Volume Articles

Efficacy of methanol extract of Zingiber officinale rhizome against acute pneumonia caused by Pseudomonas aeruginosa

Ankita S Chakotiya¹, Alka Narula³, Rakesh K Sharma^2*

¹Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi - 110054, India

²Defence Food Research Laboratory, Mysuru – 570011, India

³Department of Biotechnology, Jamia Hamdard, Delhi - 110062, India

Pseudomonas aeruginosa has become one of the major threats to public health as it causes serious diseases like pneumonia and the condition becomes sever if the disease is caused by drug-resistant strain. Thus, in the present study, the antibacterial activity of Zingiber officinale against P. aeruginosa causing a lung infection in Swiss albino mice was evaluated. Disease analysis includes bacteremia, x-rays based observation of patches formation in lungs, and destruction of lung tissue. Bacterial load showed a significant decline in the herbal treated group up to 1.13 ± 0.2 Log₁₀ CFU/ml at the 7^th day as compared to the untreated group with the bacterial burden 3.0 ± 0.12 Log₁₀ CFU/ml. The histopathology reveals more distorted alveoli in an infected group with an accumulation of immune cells while in the treated group improved lung histology was seen. The findings stated that Z. officinale is effective may provide a suitable lead for future development and possible clinical utility as inhibitors of lung infection caused by P. aeruginosa.

Combination therapy in Phe508del CFTR: how many will be enough?

Ana Margarida Matos^1,2 and Paulo Matos^1,2*

¹Department of Human Genetics, National Health Institute ‘Dr. Ricardo Jorge’, Av. Padre Cruz, 1649-016 Lisboa; Portugal

²University of Lisboa; Faculty of Sciences, BioFIG - Centre for Biodiversity, Functional and Integrative Genomics, Campo Grande-C8, 1749-016 Lisboa; Portugal

Updates on Surgical Repair of Tracheobronchomalacia

Wendy Jo Svetanoff^1*, Russell W. Jennings¹

¹Boston Children’s Hospital, Boston, MA

Surgical correction of tracheobronchomalacia (TBM) has continued to evolve over the recent years. A review of the advances in the pre-operative assessment, operative techniques, and post-operative management of patients with TBM was performed. A 3 phase bronchoscopy, as part of the pre-operative evaluation, provides the most information for operative planning for the surgeon. Multiple options for surgical intervention are available, including an open, thoracoscopic, or median sternotomy approach to relieve anterior compression, or an open or thoracoscopic approach for performing a posterior tracheobronchopexy. Excellent outcomes have been seen with both approaches; however, the posterior approach is the preferred method of repair at our institution, as this provides direct support of the posterior membrane and allows for multiple areas of airway collapse to be directly addressed during the same operation; it also makes an anterior approach, if needed, much easier and more effective. Post-operatively, the use of paravertebral catheters has helped tremendously with pain control and respiratory function. The success of TBM repair is due to a multi-disciplinary team approach, as well as experience and analysis of many patients, that can be found at a Center of Excellence due to the high referral rate.

Pneumatosis Cystoides Intestinalis

Yuusaku Sugihara^{1, 2*}, Keita Harada¹, Hiroko Ogawa², Fumio Otsuka², Hiroyuki Okada¹

¹Department of Gastroenterology and Hepatology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayaka-shi, Okayama 700-8558, Japan

²Department of General internal medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayaka-shi, Okayama 700-8558, Japan

Pneumatosis cystoides intestinalis (PCI) is the presence of air within the walls of the small intestines or colon. The prevalence of PCI is difficult to determine as patients are mostly asymptomatic. The main cause of PCI is considered to be mechanical, although bacterial and biochemical causes have also been theorized. According to the mechanical theory, PCI results from a loss of integrity of the mucosa, caused by diseases such as necrotizing enterocolitis, intestinal ischemia, inflammatory bowel disease, or obstructive pulmonary disease. On computed tomography, PCI presents as images that are cystic or linear collections of air near the lumen of the bowel. The occurrence of PCI is more common in the colon than in the small intestine, appearing as a polypoid, with the overlying mucosa displaying a blue hue on colonoscopy. PCI can usually be resolved through the discontinuation of medications that increase the formation of intestinal gas. Inhalational and hyperbaric oxygen therapy have also been used for the treatment of PCI. Patients presenting with signs of peritonitis, such as abdominal guarding, rebound tenderness, and metabolic acidosis on abdominal assessment, require emergent treatment, with exploratory laparotomy being recommended.

Commentary: Long-term Outcomes of Patients With Ground-Glass Opacities Detected Using CT Scanning Can we predict future tumor growth at the time of the first hospital visit?

Shigeki Sawada^1*

¹Department of Thoracic Surgery, Japanese Red Cross Society Himeji Hospital, Japan

Mesothelioma from household asbestos exposure

Flavia D’Agostin^1*, Paola De Michieli¹, Corrado Negro¹

¹Occupational Medicine Unit, Department of Surgical and Medical Sciences of Health University of Trieste, University of Trieste, Trieste, Italy

Non-occupational exposure to asbestos is a hazard that may contribute to the burden of mesothelioma over the next decades. Such exposure may result from cohabitation with an asbestos worker and the handling of his/her work clothes. This paper reviews the features of mesothelioma from domestic exposure reported by the literature. Household-exposure mesothelioma cases are more likely to be 1)female (primarily wife), 2) diagnosed with pleural mesothelioma 3)exposed and, in some cases, 4)diagnosed at a younger age, and to have a 4)longer latency and 5) similar lung asbestos concentrations compared to occupational cases. Non-occupational subjects are more likely to be under-recognized than those with occupational exposure. This underlines the ongoing importance of exposure history in enhancing early diagnosis and the need of a framework for insurance and welfare protection for mesothelioma cases induced by non-occupational exposure to asbestos.

Cardiopulmonary Risk of Waterpipe Smoke: A Meta-Analysis

Matthew Randolph Marshall^1*, Marya Ghazipura², Tanzib Hossain³, Terry Gordon¹, Lung-Chi Chen¹

¹New York University School of Medicine, Department of Environmental Health Sciences, New York University Langone Medical Center, New York, NY

²New York University School of Medicine, Department of Population Health, New York, NY

³New York University School of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York, NY

Purpose: This study aimed to analyze and summarize the effects that waterpipe (WP) smoke has on the cardiopulmonary system through a systematic review and meta-analysis.

Methods: We searched MEDLINE, Embase, Wiley Cochrane Library, Centre for Reviews and Dissemination, CINAHL Plus, and grey literature in March 2017. Our inclusion criteria for the studies were a comparison of WP smokers before and after waterpipe smoking (WPS) or to non-smokers.

Results: Using a random effects meta-analysis, a WPS session was associated with an elevation in systolic blood pressure (SBP) by 6.45 mmHg (95% CI 3.87 to 9.04; p < 0.0001), diastolic blood pressure (DBP) by 3.71 mmHg (95% CI 2.34 to 5.08; p < 0.0001), mean arterial pressure by 5.54 mmHg (95% CI 3.33 to 7.76; p < 0.0001), heart rate by 7.03 bpm (95% CI 4.60 to 9.46; p < 0.0001), carboxyl hemoglobin (COHb) by 4.11% (95% CI 3.38 to 4.84; p < 0.0001), and expired carbon monoxide (CO) by 22.53 ppm (95% CI 15.99 to 29.08; p < 0.0001).

Conclusion: WPS exposure is associated with significant acute increases in cardiopulmonary hemodynamic parameters, along with COHb and expired CO. These findings parallel the acute effects seen with cigarette smoking.

Diagnosis and management of idiopathic drug-induced and severe neutropenia and agranulocytosis: What should the lung specialist know?

Emmanuel Andrès^1*, Rachel Mourot-Cottet¹, Frédéric Maloise^l,2

¹Departments of Internal Medicine B, University Hospital of Strasbourg, Strasbourg 67000, France

²Department of Hematology, Saint Anne’s Clinic, Strasbourg 67000, France

In this paper, we report and discuss the diagnosis and management of severe neutropenia and agranulocytosis (neutrophil count of <0.5 x 109/L) related to non-chemotherapy drug intake, called “idiosyncratic”. Lung specialists may be faced with these events. In fact, all classes of drugs have been implicated (“causative”) and clinical manifestations may include pneumonia or related disorders. Recently, several prognostic factors have been identified that may be helpful when identifying frailty patients. Old age (>65 years), septicemia or shock, metabolic disorders such as renal failure, and a neutrophil count below 0.1×109/L have been consensually accepted as poor prognostic factors for hematological recovery. In this potentially life-threatening disorder, modern management with broad-spectrum antibiotics and hematopoietic growth factors (particularly G-CSF), is likely to improve the prognosis. Thus, with appropriate management, the mortality rate of idiosyncratic drug-induced severe neutropenia and agranulocytosis is currently around 5%.