Jaber Saud Alqahtani1, 2*

1Respiratory Care Department, Prince Sultan Military College of Health Sciences – Dhahran, Saudi Arabia

2Respiratory Medicine, University College London, London, United Kingdom

DOI: 10.29245/2689-999X/2018/1.1147 View / Download Pdf

Hamid Reza Shoraka1,3, Moslem Taheri Soodejani1, Omid Abobakri1, Narges Khanjani2*

1Dept. of Epidemiology and Biostatistics, Kerman University of Medical Sciences, Kerman, Iran

2Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran

3Vector-borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran

Background: Asthma is one of the most common chronic non-communicable diseases which is seen more in the developed than developing countries of the world. Recurrence and exacerbations of the disease are common among patients and often lead to hospitalization and therapeutic interventions. Ambient air temperature might be related to the relapse of asthma. This review was conducted to investigate the relation between ambient temperature and exacerbations of asthma in children.

Methods: Related articles were searched in PubMed, Web of Science, Science Direct, and Scopus databases with appropriate keywords and no specific limitation on October 1, 2018. Initially, the relevance of the articles was examined using the title and abstract. Out of 2633 articles, 23 articles were eligible according to the inclusion and exclusion criteria.

Results: Fourteen studies had reported inverse relations; and showed as the temperature dropped, the number of asthma attacks increased in children. Nine papers observed a relation between hot weather and asthma attacks, 3 studies reported a relation between temperature differences and asthma attacks, and two studies did not show any relation. Some studies suggested the increased incidence of asthma in the 5-14 year old age group was associated with the start of the school year and probably due to the spread of viral diseases, not temperature changes.

Conclusion: Extreme temperatures are likely to cause exacerbation of childhood asthma.

DOI: 10.29245/2689-999X/2018/1.1146 View / Download Pdf

Giuseppe Tarantini*, Luca Nai Fovino, Alberto Barioli, Alessandro Schiavo, Chiara Fraccaro

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy

The muscle overlying the intramyocardial segment of an epicardial coronary artery is defined as myocardial bridge (MB). The clinical relevance of MBs is extremely heterogeneous, ranging from incidental finding in asymptomatic patients to different clinical manifestations such as stable or unstable angina, arrhythmias, Takotsubo syndrome or other major cardiovascular events. Moreover, patients can evolve from “asymptomatic carriers” to “symptomatic carriers” over time. In this setting, haemodynamic assessment is challenging and optimal therapy still a matter of debate. This review summarizes epidemiology, pathophysiology, diagnostic work-up (including both morphological and functional assessment) and treatment of patients with MB involving the left anterior descending artery, suggesting a pragmatic clinical approach.

DOI: 10.29245/2689-999X/2017/4.1141 View / Download Pdf

Kimberly M. Clark*

MS in Respiratory Care Program, Clinical Associate Professor and Program Director, Department of Kinesiology, University of North Carolina at Charlotte, USA

Interprofessional education (IPE) and collaborative practice have been debated for several decades in the health professions. Over that course of time there have been ebbs and flows of interest in IPE and collaborative practice. Health care reform has brought about a renewed interest. IPE is considered an important component in developing collaborative practice-ready health professionals. IPE readiness, effectiveness, and challenges are considerations for successful IPE implementation. Sufficient evidence exists to suggest that faculty and students are motivated to engage in IPE. Knowledge, skills, and attitudes have been shown to improve with IPE interventions. Questions remain, however, about the linkage of IPE to collaborative practice and health outcomes.

DOI: 10.29245/2689-999X/2017/4.1139 View / Download Pdf

VI Starodubov1, AN Edeleva1, TP Sabgayda1*

1Federal Research Institute for Health Organization and Informatics of Ministry of Health of Russian Federation, 11 Dobrolyubova Str., Moscow, 127254, Russia

The article compares the prevalence of pathological changes in different organs and systems among city and rural residents of the next ages: elderly (60-74 years for men and 55-74 years for women), senile (75-84 years) and advanced (85 years and older) ages. The results of the continuous survey of all persons of the retirement age of one urban (7809 people) and two rural areas (14749) of the Nizhny Novgorod region were analyzed. The region is comparatively homogeneous in terms of the national composition of the population.

In the city, the number of chronic pathologies of different organs and systems per one person of elderly age are: 2.83 for man and 2.76 for woman of elderly ages, 3.06 and 3.07 respectively for senile ages, 2.71 and 2.75 of advanced ages. In rural areas, the analyzed indicators for men and women are respectively 1.64 and 1.58 for elderly ages, 1.84 and 1.78 for senile ages, 1.86 and 1.84 for advanced ages.

Demonstrating the difference in the phenotypic manifestations of the genes of predisposition to chronic diseases in old age between the city and village, the results make it possible to produce the following assumptions. First, better access to medical care does not guarantee the better health status of the elderly, while it contributes to an increase in the life expectancy of men. Second, in spite of better access to health care, urban lifestyle contributes to the accumulation of chronic diseases in population of a region. Third, if chronic pathology of three different classes of diseases presented, then the probability of a long life is fundamentally determined by the access to health care. Fourth, the probability of longevity is significantly reduced in result of illness by neoplasms, cardiovascular, respiratory, endocrine or genitourinary diseases in ages of working or beginning of retirement period.

DOI: 10.29245/2689-999X/2017/3.1140 View / Download Pdf

Samba Niang*

Department of pneumology of the university hospital center, St. Louis, Senegal

DOI: 10.29245/2689-999X/2017/3.1138 View / Download Pdf

Anmol Pitliya1, Asrar Ahmad2, Husnain Shaukat1, Eiman Ghaffarpasand1, Sadaf Sharfaei1, Farima Kahe1, Syed Hassan A. Kazmi1, Gerald Chi1*

1Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

2Department of Medicine, Abington Memorial Hospital, Abington, Pennsylvania, USA

Anemia, commonly defined as hemoglobin concentration <12.0 g/dL in women and <13.0 g/dL in men, is a prevalent condition that has been linked to unfavorable prognosis among hospitalized patients. Population-based studies report that low hemoglobin level is associated with various thrombotic disorders including myocardial infarction, stroke, and venous thromboembolism (VTE). A recent study on acutely ill hospitalized patients extends the previous findings and demonstrates that anemic patients were at a greater risk for symptomatic VTE through 77 days of follow-up. Specifically, decreased hemoglobin concentration was associated with a two-fold risk of symptomatic DVT or non-fatal PE, despite the provision of pharmacologic thromboprophylaxis with enoxaparin or betrixaban, an FDA approved direct oral anticoagulant for VTE prevention. Additionally, hemoglobin measurement improved the risk discrimination and reclassification of a well-validated VTE assessment tool (i.e., International Medical Prevention Registry on Venous Thromboembolism [IMPROVE] VTE risk score). Based on these results, future studies should evaluate the use of laboratory biomarkers in conjunction with clinical variables to refine individualized VTE risk assessment.

DOI: 10.29245/2689-999X/2017/3.1133 View / Download Pdf

Anania G1, Fabbri N1*, Marino S1, Resta G1, Giaccari S1, Tamburini N1, Fiorica F2, Cavallesco G1

1Department of Morphology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, University of Ferrara, Ferrara, Italy

2Department of Radiation Oncology, University Hospital Ferrara, Ferrara, Italy

Aim: The figure of cancer patient has changed. Some reasons are the increase of the average population and higher incidence of diseases related to old age (cardiovascular diseases, diabetes, etc.), but also diseases such as obesity are increasing in industrialized countries. For these reasons is necessary to choose an adequate and personalized treatment, taking into consideration the different risk of mortality and morbidity in therapeutic choices through a greater interaction between medical specialists.

Experiment: we conducted a retrospective study that took into consideration all the patients who underwent surgery of rectosigmoid junction and rectum in our hospital before and after the institution of a multidisciplinary tumour board (MTB) from January 2007 to April 2017. Furthermore, a recent retrospective single-centre analysis was performed in the same hospital by Tamburini et al. on consecutive patients who underwent surgery for non-small cell lung cancer (NSCLC) between January 2008 and December 2015.

Results: the advantage brought by the multidisciplinary evaluation teams are confirmed for the presence of benefits in terms of reduction of morbidity and improvement of the outcome of MTB patient group.

Conclusions: we find that more study depth of neoplastic disease as well as of each individual patient leads to more accurate staging and to a weighted therapy based on the needs of the individual. According to our experience, multidisciplinary tumour board should be present in all hospitals where cancer diseases are treated.

DOI: 10.29245/2689-999X/2017/3.1132 View / Download Pdf

H Rawal1*, SS Mehta2

1University of Illinois at Urbana Champaign. 611 west Park Street, Urbana, Illinois 61801, USA

2Carle Foundation Hospital. Senior clinical and Interventional cardiologist. 611 west Park Street, Urbana, Illinois 61801, USA

Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare congenital heart defect. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. Here we highlight the presentation, diagnosis and available treatment modalities for the management of this rare anomaly.

DOI: 10.29245/2689-999X/2017/3.1134 View / Download Pdf

Yousser Mohammad1*

1Department of Internal Medicine, Section Pulmonary, Syrian Private University, Syria

DOI: 10.29245/2689-999X/2017/3.1135 View / Download Pdf

C.A Hing1, A. Alaga1*, M.K Razul1

1Hospital Sultanah Bahiyah, Alor Setar, Malaysia

Pulmonary crytococcosis is a rare infection in immunocompetent patients. It is caused by encapsulated yeast-like fungus Cryptococcus neoformans. A young healthy gentleman presented with 1 day history of dyspnoea and fever, with 2 weeks history of weight loss.

Clinical examination revealed left lung collapse. CT thorax done showed a mediastinal mass with left lung collapse. Tissue obtained from bronchoscopy confirmed presence of Cryptococcus neoformans. The left main bronchial mass was removed during rigid bronchoscopy to expand the left lung. He was given T fluconazole 400 mg OD for 6 months. He improved significantly after the removal of left bronchial mass.

DOI: 10.29245/2689-999X/2017/3.1128 View / Download Pdf

Boushab Mohamed Boushab1*, Abdoulaye Mamadou Traore2, Mamoudou Savadogo3, Sidi Yeslem Ould-Bahiya4, Fatima Zahra Fall-Malick5

1Médecine Interne et Maladies Infectieuses, Centre hospitalier de Kiffa, Assaba, Mauritanie

2Service des Maladies Infectieuses, Hôpital du Point G, Bamako, Mali

3Service des Maladies Infectieuses, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso

4Service d'Imagerie Médicale, Centre National d'Oncologie, Nouakchott, Mauritanie

5Institut National d'Hépato-virologie, Faculté de Médecine de Nouakchott, Mauritanie

Background: In recent years, tuberculosis has been experiencing a renewal which appears to be linked to epidemiological, clinical and paraclinical factors. It is a real public health problem.

Summary: There is a prospective study at Kiffa regional hospital from January 1st to December 31st, 2017,

Objective: The goal was establish the real contribution of chest radiography to patient with respiratory infection diseases with a negative microscope smear.

Results: We recruited 53 cases of pulmonary tuberculosis (79% of all TB cases). For Acid-Fast Bacilli (AFB) in sputum on direct examination and optical microscopy was negative in 52% of cases. The eight patients who accepted the HIV test, 6 were HIV positive. The sex ratio M/F was 1.7 and the average age of patients was 45 years old (range 15-80 years)The most common clinical signs were fever, sputum, chronic cough and chest pain. The radiological aspects of the negative tuberculosis were caves (34%), reticular or reticulonodular (26%), lymph nodes pulmonary hilum opacities nodular (23%), pleurisy (14%) and miliary (3%). In the lung lesion, parenchymal lung lesion were majority, it account for 64%, more of the lesions were located in the right upper lobe(49%).

Conclusion: This approach provided a TB diagnostic tool in patients with pulmonary tuberculosis negative bascilloscopie. In hospital practice, the combination of simple clinical, and radiological symptoms as an aid in the diagnosis of TB. Some Similar studies are needed to improve diagnosis in patients from outpatient suspected TB.

DOI: 10.29245/2689-999X/2017/2.1131 View / Download Pdf

Shao Shuai1, 2, Gao Yue2*

1National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China

2Beijing Institute of Radiation Medicine, Beijing 100850, China

Coagulation abnormalities are critical diseases that threaten the survival of patients. Ferulic acid can regulate the blood coagulation function in two aspects. This paper reviews and discusses the reported mechanisms of the antithrombotic activities of ferulic acid. Previous studies suggested that ferulic acid played a role in antithrombosis by inhibiting platelet aggregation and protecting the endotheliocyte. Meanwhile, ferulic acid has fewer side effects on the platelet, leukocytosis and gastrointestinal tract, because it can promote the formation and differentiation of hematopoietic progenitor cells and protect the intestinal cells from injury. Therefore, ferulic acid is a potential protector from thrombotic diseases, such as cardiovascular dysfunction, pulmonary thromboembolism and deep vein thrombosis.

DOI: 10.29245/2689-999X/2017/2.1127 View / Download Pdf

Liam Rourke1*, Ron Damant1, Chris Donoff2, Anthony Singhal2

1Department of Medicine, University of Alberta, Edmonton, Canada

2Department of Psychology, University of Alberta, Edmonton, Canada

DOI: 10.29245/2689-999X/2017/2.1125 View / Download Pdf

James C. Parker1*

1Department of Physiology, College of Medicine, MSB 3074, University of South Alabama, 307 University Blvd. Mobile, AL 36688, USA

Although reduced tidal volumes have improved patient survival during ventilation for acute lung injury, further improvements will require pharmacologic interventions of the cellular pathways for inflammation and injury. We previously reported that pretreatment with mitochondrial targeted mtDNA repair enzymes largely prevented lung injury and inflammation during a protocol for moderately severe ventilation induced lung injury. GSH/GSSG ratios indicated that free radical production had been reduced to baseline levels by treatment. The central role of the alveolar macrophages and cellular mechanisms of injury are discussed. This includes a rapid calcium entry and mitochondrial production of excessive reactive oxygen species. Excessive ROS can then result in activation of the NLRP3 inflammasome and secretion of IL-1 and IL-18 by caspase-1. A simultaneous activation of NFkB to transcribe pro forms of the cytokines is stimulated by damage associated molecular pattern (DAMP) recognition receptors. These are primarily TLR4 responding to various cellular damage products and TLR9 responding to mtDNA fragments that appear to be primarily involved. Intervention in these pathways could result in useful future clinical treatments.

DOI: 10.29245/2689-999X/2017/2.1107 View / Download Pdf

Norma Helena Perlroth1* and Christina Wyss Castelo Branco2

1University Hospital Gaffrée Guinle, Department of Pediatrics, Pediatric Emergency Care, Federal University of the State of Rio de Janeiro, RJ, Brazil

2Department of Zoology, Institute of Biosciences, Federal University of the State of Rio de Janeiro, RJ, Brazil

Objective: The present study aims to identify the scientific evidence on the influence of the environment during the critical periods of children’s lung development.

Data source: The search was performed in the Bireme database, using the terms: fetal development, child development, environmental exposure, environmental pollutants, lung diseases, health vulnerability and toxicity pathways in the LILACS, MEDLINE and SciELO systems.

Data synthesis: The vulnerability of children to respiratory diseases due to environmental hazards occurs because very specific physiological characteristics are found in this population. Exposure to toxic agents during the sensitive phases of child development can cause negative impacts to the normal physical lung. The caused effects are reflected in the increased prevalence on children morbidity with temporary or permanent pulmonary damage.

Conclusion: Understanding the effects of environmental exposures on the child lung and how they are established can contribute to the ultimate goal of prevention, i.e. to avoid, minimize or reduce the exposure of children to risk factors for their health.

DOI: 10.29245/2689-999X/2017/2.1126 View / Download Pdf

A.-S. Advenier1, G. Lorin de la Grandmaison2*

1Department of Forensic Medicine, Claude Bernard Lyon 1 University, Hospices Civils de Lyon, France.

2Department of Forensic Medicine and Pathology, Versailles-Saint-Quentin University, AP-HP, Raymond Poincaré Hospital, Garches, France.

Although lesions related to chemical burns concern digestive tract first, pulmonary damage can also be observed, in cases of inhalation or secondary to gastric aspiration. Pulmonary lesions after caustic exposure are non-specific. Multiple factors may influence the pattern of lesions, including the nature of the caustic substance, the duration of contact, the amount of the substance encountering the tissue and the length of postingestion survival. Significant complications of caustic ingestion such as chemical pneumonitis can develop in the first days or later. This article summarizes the most frequent pulmonary lesions according to the corrosive agent (gas, solid and liquid caustic, arsenic).

DOI: 10.29245/2689-999X/2017/2.1119 View / Download Pdf

Ahmet Sinan Copur1*, D Erik Everhart2

1Rosalind Franklin University of Medicine and Science, Captain James Lovell Federal Health Care Center, North Chicago, IL.

2DEast Carolina University, Greenville, NC

Sleep disordered breathing (SDB) is a common health problem with significant morbidity and mortality. Positive airway pressure (PAP) therapy is the accepted first-line treatment for SDB. Despite the documented efficacy of PAP therapy in the treatment of SDB, patient adherence is problematic. Proposed reasons for this nonadherence include patient-related, therapy/medication-related, and health professional-related factors. Some research studies have been published regarding the relationship between patient psychological or personality characteristics and adherence with PAP therapy. These studies can be divided into two groups. The first group focuses on psychological/personality characteristics of SDB patients. These studies claim that hypochondriasis, depression, memory and some cognitive function impairment are prevalent among SDB patients. Patients with these psychological and personality characteristics report more symptoms and complaints compared to other SDB patients. The second group examines the PAP adherence and psychological/personality characteristics. They report that PAP adherence may negatively correlate with Type D personality, hypochondriasis, claustrophobia, depression, neuroticism, and BIS while may be positively associated with BAS-FS, and intellect imagination.

However, limited data, the significant difference of the methods, techniques, number of cases and results of the studies, and contribution of multiple other factors make it difficult to draw a reliable conclusion. More specific studies with larger sample size on proposed psychological/personality variables would give a more clear understanding of this problem.

DOI: 10.29245/2689-999X/2017/2.1122 View / Download Pdf

Yuusaku Sugihara1, 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.

DOI: 10.29245/2689-999X/2017/1.1121 View / Download Pdf

Wendy Jo Svetanoff1*, 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.

DOI: 10.29245/2689-999X/2017/1.1114 View / Download Pdf

Matthew Randolph Marshall1*, 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.

DOI: 10.29245/2689-999X/2017/1.1117 View / Download Pdf

Ana Margarida Matos1,2 and Paulo Matos1,2*

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

DOI: 10.29245/2689-999X/2017/1.1113 View / Download Pdf