? 0.4 l/m) in stage I to III, while in COPD there is no difference between V’O2max and V’O2 during 6MWT (0.85 ? 0.2 vs. 0.8 ? 0.23 l/m). 6MWT is more suitable to determine oxygen desaturation than CPET (dSaO2 ?4 ± 2% vs. ?2 ± 1%). 6MWD, the workload performed in 6MWT and V’O2max are significantly related. Conclusion: 6MWT looks as a suitable sub maximal test related CPET. Metabolic requirements under 6MWT are close to TDMA and are obtained in a suitable, self paced, usual exercise, close to everyday experience and thus related to activity daily levels. As the disease worsens the differences between V’O2 during 6MWT and V’O2max wane.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"2 1","pages":"83-90"},"PeriodicalIF":0.0,"publicationDate":"2012-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582010","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}
O. Demirhan, Z. Balta, G. A. Tosun, S. Erturan, K. Sonmezoglu
Background/Aim: Although numerous prognostic factors have been described for non-small cell lung cancer (NSCLC), there is still a requirement for better and non-invasive markers. FDG-PET is a non invasive diagnostic tool that is being used increasingly in the diagnosis of lung cancer. This study evaluates the prognostic values of PET/CT defined SUV measurements and other patient/tumor characteristics in newly diagnosed stage IIIB and IV NSCLC. Method: This retrospective study included 111 patients admitted between 2005 and 2006 with stage IIIB and IV NSCLC, whose diagnoses were verified with biopsy and staging performed with PET/CT. The prognostic values of standart uptake values (SUV) of the primary lesion on PET/CT, and other patient/tumor characteristics were analyzed using survival analysis. Results: SUV was found to be unrelated with survival. Only the presence of distant metastasis, type of metastasis (bone, brain, or the contralateral lung) and the type of radiotherapy used (curative or palliative) were found to be related to survival. SUV values in epidermoid carcinoma were found to be significantly higher compared to adenocarcinoma (16.15 ± 7.18 and 12.32 ± 5.52, respectively, p = 0.021). Conclusion: Our findings do not support that SUV of the primary lesion in inoperable NSCLC has a prognostic value with respect to survival. This condition may be explained by the inclusion of significantly advanced NSCLC patients who are known to have a low survival and a high mortality, and also the relatively small sampling size.
{"title":"Prognostic Values of PET/CT Findings and Tumor/Patient Characteristics with Non-Small Cell Lung Cancer","authors":"O. Demirhan, Z. Balta, G. A. Tosun, S. Erturan, K. Sonmezoglu","doi":"10.4236/OJRD.2012.24015","DOIUrl":"https://doi.org/10.4236/OJRD.2012.24015","url":null,"abstract":"Background/Aim: Although numerous prognostic factors have been described for non-small cell lung cancer (NSCLC), there is still a requirement for better and non-invasive markers. FDG-PET is a non invasive diagnostic tool that is being used increasingly in the diagnosis of lung cancer. This study evaluates the prognostic values of PET/CT defined SUV measurements and other patient/tumor characteristics in newly diagnosed stage IIIB and IV NSCLC. Method: This retrospective study included 111 patients admitted between 2005 and 2006 with stage IIIB and IV NSCLC, whose diagnoses were verified with biopsy and staging performed with PET/CT. The prognostic values of standart uptake values (SUV) of the primary lesion on PET/CT, and other patient/tumor characteristics were analyzed using survival analysis. Results: SUV was found to be unrelated with survival. Only the presence of distant metastasis, type of metastasis (bone, brain, or the contralateral lung) and the type of radiotherapy used (curative or palliative) were found to be related to survival. SUV values in epidermoid carcinoma were found to be significantly higher compared to adenocarcinoma (16.15 ± 7.18 and 12.32 ± 5.52, respectively, p = 0.021). Conclusion: Our findings do not support that SUV of the primary lesion in inoperable NSCLC has a prognostic value with respect to survival. This condition may be explained by the inclusion of significantly advanced NSCLC patients who are known to have a low survival and a high mortality, and also the relatively small sampling size.","PeriodicalId":83134,"journal":{"name":"The Journal of respiratory diseases","volume":"2 1","pages":"101-106"},"PeriodicalIF":0.0,"publicationDate":"2012-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70582522","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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