1,754 results on '"Emphysema etiology"'
Search Results
2. The Role of Emphysema on Postoperative Prognosis in Early-Stage Nonsmall Cell Lung Cancer.
- Author
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Ishida M, Mimae T, Kamigaichi A, Kawamoto N, Tsubokawa N, Miyata Y, and Okada M
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- Humans, Male, Female, Retrospective Studies, Survival Rate, Prognosis, Middle Aged, Aged, Follow-Up Studies, Neoplasm Staging, Emphysema surgery, Emphysema pathology, Emphysema etiology, Neoplasm Invasiveness, Carcinoma, Non-Small-Cell Lung surgery, Carcinoma, Non-Small-Cell Lung pathology, Lung Neoplasms surgery, Lung Neoplasms pathology, Lung Neoplasms mortality, Pneumonectomy, Pulmonary Emphysema surgery, Pulmonary Emphysema pathology, Pulmonary Emphysema complications
- Abstract
Background: Emphysema is generally considered a poor prognostic factor for patients with nonsmall cell lung cancer; however, whether the poor prognosis is due to highly malignant tumors or emphysema itself remains unclear. This study was designed to determine the prognostic value of emphysema in patients with early-stage nonsmall cell lung cancer., Methods: A total of 721 patients with clinical stage IA nonsmall cell lung cancer who underwent complete resection between April 2007 and December 2018 were retrospectively analyzed regarding clinicopathological findings and prognosis related to emphysema., Results: The emphysematous and normal lung groups comprised 197 and 524 patients, respectively. Compared with the normal lung group, lymphatic invasion (23.9% vs. 14.1%, P = 0.003), vascular invasion (37.6% vs. 17.2%, P < 0.001), and pleural invasion (18.8% vs. 10.9%, P = 0.006) were observed more frequently in the emphysema group. Additionally, the 5-year overall survival rate was lower (77.1% vs. 91.4%, P < 0.001), and the cumulative incidence of other causes of death was higher in the emphysema group (14.0% vs. 3.50%, P < 0.001). Multivariable Cox regression analysis of overall survival revealed that emphysema (vs. normal lung, hazard ratio 2.02, P = 0.0052), age > 70 years (vs. < 70 years, hazard ratio 4.03, P < 0.001), and SUVmax > 1.8 (vs. ≤ 1.8, hazard ratio 2.20, P = 0.0043) were independent prognostic factors., Conclusions: Early-stage nonsmall cell lung cancer with emphysema has a tendency for the development of highly malignant tumors. Additionally, emphysema itself may have an impact on poor prognosis., (© 2024. The Author(s).)
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- 2024
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3. Traumatic Orbital Compression Syndromes: A Comprehensive Study Into Etiologies, Intervention Strategies, and Clinical Outcomes.
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Dos Santos JC, Gorla LFO, Moreno R, Monnazzi MS, Pereira Filho VA, Gabrielli MFR, and Gabrielli MAC
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- Humans, Male, Adult, Female, Middle Aged, Retrobulbar Hemorrhage etiology, Orbital Fractures surgery, Orbital Fractures complications, Hematoma etiology, Treatment Outcome, Emphysema etiology, Emphysema therapy, Edema etiology, Syndrome, Aged, Tomography, X-Ray Computed, Blindness etiology, Decompression, Surgical methods, Orbital Diseases etiology, Orbital Diseases therapy, Orbital Diseases surgery
- Abstract
Facial fractures and their historical link to potential blindness have been well-documented, often attributed to optic canal injuries or retinal vascular occlusion. This dire consequence can result from both direct and indirect ocular trauma, including retrobulbar hemorrhage. Traumatic orbital compression can manifest in various forms, such as hematomas, fractured bone fragments, and emphysema, all posing a significant threat to vision, necessitating immediate intervention. In this study, 9 clinical cases of traumatic orbital compression are presented, each characterized by distinct etiologies. The study delves into traumatic orbital compressive syndromes, underscoring the critical imperative of early recognition and treatment to prevent vision loss. Orbital compression, whether from edema, hematoma, or emphysema, collectively culminates in elevated intraorbital pressure and the potential for optic nerve ischemia. Through the presentation of these 9 clinical cases, the article emphasizes the pressing need for timely intervention in addressing orbital compressive syndromes to avert vision loss. Various surgical techniques are elucidated, highlighting the pivotal role of expeditious medical intervention. This article offers invaluable insights into the diagnosis, management, and outcomes of traumatic orbital compressive syndromes., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)
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- 2024
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4. Emphysematous Urinary Tract Infections in Diabetics
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Dos Santos VM and Dos Santos LAM
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- Aged, Female, Humans, Male, Middle Aged, Diabetes Complications physiopathology, Emphysema etiology, Emphysema complications, Urinary Tract Infections complications
- Abstract
Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.
- Published
- 2024
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5. In Response to “Emphysematous Urinary Tract Infections in Diabetics”
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Yang W and He C
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- Humans, Emphysema complications, Emphysema etiology, Diabetes Complications physiopathology, Urinary Tract Infections complications
- Abstract
Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.
- Published
- 2024
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6. [Transurethral Resection of Necrotic Tissue in the Bladder Caused by Emphysematous Cystitis].
- Author
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Watanabe S, Segawa H, Tachibana H, and Kobayashi H
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- Humans, Male, Aged, Necrosis, Emphysema diagnostic imaging, Emphysema surgery, Emphysema etiology, Urinary Bladder surgery, Urinary Bladder diagnostic imaging, Urinary Bladder pathology, Tomography, X-Ray Computed, Cystitis surgery, Cystitis diagnostic imaging, Cystitis etiology
- Abstract
Emphysematous cystitis is a relatively rare form of urinary tract infection. A 72-year-old man with diabetes mellitus and long-term indwelling urethral catheterization was diagnosed with emphysematous cystitis. The clinical findings were resolved by conservatively managing the patient with antibiotics. However, cystoscopy subsequently revealed a yellowish-white soft tissue mass in the bladder, which was unlikely to be a bladder tumor. The mass could not be removed easily and frequently caused urinary catheter obstruction. We successfully removed this mass by performing transurethral resection twice. Through histopathological examination, the mass was identified as necrotic tissue comprising bacteria, fibrin, and suspected bladder mucosa.
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- 2024
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7. Body composition impacts outcome of bronchoscopic lung volume reduction in patients with severe emphysema: a fully automated CT-based analysis.
- Author
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Wienker J, Darwiche K, Rüsche N, Büscher E, Karpf-Wissel R, Winantea J, Özkan F, Westhölter D, Taube C, Kersting D, Hautzel H, Salhöfer L, Hosch R, Nensa F, Forsting M, Schaarschmidt BM, Zensen S, Theysohn J, Umutlu L, Haubold J, and Opitz M
- Subjects
- Humans, Pneumonectomy methods, Quality of Life, Bronchoscopy methods, Forced Expiratory Volume physiology, Body Composition, Tomography, X-Ray Computed, Treatment Outcome, Pulmonary Emphysema diagnostic imaging, Pulmonary Emphysema surgery, Pulmonary Emphysema etiology, Pulmonary Disease, Chronic Obstructive, Emphysema etiology
- Abstract
Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive and irreversible airflow limitation, with individual body composition influencing disease severity. Severe emphysema worsens symptoms through hyperinflation, which can be relieved by bronchoscopic lung volume reduction (BLVR). To investigate how body composition, assessed through CT scans, impacts outcomes in emphysema patients undergoing BLVR. Fully automated CT-based body composition analysis (BCA) was performed in patients with end-stage emphysema receiving BLVR with valves. Post-interventional muscle and adipose tissues were quantified, body size-adjusted, and compared to baseline parameters. Between January 2015 and December 2022, 300 patients with severe emphysema underwent endobronchial valve treatment. Significant improvements were seen in outcome parameters, which were defined as changes in pulmonary function, physical performance, and quality of life (QoL) post-treatment. Muscle volume remained stable (1.632 vs. 1.635 for muscle bone adjusted ratio (BAR) at baseline and after 6 months respectively), while bone adjusted adipose tissue volumes, especially total and pericardial adipose tissue, showed significant increase (2.86 vs. 3.00 and 0.16 vs. 0.17, respectively). Moderate to strong correlations between bone adjusted muscle volume and weaker correlations between adipose tissue volumes and outcome parameters (pulmonary function, QoL and physical performance) were observed. Particularly after 6-month, bone adjusted muscle volume changes positively corresponded to improved outcomes (ΔForced expiratory volume in 1 s [FEV
1 ], r = 0.440; ΔInspiratory vital capacity [IVC], r = 0.397; Δ6Minute walking distance [6MWD], r = 0.509 and ΔCOPD assessment test [CAT], r = -0.324; all p < 0.001). Group stratification by bone adjusted muscle volume changes revealed that groups with substantial muscle gain experienced a greater clinical benefit in pulmonary function improvements, QoL and physical performance (ΔFEV1 %, 5.5 vs. 39.5; ΔIVC%, 4.3 vs. 28.4; Δ6MWDm, 14 vs. 110; ΔCATpts, -2 vs. -3.5 for groups with ΔMuscle, BAR% < -10 vs. > 10, respectively). BCA results among patients divided by the minimal clinically important difference for forced expiratory volume of the first second (FEV1 ) showed significant differences in bone-adjusted muscle and intramuscular adipose tissue (IMAT) volumes and their respective changes after 6 months (ΔMuscle, BAR% -5 vs. 3.4 and ΔIMAT, BAR% -0.62 vs. 0.60 for groups with ΔFEV1 ≤ 100 mL vs > 100 mL). Altered body composition, especially increased muscle volume, is associated with functional improvements in BLVR-treated patients., (© 2024. The Author(s).)- Published
- 2024
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8. Gastric emphysema with massive hepatic portal venous gas.
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Niida T, Takeuchi M, Kataoka K, and Isoda K
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- Humans, Portal Vein diagnostic imaging, Gastritis, Emphysema diagnostic imaging, Emphysema etiology
- Abstract
Competing Interests: Competing interests: None declared.
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- 2024
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9. Combined Pulmonary Fibrosis and Emphysema in a Patient With Chronic Occupational Exposure to Trichloroethylene.
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Asif H and Braman SS
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- Humans, Fibrosis, Retrospective Studies, Pulmonary Fibrosis chemically induced, Pulmonary Fibrosis diagnostic imaging, Trichloroethylene toxicity, Pulmonary Emphysema chemically induced, Pulmonary Emphysema complications, Emphysema etiology, Emphysema complications
- Abstract
Combined pulmonary fibrosis and emphysema (CPFE) is a clinical syndrome of upper-zone-predominant emphysema on high-resolution CT and a peripheral and basal-predominant diffuse pulmonary fibrosis. Multiple occupational and inhalational exposures have been associated with CPFE. We describe a U.S. veteran, who developed CPFE after a prolonged, intense exposure to trichloroethylene as an aircraft maintenance worker. We believe that this may be another example of occupational-associated CPFE., (© The Association of Military Surgeons of the United States 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2024
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10. Sex-specific emphysematous changes evaluated by a three-dimensional computed tomography volumetric analysis among patients with smoking histories who underwent resection for lung cancer.
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Wijesinghe AI, Kobayashi N, Kitazawa S, Maki N, Yanagihara T, Saeki Y, Kikuchi S, Goto Y, Ichimura H, and Sato Y
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- Male, Humans, Female, Lung diagnostic imaging, Lung pathology, Tomography, X-Ray Computed methods, Smoking adverse effects, Lung Neoplasms diagnostic imaging, Lung Neoplasms surgery, Lung Neoplasms pathology, Pulmonary Emphysema diagnostic imaging, Pulmonary Emphysema etiology, Pulmonary Emphysema pathology, Emphysema diagnostic imaging, Emphysema etiology, Emphysema pathology
- Abstract
Purpose: The present study evaluated the sex-specific susceptibility to the development of emphysema in patients with smoking histories who underwent lung cancer surgeries., Methods: Lung cancer patients with smoking histories who underwent lung resection at the University of Tsukuba Hospital, Japan, were enrolled. Radiologic emphysematous changes were analyzed using three-dimensional computed tomography (3D-CT). The volume proportion of emphysematous lung per unit of smoking and the relationship between emphysematous change and clinicopathologic factors were evaluated., Results: Radiologic emphysematous changes analyzed using 3D-CT per pack-year smoked, defined as the Smoking-Emphysema Index (SEI), were greater in females than males. The difference was more profound in adenocarcinoma patients than in non-adenocarcinoma patients (0.70 ± 2.30 vs. 0.21 ± 0.28, P = 0.037)., Conclusion: Female lung cancer patients are more susceptible to smoking-induced emphysema than males. The SEI may be an effective indicator for evaluating smoking-induced emphysema., (© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.)
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- 2024
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11. Application of 3D computed tomography in emphysematous parenchyma patients scheduled for bronchoscopic lung volume reduction.
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Wei P, Tao RJ, Lu HW, Xu JF, Liu YH, Wang H, Li LL, Gu Y, and Cao WJ
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- Humans, Pneumonectomy adverse effects, Pneumonectomy methods, Retrospective Studies, Quality of Life, Lung diagnostic imaging, Lung surgery, Tomography, X-Ray Computed methods, Treatment Outcome, Pulmonary Emphysema diagnostic imaging, Pulmonary Emphysema surgery, Pulmonary Emphysema etiology, Pulmonary Disease, Chronic Obstructive diagnostic imaging, Pulmonary Disease, Chronic Obstructive surgery, Emphysema diagnostic imaging, Emphysema surgery, Emphysema etiology
- Abstract
Bronchoscopic lung volume reduction (BLVR) is a feasible, safe, effective and minimally invasive technique to significantly improve the quality of life of advanced severe chronic obstructive pulmonary disease (COPD). In this study, three-dimensional computed tomography (3D-CT) automatic analysis software combined with pulmonary function test (PFT) was used to retrospectively evaluate the postoperative efficacy of BLVR patients. The purpose is to evaluate the improvement of lung function of local lung tissue after operation, maximize the benefits of patients, and facilitate BLVR in the treatment of patients with advanced COPD. All the reported cases of advanced COPD patients treated with BLVR with one-way valve were collected and analysed from 2017 to 2020. Three-dimensional-CT image analysis software system was used to analyse the distribution of low-density areas <950 Hounsfield units in both lungs pre- and post- BLVR. Meanwhile, all patients performed standard PFT pre- and post-operation for retrospective analysis. We reported six patients that underwent unilateral BLVR with 1 to 3 valves according to the range of emphysema. All patients showed a median increase in forced expiratory volume in 1 second (FEV1) of 34%, compared with baseline values. Hyperinflation was reduced by 16.6% (range, 4.9%-47.2%). The volumetric measurements showed a significant reduction in the treated lobe volume among these patients. Meanwhile, the targeted lobe volume changes were inversely correlated with change in FEV1/FEV1% in patients with heterogeneous emphysematous. We confirm that 3D-CT analysis can quantify the changes of lung volume, ventilation and perfusion, to accurately evaluate the distribution and improvement of emphysema and rely less on the observer., (© 2023 John Wiley & Sons Australia, Ltd.)
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- 2024
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12. miR-146a regulates emphysema formation and abnormal inflammation in the lungs of two mouse models.
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Yoshikawa H, Sato T, Horikoshi K, Komura M, Nitta NA, Mitsui A, Koike K, Kodama Y, and Takahashi K
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- Animals, Male, Mice, Inflammation pathology, Lung metabolism, Matrix Metalloproteinase 2 metabolism, Mice, Inbred C57BL, Mice, Knockout, Pancreatic Elastase metabolism, Emphysema etiology, MicroRNAs genetics, MicroRNAs metabolism, Pulmonary Disease, Chronic Obstructive pathology, Pulmonary Emphysema chemically induced, Pulmonary Emphysema genetics
- Abstract
miR-146a, a microRNA (miRNA) that regulates inflammatory responses, plays an important role in many inflammatory diseases. Although an in vitro study had suggested that miR-146a is involved in abnormal inflammatory response, being a critical factor in the pathogenesis of chronic obstructive pulmonary disease (COPD), in vivo evidence of its pathogenic role in COPD remains limited. Eight-week-old male B6(FVB)-Mir146tm1.1Bal/J [miR-146a knockout (KO)] and C57BL/6J mice were intratracheally administered elastase and evaluated after 28 days or exposed to cigarette smoke (CS) and evaluated after 5 mo. miR-146a expression was significantly increased in C57BL/6J mouse lungs due to elastase administration ( P = 0.027) or CS exposure ( P = 0.019) compared with that in the control group. Compared with C57BL/6J mice, elastase-administered miR-146a-KO mice had lower average computed tomography (CT) values ( P = 0.017) and increased lung volume-to-weight ratio ( P = 0.016), mean linear intercept ( P < 0.001), and destructive index ( P < 0.001). Moreover, total cell ( P = 0.006), macrophage ( P = 0.001), neutrophil ( P = 0.026), chemokine (C-X-C motif) ligand 2/macrophage inflammatory protein-2 [ P = 0.045; in bronchoalveolar lavage fluid (BALF)], cyclooxygenase-2 , and matrix metalloproteinase-2 levels were all increased (in the lungs). Following long-term CS exposure, miR-146a-KO mice showed a greater degree of emphysema formation in their lungs and inflammatory response in the BALF and lungs than C57BL/6J mice. Collectively, miR-146a protected against emphysema formation and the associated abnormal inflammatory response in two murine models. NEW & NOTEWORTHY This study demonstrates that miR-146a expression is upregulated in mouse lungs because of elastase- and CS-induced emphysema and that the inflammatory response by elastase or CS is enhanced in the lungs of miR-146a-KO mice than in those of control mice, resulting in the promotion of emphysema. This is the first study to evaluate the protective role of miR-146a in emphysema formation and the associated abnormal inflammatory response in different in vivo models.
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- 2024
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13. Surgical and bronchoscopic pulmonary function-improving procedures in lung emphysema.
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Everaerts S, Vandervelde CM, Shah P, Slebos DJ, and Ceulemans LJ
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- Humans, Quality of Life, Bronchoscopy adverse effects, Lung surgery, Pneumonectomy adverse effects, Pneumonectomy methods, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive surgery, Pulmonary Disease, Chronic Obstructive etiology, Pulmonary Emphysema diagnosis, Pulmonary Emphysema surgery, Pulmonary Emphysema etiology, Emphysema etiology, Emphysema surgery
- Abstract
COPD is a highly prevalent, chronic and irreversible obstructive airway disease without curative treatment. Standard therapeutic strategies, both non-pharmacological and pharmacological, have only limited effects on lung function parameters of patients with severe disease. Despite optimal pharmacological treatment, many patients with severe COPD still have a high burden of dyspnoea and a poor quality of life. If these patients have severe lung emphysema, with hyperinflation as the driver of symptoms and exercise intolerance, lung volume reduction may be an effective treatment with a significant impact on lung function, exercise capacity and quality of life. Currently, different lung volume reduction approaches, both surgical and bronchoscopic, have shown encouraging results and have been implemented in COPD treatment recommendations. Nevertheless, choosing the optimal lung volume reduction strategy for an individual patient remains challenging. Moreover, there is still room for improving durability of effect and safety in all available procedures. Ongoing and innovative research is essential to push this field forwards. This review provides an overview of results and limitations of the current lung volume reduction options for patients with severe lung emphysema and hyperinflation., Competing Interests: Conflict of interest: S. Everaerts, C.M. Vandervelde and P. Shah have no conflicts of interest related to the content of the manuscript. D-J. Slebos reports grants or contracts, study material, registration fees and travel costs, and participation on a Data and Safety Monitoring Board for Pulmonx, Corp., BTG/PneumRx Inc, FreeFlowMedical, Nuvaira, PulmAir, GALA, CSA Medical and Apreo, most of them paid to his institution. L.J. Ceulemans received an unrestricted university chair from Medtronic and a philanthropic grant from Gunze., (Copyright ©The authors 2023.)
- Published
- 2023
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14. Recent advances in bronchoscopic lung volume reduction for severe COPD patients.
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Posthuma R, Vaes AW, Spruit MA, and Vanfleteren LEGW
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- Humans, Pneumonectomy adverse effects, Quality of Life, Bronchoscopy adverse effects, Pulmonary Disease, Chronic Obstructive surgery, Pulmonary Emphysema surgery, Pulmonary Emphysema etiology, Emphysema etiology
- Abstract
Purpose of Review: Bronchoscopic lung volume reduction (BLVR) is a novel and effective treatment for a specific phenotype of chronic obstructive pulmonary disease (COPD) characterized by advanced emphysema with static lung hyperinflation and severe breathlessness. This review aims to provide an overview of the recent advances made in BLVR., Recent Findings: For achieving optimal outcomes with BLVR, patient selection and target lobe identification is crucial. BLVR has recently also been established to improve pulmonary function, exercise capacity and quality of life in COPD patients falling outside the standard treatment criteria, including patients with moderate hyperinflation, chronic hypercapnic failure or with very low diffusion capacity. In a cluster analysis, target lobe characteristics like emphysema destruction, air trapping and perfusion were found to be important discriminators between responders and non-responders. A potential survival benefit has been demonstrated in BLVR-treated patients when compared to non-treated patients. Long-term outcomes showed sustained outcomes of BLVR; however, effects decline over time, probably due to disease progression., Summary: BLVR using one-way endobronchial valves has become a guideline treatment offered in specialized intervention centres for a specific subgroup of COPD patients. Recent studies further characterize responders, describe extrapulmonary effects of BLVR and show positive long-term outcomes and a potential survival benefit., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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15. Endobronchial lung volume reduction with valves reduces exacerbations in severe emphysema patients.
- Author
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Brock JM, Böhmker F, Schuster PU, Eberhardt R, Gompelmann D, Kontogianni K, Dittrich S, Benjamin N, and Herth F
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- Humans, Female, Middle Aged, Aged, Male, Pneumonectomy, Retrospective Studies, Bronchoscopy, Pulmonary Emphysema, Pulmonary Disease, Chronic Obstructive complications, Emphysema etiology, Pulmonary Atelectasis complications
- Abstract
Background and Objective: Exacerbations drive the progression of chronic obstructive pulmonary disease (COPD). Endoscopic lung volume reduction (ELVR) with valves is an established treatment option for patients with severe emphysema. Post-interventional exacerbations are observed in 8-17% of cases. Whether the exacerbation rate changes in the medium term after ELVR, is not known., Methods: This is a single-center retrospective analysis of severe emphysema patients with endobronchial valve implantation. The number of exacerbations before and after ELVR was compared, including lung function parameters, exercise capacity and degree of lung volume reduction. The primary endpoint of the study was the number of exacerbations one year after ELVR compared to one year before ELVR., Results: 129 patients (mean age 64.1 ± 7.7 years, 57% female, mean FEV
1 0.8 ± 0.2 l, mean RV 243.4 ± 54.9 %) with ELVR in the years 2016-2019 and complete exacerbation history were analyzed. Patients experienced a mean of 2.5 ± 2.2 moderate and severe exacerbations in the year before ELVR. The number of exacerbations decreased significantly to 1.8 ± 2.2 exacerbations in the first year after ELVR (p = 0.009). The decrease in exacerbation rate was associated with the development of complete lobar atelectasis (r = 0.228. p = 0.009). Accordingly, in 41 patients with complete lobar atelectasis, the decrease in exacerbation rate was higher from 2.8 ± 2.0 to 1.4 ± 1.8 exacerbations (p < 0.001)., Conclusions: ELVR with valves appears promising to reduce the exacerbation rate in COPD patients, especially when the full treatment benefit of complete lobar atelectasis is achieved., Competing Interests: Declaration of competing interest There is no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)- Published
- 2023
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16. A chronic infectious bladder stone causing an obstructive emphysematous cystitis.
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Boutin L, Zarworski J, Tang E, Goujon A, Plaud B, Donay JL, Dépret F, Bazin D, Letavernier E, and Dudoignon E
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- Humans, Chronic Disease, Emphysema microbiology, Emphysema diagnostic imaging, Emphysema etiology, Tomography, X-Ray Computed, Urinary Bladder Calculi diagnostic imaging, Urinary Bladder Calculi complications, Cystitis microbiology, Cystitis complications
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- 2023
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17. Lung volume reduction for emphysema using one-way endobronchial valves: An Australian cohort.
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Sidhu C, Wilsmore N, Shargill N, and Rangamuwa K
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- Humans, Pneumonectomy methods, Quality of Life, Retrospective Studies, Forced Expiratory Volume, Bronchoscopy methods, Australia, Treatment Outcome, Pneumothorax etiology, Pulmonary Emphysema etiology, Emphysema etiology
- Abstract
Emphysema can be associated with gas trapping and hyperinflation, which negatively impacts on quality of life, life expectancy, and functional capacity. Lung volume reduction (LVR) surgery can reduce gas trapping and improve mortality in select patients but carries a high risk of major complications. Bronchoscopic techniques for LVR using one-way endobronchial valves (EBV) have become an established efficacious alternative to surgery. A bi-center retrospective cohort study was conducted on patients with severe emphysema who underwent endoscopic lung volume reduction (ELVR) using Pulmonx Zephyr EBVs. Symptomatic patients with gas-trapping and hyperinflation on lung function testing were selected. Target-lobe selection was based on quantitative imaging analysis and ventilation-perfusion scintigraphy. Successful procedures were determined from clinical review, imaging and follow-up testing. Thirty-nine patients underwent ELVR. Mean pre-procedure forced expiratory volume in 1 second (FEV1) was 0.75 L, residual volume (RV) was 225% predicted and total lung capacity was 129% predicted. Most common treated-lobe was left upper lobe. Post-procedure pneumothorax occurred in 36.5% of patients with 73% requiring intercostal catheter insertion for drainage. Mean FEV1 improvement was +140 mL and 57% of patients achieved minimal clinical important difference FEV1 increase of ≥12%. Maximal mean RV change was -1010 mL with 69% of patients achieving minimal clinical important difference RV decrease of ≥350 mL. Clinician-determined success of ELVR was 78%. Procedure-related mortality was absent. LVR using EBVs is safe and can lead to significant improvements in lung function, particularly reduction of gas trapping and hyperinflation. Occurrence of pneumothorax post-procedure is a complication that must be monitored for and managed appropriately., Competing Interests: Dr Narinder Shargill is an employee of Pulmonx. Dr Nicholas Wilsmore has a consulting agreement with and has received honoraria from Pulmonx. The remaining authors have no conflicts of interest to declare. No direct funding was received for the conception of this manuscript., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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18. Anatomic and physiologic approach for trans-conjunctival needle decompression of orbital emphysema.
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Clauss KD and Tse DT
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- Humans, Young Adult, Adult, Orbit surgery, Conjunctiva surgery, Decompression, Surgical methods, Emphysema etiology, Emphysema surgery, Orbital Diseases etiology, Orbital Diseases surgery
- Abstract
A 19-year-old with blunt trauma and repeated nose blowing presented with orbital emphysema and orbital compartment syndrome. Orbital emphysema is the abnormal presence of air within the orbit, typically secondary to trauma. Most cases will resolve with observation alone, however orbital compartment syndrome is a feared complication that necessitates urgent decompression. A superior fornix, trans-conjunctival approach was safely utilized to decompress the orbit while avoiding unwanted complications. Various decompression techniques have previously been described, most of which describe trans-palpebral approaches. The key safety benefit to the trans-conjunctival approach is direct visualization of the needle tip adjacent to the superior fornix, therefore posterior to the equator of the globe. With the needle positioned parallel to the curvature of the globe at the equator, the posterior sclera surface curves away from the tip, rendering it difficult to pierce the globe. In addition, the needle needs to be advanced only 3-4 millimeters and traverses only the conjunctiva and Tenon's to enter the central surgical space - the most direct route to the air pocket. The trans-conjunctival approach lowers the risk of damage to eyelid neurovascular structures and is less painful.
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- 2023
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19. EXTENSIVE ORBITAL AND PARAPHARYNGEAL EMPHYSEMA REQUIRING URGENT CANTHOTOMY AND CANTHOLYSIS AFTER PARS PLANA VITRECTOMY.
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Nithianandan H, Nassrallah G, Al-Kaabi A, Politis M, Campagnoli T, Khan Z, and Kapusta MA
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- Female, Humans, Young Adult, Adult, Vitrectomy adverse effects, Orbit surgery, Retinal Detachment surgery, Emphysema etiology, Emphysema surgery, Compartment Syndromes etiology, Compartment Syndromes surgery
- Abstract
Purpose: The authors report the emergent management of a case of orbital and parapharyngeal emphysema causing orbital compartment syndrome and signs of peripheral neuropathy days after pars plana vitrectomy., Methods: Case report., Results: A 20-year-old woman underwent 3-port 23-gauge pars plana vitrectomy in the right eye for total retinal detachment under general anesthesia. All sclerotomies were secured with 7-0 polyglactin 910 (Vicryl; Ethicon) sutures before instillation of 15% C3F8 gas. On the third postoperative day, the patient presented with a 3-mm proptosis, near-total ophthalmoplegia, jaw protrusion, head deviation, tongue protrusion, and facial twitching. Computed tomography showed extensive subcutaneous gas in the right orbit and bilateral parapharyngeal spaces, and a tethered right optic nerve with globe tenting. A decision was made to perform urgent lateral canthotomy and cantholysis. Three hours after canthotomy and cantholysis, her neurologic signs had resolved except for intermittent tongue protrusion, which resolved thereafter. At postoperative Week 7, the patient's vision was 20/70 and her intraocular pressure was 13 mmHg., Conclusion: To the authors' knowledge, this is the only report of a modern small-gauge vitrectomy procedure being complicated by orbital compartment syndrome and extensive emphysema causing peripheral neuropathy, and successfully treated with urgent canthotomy and cantholysis.
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- 2023
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20. Deletion of sphingosine kinase 2 attenuates cigarette smoke-mediated chronic obstructive pulmonary disease-like symptoms by reducing lung inflammation.
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Chen Y, Zhang Y, Rao C, Huang J, and Qing Q
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- Animals, Mice, Cystic Fibrosis Transmembrane Conductance Regulator, Inflammation complications, NF-kappa B metabolism, Sphingosine-1-Phosphate Receptors metabolism, Nicotiana metabolism, Cigarette Smoking, Emphysema etiology, Pneumonia etiology, Pulmonary Disease, Chronic Obstructive etiology, Pulmonary Emphysema etiology, Pulmonary Fibrosis complications
- Abstract
Cigarette smoke (CS) is the leading cause of chronic obstructive pulmonary disease (COPD), which is characterized by chronic bronchial inflammation and emphysema. Growing evidence supports the hypothesis that dysfunctional cystic fibrosis transmembrane conductance regulator (CFTR) is critically involved in the pathogenesis of CS-mediated COPD. However, the underlying mechanism remains unclear. Here, we report that supressed CFTR expression is strongly associated with abnormal phospholipid metabolism and increased pulmonary inflammation. In a CS-exposed mouse model with COPD-like symptoms, we found that pulmonary expression of sphingosine kinase 2 (SphK2) and sphingosine-1-phosphate (S1P) secretion were significantly upregulated. Therefore, we constructed a SphK2 gene knockout (SphK2-/-) mouse. After CS exposure for six months, histological lung section staining showed disorganized alveolar structure, increased pulmonary fibrosis, and emphysema-like symptoms in wild-type (WT) mice, which were less pronounced in SphK2-/- mice. Further, SphK2 deficiency also decreased CS-induced pulmonary inflammation, which was reflected by a remarkable reduction in pulmonary infiltration of CD45+CD11b+ neutrophils subpopulation and low levels of IL-6 and IL-33 in bronchial alveolar lavage fluid. However, treatment with S1P receptor agonist suppressed CFTR expression and increased Nf-κB-p65 expression and its nuclear translocation in CS-exposed SphK2-/-mice, which also aggravated small airways fibrosis and pulmonary inflammation. In contrast, inhibition of S1P signaling with the S1P receptor analogue FTY720 rescued CFTR expression, suppressed Nf-κB-p65 expression and nuclear translocation, and alleviated pulmonary fibrosis and inflammation after CS exposure. Our results demonstrate that SphK2-mediated S1P production plays a crucial role in the pathogenesis of CS-induced COPD-like disease by impairing CFTR activity and promoting pulmonary inflammation and fibrosis.
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- 2023
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21. Orbital Emphysema.
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Lee NJ and Chiu PW
- Subjects
- Humans, Subcutaneous Emphysema diagnosis, Subcutaneous Emphysema diagnostic imaging, Subcutaneous Emphysema etiology, Emphysema diagnosis, Emphysema diagnostic imaging, Emphysema etiology, Orbital Diseases diagnosis, Orbital Diseases diagnostic imaging, Orbital Diseases etiology
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- 2023
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22. Outcomes of Lung Transplantation in Patients With Combined Pulmonary Fibrosis and Emphysema: A Single-Center Experience.
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Narula T, Martin AK, Asif AA, Fritz AV, Li Z, Erasmus DB, Alvarez F, and Thomas M
- Subjects
- Adult, Humans, Retrospective Studies, Pulmonary Fibrosis complications, Pulmonary Fibrosis surgery, Hypertension, Pulmonary etiology, Pulmonary Emphysema complications, Pulmonary Emphysema diagnosis, Pulmonary Emphysema surgery, Emphysema etiology, Lung Transplantation adverse effects
- Abstract
Background: Combined pulmonary fibrosis and emphysema (CPFE) is a distinct clinical entity that can progress to end-stage lung disease. Patients with CPFE may develop pulmonary hypertension and face a predicted 1-year mortality of 60%. Lung transplantation is the only curative therapeutic option for CPFE. This report describes our experience after lung transplantation in patients with CPFE., Methods: This retrospective, single-center study describes short- and long-term outcomes for adult patients who underwent lung transplant for CPFE., Results: The study included 19 patients with explant pathology-proven diagnosis of CPFE. The patients were transplanted between July 2005 and December 2018. Sixteen recipients (84%) had pulmonary hypertension before transplant. Of the 19 patients, 7 (37%) had primary graft dysfunction at 72 hours post-transplant. 1-, 3-, and 5-year freedom from bronchiolitis obliterans syndrome was 100%, 91% (95% CI, 75%-100%), and 82% (95% CI, 62%-100%), respectively. One-, 3-, and 5-year survival was 94% (95% CI, 84%-100%), 82% (95% CI, 65%-100%), and 74% (95% CI, 54%-100%), respectively., Conclusion: Our experience demonstrates the safety and feasibility of lung transplant for patients with CPFE. Significant morbidity and mortality without lung transplant coupled with favorable post-transplant outcomes merit prioritization of CPFE in the Lung Allocation Score algorithm for lung transplant candidacy., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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23. Emphysematous pyelonephritis in an alcoholic and diabetic patient.
- Author
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Wang CH and Liu CH
- Subjects
- Humans, Pyelonephritis complications, Pyelonephritis diagnostic imaging, Diabetes Complications, Diabetes Mellitus, Emphysema diagnostic imaging, Emphysema etiology, Diabetic Nephropathies
- Abstract
Competing Interests: Declaration of Competing Interest There are no conflicts of interest to declare.
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- 2023
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24. AN UNUSUAL COMPLICATION OF PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: ACUTE GASTRIC EMPHYSEMA.
- Author
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Tenlik İ
- Subjects
- Humans, Stomach, Enteral Nutrition adverse effects, Gastrostomy adverse effects, Emphysema diagnostic imaging, Emphysema etiology
- Abstract
Competing Interests: The author declares no conflicts of interest.
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- 2023
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25. HIV Increases the Risk of Cigarette Smoke-Induced Emphysema Through MMP-9.
- Author
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Staitieh BS, Malik S, Auld SC, Wigger GW, Fan X, Roth AT, Chatterjee T, Arora I, Raju SV, Heath S, and Aggrawal S
- Subjects
- Rats, Humans, Animals, Matrix Metalloproteinase 9, Rats, Transgenic, Lung, Bronchoalveolar Lavage Fluid, Cigarette Smoking adverse effects, HIV Infections pathology, Pulmonary Emphysema etiology, Pulmonary Emphysema metabolism, Emphysema etiology, Emphysema metabolism, Emphysema pathology
- Abstract
Background: HIV is associated with an increased risk for emphysema. Matrix metalloproteinase 9 (MMP-9) is a lung tissue remodeling enzyme associated with emphysema. We previously found MMP-9 activity increases with increases in oxidative stress and that HIV increases alveolar oxidative stress. We hypothesized that HIV proteins would increase the risk of cigarette smoke-induced emphysema due to MMP-9., Methods: HIV-1 transgenic rats and wild-type littermates were exposed to cigarette smoke or sham for 8 weeks. Lung compliance and histology were assessed. Bronchoalveolar lavage (BAL), primary alveolar macrophages (AM), and serum samples were obtained. A rat alveolar macrophage cell line was exposed to the HIV protein Tat, and MMP-9 levels were assessed by Western immunoblotting. MMP-9 protein expression and activity were assessed in AM from the HIV rat model by ELISA and cytoimmunofluoresence, respectively. Serum from human subjects with and without HIV and tobacco dependence was assessed for MMP-9 levels., Results: MMP-9 expression was significantly increased in rat alveolar macrophages after Tat exposure. HIV-1 transgenic rats developed emphysema while wild-type littermates did not. MMP-9 expression was also increased in the serum, BAL, and AM of HIV-1 transgenic rats after exposure to cigarette smoke compared with wild-type rats. In parallel, serum samples from HIV+ smokers had higher levels of MMP-9 than subjects without HIV and those who did not smoke., Conclusion: The combination of HIV and cigarette smoke increases MMP-9 expression in experimental rat HIV models and human subjects. HIV and cigarette smoke both induce alveolar oxidative stress and thereby increase MMP-9 activity., Competing Interests: The authors have no conflicts of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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26. Pediatric spontaneous retropharyngeal emphysema: A case report and comparative analysis of the existing literature.
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Arredondo Montero J, González Ruiz Y, and Bronte Anaut M
- Subjects
- Humans, Child, Emphysema etiology, Mediastinal Emphysema diagnostic imaging
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- 2023
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27. Gastric emphysema after percutaneous endoscopic gastrostomy placement.
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Mabuchi S, Mabuchi H, and Watari T
- Subjects
- Male, Humans, Aged, 80 and over, Gastrostomy adverse effects, Emphysema diagnostic imaging, Emphysema etiology, Gastritis diagnosis, Gastritis etiology, Gastritis therapy, Intraabdominal Infections
- Abstract
Emphysematous gastritis and gastric emphysema are different diseases. Sometimes, we treat the diseases without distinguishing them clearly because both are rare, and the mortality rate of emphysematous gastritis cases is high (55%). Gastric emphysema is more well known than is emphysematous gastritis after percutaneous endoscopic gastrostomy (PEG) placement (80%). Particularly, it is a self-healing disease, and treatment with antibiotics is not required. CT is commonly used to diagnose emphysematous gastritis and gastric emphysema. The amount of radiation exposure is a concern for performing multiple CTs following air disappearance in the gastric wall. Here, we report the case of a 92-year-old man with gastric emphysema after PEG. It was useful to follow-up the patient by performing radiographic examination, and the disease was managed conservatively without antibiotic administration. We report that distinguishing gastric emphysema from emphysematous gastritis was necessary. Moreover, performance excessive tests and treatments should be avoided., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2022
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28. Emphysematous cystitis in a haemodialysis patient.
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Fukui S, Tamaki H, and Masato O
- Subjects
- Humans, Renal Dialysis, Cystitis diagnostic imaging, Cystitis etiology, Cystitis therapy, Emphysema diagnostic imaging, Emphysema etiology
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2022
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29. A population-based cohort study on the risk of obstructive lung disease after bilateral oophorectomy.
- Author
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Nguyen TT, Smith CY, Gazzuola Rocca L, Rocca WA, Vassallo R, and Dulohery Scrodin MM
- Subjects
- Female, Humans, Middle Aged, Cohort Studies, Ovariectomy adverse effects, Risk Factors, Bronchitis, Chronic etiology, Pulmonary Disease, Chronic Obstructive diagnosis, Asthma epidemiology, Asthma etiology, Emphysema etiology
- Abstract
There is increasing evidence that sex hormones may impact the development of obstructive lung disease (OLD). Therefore, we studied the effect of bilateral oophorectomy (oophorectomy) on the development of OLD. Women were identified from the Mayo Clinic Cohort Study of Oophorectomy and Aging-2. Data were collected using the Rochester Epidemiology Project records-linkage system. A total of 1653 women who underwent oophorectomy and 1653 referent women of similar age were assessed for OLD using diagnostic codes and medical record abstraction. Women who underwent oophorectomy had an overall higher risk of all OLD, all chronic obstructive pulmonary disease (COPD), emphysema, and chronic bronchitis but not of all asthma, confirmed asthma, or confirmed COPD. The association with all OLD was stronger in women who were age ≤45 years at oophorectomy, never smokers, non-obese, and in women with benign indications; however, the interactions were not statistically significant. There was an increased risk of all asthma in women age ≤45 years at oophorectomy who took estrogen therapy. Never smokers of all ages had a stronger association of oophorectomy with all asthma and all COPD, whereas smokers had a stronger association of oophorectomy with emphysema and chronic bronchitis. Non-obese women of all ages had a stronger association of oophorectomy with all COPD, emphysema, and chronic bronchitis. The results of this study combined with the increased risk of several chronic diseases reported in previous studies suggest that oophorectomy in premenopausal women should be avoided unless there is clear evidence of a high genetic risk of ovarian cancer., (© 2022. The Author(s).)
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- 2022
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30. Venous gas caused by emphysematous pyelonephritis: a case report and review of literature.
- Author
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Dong X, You S, Zhang H, Wang D, Pan W, Zhang B, Huang S, Li X, Pang J, and Ji W
- Subjects
- Anti-Bacterial Agents therapeutic use, Escherichia coli, Female, Humans, Middle Aged, Vomiting complications, Vomiting drug therapy, beta-Lactamases, Diabetes Complications complications, Diabetes Mellitus, Type 2 complications, Emphysema diagnostic imaging, Emphysema etiology, Emphysema therapy, Pyelonephritis complications, Pyelonephritis diagnostic imaging
- Abstract
Background: Emphysematous pyelonephritis (EPN) is a potentially life-threatening disease caused by a gas-producing necrotizing bacterial infection that involves the renal parenchyma, collecting system, and/or perinephric tissue. EPN is often complicated by a previous diagnosis of diabetes mellitus, and venous air bubbles are an uncommon complication of it. We describe a 52-year-old woman who was admitted in coma, with a history of vomiting, and was found to have EPN with air bubbles in the uterine veins. We discuss the presentation, diagnosis, and pathogenesis of this uncommon but clinically significant event, and briefly review other case reports of venous gas or thrombosis caused by EPN., Case Presentation: We report the case of a 52-year-old woman with past history of type 2 diabetes mellitus, presenting with loss of consciousness after vomiting for half a day. Abdominal computed tomography scan revealed unilateral EPN with air bubbles in the uterine veins. The blood, pus, and urine cultures were positive for extended-spectrum beta-lactamase-producing Escherichia coli. The patient's condition improved well after conservative management comprising supportive measures, broad-spectrum antibiotics, percutaneous drainage therapy, and an open operation., Conclusions: Venous air bubbles are rare but fatal complication of EPN. Early diagnosis and treatment are critical to ensure good results., (© 2022. The Author(s).)
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- 2022
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31. Bronchoscopic Lung Volume Reduction for Emphysema: Review and Update.
- Author
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Koster TD, Dijk MV, and Slebos DJ
- Subjects
- Bronchoscopy adverse effects, Humans, Pneumonectomy adverse effects, Quality of Life, Emphysema etiology, Emphysema surgery, Pulmonary Emphysema surgery
- Abstract
In carefully selected patients with severe chronic obstructive pulmonary disease, characterized by emphysema and hyperinflation, lung volume reduction is an option to reduce lung hyperinflation, improve lung function, quality of life, and exercise capacity. Currently, there are several bronchoscopic and surgical treatment options to achieve lung volume reduction. It is important to carefully phenotype these patients, to select the optimal treatment option, with consideration of possible adverse events or contraindications, and it is highly recommended to discuss these treatment strategies in a multidisciplinary team. The treatment with one-way endobronchial valves has been investigated most extensively and more data are available regarding the treatment of more "marginal cases," or subsequent lung volume reduction surgery. Other bronchoscopic lung volume reduction options include treatment with coils, thermal vapor ablation, and sclerosant agents. In this review, we aim to summarize the current clinical evidence on the bronchoscopic lung volume reduction therapies and important aspects regarding optimal patient selection., Competing Interests: None declared., (Thieme. All rights reserved.)
- Published
- 2022
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32. Effect of hyperhomocysteinemia on a murine model of smoke-induced pulmonary emphysema.
- Author
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Nakano H, Inoue S, Minegishi Y, Igarashi A, Tokairin Y, Yamauchi K, Kimura T, Nishiwaki M, Nemoto T, Otaki Y, Sato M, Sato K, Machida H, Yang S, Murano H, Watanabe M, and Shibata Y
- Subjects
- Animals, Apoptosis, Disease Models, Animal, Homocysteine, Humans, Male, Mice, Mice, Inbred C57BL, Nicotiana adverse effects, Emphysema etiology, Hyperhomocysteinemia complications, Pulmonary Disease, Chronic Obstructive metabolism, Pulmonary Emphysema etiology, Pulmonary Emphysema metabolism
- Abstract
Hyperhomocysteinemia was reported to enhance endoplasmic reticulum (ER) stress and subsequent apoptosis in several cells. However, the precise mechanisms of smoking susceptibility associated with hyperhomocysteinemia has not been fully elucidated. This study included 7- to 9-week-old C57BL6 male mice induced with hyperhomocysteinemia and were exposed to cigarette smoke (CS). A549 cells (human alveolar epithelial cell line) were cultured with homocysteine and were exposed to cigarette smoke extract (CSE) to observe cell viability and expression of proteins related to the ER stress. After 6 months of CS exposure, pulmonary emphysema was more severely induced in the group under the condition of hyperhomocysteinemia compared to that in the control group. The apoptotic A549 cells increased as homocysteine concentration increased and that was enhanced by CSE. Protein expression levels of ER stress markers were significantly increased after simultaneous stimulation. Notably, vitamin B12 and folate supplementation improved ER stress after simultaneous stimulation of A549 cells. In this study, we showed that hyperhomocysteinemia exacerbates CS exposure-induced emphysema in mice, suggesting that hyperhomocysteinemia and CS stimulation enhance ER stress and subsequent induced apoptosis in alveolar epithelial cells. It was suggested that there is a synergistic effect between homocysteine and CS., (© 2022. The Author(s).)
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- 2022
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33. Massive hepatic portal venous gas caused by gastric emphysema.
- Author
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Fukui S, Ito H, Moritani I, and Shiraki K
- Subjects
- Humans, Portal Vein diagnostic imaging, Emphysema diagnostic imaging, Emphysema etiology, Gastritis complications
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2022
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34. Emphysematous pyelonephritis caused by C. glabrata.
- Author
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Schutz EA, Zabott AP, Boaretto RBB, Toyama G, Morais CF, Moroni JG, and Oliveira CS
- Subjects
- Candida glabrata, Female, Fluconazole, Humans, Diabetes Complications, Emphysema etiology, Emphysema therapy, Pyelonephritis complications, Pyelonephritis diagnosis
- Abstract
Emphysematous pyelonephritis (EPN) is a rare acute necrotizing infection of the kidney and surrounding tissues, with gas in the renal parenchyma, collecting system or perirenal tissue. The bacterial etiology predominates; mainly Gram-negative bacilli; Candida spp. and C. albicans are rarely described. We describe a case of EPN caused by C. glabrata, sensitive to fluconazole in a young, hypertensive woman with undiagnosed diabetes mellitus (DM), with renal dysfunction upon admission; her abdominal CT scan found a volumetric increase in the left kidney, signs of gas collections and perirenal blurring. Despite the antimicrobial therapy instituted, due to clinical refractoriness, a double J catheter and subsequent total nephrectomy were indicated, with good postoperative evolution. Her uroculture showed C. glabrata sensitive to fluconazole, and the pathology study showed tubular atrophy and intense interstitial inflammatory infiltrate. Despite the serious, potentially fatal condition, we could control the infection and the patient recovered fully. Poor DM management is an important triggering factor, and it is of great relevance to identify the EPN through imaging exams due to the peculiarities of its clinical and potentially surgical management.
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- 2022
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35. Meta-analysis and Systematic Review of Bronchoscopic Lung Volume Reduction Through Endobronchial Valves in Severe Emphysema.
- Author
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Patel M, Chowdhury J, Zhao H, Lu X, Roth S, Giovacchini CX, Wahidi MM, and Criner G
- Subjects
- Bronchoscopy adverse effects, Forced Expiratory Volume, Humans, Pneumonectomy adverse effects, Quality of Life, Treatment Outcome, Emphysema etiology, Pulmonary Emphysema
- Abstract
Background: Pharmacologic therapeutics for advanced emphysema have limited benefit. Bronchoscopic lung volume reduction with endobronchial valves (EBVs) have reported improvements in lung function, breathlessness, and quality of life through randomized clinical trials, with less morbidity as comparted to Surgical Lung volume Reduction. We here present a Meta-analysis and systematic review of bronchoscopic lung volume reduction in advanced chronic obstructive lung disease patients., Methods: PubMed (NLM), Embase (Elsevier), and Web of Science (Clarivate Analytics) search was conducted using a combination of keywords and subject headings. The search was confined to the last 15 years and was completed on October 23, 2020. Only placebo-controlled randomized control trials of emphysema patients with EBV were included. Quality assessment was done by 2 independent reviewers., Results: Nine studies were included for the meta-analysis with a total number of 1383 patients of whom 888 received EBV and 495 standard of care (SOC) medications. Our Metanalysis show statistically significant improvement in forced expiratory volume in first second, percentage forced expiratory volume in first second, St. George's respiratory questionnaire, and 6-minute walk distance in EBV group compared with SOC. Residual volume had statistically significant reduction after EBV placement compared with SOC. These differences continued to be present during short-term (<=6 mo) and long-term follow-up (>=6 mo). These improvements were even higher when the EBV patients'. Collateral ventilation was negative/fissure was intact (CV-/FI >90%). The rate of hemoptysis and pneumothorax was higher in the EBV group compared with SOC, however, did not lead to increased fatal outcomes., Conclusion: In conclusion, EBV has favorable effects on patients' outcomes in patients who have heterogeneous emphysema particularly with no collateral ventilation., Competing Interests: Disclosure: M.M.W. is a consultant for PulmonX and Olympus. G.C. has funding for medical writing from GlaxoSmithKline. He has research grants from Alung Technologies Inc, American College of Radiology, American Lung Association, AstraZeneca, BioScale Inc, Boethringer Ingelhelm, BREATH therapeutics Inc, COPD foundation, Coridea/ZIDAN, Corvus, Dr. Karen Burns of St. Michaels Hospital, Fisher & Paykel Healthcare ltd, Galapagos NV, GlaxoSmithKline, Kinevent, Lungpacer Medical Inc., National Heart Lung and Blood Institute, Nurvaira Inc, Patient-Centered Outcomes Research Insititute, Pulmonary Fibrosis Foundation, PulmonX, Respironics Inc., Respivant Sciences, Spiration Inc., Steward St. Elizabeth’s Medical Center of Boston Inc., Veracyte Inc. He has also received personal fees from Amgen, Astrazenaca, Boehringer Ingelheim, Broncus Medical, CSA Medical, EOLO Medical, Gala Therapeutics, GlaxoSmithKline, Heilos Medical, Ion, Merck, Medtronic, Mereo BioPharma, NGM Biopharmaceuticals, Novartis, Olympus, PulmonX, Respironics Inc, Respivant Sciences, The implementation Group and Verona Pharma. For the remaining authors there are no conflict of interest or other disclosures., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2022
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36. A forgotten double-J ureteral stent resulting in an emphysematous perinephric abscess: A case report.
- Author
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Lee IH, Shin HS, and Ahn DJ
- Subjects
- Abscess therapy, Child, Female, Humans, Middle Aged, Stents adverse effects, Abdominal Abscess etiology, Abdominal Abscess surgery, Emphysema etiology, Kidney Diseases etiology, Ureter, Urinary Tract Infections complications
- Abstract
Rationale: Double-J stents (DJSs) are urologic devices widely used for urinary tract obstruction treatment. Perinephric abscess is a condition with purulent accumulation resulting from urinary tract infection retained between the renal capsule and Gerota's fascia. Emphysematous urinary tract infection in patients with a forgotten DJS is extremely rare. Herein, we report a case of emphysematous perinephric abscess as a complication in a 56-year-old non-diabetic woman who neglected a 10-year-old DJS placed for obstructive uropathy treatment., Patient Concerns: The patient presented with fever and abdominal pain that persisted for 4 days. Laboratory examinations showed leukocytosis, hypoalbuminemia (2.3 g/dL), and elevated C-reactive protein level (305.5 mg/L) with no azotemia., Diagnosis: Abdominal computed tomography scan revealed a DJS with encrustation and multiple stones in the right kidney as well as a perinephric abscess with gas formation., Interventions: Intravenous administration of piperacillin/tazobactam was initiated immediately and percutaneous catheter drainage was performed. Extended-spectrum beta-lactamase-producing Escherichia coli was identified on abscess culture and antibiotics were switched to meropenem, resulting in gradual improvement of the inflammatory lesion. The patient was referred to the urology department for retained DJS removal and vesicolitholapaxy. A piece of fractured stent was removed via open ureterolithotomy., Outcomes: Since discharge on hospital day 42, she has been under regular follow-up, and the surgical wound has been healing with no significant sequelae., Lessons: Prompt medical therapy for inflammation and thorough urologic correction of the stent-induced structural deformities are crucial in long-term neglected DJS and resulting emphysematous perinephric abscess. Patients who undergo DJS placement should be systematically followed up to prevent potential neglect of device management., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2022
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37. Cardiopulmonary Effects of Bronchoscopic Left Lung Volume Reduction in the Native Emphysematous Lung Following a Right Lung Transplant Complicated by Main Stem Narrowing.
- Author
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Lashari BH, McSurdy K, and Criner GJ
- Subjects
- Humans, Lung diagnostic imaging, Pneumonectomy adverse effects, Emphysema etiology, Lung Transplantation adverse effects
- Published
- 2022
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38. Emphysematous Aortitis.
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Traver EC and Gao NJ
- Subjects
- Blood Vessel Prosthesis, Humans, Aortitis complications, Aortitis diagnostic imaging, Emphysema diagnostic imaging, Emphysema etiology
- Published
- 2022
- Full Text
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39. Emphysematous gastritis with left gastric artery gas precipitated by adhesional intestinal obstruction.
- Author
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Tan RJ, Yeo CS, and Chan DYS
- Subjects
- Gastric Artery, Humans, Tissue Adhesions, Emphysema diagnostic imaging, Emphysema etiology, Gastritis complications, Gastritis diagnosis, Intestinal Obstruction diagnostic imaging, Intestinal Obstruction etiology, Intestinal Obstruction surgery
- Published
- 2022
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- View/download PDF
40. Emphysematous pyelonephritis in a kidney transplant recipient.
- Author
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Hassanein M, Aleter O, Stephany BR, Eltemamy M, and Augustine JJ
- Subjects
- Humans, Kidney diagnostic imaging, Transplant Recipients, Emphysema diagnostic imaging, Emphysema etiology, Kidney Transplantation adverse effects, Pyelonephritis diagnosis
- Published
- 2022
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41. Emphysematous pancreatitis: Clinical course and management.
- Author
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Borao Laguna C, Martínez Domínguez SJ, Saura Blasco N, Hernández Ainsa M, García Mateo S, Velamazán Sandalinas R, Hijos Mallada G, Abad Baroja D, Alfaro Almajano E, Cañamares Orbis P, and García Rayado G
- Subjects
- Humans, Emphysema diagnostic imaging, Emphysema etiology, Emphysema therapy, Pancreatitis diagnostic imaging, Pancreatitis etiology, Pancreatitis therapy
- Published
- 2022
- Full Text
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42. Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort.
- Author
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Ezponda A, Casanova C, Divo M, Marín-Oto M, Cabrera C, Marín JM, Bastarrika G, Pinto-Plata V, Martin-Palmero Á, Polverino F, Celli BR, and de Torres JP
- Subjects
- Cohort Studies, Comorbidity, Dyspnea, Female, Humans, Male, Prevalence, Retrospective Studies, Tomography, X-Ray Computed, Bronchiectasis diagnostic imaging, Bronchiectasis epidemiology, Bronchiectasis etiology, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease epidemiology, Coronary Artery Disease etiology, Emphysema diagnostic imaging, Emphysema epidemiology, Emphysema etiology, Pulmonary Disease, Chronic Obstructive diagnostic imaging, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive mortality
- Abstract
Background and Objective: The availability of chest computed tomography (CT) imaging can help diagnose comorbidities associated with chronic obstructive pulmonary disease (COPD). Their systematic identification and relationship with all-cause mortality have not been explored. Furthermore, whether their CT-detected prevalence differs from clinical diagnosis is unknown., Methods: The prevalence of 10 CT-assessed comorbidities was retrospectively determined at baseline in 379 patients (71% men) with mild to severe COPD attending pulmonary clinics. Anthropometrics, smoking history, dyspnoea, lung function, exercise capacity, BODE (BMI, Obstruction, Dyspnoea and Exercise capacity) index and exacerbations rate were recorded. The prevalence of CT-determined comorbidities was compared with that recorded clinically. Over a median of 78 months of observation, the independent association with all-cause mortality was analysed. A 'CT-comorbidome' graphically expressed the strength of their association with mortality risk., Results: Coronary artery calcification, emphysema and bronchiectasis were the most prevalent comorbidities (79.8%, 62.7% and 33.9%, respectively). All were underdiagnosed before CT. Coronary artery calcium (hazard ratio [HR] 2.09; 95% CI 1.03-4.26, p = 0.042), bronchiectasis (HR 2.12; 95% CI 1.05-4.26, p = 0.036) and low psoas muscle density (HR 2.61; 95% CI 1.23-5.57, p = 0.010) were independently associated with all-cause mortality and helped define the 'CT-comorbidome'., Conclusion: This study of COPD patients shows that systematic detection of 10 CT-diagnosed comorbidities, most of which were not detected clinically, provides information of potential use to patients and clinicians caring for them., (© 2022 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.)
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- 2022
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43. Predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis: 5-year experience in a tertiary care hospital.
- Author
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Arrambide-Herrera JG, Robles-Torres JI, Ocaña-Munguía MA, Romero-Mata R, Gutiérrez-González A, and Gómez-Guerra LS
- Subjects
- Adult, Aged, Female, Humans, Intensive Care Units, Male, Middle Aged, Retrospective Studies, Tertiary Care Centers, Emphysema epidemiology, Emphysema etiology, Emphysema therapy, Hypoalbuminemia complications, Pyelonephritis epidemiology, Pyelonephritis therapy
- Abstract
Introduction and Objectives: Emphysematous pyelonephritis is a life-threatening infection of the kidney and surrounding tissues associated with a high mortality rate. The aim of this study was to determine predictive factors for mortality and intensive care unit admission in patients with emphysematous pyelonephritis, and to propose a therapeutic algorithm based on current literature and our experience., Methods: A retrospective study was done including patients with emphysematous pyelonephritis in a single center in the north of Mexico from 2011 to 2016. Demographic, clinical, microbiological and biochemical parameters, therapeutic management, and outcomes were assessed. Factors associated with admission to intensive care unit and mortality were determined. Comparison was assessed using X
2 test for categorical variables, and T-test for numerical variables. Univariate and multivariate logistic regression analyses were performed. Statistical significance was set at P < .05., Results: A total of 63 patients were included, of which 55 (87.3%) were females, with a mean age of 55.5 ± 12.2 years. The most common comorbidities were diabetes and hypertension. Escherichia coli was the most common isolated microorganism (51.7%) and extended-spectrum beta-lactamase-producing agents were reported in 31.7%. Conservative therapy was provided to 38.7%, double J stent 42.9%, open/percutaneous drainage 12.7%, and nephrectomy 25.3%. Overall mortality and intensive care admission were 20.6% and 36.5%, respectively. In the multivariate analysis, hemodynamic instability (P = .005), qSOFA ≥ 2 (P = .003), hypoalbuminemia (P = .02), and early nephrectomy (P = .002) were associated with intensive care admission. Huang scale 4 (P = .006) and early nephrectomy (P = .001) were associated to mortality., Conclusions: Emphysematous pyelonephritis is a life-threatening disease and evidence of management is based in small case series due to the low incidence of this condition. Hemodynamic instability, hypoalbuminemia, qSOFA ≥ 2, Huang scale ≥3, and early nephrectomy are associated with poor prognosis., (Copyright © 2021 AEU. Published by Elsevier España, S.L.U. All rights reserved.)- Published
- 2022
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44. Emphysematous changes and lower levels of plasma irisin are associated with bronchiolitis obliterans syndrome after bilateral living-donor lobar lung transplantation.
- Author
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Shiotani T, Sugimoto S, Yamamoto H, Miyoshi K, Otani S, Suzawa K, Yamamoto H, Okazaki M, Yamane M, and Toyooka S
- Subjects
- Adult, Biomarkers blood, Emphysema blood, Emphysema diagnosis, Emphysema etiology, Female, Humans, Male, Middle Aged, Patient Acuity, Syndrome, Young Adult, Bronchiolitis Obliterans diagnosis, Bronchiolitis Obliterans etiology, Emphysema pathology, Fibronectins blood, Living Donors, Lung Transplantation adverse effects, Postoperative Complications diagnosis, Postoperative Complications etiology
- Abstract
Purpose: Decreased irisin levels may be associated with the development of emphysema. Similarly, emphysematous changes may develop in patients with chronic lung allograft dysfunction (CLAD) after living-donor lobar lung transplantation (LDLLT). We investigated the severity of emphysematous changes and the relationship between irisin levels and CLAD after bilateral LDLLT and cadaveric lung transplantation (CLT)., Methods: The subjects of this retrospective study were 59 recipients of bilateral LDLLT (n = 31) or CLT (n = 28), divided into a non-CLAD group (n = 41), a LDLLT-CLAD group (n = 11), and a CLT-CLAD group (n = 7). We compared the severity of emphysematous changes, the skeletal muscle mass, and the plasma irisin levels among the groups., Results: The emphysematous changes were significantly more severe in the LDLLT-CLAD and CLT-CLAD groups (p = 0.046 and 0.036), especially in patients with bronchiolitis obliterans syndrome (BOS), than in the non-CLAD group. Although the skeletal muscle mass was similar in all the groups, the plasma irisin levels were significantly lower in the LDLLT-CLAD group (p = 0.022), especially in the patients with BOS after LDLLT, than in the non-CLAD group., Conclusion: Emphysematous changes and lower levels of plasma irisin were associated with CLAD, especially in patients with BOS, after bilateral LDLLT., (© 2021. Springer Nature Singapore Pte Ltd.)
- Published
- 2022
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45. [Retroperitoneal drainage for apostematous pyelonephritis in a patient with severe COVID-19 infection and diabetes mellitus type 1].
- Author
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Lobanov LS, Lobanov YS, Shapovalov KG, Lobanov SL, and Filev AP
- Subjects
- Adolescent, Drainage, Humans, SARS-CoV-2, COVID-19, Diabetes Mellitus, Type 2, Emphysema diagnosis, Emphysema etiology, Emphysema surgery, Pyelonephritis complications, Pyelonephritis diagnosis
- Abstract
The authors report successful surgical treatment of apostematous pyelonephritis complicated by sepsis in an 18-year-old patient with severe COVID-19 pneumonia (CT-2) and diabetes mellitus type 1. Active surgical approach with retroperitoneal drainage and decapsulation of the right kidney ensured positive dynamics in the treatment of destructive pyelonephritis, course of diabetes mellitus and elimination of sepsis. These aspects determined favorable outcome of disease.
- Published
- 2022
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46. Trauma with an air compressor, a massive emphysema.
- Author
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Geslain G, Ntorkou A, Ali L, Naudin J, and Levy M
- Subjects
- Humans, Emphysema diagnostic imaging, Emphysema etiology, Pulmonary Emphysema diagnostic imaging, Pulmonary Emphysema surgery, Subcutaneous Emphysema diagnostic imaging, Subcutaneous Emphysema etiology
- Published
- 2022
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47. Chronic bronchitis and emphysema among workers exposed to dust, vapors, or fumes by industry and occupation.
- Author
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Doney B, Kurth L, and Syamlal G
- Subjects
- Adult, Dust, Humans, Nutrition Surveys, Occupations, Prevalence, Bronchitis, Chronic epidemiology, Bronchitis, Chronic etiology, Emphysema epidemiology, Emphysema etiology, Occupational Diseases diagnosis, Occupational Diseases epidemiology, Occupational Diseases etiology, Occupational Exposure adverse effects
- Abstract
Exposures to dust, vapors, or fumes (DVF) are associated with chronic bronchitis (CB) and emphysema. The 2007-2012 National Health and Nutrition Examination Survey data were used to estimate age-standardized prevalence of CB and emphysema among ever-employed adults by exposure status and industry and occupation groups. Age-standardized CB and emphysema prevalence were 2.3% and 1.9%, respectively. Of the estimated 111 million U.S. workers exposed to DVF, 2.7% reported CB and 2.8% reported emphysema. Workers in the "accommodation, food services" industry and "food preparation, serving related" occupations were more likely to report CB and emphysema. Current findings indicate that workplace exposures may be associated with high prevalence of CB and emphysema in certain industry and occupational groups. Early diagnosis and identifying associated workplace exposures are important steps in CB and emphysema prevention efforts.
- Published
- 2022
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48. Emphysematous cystitis complicated by liver abscess.
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Zeng L and Wang Q
- Subjects
- Humans, Cystitis complications, Cystitis diagnostic imaging, Emphysema diagnostic imaging, Emphysema etiology, Liver Abscess diagnostic imaging, Liver Abscess etiology
- Abstract
Competing Interests: The authors declared no potential conflicts of interest.
- Published
- 2021
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49. Serum amyloid A promotes emphysema by triggering the reciprocal activation of neutrophils and ILC3s.
- Author
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Kim J, Shin JW, Lee HJ, Kim JH, Choi SM, Lee CH, Kang HR, Park SH, Bae YS, Chung DH, and Kim HY
- Subjects
- Humans, Immunity, Innate physiology, Serum Amyloid A Protein metabolism, Emphysema etiology, Lymphocytes drug effects, Serum Amyloid A Protein adverse effects
- Published
- 2021
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50. A 56-Year-Old Man With Emphysema, Rash, and Arthralgia.
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Goel K, Maleki-Fischbach M, George MP, Kim D, Richards J, Wise RA, and Serban KA
- Subjects
- Autoantibodies blood, Bronchodilator Agents administration & dosage, Diagnosis, Differential, Humans, Immunologic Factors administration & dosage, Male, Middle Aged, Patient Care Management methods, Rituximab administration & dosage, Arthralgia diagnosis, Arthralgia etiology, Complement C1q analysis, Complement C1q immunology, Complement C4 analysis, Emphysema diagnosis, Emphysema etiology, Exanthema diagnosis, Exanthema etiology, Prednisolone administration & dosage, Pulmonary Arterial Hypertension diagnosis, Pulmonary Arterial Hypertension etiology, Vasculitis, Leukocytoclastic, Cutaneous blood, Vasculitis, Leukocytoclastic, Cutaneous diagnosis, Vasculitis, Leukocytoclastic, Cutaneous physiopathology
- Abstract
Case Presentation: A 56-year-old man presented to the pulmonary clinic with dyspnea and hypoxemia on exertion. He was an avid biker and skier who had noticed a significant decrease in high-level physical activity over the past 3 years. He reported dyspnea, desaturations at altitudes higher than 9,000 feet, dry cough, tachycardia, and palpitations with exercise. Review of systems was also notable for gluten-intolerance, Raynaud's phenomenon, recurrent skin lesions and joint swelling, pain, and stiffness in the areas overlying the jaw, wrists, knees, and ankles (after capsaicin exposure). He denied fever, chills, anorexia, weight loss, hair loss, ocular symptoms, jaw claudication, chest pain, or lower extremity swelling. He had a five pack-year smoking history, no history of prematurity, childhood asthma, recurrent infections, or environmental and occupational exposure. Based on pulmonary function tests from an outside provider, he had received a diagnosis of exercise-induced asthma and had been prescribed an albuterol inhaler to use on an as-needed basis, which failed to improve his symptoms. He was later prescribed a mometasone-formoterol inhaler, still with no symptomatic improvement., (Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
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