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This article examines the management of benign airway stenosis in patients with COVID-19. The study compares the results of endoscopic dilation as a treatment for airway stenosis in COVID-19 patients to a control group. The study finds that COVID-19 infection does not negatively impact the success of endoscopic treatment and there is no significant difference in recurrence rates between the COVID-19 group and the control group. The article provides detailed information on the study design, patient data, endoscopic procedures, and statistical analysis. Another study discussed in the article focuses on the management and recurrence of laryngotracheal stenosis (LTS) in COVID-19 patients compared to those without COVID-19. The study finds that COVID-19 patients have a longer intubation time and a lower rate of tracheostomy compared to the control group. The recurrence rate of LTS is similar between the two groups, and COVID-19 infection is not a significant predictive factor for recurrence. Subglottic stenosis and the use of laser are identified as independent prognostic factors for stenosis recurrence. The study concludes that the endoscopic treatment for COVID-19 patients with simple tracheal stenosis should be similar to that for the general population. However, the study acknowledges limitations such as a small sample size and the lack of a standardized treatment protocol. [Extracted from the article]

Bartonella quintana is a louse-borne gram-negative bacillus that remains a poorly characterized cause of bacteremia, fever, and infective endocarditis. Due to the link with pediculosis, B quintana transmission is tied to poverty, conflict, overcrowding, and inadequate water access to maintain personal hygiene. Although these risk factors may be present globally, we argue that a substantial burden of undocumented B quintana infection occurs in Africa due to the high prevalence of these risk factors. Here, we describe the neglected burden of B quintana infection, endocarditis, and vector positivity in Africa and evaluate whether B quintana meets criteria to be considered a neglected tropical disease according to the World Health Organization. [ABSTRACT FROM AUTHOR]

As reported by ACCP/ERS guidelines, EBUS-TBNA is preferred for evaluating malignant lymph nodes and staging of primary lung cancer. Different molecular targeted drugs are widely used for the treatment of non-small cell lung cancer harboring driver gene mutations. Transbronchial mediastinal cryobiopsy allows accessing mediastinal lymph nodes to perform miniprobe cryobiopsy; it can obtain samples with a larger volume than EBUS-TBNA, with less blood contamination and crush artefacts. Furthermore, transbronchial lung cryobiopsy may be used to sample peripheral pulmonary lesions. Cryotherapy is effective for the treatment of malignant central airway obstruction; symptoms of dyspnoea, cough and haemoptysis are significantly reduced after cryotherapy; more attention needs to be put on the cryoimmunology, in order to study new therapeutic treatments for primary lung cancer. [ABSTRACT FROM AUTHOR]

Early diagnosis has demonstrated a significant reduction in mortality from primary lung cancer. Current imaging techniques guiding tissue sampling of pulmonary lesions during bron-choscopy suffer from one common drawback: the CT scan used to create a navigation map is acquired in separate time and environment and that results, during a procedure, in a so-called ‘CT-to-body-divergence’. Cone Beam CT (CBCT) is a technique that brings a significant improvement in bronchoscopy as allows to more accurately locate both bronchoscope and target lesions by generating a set of thomo-graphic images, although preserving capabilities of a real time fluoroscopic guidance. CBCT can improve the diagnostic yield of pulmonary lesions biopsies and can enable precise therapeutic procedures for selected peripheral nodules (e.g. photodynamic ablation during bronchoscopy). [ABSTRACT FROM AUTHOR]

Objectives: To determine the outcome of subclinical lupus myocarditis (LM) over twelve months with regards to: mortality; incidence of clinical LM and change in imaging parameters (echocardiography and cardiac magnetic resonance [CMR]). To evaluate the impact of immunosuppression on CMR evidence of myocardial tissue injury. Methods: SLE patients with and without CMR evidence of myocardial injury (as per 2009 Lake Louise criteria [LLC]) were included. Analysis at baseline and follow-up included: clinical evaluation, laboratory and imaging analyses (echocardiography and CMR). Clinical LM was defined as clinical features of LM supported by echocardiographic and/or biochemical evidence of myocardial dysfunction. Subclinical LM was defined as CMR myocardial injury without clinical LM. Results: Forty-nine SLE patients were included with follow-up analyses (after 12 months) available in 36 patients. Twenty-five patients (51%) received intensified immunosuppressive therapy during follow-up for indications related to SLE. Disease activity (SLEDAI-2K) improved (p < 0.001) from 13 (median;IQR:9–20) to 7 (3–11). One patient without initial CMR evidence of myocardial injury developed clinical LM. Mortality (n = 10) and SLE clinical features were similar between patients with and without initial CMR myocardial injury. Echocardiographic left ventricular ejection fraction (LVEF) (p = 0.014), right ventricular function (p = 0.001) and wall motion abnormalities (p = 0.056) improved significantly but not strain analyses nor the left LV internal diameter index. CMR mass index (p = 0.011) and LVEF (p < 0.001) improved with follow-up but not parameters identifying myocardial tissue injury (LLC). A trend towards a reduction in the presence of CMR criteria was counterbalanced by persistence (n = 7) /development of new criteria (n = 11) in patients. Change in CMR mass index correlated with change in T2-weighted signal (myocardial oedema) (r = 386;p = 0.024). Intensified immunosuppressive therapy had no significant effect on CMR parameters. Conclusion: CMR evidence of subclinical LM persisted despite improved SLEDAI-2K, serological markers, cardiac function and CMR mass index. Subclinical LM did not progress to clinical LM and had no significant prognostic implications over 12 months. Immunosuppressive therapy did not have any significant effect on the presence of CMR evidence of myocardial tissue injury. Improvement in CMR mass index correlated with reduction in myocardial oedema and may be used to monitor SLE myocardial injury. [ABSTRACT FROM AUTHOR]

Copyright of Rassegna di Patologia dell'Apparato Respiratorio is the property of AIPO - Associazione Italiana Pneumologi Ospedalieri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rassegna di Patologia dell'Apparato Respiratorio is the property of AIPO - Associazione Italiana Pneumologi Ospedalieri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Classical toxin-mediated respiratory diphtheria has become less common because of widespread effective vaccination globally but invasive disease as a result of non-toxigenic strains of Corynebacterium diphtheriae is not prevented by vaccination and may result in severe disease, including infective endocarditis (IE)., Objectives: To describe the outbreak and subsequent investigation of a cluster of five cases of non-toxigenic C. diphtheriae endocarditis., Method: A retrospective observational case series of five cases of non-toxigenic C. diphtheriae endocarditis identified in the rural West Coast district of the Western Cape province of South Africa between May 2021 and June 2021., Results: Non-toxigenic C. diphtheriae IE had an aggressive clinical course with high mortality in this cohort. Only one of five patients survived to hospital discharge. The surviving patient received a prompt diagnosis with early surgical intervention but still had a complicated clinical course. Notably, only one case had a pre-existing risk factor for IE, namely a prosthetic valve. Whole genome sequencing of clinical isolates confirmed that all isolates were of the same novel sequence type of non-toxigenic C. diphtheriae but despite a thorough investigation no epidemiological link was ever found between the cases., Conclusion: Non-toxigenic strains of C. diphtheriae are less well known but may be highly virulent and cause severe invasive disease., Contribution: This is the largest cluster of non-toxigenic C. diphtheriae IE ever described in South Africa and expands the body of literature on this unusual but possibly emerging infection., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2024. The Authors.)

Bartonella quintana is a louse-borne gram-negative bacillus that remains a poorly characterized cause of bacteremia, fever, and infective endocarditis. Due to the link with pediculosis, B quintana transmission is tied to poverty, conflict, overcrowding, and inadequate water access to maintain personal hygiene. Although these risk factors may be present globally, we argue that a substantial burden of undocumented B quintana infection occurs in Africa due to the high prevalence of these risk factors. Here, we describe the neglected burden of B quintana infection, endocarditis, and vector positivity in Africa and evaluate whether B quintana meets criteria to be considered a neglected tropical disease according to the World Health Organization., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)