Imaging aspects of interstitial lung disease in patients with rheumatoid arthritis: Literature review.

Objective: Interstitial lung disease (ILD) is a frequent and severe complication of rheumatoid arthritis (RA), resulting in pulmonary fibrosis (PF) and respiratory failure.

Methods: Chest computed tomography (CT-c) or high resolution CT (HRCT) is the main modality for assessment of ILD. We performed a systematic literature review on CT-c/HRCT findings in patients with ILD-RA, using the MEDLINE database for the period from 1991 to 2015.

Does molecular analysis increase the efficacy of bronchoalveolar lavage in the diagnosis and management of respiratory infections in hemato-oncological patients?

Objectives: The identification of the specific pathogen responsible for a respiratory infection in patients with hematological malignancies (HM) would ensure relevant treatment and prevent toxicity associated with anti-infective therapy. This large-scale study aimed to explore the clinical impact of fiberoptic bronchoscopy with bronchoalveolar lavage (FOB-BAL) in conjunction with molecular analysis on the diagnosis and management of respiratory infections in hemato-oncological patients.

Methods: All consecutive patients with HM and pulmonary infiltrates, who underwent FOB-BAL between January 2008 and January 2013, were included in the analysis.

Polymicrobial pulmonary infection in patients with hematological malignancies: prevalence, co-pathogens, course and outcome.

Purpose: The frequency and clinical significance of polymicrobial pneumonia in patients with hematological malignancies (HM) are poorly understood. The aim of the present study is to describe the prevalence, risk factors, clinical characteristics, and outcome of patients with HM and polymicrobial pneumonia.

Methods: Over a 5 year period, 436 consecutive adult patients with HM and pulmonary infiltrates underwent diagnostic fiberoptic bronchoscopy with bronchoalveolar lavage.

Long-term follow-up of patients with scleroderma interstitial lung disease treated with intravenous cyclophosphamide pulse therapy: a single-center experience.

Background: Scleroderma lung disease (ILD-SSc) is treated mainly with cyclophosphamide (CYC). The effectiveness of CYC was judged after 12-24 months in most reports.

Objectives: To analyze the effect of monthly intravenous CYC on pulmonary function tests including forced vital capacity (FVC) and diffusing lung capacity (DLCO), as well as Rodnan skin score (mRSS), during long-term follow-up.

Lipid profile and statin use: the paradox of survival after acute exacerbation of chronic obstructive pulmonary disease.

Background: A paradoxical association between cholesterol level and clinical outcome has been suggested, yet never previously established, in patients with chronic obstructive pulmonary disease (COPD).

Objectives: The authors sought to investigate the interaction between long-term survival, lipid profile and statin use in patients after acute exacerbation of COPD (AECOPD).

Methods: A retrospective study evaluating demographic, clinical and laboratory data of 615 consecutive patients admitted for AECOPD over a mean follow-up period of 24.

Evaluation of high-sensitivity serum CRP levels compared to markers of airway inflammation and allergy as predictors of methacholine bronchial hyper-responsiveness in children.

Background: Bronchial hyper-responsiveness assessed by the methacholine challenge test (MCT) may aid in the diagnosis of asthma, while a negative MCT can help in excluding the diagnosis. Laboratory measures that predict the results of MCT are expected to reduce the number of procedures. We evaluated the capacity of serum high-sensitivity C-reactive protein (hs-CRP) to predict positive or negative MCT in school-aged children and compared it to a marker of airway inflammation, fractional exhaled nitric oxide (FeNO), and markers of allergic sensitization, immune globulin E (IgE) and peripheral blood eosinophils.

D-dimer as a prognostic biomarker for mortality in chronic obstructive pulmonary disease exacerbation.

Background: A major barrier to chronic obstructive pulmonary disease (COPD) research and management is lack of easily obtained biomarkers that are predictive of clinically important outcome measures.

Objectives: We sought to investigate in patients admitted for acute exacerbation of COPD (AECOPD) the association of D-dimer (fibrin degradation product) obtained upon admission with in-hospital mortality and postdischarge prognosis.

Methods: Clinical and laboratory data were evaluated in 61 patients admitted for AECOPD in whom D-dimer levels were obtained and in whom venous thromboembolism/pulmonary embolism was excluded.

Outcome of Pneumocystis jirovecii pneumonia diagnosed by polymerase chain reaction in patients without human immunodeficiency virus infection.

Background And Objective: Pneumonia caused by Pneumocystis jirovecii (PCP) in patients without human immunodeficiency virus (HIV) infection is associated with high mortality. The diagnosis of PCP at our institution is based on detection of DNA using a polymerase chain reaction (PCR) assay. The aim of this study was to describe the clinical manifestations, outcomes and factors associated with mortality due to PCP, as diagnosed by PCR, in patients without HIV infection.

The increased risk for pneumocystis pneumonia in patients receiving rituximab-CHOP-14 can be prevented by the administration of trimethoprim/sulfamethoxazole: a single-center experience.

Recent studies suggest an increased risk for Pneumocystis jirovecii pneumonia (PJP) in adults receiving short-interval rituximab-CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) therapy for diffuse large cell B cell lymphoma (DLBCL). This retrospective study evaluates precise PJP incidence and the efficacy of anti-PJP prophylaxis in DLBCL. Patients with DLBCL, aged ≥18 years and treated between December 2004 and December 2010, were included.

Clinical spectrum and outcome of Nocardia infection: experience of 15-year period from a single tertiary medical center.

Introduction: Nocardiosis, although very rare, is considered as an important opportunistic infection; however, recent literature is limited. This study describes all cases of nocardial infection treated in the authors' hospital to provide more information about clinical manifestations, species isolated, treatment and outcome of patients with nocardiosis.

Methods: A retrospective review of the clinical features and outcome of nocardial infections was conducted during a 15-year period (1996-2010) at Rambam Health Care Campus.

Characterization of pulmonary venous hypertension patients with reactive pulmonary hypertension as compared to proportional pulmonary hypertension.

Background: Patients with pulmonary venous hypertension (PVH) secondary to left heart disease can be further classified according to their hemodynamic profile: pulmonary hypertension (PH) in proportion to the pulmonary capillary wedge pressure (PCWP) and PH out of proportion to the PCWP or reactive PH. Currently, there are no measures that enable prediction of the development of reactive PH in patients with left heart disease.

Objectives: In this study, we aim to characterize PVH patients with reactive PH as compared to proportional PH in an attempt to create a distinct profile for patients with left heart disease carrying a high risk for the development of reactive PH.

Pulmonary arteries involvement in Takayasu's arteritis: two cases and literature review.

Objectives: To review pulmonary arteritis (PA) complicated by pulmonary arterial hypertension (PAH) in Takayasu's arteritis (TA).

Methods: Two cases of PA and PAH in TA patients and similar cases published in the Medline database from 1975 to 2009 were reviewed.

Results: Forty-six cases (females 89.

Preliminary prospective explanatory observation on the impact of 3-month steroid therapy on the objective measures of sleep-disordered breathing.

Background: Excess endogenous steroids are a risk factor for obstructive sleep apnea (OSA). The role of exogenous steroids in this setup is not known. In this study, we prospectively looked at the consequences of a 3-month steroid treatment on the objective measures of sleep-disordered breathing.

Polymerase chain reaction-based detection of Pneumocystis jirovecii in bronchoalveolar lavage fluid for the diagnosis of pneumocystis pneumonia.

Introduction: The diagnosis of pneumocystis pneumonia (PCP) in non-human immunodeficiency virus (HIV)-infected immunocompromised patients is notoriously difficult. The recent advent of polymerase chain reaction (PCR)-based detection systems, based on the identification of single fungal genes, has markedly improved diagnostic accuracy in this ominous disease. In an attempt to further improve diagnostic yield, the authors used a PCR-based detection system for Pneumocystis jirovecii, based on targeting 3 distinct genes.

Idiopathic pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension: can we be certain?

Idiopathic pulmonary arterial hypertension (IPAH) is an isolated small-vessel disease comprising vasoconstriction, remodeling and thrombosis of small pulmonary arteries. However, there is evidence that IPAH does not respect anatomic boundaries and might extend into large vessels such as large central thrombi. On the other hand, chronic thromboembolic pulmonary hypertension (CTEPH) represents a distinct category of pulmonary hypertension as it is thought to be due to an occlusion of the major pulmonary arteries following a thromboembolic event.

Obstructive uropathy caused by retroperitoneal fibrosis presents as a late manifestation of sarcoidosis.

Obstructive uropathy in sarcoidosis can result from retroperitoneal involvement, retroperitoneal fibrosis (RPF), renal stones, or ureteral involvement. We report acute kidney injury (AKI) from obstructive uropathy because of RPF in a female patient, 2 years following the resolution of pulmonary sarcoidosis. We propose that RPF may occur in sarcoidosis even when a lag of years separates the presentations of the illnesses.

Validation of an ambulatory cough detection and counting application using voluntary cough under different conditions.

Background: While cough is an important defence mechanism of the respiratory system, its chronic presence is bothersome and may indicate the presence of a serious disease. We hereby describe the validation process of a novel cough detection and counting technology (PulmoTrack-CC, KarmelSonix, Haifa, Israel).

Methods: Tracheal and chest wall sounds, ambient sounds and chest motion were digitally recorded, using the PulmoTrack(R) hardware, from healthy volunteers coughing voluntarily while (a) laying supine, (b) sitting, (c) sitting with strong ambient noise, (d) walking, and (e) climbing stairs, a total of 25 minutes per subject.

Radiological features of Pneumocystis jirovecii Pneumonia in immunocompromised patients with and without AIDS.

The aim of this study was to compare chest computerized tomography (CT) findings of Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients with and without acquired immune deficiency syndrome (AIDS). Chest CT findings and clinical parameters of 38 consecutive immunocompromised patients, nine with AIDS and 29 with other causes of immunosuppression, were characterized and compared. PCP in patients without AIDS was diagnosed after a significantly shorter time interval from symptom onset: 8 +/- 6 vs.

Seasonal variability of the methacholine challenge test.

Background: Since the intensity of some variables that influence bronchial hyper-responsiveness (BHR) varies across different seasons of the year, the percentage of positive metacholine challenge test (MCT) is theoretically subjected to seasonal variation. This study has looked at the seasonal variability of MCT among young adults with suspected asthma.

Methods: The number of MCT performed and its corresponding proportion of positive results were retrospectively evaluated and compared for different seasons over a 5-year period.

Cardiac troponin-I predicts long-term mortality in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease patients are at increased risk for mortality, particularly from cardiovascular conditions. Acute exacerbation increases heart burden and may lead to release of troponin I. This study investigates the long-term prognostic value of elevated troponin I detected during acute exacerbation of chronic obstructive pulmonary disease.

Bronchodilator response after negative methacholine challenge test predicts future diagnosis of asthma.

Background: Currently there are no reliable means to predict the likelihood of a subject with negative results from a methacholine challenge test (MCT) to be diagnosed with asthma in the future. We sought to determine whether the magnitude of the response to bronchodilator (BD) administered after a negative MCT has a predictive value for future asthma.

Methods: Over a 5 -year period, starting from January 2004, the change in the forced expiratory volume in 1 second (FEV(1)) after inhaling BD (salbutamol) was recorded among subjects with negative MCT despite symptoms suggestive of asthma such as wheezing and dyspnea.

Coagulation and anticoagulation in pulmonary arterial hypertension.

Pulmonary arterial hypertension is a complex pulmonary vascular disease with a broad range of abnormal vascular abnormalities. Vasoconstriction, remodeling and thrombosis contribute to some extent to increased pulmonary vascular resistance and pressure. This review presents current knowledge on the role of the thrombotic process in the pathogenesis of PAH and evaluates the rationale for anticoagulation therapy.

The response to bronchodilators in adults is not predictive of bronchial-hyperreactivity.

Background: In some subjects with suspected asthma who have normal spirometry, administration of bronchodilators (BD) improves expiratory flow rates. The predictive value of this phenomenon in adults is not known.

Objectives: To evaluate the predictive value of the response to BD for bronchial hyper-responsiveness (BHR) using the metacholine challenge test (MCT).

Nitrofurantoin pulmonary toxicity: neglected threat.

Nitrofurantoin lung toxicity was diagnosed among ten patients receiving 50 mg/day to prevent recurrent urinary tract infection. In six patients a symptomatic period of 3-36 months preceded the diagnosis. All but one patient, with irreversible lung injury at presentation recovered completely, five after drug discontinuation and four after steroids therapy.