Research on diagnosis and treatment of pulmonary tuberculosis \r\n', u'at Department of Respiratory of Bach Mai Hospital \r\n', u'

Background: Pulmonary tuberculosis is a contagious bacterial infection that mainly involves the lungs, but may spread to other organs. Most people who develop symptoms of a tuberculosis infection first became infected in the past. However, in some cases, the disease may become active within weeks after the primary infection. Objective: To evaluate the diagnosis and treatment of pulmonary tuberculosis. Subjects and method: A retrospective study included 196 patients with pulmonary tuberculosis hospitalized in Department of Respiratory of Bach Mai Hospital in 2 years (2002 - 2003). Patients\ufffd?information of medical records was collected. Results and conclusions: 60.7% of patients were male and 39.3% were female. Tuberculous pleurisy was 59%, parenchymal lung tuberculosis 36%, and the others 5%. Clinical signs and symptoms included chest pain 67.9%, dyspnea 61.2%, cough 72.9% (nonproductive cough: 42.3%; productive cough: 30.6%), fever 61.2%. Dull to flat percussion, decreased to absent breath sound and fremitus 65.3% (89% tuberculous pleurisy). 27.6% of patients had positive AFB evident (smear, bronchial lavage fluid). The first line drugs were usually used in treatment of tuberculosis.

Transbronchial lung biopsy via the fibreoptic bronchoscope \r\n', u'in diagnosis of the lung diseases \r\n', u'

Background: Bronchoscopy is an essential technique for diagnosis of some lung diseases by taking samples for histological and cytological tests. Objective: To assess the role of transbronchial lung biopsy procedure in diagnosis some parenchymal pulmonary diseases. Subjects and method: A retrospective study conducted in 50 patients with diffuse and localized lung diseases, who were admitted to the Department of Respiratory in Bach Mai Hospital, from January 2003 to December 2005. Results: Transbronchial lung biopsy confirmed the diagnosis in 30 of 50 (60%) cases; with localized malignant lesions (12%), diffuse lung disease (16%), tuberculosis (28%), and cystic fibrosis (4%). Following transbronchial lung biopsy, two patients had pneumothorax (1 patient had chest tube drainage) and five patients had hemoptysis but no of them required further treatment. Conclusions: Transbronchial lung biopsy offer good diagnostic accuracy and low complication rate.

Clinical, subclinical manifestations and treatment of sarcoidosis \r\n', u'in Department of Respiratory of Bach Mai Hospital \r\n', u'

Background: Sarcoidosis is a rare systemic granulomatous disorder with unknown cause. It is rare in the world and Vietnam. Objective: To study clinical, subclinical manifestations and therapy of sarcoidosis in Department of Respiratory of Bach Mai Hospital. Subjects and method: A study included 14 patients in Department of Respiratory of Bach Mai hospital, from 1989 to August 2006. This was a retrospective, descriptive study. Results and conclusions: In 14 patients, 14 patients (78.6%) was females, 3 (21.4%) was males. The disease occurred common in the ages of 20-49 years (85.7%). The clinical symptoms were very multiform but pulmonary symptoms were the most manifestations (78.6%). Abnormalities on chest radiographs were 92.8%, with stage 0 (7.1%), stage 1 (57.2%), stage 2 (28.6%), stage 3 (7.1%). Histopathologically, injuries of the sarcoidosis were typical in 9 patients (64.3%). The corticoid therapy satisfied the most success in 92.8% of patients. The side effects of the treatment occurred in 4 of 12 patients.

Clinical, subclinical characteristics and treatment results of 768 patients with pleural effusion

Background: A pleural effusion is an abnormal collection of fluid in the pleural space resulting from excess fluid production or decreased absorption. It is the most common manifestation of pleural disease. Objective: To evaluate the etiological, clinical, subclinical characteristics and treatment results of patients with pleural effusions. Subjects and method: This was a retrospective, descriptive study on 768 patients with pleural effusion, who were treated in Department of Respiratory of Bach Mai Hospital, from January 2001 to October 2003. The information was taken from clinical records of patients. Results and conclusions: The causes of pleural effusion were tuberculosis 37.6%, lung cancer 23.8%, pneumonia or lung abscess 8.0%, chronic heart failure disease 7.1%, liver cirrhosis 3.5%, others causes 6.7% of cases. The patients presented with chest pain 81.6%, dyspnea 75.1%, cough 43.8%, expectoration 29.7%, and fever 54.8%, pleural effusion syndrome 92.2% of cases. On chest X-ray images, 75.3% of cases had Damoiseau curve. Pleural ultrasound demonstrated free pleural effusion in 63.8% of cases, loculated pleural effusion and pleural compartmentalization in 19.8%. Rivalta test of pleural fluid was positive in 83.7% of cases, negative in 13.7%. Malignant cells found in pleural fluid of 21.2%. Histology of pleural biopsies demonstrated malignant in 17.4% of cases; in which mesothelioma 4.0%, pleural tuberculosis 30.5%; others 52.1%. After the treatment, recovery accounted for 6.3% of cases, amelioration 58.3%, and no amelioration 37.4%. 66.9% of cases were performed therapeutic thoracocentesis, 2.7% were performed pleural lavage.

Research the epidemiology of chronic obstructive pulmonary disease in the population of Bac Giang city

Background: Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease caused worldwide. Objective: To research the epidemiology of COPD in the population of Bac Giang city and finding out the risk factors of COPD. Subjects and method: Cross-sectional survey of general population sample of 2,104 men and women with the age \ufffd?0 years in 30 wards of 11 communes of Bac Giang city. Data on respiratory symptoms, diseases, and risk factors were collected. Lung function tests were performed with Spiroanalyzer snoo, Japan. Results and conclusions: The incidence of COPD was 2.3%; in men 3.0% and in women 1.7%. The incidence of simple chronic bronchitis was 6.4%. People who smoked had higher rate of COPD than the others (OR = 2.8). The incidence of smoking in COPD was 55.9%. The three most important risk factors of COPD was the age \ufffd?0; smoking >15 pack/year and medical history of asthma.

Preliminary results of streptokinase in the treatment of exudative \r\n', u'pleural effusions and empyema \r\n', u'

Background: Standard treatment for pleural infection includes of drainage and antibiotics. Chest tube drainage often fails if the fluid is loculated by fibrinous adhesions. Intrapleural fibrinolysis may facilitate pleural drainage. Objective: To evaluate the role of Streptokinase (STK) in the treatment of empyema and exudative pleural effusions. Subjects and method: A study included 34 patients (21 patients with exudative pleural effusions, 13 patients with empyema), aged 15-77 years. All patients received intrapleural STK daily with dose of 300.0000-500.000 UI for empyema and 300.000 UI for exudative pleural effusions. Response was assessed by clinical outcome, pleural fluid drainage, chest radiography, pleural ultrasound. Results: Mean pleural fluid drainage after STK instillation was higher in all patients. Pleural fluid drainage was 640 \xb1 494 ml before STK instillation and 823 \xb1 755 ml after STK instillation for empyema; 765 \xb1 691 ml before STK instillation and 1,033 \xb1 757 ml after STK instillation for exudative pleural effusions. The success rate of clinical outcome was 100%. Only 2 patients required decortications. Fever occurred in 3 patients (8.8%) and allergy in 1 patient (3%). Conclusions: Intrapleural STK was safe and effective in the treatment of empyema and exudative pleural effusions. STK prevents pleural adhesions and reduces the risks for surgery.

Studying on value of thoracoscopy in the diagnosis and treatment of pneumothorax

Background: Thoracoscopy has used for lots of thoracic disorders. Pneumothorax may be ideally suited for thoracoscopic management. Objective: To study the value of thoracoscopy in the diagnosis and treatment of pneumothorax. Subjects and method: From September 2003 to October 2006, 30 patients with pneumothorax were treated by thoracoscopy at Department of Respiratory of Bach Mai Hospital. This was a longitudinal, retrospective and prospective study. Prospective study included 15 patients from September 2005 to October 2006. Retrospective study included 15 patients from September 2003 to August 2005. Results: In 30 patients, primary spontaneous pneumothorax accounted for 80%, secondary spontaneous pneumothorax 13.3%, catamenial pneumothorax 3.3% and iatrogenic pneumothorax 3.3%. Mean age of patients was 34\xb115 years (ranged from 17 to 77 years). 90% of cases were male. Bullea was found in 70% by thoracoscopy. Patients were in stage I 13.3%, stage II 20%, stage III 33.3%, and stage IV 33.3%. There were 3 procedures with ligation, 11 procedures with coagulator, 25 procedures with talc poudrage; mean dose of talc was 8.2\xb12.2 g. The success rates of procedures with talc poudrage were 80% and 100% after supplemental pleurodesis. Complications and side effects were subcutaneous emphysema 46.7%, empyema 3.3%, high fever 3.3% that we thought was nosocomial infections, bleeding in pleural cavity 3.3%, chest pain 96.7%, fever 63.3%, dyspnea 10%. After a mean follow up of 14.1\xb110.4 months, the recurrent rate was 3.3%. Conclusions: Medical thoracoscopy achieved a high success rate in the diagnosis and treatment of pneumothorax.

Studying on clinical, subclinical manifestations and lung CT-scan images of patients with empyema

Background: Empyema is not rare in Vietnam and in the world. Objective: To study clinical, subclinical manifestations and lung CT-scan images of patients with empyema. Subjects and method: A study included 50 patients of empyema treated in Department of Respiratory of Bach Mai Hospital, from January 2003 to August 2005. This was a retrospective, prospective, descriptive, cross-sectional, controlled study. Results and conclusions: Most empyema commonly occurred in the setting of bacterial pneumonia. Empyema was common in males and the male-to-female ratio was 2.82. The onset of empyema was suddenly with clearly infection syndrome (high fever, increased WBC count, accelerated erythrocyte sedimentation rate), chest pain, and cough. CT images of empyema were ipsilateral; almost empyema was free pleural effusion and moderate in size. Thickening pleura was 72% and located pleura were 42%. Positive culture of pleural fluid was very low (24%). Gram (-) bacteria was predominant (P. Aeruginosa 33.3%, K. Pneumoniae 25%).

Study on clinical characteristics and the TNM staging of non-small \r\n', u'cell lung cancer \r\n', u'

Background: Non-small cell lung cancer is the most common type of lung cancer. It usually grows and spreads more slowly than small cell lung cancer. Objective: To describe clinical characteristics and the TNM staging of non-small cell lung cancer. Subjects and method: It was a prospective study on clinical characteristics and the TNM staging of 53 patients with non-small cell lung cancer in Bach Mai Hospital from January 2005 to June 2005. Results and conclusions: The most common age was over 40, accounting for 92.5%, male/female (2.5/1). 64.2% of cases with smoking history (97.1% for men and 2.9% for women). 79.4% of patients had smoked over 20 years. The concordance of diagnosis between the previous hospitals and Bach Mai hospital was 34.6%. The most common clinical symptoms at the time of diagnosis were chest pain, prolonged cough, haemoptysis, weight lost and pleural effusion syndrome. Basing on the 1997 International Staging System of Non-Small Cell Lung Cancer, we have found that T4 in 64.2%, N(+) 64.2% and metastasis in 32.1%. IIIB and IV stage in 75.5%, patients with IA to IIIA stages being able to be operated was 24.5% of cases. 92.5% of patients were over 40 years old; male/female: 2.5/1. 79.4 of patients had smoked cigarette over 20 years.

Some new recommends in diagnosis and treatment of COPD

The article introduced two approaches for diagnosis of chronic obstructed pulmonary disease (COPD): definitive diagnosis by pulmometry with bronchial dilation maneuver and staging diagnosis. 4 current treatments include: reducing risk factors, drug treatment in stable periods (treatment regimen, bronchodilators, glucocorticoid and other medication), non-drug treatment (rehabilitation, long-term oxygen therapy, surgical treatment) and treatment for exacerbation.

Value of various methods of sampling in the diagnosis of lung cancer

The purpose of this study is to compare prospectively the role of transthoracic fine needle aspiration lung biopsy (TFNAB), bronchoscope, sputum cytology in the diagnosis of lung tumors and evaluate the method of small lesion in basing only on chest radiography. We performed 120 TFNAB on 102 in patients with mass lesion visible on chest radiography. The needle of 21 gauge was used. 86 patients with lung cancer, 58 had rigid bronchoscope, 66 had 1 sputum cytological exam, 60 had 2 sputum cytological exams. TFNAB had a highest sensitivity (84.4% for the first time) with a rate of correct cytological typing in 76.7% of cases suffering from lung cancer. It was complicated with pneumothorax in 4 cases (3.3%), hemoptysis in 4 cases with small lesions, two rules in aluminum sawed at interval of 5mm were fixed on the chest wall then the chest radiography was taken to determine the site and the distance of puncture for the TFNAB with good success