Instituto Nacional del Tórax

Patients undergoing lung resection surgery (LRS) may experience various postoperative complications, which can be prevented or managed through physiotherapy interventions. The current evidence concerning physiotherapy interventions for individuals undergoing LRS is inconsistent and disorganised. Our objective is to outline the methods we will employ to collect, describe, and analyse studies that have assessed the effects of physiotherapy interventions in the immediate postoperative period for hospitalized adults undergoing LRS. We will conduct our scoping review following the Joanna Briggs Institute. We will include primary studies that have enrolled hospitalized adults undergoing LRS where the effects, efficacy, effectiveness or cost-effectiveness of postoperative physiotherapy interventions has been evaluated. A systematic search of MEDLINE (Ovid), Embase (Ovid), CENTRAL (Cochrane Library), CINAHL (EBSCOhost), LILACS (BVS), and PEDro will be carried out. Additionally, we will perform forward and backward citation searches. Data selection and extraction will be done in duplicate. Conflicts will be resolved by consensus or through a third reviewer. We will utilise the Word Frequency Analyser, The Polyglot Search Translator, Citationchaser, and Catchii tools to enhance the efficiency of our review. Outlining our strategies to conduct our review will help uphold scientific rigour and enable readers to identify any deviations from our plan.•We will conduct our scoping review following the Joanna Briggs Institute. We will include primary studies that have enrolled hospitalized adults undergoing LRS and evaluated postoperative physiotherapy interventions' effects, efficacy, effectiveness or cost-effectiveness.•To enhance the efficiency of our review, we will use artificial intelligence tools such as Word Frequency Analyser, The Polyglot Search Translator, Citationchaser, and Catchii.•Understanding applications of postoperative physiotherapy interventions in hospitalized adults undergoing LRS can aid in implementing treatment strategies. It will also highlight existing research gaps that require attention from primary studies.

Patient-ventilator asynchrony (PVA) is frequent in intensive care. Its presence is associated with prolonged days of mechanical ventilation and may lead to increased mortality in the intensive care unit (ICU) and hospital. Little is known about the ability of Colombian intensive care professionals to identify asynchronies, and the factors associated with their correct identification are not apparent. To describe the ability of Colombian intensive care professionals to identify patient-ventilator asynchronies (PVA) using waveform analysis. In addition, to define the characteristics associated with correctly detecting PVA. We conducted a multicenter, cross-sectional, national survey-based study between January and August 2024. Colombian physiotherapists, respiratory therapists, nurses and intensive care physicians from 24 departments participated in the study. An online survey was used. They were asked to identify six different PVAs presented as videos. The videos were displayed using pressure/time and flow/time waveform of a Puritan Bennett 840 ventilator. We recruited 900 participants, 60% female, most of whom were physiotherapists (53%). Most professionals had specialty training in critical care (42%), and 32% reported having specific PVA training. Double triggering was the most frequently identified PVA (75%). However, only 3.67% of participants recognized all six PVAs. According to multiple logistic regression analysis, working in a mixed unit (OR 2.59; 95% CI 1.19 - 5.54), caring for neonates (OR 5.19; 95% CI 1.77 - 15.20), and having specific training (OR 2.38; 95% CI 1.16 - 4.76) increases the chance of correctly recognizing all PVAs. In Colombia, a low percentage of professionals recognize all PVAs. Having specific training in this topic, working in mixed ICUs and neonatal intensive care was significantly associated with identifying all PVAs.

Silicosis, a fibrotic lung disease caused by crystalline silica inhalation, presents unique challenges in lung transplantation. This case reports an unprecedented complication in a lung transplant recipient with chronic silicosis. A man in his 60s, post left single-lung transplantation for silica-induced pneumoconiosis, developed acute respiratory deterioration following routine bronchoscopy. Melanoptysis, followed by imaging showing extensive inflammatory involvement in the transplanted lung, required intubation and prone positioning. This case highlights the potential for residual silicotic material to trigger acute post-transplant complications. It underscores the importance of comprehensive pretransplant evaluation of occupational exposures and heightened awareness of silica-related complications in post-transplant care. The report emphasizes gaps in understanding long-term outcomes and optimal management strategies for lung transplant recipients with silicosis.

Review Stage at time of this submission -Formal screening of search results against eligibility criteria.

Abstract Background Tobacco use is one of the main risk factors for Lung Cancer (LC) development. However, about 10–20% of those diagnosed with the disease are never-smokers. For Non-Small Cell Lung Cancer (NSCLC) there are clear differences in both the clinical presentation and the tumor genomic profiles between smokers and never-smokers. For example, the Lung Adenocarcinoma (LUAD) histological subtype in never-smokers is predominately found in young women of European, North American, and Asian descent. While the clinical presentation and tumor genomic profiles of smokers have been widely examined, never-smokers are usually underrepresented, especially those of a Latin American (LA) background. In this work, we characterize, for the first time, the difference in the genomic profiles between smokers and never-smokers LC patients from Chile. Methods We conduct a comparison by smoking status in the frequencies of genomic alterations (GAs) including somatic mutations and structural variants (fusions) in a total of 10 clinically relevant genes, including the eight most common actionable genes for LC (EGFR, KRAS, ALK, MET, BRAF, RET, ERBB2, and ROS1) and two established driver genes for malignancies other than LC (PI3KCA and MAP2K1). Study participants were grouped as either smokers (current and former, n = 473) or never-smokers (n = 200) according to self-report tobacco use at enrollment. Results Our findings indicate a higher overall GA frequency for never-smokers compared to smokers (58 vs. 45.7, p-value < 0.01) with the genes EGFR, KRAS, and PIK3CA displaying the highest prevalence while ERBB2, RET, and ROS1 the lowest. Never-smokers present higher frequencies in seven out of the 10 genes; however, smokers harbor a more complex genomic profile. The clearest differences between groups are seen for EGFR (15.6 vs. 21.5, p-value:<0.01), PIK3CA (6.8 vs 9.5) and ALK (3.2 vs 7.5) in favor of never-smokers, and KRAS (16.3 vs. 11.5) and MAP2K1 (6.6 vs. 3.5) in favor of smokers. Alterations in these genes are comprised almost exclusively by somatic mutations in EGFR and mainly by fusions in ALK, and only by mutations in PIK3CA, KRAS and MAP2K1. Conclusions We found clear differences in the genomic landscape by smoking status in LUAD patients from Chile, with potential implications for clinical management in these limited-resource settings.

Introduction: Degenerative Lumbar spinal stenosis (DLSS) is the most common cause of spine surgery for patients above 55 years.Surgery options include decompression alone or with spinal fusion.The DRG system uses classification algorithms that categorize patients into groups with similar clinical and resource consumption characteristics, using ICD-10 nomenclature for diagnoses and ICD-9-CM for procedures.Objective: Identify clinical and epidemiological variables of DLSS surgery patients based on Chile's DRG system data and define factors associated with arthrodesis as a complement to decompression. Study Design: Retrospective observational study.Methods: This study used the national DRG database to analyze factors predicting the need for fusion in patients with DLSS.Data from 31 public hospitals in Chile were analyzed for patients discharged between 2020 and 2022.Variables considered included age, gender, presence of other spinal pathologies, and attending physician specialty.For the descriptive analysis of qualitative variables, frequencies and percentages were used.The study used univariate and multivariate logistic regression analysis.A statistical significance level of less than 0.05 was considered. Results:We analyzed 1024 patients with lumbar spinal stenosis and found that 54.6% were female and 45.4% were male (p= 0.0034).The majority of the patients (57.4%) were aged between 60 and 79 years.75% of orthopedic surgeons opted for decompression plus arthrodesis, while neurosurgeons preferred decompression alone in 73% of cases.The most significant predictors for decompression with fusion were the physician's specialty in orthopedic surgery, female sex, and the presence of other spinal pathologies such as scoliosis, herniated disc, and spondylolisthesis.Patients treated by an Orthopedic Surgeon had an 8.2 times greater probability of undergoing decompression plus arthrodesis as compared to those treated by a Neurosurgeon.Additionally, the presence of spondylolisthesis increased the probability of decompression with fusion by 6.2 times, and the