scholarly journals Utility and Safety of Fiberoptic Bronchoscopy in Patients Infected with COVID-19. A Case Series

2021 ◽  
Vol 7 (1) ◽  
pp. 1-5
Author(s):  
Gabriella Patricia Roa Gomez ◽  
Keyword(s):  
Lung Diseases ◽  
Case Series ◽  
Fiberoptic Bronchoscopy ◽  
Healthcare Personnel ◽  
Therapeutic Tool ◽  
Tool Performance

Bronchoscopy is a safe diagnostic and therapeutic tool. Performance of bronchoscopy in patients with highly communicable lung diseases like SARS-CoV-2 infection is controversial due to the risk for healthcare personnel.

scholarly journals Chemotherapy-Associated Pulmonary Toxicity—Case Series from a Single Center

2021 ◽  
Author(s):  
Tilak TVSVGK ◽  
Ajay Handa ◽  
Kishore Kumar ◽  
Deepti Mutreja ◽  
Shankar Subramanian
Keyword(s):  
Observational Study ◽  
Pulmonary Toxicity ◽  
Imaging Finding ◽  
Tertiary Care ◽  
Case Series ◽  
Fiberoptic Bronchoscopy ◽  
Chemotherapeutic Agents ◽  
New Drugs ◽  
Care Hospital ◽  
Persistent Symptoms

Abstract Background Pulmonary toxicity due to chemotherapeutic agents can occur with many established and new drugs. Strong clinical suspicion is important as the clinical presentation is usually with nonspecific symptoms like cough, dyspnea, fever, and pulmonary infiltrates. Timely discontinuation of the offending agent alone can improve the condition. Methods A prospective observational study on patients receiving chemotherapy at an 800-bedded tertiary care hospital was performed from 2014 to 2016. Consecutive patients on chemotherapy, presenting with nonresolving respiratory symptoms were evaluated with contrast-enhanced computerized tomography of chest, diffusion lung capacity for carbon monoxide (DLCO), fiberoptic bronchoscopy with lavage, and biopsy, after excluding all causes for pulmonary infections. Descriptive data has been depicted. Results A total of 18 patients were evaluated for persistent symptoms of dry cough, dyspnea, and fever among 624 who received chemotherapy during the study period. Ground-glass opacities on high-resolution CT was the most common imaging finding, others being patchy subpleural consolidation and pleural effusion. Lymphocyte-predominant bronchoalveolar lavage was detected in nine. Eight of the 15 patients who underwent DLCO, had abnormal results. Seven had significant histopathological findings on bronchoscopic lung biopsy, which revealed organizing pneumonia as the most common pattern. Paclitaxel, fluorouracil, gemcitabine, and tyrosine kinase inhibitors were the common culprit drugs. Discontinuation alone of the culprit drug was effective in 15 and 3 needed oral corticosteroids for relief of symptoms. None of the patients died due to the toxicity. Conclusion An incidence of 2.8% for chemotherapy-induced lung injury was seen in our observational study of 3 years, with parenchymal, interstitial, and pleural involvement due to various chemotherapeutic agents. Oral steroids maybe required in a subset of patients not responding to discontinuation of the culprit agent.

824 Case Series on the Use of Volume Assured Pressure Support in Patients with Chronic Pulmonary Disease and Progressive Hypercapnia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A321-A322
Author(s):  
William LeMaster ◽  
Dale Jun ◽  
Sharon De Cruz ◽  
Michelle Zeidler ◽  
Rajan Saggar
Keyword(s):  
Respiratory Failure ◽  
Lung Disease ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Lung Transplant ◽  
Pressure Support ◽  
Case Series ◽  
Chronic Obstructive ◽  
Hypoxemic Respiratory Failure ◽  
Chronic Lung Diseases

Abstract Introduction Chronic hypercapnia results from destruction of lung parenchyma which occurs in chronic lung diseases including interstitial lung disease (ILD), bronchiectasis, and chronic lung transplant rejection. Many patients with these diseases will experience progressive respiratory failure eventually requiring consideration of transplantation or re-transplantation. Due to physiologic changes in sleep including reduction in tidal volume, worsening air tapping, and REM atonia, hypoventilation can be exacerbated during the sleeping hours. We present four patients who were prescribed nocturnal Volume Assured Pressure Support VAPS for their progressive hypercapnia. Report of case(s) Subject 1 is a 72 year old female with severe bronchiectasis and restrictive lung disease due to TB pneumonia at a young age. Subject 2 is a 45 year old male with history of pulmonary cavitation due to extensive TB disease when he was younger. Subject 3 is a 45-year-old woman with rheumatoid arthritis related ILD with associated pulmonary arterial hypertension. Subject 4 is a 74 year old patient with a bilateral lung transplant for IPF complicated by bronchiolitis obliterans syndrome who presented with progressive dyspnea and hypercapnia. Despite optimal therapy, all of these patients were admitted for hypercapnic and hypoxemic respiratory failure requiring treatment with BPAP then transitioned to nocturnal VAPS on discharge. For all patients, dyspnea and pCO2 improved as outpatients although all patients did eventually experience an exacerbation of their lung disease requiring repeat admission. Conclusion Due to the physiologic changes that occur with sleep, patients with severe lung disease may experience worsening CO2 retention while sleeping. There is little data assessing the use of chronic nocturnal non-invasive ventilation (NIV) to treat the hypercapnia of chronic lung diseases other than chronic obstructive pulmonary disease, extra-thoracic restriction, and neuromuscular disease. In this case series, nocturnal VAPS stabilized and/or reduced pCO2 in patients with pulmonary parenchymal disease of various etiologies. Additional studies are needed to assess long term effects of VAPS in these patients, including exacerbations, symptoms, and overall mortality. Support (if any):

Exosomal MicroRNA: Diagnostic Marker and Therapeutic Tool for Lung Diseases

2021 ◽  
Vol 27 ◽  
Author(s):  
Yu Hua ◽  
Yan Ding ◽  
Yapeng Hou ◽  
Yanhong Liu ◽  
Kejun Mao ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Diagnostic Marker ◽  
Treatment Strategies ◽  
Diagnostic Methods ◽  
Chronic Obstructive ◽  
Target Cells ◽  
High Morbidity ◽  
Therapeutic Tool ◽  
Obstructive Pulmonary Disease ◽  
Exosomal Microrna

: Lung diseases are common clinical illnesses with high morbidity and mortality, which seriously threaten human health. In recent years, increasing evidence suggests that exosomes play a pivotal role in intercellular communication by delivering their cargo to pulmonary target cells，such as microRNAs. Physiologically, exosomes have been shown to be a critical mediator in maintaining homeostasis function in the complex thin-walled lung tissue and airway structure. Apart from being a diagnostic and prognostic biomarker, exosomes also participate in the progression of some lung diseases, such as chronic obstructive pulmonary disease, asthma, pulmonary fibrosis, acute lung injury, lung cancer, interstitial lung disease, and tuberculosis. Here, we summarize the recent findings on the involvement of exosomes and exosomal microRNAs in the pathogenesis, diagnosis, and therapy of lung diseases, aiming to provide more information to discover novel diagnostic methods and treatment strategies for these disorders.

scholarly journals ‘When you hear hooves, think zebras, not horses’; two challenging cases of interstitial lung disease (ILD)

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-224507
Author(s):  
Marissa O’Callaghan ◽  
Aurelie Fabre ◽  
Michael Keane ◽  
Timothy J McDonnell
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Fibrosis ◽  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Usual Interstitial Pneumonia ◽  
Case Series ◽  
Imaging Features ◽  
Exertional Dyspnoea ◽  
Multidisciplinary Team Meeting

Our case series describes two siblings with complex fibrosing lung diseases. The first patient was initially given a diagnosis of sarcoidosis based on imaging and exclusion of alternative diagnoses. A number of years after diagnosis, he had rapid deterioration of his disease and following surgical lung biopsy, his lung fibrosis was re-classified as chronic hypersensitivity pneumonitis (cHP) with a usual interstitial pneumonia pattern. He subsequently underwent successful lung transplantation. The second patient presented with rapidly progressing exertional dyspnoea. His bloods, imaging, bronchoalveolar lavage and histology were discussed at our multidisciplinary team meeting. His histology was most in keeping with subacute on cHP with overlapping imaging features between the two siblings. He was treated accordingly but unfortunately succumbed to his illness shortly after diagnosis. These cases highlight the difficulties differentiating between the various interstitial lung disease (ILD) subtypes and the challenges in management while also increasing awareness of familial ILD.

scholarly journals Comparative analyses of cytohistologic techniques in diagnoses of lung lesions

1970 ◽  
Vol 1 (2) ◽  
pp. 126-130 ◽  
Author(s):  
A Tuladhar ◽  
R Panth ◽  
AR Joshi
Keyword(s):  
Respiratory Tract ◽  
Lung Diseases ◽  
Fiberoptic Bronchoscopy ◽  
Needle Aspiration ◽  
Management Tool ◽  
Advanced Malignancy ◽  
Forceps Biopsy ◽  
Group I ◽  
Lung Malignancy ◽  
Bronchial Brushing

Background: The use of cytological methods in the diagnosis of malignant lesions of the respiratory tract has been generally acclaimed as one of its most successful applications. Flexible fiberoptic bronchoscopy revolutionized respiratory cytology, as bronchial brushings, broncho-alveolar lavage and bronchial forceps biopsy became more easy, accessible and popular, shifting the emphasis from diagnosis of advanced malignancy in inoperable patients to the use of cytology as a first line diagnostic and management tool. Respiratory tract cytology is well established throughout the world as a diagnostic procedure in the evaluation of patient with suspected lung malignancy. Materials and Methods: A prospective study was conducted on 50 patients divided in two groups who underwent fiberoptic bronchoscopy during the period from November 2007 to October 2008 at the Department of Cardiovascular and Thoracic Unit, Bir Hospital. Group I consisted of 35 cases of suspected lung malignancy on clinical and radiological examination, while group II consisted of 15 cases of non-neoplastic lung diseases. Results: Bronchial brushing and forceps biopsy showed a sensitivity of 50% and 84.21% respectively in the diagnosis of malignancy. Broncho-alveolar lavage revealed malignancy in 66.7% patients. Transthoracic needle aspiration had the highest sensitivity of 100% whereas bronchial wash was revealed malignancy only in 17.4% of the cases. Conclusion: Combination of various cytohistological techniques complements each other and enhances the diagnostic efficacy of various neoplastic and non-neoplastic lung diseases. Bronchial brushing, forceps biopsy and transthoracic needle aspiration are complimentary in diagnosis of various lung malignancies whereas broncho-alveolar lavage is a useful procedure in detection of infections diseases. Keywords: Fiberoptic bronchoscopy; Lund cancer; Infection; Cytohistologic technique DOI: http://dx.doi.org/10.3126/jpn.v1i2.5407 JPN 2011; 1(2): 126-130

scholarly journals Successful rescue with videolaryngoscopy after failed fibroscopy in anticipated difficult airway: case series

2020 ◽  
Vol 48 (2) ◽  
pp. 96-99
Author(s):  
Daniela González-Giraldo ◽  
Carlos Eriel Largo-Pineda ◽  
Mario Andrés Zamudio-Burbano
Keyword(s):  
Difficult Airway ◽  
Rare Case ◽  
Case Series ◽  
Fiberoptic Bronchoscopy ◽  
Awake Intubation ◽  
First Choice

Introduction: In the management of the anticipated difficult airway (DA), awake intubation is the strategy of choice. In this context, flexible fibroscopy is the tool most widely used as the first choice. However, there is always the rare case where it may fail. Important findings: Six successful rescue cases using videolaryngoscopy following failed fibroscopy in patients with anticipated DA, and 1 case of rescued extubation of an airway previously secured with fiberoptic bronchoscopy. Conclusion: Videolaringoscopy may be an adequate tool to use as a backup plan for the management of an anticipated DA.

Case Series of COVID-19 Disease in Pediatric Chronic Lung Diseases

2021 ◽  
Author(s):  
Ismail Güzelkaş ◽  
Nagehan Emiralioğlu ◽  
Dilber Ademhan Tural ◽  
Beste Özsezen ◽  
Birce Sunman ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Case Series ◽  
Chronic Lung Diseases

scholarly journals Protean proteases: at the cutting edge of lung diseases

2017 ◽  
Vol 49 (2) ◽  
pp. 1501200 ◽  
Author(s):  
Clifford Taggart ◽  
Marcus A. Mall ◽  
Gilles Lalmanach ◽  
Didier Cataldo ◽  
Andreas Ludwig ◽  
...  
Keyword(s):  
Protease Inhibitor ◽  
Serine Protease ◽  
Protease Activity ◽  
Serine Proteases ◽  
Lung Diseases ◽  
Serine Protease Inhibitor ◽  
Matrix Metalloproteases ◽  
Integrative Biology ◽  
Therapeutic Tool ◽  
Serine Protease Activity

Proteases were traditionally viewed as mere protein-degrading enzymes with a very restricted spectrum of substrates. A major expansion in protease research has uncovered a variety of novel substrates, and it is now evident that proteases are critical pleiotropic actors orchestrating pathophysiological processes. Recent findings evidenced that the net proteolytic activity also relies upon interconnections between different protease and protease inhibitor families in the protease web.In this review, we provide an overview of these novel concepts with a particular focus on pulmonary pathophysiology. We describe the emerging roles of several protease families including cysteine and serine proteases.The complexity of the protease web is exemplified in the light of multidimensional regulation of serine protease activity by matrix metalloproteases through cognate serine protease inhibitor processing. Finally, we will highlight how deregulated protease activity during pulmonary pathogenesis may be exploited for diagnosis/prognosis purposes, and utilised as a therapeutic tool using nanotechnologies.Considering proteases as part of an integrative biology perspective may pave the way for the development of new therapeutic targets to treat pulmonary diseases related to intrinsic protease deregulation.

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