Advances in Respiratory Medicine

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Open AccessGuidelines

Acute Subglottic Laryngitis. Etiology, Epidemiology, Pathogenesis and Clinical Picture

by Henryk Mazurek, Anna Bręborowicz, Zbigniew Doniec, Andrzej Emeryk, Katarzyna Krenke, Marek Kulus and Beata Zielnik-Jurkiewicz

Adv. Respir. Med. 2019, 87(5), 308-316; https://doi.org/10.5603/ARM.2019.0056 - 31 Oct 2019

Cited by 3 | Viewed by 1811

Abstract

In about 3% of children, viral infections of the airways that develop in early childhood lead to narrowing of the laryngeal lumen in the subglottic region resulting in symptoms such as hoarseness, abarking cough, stridor, and dyspnea. These infections may eventually cause respiratory [...] Read more.

In about 3% of children, viral infections of the airways that develop in early childhood lead to narrowing of the laryngeal lumen in the subglottic region resulting in symptoms such as hoarseness, abarking cough, stridor, and dyspnea. These infections may eventually cause respiratory failure. The disease is often called acute subglottic laryngitis (ASL). Terms such as pseudocroup, croup syndrome, acute obstructive laryngitis and spasmodic croup are used interchangeably when referencing this disease. Although the differential diagnosis should include other rare diseases such as epiglottitis, diphtheria, fibrinous laryngitis and bacterial tracheobronchitis, the diagnosis of ASL should always be made on the basis of clinical criteria. Full article

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Open AccessCase Report

An Expectorated Hydatid

by Satyajeet Sahoo and Subhra Mitra

Adv. Respir. Med. 2019, 87(5), 307; https://doi.org/10.5603/ARM.2019.0055 - 31 Oct 2019

Cited by 1 | Viewed by 302

Abstract

An 18-year-old housewife presented with a 6 cm × 4 cm specimen of greenish white material (Figure 1A) which she had expectorated after an episode of violent coughing [...] Full article

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Open AccessCase Report

A Late Presentation of an Uncommon Congenital Vascular Anomaly

by Juvva Kishan Srikanth, Abanti Das, Pranav Ish, Shibdas Chakrabarti and Nitesh Gupta

Adv. Respir. Med. 2019, 87(5), 305-306; https://doi.org/10.5603/ARM.2019.0054 - 31 Oct 2019

Viewed by 248

Abstract

A 36-year-old male presented with complaints of dyspnea on exertion, cough and sputum for the last 2 years [...] Full article

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Open AccessCase Report

Oligo-Recurrence from Anaplastic Lymphoma Kinase-Rearranged Lung Adenocarcinoma

by Yuika Sasatani, Shinichiro Okauchi, Gen Ohara, Katsunori Kagohashi, Kesato Iguchi, Koji Kawai and Hiroaki Satoh

Adv. Respir. Med. 2019, 87(5), 301-304; https://doi.org/10.5603/ARM.2019.0053 - 31 Oct 2019

Viewed by 326

Abstract

Anaplastic lymphoma kinase rearranged non-small-cell lung cancer is arare disease. Among them, asubset of patients exist who exhibit relatively slowly progressing symptoms and have oligo-metastases. In this article, we present two cases of ALK rearran-ged lung adenocarcinoma in patients who experienced postoperative oligo-recurrence. [...] Read more.

Anaplastic lymphoma kinase rearranged non-small-cell lung cancer is arare disease. Among them, asubset of patients exist who exhibit relatively slowly progressing symptoms and have oligo-metastases. In this article, we present two cases of ALK rearran-ged lung adenocarcinoma in patients who experienced postoperative oligo-recurrence. Both cases were treated with surgical resection and gamma knife irradiation for oligo-recurrence. After local therapy, the first patient remained disease free for over 23 months; the second for over 18 months. It appears that some patients with ALK rearranged NSCLC experience oligo-recurrence in their clinical course. For such patients, appropriate local therapy may be beneficial in improving both the quality of life and the prognosis. Full article

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Open AccessCase Report

Neurogenic Pulmonary Oedema as a Rare Complication of Epileptic Seizures

by Milan Sova, David Franc, Filip Ctvrtlik, Petr Jakubec, Amjad Ghazal Asswad and Vitezslav Kolek

Adv. Respir. Med. 2019, 87(5), 298-300; https://doi.org/10.5603/ARM.2019.0052 - 31 Oct 2019

Cited by 1 | Viewed by 296

Abstract

Introduction: Neurogenic pulmonary oedema (NPE) is avery rare complication of epileptic seizures, which could potentially increase mortality. Material and methods: The case of a 66-year-old male patient with NPE caused by repeated epileptic seizures is reported. Rapid resolution of pulmonary oedema [...] Read more.

Introduction: Neurogenic pulmonary oedema (NPE) is avery rare complication of epileptic seizures, which could potentially increase mortality. Material and methods: The case of a 66-year-old male patient with NPE caused by repeated epileptic seizures is reported. Rapid resolution of pulmonary oedema is well documented by X-ray and computed tomography images. Conclusions: Neurogenic pulmonary oedema could potentially increase mortality, and thus, it is important to perform achest X-ray in all patients presenting with seizures and dyspnoea. Full article

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Open AccessReview

Current Treatment Strategies in Malignant Pleural Mesothelioma with a Treatment Algorithm

by Mutlay Sayan, Mehmet Fuat Eren, Apar Gupta, Nisha Ohri, Ayse Kotek, Ibrahim Babalioglu, Sedenay Oskeroglu Kaplan, Ozge Duran, Ozlem Derinalp Or, Funda Cukurcayir, Neslihan Kurtul, Beyhan Ceylaner Bicakci, Tugce Kutuk, Sukran Senyurek, Ali Turk, Salma K. Jabbour and Banu Atalar

Adv. Respir. Med. 2019, 87(5), 289-297; https://doi.org/10.5603/ARM.2019.0051 - 31 Oct 2019

Cited by 11 | Viewed by 540

Abstract

Malignant pleural mesothelioma (MPM) is arare disease with apoor prognosis. The main therapeutic options for MPM include surgery, chemotherapy, and radiation therapy (RT). Although multimodality therapy has been reported to improve survival, not every medically operable patient is able to undergo all recommended [...] Read more.

Malignant pleural mesothelioma (MPM) is arare disease with apoor prognosis. The main therapeutic options for MPM include surgery, chemotherapy, and radiation therapy (RT). Although multimodality therapy has been reported to improve survival, not every medically operable patient is able to undergo all recommended therapy. With improvements in surgical techniques and systemic therapies, as well as advancements in RT, there has been apotential new paradigm in the management of this disease. In this review, we discuss the current literature on MPM management and propose afunctional treatment algorithm. Full article

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Open AccessArticle

Sputum Culture for the Diagnosis of Tuberculous Pleural Effusion: Analysis of Absolute and Incremental Yields

by Sevak Keshishyan, Viren Kaul, Anupam Gupta, Chul Ahn, Wilbert Aronow and Oleg Epelbaum

Adv. Respir. Med. 2019, 87(5), 281-288; https://doi.org/10.5603/ARM.2019.0050 - 31 Oct 2019

Cited by 6 | Viewed by 402

Abstract

Introduction: Pleural fluid culture yield in tuberculous pleural effusion (TPE) is disappointing in immunocompetent hosts. Herein, we attempt to define the role of serial sputum cultures in the diagnosis of TPE. Material and methods: We identified cases diagnosed with TPE over a16-year period [...] Read more.

Introduction: Pleural fluid culture yield in tuberculous pleural effusion (TPE) is disappointing in immunocompetent hosts. Herein, we attempt to define the role of serial sputum cultures in the diagnosis of TPE. Material and methods: We identified cases diagnosed with TPE over a16-year period in ahigh-prevalence US hospital. Absolute yields of one, two, and three sputa were calculated as well as the incremental yield of adding second and third sputa. These calculations were then performed separately for expectorated and induced sputum and for patients with and without infiltrates on chest X-ray. Results: Sixty sputum collections were performed in 46 patients with TPE. The per-patient sensitivity of sputum culture was 45.6%. On aper-sputum collection basis, the overall yield of the first sputum was 30%, of two sputa 39%, and of three sputa 54%. The corresponding incremental yields were 9% and 15%, respectively. The three-sputum yields of expectorated and induced collections were similar. The three-sputum yield in patients with infiltrates on X-ray was 11% lower than that in those without infiltrates. Conclusions: Serial sputum collection of three specimens can be expected to produce ayield of > 50% in cases of suspected TPE regardless of whether obtained by expectoration or induction, and the yield increases incrementally. Full article

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Open AccessArticle

The Role of Genexpert in the Diagnosis of Tubercular Pleural Effusion in India

by Anushree Chakraborty, Swapna Ramaswamy, Akshata Jayachamrajpura Shivananjiah, Raghu Bokkikere Puttaswamy and Nagaraja Chikkavenkatappa

Adv. Respir. Med. 2019, 87(5), 276-280; https://doi.org/10.5603/ARM.2019.0049 - 31 Oct 2019

Cited by 12 | Viewed by 530

Abstract

Introduction: Tubercular pleural effusion is the second most common extrapulmonary form of tuberculosis in India. Developing nations like India face several health challenges and with limited resources, appropriate planning and channelization of the same is the need of the hour. Material and methods: [...] Read more.

Introduction: Tubercular pleural effusion is the second most common extrapulmonary form of tuberculosis in India. Developing nations like India face several health challenges and with limited resources, appropriate planning and channelization of the same is the need of the hour. Material and methods: The objective of the study was to determine the role of cartridge-based nucleic acid amplification test (CBNAAT) in the diagnosis of tubercular pleural effusion (TPE) and also to study if any association exists between CBNAAT and pleural fluid adenosine deaminase (ADA) and lymphocyte counts. Clinically suspected TPE, lymphocyte predominant (≥ 70%) exudates (according to the Lights criteria) with ADA ≥ 40 U/L and microbiologically confirmed pulmonary tuberculosis patients with aco-existent pleural effusion were included. Pleural fluid CBNAAT was performed on all the samples. Results: Out of atotal of 75 patients, 57 were males and 18 were females. Alymphocyte predominance of ≥ 70% was seen in 73 subjects (97%). Mean ADA was 61.7 U/L ± 16.2 (SD). Pleural fluid CBNAAT was positive for Mycobacterium tuberculosis (MTB) in 24 patients (32%). Out of these patients, rifampicin resistance was detected in 2 individuals (8.3%). Sputum smear for acid fast bacilli (AFB) was positive in 3 (4%) patients, whereas in sputum CBNAAT MTB was detected in 8 (10.6%) persons. Association between pleural fluid ADA, lymphocyte count and CBNAAT positivity was evaluated by Student T-test. There was asignificant association between higher ADA levels and CBNAAT (p value = 0.001). Conclusions: Pleural fluid CBNAAT, owing to its low sensitivity, should not be included in the diagnostic protocol of TPE in high prevalence areas. Ahigh ADA ≥ 40 U/L in combination with Light’s criteria to define exudates, with lymphocyte predominance is sufficient evidence to diagnose TPE and initiate anti-tubercular therapy, thereby deferring the need to perform an invasive pleural biopsy. Full article

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Open AccessArticle

Diagnostic Values of Bronchodilator Response versus 9-Question Questionnaire for Asthma

by Mahdi Yadollahzadeh, Seyed Mohammadreza Hashemian, Arda Kiani, Fariba Ghorbani, Katayoun Najafizadeh, Fatemeh Razavi and Atefeh Abedini

Adv. Respir. Med. 2019, 87(5), 269-275; https://doi.org/10.5603/ARM.2019.0048 - 31 Oct 2019

Cited by 3 | Viewed by 432

Abstract

Introduction: Several studies have investigated different tools for asthma diagnosis in order to reduce the cost and improve its early recognition. The goal of this study is to establish ashort questionnaire to be used in practice for asthma screening and compare diagnostic values [...] Read more.

Introduction: Several studies have investigated different tools for asthma diagnosis in order to reduce the cost and improve its early recognition. The goal of this study is to establish ashort questionnaire to be used in practice for asthma screening and compare diagnostic values between this method and spirometric response to bronchodilators. Material and method: 208 patients presenting with chronic stable dyspnea (> 6 months) and definite clinical diagnosis of chronic obstructive pulmonary disease, bronchiectasis, pulmonary fibrosis or asthma, were enrolled. 9 questions out of 43 based on the literature search were selected by regression analysis. Patients were asked to complete the questionnaire and then their spirometric responses to bronchodilators were evaluated. Results: Of all, 53.8% of cases were diagnosed clinically to have asthma. For establishing diagnosis of asthma, the bronchodilator test had 48.2% sensitivity, 78.1% specificity, 72% positive, 56.4% negative predictive values, 2.2 positive, 0.66 negative likeli-hood ratios, and false positive, false negative and accuracy of 21.9%, 51.8% and 62.01%, respectively. The revised 9 questions from the questionnaire had 97.3% sensitivity, 77.1% specificity, 83.2% positive, 96.1% negative predictive values, 4.24 positive, 0.03 negative likelihood ratios, 22.9% false positive, 2.7% false negative and 87.98% accuracy. Conclusions: The 9-question questionnaire had better diagnostic values in defining asthma in patients with chronic dyspnea than reversibility of airway obstruction to salbutamol and can be used as auseful screening test for diagnosis of asthma in clinical practice and for investigational purposes. Full article

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Open AccessArticle

Effect of Yoga on FEV₁, 6-Minute Walk Distance (6-MWD) and Quality of Life in Patients with COPD Group B

by Resti Yudhawati and Mariani Rasjid Hs

Adv. Respir. Med. 2019, 87(5), 261-268; https://doi.org/10.5603/ARM.2019.0047 - 31 Oct 2019

Cited by 15 | Viewed by 694

Abstract

Introduction: Yoga is used in the treatment of various diseases, including chronic obstructive pulmonary disease. However, no studies have assessed the effect of yoga on COPD patients in Indonesia. The difference between this study and similar studies completed in other countries lies in [...] Read more.

Introduction: Yoga is used in the treatment of various diseases, including chronic obstructive pulmonary disease. However, no studies have assessed the effect of yoga on COPD patients in Indonesia. The difference between this study and similar studies completed in other countries lies in the type of yoga exercises completed, the method in which they were completed, and in certain, unique demographic characteristics. This study aims to analyze the effect of yoga on FEV₁, 6-minute walk distance, and quality of life in patients with COPD group B in Indonesia. Material and methods: This article reflects research done in the form of an experimental study using arandomized controlled trial with pre and post-test control group design. The samples were divided into 2 groups: the treatment group (yoga practice for 1 hour, 2 times aweek for 12 weeks) and the control group (untreated with yoga, given lung rehabilitation brochure). Assessment of the effect of yoga exercises on lung function parameters (FEV₁), 6-minute walk distance and quality of life were used using SGRQ questionnaires in COPD group B. Results: 33 COPD patients fulfilled the inclusion criteria. 30 patients completed the study. Pre and post yoga results were evalu-ated in the treatment group versus the control group and then further assessed using statistical tests. There was asignificant in-crease in FEV₁, 6-MWD and quality of life using aSGRQ questionnaire after 12 weeks of yoga (p < 0.05) as well as aasignificant change in FEV₁, 6-MWD and quality of life in the treatment group (p < 0.05) when compared with the control group (p > 0.05). Conclusions: Yoga affects FEV₁, 6-MWD, and quality of life in patients with Group B COPD. Full article

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Open AccessArticle

Thoracoscopic Pleural Brushing—An Innovative Method of Pleural Sampling in Diagnostic Medical Thoracoscopy

by Yuvarajan Sivagnaname, Praveen Radhakrishnan and Antonious Maria Selvam

Adv. Respir. Med. 2019, 87(5), 257-260; https://doi.org/10.5603/ARM.2019.0046 - 31 Oct 2019

Cited by 2 | Viewed by 451

Abstract

Introduction: Pleural biopsy is the commonest mode of obtaining thoracoscopic pleural specimens from suspected pleural lesions. However, this may be associated with arisk of bleeding in certain cases. The decision to perform biopsy could be difficult, especially when the lesions are close to [...] Read more.

Introduction: Pleural biopsy is the commonest mode of obtaining thoracoscopic pleural specimens from suspected pleural lesions. However, this may be associated with arisk of bleeding in certain cases. The decision to perform biopsy could be difficult, especially when the lesions are close to vascular structures and the visceral pleura. So, pleural brushing can be used to get safely thoracoscopic specimens in addition to biopsy samples. Aim: To determine the sensitivity and specificity of thoracoscopic pleural brushing in exudative pleural effusions. Material and methods: This prospective study was done in the Department of Pulmonary Medicine, Sri Manakula Vinayagar Medical College, Pondicherry, India on 80 patients with exudative pleural effusion in whom pleural fluid analysis and closed pleu-ral biopsy results were inconclusive. All these patients were subjected to medical thoracoscopy after getting informed consent. Pleural biopsy and pleural brushings were taken and sent for analysis. Results:Thoracoscopic pleural biopsy was diagnostic in 76 of 80 patients (95%). Thoracoscopic pleural brushing was diagnostic in 74 patients (92.5%). Histopathology revealed malignancy (82.7%), granulomatous inflammation (11.5%) and nonspecific inflam-mation (5.7%). The sensitivity and specificity of pleural brushing were 96% and 75%, respectively. Interestingly, pleural brushing was the only diagnostic modality in one patient that was reported to be adenocarcinoma. Conclusions: Thoracoscopic pleural brushing is an easy, convenient and safe procedure as it can augment the diagnostic yield of thoracoscopy. It is of significant value, especially in sampling pleural lesions close to vessels and the visceral pleura compared to pleural biopsy. Full article

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Adv. Respir. Med., Volume 87, Issue 5 (October 2019) – 11 articles , Pages 257-316

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