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Interaction between Primary Care Physicians and Specialists for Diagnosis and Management of Hypersensitivity Pneumonitis

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International Journal of Clinical Medicine 2011年第4期2卷 444-451页

作者： Keiko Morii Kozo Yoshimori Miyako Sudo Hideo Ogata Masao Okumura akihiko gemma Shoji Kudoh Kozui Kida 不详

Objective: Hypersensitivity pneumonitis (HP) may be a complex syndrome rather than a single, uniform disease entity. The problems associated with HP treatment include a lack of awareness of primary care procedures and scarcity of recent information regarding HP. The main objective of this study was to investigate the problems in the interaction between primary care physicians and chest specialists. Data source: All available clinical records of cases at the Fukujuji Chest Hospital, Tokyo, between 1994 and 2005, supervised by specialists of a university hospital. Study selection: All cases suspected of HP during the period. Results: Nine cases were excluded because of insufficient records or because they did not satisfy the clinical criteria. Twenty-eight enrolled patients (14 men and 14 women;mean age, 53.0 years) were initially treated for respiratory infections by primary care physicians. The final HP types were summer-type (n = 18), bird fancier’s lung (n = 2), ventilation-related (n = 3), or undetectable antigen (n = 5). On the basis of the interval between the onset of initial symptoms and the time of referral to our hospital, the cases can be categorized into 3 groups, which may represent acute, subacute, and chronic HP. Conclusion: All patients initially received treatment on the basis of a different diagnosis at primary evaluation. We concluded that interaction between primary care physicians and chest specialists is essential for solving problems associated with the early diagnosis and adequate treatment of HP.

关键词： Biopsy Connection Computed Tomography Criteria Pneumonitis

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Risk Factors for Postoperative Acute Exacerbation of Idiopathic Interstitial Pneumonia Following Surgery for Primary Lung Cancer

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Open Journal of Respiratory Diseases 2014年第2期4卷 48-54页

作者： Toru Tanaka Shinji Abe Hiroki Hayashi Koichiro Kamio Yoshinobu Saito Jiro Usuki Arata Azuma Iwao Mikami Shuji Haraguchi Kiyoshi Koizumi Jitsuo Usuda akihiko gemma Department of Pulmonary Medicine and Oncology Nippon Medical School Tokyo Japan Department of Thoracic Surgery Graduate School of Medicine Nippon Medical School Tokyo Japan

Objective: Postoperative acute exacerbation of idiopathic interstitial pneumonia (IIP) is a serious complication in patients with lung cancer. This study was aimed to investigate risk factors for postoperative acute exacerbation of IIP in surgery for primary lung cancer. Method: We evaluated retrospectively 37 IIP patients combined with primary lung cancer who underwent lung resection for lung cancer from January 2006 and March 2010. Preoperative and perioperative clinical data were collected and analyzed. Results: Ten of 37 patients (27.0%) developed acute exacerbation of IIP after surgery for primary lung cancer and five patients (13.5%) died of progressive respiratory failure. There was no significant difference in preoperative clinical factors between acute exacerbation (AE) group and non-acute exacerbation (non-AE) group. In perioperative factors, the duration of anesthesia is significantly longer in AE group than in non-AE group. Conclusion: These data suggest that it is unable to predict postoperative acute exacerbation of IIP from preoperative clinical data. Perioperative and postoperative management might be important to prevent acute exacerbation of IIP combined lung cancer.

关键词： Postoperative Acute Exacerbation Idiopathic Interstitial Pneumonia Lung Cancer

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