Volume Articles

A REVIEW OF PSYCHOLOGICAL AND PERSONALITY CHARACTERISTICS ON PAP THERAPY ADHERENCE AMONG SLEEP DISORDERED BREATHING PATIENTS

Ahmet Sinan Copur^1*, 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.

The Vulnerability of Children Lung to Environmental Hazards during the Sensitive Developmental Periods

Norma Helena Perlroth^1* 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.

PULMONARY ACUTE LESIONS AFTER CAUSTIC EXPOSURE

A.-S. Advenier¹, G. Lorin de la Grandmaison^2*

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).

Commentary: A neural marker of medical visual expertise

Liam Rourke^1*, Ron Damant¹, Chris Donoff², Anthony Singhal²

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

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

Mitochondrial damage pathways in ventilator induced lung injury (VILI): an update

James C. Parker^1*

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.

Strategies to Improve Outcome and Value of the Immune Check Point Inhibitors in Non-Small-Cell Lung Cancer

Helmy M. Guirgis^1*

¹The Cancer Free Foundation, 24806 Sea Crest Dr. Dana Point, CA 92629

Ferulic Acid, A Potential Antithrombotic Drug

Shao Shuai^{1, 2}, Gao Yue^2*

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.

Diagnosis of smear-negative Pulmonary Tuberculosis in Kiffa hospital, Assaba, Mauritania

Boushab Mohamed Boushab^1*, 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.