Open Journal of Respiratory Diseases

Journal Information
ISSN / EISSN : 2163-940X / 2163-9418
Published by: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 135
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Anne Marie Sweeney, Kevin Frederick Deasy, Marcus Peter Kennedy
Open Journal of Respiratory Diseases, Volume 12, pp 64-74; https://doi.org/10.4236/ojrd.2022.122006

Abstract:
Introduction: The COVID-19 pandemic has resulted in a reconsideration of our traditional teaching modalities and develop newer, dynamic methods. Both high and low fidelity bronchoscopy simulators are costly. The objective was to assess whether a combination of a low-cost bio-simulator made of recyclable materials (ALFIETM Airway Low Fidelity including EBUS (endobronchial ultrasound)) and single use flexible bronchoscopy (SUFB) has the capability of differentiating novices from experts and the ability to train novices in bronchoscopy. Materials and Methods: Trainees were evaluated individually before and after training using a modified validated Bronchoscopy Skills and Tasks Assessment Tool (B-STAT) and SUFB. Results: 18 trainees were included (14 residents and 4 fellows). Pre-training assessment of scope handling differentiated novices from experienced bronchoscopists (p = 0.0025, 95% confidence intervals (CI) 3.12 - 12.17). Training of novices was associated with an improvement in scope handling and sampling (p = 0.0001, 95% CI 4.73 - 10.27). Conclusion: ALFIETM and SUFB have the potential to create a low-cost platform to teach bronchoscopy remotely.
Saleh Muhemedi, Paul Lusamba, Jean-Claude Changachanga, Leopold Lubula, Edith Nkwembe, Pelagie Babakazo
Open Journal of Respiratory Diseases, Volume 12, pp 1-14; https://doi.org/10.4236/ojrd.2022.121001

Abstract:
Introduction: Among the lessons learned from the 2009 influenza pandemic was the lack of a robust, standardized method that would allow a timely assessment of the severity of pandemic influenza. To remedy this deficiency, WHO has set up an evaluation tool based on the following indicators: 1) transmissibility, 2) seriousness of disease, and 3) impact of the influenza pandemic. By using this pandemic influenza severity assessment (PISA) tool, this study aimed to evaluate the severity of DRC influenza seasons between 2015 and 2019 to better prepare the country against the possible occurrence of an influenza pandemic. Methods: We performed a secondary data analysis from the DRC Influenza routine surveillance. We only explored the transmissibility among PISA indicators. Results: The results of our study showed that the DRC influenza seasons had two waves. The first went from the 40th week to the 10th week, with a peak at the 50th week, and the second wave ran from the 15th week to the 40th, with a peak at the 19th week. There was an inter-wave period between the 10th and 15th weeks. Of all the studied seasons, 42.8% were characterized by low intensity, 33.3% by moderate intensity, 19.0% by high intensity, and 4.8% by extraordinary intensity. Conclusion: The use of the PISA transmissibility indicator has contributed to better understanding influenza seasons in the Democratic Republic of Congo.
John Osarenkhoe, Henry Aiwuyo, Ogbomo Aisosa, Umuerri Ejiroghene
Open Journal of Respiratory Diseases, Volume 12, pp 37-43; https://doi.org/10.4236/ojrd.2022.122003

Abstract:
Background: Destroyed lung is a lung condition commonly caused by tuberculosis. Other causes include bronchiectasis, aspergilloma, emphysema, etc. It is characterized by extensive lung destruction and reduced lung function. Chest X-ray, chest CT, bronchography, and ventilation-perfusion ratio scan are the commonest radiologic diagnostic tools. Treatment of choice may include pneumonectomy. The study aims to highlight the common causes of destroyed lung and the major presenting complaints based on age, sex and affected lungs. Method: Published cases from English medical journals were evaluated and analyzed. Results: 31 published cases on destroyed lung were reviewed. 58.1% showed that the left lung was the most commonly affected lung. The condition was more common in males (71%). Based on our review, the commonest causes are pneumonia and tuberculosis at 25.9% and 22.8%, respectively. Conclusion: Pneumonia and Tuberculosis seem to be the commonest causes of destroyed lung based on our review, with left sided affectation being more predominant.
Yadİgar Yilmaz Camgoz, Ferda Yilmaz Inal, Öznur Şen
Open Journal of Respiratory Diseases, Volume 12, pp 44-55; https://doi.org/10.4236/ojrd.2022.122004

Abstract:
The aim of this prospective study was to evaluate the incidence, etiologic agents and mortality rate of ventilator-associated pneumonia (VAP). In a six-month period, cases who were 18 years or older, dependent on mechanical ventilator for more than 3 days and without pulmonary infection on first admission were included in this study. In all cases, body temperature recordings, blood and urine culture, microbiological analyses of endotracheal aspirates, and chest X-rays were obtained and used to identify VAP. Apache II scores on admission, duration of mechanical ventilation, length of intensive care unit (ICU) stay and mortality were recorded. This study included 45 cases and 22 developed VAP (48%). The incidence of VAP was 25.34 per 1000 ventilator days. Univariate analyses showed that duration of mechanical ventilation, length of ICU stay, coma and tracheotomy were associated with the development of VAP. The mortality rate of cases with VAP (72.7%) was significantly higher than cases without VAP (39.1%). The most frequent microorganisms were Acinetobacter spp., Pseudomonas aeruginosa and Klebsiella pneumoniae. In our study, VAP was a very common and important complication of mechanical ventilation and mortality was very high. To reduce mortality, minimize morbidity, shorten the length of stay, and reduce costs, defined risk factors for VAP should be recognized and an effective infection control program for the prevention of VAP should be implemented. Surveillance results should be evaluated regularly and necessary precautions should be taken.
Khadidia Ouattara, Bocar Baya, Dianguina Soumaré, Tenin Kanouté, Mohamed Tolofodie, Kafui Komla Gaglo Koudemon, Salif Koné, Bassirou Diarra, Yaya Sadio Sarro, Yacouba Toloba, et al.
Open Journal of Respiratory Diseases, Volume 12, pp 56-63; https://doi.org/10.4236/ojrd.2022.122005

Abstract:
Introduction: Mycobacteria pulmonary diseases are chronic illnesses with various impacts on patients’ health status, and wellbeing. These diseases currently represent a global health issue due to increasing burdens and the lack of new development on therapeutic options. Policies based on the quality of life may help to improve the management of this chronic respiratory disease; this study was designed to assess the quality of life of patients treated for the pulmonary mycobacterial disease. Materials and Methods: Participants diagnosed with a mycobacterial pulmonary disease were selected from the University Clinical Research Centers’ (UCRC) 2019 mycobacterial cohort database. A telephone interview was conducted using the Medical Outcome Study Short Form (SF-36) which has 36 items evaluating physical and mental wellbeing. Scores range from 0 - 100, with higher scores indicating greater Health-related quality of life (HRQOL). Statistical analysis was performed with SPSS 23.0 and the Fisher test was used to compare percentages. A p-value less than 0.05 was considered significant. Results: A total of 26 participants were reached and interviewed by phone. The mean age was 42 ± 10.6 years, and 76.9% (20/26) were male. The most common cause of the mycobacterial pulmonary disease was Mycobacterium tuberculosis, with 84.6% (22/26). Four cases of Non-Tuberculous Mycobacteria (NTM) were diagnosed including one Mycobacterium avium complex strain (MAC). HIV-positive cases were 46.2% (12/26), and the main respiratory sign was cough for all the participants (100%), followed by dyspnea 46.2% (12/26), chest pain 38.5% (10/26). The mean BMI was 19.7 ± 6.9 kg/m2, the mean respiratory rate was 24.7 ± 8.6, and the mean hemoglobin was 11.8 ± 2.2 g/dl. The mean SF-36 score was 75.1 ± 16.6, and impairment was mainly related to mental problems in 59.6%. The mean total score was significantly lower with age more than 42 years than age less than 42 years. But HIV positive and BMI less than 18.5 do not lead to a significant change of mean total score. Conclusion: Patients with mycobacterial pulmonary diseases have more psychological problems than physical ones. Hence the importance of psychological support in their management to improve their quality of life. A large sample size with a deep interview component would be necessary to address limitations in this design.
E. A. Akazie, M. J. Mpe
Open Journal of Respiratory Diseases, Volume 12, pp 75-82; https://doi.org/10.4236/ojrd.2022.123007

Abstract:
Background: Oxygen is a commonly used drug in modern medical care. It has biochemical actions, safe dosage ranges, adverse physiologic effects and can be toxic at high doses and prolonged use. As a drug, it needs a formal prescription prior to administration. The prescription needs to meet certain basic minimums for appropriateness and safety. Objectives: The aim of the study was to assess the standards of prescriptions for oxygen therapy amongst admitted medical patients at the Dr. George Mukhari Academic Hospital. Materials and Methods: It was a cross-sectional study of 159 acutely ill medical admissions who received supplemental oxygen. The medication charts of patients on oxygen were audited; with regards to the availability and/or adequacy of the prescription for oxygen. Results: Of the one hundred and fifty nine patients on oxygen only 43 (27%) had an actual prescription for oxygen written. The target oxygen saturation was specified in 19 (44%) cases. The device for oxygen delivery was specified in 21 (49%) patients and just over half of the patients (56%) had flow rates indicated on their charts. Conclusion: The practice of oxygen administration in our medical wards was sub-optimal. The audit highlights the need for education and training in acute oxygen therapy.
Harrison Ngue, Maranda Ngue, Ian Lee, Ching-Fei Chang, Ahmet Baydur
Open Journal of Respiratory Diseases, Volume 12, pp 15-36; https://doi.org/10.4236/ojrd.2022.121002

Abstract:
Rationale: Patients with cancer commonly experience dyspnea originating from ventilatory, circulatory and musculoskeletal sources, and dyspnea is best determined by cardiopulmonary exercise testing (CPET). Objectives: In this retrospective pilot study, we evaluated patients with hematologic and solid malignancies by CPET to determine the primary source of their dyspnea. Methods: Subjects were exercised on a cycle ergometer with increasing workloads. Minute ventilation, heart rate, breathing reserve, oxygen uptake (V’O2), O2-pulse, ventilatory equivalents for carbon dioxide and oxygen (V’E/V’CO2 and V’E/V’O2, respectively) were measured at baseline and peak exercise. The slope and intercept for V’E/V’CO2 was computed for all subjects. Peak V’O2 4% predicted indicated a circulatory or ventilatory limitation. Results: Complete clinical and physiological data were available for 36 patients (M/F 20/16); 32 (89%) exhibited ventilatory or circulatory limitation as shown by a reduced peak V’O2 and 10 subjects with normal physiologic data. The largest cohort comprised the pulmonary vascular group (n = 18) whose mean ± SD peak V’O2 was 61% ± 17% predicted. There were close associations between V’O2 and spirometric values. Peak V’E/V’O2 and V’E/V’CO2 were highest in the circulatory and ventilatory cohorts, consistent with increase in dead space breathing. The intercept of the V’E-V’CO2 relationship was lowest in patients with cardiovascular impairment. Conclusion: Dyspneic patients with malignancies exhibit dead space breathing, many exhibiting a circulatory source for exercise limitation with a prominent pulmonary vascular component. Potential factors include effects of chemo- and radiation therapy on cardiac function and pulmonary vascular endothelium.
Safwat A. M. Eldaboosy, Amgad Awad, Hussein Al Qurni, Saber Abo Al Hassan, Mohamed O. Nour
Open Journal of Respiratory Diseases, Volume 11, pp 37-48; https://doi.org/10.4236/ojrd.2021.112004

Abstract:
Background: Obstructive sleep apnea syndrome (OSAS) may promote hyperglycemia, insulin resistance, and hypertension (HTN). Purpose: To evaluate if there is a relationship between the severity of OSA and the severity of type 2 diabetes mellitus (T2DM) and HTN in our patients, aiming to understand and optimize the control for comorbidities. Materials and Methods: Patients referred for polysomnography (PSG) were retrospectively recruited during the period from October 2017 to August 2020. A STOP-BANG questionnaire formed eight questions was used to assess the risk of OSAS. We divided the patients into two groups; group 1, who have snoring without T2DM, and group 2, who have snoring with T2DM. PSG was completed for all subjects and data were collected for each patient including apnoea hypopnea index (AHI), mean arterial oxygen saturation (SaO2), and Nadir SaO2 recorded during PSG. Anthropometric data, medical history, and medications for T2DM (for group 2) and HTN and HbA1c were collected (for group 2). AHI was used to evaluate the severity of OSA and its relation to T2DM and HTN. Results: The study included 300 patients who met the inclusion criteria with mean age of 49.9 ± 13.6 years. The majority of subjects (56.3%) were males and the mean body mass index (BMI) was 38.0 ± 8.4 kg/m2. Forty-two percent had HTN and 32.7% had T2DM. OSA was diagnosed in 209 patients (69.7%). OSA was more detected among those with increased age, increased BMI, and those with HTN and T2DM. The severity of both HTN and T2DM was significantly higher among patients with OSA. Conclusions: There is a relation between OSA and T2DM and HTN. The risk of OSA is higher among patients with uncontrolled T2DM and HTN. OSA should be suspected in subjects with obesity, especially with uncontrolled HTN and T2DM.
Clay Wu, Gloria Wu, Lynn Fukushima, Adupa P. Rao, Ahmet Baydur
Open Journal of Respiratory Diseases, Volume 11, pp 19-25; https://doi.org/10.4236/ojrd.2021.111002

Abstract:
Rationale: Survival and longevity in patients with cystic fibrosis (CF) have improved with new treatments, so that pregnancy can be safely undertaken despite physiologic limitations. Dyspnea still develops in the latter stages of pregnancy. To explain this symptom, we evaluated the effect of pregnancy on lung function before and after delivery. Methods: Records of 23 pregnant patients with CF were retrospectively reviewed for data analysis. Spirometry was recorded prior to pregnancy, at first and third trimesters, and every three months following delivery up to one year. Comparisons between time points were adjusted for age and pre-gestational BMI by analysis of variance (ANOVA). Results: Complete clinical and spirometric data were available for eleven of these patients (13 pregnancies total), obtained between 2009 and 2017. FEV1 and FVC declined significantly from baseline to third trimester (by 8.1%, p Conclusions: The changes in FEV1 and FVC occur as a result of increases in intravascular blood volume and lung water during the third trimester. At the same time, FEV1/FVC increases as there is reversal of bronchiolar constriction with elimination of extracellular fluid and lung water. Furthermore, restoration of end-expiratory lung volume post-partum counteracts reversal of air trapping with resolution of peribronchiolar edema, with FVC remaining unchanged. These changes would explain decrease in dyspnea following delivery in CF patients.
Houda Gharsalli, Monia Attia, Sarra Zairi, Imen Sahnoun, Aida Ayadi, Henda Neji, Sonia Maalej, Leila Douik ElGharbi
Open Journal of Respiratory Diseases, Volume 11, pp 84-89; https://doi.org/10.4236/ojrd.2021.112008

Abstract:
A 32-year-old patient with no previous history was admitted for chest pain, dyspnea, appetite and weight loss. Chest X-ray revealed an opacity involving the lower two-thirds of the right hemithorax, suggestive of a pleural effusion. Because of the absence of fluid return even after ultrasound-guided thoracentesis, a Chest Computed tomography was required showing a heterogeneous anterior mediastinal mass with soft tissue, fat, fluid and calcifications associated with extensive encysted fluid collection in the right hemithorax. A video-assisted mini-thoracotomy revealed a mediastinal tumor firmly attached to the thymus with a cystic wall lined by squamous epithelium and sebaceous gland composed of respiratory tissue, adipose tissue, cartilage, smooth muscle fibers, and well-differentiated pancreatic tissue. These findings led to the diagnosis of a mature thymic teratoma. The patient was discharged 7 days after surgery, with no recurrence on follow-up.
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