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Background Medical information regarding critically ill coronavirus disease 2019 (COVID-19) patient course of disease and outcomes are fundamental to providing the best medical care and avoiding possible complications. Objective To evaluate the clinical characters, outcomes, and mortality risk factors in COVID-19 critically ill patients Patients and methods In our study, 31 adult ICU patients admitted to Sohag General Hospital and Health Insurance Hospital in Sohag Governorate were included from September 2020 to October 2020. Coronavirus was affirmed by an reverse transcriptase-PCR of a nasopharyngeal swab. Clinical information was separated from clinical sheets. Results The mean age of the patients was 60 years, 61.3% were males, 64.5% had comorbidities, which were more in improved than dead cases (P

Introduction The occurrence of chronic obstructive airway disease and obstructive sleep apnea (OSA) is a popular syndrome called overlap syndrome. Aim To evaluate the prevalence of OSA in chronic obstructive pulmonary disease (COPD). Patients and methods A total of 86 patients with COPD (54.65% men, with a mean age of 62.065 years) were included in our study. Clinical criteria and biochemical tests were registered, and polysomnography was done. Results Overall, 38 patients with an apnea–hypopnea index more than 5 events/h were defined as having overlap syndrome (44.19%). Conclusion The results showed an OSA prevalence of 44.19% in patients with COPD. A sleep study should be considered in overweight patients with COPD, even in patients without symptoms of sleep apnea.

Background Global oxygenation can be indirectly measured by the measurement of venous oxygen saturation. Objective To estimate the value of central venous oxygen saturation (ScvO2) to predict the outcome in type 1 acute respiratory failure (ARF) patients admitted to the respiratory ICU and to assess its potential association with mortality. Patients and methods The study included 62 type 1 ARF patients admitted to respiratory ICU with indication for a central venous catheter. ScvO2 was measured from right atrium blood samples at admission, 3 and 7 days later. Arterial blood gas was assessed simultaneously. The patients were classified into three groups according to the ScvO2 level (at admission): high more than 75%, normal 65–75%, and low less than 65% (9, 34, and 19 patients, respectively). The best ScvO2 cutoff value associated with the mortality was considered the critical value of ScvO2. Acute physiology and chronic health evaluation (APACHE) II score severity, ICU, and hospital stay, and hospital mortality were reported. Results Sixty-two type 1 ARF patients with a mean age of 60±17.4 years were included. Seventy-nine percent patients had pneumonia. Mechanical ventilation was indicated in 77.4% of the patients with a mean duration of 6±3.6 days. The mean ScvO2 at day 0, 3, and 7 were 67.7±8.1, 66±11, and 69.3±9.3, respectively. The mean hospital stay was 6.8±4 days; 72.6% of the patients died in the hospital. Overall mortality in patients with low, normal, and high ScvO2 (at admission) were 42.2, 40, and 17.8%, respectively. Abnormal low and high ScvO2 was significantly related to mortality (P

Background Weaning has been classified into simple, difficult, and prolonged. Objective The aim of this study was to assess predictors of prolonged weaning (PW) and survival in the respiratory ICU (RICU). Patients and methods Fifty-three patients admitted to RICU and requiring mechanical ventilation (MV) were included in the study. According to the classification of weaning, patients were categorized into simple [20 (37.7%)], difficult [20 (37.7%)], and PW [13 (24.5%)]. Factors associated with PW and outcomes were assessed. Results Multiple factors were associated with PW: decreased serum Ca2+ (P

Background Sleep disorders have their well-documented deleterious effect on quality of life (QoL). The QoL impairment cannot be detected by polysomnography, which is the gold standard diagnostic tool for diagnosis of obstructive sleep apnea (OSA). Objective This study aimed at the evaluation of QoL, fatigue, depression and anxiety in OSA patients. Relation of QoL to disease severity and sex differences was assessed. Correlation of QoL scores to each other was assessed. Patients and methods We used three disease-specific QoL tools, namely the functional outcome of sleepiness questionnaire-10, the sleep apnea quality of life index, and the OSA patient-oriented severity index. Fatigue, anxiety, and depression were estimated using fatigue severity scale and hospital depression and anxiety scale, respectively. Results A total 170 participants were included; of them, 100 were OSA patients and 70 were non-OSA. OSA patients showed significantly lower QoL and more fatigue, depression, and anxiety symptoms in comparison with the non-OSA group, with more impairment of QoL in severe OSA patients. Female patients with OSA showed more QoL impairment. The highest correlation was observed between the sleep apnea quality of life index and the OSA patient-oriented severity index: r=−0.90, P value less than 0.001. Conclusion This study highlighted the significance of QoL, fatigue, anxiety and depression assessment in OSA patients, especially in those with severe disease.

Objectives. To highlight the possible complications of medical thoracoscopy (MT) and how to avoid them. Methods. A retrospective and prospective analysis of 127 patients undergoing MT in Nagoya Medical Center (NMC) and Toyota Kosei Hospital. The data about complications was obtained from the patients, notes on the computer system, and radiographs. Results. The median age was 71.0 (range, 33.0–92.0) years and 101 (79.5%) were males. The median time with chest drain after procedure was 7.0 (range, 0.0–47.0) days and cases with talc poudrage were 30 (23.6%). Malignant histology was reported in 69 (54.3%), including primary lung cancer in 35 (27.5), mesothelioma in 18 (14.2), and metastasis in 16 (12.6). 58 (45.7%) revealed benign pleural diseases and TB was diagnosed in 15 (11.8%). 21 (16.5%) patients suffered from complications including lung laceration in 3 (2.4%), fever in 5 (3.9%) (due to hospital acquired infection (HAI) in 2, talc poudrage in 2, and malignancy in 1), HAI in 2 (1.6%), prolonged air-leak in 14 (11.0%), and subcutaneous emphysema in 1 (0.8%). Conclusions. MT is generally a safe procedure. Lung laceration is the most serious complication and should be managed well. HAI is of low risk and can be controlled by medical treatment.

Abstract Background Amyloidosis is the extracellular deposition of amyloid fibril protein in any tissue or organ. The clinical manifestations of pulmonary amyloidosis are variable and without specific symptoms. We report a rare case of diffuse alveolar septal amyloidosis which is an extremely rare pattern of involvement, with a very poor prognosis, to improve our understanding of the disease. Case presentation A 27-year-old man complained of shortness of breath and cyanosis. High-resolution computed tomography revealed diffuse ground-glass opacifications with interlobular septal thickening in both lungs. The immune-histochemistry showed monoclonal lambda light chains. This case also showed nephrotic syndrome and cardiac arrhythmia, suggesting an involvement of the kidney and the heart. Diagnosis: The diagnosis was finally established by tru-cut transthoracic sonar guided lung biopsy (TSLB), and histological examination revealed Congo red-positive amorphous eosinophilic deposits in the alveolar sept. Interventions: The patient was admitted to a respiratory intensive care unit and put on non-invasive ventilation, then discharged on domiciliary oxygen therapy, and started treatment with chemotherapy melphalan 2 mg daily plus prednisone 60 mg daily immediately after the result of histopathology. Outcomes: Three months after treatment, dyspnea and hypoxemia improved, and he continued treatment. The patient was in a good clinical condition after 10 months of follow-up, but he died suddenly. Conclusion As it is difficult to distinguish diffuse alveolar septal amyloidosis from other interstitial and granulomatous lung diseases because of their similar symptoms and imaging findings, thus, transthoracic sonar guided lung biopsy and histological examination is very important in the diagnosis of diffuse alveolar septal amyloidosis.

Objective: To assess the effect of exposure to flour dust on respiratory symptoms and lung function of flour mill workers and to estimate the additive effect of smoking on pulmonary function. Patients and methods: This study was carried out at flour mills in Sohag Governorate. Two hundred male workers with current exposure to flour dust and two hundred non-exposed male as a control group were interviewed and self designed study questionnaire was administered to them and the parameters of their pulmonary function were measured. Results: Respiratory symptoms such as cough, expectoration, wheezing, and shortness of breath, were significantly (p