Bronchiolitis obliterans and the risk of pneumothorax after transbronchial biopsy
Abstract: The safety of bronchoscopy and specifically transbronchial biopsy has not been studied in patients with bronchiolitis obliterans. We discuss two patients with bronchiolitis obliterans as a complication of graft versus host disease following allogeneic stem cell transplant. Both underwent bronchoscopy and transbronchial biopsy, which was complicated by pneumothoraces. Patients with bronchiolitis obliterans have an increased risk of spontaneous air leak syndromes. Although no data exists regarding the safety of transbronchial biopsies in patients with airflow obstruction in general, they appear to have increased rates of pneumothoraces following transthoracic biopsies. It is important to consider the potentially increased risk of pneumothoraces when deciding to pursue bronchoscopy ......
POSTED 08/28/2010 at 02:52 AM --
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Endobronchial aspergilloma â Presenting as solitary pulmonary nodule
We report a rare case of endobronchial aspergilloma which is presented radiologically as a solitary pulmonary nodule. A 24-year-old male presented to the Department of Tuberculosis and Chest Diseases with moderate to severe hemoptysis for the last three months. Chest X-ray (PA view) showed ill-defined homogenous shadow in the right upper zone. CECT Thorax review showed intrabronchial mass in the posterior segment of the right upper lobe. CT-guided FNAC was performed, which reveals Aspergillus hyphae mixed with sputum and necrotic material, without any evidence of malignancy. Fibreoptic bronchoscopy was done, it reveals a ball-like region, occluding partially, the lumen of the posterior segment of right upper lobe with hyperemia. The ball was movable. Biopsy was performed and it revealed a ......
POSTED 08/28/2010 at 02:52 AM --
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Iatrogenic rupture of the trachea caused by double Lumen tube intubation
Abstract Acute injuries of the tracheobronchial system are rare and life-threatening situations. Tracheal rupture most commonly occurs
after blunt trauma to the chest. It is a rare but most concerning immediate complication of intubation. One-lung ventilation
is required in lung surgery. Video assisted thoracoscopic procedures are an absolute indication for one-lung intubation. The
double-lumen tube is the mainstay of one lung ventilation. Due to their larger size and rigidity, double lumen tubes are more
difficult to insert, and complications are more common than with single lumen tubes. Opinions about the need for checking
routinely the position of a double lumen tube by fiber optic bronchoscopy directly after intubation are divided. A 69-year-old
woman with epidermoid l......
POSTED 08/25/2010 at 01:13 AM --
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Endotracheal Inflammatory Pseudotumor: The Role of Interventional Bronchoscopy [CASE REPORTS]
We present the case of a 31-year-old woman with recurrent pneumonia. A chest roentgenogram, a chest computed tomographic scan, and a rigid bronchoscopy revealed a mass in the left mainstem bronchus, which was protruding into the trachea and right mainstem bronchus, with no extraluminal component. Endoscopic biopsies confirmed an inflammatory myofibroblastic tumor. The patient was treated with two sessions of bronchoscopic resection, followed by medical therapy with corticosteroids and azathioprine. She has been followed-up for 31 months without complications or recurrence. Although the usual treatment for this type of entity is surgical excision, endoscopic resection may be an adequate oncologic procedure when the tumor is completely endoluminal, as in this case. (Source: The Annals of Tho......
POSTED 08/24/2010 at 03:35 PM --
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Changes and Current State of Diagnosis of Lung Cancer After Development of the Flexible Bronchofiberscope
The flexible bronchofiberscope developed by Ikeda et al. has brought about revolutionary changes in the diagnosis and treatment of lung cancer. Advances in this device are continuing to emerge and lesions even smaller than those visible to the naked eye can now be visualized. In addition, the use of ultrasound now enables diagnosis of extramural bronchial lesions. Bronchoscopy is also used for the treatment of early hilar lung cancer, and in patients with airway stenosis due to advanced cancer, laser therapy, brachytherapy, and stenting can be performed. The bronchofiberscope is also very useful for tissue sampling from the lung periphery. Further advances in computed tomography imaging have enabled bronchoscopy under computed tomography fluoroscopy, and virtual bronchoscopy images can be ......
POSTED 08/24/2010 at 01:19 AM --
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Correlations Between Controlled Endotracheal Tube Cuff Pressure and Postprocedural Complications: A Multicenter Study.
Conclusions: ETTc pressure estimated by palpation with personal experience is often much higher than measured or what may be optimal. Proper control of ETTc pressure by a manometer helped reduce ETT-related postprocedural respiratory complications such as cough, sore throat, hoarseness, and blood-streaked expectoration even in procedures of short duration (1-3 hours).
PMID: 20736432 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)...
POSTED 08/23/2010 at 06:00 PM --
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A prospective randomized trial comparing supraglottic airways for flexible bronchoscopy in children.
Conclusion: In this trial, PVC single-use laryngeal masks were inferior to the silicone cLMA and Boss Systems laryngeal masks for flexible bronchoscopy in children.
PMID: 20716075 [PubMed - in process] (Source: Paediatric Anaesthesia)...
POSTED 08/20/2010 at 01:27 PM --
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Complications of bronchoscope removal in an infant with innominate artery.
Authors: Heyer A, Shevchenko Y, Rastogi M
PMID: 20716091 [PubMed - in process] (Source: Paediatric Anaesthesia)...
POSTED 08/20/2010 at 01:27 PM --
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A Prospective Multicenter Study of Competency Metrics and Educational Interventions in the Learning of Bronchoscopy Among New Pulmonary
Can educational interventions, such as simulation-based training, accelerate the acquisition of bronchoscopy skills among first-year pulmonary fellows? CHEST (Source: Medscape Today Headlines)...
POSTED 08/20/2010 at 05:36 AM --
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Antioxidant airway responses following experimental exposure to wood smoke in man
Conclusions:
Exposure of healthy subjects to wood smoke, derived from an experimental wood pellet boiler operating under incomplete combustion conditions with PM emissions dominated by organic matter, caused an increase in mucosal symptoms and GSH in the alveolar respiratory tract lining fluids but no acute airway inflammatory responses. We contend that this response reflects a mobilisation of GSH to the air-lung interface, consistent with a protective adaptation to the investigated wood smoke exposure. (Source: Particle and Fibre Toxicology)...
POSTED 08/19/2010 at 06:00 PM --
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The {alpha}4{beta}1 Integrin in Localization of Mycobacterium Tuberculosis-specific Th1 Cells to the Human Lung.
In this study, we assessed the role of homing molecule expression in localization of M. tb-specific recall responses to the lung. Compared to peripheral blood, baseline bronchoalveolar lavage (BAL) is significantly enriched for CD4+ T-cells expressing the alpha4beta1 integrin homing molecule. This skewing is continued following PPD-induced recruitment of CD4+ T-cell, and is even more pronounced for recruited CD4+ cells that display PPD-specific production of IFNgamma, of which over 83% express alpha4beta1. Expression of the alpha4beta1 integrin therefore appears likely to optimize localization of M. tb-specific Th1-like recall responses to the human lung.
PMID: 20724551 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory Cell and Molecular Biology)...
POSTED 08/18/2010 at 06:00 PM --
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Correspondence: Complications of bronchoscope removal in an infant with innominate artery
(Source: Pediatric Anesthesia)...
POSTED 08/18/2010 at 12:06 AM --
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Markers of fibrosis and inflammation in exhaled breath condensate (EBC) and bronchoalveolar lavage fluid (BALF) of patients with pulmonary sarcoidosis - a pilot study.
Conclusions: FOB does not significantly affect levels of airway inflammation and fibrosis markers present in EBC before and after FOB; they were also comparable to the concentrations marked by BALF. The lack of correlation between markers levels in EBC and BALF indicates that these methods are not equivalent. Due to repeatibility, and less invasive, simple method of EBC test it seems reasonable to continue the research on the larger number of patients. Pneumonol. Alergol. Pol. 2010; 78, 5: 356-362.
PMID: 20703999 [PubMed - in process] (Source: Pneumonologia i Alergologia Polska)...
POSTED 08/13/2010 at 07:03 AM --
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Juliaâs placebo effect
We describe the case of an infant affected by a tracheal agenesis who underwent a series of operative and diagnostic bronchoscopies for which she received midazolam and fentanyl. After 61 procedures the infant showed a somatosensory response which in our interpretation reflected a placebo effect. Ontogenetic considerations and specific observations indicate that the infant had the appropriate competences in her learning and memory systems and nociceptive and antinociceptive circuits for the placebo effect to take place. Generalizing, the introduction of placebo manipulation in infant pain management may be taken into consideration; its approach through observational and experimental studies is the preliminary target. (Source: Pain)...
POSTED 08/12/2010 at 12:37 AM --
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Smoking-induced Up-regulation of AKR1B10 Expression in the Airway Epithelium of Healthy Individuals.
CONCLUSIONS: Thus, smoking per se mediates up-regulation of AKR1B10 expression in the airway epithelium of healthy smokers with no evidence of lung cancer. In the context of these observations and the link of AKR1B10 to the metabolism of retinals and to lung cancer, the smoking-induced up-regulation of AKR1B10 may be an early process in the multiple events leading to lung cancer. Clinical registration info: clinicaltrials.gov / NCT00224185.
PMID: 20705797 [PubMed - as supplied by publisher] (Source: Chest)...
POSTED 08/11/2010 at 06:00 PM --
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Sarcoidosis development during induction chemotherapy for lung cancer mimicked progressive disease
We report a rare case of sarcoidosis that developed during induction chemotherapy for primary lung cancer, mimicking progressive
disease. A 63-year-old man had an abnormal shadow in the right upper lung, and a bronchoscopic examination revealed a squamous
cell carcinoma. Swelling of a pretracheal lymph node was also noted. Thus, we gave induction chemotherapy consisting of paclitaxel
(days 1, 8) + carboplatin (days 1, 8) for two cycles under clinical staging of T2N2M0. After induction chemotherapy, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed positive accumulation of FDG in mediastinal and bilateral
hilar lymph nodes that had been negative in a previous FDG-PET examination, which led us to suspect disease progression. Transbronchial
lymph node biopsy results sh......
POSTED 08/11/2010 at 04:45 PM --
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National survey to assess the content and availability of difficult-airway carts in critical-care units in the United States
Abstract We have surveyed the availability of equipment, content of difficult-airway carts (DAC), and training in the use of such equipment
in intensive-care units (ICU). We devised a set of proposals regarding what constitutes the ideal DAC. We surveyed 300 ICU
in the United States. The survey was conducted to inquire about the presence and content of a DAC. Only 70% of respondents
had a DAC in their unit. 82% of units surveyed checked the contents of the cart daily. 80% of directors were aware of its
location. 80% of units had an attached list of contents and 51% had an attached algorithm for management of a difficult airway.
LMA was present in 80% followed by 35 and 30% for Combitube and pre-assembled needle cricothyroidotomy set. Under non-invasive
airway devices, vide......
POSTED 08/07/2010 at 02:01 AM --
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Threshold of Biologic Responses of the Small Airway Epithelium to Low Levels of Tobacco Smoke.
CONCLUSIONS: The small airway epithelium detects and responds to low levels of tobacco smoke with transcriptome modifications. This provides biologic correlates of epidemiologic studies linking low level tobacco smoke exposure to lung health risk, identifies the genes most sensitive to tobacco smoke and defines thresholds at which the lung epithelium responds to low levels of tobacco smoke.
PMID: 20693378 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)...
POSTED 08/05/2010 at 06:00 PM --
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Successful diagnosis and treatment of congenital tracheal web using a fiberoptic bronchoscope
Congenital tracheal web is a very rare abnormality that often manifests as wheezing, dyspnea, and respiratory failure. Misdiagnosis is common. Here we describe the case of a 47-day-old female infant who presented after severe, extended coughing. The diagnosis of congenital tracheal web was made following coronal computer tomography (CT) reconstruction and bronchoscopy. The bronchoscope was used to facilitate tracheal expansion. This is the youngest case reported to date to highlight the diagnosis and treatment of a 47 days infant with congenital tracheal web. An infant with tracheal web, a very rare congenital anomaly can be clearly diagnosed by coronal CT reconstruction combined with bronchoscopy. If diagnosed early, the bronchoscope may be used to facilitate tracheal expansion. Pediatr. ......
POSTED 08/03/2010 at 06:00 PM --
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Mediastinal teratoma with pulmonary involvement presenting as massive hemoptysis in 2 patients.
We report 2 cases of hemoptysis caused by mediastinal teratoma with bronchial communication.
PMID: 20667158 [PubMed - in process] (Source: Respiratory Care)...
POSTED 07/31/2010 at 06:00 PM --
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