Surveillance Bronchoscopy: Is It Still Relevant?

2018 ◽  
Vol 39 (02) ◽  
pp. 219-226 ◽  
Author(s):  
Mark Benzimra
Keyword(s):  
Bronchoalveolar Lavage ◽  
Patient Population ◽  
Treatment Strategies ◽  
Transbronchial Biopsy ◽  
Therapeutic Options ◽  
Ongoing Controversy ◽  
Airway Complications ◽  
Complex Patient ◽  
Essential Tool ◽  
Diagnosis Of Rejection

AbstractThe performance of bronchoscopy with bronchoalveolar lavage and transbronchial biopsy is an essential tool and skill required by any clinician caring for patients postlung transplantation. Making a confident diagnosis is crucial in initiating different treatment strategies which may be in turn hazardous to the patient in light of an inaccurate diagnosis. Having more information available for evaluation optimizes the chances of tailoring appropriate therapeutic options in this complex patient population. Performing a bronchoscopy with bronchoalveolar lavage and transbronchial biopsy indeed provides a wealth of information via microbiological, cytological, and histological samples that assist us to differentiate infection from rejection, or to confirm the presence of both. This review aims to discuss the utility of bronchoscopy postlung transplantation in the diagnosis of rejection, infection, and airway complications, as well as looking into the ongoing controversy regarding monitoring practices worldwide and safety concerns.

Multidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement

2019 ◽  
Vol 26 (2) ◽  
pp. 199-212 ◽  
Author(s):  
Ehrin J. Armstrong ◽  
Syed Alam ◽  
Steve Henao ◽  
Arthur C. Lee ◽  
Brian G. DeRubertis ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Patient Population ◽  
Wound Care ◽  
Multidisciplinary Care ◽  
Limb Ischemia ◽  
Medical Specialty ◽  
Complex Patient ◽  
Arterial Insufficiency ◽  
Artery Disease ◽  
Improve Patient

Critical limb ischemia (CLI), defined as ischemic rest pain or nonhealing ulceration due to arterial insufficiency, represents the most severe and limb-threatening manifestation of peripheral artery disease. A major challenge in the optimal treatment of CLI is that multiple specialties participate in the care of this complex patient population. As a result, the care of patients with CLI is often fragmented, and multidisciplinary societal guidelines have not focused specifically on the care of patients with CLI. Furthermore, multidisciplinary care has the potential to improve patient outcomes, as no single medical specialty addresses all the facets of care necessary to reduce cardiovascular and limb-related morbidity in this complex patient population. This review identifies current gaps in the multidisciplinary care of patients with CLI, with a goal toward increasing disease recognition and timely referral, defining important components of CLI treatment teams, establishing options for revascularization strategies, and identifying best practices for wound care post-revascularization.

scholarly journals COVID-19 in the Healthy Patient Population

2020 ◽  
Vol 40 (11) ◽  
pp. 2764-2775
Author(s):  
Diana Maria Ronderos Botero ◽  
Alaa Mabrouk Salem Omar ◽  
Haozhe Keith Sun ◽  
Nikhitha Mantri ◽  
Ked Fortuzi ◽  
...  
Keyword(s):  
Patient Population ◽  
Cluster Model ◽  
Treatment Strategies ◽  
Inflammatory Cells ◽  
Age Group ◽  
Healthy Patient ◽  
Comorbid Conditions ◽  
Retrospective Study Design ◽  
Cluster 2

Objective: Coronavirus disease 2019 (COVID-19) can infect patients in any age group including those with no comorbid conditions. Understanding the demographic, clinical, and laboratory characteristics of these patients is important toward developing successful treatment strategies. Approach and Results: In a retrospective study design, consecutive patients without baseline comorbidities hospitalized with confirmed COVID-19 were included. Patients were subdivided into ≤55 and >55 years of age. Predictors of in-hospital mortality or mechanical ventilation were analyzed in this patient population, as well as subgroups. Stable parameters in overall and subgroup models were used to construct a cluster model for phenotyping of patients. Of 1207 COVID-19–positive patients, 157 met the study criteria (80≤55 and 77>55 years of age). Most reliable predictors of outcomes overall and in subgroups were age, initial and follow-up d -dimer, and LDH (lactate dehydrogenase) levels. Their predictive cutoff values were used to construct a cluster model that produced 3 main clusters. Cluster 1 was a low-risk cluster and was characterized by younger patients who had low thrombotic and inflammatory features. Cluster 2 was intermediate risk that also consisted of younger population that had moderate level of thrombosis, higher inflammatory cells, and inflammatory markers. Cluster 3 was a high-risk cluster that had the most aggressive thrombotic and inflammatory feature. Conclusions: In healthy patient population, COVID-19 remains significantly associated with morbidity and mortality. While age remains the most important predictor of in-hospital outcomes, thromboinflammatory interactions are also associated with worse clinical outcomes regardless of age in healthy patients.

Site-directed bronchoalveolar lavage and transbronchial biopsy in HIV-infected patients with pneumonia.

1995 ◽  
Vol 152 (3) ◽  
pp. 1103-1106 ◽  
Author(s):  
J Cadranel ◽  
K Gillet-Juvin ◽  
M Antoine ◽  
F Carnot ◽  
P Reynaud ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Transbronchial Biopsy

Recurrent abdominal pain

2011 ◽  
Author(s):  
R. Mark Beattie ◽  
Anil Dhawan ◽  
John W.L. Puntis
Keyword(s):  
General Practice ◽  
Abdominal Pain ◽  
Treatment Strategies ◽  
Recurrent Abdominal Pain ◽  
Family Factors ◽  
Therapeutic Options ◽  
Clinical Approach ◽  
Organic Disease ◽  
Disease Treatment ◽  
School Aged Children

Introduction 256Classification 257Personality type and family factors 259Common stresses in children with recurrent abdominal pain 259Therapeutic options 260Outcome 261Recommended clinical approach 261• Recurrent abdominal pain is common in school-aged children and is a frequent presenting complaint in general practice and general paediatric and paediatric gastroenterology clinics. Patients often have vague symptomatology and investigation usually results in a low yield of organic disease. Treatment strategies are varied and often subjective with very little evidence upon which to base them....

Assessment and Treatment of Sexual Dysfunction in Multiple Sclerosis

2016 ◽  
Author(s):  
Frederick W. Foley
Keyword(s):  
Multiple Sclerosis ◽  
Sexual Dysfunction ◽  
Patient Population ◽  
Behavioral Interventions ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Assessment And Treatment ◽  
Pharmacologic Agents

This chapter discusses the signs and symptoms of sexual dysfunction that are common in persons with multiple sclerosis. The epidemiology of sexual dysfunction in this patient population is presented, along with techniques and instruments for screening for sexual dysfunction. Definitions of primary, secondary, and tertiary sexual dysfunction are reviewed, and a detailed discussion of treatment strategies is presented, including pharmacologic agents, devices, and behavioral interventions.

scholarly journals Unusual Synchronous Lung Tumors: Mucoepidermoid Carcinoma and Mucinous Adenocarcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Ana M. Ponea ◽  
Creticus P. Marak ◽  
Ying Sun ◽  
Achuta Kumar Guddati ◽  
Amit S. Tibb
Keyword(s):  
Mucinous Adenocarcinoma ◽  
Patient Population ◽  
Mucoepidermoid Carcinoma ◽  
Clinical Presentation ◽  
Treatment Strategies ◽  
Pathological Examination ◽  
Unique Combination ◽  
Current State ◽  
Lung Malignancy ◽  
Lung Malignancies

Primary mucoepidermoid tumors of the lung are rare entities. Synchronous primary malignancies of the lung involving mucoepidermoid carcinoma and mucinous adenocarcinoma are even rarer and constitute a unique set of patient population. The presentation, diagnosis and treatment strategies for this patient population are not well described. In most cases, the diagnosis of synchronous primary lung malignancy is made after pathological examination of the resected lung specimen. Molecular and genetic analysis is now being used to supplement the diagnosis of synchronous primary lung malignancies. In this work, we briefly discuss the current state of knowledge of this unique combination of primary lung malignancies and describe the clinical presentation and management of a patient with a rare combination of synchronous primary lung malignancies.

scholarly journals Early experience and difficulties with bronchoalveolar lavage and transbronchial biopsy in the diagnosis of AIDS associated pneumonia in Britain.

Thorax ◽  
1985 ◽  
Vol 40 (3) ◽  
pp. 166-170 ◽  
Author(s):  
C R Swinburn ◽  
A L Pozniak ◽  
S Sutherland ◽  
R A Banks ◽  
A J Teall ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Early Experience ◽  
Transbronchial Biopsy
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