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Open Access Journal of Pulmonary And Respiratory Sciences

ISSN(p): | ISSN(e):2642-1143
Journal Papers (31) Details
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Indexed Journal

1 Intermittent and Mild Persistent Asthma in Young Children, Adolescents and Adults: What Treatment Options? , Cheepsattayakorn A* and Cheepsattayakorn R
Matching the treatment intensity with the severity of asthmatic symptoms is the basic treatment for asthma. Intermittent treatment with rapid symptom relief should be administered in asthmatic patients with infrequent and mild symptoms whereas a long-term controller medication should be given to patients with mild, persistent symptoms. Oral glucocorticoids requirement are encouraged to take daily controller medication to prevent asthmatic attacks in patients with mild, intermittent symptoms whose asthma often occur more than two times per year. Ongoing patient education, effective communication, and regular reassessment of asthma control are critical for long-term success in all types of asthma
2 Hopes for Curing Cystic Fibrosis Lung Disease by Non-Viral Gene Therapy , Di Gioia S* and Conese M
In 2015, interesting results have been published in a Phase IIb clinical trial for the treatment of cystic fibrosis (CF), and in particular for the lung disease occurring in this genetic syndrome.
3 Mine Dust and Pulmonary Health , Tripathy DP*
Mining activities mainly deal with the excavation of raw material from earth’s crust. The sources of particulate matter (PM) emission in opencast coal mines include blasting and drilling operations, coal handling plant operation, loading and transport of overburden and coal by shovel-dumper combination, crushing, conveying and handling of overburden by draglines, and vehicular emission from unpaved roads
4 Bird-On-Tree Appearance , Nobuhiro Kanaji*, Nobuyuki Kita, Norimitsu Kadowaki, and Shuji Bandoh
Birds can cause or mediate several pulmonary diseases including psittacosis and hypersensitivity pneumonitis called bird breeder’s lung. “Bud-in-tree” appearance is 2 to 4 mm centrilobular nodules or branching linear structures with more than one contiguous branching site and usually suggests bronchiolitis including diffuse panbronchiolitis and pulmonary infectious diseases such as mycobacterium infections. We here present a novel bird-related finding “bird-on-tree” appearance. In addition, birds can cause a nodule with spiculation called “nestoma”. These findings are usually observed only in winter.
5 Forgetting Curve on Basic Cardiopulmonary Resuscitation Competence in Simulation Models , Moises Natanael DlSR* , Eduardo GL, Ramón IEH, Gilberto SB, Pablo MGM and Laura REA
Introduction: Simulation model based medical education considerably improves skills on health professionals to perform high-quality cardiopulmonary resuscitation (CPR); nevertheless recent studies report low competence for CPR in latter-year students, which might be explained due to loss of skill due to the time lapse between training and actual experience. Method: This was a cohort study, performed at UADY School of Medicine’s Simulation Laboratory. 27 third-year (preclinical, group A) and 31 fifth-year (clinical, group B) students were included. Both groups received the same training by the same instructor during two weeks, and were periodically evaluated over a 3-month period. Results: Forgetting occurred in 40 (69%) students; 2 (7.4%) of group A by the first month, 14 (51.9%) by the second month, and 19 (70.4%) by the third month. On group B, forgetting occurred in 3 (9.7%) students by the first month, 18 (58.1%) by the second month, and 21 (67.7%) by the third month. No significant differences were found between groups (p=0.992). Conclusion: Competence for basic CPR in simulation models is lost within 3 months after training. There were no statistically significant differences between students already in clinical practice and those who have not started clinical practice.
6 The Human Fish Challenges with the Management of a Massive Air Leak after Pleurectomy , Martinez-Ruiz R, Matadial CM, Benitez-Lopez J and VillamizarOrtiz N
The human respiratory system is usually our“gold standard” when we compare other species’ respiratory systems; however, human lungs happen to be very inefficient compared to the gills in fish or the avian respiratory system. Try transferring oxygen (O2) from low O2water content or flying above Everest without supplemental O2! One of the reasons for the apparent inefficiency stems from the fact that the human respiratory system (like any mammal) has dead space: a common airway for the entry and exhaust of gases.
7 Pulmonary Arterial Hypertension Associated Systemic Sclerosis , Attapon C* and Ruangrong C
Pulmonary hypertension (PAH) affects up to 12 % of patients with systemic sclerosis (SSc), with mortality rate of 50 % within 3 years. Patients with SSc-associated PAH (SSc-PAH) have three times increased risk of death, compared to idiopathic PAH (IPAH). SSC-PAH patients may receive a diagnosis late in the course of disease due to insidious onset and the high prevalence of musculoskeletal, cardiac, and pulmonary parenchymal comorbidities. Conventional therapies often yield poor results, compared to IPAH cohorts.
8 Brief Review of Pharmacotherapy for Pulmonary Arterial Hypertension , Chokkalingam MB* and Scharf M
Pulmonary arterial hypertension affects the distal pulmonary vasculature causing intimal, medial, adventitial fibrosis, thickening and periadventitial changes leading to progressive increase in pulmonary vascular resistance and pulmonary arterial pressure [1]. Pulmonary hypertension (PH) is defined as mean pulmonary artery pressure equal to or greater than 25 mm Hg at rest
9 History of Mechanical Ventilation , Ghilas Boussaïd*
Background: In neuromuscular diseases, mechanical ventilation can be used to assist weakened respiratory muscles or compensate for a loss of respiratory control. A return on History may let understand the different strategies for using non-invasive and invasive of mechanical ventilation. Methods: A literature review was carried out from the PubMed, google scholar and the archives of the medical library of Descartes in Paris with the following key words "history" "mechanical ventilation" and "neuromuscular diseases". Results: France has played a major role in the development of mechanical ventilation at home. It was one of the first countries to set up a truly organized and efficient charging system. Today, the French system allows care to be taken care of at home, with genuine coordination between the hospital department, the equipment distribution network, the attending physician, the nurses, the physiotherapists, the patient and his family. Conclusion: Despite improved respiratory care, especially with the introduction of mechanical ventilation, there is a disparity in the management of respiratory care in the world
10 Sleep Apnea- Therapeutic Settings, Acclimation and Tolerance to Therapy , Shakkour-Perez H*
Sleep Apnea is a disorder that affects a vast number of our population. It is not gender or age specific. Sleep Apnea is primarily caused by an obstruction in the airway due to airway collapse or instability. Once the airway collapses/relaxes during sleep, air cannot pass freely, resulting in a pause in breathing. As this occurs, the blood oxygen levels drop below adequate values, causing hypoxemia.
11 Air Pollution Risk Assessment using Air Quality Index (AQI) , Debi Prasad T* and Tushar Ranjan D
Air is the major resource and need for sustenance of life. The advancement in technology a huge quantity of data on ambient air quality is produced and used to begin the quality of air in various areas. As per World Health Organization (WHO), air pollution refers to the presence of unwanted material in the ambient air which are harmful to mankind and their environment
12 Application of 2D-DIGE in Identification of Differentially Expressed Proteins of Mycobacterium Bovis BCG in Nonculturable and Rpf Mediated Resuscitation Phase , Amita Yadav, Ravi Kr Gupta, A Srinivasan, Tej P Singh, Brahm S Srivastava and Ranjana Srivastava*
Prolonged incubation of Mycobacterium tuberculosis and Mycobacterium bovis BCG culture in stationary phase induces a true dormancy generating nonculturable (NC) cells. Recovery of NC cells to replicating phase can be promoted by resuscitation promoting factor (Rpf) of Micrococcus luteus. There are five homologs of Rpf proteins in M. tuberculosis and M. bovis BCG and all are individually able to resuscitate the nonculturable cells of mycobacteria. In this study, we have exploited fluorescent 2D-DIGE technique to compare the protein expression profile in nonculturable and resuscitation phase cells of M. bovis BCG. The study led us to identify eight proteins that were abundantly expressed in resuscitation phase and eight proteins with pronounced expression in nonculturable state. The differential expression of corresponding genes in two phases of growth was also analyzed at mRNA level using real time-PCR analysis. The study suggests several differentially expressed proteins belonging to intermediary metabolism and respiration, lipid metabolism, information pathway, virulence detoxification and adaptation, cell wall and cell processes categories at protein as well as RNA level that intend their role in the resuscitation phase, which might be crucial in exit from dormancy.
13 Open Lung Approach in Acute Respiratory Distress Syndrome , Attapon C* and Ruangrong C
Outcome of acuten respiratory distress syndrome (ARDS) is conclusively affected by the approach to ventilator support. Substantial controversy in the application of positive end-expiratory pressure (PEEP) and the use of lung recruitment still exists.
14 Inflammatory Response in Acute Lung Injury: A Comparison between Intratracheal and Intubation Administration of P. Aeruginosa Lipopolysaccharide , Di Gioia S*, di Toma L, Castellani S and Conese M
In humans, the hallmark of the acute lung injury (ALI) is a neutrophilic inflammatory response with fibrin-rich proteinaceous exudates containing an array of pro- and anti-inflammatory cytokines.
15 Video Assisted Informed Consent Process on Level of Satisfaction and Cognition among Patients Undergoing Invasive Therapeutic / Diagnostic Cardiac Procedure , Kripa Angeline A*, Renuka K, Bhavithiran K, Bhuvaneshwari M, Dhivya G, Dhivya Bharathi V, Dhivya R
Background: The heart is a vital muscular organ in humans which pumps blood through the body's arteries and veins and the center of body’s circulatory system. Healthy arteries enable your body to respond well to periods of stress and changes in your blood pressure. If arteries become narrow or blocked (coronary artery disease, or CAD), heart attack or stroke may occur. People with cardiovascular disease or who are at high cardiovascular risk need early detection and management using counseling and medicines, as appropriate Achieving informed consent for therapeutic /diagnostic procedures is a core clinical procedure. In addition to routine consent process patients are invited to watch the video of the therapeutic/diagnostic procedure to gain knowledge of perspective what is involved and assessed its impact on patient satisfaction. Materials and Methods: True experiments (post test only design) was used for this study and sample size is 80, with 40 each in experimental and control groups. The cardiology patients were selected from MGMC and RI, puducherry by using simple randomized sampling technique. The data were collected by using structured questionnaire and standardized patient satisfactory tool. The questionnaire consists of multiple choice questions. The period of data collection was around two weeks. For control set of questions were given and ask them to answer the questions. For control group, video was shown related to invasive therapeutic/diagnostic procedures, after a set questions were given and ask them to answer the questions. Aim: The main aim of the current study was to assess the effectiveness of the patient level of satisfaction and cognition regarding informed consent by routine method and video assisted method for invasive therapeutic/diagnostic procedures and also to compare effectiveness of routine method Vs video assisted method on level of satisfaction and cognition for informed consent among patient undergoing invasive therapeutic/diagnostic procedures. Results: The post test score on level of knowledge among patients undergoing invasive therapeutic/diagnostic procedure after video assisted method revealed that 40 had adequate knowledge in experimental group. The post test score on level of satisfaction among patient undergoing invasive therapeutic/diagnostic procedure after vide assisted method revealed that 40 were fully satisfied in experimental group
16 Global Asthma Research with Special Reference to India: A Scientometric Assessment of Publication Output during 2007-16 , Gupta BM, Jeevanjyot Kaur, Kiran Baidwan and Ritu Gupta*
The paper examines 2094 Indian publications on asthma research, as covered in Scopus database during 2007-16, registering an annual average growth rate of 12.14%, global share of 2.72%, qualitative citation impact averaged to 10.857citations per paper and international collaborative publication share of 13.51%. The top 12 most productive countries individually contributed global share from 2.72% to31.27%, with largest global publication share coming from USA (31.27%), followed by U.K. (10.45%), Germany (5.60%), Canada (5.44%), etc. Together, the 12 most productive countries accounted for 83.80% share of global publication output during 2007-16.Medicine, among subjects, accounted for the highest publications share (61.32%), followed by pharmacology, toxicology & pharmaceutics (35.05%) biochemistry, genetics & molecular biology (20.25%), immunology & microbiology (7.78%), agricultural & biological sciences (3.44%) and chemistry (2.88%) and during 2007-16. Among different type of asthma, allergic asthma contributed the highest number of publications, followed by bronchial asthma, atopic asthma, occupational asthma and seasonal asthma, etc. during 2007-16.The top 15most productive organizations and authors together contributed 33.48% and 19.96% respectively as their share of global publication output and 43.88% and 36.93% respectively as their share of global citation output during 2007-16. Among 2059 journal papers, the top 15 journals contributed 25.89% share to the Indian journal output during 2007-16. Only 29 publications registered citations from 100 to 868 and received 6792 citations, with citations per paper of 234.21.
17 Modern Treatment of Community-Acquired Pneumonia: A Scientific Justification or Belief in a Panacea? , Igor Klepikov*
The results of scientific research are the basis and intellectual potential of practical medicine and its main driving force of improvement and development. When the results of such research become clear and generally accepted, they can usually acquire the features of direct directives for practical application.
18 Oncological Emergencies in Chest Medicine , Gamal Agmy*
Lung cancer is the most common malignancy coexisting in patients with venous thromboembolism (VTE). A large population-based, case–control study demonstrated that patients with hematologic malignancies had the highest risk of VTE, followed by patients with lung and gastrointestinal cancers.
19 Alpha-1 Antitrypsin Genotypes in Patients with Chronic Obstructive Pulmonary Disease , Attapon C and Ruangrong C
Alpha-1 antitrypsin (AAT), a proteinase inhibitor produced by the SERPINA1 gene that protects the pulmonary alveoli and other connective tissues in the lungs against the destructive effects of neutrophil elastase and other proteases. SERPINA gene is known to be associated with COPD.
20 Increased Risk of HIV-Associated Pulmonary Diseases by Environmental Factors , Chinnapaiyan S*, Dutta R and Unwalla HJ
People living with HIV (PLWH) are at increased risk of airway abnormalities and exacerbation of several lung diseases. Several diseases such as primary lung cancer, chronic obstructive pulmonary disease (COPD), asthma, pulmonary arterial hypertension, bronchial hyper responsiveness and sleep-disordered breathing can be exacerbated by environmental factors such as second-hand cigarette smoke, diesel exhaust, etc. In the United States, HIV smokers outnumber HIV nonsmokers by a 3-fold margin. Moreover, use tobacco is one of emerged as a leading cause of death and comorbidities in the highly active antiretroviral therapy (HAART) era. For pulmonary diseases in particularly, smoking is the most prevalent but preventable causes of morbidity and mortality affecting PLWH. Incidence of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is already elevated in HIV-infected compared to uninfected patients and current smoking and alcohol abuse further substantially increases the risk of AECOPD. Several studies have also reported a link between high exposure levels of air pollution and the development of airflow obstruction as well as prevalence of COPD. Some other environmental factors due to rapid urbanization and industrialization may also contribute to COPD in HIV, This is possibly due to increased occupational dust exposure. This review will discuss the current highly risk of HIVassociated pulmonary disease by environmental factors such as tobacco smoke and air pollution (includes outdoor and indoor air pollutant).
21 Systemic Lupus Erythematosus Female with (Diffuse Large BCell) Non-Hodgkin’s Lymphoma , Salem M, Alharbi O, Alhujely A, Abdaljawad M and Alharbi A*
Systemic lupus erythematosus (SLE) is an autoimmune disease with multisystem complications arising from both underlying disease activity and therapy-related side effects. SLE’s association with lymphoma is a well-established phenomenon. Studies have reported a higher incidence of lymphoma in the SLE population compared with healthy cohorts [1,2]. A 45-year-old woman with systemic lupus erythematosus (SLE) presented with fever, cough, sputum, loss of appetite and fatigue for 4 months. Before that time, her (SLE) symptoms had been well controlled on hydroxyl chloroquine, azathioprine, and small dose prednisone. Physical exam at initial evaluation was remarkable for bilateral inspiratory crackles. Laboratory investigations were normal. Computed tomography to chest showed bilateral cavitary pulmonary nodules and masses. Bronchoscopy with transbronchial biopsy was done. The histopathology showed diffuse large B-cell non-Hodgkin’s lymphoma. Patient referred to oncology service, where they started her on 4 cycles of R-CHOP, followed by 4cycles of high dose chemotherapy (HDCT). She underwent Hematopoietic stem cell transplantation, and achieved complete remissions.
22 The Imperative of Modern Concepts of Acute Pneumonia in Comparison with Basic Medical Science , Igor Klepikov*
The reason for my present appeal is to draw the attention of a wide range of experts to long-known and proven scientific facts, which despite their importance remain unclaimed.
23 A Prospective Observational Study in a Tertiary Care Hospital to Evaluate the Utility of Pleural Fluid Cholesterol and Lactate Dehydrogenase (LDH) in Differentiating Exudative from Transudative Pleural Effusions , Sujith Halappa, Gayathri Devi HJ*, Majeed Pasha MD and Padmaja MS
Background: Light’s criteria have been the gold standard to differentiate exudative from transudative pleural effusions. It requires biochemical estimations from both pleural fluid and serum which may not be feasible in all patients due to economic constraints. Pleural fluid cholesterol and Lactate Dehydrogenase (LDH) have been reported to be extremely useful in distinguishing between transudative and exudative pleural effusion. Methods: This was a Prospective Observational study carried out at a tertiary care hospital. In this study with a sample size of 76, pleural fluid cholesterol and LDH were analysed in patients with pleural effusion. Etiological diagnosis was based on clinical history with radiological imaging, biochemical and cytological examination of pleural fluid. Results: The study included 76 patients with 69.7% (n=53) males and 30.3% (n=23) females. The mean age of patients was 48.97 + 17.03 years. Of 76 cases, 62 were exudates and 14 transudates. The sensitivity and specificity of pleural fluid cholesterol (>45mg/dl) for distinguishing exudates from transudates was 98.4% and 86%, while for LDH (>200 mg/dl), 93.5% and 78.6% respectively. Pleural Fluid cholesterol and LDH together (Costa’s Criteria) had a sensitivity of 95% and specificity of 93% for differentiating effusions in comparison to gold standard Light’s criteria which had sensitivity and specificity of 100% and 71.4% which was statistically significant.
24 Rescue of Inherited Traits for Lethal Respiratory Diseases by Prenatal Gene Editing: More than One Single Gene and One Vector , Di Gioia S* and Conese M
A paper recently published in Science Translational Medicine [1] reports for the first time a proof of concept study on the potential application of in utero gene editing to face monogenic lung diseases that are lethal at birth. The authors, belonging to a team of researchers from the Children’s Hospital of Philadelphia and Penn Medicine, focused their attention on a particular type of congenital lung disease characterised by mutations in an essential protein for lung function: the surfactant protein (SP).
25 Successful Prolonged Use of Ketamine Intravenous Infusion in Status Asthmaticus , Muhammad H Gul*, Suresh Kumar and Zin Mar Htun
Status asthmaticus is a life-threatening condition with significant morbidity and mortality. There is limited experience with the use of ketamine intravenous infusion as a sedative in mechanically ventilated status asthmaticus patients. We are reporting a case of mechanically ventilated status asthmaticus patient being successfully managed with prolonged use of ketamine infusion. A 20-year-old female with a history of asthma was admitted for acute severe asthma exacerbation. She had worsening acute hypercarbic respiratory failure despite the treatment with a traditional bronchodilator, steroids, and magnesium, and she was intubated. She became hypotensive with the use of propofol and was started on ketamine infusion, which was continued for four days. Ketamine provided better sedation, blood pressure stability, and gradual improvement in bronchospasm, which led to the successful extubation and resolution of the asthma attack. She did not report any nightmares or dreams with the use of ketamine. Prolonged use of ketamine infusion has not been studied in acute asthma exacerbation. We report a case where ketamine infusion was successfully used for four days in an intubated patient with status asthmaticus without any significant side effects.
26 Acute Respiratory Syndrome and Pneumonia caused by COVID-19: A Systematic Review and Meta-Analysis , Attapon Cheepsattayakorn* and Ruangrong Cheepsattayakorn
Objectives: The objectives of this study are to identify sources of the transmission, the starting date of outbreak, epidemic trend of the COVID-19 in China, risk of global spread, case definition for surveillance, detection, prevention, control, diagnosis, and treatment options. Study Method: A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including ScienDirect, PubMed, Scopus, and ISI Web of Science, including the websites of the news on the google scholar. The search was applied to the articles that were published between 2003 and February 2020. Study Results: With strict literature search and screening processes, it yielded 32 articles from 366 articles of initial literature database and websites of the news. Coronavirus were found in the mid-1960s that can infect both humans and animals (birds and mammals), whereas seven coronaviruses are known to infect humans, such as Betacoronavirus HCoV-OC43 and HCoVHKU1 and Alphacoronavirus HCoV-229E. These coronaviruses primarily target on epithelial cells in the respiratory and gastrointestinal tracts through various routes of transmission, such as respiratory droplets, airborne, fecal-oral or fomites. On December 31, 2019, the Wuhan Municipal Health Commission in Wuhan City, Hubei province, China reported a cluster of 27 pneumonia cases of unknown etiology, including 7 severe cases, with a common reported connection with Wuhan’s Huanan Seafood Wholesale Market (a wholesale fish and live animal market selling different animal species). These cases presented with several infectious respiratory disease, such as fever, dyspnea, and bilateral pulmonary infiltrates on chest roentgenograms. Nevertheless, on January 19, 2020, first COVID-19-infected case of 35-year-old man presented to an urgent care clinic in Snohomish County, Washington was detected and reported in the United States. Intravenous remdesivir (a novel nucleoside analogue prodrug in development) was administrated on the evening of day 7 of hospitalization due to the patient’s ongoing fevers, the persistent positive COVID-19 RNA at multiple sites, and notification of rales in both lungs at a period consistent with the development of roentgenographic pneumonia. On hospital day 8 (illness day 12), there is improvement of the patient’s clinical condition. Another recent study on COVID-19 inhibition in vitro by remdesivir and chloroquine demonstrated that these drugs were highly effective in the control of COVID-19 infection in vitro. These drugs should be evaluated in humans infected with COVID-19. Conclusion: Without implementation of proper infection prevention and control measures at the point of care for individuals under investigation, there will be a likelihood of disease outbreaks, particularly via traveler transmission, transmission on aircrafts, and healthcare-related transmission in the destination countries. Further investigations for COVID-19 are urgently needed due to its potentially global health threat.
27 Dorothy H Andersen, A Woman in Science and her Importance in Cystic Fibrosis , Sante Di Gioia*, Md Niamat Hossain and Massimo Conese
Cystic fibrosis (CF) is the commonest autosomal recessive disease in the Caucasian population, with an incidence of 1 in 2500 newborns. Nowadays the molecular defect underlying the disease has been clarified and has become the target for both antenatal screening programmes and stratified approaches to treatment.
28 Why can’t be Special Medications for Pneumonia? , Klepikov I*
Each disease known to modern medicine has its own causes (etiology) and mechanisms of development (pathogenesis). Acute pneumonia (AP) is no exception to this rule. The causes of this disease are known, and among them the most common are bacteria, viruses and fungi.
29 COVID-19: Success Depends on Medical Concepts, not Political Views , Klepikov I*
The appearance of the current COVID-19 pandemic has not only significantly changed the usual rhythm and conditions of our life, but also came as a direct surprise to many, causing a sense of anxiety and insecurity. As the new situation developed and its consequences accumulated, long-standing problems that had previously gone unnoticed or unimportant for many were increasingly identified. And if a year ago the discussion of these issues was not perceived properly in the medical community, today the situation itself dictates the need for such an analysis.
30 Surfactant and RDS: What’s a Neonatologist to Do? , Donn SM*
The creation of exogenous pulmonary surfactant has been one of, if not the most, significant breakthroughs in the field of neonatal medicine. The early clinical studies, utilizing either animal-derived surfactants or synthetic preparations, demonstrated an impressive improvement in the survival of preterm infants with respiratory distress syndrome, a disorder whose hallmark is surfactant deficiency.
31 Will the Pill Help Defeat the Coronavirus? , Klepikov I*
The onset of the pandemic has caused widespread concern about the rapid spread of the infection and serious concern about the lack of specific treatment for it. Calls and demands for strict compliance with sanitary and antiepidemic measures, a sharp reduction in direct contacts and movements of people with the introduction of quarantine measures in large regions and even countries have become a familiar modern reality.