Current Issue : April - June Volume : 2019 Issue Number : 2 Articles : 7 Articles
Objective: Exploration for chronic obstructive pulmonary disease with\nbranched air lumen hamartoma by bronchoscoptic treatment. Material and\nMethod: An old man was referred to our hospital with shortness of breath for\nmany years. Clinical evidence emphysema on respiratory examination, lung\nfunction and chest X-ray gave rise to concern. He was diagnosed as COPD\nand treated with ICS + LABA. But the shortness of breath is still existed. Initial\nassessment by CT suggested a left lower lobe collapse. Then bronchoscope\nidentified a solid abnormality in main left bronchus. The pathology showed a\nbenign neoplasm. Because of intolerance of operation, the patient was treated\nby brochoscopic intervention. The endoscopic intervention included resection\nby electrosurgical snare, electrocautery, argon plasma coagulation\n(APC). Result: After intervention, the neoplasm was partly removed and the\npathological result was endobrochial hematoma. After treatment, the patientâ??s\npanting had taken a turn for the better. After one month later, the patientâ??s\nlung function improved a lot. Conclusion: In conclusion, endobronchial\nhamartomas are one of benign neoplasms. It can cause persistent bronchial\nobstruction and recurrent pneumonias. In this case, invasive endoscopic\ntreatment provides an excellent outcome....
The current developments of the new biological drugs targeting interleukin 5 (IL-5) and IL-5 receptor allowed to expand the\ntreatment options for severe hypereosinophilic asthma. Clinicians will then be able to choose between antibodies targeting either\ncirculating IL-5 or its receptor expressed on eosinophils and basophils.The available clinical trials consistently reported favorable\nresults about the reduction of exacerbations rate, improvement in quality of life, and sparing of the systemic steroid use, with a\nfavorable safety profile. Two of these new drugs are administered subcutaneously, mepolizumab every 4 weeks and benralizumab\nevery 8 weeks, whereas reslizumab is given intravenously monthly on a weigh-based dose. In the future, the research actions will be\ninvolved in the identification of a single biomarker ormultiple biomarkers for the optimal choice of biological agents to be properly\nprescribed....
Background: Distinguishing tuberculous pleural effusion (TPE) from other\ncauses of exudative effusion is often challenging. Delay in treatment initiation\ncan occur while awaiting histo-microbiologic confirmation owing to the paucibacillary\nnature of the disease. Sago-like nodules are the most common visual\nfinding on gross thoracoscopic appearance. The primary objective was to\ndetermine the diagnostic utility of the presence of sago-like nodules on gross\nthoracoscopic appearance in TPE to help justify early initiation of tuberculosis\n(TB) treatment based on their finding while awaiting final histo-microbiologic\nconfirmation. Secondary objective was to study the correlation between the\npresence of sago-like nodules and the final histo-microbiologic findings in\npleural biopsy specimens. Methods: This was a retrospective-descriptive\nstudy of all patients with exudative pleural effusion who underwent diagnostic\nmedical thoracoscopy (MT) at Hamad General Hospital during an eight-year\nperiod (from January, 2008 to December, 2015). Results: The presence of sago-\nlike nodules on gross thoracoscopic appearance of the pleural surface had\na sensitivity of 58%, a specificity of 89% and a positive predictive value of 97%\nfor TPE with a diagnostic accuracy of 62%. There is significant association\nbetween the presence of sago-like nodules and demonstration of granulomatous\ninflammation in pleural biopsy specimens (P = 0.000). There is no\nassociation between sago-like nodules and positive TB smear and culture in\nbiopsy specimens. Conclusion: The presence of sago-like nodules on gross thoracoscopic appearance has a high specificity and positive predictive value\nfor TPE and significantly correlates with the presence of granulomatous inflammation.\nPatients from TB prevalent areas with exudative pleural effusion\nand sago-like nodules on gross thoracoscopic appearance may be commenced\non TB chemotherapy while awaiting final histologic confirmation....
Background: Hsp90-beta has been investigated to be correlated with the occurrence and development of tumor.\nThe intention of this research was to test the level of Hsp90-beta in malignant pleural effusion (MPE) of patients\nwith lung cancer and disclose the clinical significance of Hsp90-beta as a potential tumor marker for differential\ndiagnosis of pleural effusion caused by lung cancer.\nMethods: The level of Hsp90-beta was determined using enzyme-linked immunosorbent assay. Calculations of\nthe Hsp90-beta threshold, the sensitivity and specificity for distinguishing MPE from benign pleural effusion were\nperformed using receiver operator characteristic curve.\nResults: The level of Hsp90-beta in MPE of lung cancer patients was higher than that in control individuals\n(P < 0.05) and increased MPE Hsp90-beta was correlated with the pathological differentiation, tumor size and\nlymphatic metastasis (P < 0.05). The cutoff value of Hsp90-beta produced by receiver operator characteristic\ncurve for distinguishing lung cancer from control individuals were 1.659 ng/mL and the sensitivity and specificity\nwere 93.46 and 79%.\nConclusions: Increased Hsp90-beta in MPE was correlated with malignant biological behavior of lung cancer\npatients, indicating that the level of Hsp90-beta could be a tool of referential value for differential diagnosis of\npleural effusion caused by lung cancer....
Background: Lung hyperinflation contributes to dyspnea, morbidity and mortality in chronic obstructive pulmonary\ndisease (COPD). The inspiratory-to-total lung capacity (IC/TLC) ratio is a measure of lung hyperinflation and is\nassociated with exercise intolerance. However, knowledge of its effect on longitudinal change in the 6-min walk\ndistance (6MWD) in patients with COPD is scarce. We aimed to study whether the IC/TLC ratio predicts longitudinal\nchange in 6MWD in patients with COPD.\nMethods: This prospective cohort study included 389 patients aged 40â??75 years with clinically stable COPD in\nGlobal Initiative for Chronic Obstructive Lung Disease stages II-IV. The 6MWD was measured at baseline, and\nafter one and 3 years. We performed generalized estimating equation regression analyses to examine\npredictors for longitudinal change in 6MWD. Predictors at baseline were: IC/TLC ratio, age, gender, pack years,\nfat mass index (FMI), fat-free mass index (FFMI), number of exacerbations within 12 months prior to inclusion,\nCharlson index for comorbidities, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and light\nand hard self-reported physical activity.\nResults: Reduced IC/TLC ratio (p < 0.001) was a statistically significant predictor for decline in 6MWD. With a\n0.1-unit decrease in baseline IC/TLC ratio, the annual decline in 6MWD was 12.7 m (p < 0.001). Study\nparticipants with an IC/TLC ratio in the upper quartiles maintained their 6MWD from baseline to year 3, while\nit was significantly reduced for the patients with an IC/TLC ratio in the lower quartiles. Absence of light and\nhard physical activity, increased age and FMI, decreased FEV1 and FVC, more frequent exacerbations and\nhigher Charlson comorbidity index were also predictors for lower 6MWD at any given time, but did not\npredict higher rate of decline over the timespan of the study.\nConclusion: Our findings demonstrated that patients with less lung hyperinflation at baseline maintained their\nfunctional exercise capacity during the follow-up period, and that it was significantly reduced for patients with increased\nlung hyperinflation....
Background: The optimal procedure for maximizing the diagnostic yield and minimizing the procedural complexity\nof endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is controversial. We conducted a\nprospective randomized controlled trial to determine the optimal procedure of EBUS-TBNA for mediastinal and hilar\nlymphadenopathy, with a particular focus on the roles of the inner-stylet and suction.\nMethods: Consecutive patients with enlarged mediastinal and hilar lymph nodes (LNs), detected by computed\ntomography (CT) or positron emission tomography-CT (PET-CT), who underwent EBUS-TBNA were included. Each LN\nwas sampled with three needle passes using suctionâ??stylet, suctionâ??no stylet, and styletâ??no suction procedures. The\nsamples were smeared onto glass slides for cytological evaluation. A single, blinded cytopathologist evaluated each set\nof slides. The primary outcomes were cytological specimen adequacy rate and diagnostic yield of malignant LNs. The\nsecondary outcomes were tissue-core acquisition rate, procedural time, and the amount of bleeding....
Interstitial lung diseases (ILDâ??s) are a group of heterogenous chronic, ferociously\nprogressive lung diseases. The aetiology of the aforementioned diseases\nis not always recognisable. The diagnosis of these dismal diseases is a\nvivid challenge for the physicians. Through the intervening years different\ndiagnostic algorithms have been implemented towards more accurate outcome.\nDifferent types of ILDâ??s demand diverse diagnostic approaches. In the\nlatest years a novel diagnostic mini invasive approach seems to gain continuously\nterrain towards the diagnosis of ILDâ??s. Transbronchial cryobiopsy\nmay be the Holy Grail in the diagnosis of these diseases or a misleading diagnostic\ntool in this challenging field....
Loading....