B-lines: Transthoracic chest ultrasound signs useful in assessment of interstitial lung diseases
Conclusion: B-lines that are lung Ultrasound signs seem to be useful in the assessment of ILD. (Source: Annals of Thoracic Medicine)
Sté Tunisienne des Maladies Respiratoires et d'Allergologie
Cercle des Bureaux - Appartement B 5-3 . 1082 Centre urbain Nord Tunis
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Obstructive sleep apnea is associated with higher healthcare utilization in elderly patients
Conclusion: Patients with OSA had a higher incidence of healthcare utilization compared to patients without OSA. New OSA patients had a higher rate of healthcare utilization in the year of diagnosis compared to chronic patients and patients without OSA. Early OSA recognition may reduce healthcare utilization in these patients. (Source: Annals of Thoracic Medicine)
Drug-resistant ventilator associated pneumonia in a tertiary care hospital in Saudi Arabia
There is a wide geographic and temporal variability of bacterial resistance among microbial causes of ventilator-associated pneumonia (VAP). The contribution of multi-drug resistant (MDR) pathogens to the VAP etiology in Saudi Arabia was never studied. We sought to examine the extent of multiple-drug resistance among common microbial causes of VAP.
Materials and Methods: We conducted a retrospective susceptibility study in the adult intensive care unit (ICU) of King Abdulaziz Medical City, Riyadh, Saudi Arabia. Susceptibility results of isolates from patients diagnosed with VAP between October 2004 and June 2009 were examined. The US National Healthcare Safety Network definition of MDR was adopted.
Results: A total of 248 isolates including 9 different pathogens were included. Acinetobacter spp. was highly (60-89%) resistant to all tested antimicrobials, including carbapenems (three- and four-class MDR prevalence were 86% and 69%, respectively). Pseudomonas aeruginosa was moderately (13-31%) resistant to all tested antimicrobials, including antipseudomonal penicillins (three- and four-class MDR prevalence were 13% and 10%, respectively). With an exception of ampicillin (fully resistant), Klebsiella spp. had low (0-13%) resistance to other tested antimicrobials with no detected MDR. Staphylococcus aureus was fully susceptible to vancomycin with 42% resistance to oxacillin. There were significant increasing trends of MDR Acinetobacter spp. however not P. aeruginosa during the study. Resistant pathogens were associated with worse profile of ICU patients but not patients' outcomes.
Conclusion: Acinetobacter in the current study was an increasingly resistant VAP-associated pathogen more than seen in many parts of the world. The current finding may impact local choice of initial empiric antibiotics.
Red cell distribution width: A new predictor for chronic thromboembolic pulmonary hypertension after pulmonary embolism.
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Red cell distribution width: A new predictor for chronic thromboembolic pulmonary hypertension after pulmonary embolism.
Chron Respir Dis. 2014 Mar 4;
Authors: Abul Y, Ozsu S, Korkmaz A, Bulbul Y, Orem A, Ozlu T
Abstract
The most important long-term complication of pulmonary thromboembolism is chronic thromboembolic pulmonary hypertension (CTEPH) that is associated with considerable morbidity and mortality. It is uncertain why some patients with acute pulmonary embolism (PE) develop CTEPH and others do not. Elevated red cell distribution width (RDW) has been associated with adverse outcomes of heart failure, PE, and idiopathic pulmonary hypertension. The aim of the present study was to investigate whether RDW might be a predictor of CTEPH in PE patients or not. This study is a retrospective cohort study. A total of 203 consecutive patients with acute PE were included. The RDW was higher in the CTEPH patients than the patients without CTEPH (17.04 ± 3.46, 14.64 ± 1.82, respectively, p = 0.015). RDW was also higher in the CTEPH patients at the time of diagnosis of CTEPH during follow-up compared with the baseline RDW level at the time of PE diagnosis (18.63 ± 3.58, 17.02 ± 3.59, respectively, p = 0.014). The optimal cutoff value of the RDW for predicting CTEPH was 14.65. The area under the curve of RDW for the prediction of CTEPH was 0.735 (95% confidence interval (CI): 0.600-0.869); in cases with RDW levels >14.65%, the specificity, sensitivity, and negative predictive value for CTEPH were 62% (95% CI: 0.55-0.69), 75% (95% CI: 0.47-0.92), and 96.7% (95% CI: 0.91-0.99), respectively. A multivariate regression analysis showed that RDW, hazard ratio: 1.58 (95% CI: 1.09-2.30), was a predictor of CTEPH (p = 0.016). High level of RDW was an independent predictor of CTEPH in PE patients. Therefore, RDW levels may provide a prediction for CTEPH in PE patients.
PMID: 24595892 [PubMed - as supplied by publisher]
[Management of the cardiovascular complications of treatment in thoracic oncology.]
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[Management of the cardiovascular complications of treatment in thoracic oncology.]
Rev Mal Respir. 2014 Feb;31(2):173-180
Authors: Ederhy S, Hollebecque A, Haddour N, Massard C, Fleury G, Ferte C, Adavane S, Besse B, Boccara F, Soria JC, Cohen A
Abstract
The management of patients suffering from bronchial and lung tumors depends on conventional chemotherapy and/or targeted molecular therapies. The prescription of these chemotherapies may be accompanied by cardiovascular complications, principally congestive heart failure, arterial hypertension and arterial or venous thrombo-embolism, the frequency of which varies with the molecule administered. The management of these complications is currently poorly standardized and should take account of the patient's oncological prognosis.
PMID: 24602684 [PubMed - as supplied by publisher]