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Advances in Respiratory Medicine is published by MDPI from Volume 90 Issue 4 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Via Medica.

Adv. Respir. Med., Volume 88, Issue 5 (October 2020) – 21 articles , Pages 369-475

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243 KiB  
Article
Diagnostic Implications of Bronchial Lavage in Patients with Pleural Tuberculosis
by Kamran Khan Sumalani, Nousheen Akhter, Maqbool Ahmed, Dimple Chawla and Nadeem Ahmed Rizvi
Adv. Respir. Med. 2020, 88(5), 389-393; https://doi.org/10.5603/ARM.a2020.0149 - 31 Oct 2020
Cited by 4 | Viewed by 619
Abstract
Introduction: The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. It is difficult to obtain sputum even after induction in these patients. An alternative method of acquiring respiratory specimens is via bronchial lavage. This study was [...] Read more.
Introduction: The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. It is difficult to obtain sputum even after induction in these patients. An alternative method of acquiring respiratory specimens is via bronchial lavage. This study was undertaken to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay of bronchial lavage fluid in the workup of pleural tuberculosis patients. Material and methods: All patients who met the inclusion criteria of the study underwent thoracentesis, pleural biopsy, and bronchial lavage. Specimens of pleural fluid, pleural biopsy, and bronchial lavage fluid were sent for acid fast bacilli smear, culture, and Xpert assay. Result: Bronchial lavage AFB smear, culture, and Xpert assay was positive in 9.5%, 17.9%, and 26.2% of patients, respectively. It gave an immediate diagnosis in 22 (26.2%) patients. Conclusion: Bronchial lavage, though not a surrogate to pleural biopsy, offers an additional approach to the early diagnosis of pleural tuberculosis in patients not producing sputum. Besides being diagnostic, this method also has epidemiologic significance in containing the tuberculosis epidemic because detecting Mycobacterium in bronchial lavage confirms that the patient is infectious. Full article
294 KiB  
Review
Short-Acting Inhaled β2-Agonists: Why, Whom, What, How?
by Andrzej Emeryk and Justyna Emeryk-Maksymiuk
Adv. Respir. Med. 2020, 88(5), 443-449; https://doi.org/10.5603/ARM.a2020.0132 - 30 Oct 2020
Cited by 4 | Viewed by 953
Abstract
We showed the present data about the efficacy and safety of inhaled short-acting β2-agonists (SABA), such as salbutamol and fenoterol, in the management of obstructive diseases in children and adults. Our work discusses major mechanisms of action, clinical effects, possible side effects [...] Read more.
We showed the present data about the efficacy and safety of inhaled short-acting β2-agonists (SABA), such as salbutamol and fenoterol, in the management of obstructive diseases in children and adults. Our work discusses major mechanisms of action, clinical effects, possible side effects and indications of inhaled SABA. We presented current recommendations for the position of SABA in the therapy of obstructive diseases in children and adults, particularly in asthma and chronic obstructive pulmonary disease. Full article
170 KiB  
Letter
Capacity of Exercise in Sarcoidosis: What Is the Importance of Cardiopulmonar Exercise Test in These Patients?
by Eunice Maria Ferreira Eira Marques Dias, Margarida Valério and Cidália Rodrigues
Adv. Respir. Med. 2020, 88(5), 473-475; https://doi.org/10.5603/ARM.a2020.0157 - 24 Oct 2020
Viewed by 380
Abstract
Sarcoidosis is a heterogeneous multisystem granulomatous disease of unknown etiology [...] Full article
274 KiB  
Letter
Removal of a Self-Sxpanding Metallic Y Stent in the Management of Reversible Central Airway Obstruction Due to Mediastinal Lymphoma
by Gopal Chawla, Karan Madan, Hariharan Iyer, Pawan Tiwari, Vijay Hadda, Anant Mohan and Saurabh Mittal
Adv. Respir. Med. 2020, 88(5), 470-472; https://doi.org/10.5603/ARM.a2020.0146 - 24 Oct 2020
Cited by 1 | Viewed by 427
Abstract
In adults, central airway obstruction (CAO) can occur due to several benign and malignant etiologies either due to an endobronchial growth or extrinsic compression [...] Full article
202 KiB  
Letter
Vascular Microthrombosis Associated with Increased Interleukin-6. A Severe Acute Respiratory Distress Syndrome in COVID-19 Patients Treated with Tocilizumab
by Niayesh Mohebbi, Atefeh Abedini, Reza Lashgari, Fatemeh Razavi, Mohammad Varahram and Arda Kiani
Adv. Respir. Med. 2020, 88(5), 468-469; https://doi.org/10.5603/ARM.a2020.0123 - 24 Oct 2020
Cited by 1 | Viewed by 441
Abstract
Thrombosis is an important pathology in the deterioration of COVID-19 patient [...] Full article
513 KiB  
Case Report
Pneumomediastinum and Subcutaneous Emphysema after Noninvasive Ventilation in a COVID-19 Patient
by Natale Vazzana, Silvia Ognibene and Francesco Dipaola
Adv. Respir. Med. 2020, 88(5), 466-467; https://doi.org/10.5603/ARM.a2020.0141 - 24 Oct 2020
Cited by 6 | Viewed by 487
Abstract
An 80-year-old man was admitted because of persistent fever and dyspnea [...] Full article
704 KiB  
Case Report
A Young Non-Smoker with High ADA Pleural Effusion. It’s Not Always Tuberculosis
by Gopal Chawla, Amrit Pal Kansal and Kunal Deokar
Adv. Respir. Med. 2020, 88(5), 464-465; https://doi.org/10.5603/ARM.a2020.0144 - 24 Oct 2020
Cited by 1 | Viewed by 407
Abstract
Lung cancer is posing an ever-increasing medical and social problem due to its increasing morbidity and mortality [...] Full article
555 KiB  
Case Report
Massive Hemoptysis Due to Anastomosis between the Left Phrenic Artery and Pulmonary Arteries/Veins
by Jolita Palacionyte, Vilma Hofertiene, Kristina Bieksiene and Skaidrius Miliauskas
Adv. Respir. Med. 2020, 88(5), 458-461; https://doi.org/10.5603/ARM.a2020.0136 - 24 Oct 2020
Viewed by 422
Abstract
Massive hemoptysis is a serious medical condition or emergency which needs immediate treatment. It typically appears in the bronchial arteries and can be caused by a wide range of pulmonary diseases. This report is based on a very rare case of a patient [...] Read more.
Massive hemoptysis is a serious medical condition or emergency which needs immediate treatment. It typically appears in the bronchial arteries and can be caused by a wide range of pulmonary diseases. This report is based on a very rare case of a patient bleeding from an anastomosis between the left phrenic artery and pulmonary arteries/veins. In this case, the chest computed tomography had detected changes which required doctors to perform a successful embolization. Full article
1114 KiB  
Case Report
A Case of an 81-Year-Old with Cough and Dyspnea
by Nitesh Gupta, Abanti Das, Pranav Ish, Rohit Kumar, Ankit Sharma and Shibdas Chakrabarti
Adv. Respir. Med. 2020, 88(5), 454-457; https://doi.org/10.5603/ARM.a2020.0158 - 24 Oct 2020
Viewed by 505
Abstract
It is uncommon to diagnose usual interstitial pneumonitis as a unilateral presentation. We present a case of an 81-year-old current smoker who presented with exertional dyspnea and dry cough. The patient had right sided UIP pattern in the CT chest along with hiatus [...] Read more.
It is uncommon to diagnose usual interstitial pneumonitis as a unilateral presentation. We present a case of an 81-year-old current smoker who presented with exertional dyspnea and dry cough. The patient had right sided UIP pattern in the CT chest along with hiatus hernia. The etiology for the unilateral lung involvement was postulated to be due to the hiatus hernia leading to gastro-esophageal reflux disease (GERD) which caused micro aspirations leading to lung injury and fibroblast activation. Whether this can be prevented by anti-reflux medications needs further research. Our patient was managed with pirfenidone, metered dose inhalers containing tiotropium and proton-pump inhibitors Thus, a high index of suspicion for underlying gastro-esophageal reflux must be kept in such patients to arrive at an early diagnosis and start treatment. Full article
925 KiB  
Review
Bronchoscopic Lung Volume Reduction Using Coil Therapy: Complications and Management
by Askin Gulsen
Adv. Respir. Med. 2020, 88(5), 433-442; https://doi.org/10.5603/ARM.a2020.0152 - 24 Oct 2020
Cited by 1 | Viewed by 752
Abstract
Nonsurgical approaches involving bronchoscopic lung volume reduction (BLVR) have been developed in the last decade. One of these, the BLVR coil procedure, is a treatment option for patients with homogeneous and heterogeneous end-stage emphysema and a forced expiratory volume in 1 second (FEV [...] Read more.
Nonsurgical approaches involving bronchoscopic lung volume reduction (BLVR) have been developed in the last decade. One of these, the BLVR coil procedure, is a treatment option for patients with homogeneous and heterogeneous end-stage emphysema and a forced expiratory volume in 1 second (FEV1) of 15–45%. This treatment decreases hyperinflation and improves lung function, the quality of life, and exercise capacity. It is very important to prepare patients for treatment, premedications, anesthesia applications, intubation, post-procedure follow-up and treatments. Further, it has been observed that various complications can develop during and after the procedure. Generally, the observed and reported complications are chronic obstructive pulmonary disease (COPD) exacerbation, chest pain, mild bleeding, pneumonia, pneumothorax, and respiratory failure. Rarely, aspergillus cavitation (coil-related aspergilloma), bronchopleural fistula and penetration into the pleural space, bronchiectasis, coil-associated inflammatory response and opacities, and hiccups are observed. Common complications are usually mild or moderate, while the rare ones can be life-threatening (except hiccup), so early diagnosis and treatment are necessary. However, patients treated with BLVR have lower mortality rates than untreated patients with similar morbidity. Based on the findings of this review, we can estimate that premedication one day before and just before the procedure may reduce potential complications. Some medical centers apply and recommend 30-day macrolide treatment after the procedure. New generation supraglottic devices may be preferred to avoid complications due to endotracheal intubation. Moreover, further research is needed to identify risk factors, prevent potential complications, and a common consensus is required for routine preventive treatment. Full article
610 KiB  
Article
Basics of Mechanical Ventilation for Non-Anaesthetists. Part 1: Theoretical Aspects
by Zbigniew Putowski, Marcelina Czok, iotr S. Liberski and Łukasz J. Krzych
Adv. Respir. Med. 2020, 88(5), 424-432; https://doi.org/10.5603/ARM.a2020.0143 - 24 Oct 2020
Cited by 1 | Viewed by 646
Abstract
The expanding number of chronic respiratory diseases and the new Covid-19 outbreak create an increasing demand for mechanical ventilation (MV). As MV is no longer limited to intensive care units (ICU) and operating rooms (OR), more clinicians should acquaint themselves with the principles [...] Read more.
The expanding number of chronic respiratory diseases and the new Covid-19 outbreak create an increasing demand for mechanical ventilation (MV). As MV is no longer limited to intensive care units (ICU) and operating rooms (OR), more clinicians should acquaint themselves with the principles of mechanical ventilation. To fully acknowledge contemporary concepts of MV, it is crucial to understand the elemental physiology and respiratory machine nuances. This paper addresses the latter issues and provides insight into ventilation modes and essential monitoring of MV. Full article
207 KiB  
Communication
Longitudinal Changes in Exercise Capacity among Adult Cystic Fibrosis Patients
by Afroditi K. Boutou, Katerina Manika, Marija Hajimitrova, Georgia Pitsiou, Pinelopi Giannakopoulou, Evdokia Sourla and Ioannis Kioumis
Adv. Respir. Med. 2020, 88(5), 420-423; https://doi.org/10.5603/ARM.a2020.0145 - 24 Oct 2020
Cited by 4 | Viewed by 442
Abstract
Introduction: Longitudinal data regarding changes in exercise capacity among adult cystic fibrosis (CF) patients are currently scarce. The aim of this brief report was to assess changes in exercise capacity among adult CF patients with stable and mild-to-moderate disease eight years after their [...] Read more.
Introduction: Longitudinal data regarding changes in exercise capacity among adult cystic fibrosis (CF) patients are currently scarce. The aim of this brief report was to assess changes in exercise capacity among adult CF patients with stable and mild-to-moderate disease eight years after their initial evaluation. Material and methods: Maximum cardiopulmonary exercise testing (CPET) was utilized. Other assessments included Doppler echocardiography, the 6-minute walking test, spirometry, and lung volume evaluation. Results: Eleven (6 male, 5 female) patients completed both evaluations (initial and after eight years). During follow-up, indices of ventilatory impairment (such as ventilatory reserve; p=0.019, and ventilatory equivalent for carbon dioxide; p = 0.047) deterio-rated significantly following a decline in respiratory function measurements. Peak oxygen uptake (VO2), both as an absolute (26.6 ± 8.46 vs 23.89 ± 6.16 mL/kg/min; p = 0.098) and as a % of predicted value (71.21 ± 16.54 vs 70.60 ± 15.45; p = 0.872), did not deteriorate. This is also true for oxygen pulse (p = 0.743), left heart ejection fraction (p = 0.574), and pulmonary artery systolic pressure (p = 0.441). However, the anaerobic threshold, both as an absolute (p = 0.009) and as a % of predicted value (p = 0.047), was significantly lower during follow-up. Conclusion: In adult CF patients with stable, mild-to-moderate disease, a peak VO2 may be preserved for several years. However, even in these patients, deconditioning is present. Full article
290 KiB  
Article
Echocardiographic Assessment of the Right Ventricle and Its Correlation with Patient Outcome in Acute Respiratory Distress Syndrome
by Ahmed Taha, Tayseer Zaytoun, Hany Eid, Ayman Baess and Ehab Elreweny
Adv. Respir. Med. 2020, 88(5), 412-419; https://doi.org/10.5603/ARM.a2020.0153 - 24 Oct 2020
Cited by 7 | Viewed by 674
Abstract
Introduction: Acute respiratory distress syndrome (ARDS) is a life-threatening chest disease associated with a poor outcome and increased mortality. It may lead to pulmonary hypertension and, eventually, right ventricular failure. These changes can be investigated by transthoracic echocardiography (TTE) which is considered a [...] Read more.
Introduction: Acute respiratory distress syndrome (ARDS) is a life-threatening chest disease associated with a poor outcome and increased mortality. It may lead to pulmonary hypertension and, eventually, right ventricular failure. These changes can be investigated by transthoracic echocardiography (TTE) which is considered a non-invasive and cost-effective modality. We studied the role of right ventricular function in the prediction of the severity and mortality in ARDS. Material and methods: In this observational study, 94 patients suffering from ARDS were subjected to TTE to evaluate the parameters of right ventricular function by measuring tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RV-FAC), myocardial performance index (Tei index), and systolic pulmonary artery pressure (SPAP) to assess their relation to the severity and mortality in ARDS. Results: TAPSE, SPAP, Tei index, and RV-FAC showed significant differences between survivors and non-survivors after 30 days (all p < 0.001). An increased length of intensive care unit stay was significantly correlated with TAPSE, Tei index, and RV-FAC (p = 0.002‚ 0.007‚ and 0.013, respectively). Meanwhile, the length of mechanical ventilation days was significantly correlated with the Tei index only (p < 0.001). Multivariate regression analysis found that TAPSE and the Tei index were independent factors affecting mortality (p = 0.004‚ and 0.006, respectively). RV-FAC, with a cut-off point ≤ 57%, had the highest sensitivity‚ while TAPSE, with a cut-off point ≤ 17 mm, had the highest specificity to predict mortality. Conclusions: Transthoracic echocardiographic parameters of the right ventricle could be used to predict severity and mortality in patients with ARDS with high sensitivity and specificity. Full article
306 KiB  
Article
The Role of Bronchoscopy in Diagnosis of Chronic Cough in Adults: A Retrospective Single-Center Study
by Patryk A. Sobczak, Justyna M. Sobczak, Sebastian Majewski, Joanna Miłkowska-Dymanowska, Zofia Kurmanowska, Karolina Szewczyk, Ewa Tyczkowska-Sieroń, Adam J. Białas, Adam Antczak, Paweł Górski and Wojciech J. Piotrowski
Adv. Respir. Med. 2020, 88(5), 406-411; https://doi.org/10.5603/ARM.a2020.0140 - 24 Oct 2020
Cited by 3 | Viewed by 548
Abstract
Introduction: Cough is one of the most frequent symptoms reported to pulmonologists. The role of bronchoscopy in the diagnostic work-up of chronic cough is not clearly defined. The aim of this study was to evaluate the utility of fiberoptic bronchoscopy (FOB) and additional [...] Read more.
Introduction: Cough is one of the most frequent symptoms reported to pulmonologists. The role of bronchoscopy in the diagnostic work-up of chronic cough is not clearly defined. The aim of this study was to evaluate the utility of fiberoptic bronchoscopy (FOB) and additional testing of samples collected during FOB in the differential diagnosis of chronic cough in adults. Material and methods: This was a single-center retrospective study. Out of 7115 conventional white light FOB examinations, we finally selected 198 with cough as the only indication. Results: In 40.9% of bronchoscopic examinations, no visible cause of cough was found. Visual signs of chronic bronchitis (CB) were detected in 57.6% of reports. Only in 3 cases (1.5%) bronchoscopy revealed a potential cause of chronic cough other than CB. Mycobacterium tuberculosis or other mycobacteria were spotted in none of the samples. In 91.1% of bronchoalveolar lavage (BAL) cytologic examinations, at least one cell count abnormality was detected, but only in case of increased percentage of eosinophils, it might be considered clinically relevant. In 53% of bacteriological culture results, at least one potentially pathogenic bacterium was isolated. Conclusions: The present study results strengthen the evidence that FOB combined with additional testing of airway specimens obtained during FOB is not a powerful tool in the differential diagnosis of chronic cough, and FOB as a diagnostic tool may be overused. The appropriate timing and decision regarding referral for FOB and additional testing of achieved material requires careful clinical consideration. Full article
701 KiB  
Article
Using a Simple Open-Source Automated Machine Learning Algorithm to Forecast COVID-19 Spread: A Modelling Study
by Shahir Asfahan, Maya Gopalakrishnan, Naveen Dutt, Ram Niwas, Gopal Chawla, Mehul Agarwal and Mahendera Kumar Garg
Adv. Respir. Med. 2020, 88(5), 400-405; https://doi.org/10.5603/ARM.a2020.0156 - 24 Oct 2020
Cited by 4 | Viewed by 797
Abstract
Introduction: Machine learning algorithms have been used to develop prediction models in various infectious and non-infectious settings including interpretation of images in predicting the outcome of diseases. We demonstrate the application of one such simple automated machine learning algorithm to a dataset obtained [...] Read more.
Introduction: Machine learning algorithms have been used to develop prediction models in various infectious and non-infectious settings including interpretation of images in predicting the outcome of diseases. We demonstrate the application of one such simple automated machine learning algorithm to a dataset obtained about COVID-19 spread in South Korea to better understand the disease dynamics. Material and methods: Data from 20th January 2020 (when the first case of COVID-19 was detected in South Korea) to 4th March 2020 was accessed from Korea’s centre for disease control (KCDC). A future time-series of specified length (taken as 7 days in our study) starting from 5th March 2020 to 11th March 2020 was generated and fed to the model to generate predictions with upper and lower trend bounds of 95% confidence intervals. The model was assessed for its ability to reliably forecast using mean absolute percentage error (MAPE) as the metric. Results: As on 4th March 2020, 145,541 patients were tested for COVID-19 (in 45 days) in South Korea of which 5166 patients tested positive. The predicted values approximated well with the actual numbers. The difference between predicted and observed values ranged from 4.08% to 12.77% . On average, our predictions differed from actual values by 7.42% (MAPE) over the same period. Conclusion: Open source and automated machine learning tools like Prophet can be applied and are effective in the context of COVID-19 for forecasting spread in naïve communities. It may help countries to efficiently allocate healthcare resources to contain this pandemic. Full article
269 KiB  
Article
A Comparative Study Evaluating C-Reactive Protein, Sputum Eosinophils and Forced Expiratory Volume in One Second in Obese and Nonobese Asthmatics
by Harish Mahender, Raja Amarnath and Sreenivasan Vadivelu
Adv. Respir. Med. 2020, 88(5), 394-399; https://doi.org/10.5603/ARM.a2020.0155 - 24 Oct 2020
Cited by 1 | Viewed by 520
Abstract
Introduction: Asthma and obesity are considered inflammatory disorders. Inflammatory markers—sputum eosinophils, C-reactive protein (CRP) and the forced expiratory volume in one second (FEV1) were analysed to find their association in obese asthmatics and compared with their asthma control test (ACT) to understand these [...] Read more.
Introduction: Asthma and obesity are considered inflammatory disorders. Inflammatory markers—sputum eosinophils, C-reactive protein (CRP) and the forced expiratory volume in one second (FEV1) were analysed to find their association in obese asthmatics and compared with their asthma control test (ACT) to understand these parameters in this phenotype. Material and methods: After completing the asthma control test (ACT), the CRP, FEV1 and sputum eosinophils of sixty asthmatics were compared to find the association of them in obese and nonobese asthmatics and contrasted with their ACT. The data were analysed using IBM SPSS V20.0, Mann-Whitney U test (non-parametric test), Pearson’s correlation coefficient and Fisher’s exact test. Results: We found significant differences for CRP (P = 0.001) and sputum eosinophils (P = 0.001) between obese and nonobese asthmatics, both higher in obese asthmatics and with a significant association with body mass index (BMI) (P < 0.05). The FEV1 levels were independent of the BMI levels of asthmatics. There was a significant correlation between the CRP and sputum eosin-ophils (0.52, P = 0.001) for all asthmatics. There was no significant correlation between FEV1 and sputum eosinophils (nonobese P = 0.120, obese P = 0.388) and between FEV1 and CRP (obese P = 0.423, nonobese P = 0.358) in both obese and nonobese asthmatics. Obesity had an association (P = 0.001) with ACT scores (≤ 19). Conclusions: Sputum eosinophils and CRP were raised in obese asthmatics and had a positive association with BMI. Obese asthmatics had a poorer subjective asthma control than nonobese asthmatics despite FEV1 being independent of the BMI levels. Measuring the systemic inflammatory markers could help in additional interventions in reducing systemic inflammation and thus possibly facilitating better symptom control. Full article
242 KiB  
Article
Association of Smoking and Drug Abuse with Treatment Failure in Individuals with Tuberculosis: A Case-Control Study
by Homa Serpoosh, Yadollah Hamidi, Payman Eini and Younes Mohammadi
Adv. Respir. Med. 2020, 88(5), 383-388; https://doi.org/10.5603/ARM.a2020.0138 - 24 Oct 2020
Cited by 3 | Viewed by 621
Abstract
Introduction: Treatment failure in tuberculosis (defined as a positive sputum smear 5 months after the initiation of anti-TB treat-ment) is a major threat to the control over TB. This study aimed to investigate the association of smoking and drug abuse with treatment failure [...] Read more.
Introduction: Treatment failure in tuberculosis (defined as a positive sputum smear 5 months after the initiation of anti-TB treat-ment) is a major threat to the control over TB. This study aimed to investigate the association of smoking and drug abuse with treatment failure among individuals with TB. Material and methods: Out of 286 TB patients with available data registered by the health system of Hamadan Provinces in western Iran, 24 TB patients with treatment failure (positive sputum smear, 5 months after initiation of anti-TB treatment) and 262 patients without treatment failure (negative sputum smear, five months after initiation of anti-TB treatment) were selected as case and control groups, respectively. These two groups were compared to each other in terms of demographic status which include age, sex, job, residence, and risk factors such as smoking and drug abuse status. An odds ratio (OR) with a 95% confidence interval was used as a measure of association. The Bonferroni correction was used to counteract multiple comparisons, therefore, a p-value of less than 0.004 was statistically significant. Results: No significant association was found between treatment failure and age, residence, comorbidity, education level, job status, sex, smoking, and method of drug abuse (P > 0.004). However, a significant association was found between duration of smoking, number of cigarettes per day, and drug abuse with treatment failure in univariate analysis (P < 0.004). In multivariate analysis, only an association with drug abuse was significantly associated with treatment failure (P = 0.047). Conclusion: Drug abuse substantially increases the risk of treatment failure. Therefore, in order to control TB, it is suggested that preventive programs are designed in order to decrease drug abuse among TB patients before starting treatment. Full article
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Article
Exposure to Stressful Life Events among Patients with Chronic Obstructive Pulmonary Disease: A Prospective Study
by Mohammad Ali Zohal, Sima Rafiei, Nafise Rastgoo and Sanaz Jamshidi
Adv. Respir. Med. 2020, 88(5), 377-382; https://doi.org/10.5603/ARM.a2020.0122 - 24 Oct 2020
Cited by 3 | Viewed by 603
Abstract
Introduction: Although depression and anxiety have been widely investigated among patients with chronic obstructive pulmonary disease (COPD), experiencing stressful life events and its effect on increasing risk of exacerbations was rarely assessed. This study aimed to clarify the association between facing with stressful [...] Read more.
Introduction: Although depression and anxiety have been widely investigated among patients with chronic obstructive pulmonary disease (COPD), experiencing stressful life events and its effect on increasing risk of exacerbations was rarely assessed. This study aimed to clarify the association between facing with stressful events among COPD patients and their disease severity leading to hospitalization. Material and methods: A prospective study was conducted among 128 COPD patients from the population of Qazvin, a north-west, industrialized city of Iran from December 2017 to December 2018. Patients were followed up for one-year and their related measures were gathered. To compare variables among patients stratified by reporting stressful life conditions, Pearson’s chi-square and Fisher’s exact tests were used. Furthermore, to assess the effect of several covariates on the response variable, a logistic regression modelling was applied. Results were reported in form of odds ratios and their 95% confidence intervals. Results: Study findings affirmed that patients who had experienced stressful situation had lower BMI, were retired, experienced more frequent exacerbations, and reported higher levels of anxiety/ depression. Moreover, those with stressful conditions were among current or former smokers (p < 0.05). Logistic regression analysis revealed that facing with stressful situations was significantly associated with the severity of COPD disease (OR 1.9; 95% CI 2.5 to 5.6), smoking habit (OR 2.8; 95% CI 1.6 to 4.2; OR 1.5; 95% CI 1.4 to 2.2), and hospitalization during one-year follow up (OR 1.2; 95% CI 1 to 3.3). Conclusions: To improve health outcomes of COPD patients, close attention should be given to their psychological disorder and appropriate strategies should be applied to reduce patients’ exposure to stressful life events and subsequent anxieties. Full article
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Article
The Gender–Age–Physiology System as a Prognostic Model in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib: A Longitudinal Cohort Study
by Mitsuhiro Abe, Kenji Tsushima, Keiichiro Yoshioka, Masashi Sakayori, Kenichi Suzuki, Yasutaka Hirasawa, Takeshi Kawasaki, Jun Ikari, Jiro Terada and Koichiro Tatsumi
Adv. Respir. Med. 2020, 88(5), 369-376; https://doi.org/10.5603/ARM.a2020.0137 - 24 Oct 2020
Cited by 3 | Viewed by 585
Abstract
Introduction: The Gender-Age-Physiology (GAP) system is a tool for predicting prognosis in patients with idiopathic pulmonary fibrosis (IPF). Yet, to date, the GAP system has not been evaluated in patients with IPF who received nintedanib. Material and methods: This single-center retrospective study included [...] Read more.
Introduction: The Gender-Age-Physiology (GAP) system is a tool for predicting prognosis in patients with idiopathic pulmonary fibrosis (IPF). Yet, to date, the GAP system has not been evaluated in patients with IPF who received nintedanib. Material and methods: This single-center retrospective study included 89 patients with IPF who received Nintedanib for at least 3 months. All-cause mortality was set as the end point. Clinical parameters, including the GAP stage, were statistically analyzed for risk factors leading to mortality using the Cox proportional hazard model. Results: The median follow-up was 16.4 months (range 3.7–37.4 months), during which 23 patients died. Univariate analysis revealed that the GAP stage (hazard ratio [HR] 3.00, 95% confidence interval [CI] 1.52–5.92, p = 0.0014) and PaO2 (HR 0.95, 95% CI 0.92–0.98, p = 0.0063) were significant prognostic factors. Multivariate analysis revealed that the GAP stage was a significant prognostic factor (HR 2.26, 95% CI 1.07–4.78, p = 0.031). Log-rank analysis revealed that there were no significant differences in “Gender” (p = 0.47) and “Age” (p = 0.18) factors. However, there were significant differences in “Physiology” factors (% of forced vital capacity, p = 0.018; % of diffusing capacity of lung carbon monoxide, p < 0.001). The cumulative incidences of mortality at 1 and 2 years were as follows: GAP I: 5.1% and 6.8%; GAP II: 9.5% and 29.3%; and GAP III: 18.9% and 84.2%. Conclusions: The GAP system is useful as a prognostic tool in patients with IPF who have been treated with nintedanib. Full article
477 KiB  
Case Report
A Rare Initial Presentation of Miliary Tuberculosis
by Somya Ish, Vidushi Rathi, Pranav Ish, Himanshu Garkoti and Deepa Sharma
Adv. Respir. Med. 2020, 88(5), 462-463; https://doi.org/10.5603/ARM.a2020.0127 - 27 Jul 2020
Cited by 2 | Viewed by 410
Abstract
A sixteen-year-old female presented with a gradual decrease of vision in the left eye for two weeks [...] Full article
547 KiB  
Case Report
Early and Interdisciplinary Physiotherapy in a Patient in the Intensive Care Unit with a Bronchopulmonary Fistula after Thoracic Fenestration: A Case Report
by Monika Bal-Bocheńska, Justyna Wyszyńska and Wojciech Kądziołka
Adv. Respir. Med. 2020, 88(5), 450-453; https://doi.org/10.5603/ARM.a2020.0128 - 27 Jul 2020
Viewed by 445
Abstract
The aim of this study is to present the effects of the medical team’s therapy with particular focus on early physiotherapy in a patient subjected to elective pneumonectomy due to pleural empyema and chest fenestration. Our patient was 48 years old and underwent [...] Read more.
The aim of this study is to present the effects of the medical team’s therapy with particular focus on early physiotherapy in a patient subjected to elective pneumonectomy due to pleural empyema and chest fenestration. Our patient was 48 years old and underwent an elective pneumonectomy due to pleural empyema and cicatrization atelectasis as a result of complications. A lack of lung recoil after chest fenestration was the indication to transfer the patient to the intensive care unit (ICU) from the operating theater. Respective rehabilitation is necessary to restore the function of the respiratory system. It should be an integral part of the treatment plan, must be implemented in a timely manner, and should continue until the patient’s full recovery. This paper presents the effects of the medical team’s work with the emphasis on early physiotherapy in a patient in the ICU that resulted in a shorter hospitalization and a full return to functional capacity. Full article
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