Subject(s)
Humans , Male , Adult , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/immunology , Antibodies, Antinuclear , Antibodies, Antinuclear/immunology , Autoimmunity , Polymerase Chain Reaction/methods , Radiography, Thoracic/methods , Radiography, Thoracic/trends , Electromyography/methods , Electromyography/trends , Autoimmune Diseases/diagnosis , Autoimmune DiseasesSubject(s)
Community-Acquired Infections/diagnosis , Eosinophils/immunology , Lung Diseases, Interstitial/diagnosis , Neutrophils/immunology , Pneumonia/diagnosis , Threonine-tRNA Ligase/immunology , Adult , Alanine Transaminase/blood , Autoantibodies/blood , C-Reactive Protein/metabolism , Cyclophosphamide/administration & dosage , Diagnosis, Differential , Humans , Lung Diseases, Interstitial/drug therapy , Lung Diseases, Interstitial/immunology , Male , Methylprednisolone/administration & dosage , Radiography, Thoracic , SyndromeABSTRACT
The occurrence of a bronchopleural fistula (BPF) continues to represent a challenging management problem, and is associated with high morbidity and mortality. A novel and successful technique that uses submucosal injection of a tissue expander for bronchoscopic occlusion of BPFs has been designed. This method may be used either alone or in combination with bronchoscopic instillation of n-butyl-cyanoacrylate glue. The occlusion technique is described, with a presentation of two patients who were successfully treated with this method. The submucosal injection of a tissue expander is an effective, economical and minimally invasive technique for managing BPFs.
Subject(s)
Biocompatible Materials , Bronchial Fistula/therapy , Bronchoscopy/methods , Glucans , Pleural Diseases/therapy , Zirconium , Humans , Injections , Male , Middle Aged , Treatment OutcomeABSTRACT
BACKGROUND: Continuous positive airway pressure (CPAP) is the main treatment for obstructive sleep apnea-hypopnea syndrome (OSAHS). Polysomnography (PSG) is the gold standard for CPAP titration. However, alternative methods have been sought to titrate CPAP at less expense in terms of time and resources. The aim of this study was to analyze CPAP success in controlling OSAHS symptoms and adverse effects by two titration methods. METHODS: This was a retrospective, observational cohort study in which 200 CPAP-naive patients who had been referred to our sleep laboratory and diagnosed with OSAHS were evaluated on two consecutive visits. During the first visit, an initial CPAP pressure was established either by split-night PSG or by using a mathematical formula. On the second visit, 1 month later, symptom persistence and adverse effects of CPAP treatment were assessed. RESULTS: Patients included were 157 males (78.5%) and 43 females (21.5%) aged 56+/-10 years. 87 patients (43.5%) were titrated by PSG and 113 (56.5%) using the formula. At the second visit, symptoms had improved significantly for both groups with no significant differences in the presence of adverse effects. The initial pressure had to be readjusted in five patients. CONCLUSIONS: This study suggests that formula titration can control symptoms as effectively as split-night titration. A prompt evaluation of the patient is advisable in order to ensure compliance with treatment and to correct possible adverse effects.
