9 research outputs found
Qualitative Assessment of Pain Management in Patients Undergoing Computed Tomography-Guided Transthoracic Lung Biopsy
BACKGROUND: Unpublished questionnaire data collected by the authors’ institution (Toronto General Hospital, Toronto, Ontario) indicates that patients often experience significant pain while undergoing lung biopsy, yet receive only a fraction of the maximum allowable dosage of analgesic.OBJECTIVES: To qualitatively assess current pain management practices from the patient perspective. Patient education and patient satisfaction were also evaluated.METHODS: From March through June 2012, participants were contacted via telephone within one week of their procedure until data saturation was reached. The semistructured interviews were based on a study-specific interview template. Thematic analysis of qualitative study data was used to identify recurring interview topics.RESULTS: A consecutive sample of 16 outpatients who had undergone image-guided transthoracic lung biopsy at the authors’ institution were interviewed. None of the study participants reported noteworthy pain associated with the insertion of lung biopsy needles. The most significant pain was caused by positioning within the computed tomography scanner, particularly among participants who were in the prone position. All participants reported high satisfaction with the amount of analgesic received. Potential complications and recovery period details were identified as areas for improved patient education.CONCLUSIONS: At the authors’ institution, pain associated with lung biopsy needle insertion was well controlled. Positional pain is common for patients required to be in the prone position. Potential solutions include increasing awareness of positional pain and instituting additional supportive equipment.Peer Reviewe
Prognostic impact of patterns of nodal subcategories and pleural or pericardial effusions in Small Cell Lung Cancer (SCLC)
The utility of computer-aided detection (CAD) for lung cancer screening using low-dose CT
Soluble Mesothelin-Related Peptide and Osteopontin As Markers of Response in Malignant Mesothelioma
Adjuvant lung resection in the management of nontuberculous mycobacterial lung infection: A retrospective matched cohort study
Screening for Malignant Pleural Mesothelioma and Lung Cancer in Individuals with a History of Asbestos Exposure
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The importance of low-dose CT screening to identify emphysema in asymptomatic participants with and without a prior diagnosis of COPD
Chronic Obstructive Pulmonary Disease (COPD) includes chronic bronchitis, small airways disease, and emphysema. Diagnosis of COPD requires spirometric evidence and may be normal even when small airways disease or emphysema is present. Emphysema increases the risk of exacerbations, and is associated with all-cause mortality and increased risk of lung cancer. We evaluated the prevalence of emphysema in participants with and without a prior history of COPD.
We reviewed a prospective cohort of 52,726 subjects who underwent baseline low dose CT screening for lung cancer from 2003 to 2016 in the International Early Lung Cancer Action Program.
Of 52,726 participants, 23.8%(12,542) had CT evidence of emphysema. Of these 12,542 participants with emphysema, 76.5%(9595/12,542) had no prior COPD diagnosis even though 23.6% (2258/9595) had moderate or severe emphysema. Among 12,542 participants, significant predictors of no prior COPD diagnosis were: male (OR = 1.47, p < 0.0001), younger age (ORage10 = 0.72, p < 0.0001), lower pack-years of smoking (OR10pack-years = 0.90, p < 0.0001), completed college or higher (OR = 1.54, p < 0.0001), no family history of lung cancer (OR = 1.12, p = 0.04), no self-reported cardiac disease (OR = 0.76, p = 0.0003) or hypertension (OR = 0.74, p < 0.0001). The severity of emphysema was significantly lower among the 9595 participants with no prior COPD diagnosis, the OR for moderate emphysema was ORmoderate = 0.58(p = 0.0007) and for severe emphysema, it was ORsevere = 0.23(p < 0.0001).
Emphysema was identified in 23.8% participants undergoing LDCT and was unsuspected in 76.5%. LDCT provides an opportunity to identify emphysema, and recommend smoking cessation.
•Emphysema was identified in 23.8% participants and was unsuspected in 76.5%.•23.6% of participants with unsuspected COPD had moderate or severe emphysema on LDCT.•COPD is underdiagnosed in patients undergoing LDCT.•LDCT provides an opportunity to identify emphysema, reduce morbidity and mortality