The Experts below are selected from a list of 252 Experts worldwide ranked by ideXlab platform
Jeffrey L Myers - One of the best experts on this subject based on the ideXlab platform.
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Hypersensitivity pneumonia: role of surgical Lung Biopsy.
Archives of pathology & laboratory medicine, 2012Co-Authors: Jonathon B. Herbst, Jeffrey L MyersAbstract:Lung Biopsy often plays a key role in identifying patients with hypersensitivity pneumonia, especially in the absence of a typical history. A 69-year-old woman with a 2-year history of unexplained dyspnea on exertion underwent surgical Lung Biopsy for diagnosis of diffuse Lung disease thought to represent idiopathic pulmonary fibrosis. Her Biopsy showed honeycomb change and fibroblast foci suggestive of usual interstitial pneumonia, but also showed areas of cellular interstitial pneumonia with chronic bronchiolitis and a pattern of granulomatous inflammation typical of hypersensitivity pneumonia. The classic features of hypersensitivity pneumonia in surgical Lung Biopsy are emphasized, including a bronchiolocentric cellular interstitial pneumonia, chronic bronchiolitis, and poorly formed nonnecrotizing granulomas. As illustrated in our patient, sometimes subtle histologic clues are key in separating hypersensitivity pneumonia from usual interstitial pneumonia and other forms of idiopathic interstitial pneumonia. Making the distinction is important given differences in treatment strategies and natural history.
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high short term mortality following Lung Biopsy for usual interstitial pneumonia
European Respiratory Journal, 2001Co-Authors: William W. Douglas, T E Hartman, Henry D. Tazelaar, Jeffrey L Myers, Mark S. Allen, Darrell R. SchroederAbstract:Usual interstitial pneumonia (UIP) is a specific histological pattern of interstitial pneumonia most often associated with the clinical syndrome of idiopathic pulmonary fibrosis (IPF). There is controversy regarding the use of surgical Lung Biopsy in the diagnosis of UIP, and the risk of Lung Biopsy in these patients is largely unknown. This study investigated the 30 day surgical mortality rate in patients undergoing surgical Lung Biopsy for UIP. Patients undergoing surgical Lung Biopsy over a 10-yr period from 1986–1995 with the ultimate diagnosis of UIP (with or without underlying connective tissue disease) were identified. Pathology, computed tomography, medical records, and survival were assessed. Ten of sixty patients with usual interstitial pneumonia were found to be dead within 30 days of surgical Biopsy. All of these were patients with idiopathic UIP, unassociated with connective tissue disease (clinical condition of IPF). In conclusion, patients with usual interstitial pneumonia of the idiopathic type, who present with atypical features, may be at higher risk for death following surgical Biopsy than patients presenting with more typical features or patients with other interstitial illnesses.
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Pathologic comparison of video-assisted thoracic surgical Lung Biopsy with traditional open Lung Biopsy.
The Journal of thoracic and cardiovascular surgery, 1995Co-Authors: Mitsutaka Kadokura, Jeffrey L Myers, Mark S. Allen, Thomas V Colby, Claude Deschamps, Victor F. Trastek, Peter C. PairoleroAbstract:Abstract Video-assisted thoracic surgical Lung Biopsy is an alternative to traditional open Lung Biopsy for diagnosis in patients with pleuropulmonary diseases. Between January 7, 1991, and August 3, 1993, 71 consecutive patients had video-assisted thoracic surgical Lung Biopsy and 42 patients had traditional open Lung Biopsy. A specific histologic diagnosis that correlated with the clinical findings was sought in each case and the yield was compared between the two groups. Procedure-related artifactual changes were also evaluated; the extent of traumatic hemorrhage and neutrophil margination as a result of tissue manipulation was significantly greater for patients in the video-assisted thoracic surgical Lung Biopsy group than for those in the open Lung Biopsy group, but the changes were generally minor and did not affect diagnostic yield. Complications developed in 11 (15%) of 71 patients in the video-assisted thoracic surgical Lung Biopsy group including 5 patients with prolonged air leakage (more than 10 days); 2 width pneumonia; and 1 each with bleeding, late pneumothorax necessitating readmission, mucus plug necessitating bronchoscopy, and a hypoxic episode necessitating mechanical ventilation. On the other hand, 7 (17%) of 42 patients in the open Lung Biopsy group had complications including 4 patients with prolonged air leakage (more than 10 days) and 3 with pneumonia. There were 6 (8%) operative deaths in patients who had video-assisted thoracic surgical Lung Biopsy and (17%) in the open Lung Biopsy group; all had preoperative respiratory failure. We conclude that video-assisted thoracic surgical Lung Biopsy is an acceptable alternative to open Lung Biopsy for diagnosis of pulmonary infiltrates or indeterminate nodules. (J THORAC CARDIOVASC SURG 1995; 109: 494-8)
Michael T Durheim - One of the best experts on this subject based on the ideXlab platform.
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mortality and respiratory failure after thoracoscopic Lung Biopsy for interstitial Lung disease
The Annals of Thoracic Surgery, 2017Co-Authors: Michael T Durheim, Sunghee Kim, Brian C Gulack, William R Burfeind, Henning A Gaissert, Andrzej S Kosinski, Matthew G HartwigAbstract:Background Surgical Lung Biopsy contributes to establishing a specific diagnosis among many patients with interstitial Lung disease (ILD). The risks of death and respiratory failure associated with elective thoracoscopic surgical Lung Biopsy, and patient characteristics associated with these outcomes, are not well understood. Methods This is a retrospective cohort study of patients who underwent elective thoracoscopic Lung Biopsy for ILD between 2008 and 2014, according to The Society of Thoracic Surgeons database. The study determined the incidence of operative mortality and of postoperative respiratory failure. Multivariable models were used to identify risk factors for these adverse outcomes. Results Among 3,085 patients, 46 (1.5%) died before hospital discharge or within 30 days of thoracoscopic Lung Biopsy. Postoperative respiratory failure occurred in 90 (2.9%) patients. Significant risk factors for operative mortality among patients with ILD included a diagnosis of pulmonary hypertension, preoperative corticosteroid treatment, and low diffusion capacity. Conclusions Elective thoracoscopic Lung Biopsy among patients with ILD is associated with a low risk of operative mortality and postoperative respiratory failure. Attention to the presence of pulmonary hypertension, preoperative corticosteroid treatment, and diffusion capacity may help inform risk stratification for thoracoscopic Lung Biopsy among patients with ILD.
Matthew G Hartwig - One of the best experts on this subject based on the ideXlab platform.
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mortality and respiratory failure after thoracoscopic Lung Biopsy for interstitial Lung disease
The Annals of Thoracic Surgery, 2017Co-Authors: Michael T Durheim, Sunghee Kim, Brian C Gulack, William R Burfeind, Henning A Gaissert, Andrzej S Kosinski, Matthew G HartwigAbstract:Background Surgical Lung Biopsy contributes to establishing a specific diagnosis among many patients with interstitial Lung disease (ILD). The risks of death and respiratory failure associated with elective thoracoscopic surgical Lung Biopsy, and patient characteristics associated with these outcomes, are not well understood. Methods This is a retrospective cohort study of patients who underwent elective thoracoscopic Lung Biopsy for ILD between 2008 and 2014, according to The Society of Thoracic Surgeons database. The study determined the incidence of operative mortality and of postoperative respiratory failure. Multivariable models were used to identify risk factors for these adverse outcomes. Results Among 3,085 patients, 46 (1.5%) died before hospital discharge or within 30 days of thoracoscopic Lung Biopsy. Postoperative respiratory failure occurred in 90 (2.9%) patients. Significant risk factors for operative mortality among patients with ILD included a diagnosis of pulmonary hypertension, preoperative corticosteroid treatment, and low diffusion capacity. Conclusions Elective thoracoscopic Lung Biopsy among patients with ILD is associated with a low risk of operative mortality and postoperative respiratory failure. Attention to the presence of pulmonary hypertension, preoperative corticosteroid treatment, and diffusion capacity may help inform risk stratification for thoracoscopic Lung Biopsy among patients with ILD.
Andrzej S Kosinski - One of the best experts on this subject based on the ideXlab platform.
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mortality and respiratory failure after thoracoscopic Lung Biopsy for interstitial Lung disease
The Annals of Thoracic Surgery, 2017Co-Authors: Michael T Durheim, Sunghee Kim, Brian C Gulack, William R Burfeind, Henning A Gaissert, Andrzej S Kosinski, Matthew G HartwigAbstract:Background Surgical Lung Biopsy contributes to establishing a specific diagnosis among many patients with interstitial Lung disease (ILD). The risks of death and respiratory failure associated with elective thoracoscopic surgical Lung Biopsy, and patient characteristics associated with these outcomes, are not well understood. Methods This is a retrospective cohort study of patients who underwent elective thoracoscopic Lung Biopsy for ILD between 2008 and 2014, according to The Society of Thoracic Surgeons database. The study determined the incidence of operative mortality and of postoperative respiratory failure. Multivariable models were used to identify risk factors for these adverse outcomes. Results Among 3,085 patients, 46 (1.5%) died before hospital discharge or within 30 days of thoracoscopic Lung Biopsy. Postoperative respiratory failure occurred in 90 (2.9%) patients. Significant risk factors for operative mortality among patients with ILD included a diagnosis of pulmonary hypertension, preoperative corticosteroid treatment, and low diffusion capacity. Conclusions Elective thoracoscopic Lung Biopsy among patients with ILD is associated with a low risk of operative mortality and postoperative respiratory failure. Attention to the presence of pulmonary hypertension, preoperative corticosteroid treatment, and diffusion capacity may help inform risk stratification for thoracoscopic Lung Biopsy among patients with ILD.
Brian C Gulack - One of the best experts on this subject based on the ideXlab platform.
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mortality and respiratory failure after thoracoscopic Lung Biopsy for interstitial Lung disease
The Annals of Thoracic Surgery, 2017Co-Authors: Michael T Durheim, Sunghee Kim, Brian C Gulack, William R Burfeind, Henning A Gaissert, Andrzej S Kosinski, Matthew G HartwigAbstract:Background Surgical Lung Biopsy contributes to establishing a specific diagnosis among many patients with interstitial Lung disease (ILD). The risks of death and respiratory failure associated with elective thoracoscopic surgical Lung Biopsy, and patient characteristics associated with these outcomes, are not well understood. Methods This is a retrospective cohort study of patients who underwent elective thoracoscopic Lung Biopsy for ILD between 2008 and 2014, according to The Society of Thoracic Surgeons database. The study determined the incidence of operative mortality and of postoperative respiratory failure. Multivariable models were used to identify risk factors for these adverse outcomes. Results Among 3,085 patients, 46 (1.5%) died before hospital discharge or within 30 days of thoracoscopic Lung Biopsy. Postoperative respiratory failure occurred in 90 (2.9%) patients. Significant risk factors for operative mortality among patients with ILD included a diagnosis of pulmonary hypertension, preoperative corticosteroid treatment, and low diffusion capacity. Conclusions Elective thoracoscopic Lung Biopsy among patients with ILD is associated with a low risk of operative mortality and postoperative respiratory failure. Attention to the presence of pulmonary hypertension, preoperative corticosteroid treatment, and diffusion capacity may help inform risk stratification for thoracoscopic Lung Biopsy among patients with ILD.
