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International Journal of Infectious... Aug 2024The prevalence of respiratory infectious diseases has changed in the post-COVID-19 epidemic era, and mycoplasma pneumoniae (MP) infection in children has attracted wide...
OBJECTIVES
The prevalence of respiratory infectious diseases has changed in the post-COVID-19 epidemic era, and mycoplasma pneumoniae (MP) infection in children has attracted wide attention.
METHODS
Children hospitalized for pneumonia in Wuhan, China, in 2023 were enrolled. Respiratory secretions were obtained for the targeted next-generation sequencing (tNGS) including mutation of MP. Pulmonary inflammation was divided into bronchopneumonia and pulmonary consolidation/atelectasis according to lung computed tomography imaging.
RESULTS
Of the 667 pediatric pneumonia, 478 were MP positive (72%). The positive rate of MP detected by tNGS increased from April, and MP had become the primary pathogen of pneumonia in children in 2023. The 23S rRNA mutations were all A2063G, accounting for 85% of detected MP. The clinical symptoms of the mutant and wild-type strains were similar, with half of them experiencing atelectasis and lung consolidation. Early bronchoscopic lavage combined with azithromycin in pediatric pulmonary consolidation was an effective therapy strategy, which could be an alternative selection to MP pneumonia treatment.
CONCLUSIONS
A2063G mutant strain MP was the primary pathogen of mycoplasma pneumoniae in children recently, which was often complicated by extra-pulmonary symptoms and complications.
Topics: Humans; Pneumonia, Mycoplasma; China; Mycoplasma pneumoniae; Female; Child; Male; Child, Preschool; Mutation; Infant; RNA, Ribosomal, 23S; Anti-Bacterial Agents; Azithromycin; COVID-19; High-Throughput Nucleotide Sequencing; Adolescent
PubMed: 38734057
DOI: 10.1016/j.ijid.2024.107074 -
SAGE Open Medical Case Reports 2024Re-expansion pulmonary edema is defined as pulmonary edema that occurs when a chronically collapsed lung rapidly re-expands, most commonly following chest tube placement...
Re-expansion pulmonary edema is defined as pulmonary edema that occurs when a chronically collapsed lung rapidly re-expands, most commonly following chest tube placement for pneumothorax, re-expansion of severe atelectasis, and evacuation of pleural effusion. Though it is very rare, the sudden onset and clinical features of re-expansion pulmonary edema make it a lethal complication that requires urgent treatment. We present a 60-year-old patient who underwent an aortic valve replacement with pre-existing large bilateral pleural effusions. Intraoperatively, upon evacuation of the pleural effusions, the patient developed worsening lung compliance, refractory hypoxemia, and hypercapnia that required emergent veno-venous extracorporeal membrane oxygenation support.
PubMed: 38711679
DOI: 10.1177/2050313X241249081 -
PloS One 2024The Incentive Spirometer (IS) increases lung volume and improves gas exchange by visually stimulating patients to take slow, deep breaths. It prevents respiratory... (Comparative Study)
Comparative Study
Comparative analysis of pulmonary ventilation distribution between low-cost and branded incentive spirometers using electrical impedance tomography in healthy adults: Study protocol.
BACKGROUND
The Incentive Spirometer (IS) increases lung volume and improves gas exchange by visually stimulating patients to take slow, deep breaths. It prevents respiratory complications and treats postoperative atelectasis in patients undergoing abdominal, thoracic, and neurosurgical procedures. Its effectiveness has been validated in studies that support improved lung capacities and volumes in individuals with respiratory complications, postoperative thoracic surgery, upper abdominal surgery, and bariatric surgery. The modified Pachón incentive spirometer (MPIS) is a cost-effective alternative to branded IS. It is crucial to validate whether the MPIS distributes ventilation as effectively as commercial devices do. Ventilation distribution will be measured using electrical impedance tomography.
OBJECTIVE
The aim is to compare the distribution of pulmonary ventilation between the MPIS and another commercial IS in healthy adults using electrical impedance tomography.
METHODS
A crossover clinical trial is proposed to evaluate the measurement of pulmonary ventilation distribution using EIT in a sample of healthy adults. All participants will use a commercial flow IS and the MPIS, with the order of assignment randomized. This research will use electrical impedance tomography to validate the operation of the MPIS.
CONCLUSIONS
This study protocol will compare two incentive spirometers' impact on pulmonary ventilation, potentially endorsing the adoption of a cost-effective device to enhance accessibility for targeted populations.
TRIAL REGISTRATION
The study was registered in ClinicalTrials.gov (NTC05532748).
Topics: Humans; Electric Impedance; Adult; Spirometry; Tomography; Pulmonary Ventilation; Male; Female; Healthy Volunteers; Cross-Over Studies; Lung; Middle Aged; Young Adult
PubMed: 38709742
DOI: 10.1371/journal.pone.0302476 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... Apr 2024To explore the effects of Rhodiola rosea injection on pulmonary shunt and serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels during single lung... (Randomized Controlled Trial)
Randomized Controlled Trial
[Effects of injection on intrapulmonary shunt and blood IL-6 and TNF-α levels during single lung ventilation in patients undergoing radical resection of esophageal cancer].
OBJECTIVE
To explore the effects of Rhodiola rosea injection on pulmonary shunt and serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels during single lung ventilation in patients undergoing radical resection of esophageal cancer.
METHODS
Forty-six patients undergoing radical operation for esophageal cancer were randomized equally into control group and Rhodiola rosea injection group. In the Rhodiola group, 10 mL of Rhodiola rosea injection was added into 250 mL of normal saline or 5% glucose solution for slow intravenous infusion, and normal saline of the same volume was used in the control group after the patients entered the operation room. At T, T and T, PaO of the patient was recorded and 2 mL of deep venous blood was collected for determination of serum TNF-α and IL-6 levels. The incidence of postoperative atelectasis of the patients was recorded.
RESULTS
Compared with those in the control group, the patients receiving Rhodiola rosea injection had significantly higher PaO and Qs/Qt at T and T (<0.05) and lower serum IL-6 and TNF-α levels at T (<0.05). No significant difference in the incidence of postoperative atelectasis was observed between the two groups (>0.05).
CONCLUSION
Rhodiola rosea injection before anesthesia induction can reduce intrapulmonary shunt during single lung ventilation, improve oxygenation, reduce serum IL-6 and TNF-α levels, and alleviate intraoperative lung injury in patients undergoing radical resection of esophageal cancer.
Topics: Humans; Esophageal Neoplasms; Tumor Necrosis Factor-alpha; Rhodiola; Interleukin-6; One-Lung Ventilation; Female; Male; Middle Aged
PubMed: 38708504
DOI: 10.12122/j.issn.1673-4254.2024.04.12 -
Cancer Diagnosis & Prognosis 2024Malignant airway obstruction (MAO) secondary to tumor growth occurs in nearly a third of patients with lung cancer and portends a very poor prognosis if untreated....
BACKGROUND
Malignant airway obstruction (MAO) secondary to tumor growth occurs in nearly a third of patients with lung cancer and portends a very poor prognosis if untreated. Treatment options include bronchoscopic intervention with tumor debulking, stent placement, endobronchial brachytherapy, or palliative radiotherapy.
CASE REPORT
This is a report of a 74-year-old woman with a medical history of metastatic lung adenocarcinoma, hospitalized for dyspnea, hemoptysis, and chest pain with a radiographic finding of MAO on chest X-ray and computed tomography. Patient underwent radiation with a total dose of 13 Gy in two once-weekly fractions of 6.5 Gy per fraction. Three days after the end of radiation treatment, chest X-ray showed a completely right lung re-expansion without atelectasis. Two weeks after radiotherapy treatment, the patient was discharged from hospital without pulmonary symptoms.
CONCLUSION
A different fractionation with a lower equivalent dose in 2 Gy fraction compared to literature data showed efficacy in resolving MAO with excellent local control in the first three months of follow-up.
PubMed: 38707719
DOI: 10.21873/cdp.10332 -
Cureus Apr 2024Silent sinus syndrome is a rare clinical entity affecting the maxillary sinus, characterized by ipsilateral enophthalmos and hypoglobus. Its etiology and...
Silent sinus syndrome is a rare clinical entity affecting the maxillary sinus, characterized by ipsilateral enophthalmos and hypoglobus. Its etiology and pathophysiology are still debated. It is diagnosed by clinical examination and confirmed with computed tomography. It is commonly managed surgically. We present the case of a 34-year-old woman with silent sinus syndrome treated with a patient-specific implant for orbital reconstruction, functional endoscopic sinus surgery approach, intraoperative scan, and surgical navigation, successfully restoring orbital volume and sinus ventilation.
PubMed: 38707145
DOI: 10.7759/cureus.57577 -
Transplantation Proceedings May 2024The risk of morbidity and mortality in the group of people qualified for kidney transplantation is high. Although currently, the qualification for kidney transplantation...
BACKGROUND
The risk of morbidity and mortality in the group of people qualified for kidney transplantation is high. Although currently, the qualification for kidney transplantation is very extensive and detailed, the final examination and assessment at the transplant center is crucial for the success of the transplantation.
CASE REPORT
A 50-year-old woman with end-stage kidney disease was admitted to the Department of General, Vascular, and Transplant Surgery on July 21, 2023, for kidney transplantation. A month earlier, she had undergone surgery to create an arteriovenous fistula on the left forearm. The regional anesthesia was performed. Apart from temporary pain and cough, the postoperative course was uncomplicated. Upon admission to the Department, the patient was in good general condition, and only a dry cough was noted during the physical examination. Chest X-ray revealed pneumothorax on the left side with partial lung atelectasis. The patient was temporarily disqualified from kidney transplantation and the pneumothorax was cured. She is currently on the active list waiting for a kidney transplant.
CONCLUSIONS
The analysis of the above case emphasizes the importance of a physical examination and final qualification at the transplant center. Detailed examination and evaluation at the above center can improve patients' quality of life and survival.
Topics: Humans; Kidney Transplantation; Female; Middle Aged; Pneumothorax; Kidney Failure, Chronic
PubMed: 38705736
DOI: 10.1016/j.transproceed.2024.04.010 -
Cureus Apr 2024Continuous negative abdominal pressure (CNAP) therapy effectively provides respiratory support in patients with respiratory failure and severe obesity; however, its use...
Successful Management With Continuous Negative Abdominal Pressure Therapy in a Severely Obese Patient With Inhalation Burn-Induced Severe Respiratory Failure Requiring Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report.
Continuous negative abdominal pressure (CNAP) therapy effectively provides respiratory support in patients with respiratory failure and severe obesity; however, its use in clinical practice remains limited. In this case, we report a significant improvement in the respiratory condition of a patient with severe obesity and inhalation burns following the application of CNAP in addition to venovenous extracorporeal membrane oxygenation (V-V ECMO) and mechanical ventilation. The patient was able to wean off these devices successfully. This case highlights the potential of CNAP therapy as an adjunct treatment for severe respiratory failure, particularly in obese patients for whom conventional interventions are insufficient.
PubMed: 38699094
DOI: 10.7759/cureus.57436 -
Frontiers in Medicine 2024The application of preoperative noninvasive respiratory support (NRS) has been expanding with increasing recognition of its potential role in this setting as a... (Review)
Review
The application of preoperative noninvasive respiratory support (NRS) has been expanding with increasing recognition of its potential role in this setting as a physiological optimization for patients with a high risk of developing atelectasis and postoperative pulmonary complications (PPC). The increased availability of high-performance anesthesia ventilator machines providing an easy way for NRS support in patients with reduced lung function should not be under-evaluated. This support can reduce hypoxia, restore lung volumes and theoretically reduce atelectasis formation after general anesthesia. Therapeutic purposes should also be considered in the perioperative setting, such as preoperative NRS to optimize treatment of patients' pre-existing diseases, e.g., sleep-disordered breathing. Finally, the recent guidelines for airway management suggest preoperative NRS application before anesthesia induction in difficult airway management to prolong the time needed to secure the airway with an orotracheal tube. This narrative review aims to revise all these aspects and to provide some practical notes to maximize the efficacy of perioperative noninvasive respiratory support.
PubMed: 38695030
DOI: 10.3389/fmed.2024.1364475 -
Kardiochirurgia I Torakochirurgia... Mar 2024The outcomes of lung cancer surgery depend on the patients' nutritional status. Body fat percentage (BF%) is one of the indicators of body composition and nutritional...
INTRODUCTION
The outcomes of lung cancer surgery depend on the patients' nutritional status. Body fat percentage (BF%) is one of the indicators of body composition and nutritional status. Direct measurement of BF% is complicated, requires significant resources and is rarely performed. The CUN-BAE (Clínica Universidad de Navarra - Body Adiposity Estimator) index has been shown to accurately predict BF% is several clinical settings, but its relation to the outcomes of lung surgery has not been reported so far.
AIM
To determine the relation of the BF% to the outcomes of thoracoscopic lobectomy.
MATERIAL AND METHODS
This retrospective study included 1,183 patients who underwent thoracoscopic lobectomy for non-small cell lung cancer between June 1999, and September 2019 at one department. BF% was calculated according to the Clínica Universidad de Navarra - Body Adiposity Estimator equation. The primary endpoints were postoperative complications and long-term survival.
RESULTS
Univariate analysis showed that higher BF% was related to lower incidence of complications ( = 0.001), including prolonged air leak ( < 0.001), atelectasis ( < 0.05), psychosis ( < 0.001), reoperations ( < 0.05), and shorter chest drainage ( = 0.001) and hospitalization duration ( < 0.001). Multivariate analysis showed that higher BF% was correlated with lower risk of complications ( = 0.005; OR = 0.964; 95% CI: 0.940 to 0.989), including prolonged air leak ( < 0.001; OR = 0.923; 95% CI: 0.886 to 0.962), and shorter duration of chest drainage ( < 0.001; B = -0.046; 95% CI: -0.069 to -0.023) and hospitalization ( < 0.001; B = -0.112; 95% CI: -0.176 to -0.048). Cox proportional hazards regression analysis showed that BF% was not related to long-term survival.
CONCLUSIONS
Body fat percentage is a valuable tool that can help predict the short-term outcomes of minimally lobectomy for lung cancer.
PubMed: 38693981
DOI: 10.5114/kitp.2024.138524