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1.
Article | IMSEAR | ID: sea-241957

ABSTRACT

Introduction:- The word 'yoga' is derived from the roots of Sanskrit 'Yuj' which means to join, to attach, to bind, yoke and a concentrate or one attention. The literal meaning of the word 'Yoga' is 'yoke'. It means for uniting the individual spirit with the Universal spirit or God. Purpose of the study is to ?nd out the 揈ffect of yoga on Pulmonary Variables among Yoga and Non-Purpose: - Yoga students in Paschim Medinipur District�. To achieve the purpose, total Sixty (60) subjects whose age rangingMaterials & Methods:- between 19-22 years were selected for the study from various college in Paschim Medinipur district, West Bengal. The subjects were divided into two groups. They are Yoga Group and Non- yoga group. Each group contains 30 each. The Pulmonary variables were vital capacity (VC), Inspiratory reserve volume (IRV), expiratory reserve volume (ERV) and Tidal volume (TV) which were measured by Spirometer, .The Yoga group were given the twelve (12) weeks yoga training in Paschim Medinipur district yoga centre. The training schedule was ?xed in the morning session as well as in the afternoon session minimum time duration 60-90 minutes per session with various types of yogasana including slow warming up, warm down and resting time between and set of the exercises. Non-yoga group does not practice yoga training. They are involved in normal physical activities in that period. A pre-test mean score was taken on both groups and the scores were recorded. Similarly, after Twelve (12) weeks of yoga training a post-test mean score was taken and scores were recorded. The Independent Paired- 't' test was conducted for evaluate the data and the level of signi?cance is ?xed at 0.05 level of con?dence. The data was analyzed statistically byResults & Discussion: - computing mean, standard deviation and't' test. It was observed that the Post-test mean score of yoga group were better improved than the Post- test mean scores of Non-yoga group. It is also evident that the calculated value of pulmonary variables in yoga group is more than the table value at 0.05 level of signi?cant. So, the result is signi?cant due to yoga practice. On the other hand, the calculated value of pulmonary variables in Non-yoga group is less than the table value at 0.05 level of signi?cant. So, the result is insigni?cant. The hypothesis is accepted since there was a signi?cant improvement in pulmonary variables due to 12 weeks of yoga training programmes. On the basis of the obtained result,Conclusion: - I concluded that Yogasana helps to improve the pulmonary variables due to twelve (12) weeks of yoga training programmes. So, Yoga group was better than the Non-yoga group.

2.
Article | IMSEAR | ID: sea-241294

ABSTRACT

The occurrence of hemoptysis in patients with COVID-19 and associated fungal infections is not uncommon. Patients may experience mild to massive hemoptysis depending on the underlying cause. We present a case of a middle-aged male who developed severe respiratory distress syndrome and a non-Mucor fungal infection, resulting in massive hemoptysis secondary to a pseudoaneurysm of the pulmonary artery. The diagnosis was confirmed through CT pulmonary angiography, and coiling of the pseudoaneurysm was employed as a treatment modality. Following the treatment, the patient experienced an excellent outcome.

3.
Cambios rev. méd ; 23(2): 972, 30/11/2024. ilus, tabs
Article in Spanish | LILACS | ID: biblio-1579264

ABSTRACT

INTRODUCCIÓN. En Ecuador se diagnosticaron 6094 nuevos casos de tuberculosis en el 2018, siendo la mayoría diagnosticados en las provincias de la costa Las presentaciones extra-pulmonares abarcan una minoría de casos, y la tuberculosis abdominal (intestinal y peritoneal) solo representan el 2,5%, sin embargo, esta prevalencia está en incremento debido al aumento de la sobrevida de pacientes inmunodeprimidos. Las manifestaciones clínicas de esta son muy inespecíficas y puede presentarse como formas ulcerativas o estenosantes (tuberculosis in-testinal) y ascítica o adherencial (tuberculosis peritoneal), pudiendo similar a la enfermedad de Crohn y a la carcinomatosis peritoneal, respectivamente. El manejo de tuberculosis abdominal no complicada se realiza con esquema antifímico similar al empleado en tuberculosis pulmonar, reservando la cirugía para casos de perforación u obstrucción intestinal, fístulas, abscesos o hemorragia. CASO CLÍNICO. Paciente masculino de 28 años con antecedente de enfermedad linfoproliferativa en estudio, presentó cuadro de abdomen agudo secundario a perforación in-testinal, identificando durante periodo transquirúrgico múltiples adenopatías accidentadas con producción de secreción caseosa, con resultado histopatológico de tuberculosis peritoneal e intestinal, requiriendo múltiples intervenciones quirúrgicas por formación de fístulas intestinales. DISCUSIÓN. La tuberculosis abdominal se presenta predominantemente en adultos jóvenes, afectando generalmente la región ileocecal, siendo el abdomen agudo una presentación poco frecuente, por lo que no existe recomendaciones para el manejo quirúrgico de dichas compli-caciones, recomendamos se tome en consideración características generales para el manejo de fístulas de otras causas inflamatorias/infecciosas, siendo fundamental el tiempo en que se planifique la resolución quirúrgica de esta. CONCLUSIÓN. La tuberculosis es un problema de salud pública que puede afectar a diferentes órganos y sistemas, implicando que su sintoma-tología será diversa e inespecífica, requiriendo alta sospecha clínica y epidemiológica para realizar un diagnóstico y tratamiento oportuno que permita mejorar el pronóstico y calidad de vida del paciente.


INTRODUCTION. In Ecuador, 6,094 new cases of tuberculosis were diagnosed in 2018. Most of these occurred in the coastal region. Extrapulmonary presentations cover a minority of cases and abdominal tuberculosis (intestinal and peritoneal) only represents 2.5%, however, this pre-valence is increasing due to the increased survival of immunosuppressed patients. The clinical manifestations of this are non-specific and can present as ulcerative or stenosing forms (intes-tinal tuberculosis) and ascites or adhesion (peritoneal tuberculosis) and may be like Crohn's disease and peritoneal carcinomatosis, respectively. The management of uncomplicated abdo-minal tuberculosis is carried out with an antifimic scheme like that used in pulmonary tubercu-losis, reserving surgery for cases of intestinal perforation or obstruction, fistulas, abscesses, or hemorrhage. CLINICAL CASE. A 28-year-old male patient with a history of lymphoproliferative disease under study presented symptoms of acute abdomen secondary to intestinal perforation, identifying during the surgical period multiple irregular lymphadenopathies with production of caseous secretion, with histopathological results of peritoneal and intestinal tuberculosis, requi-ring multiple surgical interventions for formation of intestinal fistulas. DISCUSSION. Abdominal tuberculosis occurs predominantly in young adults, generally affecting the ileocecal region, with acute abdomen being a rare presentation, so there are no recommendations for the surgical management of these complications. We recommend that general characteristics be taken into consideration for the management of fistulas from other inflammatory/infectious causes, being essential the time in which the surgical resolution is planned. CONCLUSION. Tuberculosis is a public health problem that can affect different organs and systems, implying that its symptoms will be diverse and non-specific, requiring high clinical and epidemiological suspicion to make a timely diagnosis and treatment that improves the patient's prognosis and quality of life.


Subject(s)
Humans , Male , Adult , Tuberculosis , Tuberculosis, Gastrointestinal , Peritonitis, Tuberculous , Tuberculosis, Pulmonary , Public Health , Abdomen, Acute , Ecuador
4.
Ann Card Anaesth ; 2024 Oct; 27(4): 361-363
Article | IMSEAR | ID: sea-240941

ABSTRACT

Re?expansion pulmonary edema (RPE) is a rare complication of minimally invasive cardiac surgery (MICS). We present a case of RPE following atrial septal defect (ASD) closure using a thoracotomy approach and cardiopulmonary bypass (CPB). REP contributes to significant morbidity and extends the length of stays in the intensive care unit. Understanding the pathophysiology and risk factors of RPE allows us to prevent or minimize the incidence.

5.
Article | IMSEAR | ID: sea-240418

ABSTRACT

Background: This study investigates the correlation between different blood groups and pulmonary function, hypothesizing that certain blood groups may exhibit unique pulmonary function profiles, potentially influencing susceptibility to respiratory conditions, thereby providing valuable insights for personalized medicine and improving patient care in respiratory health. Aims and Objectives: The aim of this research is to explore the correlation between different blood groups and pulmonary function, with the objective of identifying unique pulmonary function profiles across blood groups, thereby potentially influencing susceptibility to respiratory conditions, and providing valuable insights for personalized medicine to improve patient care in respiratory health. Materials and Methods: This study, approved by the Institutional Ethics Committee, involved 102 healthy male and female individuals aged 18–20 years, with no known lung diseases. Participants were informed about the study’s aims, objectives, risks, and benefits, and their voluntary consents were obtained. Blood groups were determined, and basic information was collected. Pulmonary function was assessed using a computerized spirometer developed by RMS company, performing tests including forced vital capacity (FVC), forced expiratory volume in first second (FEV1)/FVC, forced expiratory flow rate (FEFR), FEF 25–75, and maximum voluntary ventilation (MVV). Faulty procedures were repeated for accuracy, and data were analyzed using single-factor analysis of variance with MedCalc v22.023, considering P > 0.05 as not significant, P < 0.05 as significant, and P < 0.001 as highly significant. Results: The results of our study indicate significant associations between certain blood groups and various pulmonary function test parameters. The highest obtained FVC was found in the B- blood group, with a significant association (P = 0.041). However, no significant association was found between the percent FVC and blood group (P = 0.924). The FEV1/FVC ratio showed a significant association with the blood group for both obtained and percent values (P = 0.001 and P = 0.002, respectively). The obtained FEF 25–75 showed a strong association with the blood group (P = 0.013), but no association was found for percent FEF 25–75 (P = 0.328). The obtained FEFR showed a strong association with the blood group (P = 0.031), as did the percent FEFR (P = 0.043). Finally, no association was found between MVV and blood groups (P = 0.656). These findings contribute to our understanding of the complex relationship between blood groups and pulmonary function. Conclusion: Our study suggests that individuals with the B-positive blood group tend to have higher pulmonary function values, particularly FEV1/FVC and FEFR. However, further research is needed due to the lower sample size and fewer cases in Rh-negative blood groups.

6.
Article | IMSEAR | ID: sea-240415

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) indicates chronic lung disorders presented by a gradually progressive irrevocable bronchial obstruction (progressive restriction of the enforced expiratory capacity in 1 s forced expiratory volume-1) and manifestation compound of recurring bronchial cough and breathlessness. The patient’s life enters into a vicious cycle due to the complications of concurrent depressive disorder. Aims and Objectives: This research was conducted to evaluate the occurrence of despair among COPD patients in an advanced care hospital using a patient health questionnaire (PHQ-9) scale. Materials and Methods: This research was led subsequently receiving authorization from Institutional Ethical Board and inscribed well-versed agreement from the patients in the department of respiratory medicine. The PHQ-9 scale was employed for screening and assessment of despair yielding relevant details. No intervention was administered for the research. The analysis was based on the information obtained from the investigation reports. Results: Reddy et al. suggested the arbitrary classification of PHQ-9 scores: 0–4 indicates negligible misery, 5–9 minor misery, 10 and higher than indicates reasonable to acute misery. In our research, 39 patients scored PHQ-9 score between 0 and 4, 46 patients scored PHQ-9 score between 5 and 9, and 15 patients scored PHQ-9 score 10 and above. Conclusion: The occurrence of depression among COPD patients is significantly excessive so validated screening tool for depression is required in COPD management.

7.
Article | IMSEAR | ID: sea-240405

ABSTRACT

Background: Acute exacerbations of chronic obstructive pulmonary diseases (AECOPD) are a frequent cause of hospitalization, morbidity, and mortality and require serious medical attention. Much research has demonstrated the beneficial effects of intravenous and nebulized magnesium sulfate (MgSO4) as a bronchodilator, in the management of acute severe asthma. Nevertheless, the extent of the benefits of intravenous MgSO4 as an adjuvant to bronchodilators in AECOPD remains uncertain. Therefore, the current study aims to address this gap in knowledge. Aims and Objectives: The study aimed to compare the effectiveness of intravenous magnesium sulfate (MgSO4) versus placebo when used as an adjuvant to nebulized salbutamol in managing AECOPD. Materials and Methods: In this comparative prospective interventional, parallel-group, placebo-controlled study, a total of 60 subjects were assigned to two groups consisting of 30 individuals each. The allocation was non-randomized and open-label, with one group receiving intravenous MgSO4 as an adjuvant to nebulized salbutamol, while the other group received a placebo in the same manner. The evaluation of MgSO4 efficacy involved measuring the peak expiratory flow rate (PEFR), which served as the primary outcome parameter. PEFR measurements were taken at 0, 15, 30, and 45 min to assess the effectiveness of MgSO4. Safety and tolerability of MgSO4 were assessed based on changes in heart rate, blood pressure, deep tendon reflexes, and respiratory rate. Results: At 45 min, the mean change in PEFR was significantly higher (P = 0.061) in the MgSO4 group (178.33 ± 49.18) compared to the placebo group (155.43 ± 41.86). Moreover, the mean difference in PEFR between the two groups was consistently higher in the MgSO4 group at every observation. MgSO4 showed considerable safety and tolerability in subjects based on the postmedication monitoring of hypermagnesemia symptoms. Conclusion: Administering intravenous magnesium sulfate (MgSO4) as an adjuvant to bronchodilators in AECOPD led to the improvement of both clinical condition and PEFR. In AECOPD, MgSO4 exhibits enhanced early bronchodilator response when combined with other drugs, demonstrating significant efficacy, good safety, and tolerability at the prescribed dosage.

8.
Article | IMSEAR | ID: sea-240005

ABSTRACT

Background: Nocardiosis, a rare but serious infection caused by Gram-positive, aerobic actinomycetes, primarily affects immunocompromised individuals. This report highlights an uncommon case of pulmonary nocardiosis in an immunocompetent patient leading to acute hypoxic respiratory failure. Case Presentation: A 45-year-old male gardener with no significant past medical history presented with acute dyspnea, pleuritic chest pain, fever, night sweats, and weight loss. Physical examination revealed respiratory distress and hypoxia. Imaging showed bilateral alveolar infiltrates and cavitary lesions. Sputum analysis identified Gram-positive branching filamentous bacteria, and Nocardia species were cultured. HIV test was negative. Management: The patient was admitted to the ICU and treated with high-flow oxygen therapy and empirical antibiotics (trimethoprim-sulfamethoxazole [TMP-SMX] and meropenem). Upon culture results, TMP-SMX was continued, and meropenem was discontinued. The patient showed significant improvement and was discharged on oral TMP-SMX for a six-month course. Discussion: This case underscores the importance of considering pulmonary nocardiosis in acute respiratory failure, even in immunocompetent patients. Early diagnosis and appropriate treatment are crucial for favorable outcomes. Conclusion: Pulmonary nocardiosis can cause severe respiratory symptoms in otherwise healthy individuals. Prompt recognition and treatment are essential to manage this potentially life-threatening condition effectively.

9.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Méd. Bras. (Online);70(10): e20240589, Oct. 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1583040

ABSTRACT

SUMMARY OBJECTIVE: Vascular endothelial growth factor is a signaling protein created by cells performing important bodily functions. Vascular endothelial growth factor is abundant in the lung, and plasma levels are elevated in patients with severe pulmonary arterial hypertension. An association between soluble urokinase plasminogen activator receptor, an inflammatory biomarker, and soluble urokinase plasminogen activator receptor levels and interstitial pulmonary and vascular involvement (e.g., development of pulmonary hypertension) has been shown in SSc patients. The tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio, which has been recommended as a useful diagnostic tool in the last guideline, is one of the additional echocardiographic signs suggestive of pulmonary hypertension. We aimed to examine whether these biomarkers contribute to the diagnosis and management of pulmonary hypertension. METHODS: Patients with group E chronic obstructive lung disease were included in this prospective study. Demographic data, echocardiographic signs about the right ventricle (right atrium area, tricuspid annular plane systolic excursion/systolic pulmonary artery pressure, fractional area change, and right ventricular outflow tract), and peripheral blood analysis were examined and recorded. RESULTS: A total of 70 patients, 12 of whom were female, were analyzed in the study. The mean age was 66.6±8.7 years. The mean vascular endothelial growth factor-A and soluble urokinase plasminogen activator receptor were 91.05±70.7 and 955.8±571.1, and their Pearson correlation coefficients between vascular endothelial growth factor-A and tricuspid annular plane systolic excursion/systolic pulmonary artery pressure, and soluble urokinase plasminogen activator receptor and tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio were 0.341 (p=0.004) and −0.045 (p=0.70), respectively. The linear regression model included four variables with significant correlation (vascular endothelial growth factor-A, right atrium area, fractional area change, and right ventricular outflow tract). Three steps were performed, and adjusted r2 was 0.22, 0.22, 0.20, and p<0.001 for each step. Vascular endothelial growth factor-A and right ventricular outflow tract remained in the last step. It was detected a standardized coefficient beta of 0.322 (p=0.004) and a 95%CI 0.000-0.001 for vascular endothelial growth factor-A. CONCLUSION: Vascular endothelial growth factor-A is correlated with the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio and not with soluble urokinase plasminogen activator receptor.

10.
Article | IMSEAR | ID: sea-242309

ABSTRACT

One of the newer concepts and current focuses of tuberculosis management is the concept of palliative care for tuberculosis (TB) patients. Target patients for this approach include mainly patients with drug-resistant and advanced forms of tuberculosis but also drug-sensitive tuberculosis in some settings like malignancy and extra-pulmonary tuberculosis. Integral to this approach of palliative care is the concept of managing of comorbidities with tuberculosis. Addressing the various comorbidities associated with tuberculosis taking an integral approach to the management of comorbidities is the need of the hour.

11.
Article | IMSEAR | ID: sea-242306

ABSTRACT

Aim and background: The aim is to illustrate the diagnostic challenge posed by pulmonary mucosa-associated lymphoid tissue (MALT) cell lymphoma, which can mimic interstitial lung disease (ILD). Representing 0.5–1% of lung neoplasia cases, primary pulmonary lymphomas, particularly MALT lymphomas, present diagnostic challenges due to varied imaging features and lack of specific biological markers. This case report highlights the diagnostic complexities when pulmonary MALT cell lymphoma mimics ILD, emphasizing the need for accurate histopathological confirmation. Case description: A 50-year-old female initially diagnosed and treated for ILD based on radiological findings, presented with worsening breathlessness and a dry cough. Examination revealed fine crackles in both lung fields, and imaging indicated reticular opacities suggesting ILD. Laboratory tests showed elevated serum lactate dehydrogenase and a positive ANA in autoimmune profiling. Despite treatment, symptoms worsened. Subsequent transbronchial biopsy confirmed pulmonary MALT cell lymphoma, prompting Rituximab therapy after multidisciplinary consultation. Conclusion: This case underscores the challenge of distinguishing between pulmonary MALT cell lymphoma and ILD solely based on radiological similarities. Accurate histopathological diagnosis through biopsies is pivotal in managing such cases effectively. Multidisciplinary collaboration facilitated a precise diagnosis and appropriate therapy, emphasizing its crucial role in managing complex conditions. Clinical significance: The case demonstrates the diagnostic complexity of differentiating pulmonary MALT cell lymphoma from ILD, stressing the necessity of histopathological confirmation. An accurate diagnosis significantly influences therapy prognosis and highlights the indispensable role of multidisciplinary collaboration in managing such rare cases.

12.
Article | IMSEAR | ID: sea-242302

ABSTRACT

Background: To estimate the prevalence of asthma-chronic obstructive pulmonary disease (COPD) overlap among patients of asthma and COPD and to compare its frequency in both groups. Materials and methods: About 200 patients presenting to the out patient department (OPD) and in patient department (IPD) between April 1, 2021 and July 31, 2022 were enrolled and inquired about their symptoms. History regarding smoking, biomass fuel exposure, old pulmonary tuberculosis or a family history of obstructive airway disease was obtained. All these patients performed spirometry and based on GINA-GOLD guidelines, they were diagnosed as asthma, COPD, or asthma-chronic obstructive overlap (ACO). Results: About 125 patients out of a total of 200 were known cases of COPD while 75 were known cases of asthma. Post-spirometry, 112 patients were diagnosed as COPD (56%), 59 as asthma (29.5%) and 29 were labeled as ACO (14.5%). From a total of 125 COPD patients, 13 had ACO which is 10.4%. In contrast out of 75 asthma patients 16 had ACO which is 21.33%. Asthma and ACO patients belonged to a younger age group and COPD patients were older (p-value < 0.001). A male predominance was found among ACO patients with 21.8% of total male patients being diagnosed as ACO while only 5.6% of females were labeled as ACO (p-value 0.001). Conclusion: Asthma-chronic obstructive overlap patients are underdiagnosed and frequently mislabeled as either asthma or COPD. These patients have a male predominance and are younger as compared with COPD patients. Spirometry should be done in all patients having symptoms of obstructive airway disease to make a final diagnosis.

13.
Article | IMSEAR | ID: sea-241649

ABSTRACT

Pulmonary Tuberculosis (PTB) and Type 2 Diabetes Mellitus (T2DM) are two signicant public health issues, particularly in countries like India. This study evaluates the clinico-radiological prole of patients with PTB coexisting with T2DM in a tertiary care hospital in Chennai. A cross-sectional study of 212 patients was conducted to analyze clinical symptoms, radiological ndings, and their correlation with diabetic parameters such as fasting blood sugar (FBS), postprandial blood sugar (PPBS), and HbA1C levels. The study revealed a signicant correlation between uncontrolled diabetic parameters and the severity of tuberculosis. Cavitatory lesions were the most common radiological nding in PTB- T2DM patients. The ndings suggest that careful management of blood sugar levels in PTB patients can potentially improve clinical outcomes.

14.
Article | IMSEAR | ID: sea-241282

ABSTRACT

This report presents a case of a 42-year-old patient diagnosed with ostium secundum atrial septal defect (ASD) with severe pulmonary arterial hypertension (PAH). The patient presented with progressive chest pain and dyspnea and was found to have a lesion in the left main coronary artery (LMCA) ostium by coronary angiography. Computed tomography (CT) imaging revealed a significant enlargement of the main pulmonary artery (MPA), which indicated possible compression of the LMCA by the pulmonary artery which was subsequently confirmed by coronary angiography and intravascular ultrasound (IVUS). Our patient underwent IVUS guided percutaneous coronary intervention by which a stent was deployed in the ostial LMCA, leading to near resolution of the patient's symptoms. Currently, the patient is under follow-up. This case highlights an often-overlooked cause of chest pain and dyspnea in patients with PAH. Although these patients often experience typical and atypical angina due to elevated right-sided pressures, the current report reveals that external compression of the LMCA by an enlarged pulomonarya artery(PA) can also cause coronary ischemia. Physicians should consider LMCA compression when assessing PAH patients with chest pain, as percutaneous coronary intervention and stenting can safely and effectively manage this condition.

15.
Article | IMSEAR | ID: sea-241281

ABSTRACT

Pulmonary hypertension (PH) diagnosis can be challenging, particularly in young patients with systemic lupus erythematosus (SLE). We report a 10-year-old female presenting with suspected sinus venosus atrial septal defect (ASD) with Eisenmengerisation, later diagnosed with primary pulmonary arterial hypertension (PAH) secondary to SLE. She received vasodilators and immunosuppressants, showing partial treatment response.

16.
Medwave ; 24(8): e2918, 30-09-2024.
Article in English | LILACS-Express | LILACS | ID: biblio-1578157

ABSTRACT

Objetivos La ablación con criobalón para el aislamiento de venas pulmonares es un procedimiento que ahorra tiempo y puede ahorrar recursos del laboratorio de electrofisiología. Este análisis modeló el impacto de la ablación con criobalón en el funcionamiento del laboratorio de electrofisiología utilizando datos de América Latina. Métodos Los datos de los centros de Argentina, México, Colombia y Chile del Cryo Global Registry se utilizaron como datos de entrada para un modelo de simulación de la eficiencia del laboratorio de electrofisiología. El modelo partió del supuesto de que se podían realizar dos (operaciones actuales del laboratorio de electrofisiología) o tres (incluidos los cambios operativos del laboratorio de electrofisiología) procedimientos de ablación con criobalón por día. Los criterios de valoración eran el porcentaje de días en los que se producían 1) horas extraordinarias y 2) tiempo restante para un procedimiento electrofisiológico adicional no relacionado con la ablación. Resultados Se incluyeron en el análisis los datos un total de 232 procedimientos de seis centros latinoamericanos. El tiempo medio de ocupación del laboratorio de electrofisiología para todos los procedimientos en Latinoamérica fue de 132 ± 62 minutos. En el escenario actual (dos procedimientos por día), el 7,4% de los días simulados resultaron en horas extras, y el 81,4% tuvo tiempo suficiente para un procedimiento de electrofisiología adicional. En el escenario de productividad mejorada (tres procedimientos por día), el 16,4% de los días utilizó horas extraordinarias, mientras que el 67,4% dispuso de tiempo suficiente para un procedimiento electrofisiológico extra sin ablación. Conclusiones Utilizando datos del mundo real específicos de América Latina, descubrimos que, aplicando cambios operativos, es factible realizar tres procedimientos de ablación al día, lo que deja tiempo para un procedimiento de electrofisiología adicional en más de la mitad de los días. Por lo tanto, el uso de la ablación con criobalón es una herramienta eficaz para mejorar la eficiencia de los laboratorios de electrofisiología en regiones con recursos limitados como América Latina.


Objective Cryoballoon ablation for pulmonary vein isolation is a time-efficient procedure that can alleviate stress on electrophysiology lab resources. This analysis modeled the impact of cryoballoon ablation on electrophysiology lab operation using data from Latin America. Methods Data from centers in Argentina, Mexico, Colombia, and Chile of the Cryo Global Registry were used as inputs for an electrophysiology lab efficiency simulation model. The model used the assumption that either two (today's electrophysiology lab operations) or three (including electrophysiology lab operational changes) cryoballoon ablation procedures could be performed per day. The endpoints were the percentage of days that resulted in 1) overtime and 2) time left for an extra non-ablation electrophysiology procedure. Results Data from a total of 232 procedures from six Latin American centers were included in the analysis. The average electrophysiology lab occupancy time for all procedures in Latin America was 132 ± 62 minutes. In the Current Scenario (two procedures per day), 7.4% of simulated days resulted in overtime, and 81.4% had enough time for an extra electrophysiology procedure. In the Enhanced Productivity Scenario (three procedures per day), 16.4% of days used overtime, while 67.4% allowed time for an extra non-ablation electrophysiology procedure. Conclusions Using real-world, Latin American-specific data, we found that with operational changes, three ablation procedures could feasibly be performed daily, leaving time for an extra electrophysiology procedure on more than half of days. Thus, use of cryoballoon ablation is an effective tool to enhance electrophysiology lab efficiency in resource-constrained regions such as Latin America.

17.
Article | IMSEAR | ID: sea-232844

ABSTRACT

Pulmonary Arteriovenous Malformations (PAVM) are abnormal fistulous connections between a pulmonary artery and a pulmonary vein that generate a right-to-left shunt by avoiding the normal pulmonary capillary bed. We report an unusual case of a young female patient who presented to the department of Obstetrics and Gynaecology with Bleeding per vagina diagnosed as Failed intrauterine pregnancy; Unilateral pedal edema and Breathlessness. Pulmonary Thromboembolism was suspected and Computed Tomography pulmonary angiogram (CTPA) was advised for, which showed abnormal communication between dilated left main pulmonary artery and dilated tortuous superior pulmonary vein. Multiple adjacent solid and ground glass nodules were also noticed which were suggestive of initial telangiectatic state of PAVMs. Most of PAVMs are related to Hereditary Hemorrhagic Telangiectasia, whereas only 10 to 20% are isolated sporadic cases. Pregnancy has been considered as a precipitant factor for PAVMs in most of the cases, patients and pregnant women affected by PAVMs are asymptomatic, but when the clinical manifestations occur, they are often related to the right-to-left shunting and may include dyspnoea, hypoxia, and pulmonary hypertension. Moreover, presence of one or multiple PAVMs during pregnancy is associated with an increased risk of severe complications such as rupture, haemothorax, and hypovolemic shock. Hence this case reports highlights the necessity for the radiologists to think in terms of PAVM as a differential diagnosis beyond the suspicion of Pulmonary thromboembolism to look for any abnormal arteria venous communication while reporting CTPA in pregnant women with breathlessness and foresee the catastrophic complications in an already known case of PAVM during pregnancy. Also, the radiologists should identify subtle solid or ground-glass nodules adjacent to large PAVMS which are the initial telangiectatic stage of PAVMs.

18.
Article | IMSEAR | ID: sea-241277

ABSTRACT

The simultaneous occurrence of acute coronary syndrome (ACS) and pulmonary embolism (PE) in patients with sickle cell disease (SCD) presents notable diagnostic and management challenges. This case report describes a 25-year-old woman with SCD who, after an uncomplicated laparoscopic cholecystectomy, developed acute retrosternal chest pain, severe dyspnea, and tachycardia. Diagnostic workup included several key methods: thoracic CT angiography was performed, revealing massive bilateral pulmonary embolism and a pulmonary infarct. Echocardiography demonstrated myocardial abnormalities, such as wall motion defects and a mildly reduced ejection fraction. Electrocardiography showed ST-segment depression and T-wave inversions in the anteroseptal leads. To confirm the presence of coronary artery disease, coronary angiography identified significant thrombotic stenosis in the proximal left anterior descending artery. Sickle cell disease was confirmed through a positive sickle cell test, which identified the characteristic hemoglobin S. Despite aggressive treatment, the patient’s condition rapidly deteriorated, leading to death within 24 hours. This case underscores the critical role of a comprehensive diagnostic approach, including specific tests for SCD, in managing severe cardiovascular complications and highlights the need for tailored treatment strategies to improve patient outcomes.

19.
J Cancer Res Ther ; 2024 Aug; 20(4): 1109-1123
Article | IMSEAR | ID: sea-238216

ABSTRACT

This expert consensus reviews current literature and provides clinical practice guidelines for the diagnosis and treatment of multiple ground glass nodule?like lung cancer. The main contents of this review include the following: ? follow?up strategies, ? differential diagnosis, ? diagnosis and staging, ? treatment methods, and ? post?treatment follow?up.

20.
J. bras. econ. saúde (Impr.) ; 16(2): 87-97, Agosto/2024.
Article in Portuguese | LILACS, ECOS | ID: biblio-1571616

ABSTRACT

Objetivo: Estimar as perdas de produtividade causadas pela doença pulmonar obstrutiva crônica (DPOC) na população brasileira. Métodos: O estudo utilizou dados obtidos do Datasus, IBGE, indicadores previdenciários, óbitos e aposentadorias precoces por DPOC no Brasil de 2017 a 2022. Para estimar o impacto da DPOC, foram utilizados: anos de vida saudável perdidos (DALYs) e anos de vida ajustados por produtividade (PALYs), assim como as métricas de perda de produtividade salarial (PPS) e perda de produtividade nacionalizada (PPN), que avalia a perda em função do PIB. Resultados: Mais de 196 milhões de dias de trabalho foram perdidos devido à DPOC. As principais fontes são: óbitos precoces (95.264.088), afastamentos permanentes (67.314.232) e aposentadoria precoce (30.304.490). Diárias hospitalares (3.221.591) têm uma contribuição minoritária. O valor total de DALYs observado no período do estudo foi de 2.819.332,63 anos de vida saudável perdidos causados pela DPOC; um total de 14.997.166 PALYs foi perdido por conta da DPOC ou um valor anual equivalente de R$ 230,7 bilhões. Considerando a PPS, estimamos que a DPOC acarretou perdas de produtividade associadas à reposição da mão de obra de R$ 1,38 bilhão anual e, em relação à PPN, de R$ 8,28 bilhões por ano. Conclusões: Afastamentos de pacientes com DPOC podem acarretar maiores dispêndios com pagamentos de benefícios previdenciários. Este estudo atualiza e amplia correlações entre dados socioepidemiológicos, custos de saúde e previdenciários da DPOC no Brasil. Considerando todas as perdas, a DPOC pode causar perdas de R$ 240 bilhões por ano.


Objective: To estimate productivity losses due to workdays lost caused by chronic obstructive pulmonary disease (COPD) in the Brazilian population. Methods: The study used data from DATASUS, IBGE, social security indicators, deaths, and early retirements due to COPD in Brazil from 2017 to 2022. To estimate the impact of COPD, the following were used: Disability-Adjusted Life Years (DALYs) and Productivity-Adjusted Life Years (PALYs), as well as metrics for wage productivity loss (PPS) and nationalized productivity loss (PPN), which evaluates the loss in relation to GDP. Results: More than 196 million workdays were lost due to COPD. The main sources are premature deaths (95,264,088), permanent absences (67,314,232), and early retirement (30,304,490). Hospitalization days (3,221,591) had a minor contribution. The total DALYs observed during the study period was 2,819,332.63 years of healthy life lost due to COPD; a total of 14,997,166 PALYs were lost due to COPD, equivalent to an annual value of R$ 230.7 billion. Considering PPS, we estimate that COPD resulted in productivity losses associated with workforce replacement of R$ 1.38 billion annually; and in relation to PPN, R$ 8.28 billion per year. Conclusions: Absences in COPD patients can lead to higher expenditures on social security benefit payments. This is the first study to correlate socioepidemiological data, health, and social security costs of COPD in Brazil. Considering all losses, COPD can cause losses of R$ 240 billion per year.


Subject(s)
Life Expectancy , Costs and Cost Analysis , Pulmonary Disease, Chronic Obstructive
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