bluuebunny/crossref_metadata_2025 huggingface dataset:
Em termos alheios: Contradições da implementação de termos de compromisso em territórios tradicionalmente ocupados
Authors: Guerrero Natalia Ribas
Published: January 2020

Este artigo tem como propósito analisar contradições da política ambiental brasileira envolvendo sobreposições de territórios tradicionalmente ocupados e unidades de conservação de proteção integral, em especial, a implementação dos termos de compromisso, instrumentos ditos de “gestão e mediação de conflitos”, de caráter transitório, cujo objetivo seria “garantir a conservação da biodiversidade e as características socioeconômicas e culturais dos grupos sociais envolvidos”. Embora tais documentos resultem do reconhecimento de ocupações tradicionais – situando-as em um campo de direitos que envolve peças da legislação nacional e internacional –, os protocolos de elaboração e sua tramitação sugerem conflitos com essas normativas e possíveis violações aos direitos territoriais dos grupos em questão. Com base em dois casos na região conhecida como Terra do Meio (Pará), gostaríamos também de aludir sobre como famílias autoidentificadas beiradeiras, com termos de compromisso em implementação, têm estruturado formas cotidianas de resistência, expressas em proposições locais como a seguinte: “O ICMBio [Instituto Chico Mendes de Conservação da Biodiversidade], ele bota uma regra alta, mas vamos derrubando devagar”.
Register-Based Subject Omission in English and its Implication for the Syntax of Adjuncts
Authors: Haegeman Liliane
Published: January 2020

Cette contribution étudie l’omission du sujet des phrases finies en anglais dans le contexte de certains registres « abrégés » écrits, représentés en particulier par le journal intime. Après un survol des caractéristiques et contraintes distributionnelles de l’omission du sujet, l’article porte une attention particulière à l’asymétrie entre les contextes avec un argument verbal en position initiale et ceux avec un complément circonstanciel dans la même position. Tandis que l’omission du sujet est interdite catégoriquement dans le premier contexte, dans le deuxième elle est parfaitement acceptable et attestée régulièrement. Pour rendre compte de cette asymétrie l’article développe une analyse particulière des compléments circonstanciels ‘initiaux’ selon laquelle en fait, ces derniers peuvent aussi être engendrés dans une position intra-clausale, à la droite de la position canonique du sujet. L’hypothèse développée est fondée sur les principes de l’approche formelle générative à la syntaxe, incluant des concepts récents développés dans l’approche dite cartographique. Toutefois, les détails techniques d’analyse seront limités pour raison d’accessibilité pour le lecteur. Un point central de l'hypothèse développée ici repose sur une reformulation de l’idée traditionnelle que la structure de la phrase est profondément à identifier en termes d’une relation prédicative, reliant le sujet dans sa position canonique avec le prédicat. Il est démontré que l’analyse développée ici permet aussi de rendre compte de certaines restrictions interprétatives concernant la référence du sujet canonique par rapport aux constituants nominaux à l’intérieur des subordonnées.
A Study of Non-Finite Forms of Anaphoric do in the Spoken BNC
Authors: Oger Kimberly
Published: January 2020

Il existe en anglais britannique une forme non finie de do intransitif, utilisée en contexte anaphorique, appelé « do britannique ». Ce do britannique est considéré par certains comme un « proprédicat » ou « substitut ». Il est rarement utilisé dans d’autres variétés d’anglais et les locuteurs américains, notamment, le jugent agrammatical. Le « do britannique » a jusqu’ici fait très peu l'objet de discussion dans la littérature, surtout comparé à d’autres formes d’anaphore faisant appel à do telles que l’ellipse, par exemple. Dans l’ensemble, les quelques lignes consacrées à son sujet se limitent à quelques traits descriptifs basés sur des exemples inventés ou glanés çà et là dans des œuvres littéraires. Il n’a jamais été entrepris d’étudier le phénomène à partir d’un corpus d’exemples authentiques représentatif de l’utilisation de la langue en situation de communication. Cet article présente la première étude réalisée sur do britannique à partir de données empiriques, à savoir 486 occurrences prélevées dans la composante orale du British National Corpus (BNC). Les premiers résultats de cette étude sont présentés et commentés. Ils tendent à contredire nombre d’affirmations formulées par le passé au sujet du do britannique, et donnent lieu à de nouvelles interrogations.
Années de formation et premiers travaux de La Blanchère
Authors: Rey Sarah
Published: January 2020

La Blanchère fait partie des premières générations d’élèves de l’École française de Rome, nouvellement créée. Normalien, agrégé d’histoire, le jeune historien se démarque par son fort caractère. Dans ses années parisiennes, il a reçu l’empreinte de l’enseignement de Fustel de Coulanges et s’est montré sensible aux commandements de la géographie, discipline en devenir. Avant même de partir pour l’Italie, il s’est également formé à l’épigraphie en suivant les cours de Léon Renier. Ce savoir épigraphique est alors une science de combat, qui permet à La Blanchère de défendre les couleurs de la France dans la course à la publication d’inscriptions. L’espace ingrat des Marais Pontins lui donne la possibilité de conduire une enquête de terrain originale, à partir de laquelle l’historien peut dénoncer la violence de l’impérialisme romain.
La Blanchère epigrafista e storico dell’epigrafia romana
Authors: Di Brino Giovanni
Published: January 2020

La bibliografia di Marie-René de La Blanchère annovera numerose pubblicazioni dedicate all’epigrafia latina: lo studioso si impegnò sia come teorico, pubblicando un breve trattato di storia degli studi, sia come epigrafista militante, nell’area del Lazio meridionale, dove soggiornò nel triennio 1879-1881. La produzione dello studioso in ambito epigrafico, ad oltre un secolo di distanza, conserva la sua utilità negli studi di carattere locale, ed una particolare validità quale documento storico-antiquario.
«Un grand travail qui manque encore à l’École»
Authors: Palombi Domenico
Published: January 2020

Nel triennio di permanenza nella giovane École Française de Rome (1878-1881), M.-R. de La Blanchère si dedicò alla analisi, ricostruzione e interpretazione del paesaggio antico nella regione laziale compresa tra Velletri e Terracina, tra i Monti Lepini e il Mare Tirreno, regione nella quale la Via Appia veniva identificata come fatto storico e archeologico portante della sua evoluzione, dall’antichità all’età contemporanea. Nel complesso delle ricerche sul Lazio meridionale – e in particolare nella incompiuta opera sulla Via Appia e le Terre Pontine – La Blanchère dimostra una straordinaria capacità di identificare problematiche storiche e archeologiche del tutto innovative. Tuttavia, rispetto alla produzione scientifica successiva, gli studi di La Blanchère si caratterizzano non soltanto per l’ampiezza della visione disciplinare (geografia, demografia, topografia, archeologia, epigrafia, storia) e per il taglio diacronico (dall’antichità al medioevo, fino all’età moderna e contemporanea) ma anche per l’innovativa attenzione al rapporto uomo-ambiente, per l’interpretazione storica in chiave socioeconomica delle trasformazioni delle città e dei paesaggi antichi, per la costante proiezione di quei processi nell’osservazione e nella valutazione del presente.
Voir et connaître la société
Authors: Gautier Claude
Published: January 2020

Cet ouvrage a pour ambition de récrire une partie de l’histoire préalable à la constitution des savoirs des sciences de l’homme. Il propose une analyse de la manière de construire la relation sujet/objet et de faire de la société une « nature » qu’il devient possible d’observer à distance. Comment une telle extraction du sujet connaissant est-elle devenue pensable au XVIIIe siècle ? Comment l’éloignement du regard peut-il contribuer à modifier la nature même de ce qui est observé, à poser les principes d’un savoir nouveau, la sociologie ?
Sur la base des textes des figures éminentes du Scottish Enlightenment et des auteurs issus de l’École historique écossaise – Bernard Mandeville, David Hume, Adam Smith et, dans une moindre mesure, Adam Ferguson –, Claude Gautier rend compte des nouvelles exigences ontologique, épistémologique et méthodologique qui conditionnent la possibilité de l’éloignement empirique du regard. Que s’agit-il de regarder ? La société. Que faire pour se mettre en situation de pouvoir la regarder ? S’éloigner.
Lost and Found: The Missing Flamboyant Gothic Door from the Château de Varaignes
Authors: Easton Martha
Published: January 2020

In the late 1920s, the Flamboyant Gothic portal that had graced the Château de Varaignes since the late Middle Ages was sold after the château itself had fallen into disrepair. The townspeople of Varaignes did not know what had become of the door although it was rumored it had been sent to the United States. In 2014, a group of researchers from Varaignes discovered that the door had ended up at Hammond Castle, constructed between 1926 and 1929 in Gloucester, Massachusetts. It was one of the many pieces of architectural salvage from Europe collected by the scientist and inventor John Hays Hammond Jr. and installed in the revivalist medieval-style castle that served as both his home and his laboratory. In following the journey of the Varaignes portal, this paper will discuss the acquisition of architectural elements from Europe by American collectors in the early twentieth century as both a form of philanthropic intervention, but also as cultural imperialism. The Château de Varaignes, now a museum dedicated to the region’s history, particularly textile production, is raising funds to replicate the door in its original location. Just as Hammond used the original Gothic door to evoke the past and lend authenticity to his revivalist castle, the replicated door in Varaignes will serve as a powerful reminder of the lost original.
Il perduto mosaico della cattedrale di Capua (1130 ca.) nell’erudizione Sei e Settecentesca: una premessa al concetto di «arte riformata»?
Authors: Croci Chiara
Published: January 2020

La cattedrale di Capua, pesantemente trasformata in seguito ai danni bellici, era dominata fino alla prima metà del XVIII secolo da un mosaico absidale commissionato dal vescovo Ugone (1129-1135). Noto da testimonianze grafiche Seicentesche, era presentato dagli eruditi locali come una sintesi dei mosaici absidali delle tre principali chiese paleocristiane perdute dell’antico centro (Santa Maria Maggiore, SS. Stefano e Agata e San Pietro in Corpo): una tesi che ne fece, ante litteram, un prodotto artistico della riforma gregoriana. Lo studio della reliquia iconografica del mosaico ugoniano rispetto ai suoi pretesi modelli paleocristiani consente di relativizzare la lettura e di interpretarla alla luce del contesto capuano sei e settecentesco. Enfatizzando il legame tra l’antica e la nuova Capua in un particolare momento politico-ecclesiastico, il mosaico di Ugone offre nuovi argomenti per una revisione del mito storiografico dell’arte della riforma.
Continuous Deployment Transitions at Scale
Authors: Williams Laurie , Beck Kent , Creasey Jeffrey , Glover Andrew , Holman James , Humble Jez , McLaughlin David , Micco John Thomas , Murphy Brendan , Cox Jason A. , Pendyala Vishnu , Place Steven , Pritchard Zachary T. , Rossi Chuck , Savor Tony , Stumm Michael , Parnin Chris
Published: January 2020

Predictable, rapid, and data-driven feature rollout; lightning-fast; and automated fix deployment are some of the benefits most large software organizations worldwide are striving for. In the process, they are transitioning toward the use of continuous deployment practices. Continuous deployment enables companies to make hundreds or thousands of software changes to live computing infrastructure every day while maintaining service to millions of customers. Such ultra-fast changes create a new reality in software development. Over the past four years, the Continuous Deployment Summit, hosted at Facebook, Netflix, Google, and Twitter has been held. Representatives from companies like Cisco, Facebook, Google, IBM, Microsoft, Netflix, and Twitter have shared the triumphs and struggles of their transition to continuous deployment practices—each year the companies press on, getting ever faster. In this chapter, the authors share the common strategies and practices used by continuous deployment pioneers and adopted by newcomers as they transition and use continuous deployment practices at scale.
Case Study Method and Research Design
Authors: Carter Susan
Published: January 2020

Case study is prominent in qualitative research literature, yet the methodologists do not have a full consensus on whether it is an approach, a method, a methodology, or a design. Perhaps this flexibility contributes to ambiguity for the burgeoning researcher. The works of prominent methodologists, namely Robert Yin, Sharan Merriam, and Robert Stake, are explored as an attempt to define case study and then explain how it can be utilized as a ‘road map' for engaging case study to investigate current practices in inclusivity and wellbeing. The author serves as a provocateur and explores the question: “How do you surface deep knowledge in your interview participants?” This chapter contributes knowledge to the field of research, specifically methodological information for the novice researcher considering using case study as a research method. Dually, this chapter brings into focus examples of case study method applied to explore inclusion and wellbeing.
Non-HIV Pneumocystis pneumonia: do conventional community-acquired pneumonia guidelines under estimate its severity?
Authors: Asai Nobuhiro , Motojima Shinji , Ohkuni Yoshihiro , Matsunuma Ryo , Nakasima Kei , Iwasaki Takuya , Nakashita Tamao , Otsuka Yoshihito , Kaneko Norihiro
Published: January 2020

Background: Non-HIV Pneumocystis pneumonia (PCP) can occur in immunosuppressed patients having malignancy or on immunosuppressive agents. To classify severity, the A-DROP scale proposed by the Japanese Respiratory Society (JRS), the CURB-65 score of the British Respiratory Society (BTS) and the Pneumonia Severity Index (PSI) of the Infectious Diseases Society of America (IDSA) are widely used in patients with community-acquired pneumonia (CAP) in Japan. To evaluate how correctly these conventional prognostic guidelines for CAP reflect the severity of non-HIV PCP, we retrospectively analyzed 21 patients with non-HIV PCP. Methods: A total of 21 patients were diagnosed by conventional staining and polymerase chain reaction (PCR) for respiratory samples with chest x-ray and computed tomography (CT) findings. We compared the severity of 21 patients with PCP classified by A-DROP, CURB-65, and PSI. Also, patients’ characteristics, clinical pictures, laboratory results at first visit or admission and intervals from diagnosis to start of specific-PCP therapy were evaluated in both survivor and non-survivor groups. Results: Based on A-DROP, 18 patients were classified as mild or moderate; respiratory failure developed in 15 of these 18 (83.3%), and 7/15 (46.7%) died. Based on CURB-65, 19 patients were classified as mild or moderate; respiratory failure developed in 16/19 (84.2%), and 8 of the 16 (50%) died. In contrast, PSI classified 14 as severe or extremely severe; all of the 14 (100%) developed respiratory failure and 8/14 (57.1%) died. There were no significant differences in laboratory results in these groups. The time between the initial visit and diagnosis, and the time between the initial visit and starting of specific-PCP therapy were statistically shorter in the survivor group than in the non-survivor group. Conclusions: Conventional prognostic guidelines for CAP could underestimate the severity of non-HIV PCP, resulting in a therapeutic delay resulting in high mortality. The most important factor to improve the mortality of non-HIV PCP is early diagnosis and starting of specific-PCP therapy as soon as possible.
Extrapulmonary features of bronchiectasis: muscle function, exercise capacity, fatigue, and health status
Authors: Ozalp Ozge , Inal-Ince Deniz , Calik Ebru , Vardar-Yagli Naciye , Saglam Melda , Savci Sema , Arikan Hulya , Bosnak-Guclu Meral , Coplu Lutfi
Published: January 2020

Background: There are limited number of studies investigating extrapulmonary manifestations of bronchiectasis. The purpose of this study was to compare peripheral muscle function, exercise capacity, fatigue, and health status between patients with bronchiectasis and healthy subjects in order to provide documented differences in these characteristics for individuals with and without bronchiectasis. Methods: Twenty patients with bronchiectasis (43.5 ± 14.1 years) and 20 healthy subjects (43.0 ± 10.9 years) participated in the study. Pulmonary function, respiratory muscle strength (maximal expiratory pressure – MIP - and maximal expiratory pressure - MEP), and dyspnea perception using the Modified Medical Research Council Dyspnea Scale (MMRC) were determined. A six-minute walk test (6MWT) was performed. Quadriceps muscle, shoulder abductor, and hand grip strength (QMS, SAS, and HGS, respectively) using a hand held dynamometer and peripheral muscle endurance by a squat test were measured. Fatigue perception and health status were determined using the Fatigue Severity Scale (FSS) and the Leicester Cough Questionnaire (LCQ), respectively. Results: Number of squats, 6MWT distance, and LCQ scores as well as lung function testing values and respiratory muscle strength were significantly lower and MMRC and FSS scores were significantly higher in patients with bronchiectasis than those of healthy subjects (p<0.05). In bronchiectasis patients, QMS was significantly associated with HGS, MIP and MEP (p<0.05). The 6MWT distance was significantly correlated to LCQ psychological score (p<0.05). The FSS score was significantly associated with LCQ physical and total and MMRC scores (p<0.05). The LCQ psychological score was significantly associated with MEP and 6MWT distance (p<0.05). Conclusions: Peripheral muscle endurance, exercise capacity, fatigue and health status were adversely affected by the presence of bronchiectasis. Fatigue was associated with dyspnea and health status. Respiratory muscle strength was related to peripheral muscle strength and health status, but not to fatigue, peripheral muscle endurance or exercise capacity. These findings may provide insight for outcome measures for pulmonary rehabilitation programs for patients with bronchiectasis.
Pulmonary alveolar proteinosis: diagnostic and therapeutic challenges
Authors: Campo Ilaria , Kadija Zamir , Mariani Francesca , Paracchini Elena , Rodi Giuseppe , Mojoli Francesco , Braschi Antonio , Luisetti Maurizio
Published: January 2020

Pulmonary Alveolar Proteinosis (PAP) is a rare syndrome characterized by pulmonary surfactant accumulation within the alveolar spaces. It occurs with a reported prevalence of 0.1 per 100,000 individuals and in distinct clinical forms: autoimmune (previously referred to as the idiopathic form, represents the vast majority of PAP cases, and is associated with Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF) auto-antibodies; GMAbs), secondary (is a consequence of underlying disorders), congenital (caused by mutations in the genes encoding for the GM-CSF receptor), and PAP-like syndromes (disorders associated with surfactant gene mutations). The clinical course of PAP is variable, ranging from spontaneous remission to respiratory failure. Whole lung lavage (WLL) is the current standard treatment for PAP patients and although it is effective in the majority of cases, disease persistence is not an unusual outcome, even if disease is well controlled by WLL. In this paper we review the therapeutic strategies which have been proposed for the treatment of PAP patients and the progress which has been made in the understanding of the disease pathogenesis.
Anatomy and neuro-pathophysiology of the cough reflex arc
Authors: Polverino Mario , Polverino Francesca , Fasolino Marco , Andò Filippo , Alfieri Antonio , De Blasio Francesco
Published: January 2020

Coughing is an important defensive reflex that occurs through the stimulation of a complex reflex arc. It accounts for a significant number of consultations both at the level of general practitioner and of respiratory specialists. In this review we first analyze the cough reflex under normal conditions; then we analyze the anatomy and the neuro-pathophysiology of the cough reflex arc. The aim of this review is to provide the anatomic and pathophysiologic elements of evaluation of the complex and multiple etiologies of cough.
Pulmonary function tests and rehabilitation in 2012: beyond sitting position
Authors: Gamna Federica , Torchio Roberto
Published: January 2020

Not available.
The sarcoid granuloma: ‘epithelioid’ or ‘lymphocytic-epithelioid’ granuloma?
Authors: Kosjerina Zdravko , Zaric Bojan , Vuckovic Dejan , Lalosevic Dusan , Djenadic Goran , Murer Bruno
Published: January 2020

Background: This study aims to analyze the structure and quantities of cellular elements in sarcoid granulomas. Methods: We investigated 34 transbronchial lung biopsy samples obtained from 34 sarcoid patients. The quantity and composition of the cellular elements inside a granuloma were determined by the quantitative stereometry method, employing the numerical density as a stereological method. Results: A total of 102 sarcoid granulomas were analyzed. The central part of all granulomas was occupied by epithelioid cells. Besides these, giant cells, lymphocytes, macrophages and plasma cells were also seen. The mean numerical density of all the cells in the central part of a sarcoid granuloma was 111,751 mm-3. Lymphocytes prevailed in number, exceeding the total count of all other cells. With a mean numerical density of 74,321 mm-3, lymphocytes were twice as numerous as both epithelioid cells and macrophages with a mean numerical density of 37,193 mm-3. Conclusions: Lymphocytes are the predominant cell type in the central part of a sarcoid granuloma, significantly exceeding both epithelioid cells and macrophages in number, raising the question if the term “epithelioid granuloma”, routinely used to designate sarcoid granulomas, is correct, or if it would be more logical to call them “lymphocytic-epithelioid granulomas” instead. Trial registration: This study was supported by the Serbian Ministry of Science and Environmental Protection Grant Number 175006/2011.
Propylthiouracil-induced lupus-like or vasculitis syndrome
Authors: Tetikkurt Cuneyt , Yuruyen Mehmet , Tetikkurt Seza , Bayar Nihal , Ozdemir Imran
Published: January 2020

A 27 year old female with Graves’ disease presented with fever, exertional dyspnea and polyarthralgia. Erythema nodosum had occured three months earlier. The patient declared irregular use of propylthiouracil (PTU) for the last 8 months. Neutropenia and microscopic hematuria developed in the second week of admission. Chest X-ray showed inhomogenous pulmonary opacities, left pleural effusion and cardiomegaly. Computed tomography (CT) revealed multiple subpleural nodules, left pleural effusion, pericardial effusion, enlarged mediastinal and axillary lymph nodes. Bronchoalveolar lavage (BAL) cytology demonstrated hemosiderin laden macrophages. Histopathologic examination of the transbronchial biopsy specimen revealed a nonspecific inflammation. Serum was positive for ANA, P-ANCA, MPO-ANCA, PR3-ANCA and negative for anti-ds-DNA, C-ANCA, C3, C4 and antihistone antibody. All symptoms resolved in two months after PTU withdrawal and starting steroid treatment. The same clinical manifestations recurred when the patient used PTU erronously one month after discharge. This is a case of PTU induced-autoimmune disease in whom the accurate distinction between drug-induced-lupus (DIL) and vasculitis was not possible due to the significant overlap of clinical and laboratory findings causing a significant diagnostic challenge for the chest physician.
Perspective on long term oxygen therapy Peter
Authors: Howard Peter
Published: January 2020

Not available.
Analysis of two cases with bronchopulmonary neurofibromatosis
Authors: Yuan Ting , Luo Bai-ling , Gu Qi-hua , Yao Ji
Published: January 2020

Neurogenic tumor of lung is very rare. Only few cases have been reported in the literature. We present here two cases of bronchopulmonary neurofibromatosis in two adults. In both cases, attempts at imaging failed to diagnose the case, and it was the histological study that ensured the diagnosis of neurofibromatosis. Biopsy specimens showed bundles of spindle-shaped cells mixed with collagen, and on immunohistochemistry some cells were positive for S-100 protein.
Can high-quality palliative care for respiratory patients be improved?
Authors: Ambrosino Nicolino
Published: January 2020

Not available.
Intensive long-term pulmonary rehabilitation program after oesophagectomy, a reflection
Authors: Pasqua Franco
Published: January 2020

Not available.
Aspiration of tracheoesophageal prosthesis in a laryngectomized patient
Authors: Conte Sergio C. , De Nardi Elena , Conte Federico , Nardini Stefano
Published: January 2020

Background: The voice prosthesis inserted into a tracheoesophageal fistula has become the most widely used device for voice rehabilitation in patients with total laryngectomy. Case presentation: We describe a case of tracheoesophageal prosthesis’ (TEP) aspiration in a laryngectomized patient, with permanent tracheal stoma, that appeared during standard cleaning procedure, despite a programme of training for the safe management of patients with voice prosthesis. Conclusions: The definitive diagnosis and treatment were performed by flexible bronchoscopy, that may be considered the procedure of choice in these cases, also on the basis of the literature.
Multiplanar and two-dimensional imaging of central airway stenting with multidetector computed tomography
Authors: Ozgul Mehmet Akif , Ozgul Guler , Cetinkaya Erdogan , Abul Yasin , Kirkil Gamze , Seyhan Ekrem Cengiz , Kamiloglu Emine , Gul Sule
Published: January 2020

Background: Multidetector computed tomography (MDCT) provides guidance for primary screening of the central airways. The aim of our study was assessing the contribution of multidetector computed tomography- two dimensional reconstruction in the management of patients with tracheobronchial stenosis prior to the procedure and during a short follow up period of 3 months after the endobronchial treatment. Methods: This is a retrospective study with data collected from an electronic database and from the medical records. Patients evaluated with MDCT and who had undergone a stenting procedure were included. A Philips RSGDT 07605 model MDCT was used, and slice thickness, 3 mm; overlap, 1.5 mm; matrix, 512x512; mass, 90 and kV, 120 were evaluated. The diameters of the airways 10 mm proximal and 10 mm distal to the obstruction were measured and the stent diameter (D) was determined from the average between D upper and D lower. Results: Fifty-six patients, 14 (25%) women and 42 (75%) men, mean age 55.3 ± 13.2 years (range: 16-79 years), were assessed by MDCT and then treated with placement of an endobronchial stent. A computed tomography review was made with 6 detector Philips RSGDT 07605 multidetector computed tomography device. Endobronchial therapy was provided for the patients with endoluminal lesions. Stents were placed into the area of stenosis in patients with external compression after dilatation and debulking procedures had been carried out. In one patient the migration of a stent was detected during the follow up period by using MDCT. Conclusions: MDCT helps to define stent size, length and type in patients who are suitable for endobronchial stinting. This is a non-invasive, reliable method that helps decisions about optimal stent size and position, thus reducing complications.
Anti-reflux procedure for difficult-to-treat asthmatic children, case report and literature review
Authors: Hu Zhi-Wei , Wang Zhong-Gao , Wu Ji-Min , Tan Song-Tao
Published: January 2020

Gastroesophageal reflux disease (GERD) is a commonly encountered condition in children, which at times causes respiratory distress, such as asthmatic symptoms, and results in serious morbidity and even mortality. The complexity is sometimes so obscure, that it can cause paradoxical diagnoses and treatment. Here we present two cases of children with difficult-to-treat asthmatic symptoms, which were eventually found to be related to GERD. The two children were treated with anti-reflux procedures and both became symptom free. Literature was also reviewed to shed a light into this complex disease.
Prognostic value of p53 and Ki67 expression in fiberoptic bronchial biopsies of patients with non small cell lung cancer
Authors: Ciancio Nicola , Galasso Maria Grazia , Campisi Raffaele , Bivona Laura , Migliore Marcello , Di Maria Giuseppe U.
Published: January 2020

Background: Overexpression of the tumor suppressor gene p53 and the marker for cellular proliferation Ki67 in open lung biopsies are indicated as predictor factors of survival of patients with lung cancer. However, the prognostic value of p53 and Ki67 in fiberoptic bronchial biopsies (FBB) has not been fully investigated. We evaluated p53 and Ki67 immunostaining in FBB from 19 with Non Small-Cell Lung Cancer (NSCLC: 12 adenocarcinomas, 5 squamous cell carcinomas and 2 NSCLC-NOS). Methods: FBB specimens were fixed in formalin, embedded in paraffin, and immunostained using anti-p53 and anti-Ki67 antibodies. Slides were reviewed by two independent observers and classified as positive (+ve) when the number of cells with stained nuclei exceeded 15% for p53 or when >25% positive cells were observed throughout each section for Ki67. Results: Positive (+ve) immunostaining was found in 9 patients for p53 (47.37%) and 8 patients for Ki67 (42.10%). We examined overall survival curves of the patients with Mantel's logrank test, both p53 -ve and Ki67 -ve patients had significantly higher survival rates than p53 + ve (p < 0.005) and Ki67 + ve (p < 0,0001), respectively. Conclusion: This study suggests that negative immunostaining of fiberoptic bronchial biopsies for p53 and Ki67 could represent a better prognostic factor for patients with NSCLC.
Flexible bronchoscopy may decrease respiratory muscle strength: premedicational midazolam in focus
Authors: Tulek Baykal , Kanat Fikret , Tol Sule , Suerdem Mecit
Published: January 2020

Background: Flexible bronchoscopy (FB) is a procedure accepted to be safe in general, with low complication rates reported. On the other hand, it is known that patients with pre-existing respiratory failure have developed hypoventilation following FB. In this study the effects of FB on respiratory muscle strength were investigated by measuring maximum respiratory pressures. Methods: One hundred and forty patients, aged between 25 and 90 years, who had undergone diagnostic bronchoscopy between February 2012 and May 2012, were recruited to the study. Pre- and post-procedure maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured. A correlation between the MIP and MEP changes and patient characteristics and FB variables were investigated. Results: Significant decreases in both MIP and MEP values were observed following FB (p < 0.001 for both). Decreases were attributed to the midazolam used for sedation. Significant decreases in respiratory muscle strengths were observed especially in the high-dose midazolam group, compared to both low-dose and non-midazolam groups. Conclusions: It was determined that respiratory muscle weakness may arise post-procedure in patients who have undergone FB, and this is constitutively related to midazolam premedication. Respiratory muscle weakness might play a role in potential hypoventilation in critical patients who undergo FB.
Factors associated with health-related quality of life in adults with asthma. A cross-sectional study
Authors: Gonzalez-Barcala Francisco-Javier , De la Fuente-Cid Ramon , Tafalla Mónica , Nuevo Javier , Caamaño-Isorna Francisco
Published: January 2020

Background: The measurement of health-related quality of life (HRQoL) is increasingly recognized as an important endpoint, as a reflection of the effects of the disease from a patient perspective. Our aim was to evaluate the factors determining the HRQoL in patients with asthma, according to the EQ-5D questionnaire. Methods: Patients were included using multi-stage sampling, from Primary Care clinics from all the Autonomous Communities in Spain. The patients included were: over 18 years-old, with a confirmed diagnosis of asthma for at least one year, and had visited a Health Centre in the previous 2 years. The characteristics of the asthma disease, the adherence to treatment, the socio-demographic variables, the smoking habits, and the asthma control were collected using a questionnaire. The influence of the different variables included in the study on the EQ-5D was evaluated using multivariate logistic regression analysis. Results: A total of 2,125 patients were finally included (57.7% females, mean age 48 years). The response rate was 95.4%. Some factors showed a considerable detrimental effect on the HRQoL of asthmatics. Advanced age, lower educational level and poor control of asthma are significantly associated with a worse quality of life in all the dimensions assessed by the EQ-5D scale. The baseline severity of the asthma, and having been admitted to hospital are related to a worse quality of life in 5 of the 6 dimensions analyzed. Conclusion: In our study, we could identify some factors related to quality of life in asthma patients. The most important were advanced age, lower education level, and poor control of the asthma.
Endobronchial tuberculosis: histopathological subsets and microbiological results
Authors: Ozkaya Sevket , Bilgin Salih , Findik Serhat , Çete Kök Hayriye , Yuksel Canan , Atıcı Atilla Güven
Published: January 2020

Background: Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. Bronchoscopic appearances of EBTB have been divided into seven subtypes: actively caseating, edematous-hyperemic, fibrostenotic, tumorous, granular, ulcerative, and nonspecific bronchitic. However, information for establishing a definite microbiological diagnosis in each of these categories is lacking. We aimed to present bronchoscopic appearances and percentages for the EBTB subtypes and to compare bronchoscopic appearances with microbiological positivity in bronchial lavage fluid. Methods: From 2003 to 2009, 23 biopsy-proven EBTB patients were enrolled in the study. Diagnosis of EBTB was histopathologically confirmed in all patients. Results: The commonest subtype was the edematous-hyperemic type (34.7%); other subtypes in order of occurrence were: tumorous (21.7%), granular (17.3%), actively caseating (17.3%), fibrostenotic (4.3%), and nonspecific bronchitic (4.3%). Although all patients were sputum-smear-negative for acid-fast bacilli (AFB), 26% of patients were smear-positive for AFB in the bronchial lavage fluid. The bronchial lavage fluid grew Mycobacterium tuberculosis in 39.1% of all patients. The bronchial lavage smear positivity for AFB in the bronchial lavage fluid was 75%, 25%, 20%, 12.5%, 0%, and 0% for the granular, actively caseating, tumorous, edematous-hyperemic, fibrostenotic, and nonspecific bronchitic subtypes of EBTB, respectively. Culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid was 75%, 50%, 40%, 25%, 0%, and 0%, respectively. Conclusion: The commonest subtype of EBTB was the edematous-hyperemic subtype. The granular type had the highest smear positivity and culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid. Bronchoscopy should be performed in all patients suspected to have EBTB.
Endobronchial Tubercolosis: a peculiar feature of TB often underdiagnosed
Authors: Casali Lucio , Crapa Mariano E.
Published: January 2020

Not available.
Chronic obstructive pulmonary disease phenotype desaturator with hypoxic vascular remodelling and pulmonary hypertension obtained by cluster analysis
Authors: Toraldo Domenico Maurizio , Minelli Mauro , De Nuccio Francesco , Nicolardi Giuseppe
Published: January 2020

Significant heterogeneity of clinical presentation and disease progression exists within chronic obstructive pulmonary disease (COPD). This article discusses and refines the concept of desaturator phenotypes in COPD with pulmonary hypertension (PH) obtained by cluster analysis and presents a pattern of phenotypic markers that could be used as a framework for future diagnosis and research. Nocturnal oxygen desaturation results in sleep disturbances which predispose to nocturnal cardiac dysrhythmias, PH and possibly nocturnal death, particularly during acute exacerbations. We assume that in patients with COPD at least two factors play a role in PH: the severity of pulmonary impairment, and the severity of systemic nocturnal hypoxaemia due to reduced pulmonary functions. Establishing a common language for future research will facilitate our understanding and management of such a disease. This knowledge could lead to different pharmacological treatments and other interventions directed at specific phenotypic groups.
Bronchial cast hiding a lung cancer
Authors: Migliore Marcello , Ciancio Nicola , Giuliano Riccardo , Di Maria Giuseppe
Published: January 2020

A 70-year-old man was admitted for severe hypoxia, haemoptysis and cough. Chest-X-ray and CT-scan indicated a right-lower-lobe collapse. Bronchoscopy showed its occlusion by whitish dense mucus. Aspiration revealed a Bronchial Cast (BC) and a stenotic and inflamed orifice of the right-lower-lobe-bronchus which was biopsied. Histopathologic examination of BC showed fibrin with lymphocytes and neutrophils, and, surprisingly, also the presence of lung cancer. Although the association between BC and benign, myxoid-soft-tissue, tracheobronchial tumors has been described, the association with lung cancer has not previously been reported, and it remains unclear whether it is causal or casual.
Dynamics of regional lung aeration determined by electrical impedance tomography in patients with acute respiratory distress syndrome
Authors: Pulletz Sven , Kott Matthias , Elke Gunnar , Schädler Dirk , Vogt Barbara , Weiler Norbert , Frerichs Inéz
Published: January 2020

Background: Lung tissue of patients with acute respiratory distress syndrome (ARDS) is heterogeneously damaged and prone to develop atelectasis. During inflation, atelectatic regions may exhibit alveolar recruitment accompanied by prolonged filling with air in contrast to regions with already open alveoli with a fast increase in regional aeration. During deflation, derecruitment of injured regions is possible with ongoing loss in regional aeration. The aim of our study was to assess the dynamics of regional lung aeration in mechanically ventilated patients with ARDS and its dependency on positive end-expiratory pressure (PEEP) using electrical impedance tomography (EIT). Methods: Twelve lung healthy and twenty ARDS patients were examined by EIT during sustained step increases in airway pressure from 0, 8 and 15 cm H2O to 35 cm H2O and during subsequent step decrease to the corresponding PEEP. Regional EIT waveforms in the ventral and dorsal lung regions were fitted to bi-exponential equations. Regional fast and slow respiratory time constants and the sizes of the fast and slow compartments were subsequently calculated. Results: ARDS patients exhibited significantly lower fast and slow time constants than the lung healthy patients in ventral and dorsal regions. The time constants were significantly affected by PEEP and differed between the regions. The size of the fast compartment was significantly lower in ARDS patients than in patients with healthy lung under all studied conditions. Conclusion: These results show that regional lung mechanics can be assessed by EIT. They reflect the lower respiratory system compliance of injured lungs and imply more pronounced regional recruitment and derecruitment in ARDS patients.
C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit
Authors: Devran Özkan , Karakurt Zuhal , Adıgüzel Nalan , Güngör Gökay , Moçin Özlem Yazıcıoğlu , Balcı Merih Kalamanoğlu , Çelik Ece , Saltürk Cüneyt , Takır Huriye Berk , Kargın Feyza , Yılmaz Adnan
Published: January 2020

Background: Severe sepsis is a primary cause of morbidity and mortality in the intensive care unit (ICU). Numerous biomarkers have been assessed to predict outcome and CRP is widely used. However, the relevance for mortality risk of the CRP level and the day when it is measured have not been well studied. We aimed to assess whether initial and/or third dayCRP values are as good predictors of mortality in ICU patients with severe sepsis as other well-known complex predictors of mortality, i.e., SOFA scores. Methods: An observational cohort study was performed in a 20-bed respiratory ICU in a chest disease center. Patients with severe sepsis due to respiratory disease were enrolled in the study. SOFA scores, CRP values on admission and on the third day of hospital stay, and mortality rate were recorded. ROC curves for SOFA scores and CRP values were calculated. Results: The study included 314 ICU patients with sepsis admitted between January 2009 and March 2010. The mortality rate was 14.2% (n = 45). The area under the curve (AUC) for CRP values and SOFA scores on admission and on the 3rd day in ICU were calculated as 0.57 (CI: 0.48-0.66); 0.72 (CI: 0.63-0.80); 0.72 (CI: 0.64-0.81); and 0.76 (CI: 0.67-0.86), respectively. Sepsis due to nosocomial infection, a CRP value > 100 mg/L and higher SOFA scores on 3rd day, were found to be risk factors for mortality (odds ratio [OR]: 3.76, confidence interval [CI]: 1.68-8.40, p < 0.001, OR: 2.70, CI: 1.41-2.01, p < 0.013, and OR: 1.68, CI: 1.41-2.01, p < 0.0001, respectively). Conclusions: The risk of sepsis related mortality appears to be increased when the 3rd day CRP value is greater than 100 mg/dL. Thus, CRP appears to be as valuable a predictor of mortality as the SOFA score.
A survey of the burden of allergic rhinitis in Hungary from a specialist’s perspective
Authors: Szilasi Mária , Gálffy Gabriella , Fónay Károly , Márk Zsuzsa , Rónai Zoltán , Szalai Zsuzsanna , Szilasi Magdolna E. , Budai Marianna , Müller Veronika , Somfay Attila , Horváth Ildikó , Tamási Lilla
Published: January 2020

Background: The casual and severity distribution of allergic rhinitis (AR) in Hungary is unknown. The aim of this survey was to evaluate symptom perception, disease severity, concomitant asthma frequency and the impact of AR on everyday life activities in a cross-sectional, multicenter study in Hungary under the supervision of Hungarian Respiratory Society. Methods: Data were recorded by 933 AR patients (65.93% women) and their treating specialists. The perceptions of patients regarding the symptoms (nasal, ocular and others) of AR and its severity, together with its impact on everyday life were assessed. Physicians recorded data regarding the diagnosis and severity of AR, and comorbidities. Results: 52.5% of patients suffered from seasonal AR, 35.1% from perennial AR. A large proportion of patients had moderate to severe disease (MS-AR) (57.34%), persistent disease (98.0%) and concomitant asthma (53.32% in the mild, 57.52% in the MS-AR group). MS-AR was more frequent among women. Despite the treatment used, in MS-AR the proportions of patients reporting moderate to severe rhinorrhoea, nasal obstruction, ocular itching/redness, watering, itchy throat and sneezing were as high as 52.0%, 54.0%, 33.8%, 26.5%, 44.0% and 31.2%, respectively. Overall, there was a poor agreement between disease severity reported by patients and specialists. The adherence to oral antihistamines and intranasal corticosteroids was found to be between 50 and 65%; mostly depending on the dosage form. Conclusions: AR remains a significant health problem in Hungary because of the burden of symptoms, high rate of concomitant asthma and the significant proportion of MS-AR affecting general well being.
Gastroesophageal reflux disease in our asthma patients: the presence of dysphagia can influence pulmonary function
Authors: Aras Gulfidan , Kanmaz Dilek , Kadakal Figen , Purisa Sevim , Sonmez Kenan , Tuncay Esin , Ozdemir Arzu
Published: January 2020

Background: The prevalence of Gastroesophageal Reflux Disease (GERD) in Turkey is reported as 11.6%. Studies of pulmonary function in asthmatics have demonstrated a correlation between lung resistance and the occurrence of spontaneous gastroesophageal reflux. Few studies have included measures of lung diffusing capacity for carbon monoxide. The aim of this study is to assess whether asthma patients had worse lung function and gas diffusion according to diversity of GERD symptoms they concurrently experienced. The secondary aim of the study is to determine the frequency and different faces of GERD in our asthma patients compared to healthy controls. Methods: Sixty consecutive asthma patients evaluatd at the pulmonary specialty outpatient clinic were included in the study. The control group included 60 healthy volunteers who had normal pulmonary function and routine laboratory tests. A modified version of a self-reported questionnaire developed by Locke and associates at the Mayo Clinic was conducted face-to-face with consecutive asthma patients and control subjects. Pulmonary function measurements were taken using spirometry. DLCO (mL/dk/mmHg) and DLCO/VA (DLCO adjusted according to alveolar volume) were measured using a single-breath technique. Statistical analyses were performed using the SPSS 17.0 statistical software. Results: DLCO and DLCO/VA were significantly lower in asthma patients who had dysphagia symptoms. Frequent and significant acid regurgitations were seen in 28.33% (n = 17) of patients in the study group and 6.7% (n = 4) of patients in the control group. Severe, troublesome heartburn symptoms were reported by 28.2% (n = 17) of patients in the study group and 16.7% (n = 10) of subjects in the control group. Dysphagia was detected in 38.3% (n = 23) of all asthma cases and in 1.7% (n = 1) of the subjects in the control group. Conclusions: There were many faces of gastroesophageal reflux disease in our asthmatic patients. Dysphagia was the only GERD symptom influencing on pulmonary function tests, while gastroesophageal reflux symptoms and nocturnal awakening attacks were common in this study.
Husband and wife with sarcoidosis: possible environmental factors involved
Authors: Leli Ilaria , Salimbene Ivano , Varone Francesco , Fuso Leonello , Valente Salvatore
Published: January 2020

Sarcoidosis is a granulomatous multisystem disorder of unclear etiology that involves any organ, most commonly the lung and the lymph nodes. It is hypothesized that the disease derives from the interaction between single or multiple environmental factors and genetically determined host factors. Multiple potential etiologic agents for sarcoidosis have been proposed without any definitive demonstration of causality. We report the case of two patients, husband (57 years old) and wife (55 years old), both suffering from sarcoidosis. They underwent a lymph node biopsy by mediastinoscopy which showed a “granulomatous epithelioid giant cell non-necrotising chronic lymphadenitis”. They had lived up to 3 years ago in the country in a farm, in contact with organic dusts, animals such as dogs, chickens, rabbits, pigeons; now they have lived since about 3 years in an urban area where there are numerous chemical industries and stone quarries. The aim of this case report was to focus on environmental factors that might be related to the pathogenesis of the sarcoidosis.
Reviewer acknowledgement 2012
Authors: De Benedetto Fernando , Donner Claudio F. , Sanguinetti Claudio M.
Published: January 2020

Not available.