Editor’s Choice – Flexible Bronchoscopy Biopsy Tools and Techniques to Optimize Diagnostic Yield: A Contemporary Review

Author(s):Snehamayi Ramayanam and Jonathan Puchalski*

Volume 17, Issue 3, 2021

Published on: 15 July, 2021

Page: [129 – 138]

Pages: 10

DOI: 10.2174/1573398X17666210716101940

Abstract

Background: Flexible bronchoscopy is essential in diagnosing many pathologic conditions, and tools such as lavage and biopsies using brushes, forceps, and needles are paramount to success.

Introduction: Bronchoscopists worldwide are routinely confronted with questions about such tools regarding the type, size, utility, costs, safety, anticipated yield, and others. Does the underlying suspected condition matter to the choice of instruments used? What is the anticipated outcome for benign versus malignant diseases? These and other questions are raised daily by bronchoscopists.

Methods: Pubmed was reviewed for research in the English language pertaining to diagnostic bronchoscopy. The literature is conflicting on the benefits of the types of tools available. The success of brush biopsies, forceps, and transbronchial needle aspiration is only partially dependent on the size of the instrument used or its other characteristics. Multiple biopsies are needed, and different approaches may be complementary in some circumstances.

Results: By understanding the factors that involve in a biopsy, the bronchoscopist is more likely to be successful when a crucial diagnosis is mandatory.

Conclusion: This review aims to be a reference to bronchoscopists everywhere as they contemplate their approach to flexible diagnostic bronchoscopy. Read now: https://bit.ly/3E6peaH

Editor’s Choice – Comparison Between Kidney and Liver Transplant Recipients Admitted to a Referral Center Regarding Coronavirus-2019 Manifestations in the Northeast of Iran During Three Peaks of Pandemic

Author(s):Mohsen Aliakbarian, Rozita Khodashahi *, Mahin Ghorban Sabbagh, Hamid Reza Naderi , Mandana Khodashahi , Shahrzad Jahanian and Maliheh Dadgar Moghaddam

Volume 17, Issue 4, 2021

Published on: 09 December, 2021

Page: [232 – 241]

Pages: 10

DOI: 10.2174/1573398X17666211122160608

Abstract

Background: Transplant recipients are at high risk for severe Coronavirus disease-2019 (COVID-19). Transplant recipients are immune-compromised individuals at high risk for severe infection. This study aimed to compare the presentations and outcomes of liver and kidney transplant recipients who were infected with COVID-19 in the Iranian population.

Methods: This cross-sectional study was conducted at Imam Reza and Montaserieh Hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, between 2020 and 2021. In general, 52 patients were selected and divided into two groups of the kidney (n=28) and liver (n=24) transplantation. Two groups were compared in terms of demographic characteristics and clinical findings.

Results: Of the 52 patients, severe COVID-19 infection was reported in 61% of the patients. There was no significant difference between the two groups in terms of symptoms, except for cough (χ²=8.09; P=0.004), clinical condition, and laboratory symptoms, except for creatinine (Z=14; P<0.005), alkaline phosphatase (Z=4.55; P=0.03), total bilirubin (Z=8.93; P=0.03), and partial thromboplastin time (Z=5.97; P=0.01). There was no relationship between the outcome and the use of immunosuppressive medications (P>0.05). All patients with kidney transplantation survived, while two cases in the liver transplantation group failed to survive (χ²=2.42; P=0.11).

Conclusion: The mortality rate was higher in the liver transplant recipients, compared to the patients who underwent kidney transplantation. Read now: https://bit.ly/3UQ8N8c

Editor’s Choice – Changes in Physiological Variables in Patients with Diffuse Interstitial Lung Disease in the Six-minute Walk Test

Author(s):Jhonatan Betancourt-Peña*, Daniela Domínguez-Muñoz, Paola Salazar-Vargas and Juan Carlos Ávila-Valencia 

Volume 17, Issue 4, 2021

Published on: 06 December, 2021

Page: [252 – 259]

Pages: 8

DOI: 10.2174/1573398X17666211201114933

Abstract

Objective: Diffuse Interstitial Lung Disease (DILD) is a pathology with a high mortality rate in Colombia as well as around the world. Linking patients to pulmonary rehabilitation programs is essential to improve their quality of life and aerobic capacity; thus, all patients perform the six-minute walk test (6-MWT). This study aimed to describe the changes in physiological and aerobic capacity-related variables in patients with DILD in the 6-MWT at admission to a pulmonary rehabilitation program and determine possible differences between patients with Idiopathic Pulmonary Fibrosis (IPF) and other DILDs.

Methods: This is a cross-sectional descriptive study on patients with DILD who performed the 6- MWT between January 2017 and February 2019. Sociodemographic, clinical, physiological, and exercise tolerance variables were taken into account at four different times of the 6-MWT: Rest time, the end, and the first and the fifth minute after the end of the test. The Human Ethics Committee endorsed the study, and all participants signed the informed consent form.

Results: There were 64 patients with DILD. The average age was 60.84 years, 53.1% were female, 73.4% required home oxygen, and 53.1% had a diagnosis of IPF. There were no statistically significant differences in the Heart Rate (HR), Respiratory Rate (RR), peripheral oxygen saturation (SpO2), Borg scale, and fatigue in lower limbs at the four evaluated moments of the test for both groups of patients with DILD (p=0.000); moreover, the FEV1/FVC ratio for patients with other DILD was higher (p=0.000). The distance traveled for IPF was 339.26 ± 124.84, while for other DILDs, it was 365.63 ± 113.00 (p=0.382).

Conclusion: Patients with other DILDs have better FEV1/FVC and travel longer distances with less dyspnea and fatigue than patients with IPF during the 6-MWT. Both groups’ HR, RR, SpO2, Borg, and fatigue variables presented significant changes during the 6-MWT. Read now: https://bit.ly/3SDPSvF

Editor’s Choice – Noninvasive or Invasive Mechanical Ventilation in Oncohematologic Patients with Acute Respiratory Failure: A Systematic Review and Meta-Analysis

Author(s):Lídia Miranda Barreto*, Cecilia Gómez Ravetti, Nathália Sernizon Guimarães and Vandack Nobre

Volume 18, Issue 1, 2022

Published on: 25 February, 2022

Page: [20 – 28]

Pages: 9

DOI: 10.2174/1573398X18666220127104656

Abstract

Background: Acute respiratory failure (ARF) in oncohematologic subjects is one of the most common causes of high mortality rates. Noninvasive mechanical ventilation (NIMV) has arisen as an accessory treatment in this clinical scenario.

Objective: This study aimed to compare mortality rates and severity of illness associated with NIMV or invasive mechanical ventilation (IMV) in oncohematologic patients with ARF.

Methods: A search was conducted in the PubMed, SCOPUS, Cochrane Library, LILACS, Web of Science, and gray literature databases, published between November 2007 and May 2021.

Results: Eight studies with a total of 570 patients were included. Patients with good responses to NIMV showed lower values of the Simplified Acute Physiology Score III (SAPS 3) (range: 42±7 to 53±17) when compared to those intubated following NIMV failure (range: 50±11 to 63.3±17.4) and those who underwent IMV as the primary ventilator support (range: 64.9±17.5 to 66±17). Similarly, patients whose NIMV treatment failed and those that initially used IMV had higher baseline values of Sequential Organ Failure Assessment Score (SOFA) when compared to the group with a good response to NIMV. ICU mortality ranged from 40% to 68% in NIMV success, 54% to 79% in NIMV failure, and from 54% to 80% in the group treated with IMV. NIMV therapy had a significant protective effect on mortality (RR=0.71, 95% CI: 0.53-0.94, p=0.02).

Conclusions: NIMV use in oncohematologic patients admitted to the intensive care units (ICU) with ARF was associated with lower mortality. Patients successfully treated in the NIMV group showed lower values of SOFA and SAPS 3 (Prospero Systematic Review -protocol number: 132770). Read now: https://bit.ly/3rhfov2

Open Access Article – Indacaterol Acetate/Glycopyrronium Bromide/Mometasone Furoate: A Combination Therapy for Asthma

Author(s):Alberto Papi*, Konstantinos Kostikas, Ivan Nikolaev and Ioannis Kottakis

Volume 18, Issue 2, 2022

Published on: 24 March, 2022

Page: [77 – 85]

Pages: 9

DOI: 10.2174/1573398X18666220217151845

Abstract

Despite the wide range of available therapies, asthma remains uncontrolled in 40-65% of patients for a number of different reasons. Treatment with an inhaled corticosteroid (ICS) is recommended in the Global Initiative for Asthma 2021 report for patients across all asthma severities, with treatment options combining an ICS with a long-acting β₂-agonist (LABA) or a LABA and a long-acting muscarinic antagonist (LAMA), depending on disease severity. Based on this, the availability of a single inhaler fixed-dose ICS/LABA/LAMA combination is a major need in asthma management. Indacaterol acetate/glycopyrronium bromide/mometasone furoate has been developed as a once-daily inhaled asthma treatment that combines an ICS (mometasone furoate), a LABA (indacaterol acetate), and a LAMA (glycopyrronium bromide) in a formulation delivered using the dry powder inhaler Breezhaler®, for patients with uncontrolled asthma on medium- or high-dose ICS/LABA. This article provides an overview of the different and complementary mechanisms of action and the clinical effectiveness of the monocomponents of the indacaterol/glycopyrronium/ mometasone furoate fixed combination and highlights the benefits of using the three agents in combination in patients with moderate and severe asthma. Read now: https://bit.ly/3ffk29V

Open Access Article – Bacterial Profile and Antibiotic Use in Pneumonia Patients at Dr. Soetomo General Hospital

Author(s):Rika Yulia, Josephine Witha Mariza, Soedarsono and Fauna Herawati*

Volume 16, Issue 1, 2020

Page: [21 – 27]

Pages: 7

DOI: 10.2174/1573398X16666200217122825

Abstract

Background: Pneumonia is one of the causes of morbidity and mortality in children and adults worldwide. WHO report in 1999 stated that the main cause of death due to infectious disease is pneumonia. The rising mortality rate among severe pneumonia patients is because they do not receive empirical antibiotic treatment according to the infecting pathogens.

Objective: The purpose of this study is to identify the bacterial profile and the use of antibiotic treatment on pneumonia patients admitted to the pulmonology ward of Dr. Soetomo General Hospital in Surabaya, Indonesia.

Methods: This descriptive observational study used the data from pneumonia patients admitted to the pulmonology ward of Dr. Soetomo General Hospital, Surabaya, from February to April 2018. The data was collected from the patients’ medical records, antibiotic use notes, and culture results of bacterial antibiotic sensitivity test. The total of antibiotic use was calculated using a defined daily dose (DDD) per 100 bed days. The quality of antibiotics was assessed using Gyssens method. The microbial mapping was acquired from a sputum culture test result.

Results: The most prevalent bacteria in pneumonia patients were the Gram-negative bacteria and the most common species was Acinetobacter baumannii followed by Klebsiella pneumoniae. In contrast, the most common Gram-positive bacteria species was Streptococcus viridans. The total antibiotic use was 35.53 DDD/100 bed days, and ceftriaxone was the most commonly used antibiotic with 9.23 DDD/100 bed days. Fifty percent of the antibiotic use was in category wise use of antibiotic.

Conclusion: The Gram-negative bacteria were the most common cause of pneumonia and ceftriaxone was the most commonly used antibiotic for its cure. Fifty percent of the patients received ceftriaxone appropriately. Read now: https://bit.ly/3Swrmwf

Most Cited Article – Persistent/Late Complications of COVID-19 in Affected Emergency Medical Technicians: A Case Series and Brief Literature Review

Author(s):Peyman Saberian, Behshad Pazooki, Zahra Shajari, Parisa Hasani-Sharamin, Mahnaz Jamshididana, Somayeh Karimi and Alireza Baratloo*

Volume 18, Issue 2, 2022

Published on: 27 May, 2022

Page: [152 – 157]

Pages: 6

DOI: 10.2174/1573398X18666220509154612

Abstract

Background: The present study aimed to assess the prevalence of persistent/late complications after recovery from the acute phase of COVID-19 in emergency medical technicians (EMTs).

Methods: This is a cross-sectional case-series study performed during the last quarter of 2020 in Tehran, Iran. All EMTs who had been diagnosed with COVID-19 were eligible. The researcher contacted the EMTs via telephone to determine any complications following their recovery. Those who suffered from any complication were referred to an internal specialist physician for a detailed history and physical examination. Based on the physician’s opinion, some paraclinical or clinical evaluations were requested to be performed.

Results: Four hundred thirty-one confirmed cases and two deaths due to this disease were registered among the Tehran EMS center’s EMTs during the study period. Two hundred thirty-eight EMTs were contacted, and 22.7% of them had at least one persistent/late complication following recovery of the acute phase of COVID-19; of whom, 28 EMTs were visited by an internist and completed the tests. The final participants mentioned seventy-five persistent/late complications. Only one EMT had a residual lesion among those who underwent lung CT scans. There were also some pathological findings in the echocardiographic examination and spirometry.

Conclusion: Our study showed that persistent/late-onset complications could likely accompany by COVID-19. Read now: https://bit.ly/3Cc0VXE

Most Cited Article – The Prognostic Effect of Clinical and Laboratory Findings on in-hospital Mortality in Patients with Confirmed COVID-19 Disease

Author(s):Ali Jangjou, Razieh Sadat Mousavi-Roknabadi*, Hossein Faramarzi, Alireza Neydani, Seyed Rouhollah Hosseini-Marvast and Mostafa Moqadas

Volume 18, Issue 2, 2022

Published on: 02 June, 2022

Page: [134 – 141]

Pages: 8

DOI: 10.2174/1573398X18666220413113142

Abstract

Background: COVID-19 is known as a global health issue, which can cause high morbidity and mortality in patients. It is necessary to identify biomarkers, clinical and laboratory findings and effects on patients’ mortality.

Objective: This study aimed to evaluate the prognostic effect of clinical and laboratory findings on in-hospital mortality in patients with confirmed COVID-19.

Methods: This retrospective cross-sectional study (February-August 2020) was conducted on adult patients with COVID-19 who were hospitalized in one of the main reference hospitals affiliated with Shiraz University of Medical Sciences, southern Iran. Patients with uncompleted or missed medical files were excluded from the study. Clinical and laboratory findings were extracted from the patients’ medical files and then analyzed. The patients were categorized and later compared as survivor and nonsurvivors groups.

Results: 345 patients were enrolled and 205 (59.4%) were male. The mean±SD of age was 53.67±16.97 years, and 32 (9.3%) out of the total did not survive. Hypertension (28.4%) and diabetes (25.5%) were the most prevalent comorbidities. All clinical symptoms were similar in both groups, except fever, which was observed significantly more in nonsurvivors (P=0.027). The duration of hospitalization was 9.20±5.62 (range; 2-42) days, which was higher in nonsurvivors (P<0.001). The results of Multivariate Logistic Regression Model showed that CRP (OR=1.032, P=0.01) and INR (OR=48.88, P=0.049) were the predictor factors for in-hospital mortality in hospitalized patients with confirmed COVID-19.

Conclusion: The current study showed that in-hospital mortality was 9.3%. It was found that CRP and INR were the predictor factors for in-hospital mortality in hospitalized patients with confirmed COVID-19. Read now: https://bit.ly/3DIzVA5

Most Cited Article – Indacaterol Acetate/Glycopyrronium Bromide/Mometasone Furoate: A Combination Therapy for Asthma

Author(s):Alberto Papi*, Konstantinos Kostikas, Ivan Nikolaev and Ioannis Kottakis

Volume 18, Issue 2, 2022

Published on: 24 March, 2022

Page: [77 – 85]

Pages: 9

DOI: 10.2174/1573398X18666220217151845

Abstract

Despite the wide range of available therapies, asthma remains uncontrolled in 40-65% of patients for a number of different reasons. Treatment with an inhaled corticosteroid (ICS) is recommended in the Global Initiative for Asthma 2021 report for patients across all asthma severities, with treatment options combining an ICS with a long-acting β₂-agonist (LABA) or a LABA and a long-acting muscarinic antagonist (LAMA), depending on disease severity. Based on this, the availability of a single inhaler fixed-dose ICS/LABA/LAMA combination is a major need in asthma management. Indacaterol acetate/glycopyrronium bromide/mometasone furoate has been developed as a once-daily inhaled asthma treatment that combines an ICS (mometasone furoate), a LABA (indacaterol acetate), and a LAMA (glycopyrronium bromide) in a formulation delivered using the dry powder inhaler Breezhaler®, for patients with uncontrolled asthma on medium- or high-dose ICS/LABA. This article provides an overview of the different and complementary mechanisms of action and the clinical effectiveness of the monocomponents of the indacaterol/glycopyrronium/ mometasone furoate fixed combination and highlights the benefits of using the three agents in combination in patients with moderate and severe asthma. Read now: https://bit.ly/3ffk29V

Most Cited Article – A Literature Review of Pulmonary Arterial Hypertension (PAH)

Author(s):Ashima Panchal*, Jigar Panchal, Sonika Jain and Jaya Dwivedi

Volume 18, Issue 2, 2022

Published on: 29 April, 2022

Page: [104 – 114]

Pages: 11

DOI: 10.2174/1573398X18666220217151152

Abstract

In 1891, German doctor E. Romberg was the first to report PAH. It is widespread throughout the world, but it is particularly problematic in India and other developing countries. Pulmonary arterial hypertension (PAH) is characterised by an increase in pulmonary arterial pressure as well as the emergence of progressive symptoms, such as a loss of functional ability, shortness of breath, and fatigue.

Blood flows from the right side of the heart to the lungs through the pulmonary arteries. Pulmonary arterial pressure refers to the pressure in the arteries of the lungs (PAH). It necessitates immediate treatment because high blood pressure in the lungs causes the right side of the heart to work much harder, increasing the risk of heart failure. This article aimed to provide brief information about the prevalence, pathology, classification, and different therapies of PAH. Read now: https://bit.ly/3RbMg2B