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Emanuela Barisione, Rita Bianchi, Roberto Fiocca, Mario Salio
Pneumomediastinum is defined as the presence of air or gas within the mediastinum and it rarely complicates bronchoscopy. We report, to our best knowledge, the first case of pneumomediastinum following a transbronchial cryobiopsy (TBLC). TBLC is considered a safe procedure as compared with both transbronchial biopsy and surgical lung biopsy. Systematic reviews, metanalysis and a Pubmed research, revealed that in literature no pneumomediastinum has been mentioned after TBLC. We report this case for to make it known to interventional pulmonologists the possibility that a pneumomediastinum can follow a TBLC...
June 22, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Min Cheol Jeon, Ju Ock Kim, Sung Soo Jung, Hee Sun Park, Jeong Eun Lee, Jae Young Moon, Chae Uk Chung, Da Hyun Kang, Dong Il Park
BACKGROUND: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. METHODS: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. RESULTS: There were nine false-negative results among the 238 total cases...
June 19, 2018: Tuberculosis and Respiratory Diseases
Veronica Rivera, Linda V DeCherrie, Audrey Chun
Patients with advanced respiratory illness are often hospitalized, requiring close follow up after discharge and also requiring care coordination outside of traditional face-to-face outpatient visits. Primary Care providers and specialists often provide services outside of outpatient visits that have not been captured and reimbursed with traditional billing evaluation and management codes (E/M). Within the last five years, the Centers for Medicare and Medicaid (CMS) added new codes to the Medicare Physician Fee Schedule that reimburse for care coordination services not paid for by traditional evaluation and management codes (E/M)...
May 31, 2018: Chest
Firuzan Sari Kundt, Nina Enthaler, Anna Maria Dieplinger, Michael Studnicka, Anna Knoll, Jürgen Osterbrink, Tim Johansson, Maria Flamm
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a frequent disease of the lungs. Its prevalence was estimated to be 26% in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) I and 11% for GOLD II-IV in Austria. Globally, it ranks third in mortality rate. The particular challenge is that care for these patients falls short due to the lack of structured integrated care. The aim was to assess the current status of multiprofessional COPD care in Austria and identify gaps and potentials...
May 28, 2018: Wiener Klinische Wochenschrift
Michael E Ohl, Margaret Carrell, Andrew Thurman, Mark Vander Weg, Teresa Hudson Pharm, Michelle Mengeling, Mary Vaughan-Sarrazin
BACKGROUND: Military Veterans in the United States are more likely than the general population to live in rural areas, and often have limited geographic access to Veterans Health Administration (VHA) facilities. In an effort to improve access for Veterans living far from VHA facilities, the recently-enacted Veterans Choice Act directed VHA to purchase care from non-VHA providers for Veterans who live more than 40 miles from the nearest VHA facility. To explore potential impacts of these reforms on Veterans and healthcare providers, we identified VHA-users who were eligible for purchased care based on distance to VHA facilities, and quantified the availability of various types of non-VHA healthcare providers in counties where these Veterans lived...
May 29, 2018: BMC Health Services Research
Diego A Rodríguez Chiaradía, Michael J Cuttica, David Jimenez
No abstract text is available yet for this article.
May 19, 2018: Archivos de Bronconeumología
Dmytro M Boiko, Volodymyr H Pecherytsia, Oksana S Boiko, Svitlana M Kulyk
OBJECTIVE: Introduction: Lung sarcoidosis is a systemic granulomatous disease that can affect various organs and systems of a person. Due to the lack of a uniform standardized approach to the diagnosis of sarcoidosis, the epidemiological pattern is heterogeneous and depends on many factors. The aim: To investigate the correlation between the number of patients with sarcoidosis among the population of the Poltava region (Ukraine) and the ecological characteristics of the industrial activity of the region in comparison with the data on the availability of subspecialists in respiratory diseases...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
John C Carter, Daniel W Sheehan, Andre Prochoroff, David J Birnkrant
Muscular dystrophies represent a complex, varied, and important subset of neuromuscular disorders likely to require the care of a pulmonologist. The spectrum of conditions encapsulated by this subset ranges from severe and fatal congenital muscular dystrophies with onset in infancy to mild forms of limb and girdle weakness with onset in adulthood and minimal respiratory compromise. The list and classification of muscular dystrophies are undergoing near-constant revision, based largely on new insights from genetics and molecular medicine...
June 2018: Clinics in Chest Medicine
Oded Shamriz, Bella Shadur, Adeeb NaserEddin, Irina Zaidman, Natalia Simanovsky, Orly Elpeleg, Eitan Kerem, Joel Reiter, Polina Stepensky
Lipopolysaccharide (LPS)-responsive beige-like anchor (LRBA) protein deficiency is a rare syndrome of primary immune deficiency and immune dysregulation. In this study, we sought to summarize our experience with respiratory manifestations in LRBA-deficient patients. We conducted a retrospective analysis of the medical records of LRBA-deficient patients treated at Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Data retrieved included pulmonary workup, disease course, treatment, and outcome. Ten patients were included...
May 18, 2018: European Journal of Pediatrics
Ricardo Sales Dos Santos, Marcia Jacomelli, Juliana Pereira Franceschini, Iunis Suzuki, Altair da Silva Costa, Christina Shiang, Addy Lidvina Mejia Palomino
OBJECTIVE: To describe the results of endobronchial ultrasound-guided transbronchial needle aspiration in making diagnosis of mediastinal injuries associated to different causes. METHODS: A retrospective cross-sectional study of patients submitted to Endobronchial ultrasound-guided transbronchial needle aspiration at a private organization, between June 2013 and October 2016. All cases referred for collection of lymph nodes or peritracheal/peribronchial masses by endobronchial ultrasound-guided transbronchial needle aspiration, and evaluated through tomography or PET-CT were included...
May 14, 2018: Einstein
Kirsten Meenan, Lisa Catanoso, Julien Aoyama, Stephen R Stephan, Ridley Chauvin, Robert T Sataloff
OBJECTIVE: We aimed to evaluate the utility of pulmonary function testing (PFT), particularly forced expiratory flow (FEF) 25-75%, in patients presenting with dysphonia. STUDY DESIGN: A retrospective chart review was carried out. METHODS: Records of 199 patients who presented with dysphonia were reviewed to determine whether in-office PFTs, which we perform routinely, lead to new pulmonary diagnoses or the need for additional pulmonary medications, after assessment by a pulmonologist...
May 9, 2018: Journal of Voice: Official Journal of the Voice Foundation
Deborah R Liptzin, Michael V Di Maria, Adel Younoszai, Michael R Narkewicz, Sarah L Kelly, Kelly R Wolfe, Livia A Veress
OBJECTIVES: To review the pulmonary findings of the first 51 patients who presented to our interdisciplinary single-ventricle clinic after undergoing the Fontan procedure. STUDY DESIGN: We performed an Institutional Review Board-approved retrospective review of 51 patients evaluated following the Fontan procedure. Evaluation included history, physical examination, pulmonary function testing, and 6-minute walk. Descriptive statistics were used to describe the population and testing data...
May 7, 2018: Journal of Pediatrics
Antonietta Cappuccio, Alessandro Sanduzzi Zamparelli, Massimo Verga, Stefano Nardini, Alessandro Policreti, Pasquale Alberto Porpiglia, Silvia Napolitano, Maria Giulia Marini
Chronic obstructive pulmonary disease (COPD) is characterised by a progressive loss of pulmonary function. Often patients do not adhere to inhaled therapies and this leads clinicians to switch treatments in order to improve control of the symptoms. Narrative medicine is a useful approach that helps healthcare professionals to think over the doctor-patient relationship and how patients live with their disease. The aim of this training project was to teach pulmonologists the basics of narrative medicine: to carefully listen to patients and to practice reflective writing in their relationship with them...
April 2018: ERJ Open Research
Leslie B Tolle, Brian D Southern, Daniel A Culver, Jeffrey C Horowitz
Idiopathic pulmonary fibrosis (IPF) is a specific type of fibrosing interstitial pneumonia of unknown cause. It is usually chronic and progressive, tends to affect mainly adults over age 60, has a predilection for men, and is often fatal. The condition is still underappreciated by pulmonologists and primary care physicians. This article attempts to close that information gap by reviewing the natural course of IPF and presenting an algorithmic approach to diagnosis and treatment based on evidence-based international guidelines...
May 2018: Cleveland Clinic Journal of Medicine
S Christy Sadreameli, Kristin A Riekert, Elizabeth C Matsui, Cynthia S Rand, Michelle N Eakin
BACKGROUND: Urban minority children are at risk for poor asthma outcomes and may not receive appropriate primary or subspecialty care. OBJECTIVE: We hypothesized that preschool children with asthma whose caregivers reported more barriers to care would be less likely to have seen their primary care provider (PCP) or an asthma subspecialist and more likely to have had a recent emergency department (ED) visit for asthma. METHODS: The Barriers to Care Questionnaire (BCQ) measures expectations, knowledge, marginalization, pragmatics, and skills...
May 3, 2018: Academic Pediatrics
Hitesh Batra, Lonny Yarmus
Rigid bronchoscopy is an invaluable tool for the management of airway disorders and an essential skill for an interventional pulmonologist. Since its introduction in the late 19th century, it has remained an important technique for the management of central airway obstruction, foreign body aspiration and massive hemoptysis. Areas covered: This article will review the history, indications, contraindication, technique and complications of rigid bronchoscopy. We will also briefly discuss the methods of anesthesia and ventilation and finally our perspective on the future of rigid bronchoscopy...
June 2018: Expert Review of Respiratory Medicine
S Takkal, A Van Muylem, P A Gevenois
OBJECTIVE: To explore the possible benefit of detecting lung cancer in COPD patients and to assess the pulmonologist's compliance with the Fleischner Society guidelines for management of pulmonary nodules. METHODS: This monocentric retrospective study was approved by the institutional ethical Committee. Patients with COPD undergoing a CT scan between January 2010 and March 2017 were included. Depending on CT indication (respectively screening or other indications), patients were divided into Group 1 and 2...
2018: Revue Médicale de Bruxelles
Sidney S Braman, Brian W Carlin, Nicola A Hanania, Donald A Mahler, Jill A Ohar, Victor Pinto-Plata, Tina Shah, David Eubanks, Rajiv Dhand
BACKGROUND: COPD guidelines advise on inhaled medication use, yet no advice is offered on when to use and which type of patient could benefit from a specific delivery device. We investigated pulmonologists' perception of their knowledge and practices with delivery devices for COPD management. METHODS: An online survey was designed by a steering committee of American Thoracic Society clinicians and scientists and conducted by a national market research firm between January 7 and 29, 2016...
May 1, 2018: Respiratory Care
Pall Jens Reynisson, Håkon Olav Leira, Thomas Langø, Geir Arne Tangen, Peter Hatlen, Tore Amundsen, Erlend Fagertun Hofstad
OBJECTIVE: Endoluminal visualization in virtual and video bronchoscopy lacks information about the surrounding structures, and the traditional 2 D axial, coronal and sagittal CT views can be difficult to interpret. To address this challenge, we previously introduced a novel visualization technique, Anchored to Centerline Curved Surface, for navigated bronchoscopy. The current study compares the ACCuSurf to the standard ACS CT views as planning and guiding tools in a phantom study. MATERIAL AND METHODS: Bronchoscope operators navigated in physical phantom guided by virtual realistic image data constructed by fusion of CT dataset of phantom and anonymized patient CT data...
April 27, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Victoria K Tang, Praveen Vijhani, Sujith V Cherian, Manju Ambelil, Rosa M Estrada-Y-Martin
Pulmonary lymphoproliferative neoplasms are rare lung tumors and account for <1% of all lung tumors. Among them, primary pulmonary lymphomas (PPL) constitute the majority, which include Non-Hodgkin's lymphoma (NHL) that comprise of mucosa-associated lymphoid tissue lymphoma, diffuse large B-cell lymphomas and other rare types of NHL and lymphomatoid granulomatosis. HL, which arises secondary to contiguous spread from the mediastinum, is the rarest type of PPL. Other entities described within the umbrella of pulmonary lymphoproliferative neoplasms include pleural lymphomas and posttransplant lymphoproliferative disorders (PTLD) - which occurs in the poststem cell and organ transplant patients...
May 2018: Lung India: Official Organ of Indian Chest Society
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