bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum surfactant protein D as a prognostic factor in idiopathic pulmonary fibrosis
Authors: El-Miligy Dawalat , Zakaria Mohamed W. , Rashed Laila , Abu-Hussein Haidi 
Published: September 2023

Abstract
Background/aim
The aim of this study was to investigate the possible role of surfactant protein D (SP-D) in the pathogenesis and the prognosis of idiopathic pulmonary fibrosis (IPF).

Materials and methods
This study was performed on 10 healthy volunteers (group 1) and 30 patients from the Chest Diseases Department, Kasr El-Aini Hospital, who were divided into three groups: group 2 consisted of 10 patients with IPF receiving steroids; group 3 consisted of 10 patients with IPF not receiving steroids; and group 4 consisted of 10 patients with chronic chest diseases other than IPF and not receiving steroids. All patients underwent full history taking, thorough clinical examination, chest radiography and high-resolution computed tomography of the chest, pulmonary function testing, and estimation of SP-D by enzyme-linked immunosorbent assay.

Results
There was no statistical significance in the mean age of the four included groups. With regard to smoking in patients in groups 2, 3, and 4, there was no statistical significance in the duration or the number of cigarettes smoked per day. There was a significant decrease in FEV1, FVC, and FEV1/FVC in groups 2, 3, and 4 compared with the control group (group 1). SP-D shows a significant increase in groups 2, 3, and 4 compared with the control group, and also shows a significant increase in IPF patients not receiving steroids (group 3) compared with IPF patients receiving steroids (group 2) and patients with chronic chest diseases (group 4). A negative correlation was found between SP-D and FEV1, FVC, and FEV1/FVC. No correlation was found between SP-D, age, the duration of smoking, or the number of cigarettes smoked per day.

Conclusion
The SP-D assay may indicate the rate of decline in the pulmonary function in cases of IPF and in the follow-up of disease progress. It may also assist in making clinical choices for the therapeutic management of patients with IPF.
Study of cardiopulmonary rehabilitation versus cardiac rehabilitation in patients suffering from coronary artery diseases and chronic obstructive pulmonary disease
Authors: Mohamed Yasser M. , Salem Hala M. , Khorshid Hazem M. , Abdel Fattah Karim H. 
Published: September 2023

Abstract
Introduction
Chronic obstructive pulmonary disease (COPD) and coronary artery disease are common treatable and preventable chronic diseases. Rehabilitation is now considered an important part of the long-term management in both diseases and includes exercise, education, and smoking cessation.

Patients and methods
This study included 40 patients with COPD and coronary artery disease referred to the cardiac rehabilitation unit at Ain Shams University hospitals. Patients were assessed by clinical assessment, ECG, ECHO, modified Bruce protocol, spirometry, and St George’s Respiratory Questionnaire (SGRQ). Then, patients were divided into two groups: a cardiac rehabilitation group and a cardiopulmonary rehabilitation group. All patients received 8–12 weeks of rehabilitation and were reassessed by spirometry, the modified Bruce protocol, and SGRQ.

Results
Both groups improved in terms of spirometric parameters (forced expiratory volume in 1 s and forced expiratory volume in 1 s/forced vital capacity), SGRQ, and metabolic equivalents of tasks, but there was a statistically significant in resting heart rate in the cardiopulmonary rehabilitation group.

Conclusion
The inclusion of upper limb exercise and inspiratory muscles training in pulmonary rehabilitation improves exercise tolerance in patients suffering from both COPD and coronary artery disease compared with cardiac rehabilitation alone.
Serum adiponectin as a biomarker for chronic obstructive pulmonary disease and lung cancer and its relation to severity
Authors: Gayed Amany T. , Raafat Riham H. 
Published: September 2023

Abstract
Introduction
‘Chronic obstructive pulmonary disease’ (COPD) is an inflammatory disorder associated with airway narrowing and airflow limitation in response to air pollution, gases, and smoking and is associated with morbidity and mortality. Cancer is also considered as a systemic inflammatory disorder where pro-inflammatory cytokines and mediators are released.

Aim
To evaluate serum adiponectin level in COPD and lung cancer and its importance in detecting and predicting severity.

Patients and methods
A total of 40 patients were recruited in the study: 20 had stable COPD and 20 had lung cancer. Moreover, another 10 age-matched and sex-matched individuals were included as a control group. All were subjected to routine laboratory chest radiography, spirometry, and serum adiponectin level measurement.

Results
The results showed an increase of adiponectin level in both patients with COPD and those with lung cancer, and significant correlation was found between adiponectin level and forced expiratory volume in 1 s and performance status.

Conclusion
Adiponectin serum level is elevated in both COPD and lung cancer and significantly elevated in severe cases.
Pulmonary complications within the first year after bone marrow transplantation
Authors: Sadon Amal Abd El-Azem , El-Hagrasy Rehab S. , Saraya Mohamed A. 
Published: September 2023

Abstract
Background
Pulmonary complications (PCs) are a significant cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. Pulmonary infiltrates in such patients pose a major challenge for clinicians because of the wide differential diagnosis of infectious and noninfectious conditions. It is rare for the diagnosis to be made by chest radiograph, and commonly these patients will need further invasive and noninvasive studies to confirm the etiology of the pulmonary infiltrates.

Aim
The aim of this research was to study the pattern of lower respiratory tract infection within the first year after HSCT.

Patients and methods
This is a prospective study of 60 patients receiving HSCT (because of hematological and nonhematological malignancy) at Kuwait Cancer Center within the first year after transplantation for any suspicious respiratory tract infection. Patients were subjected to sputum and blood examination along with bronchoscopic examination and bronchoalveolar lavage if indicated, and all samples were subjected to microbiological examination for diagnosis of the causative organism.

Results
Sixty patients were studied for PCs either infectious or noninfectious within the first year after HSCT. The most common complications were infectious complications (70%). Severe PCs were the main causes of death in 13 (21.6%) cases. The PCs were more common and recurrent in allogeneic bone marrow transplantation (BMT) recipients, in whom PCs contributed to death in 12 cases. Bacterial infection, pulmonary edema, and diffuse alveolar hemorrhage were seen more in the early post-BMT period (<100 days), whereas viral, fungal infection, graft-versus-host disease, and bronchiolitis obliterans were seen more in the late post-BMT period (>100 days).

Conclusion
Lower respiratory tract infection is a serious complication after BMT transplantation. Mixed bacterial and opportunistic infections are the most common etiologies. Pulmonary infiltrates in such patients pose a wide differential diagnosis of infectious and noninfectious conditions. PCs are a significant causes of death in BMT recipients.
Role of bronchoscopy in diagnosis of smear-negative pulmonary tuberculosis
Authors: Prasad Rajendra , Singh Abhijeet 
Published: September 2023

AbstractTuberculosis (TB) remains an important cause of morbidity and mortality in many developing countries including India. Prompt and accurate establishment of diagnosis is one of the essential basic principles of care for persons with TB. Sputum smear microscopy and culture remain the cornerstone of diagnosis but can be negative in a substantial proportion of pulmonary TB patients (multiple smear-negative status or scanty sputum). Bronchoscopy has been proven to be a safe and effective method for those patients with varying diagnostic yields ranging from 30 to 90%. Various specimens are obtained from a fiber-optic bronchoscope such as smear and culture for mycobacteria from the bronchial aspirate or wash, bronchoalveolar lavage fluid, bronchial brushing, postbronchoscopy sputum, transbronchial needle aspiration, and transbronchial biopsy. The diagnostic yield is significantly enhanced when nucleic acid amplification testing is applied to bronchoscopic specimens. The role of bronchoscopy in TB diagnosis is likely to be limited because of availability, cost, and logistical challenges. Future studies are needed to better define the role of the newer diagnostic modalities to improve early TB diagnosis.
Efficacy and safety of intrapleural cisplatin versus silver nitrate in treatment of malignant pleural effusion
Authors: El Badrawy Mohammad K. , Ali Raed El-Metwally , Hewidy Asem A. , El-Layeh Mohamed A. , Akl Fatma M. F. , Shebl Abdelhadi 
Published: September 2023

Abstract
Introduction
Malignant pleural effusion is a frequent problem. Pleurodesis is performed to prevent its recurrence. New, effective, and safe sclerosing agents are needed.

Aim
The aim of this was to compare efficacy and safety of silver nitrate solution 0.5% versus cisplatin in achievement of pleurodesis in malignant pleural effusion.

Patients and methods
Prospective randomized single-blinded clinical trial performed at Chest, Clinical Oncology and Nuclear Medicine and Pathology Departments, Mansoura University, from February 2016 to March 2017. A total of 60 patients (26 male and 34 female) with malignant pleural effusion were divided into two groups: first group included 30 patients who were managed with silver nitrate pleurodesis, and second group included 30 patients who were managed by intrapleural cisplatin injection. The success rate of pleurodesis was considered if there was no clinical or radiological recurrence of effusion for 1 month after intervention.

Results
There were significant improvements in cough, chest pain, and dyspnea in the two groups after 1 month versus that before pleurodesis. The success rate of pleurodesis in silver nitrate group was 90 versus 76.7% in cisplatin group, without significant difference (P=0.166). Chest pain was reported in 26.7% in silver nitrate group and 13.3% in cisplatin group, and fever was reported in 33.3% in silver nitrate group and 20.0% in cisplatin group. Recurrence was reported in 10% in silver nitrate group and in 23.3% in cisplatin group.

Conclusion
Silver nitrate and cisplatin were nearly equally effective, safe, and less expensive agents in achievement of pleurodesis in patients with malignant effusion with high success rate and low complications.
Assessment of coronary artery diseases in COPD
Authors: Abdalrazik Fatmaalzahraa S. , El-Sorougi Waleed M. 
Published: September 2023

Abstract
Context
Chronic obstructive pulmonary disease (COPD) is associated with significant systemic inflammatory response, with downstream adverse clinical effects. This inflammatory response is referred to oxidative stress and inflammatory mediators, which play an important role in the development of atherosclerosis. Preclinical carotid atherosclerosis, characterized by increased intima-media thickness (IMT) on ultrasound imaging, is a surrogate marker for atherosclerosis burden and risk of cardiovascular diseases.

Aim
To evaluate carotid IMT, in relation to post-forced expiratory volume in 1 s (FEV1) (FEV1 after bronchodilator inhalation) in COPD.

Patients and methods
A total of 50 patients with COPD were clinically and functionally diagnosed. IMT was measured by B-mode ultrasonography. The correlations between IMT, C-reactive protein (CRP), serum lipids, and post-FEV1 were analyzed. The primary outcome was carotid arteries’ IMT in relation to post-FEV1.

Results
Cases were divided into three groups according to post-FEV1. In mild COPD severity, mean±SD IMT value was 1.0±0.2, whereas in moderate severity, it was 1.5±0.2, and in severe COPD, IMT was 1.75±0.05 (P<0.001). In mild group, mean±SD value of CRP was 5.2±1.7, in moderate group was 7.5±1.5, and in severe COPD group was 8.4±0.2 (P<0.001). When CRP was correlated with IMT, the correlation was found to be highly significant (P<0.001). In severe airway obstruction group, mean values of serum cholesterol and triglycerides were 239.5 and 189.5, respectively; in moderate group 219.4 and 161.9, respectively; and in mild group 184.2 and 125.6, respectively (P<0.000). Multinomial logistic regression analysis revealed low post-FEV1 as predictor of IMT (P<0.000).

Conclusion
Carotid duplex should be added to the standard investigations of COPD.
Effectiveness of pulmonary rehabilitation on pulmonary function parameters and dyspnea in patients with stable chronic obstructive pulmonary disease
Authors: Karn Atef F. Al , Hassan Wafaa A. , Fadl Abdel A. Abo El , Mahmoud Manal A. 
Published: September 2023

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by persistent airflow limitation that is usually progressive. The characteristic symptoms of COPD are chronic and progressive dyspnea, cough, and sputum production. Breathing exercises aim to reduce hyperinflation, improve respiratory muscle performance, and reduce dyspnea.

Aim
The aim of the study was to assess the effectiveness of breathing exercises among patients with stable COPD in improvement of pulmonary function parameters, 6-min walk distance, and dyspnea score.

Patients and methods
Randomized controlled design was used in this study. Patients recruited for this study were enrolled from the outpatient clinic of Department of Chest Diseases and Tuberculosis. Overall, 15 patients with stable COPD were enrolled in pulmonary rehabilitation group and underwent breathing exercises for 12 weeks. Moreover, 15 patients were enrolled in the control group. Statistical package for the social sciences (SPSS version 20) software was used for statistical analysis.

Results
In the breathing exercise group, there was a significant increase in the mean forced expiratory volume in first second (P=0.001), forced vital capacity (P=0.001), and inspiratory capacity (P=0.015). There was a significant decrease in the mean functional residual capacity (P=0.005), residual volume (P=0.001), and total lung capacity (P=0.001). There was no significant difference between the values of the previous parameters in the control group.

Conclusion
In stable COPD, breathing exercises improved pulmonary function parameters, 6-min walk distance, and dyspnea score.
Predictors and outcome of prolonged stay in the respiratory ICU
Authors: Khattab Adel M. , Elgawad El-Masry Ahmed Abd , El Maraghy Ashraf A. , Ahmed Noha O. 
Published: September 2023

Abstract
Introduction
Prolonged ICU stay is associated with high mortality, morbidity, and costs. Understanding the predictors of prolonged stay ICU patients is helpful in improving the patients’ outcomes, especially if some factors could be modified or useful in clinical decisions.

Aim
The aim of this study was to evaluate the characteristics, outcomes, and cost of ICU patients with a prolonged stay (≥15 days) and very long stay (≥30 days) in Ain Shams University Hospital Respiratory ICUs.

Patients and methods
This multidisciplinary prospective study was conducted on 213 patients admitted at the two respiratory ICUs at Ain Shams University Hospitals from May 2013 to May 2014. In addition, the relationships between residents, consultants, nurses, and patients’ families are evaluated through multiple surveys.

Results
A total of 213 patients met the inclusion criteria in both ICUs, with a mean age of 54.7 years (minimum: 20 years; maximum: 80 years) and mean ICU stay of 23.4 days (minimum: 15 days; maximum: 60 days). Mechanical ventilation, vasopressor support, type of nutrition, BMI, tracheostomy, and Acute Physiology And Chronic Health Evaluation II Score on admission had a significant association with prolonged ICU stay and mortality.
The surveys’ results showed that the nurse–physician relationship is of friendly stranger type. The residents’ pitfalls were mostly the grandiosity and lack of decision taking. Most of physicians of different medical degrees had highlightened the quality of leadership as the most important cause straining the relationship with colleagues. The family members’ satisfaction is correlated with the progression and length of stay of patients.

Conclusion
Patients with prolonged ICU stay consume the ICU resources. Studies identifying predictors of prolonged stay are essential to improve both resource utilization and the efficiency of ICU care. Personal relationship and communication skills have their impact on working environment.
The role of medical thoracoscopy in the management of empyema
Authors: El Gazzar Ahmad G. , El-Mahdy Mohammad A. E. , Al Mehy Gehan F. , El Desoukey Mohammad Asmaa 
Published: September 2023

Abstract
Background
Empyema thoracis is defined as accumulation of pus in the pleural space. Despite advanced medical diagnostic and therapeutic methods, thoracic empyema remains a common clinical entity and a serious problem all over the world with significant associated morbidity and mortality.

Aim
The aim of this work was to study the efficacy and safety of medical thoracoscopy (MT) in the management of empyema.

Patients and methods
This study included 30 inpatients with empyema. Included patients had frank pus on aspiration (turbid purulent fetid fluid) with or without positive Gram stain smear and microbiological culture findings or pH less than 7.20, with signs of sepsis. Patients were managed by MT. MT using rigid thoracoscopy was performed with evacuation of the purulent fluid, visualization of the pleural space, assessment of adhesions and purulent material, forceps adhesiolysis, and irrigation by normal saline with partial debridement of accessible parietal pleural surface.

Results
The present study included 30 patients with empyema (17 men, 13 women with a mean age of 47.4±14.5 years; range, 18–70 years); 19 (63.3%) patients had free-flowing empyema (by computed tomography/ ultrasonography) and 11 (36.7%) patients had multiloculated empyema. The etiology of empyema included pneumonia (parapneumonic effusion) (33.3%), malignancy (23.3%), tuberculosis (6.7%), lung abscess (6.7%), and no cause was identified in nine patients (spontaneous pleural infection) (30%). MT was considered successful without subsequent interventional procedures in 26 of 30 (86.7%) patients, including all patients with free-flowing empyema (19 patients), 63.6% of patients with multiloculated empyema (seven patients), and four (13.3%) patients required surgical intervention (surgical decortication). No procedure-related mortality or chronic morbidity occurred in this study.

Conclusion
MT is a simple, safe, minimally invasive, and effective modality in the management of empyema.
Experience in medical thoracoscopy: a 4-year retrospective study
Authors: Baess Ayman I. , Sweed Rania A. 
Published: September 2023

Abstract
Objective
The aim was to document our experience in rigid medical thoracoscopy in the diagnosis of pleural effusion of undetermined origin in a 4-year retrospective study regarding its safety, complications, and diagnostic yield.

Patients and methods
Data of 134 patients who underwent medical thoracoscopy in Alexandria Main University Hospital, Chest Department, for diagnosing pleural effusion of undetermined origin were reviewed to assess the diagnostic yield, safety, and complications of rigid medical thoracoscopy.

Results
We reviewed records of 134 patients [62 (46%) males and 72 (54%) females]. Their mean age was 54±13.43 years. On combining histopathological and bacteriological examination results of thoracoscopic pleural biopsies, all patients were finally diagnosed, except for 13 (10%) patients who remained idiopathic; 97 (72%) patients were diagnosed as having malignant pleural effusion and 24 (18%) patients were diagnosed as having benign pleural effusion. The commonest complication encountered was postprocedural pain (35%), followed by subcutaneous emphysema (19%). Overall, the procedure was safe even in elderly patients. No procedure-related mortality was reported.

Conclusion
Medical thoracoscopy, in our experience, is a safe and well-tolerated procedure even in elderly patients with high diagnostic yield.
Evaluation of the role of bronchoscopy in the intensive care units
Authors: Korraa Emad A. , Dwedar Ibrahim A. , Gomaa Ashraf A. , Shata Aalaa K. 
Published: September 2023

Abstract
Objectives
The aim of this study was to evaluate the role of bronchoscopy in the intensive care units (indications, advantages, disadvantages, results, and complications).

Patients and methods
Bronchoscopy (rigid or fibroptic) was performed in Ain shams University hospital and Ain Shams University Specialized Hospitals on 80 ICU patients requiring diagnostic and/or therapeutic indication. The patients were grouped into ventilated and nonventilated.

Results
A total of 50 (62%) fibroptic bronchoscopies and 30 (37%) rigid bronchoscopies were performed on 30 (37.5%) ventilated patients and 50 (62.5%) nonventilated. Overall, 90% of flexible bronchoscopies were done for ventilated patients and 54% of rigid bronchoscopies was done in nonventilated patients (54%). Moreover, 80% of the procedures were done for diagnostic purposes using fibroptic bronchoscopies in 98%, whereas 36.7% of bronchoscopies were done for combined indications and 13.3% of therapeutic indications bronchoscopies were done with rigid bronchoscopy. In addition, 51.25% of the procedures that were done with bronchoscopies were lavage followed by stent insertion (25%). In 83.3% of ventilated patients, lavage was done, whereas stent insertion was more in nonventilated patient group. Overall, 26.25% of the patients were diagnosed as having malignant disease and 20% had infections of lower respiratory tract. Complications occurred in 21.25%, with mortality rate of 0.0%, and hypoxia was the most common.

Conclusion
Safety is one of the most important issues when deciding to perform bronchoscopy in the ICU, which depends on the accuracy of selection of the patients for the procedure and the experience of the bronchoscopist and facilities available.