Claude Poirier

Endoscopic lung abscess drainage with argon plasma coagulation.

From CHUM Endoscopic Tracheobronchial and Oesophageal Center (CETOC), University of Montreal, Montreal, Quebec, Canada. Disclosures: Authors have nothing to disclose with regard to commercial support. Received for publication March 3, 2013; revisions received May 10, 2013; accepted for publication May 21, 2013; available ahead of print July 15, 2013. Address for reprints: Moishe Liberman, MD, PhD, CHUM Endoscopic Tracheobronchial and Oesophageal Center (CETOC), Division of Thoracic Surgery, Centre Hospitalier de l’Universit e de Montr eal, 1560 Rue Sherbrooke E, 8e CD, Pavillon Lachapelle, Bureau D-8051, Montreal, Quebec H2L 4M1, Canada (E-mail: moishe.liberman@umontreal.ca). J Thorac Cardiovasc Surg 2013;146:e35-7 0022-5223/

Impact of peritoneal dialysis on pulmonary function test in a patient with diaphragm paralysis.

36.00 Copyright 2013 by The American Association for Thoracic Surgery http://dx.doi.org/10.1016/j.jtcvs.2013.05.031

Stair-Climbing Capacity as a Marker of Improvement Following Pulmonary Rehabilitation

It is well known that auditory ability deteriorates with aging, centered on high-frequency hearing loss (4). In addition to aging, diabetes, the most common primary disease of patients on dialysis, is often complicated by hearing loss (5). Additionally, other ESKD patients have hearing loss due to impairment that can be drug-induced or inherited. The present patient had MELAS syndrome, which is a rare inherited disease. There are reports in the literature of adult patients on maintenance hemodialysis for treatment of ESKD due to MELAS syndrome (6). On the other hand, there have been very few reports concerning adult patients with ESKD due to MELAS syndrome who are treated with continuous APD (7,8). Additionally, there have been no previous reports of adult patients introduced to APD. Hameed et al. reported a case of a boy who was introduced to APD due to a mitochondrial disorder with hearing loss (9). However, the boy is 6 years old, and is unlikely to perform APD without assistance from a hearing adult. Various assistive listening devices (ALDs) are available to improve the quality of life of patients with severe hearing loss. For example, methods of converting the auditory signals of doorbells and telephones to optical signals have been developed; these devices are already available in the marketplace. However, it is difficult to detect optical signals during sleep. Kushner et al. reported a hearing-impaired patient who was introduced to APD using ALDs with a vibration function (10). However, the Kushner report contained no patient details, such as age, gender, or underlying disease. The present report is the first to provide detailed background information on the introduction of APD to an ESKD patient with hearing loss. In conclusion, the SilWatch is effective for use in conjunction with APD by ESKD patients with hearing loss. We expect that the quality of life of patients with hearing loss will be improved by this method in the future. This experience suggests that novel techniques can remove hearing-loss as an impediment to the use of APD and that hearing-impaired patients can be considered candidates for APD.

Regular exercise improves airway inflammation in cystic fibrosis patients

PURPOSE: The aim of this study was to explore the potential and safety of a stair-climbing test as a tool to monitor improvement following pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD). METHODS: Stair-climbing capacity was assessed in 139 patients with COPD before and after a comprehensive 8-week PR program, which included stair-climbing training. Stair-climbing capacity was assessed as the total number of flights of stairs climbed without stopping. A constant work rate endurance test (CET) was also performed before and after PR. Change in stair-climbing after PR (&Dgr;stairs) was compared and correlated to the change in endurance time (&Dgr;CET) and, for 40 patients, to the change in COPD assessment test (&Dgr;CAT) score. RESULTS: Most patients had moderate to severe COPD (mean forced expiratory volume in 1 second = 54% ± 20% predicted). Stair-climbing capacity, endurance time, and CAT score improved after PR (2.8 ± 1.4 vs 8.3 ± 3.3 flights, 408 ± 272 vs 717 ± 415 seconds, and 20.0 ± 6.4 vs 17.6 ± 6.6 units, respectively; P value for all < .001). &Dgr;stairs was moderately correlated to &Dgr;CET (r = 0.49; P < .001) and well correlated to &Dgr;CAT (r = −0.71; P < .001). Patients with greater change in &Dgr;stairs had better baseline resting lung function and aerobic capacity. No adverse events were reported during stair-climbing. CONCLUSION: Stair-climbing is responsive to training in patients with COPD and is correlated to the change in CAT score following PR. Although the test requires further standardization, it could eventually be used as a simple and safe way to assess improvement following interventions in COPD.