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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 89, Issue 4 (September 2021) – 23 articles , Pages 353-476

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205 KiB  
Letter
Asthma Control Test to Identify Uncontrolled Asthma in Pediatric Clinical Practice
by Giorgio Ciprandi, Maria Angela Tosca and Irene Schiavetti
Adv. Respir. Med. 2021, 89(4), 474-476; https://doi.org/10.5603/ARM.a2021.0094 - 02 Sep 2021
Cited by 1 | Viewed by 450
Abstract
Asthma management is a daily challenge in pediatric practice as many clinical and functional aspects continuously change over time [...] Full article
211 KiB  
Letter
Potential Effects of A Flavonoid, Hesperidin on SARS-CoV-2 Disease
by Mohammad Reza Reza Khazdair
Adv. Respir. Med. 2021, 89(4), 472-473; https://doi.org/10.5603/ARM.a2021.0093 - 02 Sep 2021
Cited by 1 | Viewed by 494
Abstract
The novel coronavirus, COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in China in December 2019 [...] Full article
318 KiB  
Review
Impact of Inhalers Used in the Treatment of Respiratory Diseases on Global Warming
by Andrzej Emeryk, Tomasz R. Sosnowski, Maciej Kupczyk, Paweł Śliwiński, Justyna Zajdel-Całkowska, Tadeusz M. Zielonka and Agnieszka Mastalerz-Migas
Adv. Respir. Med. 2021, 89(4), 427-438; https://doi.org/10.5603/ARM.a2021.0092 - 02 Sep 2021
Cited by 9 | Viewed by 1306
Abstract
The term “carbon footprint” describes the emission of greenhouse gases into the environment as a result of human activities. The healthcare sector is responsible for 5–8% of the value of global greenhouse gas emissions, of which medical aerosols account for only 0.03% of [...] Read more.
The term “carbon footprint” describes the emission of greenhouse gases into the environment as a result of human activities. The healthcare sector is responsible for 5–8% of the value of global greenhouse gas emissions, of which medical aerosols account for only 0.03% of the total emissions. The reduction of greenhouse gases, including those used for the production and use of medicinal products and medical devices, is part of the responsibilities that Poland and the respective countries should undertake in order to implement the assumptions of international law. At the level of medical law, this obligation correlates with the need to exercise due diligence in the process of providing health services, including the selection of low-emission medical products and devices (inhalers) and providing patients with information on how to handle used products and devices, with particular emphasis on those that imply greenhouse gas emissions. Pressurized metered dose inhalers (pMDI) containing the hydrofluoroalkane 134a demonstrate the largest carbon footprint, followed by a metered dose liquid inhaler and dry powder inhalers (DPI). The carbon footprint of DPI with a given drug is 13–32 times lower than it is in the case of the corresponding pMDI. Replacement of pMDI by DPI is one of the effective methods to reduce the carbon footprint of inhalers, and the replacement should be based on current medical knowledge. A recycling system for all types of inhalers must be urgently implemented. Full article
315 KiB  
Review
Proteomic Biomarkers of Non-Small Cell Lung Cancer Patients
by Kamila Baran and Ewa Brzeziańska-Lasota
Adv. Respir. Med. 2021, 89(4), 419-426; https://doi.org/10.5603/ARM.a2021.0089 - 02 Sep 2021
Cited by 13 | Viewed by 1091
Abstract
Lung cancer is a disease with a very low 5-year survival rate (6–13%) worldwide. The most frequently diagnosed histological type of this cancer is non-small cell lung cancer (NSCLC). Poor prognosis for lung cancer—including NSCLC—is mainly related to the fact that patients are [...] Read more.
Lung cancer is a disease with a very low 5-year survival rate (6–13%) worldwide. The most frequently diagnosed histological type of this cancer is non-small cell lung cancer (NSCLC). Poor prognosis for lung cancer—including NSCLC—is mainly related to the fact that patients are diagnosed in the advanced stages of the disease. The aim of this study is to summarize data that concerns new directions of research regarding diagnostic biomarkers that could be used to support the routine diagnosis of this cancer. In recent years, proteomic analysis has become an important tool for cancer biology research, complementing genetic analysis. Among the numerous methods of proteomic analysis, mass spectrometry techniques enable the extremely accurate qualitative and quantitative identification of hundreds of proteins in small volumes of various biological samples. Such analyses may soon become the basis of improvement in lung cancer diagnostic procedures. This study presents the latest reports in proteomic research concerning the diagnosis of NSCLC. New potential proteomic biomarkers, whose presence indicates the development of a neoplastic process at an early stage, are presented. We describe biomarkers whose altered expression levels correlate with different stages of cancer. We also present protein biomarkers that help differentiate NSCLC subtypes. In the clinical workup of NSCLC patients, it is important not only to make an early diagnosis, but also to monitor the development of the neoplastic disease. Considering this fact, we also present examples of biomarkers whose abnormal expression may indicate a high risk of metastasis to the lymph nodes. This paper also emphasizes the need to conduct further research that would confirm the usefulness of the described biomarkers in clinical practice. Full article
193 KiB  
Review
Role of Ivermectin in Patients Hospitalized with COVID-19: A Systematic Review of Literature
by Muhammad Waleed Chaudhry, Syed Muhammad Zubair, Ali Bin Sarwar Zubairi and Muhammad Irfan
Adv. Respir. Med. 2021, 89(4), 413-418; https://doi.org/10.5603/ARM.a2021.0088 - 02 Sep 2021
Cited by 4 | Viewed by 706
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected almost every country in the world since De-cember 2019. Despite the efforts of the human race to combat the virus, we are still looking for an evidence-based permanent cure for the disease. Ivermectin [...] Read more.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected almost every country in the world since De-cember 2019. Despite the efforts of the human race to combat the virus, we are still looking for an evidence-based permanent cure for the disease. Ivermectin has recently emerged as one of the therapies having a beneficial effect on COVID-19. Ivermectin, owing to its properties, continues to be a possible treatment against the COVID-19 disease. Already being a mainstream drug with minimal adverse effects, it garners valid consideration. It’s use in hospitalized patients, randomized controlled trials, and observational studies has also supported its implementation. In this article, we have reviewed recent studies and explored the effectiveness of ivermectin in hospitalized COVID-19 patients. Full article
213 KiB  
Review
Endocrine Paraneoplastic Syndromes in Lung Cancer: A Respiratory Physician’s Perspective
by Pratap Upadhya, Arpitha Ananthraju, Rohit Vadala and Madhusmita Mohanty Mohapatra
Adv. Respir. Med. 2021, 89(4), 403-412; https://doi.org/10.5603/ARM.a2021.0075 - 02 Sep 2021
Cited by 2 | Viewed by 726
Abstract
Lung malignancy is known to be one of the leading causes of cancer-related mortality. Endocrine paraneoplastic syndromes in lung cancer are common. These are due to secretion of various substances and not because of direct tumour invasion or me-tastasis. These syndromes have also [...] Read more.
Lung malignancy is known to be one of the leading causes of cancer-related mortality. Endocrine paraneoplastic syndromes in lung cancer are common. These are due to secretion of various substances and not because of direct tumour invasion or me-tastasis. These syndromes have also been associated with lung cancer prognosis. This review describes the many endocrine paraneoplastic syndromes seen in lung cancer and narrates their incidence, biology, clinical features, diagnosis, and management. Full article
516 KiB  
Article
“To Do or Not to Do—That Is the Question”. Transvascular Needle Aspiration during EBUS (EBUS-TVNA) with Review of the Literature
by Arvind M. Perathur, Tinku Joseph, Sreeraj R. Nair and Umesh Varma
Adv. Respir. Med. 2021, 89(4), 386-391; https://doi.org/10.5603/ARM.a2021.0074 - 02 Sep 2021
Cited by 6 | Viewed by 692
Abstract
Introduction: Large vessels are often encountered during endobronchial ultrasound (EBUS). Safety of traversing the vessels weighed against a more invasive procedure can be a dilemma. Material and methods: We describe a case series of 8 patients who underwent transvascular needle aspiration [...] Read more.
Introduction: Large vessels are often encountered during endobronchial ultrasound (EBUS). Safety of traversing the vessels weighed against a more invasive procedure can be a dilemma. Material and methods: We describe a case series of 8 patients who underwent transvascular needle aspiration during EBUS, to access a lesion in the absence of an alternate safe window. A 21 gauge EBUS needle was used to traverse either the main or a major branch of the pulmonary artery. Results: Malignancy was suspected at ROSE in five cases. Granuloma and necrosis noted in 2 cases were confirmed as tubercu-losis on culture. Diagnostic yield of EBUS-TVNA was 87.5% (7/8). No complications were noted in the immediate post-operative period as well as during 6 months of follow up. Conclusion: EBUS-TVNA in carefully selected patients is a feasible alternative to more invasive procedures with excellent yield. Appropriate intraoperative, perioperative and postoperative monitoring and care must be available in the case of fatal bleeds. Full article
293 KiB  
Article
Epidemiological Characteristics and Outcomes from 187 Patients with COVID-19 Admitted to 6 Reference Centers in Greece: An Observational Study during the First Wave of the COVID-19 Pandemic
by Argyris Tzouvelekis, Karolina Akinosoglou, Theodoros Karampitsakos, Vassiliki Panou, Ioannis Tomos, Georgios Tsoukalas, Magdalini Stratiki, Katerina Dimakou, Serafeim Chrysikos, Ourania Papaioannou, Georgios Hillas, Petros Bakakos, Grigoris Stratakos, Aris Anagnostopoulos, Athanasios Koromilias, Afroditi Boutou, Ioannis Kioumis, Diamantis Chloros, Theodoros Kontakiotis, Despoina Papakosta, Spyridon Papiris, Effrosyni Manali, Elvira-Markela Antonogiannaki, Nikolaos Koulouris, Demosthenes Bouros, Stylianos Loukides and Charalampos Gogosadd Show full author list remove Hide full author list
Adv. Respir. Med. 2021, 89(4), 378-385; https://doi.org/10.5603/ARM.a2021.0087 - 02 Sep 2021
Cited by 3 | Viewed by 789
Abstract
Introduction: Epidemiological data from patients with COVID-19 has been recently published in several countries. Nationwide data of hospitalized patients with COVID-19 in Greece remain scarce. Material and methods:This was an observational, retrospective study from 6 reference centers between February 26 and [...] Read more.
Introduction: Epidemiological data from patients with COVID-19 has been recently published in several countries. Nationwide data of hospitalized patients with COVID-19 in Greece remain scarce. Material and methods:This was an observational, retrospective study from 6 reference centers between February 26 and May 15, 2020. Results: The patients were mostly males (65.7%) and never smokers (57.2%) of median age 60 (95% CI: 57.6–64) years. The majority of the subjects (98%) were treated with the standard-of-care therapeutic regimen at that time, including hydroxychlo-roquine and azithromycin. Median time of hospitalization was 10 days (95% CI: 10–12). Twenty-five (13.3%) individuals were intubated and 8 died (4.2%). The patients with high neutrophil-to-lymphocyte ratio (NLR) (> 3.58) exhibited more severe disease as indicated by significantly increased World Health Organization (WHO) R&D ordinal scale (4; 95% CI: 4–4 vs. 3; 95% CI: 3–4, p = 0.0001) and MaxFiO2% (50; 95% CI: 38.2–50 vs 29.5; 95% CI: 21–31, p < 0.0001). The patients with increased lactate dehydrogenase (LDH) levels (> 270 IU/ml) also exhibited more advanced disease compared to the low LDH group (< 270 IU/ml) as indicated by both WHO R&D ordinal scale (4; 95% CI: 4–4 vs. 4; 95% CI: 3–4, p = 0.0001) and MaxFiO2% (50; 95% CI: 35–60 vs. 28; 95% CI: 21–31, p < 0.0001). Conclusion: We present the first epidemiological report from a low-incidence and mortality COVID-19 country. NLR and LDH may represent reliable disease prognosticators leading to timely treatment decisions. Full article
208 KiB  
Article
Clinical Outcomes of Chronic Obstructive Pulmonary Disease Phenotypes. One Center Prospective Study
by Azza Said, Mernal Esmail, Emad Abdel Naiem, Zaki Zaki and Rasha Raouf
Adv. Respir. Med. 2021, 89(4), 369-377; https://doi.org/10.5603/ARM.a2021.0086 - 02 Sep 2021
Cited by 1 | Viewed by 713
Abstract
Introduction: The clinical outcome of different chronic obstructive pulmonary disease (COPD) phenotypes is still unclear. Objectives: This study was designed to detect the effect of different COPD phenotypes on disease outcomes. Material and methods: One hundred stable COPD patients were [...] Read more.
Introduction: The clinical outcome of different chronic obstructive pulmonary disease (COPD) phenotypes is still unclear. Objectives: This study was designed to detect the effect of different COPD phenotypes on disease outcomes. Material and methods: One hundred stable COPD patients were included. They were divided into 3 phenotypes; 45 patients in exacerbator phenotype, 37 patients in non-exacerbator, and 18 patients in asthma COPD overlap (ACO) phenotype. Patient demo-graphics, respiratory symptoms, grading of COPD, co-morbidities, spirometry, six minute walk test, and systemic inflammatory markers were measured. Also, exacerbation frequency and severity were assessed throughout the study period. Results: COPD Assessment Test (CAT) score was significantly higher in exacerbator phenotype versus the other phenotypes(14.7 ± 1.5; p = 0.04).In addition, about 60% and 42% of exacerbator phenotype were in Global Initiative for Chronic Obstructive Lung Disease (GOLD) class D and C respectively which were significantly higher than the other phenotypes(p = 0.001), while 58% and 50% of non-exacerbator and ACO patients respectively were in class B of GOLD. Twenty eight percent of patients of ACO had no comorbidity and this was significantly higher versus the other phenotypes (p = 0.03), while 40% of non-exacerbator had one comorbidity (p = 0.003) and 86% of exacerbator had ≥ 2 comorbidities (p = 0.002). COPD comorbidity index was significantly higher in exacerbator phenotype (2.5 ± 0.8; p = 0.01). Although patients of exacerbator phenotype had more and severe form of exacerbations than the other phenotypes, no significant difference in in-hospital outcome was found (p = 0.3). Conclusions: Exacerbator phenotype has worse disease outcome than those of non-exacerbator and ACO phenotypes. These results support the need for more treatment options to alleviate the morbidity of COPD especially among exacerbator phenotype. Full article
117 KiB  
Letter
Management of Non-COVID Respiratory Illnesses during the COVID-19 Pandemic—A Pulmonologist’s Perspective
by Benhur Joel Shadrach, Anukool Jain and Rishabh Goel
Adv. Respir. Med. 2021, 89(4), 469-471; https://doi.org/10.5603/ARM.a2021.0046 - 16 Jul 2021
Viewed by 376
Abstract
The novel coronavirus disease 2019(COVID-19) caused by the SARS-CoV-2 virus continues to wreak havoc all over the world with approximately 57,714,184 infections and 1,373,065 deaths reported to date [...] [...] Read more.
The novel coronavirus disease 2019(COVID-19) caused by the SARS-CoV-2 virus continues to wreak havoc all over the world with approximately 57,714,184 infections and 1,373,065 deaths reported to date [...] Full article
212 KiB  
Article
Enteroclysis in Gastrointestinal Tuberculosis: An Overview
by Petru Emil Muntean
Adv. Respir. Med. 2021, 89(4), 468; https://doi.org/10.5603/ARM.a2021.0063 - 16 Jul 2021
Viewed by 432
Abstract
42-year-old female, working on a cow farm, without known comorbidities, complained of intermittent bowel movements (2 stools/day) lasting over 8 weeks, weight loss (6 kg), enduring low-grade fever, recurrent dry cough, asthenia and occasionally pain in the right lower abdominal quadrant [...] [...] Read more.
42-year-old female, working on a cow farm, without known comorbidities, complained of intermittent bowel movements (2 stools/day) lasting over 8 weeks, weight loss (6 kg), enduring low-grade fever, recurrent dry cough, asthenia and occasionally pain in the right lower abdominal quadrant [...] Full article
175 KiB  
Case Report
An Unusual Origin of Ewing Sarcoma
by Juvva Kishan Srikanth, Rajendra Kumar, Nitesh Gupta, Pranav Ish, Rohit Kumar and Neeraj Kumar Gupta
Adv. Respir. Med. 2021, 89(4), 466-467; https://doi.org/10.5603/ARM.a2021.0044 - 16 Jul 2021
Viewed by 389
Abstract
An 18-year-old boy presented with right-sided chest tightness for 2 months [...] Full article
366 KiB  
Case Report
Acute Pulmonary Histoplasmosis Masquerading As Miliary Tuberculosis in A Non-Endemic Region
by Mehul Agarwal and Benhur Joel Shadrach
Adv. Respir. Med. 2021, 89(4), 464-465; https://doi.org/10.5603/ARM.a2021.0051 - 16 Jul 2021
Cited by 3 | Viewed by 492
Abstract
A 28-year-old female who worked as a house maid presented with fever, troublesome cough, progressive breathlessness, and anorexia which had been present for 25 days [...] Full article
225 KiB  
Case Report
An Uncommon Cause of A Benign Posterior Mediastinal Mass in An Adult
by Vishnukanth Govindaraj, Ramya Priya Anbalagan, Ravindra Chary and Vidhyalakshmi Rangarajan
Adv. Respir. Med. 2021, 89(4), 462-463; https://doi.org/10.5603/ARM.a2021.0048 - 16 Jul 2021
Cited by 1 | Viewed by 385
Abstract
A 63 year old homemaker with a history of diagnosed type II diabetes mellitus treated with oral hypo-glycemics presented with complaints of breathlessness (mMRC grade II) that had been present for 3 months [...] Full article
310 KiB  
Case Report
Diagnosis and Management of Combined Post- and Precapillary Pulmonary Hypertension in A Patient with Multiple Comorbidities
by Evangelia Panagiotidou, Afroditi Boutou, Evgenia Kalamara, Evdokia Sourla, Evangelos Chatzopoulos, Ioannis Stanopoulos and Georgia Pitsiou
Adv. Respir. Med. 2021, 89(4), 444-447; https://doi.org/10.5603/ARM.a2021.0047 - 16 Jul 2021
Cited by 1 | Viewed by 525
Abstract
Diagnosis of pulmonary hypertension requires a laborious investigation that must be performed in accordance with international Guideliness. Right-heart catheterization is the gold standard examination to assess the degree of hemodynamic impairment of post- or precapillary origin, guiding management. The presence of comorbidities is [...] Read more.
Diagnosis of pulmonary hypertension requires a laborious investigation that must be performed in accordance with international Guideliness. Right-heart catheterization is the gold standard examination to assess the degree of hemodynamic impairment of post- or precapillary origin, guiding management. The presence of comorbidities is becoming rather frequent in real-life pulmonary hypertension cases, thus creating diagnostic and therapeutic complexity. We present a case of combined post- and precapillary pulmonary hypertension in a patient with ischemic heart disease and combined pulmonary fibrosis and emphysema, in order to describe the diagnostic algorithm for pulmonary hypertension and elucidate the problematic aspects of managing this debilitating disease in a patient with several comorbidities. Current Guideliness do not support the use of specific vasodilator treatment in group II — due to heart disease and group III-due to lung disease pulmonary hypertension, unless the patient presents with severe pulmonary hypertension (mean pulmonary artery pressure > 35 mm Hg or cardiac index < 2.0 L/min) with right ventricular dysfunction and is treated in an expert center and preferably in the context of a randomized control trial. In the case presented, therapeutic management focused, firstly, on treatment of the underlying heart and lung disease and, subsequently, on specific vasoactive therapy, due to severe hemodynamic deterioration. Full article
360 KiB  
Article
Risk Factors for Complicated Community-Acquired Pneumonia Course in Patients Treated with β-Lactam Monotherapy
by Giedrė Cincilevičiūtė, Vaida Averjanovaitė, Rūta Mereškevičienė, Gabrielė Pliatkienė, Rolandas Zablockis and Edvardas Danila
Adv. Respir. Med. 2021, 89(4), 359-368; https://doi.org/10.5603/ARM.a2021.0070 - 16 Jul 2021
Viewed by 573
Abstract
Introduction: We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with β-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course. Material and methods: A prospective observational study was conducted at the Pulmonology and Allergology Department [...] Read more.
Introduction: We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with β-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course. Material and methods: A prospective observational study was conducted at the Pulmonology and Allergology Department in a tertiary care university hospital. 253 consecutive patients diagnosed with CAP requiring hospitalisation were enrolled. Hospital admission was based on PSI or CRB-65 scores, severe comorbidities, signs of intoxication, aspiration risk, social risk consider-ations, ineffective prior antibiotic treatment. Results: Fourty seven percent of the subjects had complications on admission, 13% developed new CAP complications during inpatient treatment. Overall, 53% of individuals had a complicated CAP course. 30-day mortality rate was 5.9%. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm’s criteria. Conclusions: The mortality rate in CAP patients treated with b-lactam monotherapy is low. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm’s criteria predict a complicated CAP course. Full article
200 KiB  
Article
The Relationship Between Nasal Mucociliary Clearance Time and the Degree of Smoking Dependence in Smokers with Obstructive Sleep Apnea Syndrome
by Seyhan Dülger, Çağla Çapkur, Sündüs Gençay, Süay Özmen, Fevzi Solmaz, Özlem Şengören Dikiş and Tekin Yıldız
Adv. Respir. Med. 2021, 89(4), 353-358; https://doi.org/10.5603/ARM.a2021.0069 - 16 Jul 2021
Viewed by 462
Abstract
Introduction: The aim of this study was to investigate the relationship between nasal mucociliary clearance time (NMCT), degree of smoking dependence, cumulative smoking burden and OSAS severity in smokers. Material and methods: 123 patients (Group 1) with OSAS and 92 healthy [...] Read more.
Introduction: The aim of this study was to investigate the relationship between nasal mucociliary clearance time (NMCT), degree of smoking dependence, cumulative smoking burden and OSAS severity in smokers. Material and methods: 123 patients (Group 1) with OSAS and 92 healthy controls (Group 2) were included in the study. Group 1 was divided into smokers (Group 1a) and non-smokers (Group 1b). In Group 1a, cumulative smoking burden and Fagerström nicotine dependence test (FNDT) were questioned. Saccharin test was applied to Groups 1 and 2. Student-t, Mann-Whitney-U, Anova, Kruskal-Wallis tests were used to compare the means. Results: NMCT was higher in Group 1 than Group 2 (p = 0.005). The duration of NMCT was higher in Group 1A than Group 1B (p = 0.002). In Group 1a, NMCT values of mild and moderate OSAS patients were longer than in Group 1b (p = 0.02, p = 0.01, respectively). NMCT values of patients with mild dependence were shorter than those with moderate or severe dependence (p = 0.032, p < 0.001, respectively). Conclusion: Mucociliary clearance time was higher in smokers with OSAS than non-smokers. While OSAS has a negative effect on mucociliary clearance, smoking also exacerbates the condition. Full article
562 KiB  
Case Report
Probe-Based Confocal Laser Endomicroscopy in COVID-19
by Igor Vladimirovich Vasilev, Igor Sergeevich Mamenko, Anna Valerievna Makarova, Olga Pavlovna Sokolova, Vladimir Fedorovich Lee, Mahmud Mustafa Mortada, Tatiana Alexandrovna Novickaya and Piotr Kazimirovich Yablonskii
Adv. Respir. Med. 2021, 89(4), 456-459; https://doi.org/10.5603/ARM.a2021.0067 - 15 Jul 2021
Cited by 3 | Viewed by 657
Abstract
Probe-based confocal laser endomicroscopy (pCLE) is a method that produces microscopic imaging of a lung tissue during bronchoscopy. We report a case ot a patient with negative nasopharyngeal swabs and suspected lung cancer who underwent pCLE. The diagnosis of COVID-19 was confirmed by [...] Read more.
Probe-based confocal laser endomicroscopy (pCLE) is a method that produces microscopic imaging of a lung tissue during bronchoscopy. We report a case ot a patient with negative nasopharyngeal swabs and suspected lung cancer who underwent pCLE. The diagnosis of COVID-19 was confirmed by PCR analyses of lavage fluid and transbrohial biopsy. The pCLE image shows density of alveolar thickened fibres, disorganization of elastin network, and multiple large drops of intraalveolar secretions. As far as we know, this is the first pCLE image discribed in patient with COVID-19 at that moment. Full article
775 KiB  
Case Report
Vanishing Lung Syndrome with Community-Acquired Pneumonia and Infection of Bullae
by Andra Pekša, Madara Tirzīte and Sergejs Daņilovs
Adv. Respir. Med. 2021, 89(4), 451-455; https://doi.org/10.5603/ARM.a2021.0066 - 15 Jul 2021
Cited by 1 | Viewed by 563
Abstract
We present a case of a 36-year old male who was a long-term smoker and was found to have giant bullous emphysema on chest imaging as an accidental finding. At the time, when his first chest CT was obtained, he was asymptomatic and [...] Read more.
We present a case of a 36-year old male who was a long-term smoker and was found to have giant bullous emphysema on chest imaging as an accidental finding. At the time, when his first chest CT was obtained, he was asymptomatic and was recommended to consult a pulmonologist but was lost to follow-up for a year until he presented to the emergency department with fever, dyspnea, and chest pain. He was admitted to a pulmonology department. Chest CT was performed and it revealed infected bullae containing air-fluid levels as a complication of community-acquired pneumonia. After successful antibacterial treatment, the patient was discharged and recommended to consult with a thoracic surgeon. A few months later, he had video-assisted thoracoscopic surgery and left upper lobectomy as part of definitive treatment. Full article
260 KiB  
Review
Potential Benefits and Hazards Associated with the Use of E-Cigarettes—A Guide for Practitioners and Current Status in Poland
by Jakub Kruszewski, Daniel Worobiej, Weronika Kolasińska, Rafał Andrzej Sokołowski and Michał Rząd
Adv. Respir. Med. 2021, 89(4), 392-402; https://doi.org/10.5603/ARM.a2021.0058 - 09 Jul 2021
Viewed by 500
Abstract
The use of electronic cigarettes has dynamically increased over the last few years. Meanwhile, the knowledge regarding their safety has been rapidly changing, which could be a challenge for a medical practitioner. The purpose of this review is to summarize the latest reports [...] Read more.
The use of electronic cigarettes has dynamically increased over the last few years. Meanwhile, the knowledge regarding their safety has been rapidly changing, which could be a challenge for a medical practitioner. The purpose of this review is to summarize the latest reports and to verify statements on e-cigarettes’ influence on health, including in the context of the ongoing SARS-CoV-2 pandemic. Awareness of the benefits of e-cigarettes can provide vital support for doctors caring for patients who smoke tra-ditional cigarettes. Nevertheless, attention should be paid to the dangers of the medically unjustified use of electronic cigarettes. Despite the idea of releasing e-cigarettes into the market as a harmless alternative to traditional cigarettes, this product also has a negative impact on health. Replacing traditional cigarettes with e-cigarettes provides well-documented benefits to patients with certain indications such as hypertension and asthma, as well as to smokers who intend to minimize the negative effects of passive smoking on their environment. Moreover, it could be valuable for patients who are willing to permanently overcome a nicotine addiction, especially when previous attempts to quit smoking with nicotine replacement therapy (NRT) monotherapy were unsuccessful. Electronic cigarettes are a rapidly developing technology and an innovative form of a well-known addiction, so it is essential for practitioners to stay informed. Full article
254 KiB  
Case Report
Unusual Presentation of Tuberculosis in Pregnancy: A Diagnostic Difficulty
by Ravindra Chari, Madhusmita Mohapatra, Ramya Priya and Vinod Kumar
Adv. Respir. Med. 2021, 89(4), 460-461; https://doi.org/10.5603/ARM.a2021.0059 - 06 Jul 2021
Viewed by 384
Abstract
In India, pulmonary tuberculosis (TB) is highly prevalent but has rarely been reported as an underlying cause of Acute Respiratory Distress Syndrome (ARDS) [...] Full article
208 KiB  
Case Report
Acute Hypoxemia Due to Lung Collapse in COVID-19: The Role of Therapeutic Bronchoscopy
by Sryma PB, Karan Madan, Anant Mohan, Vijay Hadda, Pawan Tiwari, Randeep Guleria and Saurabh Mittal
Adv. Respir. Med. 2021, 89(4), 448-450; https://doi.org/10.5603/ARM.a2021.0009 - 21 Apr 2021
Viewed by 428
Abstract
Bronchoscopy is an aerosol-generating procedure and involves a high risk of transmission of SARS-CoV-2 to health care workers. There are very few indications for performing bronchoscopy in a patient with confirmed COVID-19. These include atelectasis, foreign body aspiration, and suspected superinfection in immunocompromised [...] Read more.
Bronchoscopy is an aerosol-generating procedure and involves a high risk of transmission of SARS-CoV-2 to health care workers. There are very few indications for performing bronchoscopy in a patient with confirmed COVID-19. These include atelectasis, foreign body aspiration, and suspected superinfection in immunocompromised patients. Proper use of standard personal protective equipment is mandatory to reduce the risk of transmission to health care workers. In this article, we describe a case of acute lung collapse in a 16-year-old boy with cerebral palsy who was infected with COVID-19. This patient responded to therapeutic bronchoscopy and had complete resolution of lung collapse within 24 h of the procedure. Full article
264 KiB  
Case Report
The Effect of Buprenorphine vs. Methadone on Sleep Breathing Disorders
by Parisa Adimi Naghan, Javad Setareh and Majid Malekmohammad
Adv. Respir. Med. 2021, 89(4), 439-443; https://doi.org/10.5603/ARM.a2020.0160 - 16 Apr 2021
Cited by 1 | Viewed by 1157
Abstract
Opioids are used widely as analgesics and can play an important role in agonist maintenance therapy for opium dependence. Despite their benefits, the negative effects on the respiratory system remain an important side effect to be considered. Ataxic breathing, obstructive sleep apnea, and [...] Read more.
Opioids are used widely as analgesics and can play an important role in agonist maintenance therapy for opium dependence. Despite their benefits, the negative effects on the respiratory system remain an important side effect to be considered. Ataxic breathing, obstructive sleep apnea, and most of all central sleep apnea are among these concerns. Obstructive sleep apnea leads to various metabolic, cardiovascular, cognitive, and mental side effects and may result in abrupt mortality. Buprenorphine is a semisynthetic opioid, a partial mu-opioid agonist with limited respiratory toxicity preferably used by these patients, as it is accompanied by significantly lower risk factors in the development of obstructive and central sleep apnea. In this manuscript, the case of a patient is reported who underwent methadone maintenance therapy which was shifted to buprenorphine in order to observe possible changes in sleep-related breathing disorders. The results of this study indicate a reduction in these problems through the desaturation and apnea hypopnea index of methadone substituted by buprenorphine while no change in sleepiness was observed. Full article
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