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https://www.readbyqxmd.com/read/28731576/influence-of-trainee-involvement-on-procedural-characteristics-for-linear-endobronchial-ultrasound
#1
Sébastien Nguyen, Nancy Ferland, Stéphane Beaudoin, Simon Martel, Mathieu Simon, Francis Laberge, Noel Lampron, Marc Fortin, Antoine Delage
BACKGROUND: Linear endobronchial ultrasound (EBUS) is a safe and effective method for the diagnostic sampling of mediastinal lymph nodes. However, there is a learning curve associated with the procedure and operator experience influences diagnostic yield. We sought to determine if trainee involvement during EBUS influences procedural characteristics, complication rate, and diagnostic yield. METHODS: We performed a retrospective analysis of 220 subjects who underwent an EBUS procedure at our center from December 2012 to June 2013...
July 21, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28721354/diagnostic-outcomes-after-chest-radiograph-interpretation-in-patients-with-suspected-tuberculosis-and-negative-sputum-smears-in-a-high-burden-human-immunodeficiency-virus-and-tuberculosis-setting
#2
Patrick G T Cudahy, Rodney Dawson, Brian W Allwood, Gary Maartens, Douglas Wilson
BACKGROUND: Evaluation of patients with suspected tuberculosis and negative sputum smears for acid-fast bacilli (AFB) is challenging, especially in high human immunodeficiency virus coinfection settings where sputum smears have lower sensitivity for detecting AFB. METHODS: We examined the utility of chest radiographs for detecting smear-negative pulmonary tuberculosis. Three hundred sixty sputum smear-negative patients who were referred from primary care clinics in the KwaZulu-Natal province of South Africa were evaluated...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28713683/do-we-really-care-about-incidental-lung-nodules-review-of-atypical-lung-carcinoid-and-a-proposal-for-systematic-patient-follow-up
#3
Henal Motiwala, Itisha Bansal, Pradeep Goyal, Olena Dorokhova, Yogesh Kumar, Thomas D Olsavsky, Albert DiMeo, Nishant Gupta
Atypical lung carcinoids are intermediate-grade neuroendocrine tumors (NETs) with malignant potential. They are often detected incidentally on imaging done for non-related causes, as the patients are frequently asymptomatic. Histopathology is required to confirm the diagnosis with immunohistochemistry (IHC). Due to their indolent nature, these are often diagnosed only in the advanced stages. Treatment options include chemoradiation for widespread disease versus surgery for local or minimally invasive disease...
June 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28712576/comparing-effectiveness-and-outcomes-in-asthma-and-cystic-fibrosis
#4
REVIEW
Michael S Schechter
As technology yields new treatments, pediatric pulmonologists need determine how best to use them and how to decide which ones are best for any specific group or individual patient. Physicians have always customized therapies based upon patient response, but the new concept of "Personalized (or precision) medicine" focuses attention to a greater degree on the individual needs of patients based on their genetic, biomarker, phenotypic, or psychosocial characteristics. The newly developed biologics for treatment of asthma and CFTR modulators for treatment of cystic fibrosis (CF) highlight this newer approach...
June 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28705304/clinical-practice-of-acute-respiratory-distress-syndrome-in-japan-a-nationwide-survey-and-scientific-evidences
#5
Sadatomo Tasaka, Koichiro Tatsumi
BACKGROUND: There has been limited information about epidemiology and clinical practice of acute respiratory distress syndrome (ARDS) in Japan. METHODS: An invitation letter to the web-based survey was mailed to all 871 board certified hospitals of the Japanese Respiratory Society. The questionnaires were designed to collect data on epidemiology and clinical practice of ARDS, including diagnostic measures and therapeutics. RESULTS: Within 4 months of the survey period, valid responses were obtained from 296 (34%) hospitals...
July 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28704913/treatment-of-connective-tissue-disease-associated-interstitial-lung-disease-the-pulmonologist-s-point-of-view
#6
REVIEW
So-My Koo, Soo-Taek Uh
Interstitial lung disease (ILD) occurs in 15% of patients with collagen vascular disease (CVD), referred to as connective tissue disease (CTD). Despite advances in management strategies, ILD continues to be a significant cause of mortality in patients with CVD-associated ILD (CTD-ILD). There is a lack of randomized, clinical trials assessing pharmacological agents for CTD-ILD, except in cases of ILD-associated systemic sclerosis (SSc). This may be due to the lack of CTD cases available, the difficulty of histological confirmation of ILD, and the various types of CTD and ILD...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28702333/cough-syncope-induced-by-post-nasal-drip-successfully-managed-by-gabapentin
#7
Hussein Algahtani, Bader Shirah
Syncope is a common complaint in both neurology clinic and emergency department. It is defined as transient loss of consciousness with loss of postural tone, which is usually self-limited and followed by a spontaneous recovery. Our report describes a case of cough syncope resulting from chronic intractable cough caused by post nasal drip. Although his experience was debilitating, we were able to control his symptoms significantly using a small dose of Gabapentin. This dose is much lower when compared with the already established licensed indicated higher doses used for the treatment of neuropathic pain and epilepsy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28696803/thai-pediatricians-current-practice-toward-childhood-asthma
#8
Harutai Kamalaporn, Pongpan Chawalitdamrong, Aroonwan Preutthipan
BACKGROUND: Childhood asthma is a substantial health burden in Thailand. Due to a lack of pediatric respiratory specialists (pediatric pulmonologists and allergists; RS), most Thai children are cared for by general pediatricians (pediatric primary care providers (PCP)). OBJECTIVES: We investigated whether current practices of Thai pediatricians complied with asthma guidelines and compared practices (diagnosis and treatments) provided by PCP and RS. METHODS: A cross-sectional study was conducted using electronic surveys including four case scenarios of different asthma phenotypes distributed to Thai pediatricians...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28696635/-how-to-handle-a-non-resolving-pneumonia
#9
Benoit Lechartier, Maura Prella, Oriol Manuel, Laurent P Nicod
Persistent pneumonias are frequent both in hospital and primary care settings. Several parameters have to be taken into account. Firstly the appropriateness of treatment; secondly the immune status of the host; and finally infectious complications need to be ruled out. Several non-infectious diagnoses can mimic a persistent infiltrate, such as neoplastic disorders, organising pneumonias, interstitial disorders and drug - or radiation-induced lung diseases. Uncommon pathogens will not respond to common treatment, for instance atypical bacteria, mycobacteria, fungi including Pneumocystis as well as viruses...
November 16, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28667654/idiopathic-pulmonary-fibrosis-ipf-common-practice-in-poland-before-the-antifibrotic-drugs-era
#10
Wojciech Jerzy Piotrowski, Magdalena M Martusewicz-Boros, Adam J Białas, Katarzyna Lewandowska
INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and debilitating lung disease with a median survival time of 3-5 years. For now, pirfenidone (PIR) and nintedanib (NTB) are the only drugs that can slow down the disease's progression. In Poland, these drugs, although registered for legal use, had not been reimbursed for IPF patients until the end of the year 2016. Aim of the study was to assess what was common practice in terms of diagnosis and treatment in the period before antifibrotic drugs became available for IPF patients in Poland...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28656131/iatrogenic-bleeding-during-flexible-bronchoscopy-risk-factors-prophylactic-measures-and-management
#11
REVIEW
Maurizio Bernasconi, Coenraad F N Koegelenberg, Angela Koutsokera, Adam Ogna, Alessio Casutt, Laurent Nicod, Alban Lovis
Significant iatrogenic bleeding during flexible bronchoscopy is fortunately rare and usually self-limiting. Life-threatening bleeding, however, can occur, especially after conventional or cryoprobe-assisted transbronchial biopsy. The aim of this review is to provide the practising pulmonologist with a concise overview of the incidence, severity and risk factors for bleeding, to provide sensible advice on prophylactic measures and to suggest a plan of action in the case of significant bleeding. Bronchoscopy units should have a standardised approach and plan of action in the case of life-threatening haemorrhage...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28650738/recommendations-for-measuring-pulmonary-nodules-at-ct-a-statement-from-the-fleischner-society
#12
Alexander A Bankier, Heber MacMahon, Jin Mo Goo, Geoffrey D Rubin, Cornelia M Schaefer-Prokop, David P Naidich
These recommendations for measuring pulmonary nodules at computed tomography (CT) are a statement from the Fleischner Society and, as such, incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. The recommendations address nodule size measurements at CT, which is a topic of importance, given that all available guidelines for nodule management are essentially based on nodule size or changes thereof. The recommendations are organized according to practical questions that commonly arise when nodules are measured in routine clinical practice and are, together with their answers, summarized in a table...
June 26, 2017: Radiology
https://www.readbyqxmd.com/read/28649564/primary-ciliary-dyskinesia-an-update-on-clinical-aspects-genetics-diagnosis-and-future-treatment-strategies
#13
REVIEW
Virginia Mirra, Claudius Werner, Francesca Santamaria
Primary ciliary dyskinesia (PCD) is an orphan disease (MIM 244400), autosomal recessive inherited, characterized by motile ciliary dysfunction. The estimated prevalence of PCD is 1:10,000 to 1:20,000 live-born children, but true prevalence could be even higher. PCD is characterized by chronic upper and lower respiratory tract disease, infertility/ectopic pregnancy, and situs anomalies, that occur in ≈50% of PCD patients (Kartagener syndrome), and these may be associated with congenital heart abnormalities...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28649310/lung-ultrasound-has-limited-diagnostic-value-in-rare-cystic-lung-diseases-a-cross-sectional-study
#14
Jesper Rømhild Davidsen, Elisabeth Bendstrup, Daniel P Henriksen, Ole Graumann, Christian B Laursen
Background: Lung ultrasound (LUS) used to identify interstitial syndrome (IS) and pleural thickening related to diffuse parenchymal lung disease (DPLD) has shown significant correlations with ground glass opacity (GGO) on high-resolution computed tomography (HRCT). However, the applicability of LUS in patients with DPLD subtypes as rare cystic lung diseases has not previously been investigated. This study aimed to observe if distinctive LUS findings could be found in patients with lymphangioleiomyomatosis (LAM), pulmonary Langerhans cell histiocytosis (PLCH), and Birt-Hogg-Dubé syndrome (BHDS)...
2017: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28646217/why-do-physicians-lack-engagement-with-smoking-cessation-treatment-in-their-copd-patients-a-multinational-qualitative-study
#15
Eva Anne Marije van Eerd, Mette Bech Risør, Mark Spigt, Maciek Godycki-Cwirko, Elena Andreeva, Nick Francis, Anja Wollny, Hasse Melbye, Onno van Schayck, Daniel Kotz
Smoking cessation is the only effective intervention to slow down the accelerated decline in lung function in smokers with chronic obstructive pulmonary disease. Nevertheless, physicians often do not routinely provide evidence-based smoking cessation treatment to their patients. To understand underlying reasons, we explored how physicians engage in smoking cessation treatment in their chronic obstructive pulmonary disease patients. In total, 21 focus group discussions were held with general practitioners and pulmonologists in seven different countries in Europe and Asia...
June 23, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28643675/-stop-bang-a-useful-and-easy-tool-for-the-screening-of-obstructive-sleep-apnea
#16
Matías Baldini, María Nélida Chiapella, María Alejandra Fernández, Sergio Guardia
The STO-BANG questionnaire, S standing for snore, T tired, O observed apneas, P pressure (arterial hypertension), B BMI (body mass index > 35 kg/ m2), A age (> 50 years old), N neck circumference (> 40 cm), G gender (male); is a simple tool that enables the detection of patients with obstructive sleep apnea syndrome (OSA). If the patient adds 3 or more points, it is considered to have a high probability of having this disease. Our goal was to evaluate the capacity of the STOP-BANG questionnaire and to compare it with the ability of a sleep trained pulmonologist in determining the probability of OSA...
2017: Medicina
https://www.readbyqxmd.com/read/28642108/investing-in-new-technology-in-pulmonary-medicine-navigating-the-tortuous-path-to-success
#17
REVIEW
Robert Kruklitis, Kim French, Michael Joseph Cangelosi, Kevin L Kovitz
The introduction of new technologies offers the promise to advance medicine. This occurs alongside improved efforts to control costs of health care by hospital administrators, the Centers for Medicare & Medicaid Services' (CMS) pivot to value programs, and commercial payers' efforts to reduce reimbursement. These trends present a challenge for the pulmonologist, among others, who must navigate increasingly complex and highly scrutinized evaluation processes used to secure new technology (NT). Health-care providers are turning toward value assessments while simultaneously tasked with the mission of offering state of the art technologies and services...
June 20, 2017: Chest
https://www.readbyqxmd.com/read/28641356/-tracheal-surgery
#18
Jan Volmerig, Erich Hecker
Surgery of the trachea is a specialised field in which many disciplines work jointly due to the variety of indications and the extended topography. Not only because of its particular functional importance, but also because of its complex morphology, anatomy and physiology, this organ represents a special therapeutic challenge. A variety of diseases require surgical procedures of the trachea; the therapeutic strategy is influenced both by the disease itself as well as patient-dependent parameters. Regardless of the nature of the underlying disorder, good results require a high level of expertise in airway management, a careful diagnosis and interventional planning as well as an experienced surgical team that masters extended operative techniques...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28638422/cognitive-impairment-among-patients-with-chronic-obstructive-pulmonary-disease-compared-to-normal-individuals
#19
Mitra Samareh Fekri, Seyed-Mehdi Hashemi-Bajgani, Ahmad Naghibzadeh-Tahami, Fateme Arabnejad
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most important causes of morbidity and mortality worldwide. The complications of COPD are numerous, and cognitive impairment is one of the most common complications that relates to mortality and morbidity directly. The present study was conducted with the aim of evaluating the prevalence of cognitive impairment in patients with COPD in comparison to normal individuals. MATERIALS AND METHODS: In this case-control study, 87 patients with COPD, whose diagnoses were confirmed by a pulmonologist based on the spirometry test findings, were included...
2017: Tanaffos
https://www.readbyqxmd.com/read/28637050/ultrasonography-for-the-diagnosis-of-pneumothorax-after-transbronchial-lung-cryobiopsy-in-diffuse-parenchymal-lung-diseases
#20
Luca Viglietta, Riccardo Inchingolo, Cristina Pavano, Sara Tomassetti, Sara Piciucchi, Andrea Smargiassi, Claudia Ravaglia, Alessandra Dubini, Christian Gurioli, Carlo Gurioli, Venerino Poletti
BACKGROUND: Transbronchial lung cryobiopsy (TBLC) can be indicated in diffuse parenchymal lung diseases (DPLDs) when a confident noninvasive diagnosis cannot be made. The 2 most relevant complications of TBLC are bleeding and pneumothorax (PTX). The accuracy of chest ultrasonography (US) for the detection of PTX is higher when compared to chest X-ray (CXR) with reference to computed tomography (CT) scan as a gold standard. OBJECTIVE: We evaluated the accuracy of chest US in detecting PTX after TBLC in patients with DPLDs...
2017: Respiration; International Review of Thoracic Diseases
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