Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
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   2009| April-June  | Volume 4 | Issue 2  
    Online since April 20, 2009

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Obesity hypoventilation syndrome
Laila Al Dabal, Ahmed S BaHammam
April-June 2009, 4(2):41-49
DOI:10.4103/1817-1737.49411  PMID:19561923
Obesity is becoming a major medical concern in several parts of the world, with huge economic impacts on health- care systems, resulting mainly from increased cardiovascular risks. At the same time, obesity leads to a number of sleep-disordered breathing patterns like obstructive sleep apnea and obesity hypoventilation syndrome (OHS), leading to increased morbidity and mortality with reduced quality of life. OHS is distinct from other sleep- related breathing disorders although overlap may exist. OHS patients may have obstructive sleep apnea/hypopnea with hypercapnia and sleep hypoventilation, or an isolated sleep hypoventilation. Despite its major impact on health, this disorder is under-recognized and under-diagnosed. Available management options include aggressive weight reduction, oxygen therapy and using positive airway pressure techniques. In this review, we will go over the epidemiology, pathophysiology, presentation and diagnosis and management of OHS.
  14,891 2,075 16
Lung function changes and complications after lobectomy for lung cancer in septuagenarians
Dragan Subotic, Dragan Mandaric, Gordana Radosavljevic, Jelena Stojsic, Milan Gajic
April-June 2009, 4(2):54-59
DOI:10.4103/1817-1737.49413  PMID:19561925
Background: In septuagenarians, lobectomy is the preferable operation, with lower morbidity than for pneumonectomy. However, the 1-year impact of lobectomy on lung function has not been well studied in elderly patients. Materials and Methods: Retrospective study including 30 patients 70 years or older (study group), 25 patients with chronic obstructive pulmonary disease (COPD) under 70 years (control group 1), and 22 patients under 70 years with normal lung function (control group 2) operated for lung cancer in a 2-year period. The study and control groups were compared related to lung function changes after lobectomy, operative morbidity, and mortality. Results: Postoperative lung function changes in the elderly followed the similar trend as in patients with COPD. There were no significant differences between these two groups related to changes in forced expiratory volume in the first second (FEV 1 ) and vital capacity (VC). Unlike that, the pattern of the lung function changes in the elderly was significantly different compared with patients with normal lung function. The mean postoperative decrease in FEV 1 was 14.16% in the elderly, compared with a 29.23% decrease in patients with normal lung function ( P < 0.05). In the study and control groups, no patients died within the first 30 postoperative days. The operative morbidity in the elderly group was significantly lower than in patients with COPD (23.3% vs. 60%). Conclusions: The lung function changes after lobectomy in the elderly are similar to those in patients with COPD. The explanation for such a finding needs further investigation. Despite a high proportion of concomitant diseases, the age itself does not carry a prohibitively high risk of operative mortality and morbidity.
  14,931 703 5
Reading chest radiographs in the critically ill (Part I): Normal chest radiographic appearance, instrumentation and complications from instrumentation
Ali Nawaz Khan, Hamdan Al-Jahdali, Sarah Al-Ghanem, Alaa Gouda
April-June 2009, 4(2):75-87
DOI:10.4103/1817-1737.49416  PMID:19561929
  10,334 1,926 12
Respiratory tract infection during Hajj
Abdulaziz H Alzeer
April-June 2009, 4(2):50-53
DOI:10.4103/1817-1737.49412  PMID:19561924
Respiratory tract infection during Hajj (pilgrimage to Mecca) is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M. tuberculosis is expected to be high. These pilgrims can be a source for spreading infection on their return home. Although vaccination program for influenza is implemented, its efficacy is uncertain in this religious season. Future studies should concentrate on prevention and mitigation of these infections.
  10,414 1,141 65
The six-minute walk test in patients with pulmonary sarcoidosis
Esam H Alhamad
April-June 2009, 4(2):60-64
DOI:10.4103/1817-1737.49414  PMID:19561926
Background: The 6-min walk test (6MWT) is a useful tool to assess prognosis and functional impairment in various pulmonary diseases. Aims: To evaluate functional capacity during various stages of pulmonary sarcoidosis and develop a scoring system clinical radiological physiological score (CRP) that can potentially be used to assess the functional status among patients with sarcoidosis. Materials and Methods: We performed a retrospective study on 26 patients diagnosed with pulmonary sarcoidosis from 2001 to 2007. All patients completed the 6MWT. The parameters assessed during the test included spirometry, arterial blood gas, 6-min walk distance (6MWD), Borg dyspnea score, and initial and end oxygen saturation. Results: Females covered a significantly shorter distance than males (343 m (223-389) vs. 416.5 m (352-500); P < 0.0001). In addition, females had a significantly lower SpO 2 at the end of the 6MWT than males (90.5 (61-99) vs. 96 (75-98); P < 0.03). The 6MWD was inversely correlated with the final Borg score (r = −0.603, P = 0.004) and the CRP score (r = -0.364, P = 0.047) and positively correlated with forced expiratory volume in 1 s (FEV 1 ) % (r = 0.524, P = 0.006) and forced vital capacity (FVC) % (r = 0.407, P = 0.039). Conclusions: Female gender, FEV 1 %, final Borg score, FVC%, CRP score, and SpO 2 at the end of the 6MWT are associated with reduced 6MWD. It appears that Saudi patients diagnosed with sarcoidosis have a markedly reduced walking distance compared with other races. The effect of race and ethnicity and the utility of the CRP score as a potential marker to assess functional status require further exploration.
  10,041 845 17
The effect of age on the outcome of esophageal cancer surgery
Abbas Alibakhshi, Ali Aminian, Rasoul Mirsharifi, Yosra Jahangiri, Habibollah Dashti, Faramarz Karimian
April-June 2009, 4(2):71-74
DOI:10.4103/1817-1737.49415  PMID:19561928
Background: Surgery is still the best way for treatment of esophageal cancer. The increase in life expectancy and the rising incidence of esophageal tumors have led to a great number of elderly candidates for complex surgery. The purpose of this study was to evaluate the effects of advanced age (70 years or more) on the surgical outcome of esophagectomy for esophageal cancer at a single high-volume center. Materials and Methods: Between January 2000 and April 2006, 480 cases with esophageal cancer underwent esophagectomy in the referral cancer institute. One hundred sixty-five patients in the elderly group (70 years old or more) were compared with 315 patients in the younger group (<70 years). All in-hospital morbidity and mortality were studied. Results: The range of age was 38-84 years, with a mean of 58.7. The mean age of the elderly and younger groups was 74 and 53.2, respectively. In the younger group, 70 patients (22.2%) and in the elderly group, 39 patients (23.6%) were complicated ( P 0.72).The most common complications in the two groups were pulmonary complications (9.8% in younger and 10.3% in elderly) ( P 0.87). Rates of anastomotic leakage and cardiac complications were also similar between the two groups. Hospital mortality rates in younger and elderly patients were 2.8% and 3%, respectively. There was no significant difference between the two groups in morbidities and mortality ( P -value > 0.05). Conclusions: With increased experience and care, the outcomes of esophagectomy in elderly patients are comparable to young patients. Advanced age alone is not a contraindication for esophagectomy.
  8,447 718 30
Exhaled nitric oxide in stable chronic obstructive pulmonary disease
Mohammed F.S Beg, Mohammad A Alzoghaibi, Abdullah A Abba, Syed S Habib
April-June 2009, 4(2):65-70
DOI:10.4103/1817-1737.44649  PMID:19561927
Study Objective : The objective of the study was to test the hypothesis that fraction of exhaled nitric oxide (FENO) is elevated in nonsmoking subjects with stable chronic obstructive pulmonary disease (COPD) and compare it with the results in patients with asthma and a control population. Design : Cross-sectional study. Materials and Methods : Pulmonology Clinic at a University Hospital. Twenty five control subjects, 25 steroid naοve asthmatics and 14 COPD patients were studied. All the patients were nonsmokers and stable at the time of the study. All subjects completed a questionnaire and underwent spirometry. Exhaled nitric oxide was measured online by chemiluminescence, using single-breath technique. Results : All the study subjects were males. Subjects with stable COPD had significantly higher values of FENO than controls (56.5428.01 vs 22.006.69; P =0.0001) but lower than the subjects with asthma (56.5428.01 vs 84.7839.32 P = 0.0285).The FENO values in COPD subjects were inversely related to the FEV 1 /FVC ratio. There was a significant overlap between the FENO values in COPD and the control subjects. Conclusion : There is a significant elevation in FENO in patients with stable COPD, but the elevation is less than in asthmatic subjects. Its value in clinical practice may be limited by the significant overlap with control subjects.
  7,619 884 20
Prevalence of chronic obstructive pulmonary disease in patients with catheter-diagnosed coronary artery disease
AlaEldin H Ahmed, Tarig E Yagoub, Faris Muthana
April-June 2009, 4(2):91-92
DOI:10.4103/1817-1737.49418  PMID:19561931
  4,689 721 -
A 70 year old male with difficulty in breathing
Sanjay Kumar, Sarita Magu, Shalini Agarwal
April-June 2009, 4(2):88-90
DOI:10.4103/1817-1737.49417  PMID:19561930
  4,050 536 -
Can we change the way we look at BCG vaccine?
Sahal Abdulaziz Al-Hajoj
April-June 2009, 4(2):92-93
DOI:10.4103/1817-1737.49419  PMID:19561932
  3,897 519 1
Saudi Thoracic Society annual award for achievement
Mohamed S Al-Hajjaj
April-June 2009, 4(2):39-40
  3,630 490 -
Author's reply
Ibrahim O Al-Orainey
April-June 2009, 4(2):93-94
  2,910 389 -
Abstracts from the the 7th Annual Scientific Conference of The Saudi Thoracic Society and the 8th Annual Asthma Meeting

April-June 2009, 4(2):95-106
Full text not available  [PDF]  [Mobile Full text]  [EPub]
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