Lung (2021)

21st June 2021.
In a crisis situation like in a pandemic it is acceptable to unilaterally withdraw and reallocate the use of scarce life sustaining medical equipment such as ventilators, ECMO circuits etc from one patient to another without the consent of the patient or his family according to a recently published editorial  in the journal of the American College of Chest Physicians – Chest. This places a huge ethical and moral responsibility on the medical team that is required to make these tough decisions. Not easy at all.

14th June 2021.
Angiotension converting enzyme inhibitors (ACEIs), and angiotension receptor blockers (ARBs) are two common classes of drugs used to treat high blood pressure. A cloud however hangs over these drugs as some research pointed to a possible worsening of COVID 19 disease when these drugs were continued. according to a recently published editorial  in the journal of the American College of Chest Physicians – Chest.

7th June 2021.
COVID 19 is known to cause fibrosis of the lungs. Fibrosis is usually visible on a CT scan of the chest. Sometimes occult fibrosis with an apparently normal CT Chest can cause dyspnoea in COVID 19 long haulers. This occult fibrosis can now be diagnosed by a new technique the Xenon 129 aided MRI of the chest. according to a recent article in the journal Radiology.

28th May 2021.
In a pre-print manuscript soon to be published in the Annals of Rheumatic Diseases, a study which looked at the immune response to COVID 19 mRNA vaccinations, found that the response was significantly muted in people who were on methotrexate. Methotrexate is a commonly used immunomodulatory drug with many uses. This finding could possibly be extrapolated to other vaccines and other immunomodulatory drugs as well.

21st may 2021.
Artificial intelligence can now be used to predict with reasonable accuracy which lung nodules detected on CT scans of the chest could later turn malignant (cancerous). Could they could soon replace Radiologists? only time will tell.

14th May 2021.
A excellent synopsis of the deadly COVID 19 virus disease (especially relevant to practicing physicians)  has been recently published in the Lancet.

May 7th 2021.
Loss of smell is a well known symptom of COVID 19. According to a recently published study in the Lancet it may also be a symptom of pneumonias from many other causes as well, especially in the elderly. Anosmia (lack of smell) does not always mean COVID 19!

28th April 2021.
Probiotics could reduce the occurrence of respiratory tract infections including viral infections like Influenza and COVID 19 according to recently published research. Mechanisms by which such bacteria suppress respiratory pathogens include absorptive trapping by the production of lipopolysaccharides that binds to and destabilizes the viral structure. Probiotic supplementation also was found to enhance defensive interferon responses and also increase TNF production from nasal lymphocytes in response to respiratory viral infections.

21st April 2021.
There is now convincing evidence that the main mode of spread of the COVID 19 virus is airborne transmission rather than other methods such as through fomites according to this recent study published in the Lancet. 

14th April 2021.
Lung tumors consist not only of cancer cells but many other cells including lymphocytes and neutrophils. Recent research published in the journal Cancer Research has identified that tumor associated neutrophils metabolize glucose much more efficiently than non tumor associated neutrophils because of a protein on the cell surface called Glut 1. targetting Glut 1 with immunotherapy was foung to slow down the speed of tumor growth considerably.

7th April 2021.
Asthma is a common condition that affects the lungs and is exacerbated by atmospheric pollutants. A recent study published in the journal Thorax concluded that the incidence of acute exacerbations of asthma are significantly less in England during the pandemic possibly because everybody wore a mask and stayed at home! A positive fall out of the pandemic if ever there could be one!

30th March 2021.
Are you a physician who is having a “burnout” or one with irregular sleep habits? You are much more likely to contract COVID 19 according to a recent study published in the British Medical Journal. H Kim, S Hedge et al who evaluated over 2800 health care workers in six countries between July and September 2020. HCW who were suffering a burnout and had sleep related issues were found to have an 88% higher chance of contracting COVID 19 according to their study.

21st March 2021.
Metal foams derived from copper can be the basis for robust reusable  filters for masks and air conditioners in the future according to recent research published in the journal Nano letters published by the American Chemical Society. This technology has implications in providing clean air to the indoors long after the COVID 19 pandemic  subsides.

14th March 2021.
Having the Influenza vaccine (the common flu shot) seems to provide some cross immunity against the COVID 19 virus according to a study recently published in the American Journal of Infection Control. The study found that there was an approximately 24% less chance of contracting COVID after a flu shot and even if contracted, the disease mild.

7th March 2021.
Alterations in the intestinal microflora could increase the susceptibility to COVID 19 infection. A recently  published study in the journal Frontiers in Immunology suggest that administration of probiotics and correction of intestinal floral dysbiosis could have a significant protective effect against COVID 19.

28th February 2021.
According to recent research published in the British Medical Journal, reliable screening for OSA can be done using the STOP – Bang questionnaire.  OSA is widely known to be associated with impaired endothelial function and various cardiovascular diseases, such as hypertension, stroke, heart failure, atrial fibrillation and severe obstructive coronary artery disease. It is also well known that patients with OSA and cardiovascular risk factors have signficantly poor disease outcomes, this questionnaire based survey comes in very handy.

21st February 2021.
Bedside, point of care ultrasonography of the lungs has been found to be useful to prognosticate the progression of disease in COVID 19 patients needing hospitalization using a severity grading based on ultrasound findings. This grading was found to correlate well with the ultimate outcome of hospitalization. This is particularly useful in hemodynamically unstable patients who cannot be shifted to a radiology facility fearing a hemodynamic collapse during transport.

14th February 2021.
Evidence has recently been published of what has been suspected all along – OSA is a risk factor for severe COVID 19.

7th February 2021.
An update from the European Respiratory Society on Obstructive Sleep Apnoea, sleepiness and the risks of driving 2021.

29th January 2021.
The rationale for the addition of easily available, inexpensive and well known antibiotic with very few side effects, Azithromycin into the arsenal for the treatment of COVID 19 has been recently published in the British Medical Journal

21st January 2021.
Metastasis of breast cancer to the lungs was found to be significantly higher in smokers compared to non smokers in a study recently published in the journal Nature Communications. The authors hypothesize that smoking creates an inflammatory micro environment in the lungs that causes pro tumor neutrophil aggregation leading to metastasis.

14th January 2021.
The European Respiratory Society has recently updated its guidelines for the management of hospitalized adults with COVID 19 disease.

7th January 2021.
Tuberculosis is caused by the microbe Mycobacterium Tuberculosis. Non tuberculous mycobacteria can also cause serious lung infections. The European Respiratory Society has recently updated its official guidelines for the treatment of non tuberculous mycobacterial lung diseases.

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