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Ann Thorac Med 2019 Jan-Mar;14(1):99-100

Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq. E-mail:

Ann Thorac Med 2019 Jan-Mar;14(1):99

Department of 1st Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece.

Ann Thorac Med 2019 Jan-Mar;14(1):94-98

Section of Pulmonary Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Idiopathic Pleuro-Parenchymal Fibroelsatosis (PPFE) is a rare, progressive and recently recognized subtype of idiopathic interstitial lung disease with no recorded successful treatment other than lung transplant. We report a case of idiopathic pleuroparenchymal fibroelastosis from the Middle East, managed successfully by bilateral lung transplant performed on a 26 year old Saudi male. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):90-93

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.

Although accurate identification of is the gold standard for tuberculosis (TB) diagnosis, there have been several reports of false-positive results. After identifying a sudden increase in extensively drug-resistant TB, false-positive mycobacterial culture tests were suspected, and we contacted the supranational reference center for molecular typing. genotyping tests showed that isolates from all five patients had an identical genotype pattern, and all harbored the same Beijing strain based on sequence-based phylogenic analysis and drug-resistant single nucleotide polymorphisms (SNPs) analysis. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):83-89

Department of Medicine, Division of Rheumatology, King Saud University, Riyadh, Saudi Arabia.

Background: Pulmonary arterial hypertension (PAH) is a major cause of morbidity and mortality in patients with systemic sclerosis (SSc). The objective of this study is to describe the clinical characteristics, mortality, and predictors of SSc-PAH in Saudi patients.

Methods: Retrospective chart review study of SSc patients who were followed for at least 1 year in three tertiary care centers in Saudi Arabia was conducted. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):75-82

Chest Disease Clinic, Afyon State Hospital, Afyon, Turkey.

Objective: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey.

Methods: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey.

Results: During the study period, 4968 patients were included. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):69-74

Department of Medicine, The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Background: Many individuals complain of disturbed sleep during the wintertime when their air conditioner (AC) is off. Therefore, we conducted this study to objectively assess the impact of AC sound on sleep latency, sleep duration, and sleep efficiency.

Methods: An experimental study was conducted on 48 healthy young adults, in their homes, to assess the effect of a standardized AC white noise, on sleep latency, duration, and efficiency, while simultaneously monitoring light intensity and room temperature. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):63-68

Department of Medical Biochemistry, Medical Faculty, Yuzuncu Yil University, Van, Turkey.

Background: Obstructive sleep apnea (OSA) is a common sleep problem, in which patients are at increased risk for metabolic and cardiovascular problems, including metabolic syndrome, diabetes mellitus (DM), and dyslipidemia. Betatrophin is a novel protein that regulates fatty acid and triglyceride (TG) metabolism and is related to obesity and metabolic abnormalities, including metabolic syndrome, DM, and dyslipidemia. Although OSA and betatrophin share common abnormalities, their relationship has not been investigated. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):56-62

Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia.

Background: Electronic cigarette (E-cigarette) is an electronic nicotine delivery device that has been advocated as a safe alternative for cigarette smokers. Since the introduction of E-cigarette internationally and in the Kingdom of Saudi Arabia (KSA), it gained popularity, particularly among the youth and young adults. Moreover, many nonsmoker (nicotine-naïve) youth started to use E-cigarette as a new social habit. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):49-55

Astria Health Center, Euclid, Grandview, Washington, USA.

Introduction: Nonbenzodiazepine (non-BZD) sedative hypnotics (NBSH) refer to non-BZD sedatives that act as BZD receptor agonists such as zolpidem, zaleplon, and eszopiclone. Today, there is a high prevalence of insomnia with or without concurrent obstructive sleep apnea (OSA). Our goal was to study how NBSH use impacts the baseline apnea-hypopnea index (AHI) in patients with or without OSA. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):3-48

Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.

This is the fourth version of the updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. Read More

Ann Thorac Med 2019 Jan-Mar;14(1):1-2

Department of Pediatric, Imperial College, London, UK.

Ann Thorac Med 2018 Oct-Dec;13(4):258

Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Kingdom of Saudi Arabia. E-mail:

Ann Thorac Med 2018 Oct-Dec;13(4):257

Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Ibaraki, Japan E-mail:

Ann Thorac Med 2018 Oct-Dec;13(4):254-256

Department of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Cutis laxa (CL) is a rare connective tissue disease characterized by a loose, wrinkled, and inelastic skin. Here, we report an unusual presentation in a 15-year-old male patient who is a known patient of CL who presented with bilateral pneumothorax. He was successfully managed initially by chest tube insertion and then he was treated surgically with bilateral staged thoracoscopy, apical bullectomy, and pleurodesis with full uneventful recovery. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):251-253

Department of Pathology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.

Pulmonary pleomorphic carcinoma is defined as a nonsmall cell lung carcinoma (NSCLC) that contains at least 10% sarcomatoid components. We report a case of pulmonary pleomorphic carcinoma of which only the sarcomatoid component metastasized to the small bowel and adenocarcinoma was identified on percutaneous transthoracic needle biopsy (PTNB). We suggest that if an NSCLC is diagnosed by PTNB and a sarcoma is found at another site, or vice versa, pulmonary pleomorphic carcinoma with a single metastasis should be considered as a differential diagnosis to establish the best effective treatment plan. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):243-250

Department of Thoracic Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China.

Objective: The objective of this study was to compare the efficacy and safety of radiofrequency ablation (RFA), cryoablation, and microwave ablation (MWA) for patients with lung malignancies.

Methods: We performed a network meta-analysis to identify both direct and indirect evidence from relevant trials by searching PubMed, Embase, and the Cochrane Library to December 31, 2017, for the treatment of malignant lung tumors with the use of RFA, MWA, or cryoablation. We extracted the relevant information from the published studies with a predefined data sheet and assessed the risk of bias with the Cochrane risk of bias tool. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):237-242

Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia.

Introduction: Noninvasive ventilation (NIV) has been extensively used globally and is often administered as the first-line treatment. Currently, data regarding the utilization of NIV in the Kingdom of Saudi Arabia (KSA) is scarce. The present study aimed to assess and quantify the utilization of NIV in clinical practice across the KSA and investigate obstacles that may cause NIV underutilization. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):230-236

Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA.

Background: The clinical relevance of positive human rhinovirus (HRV) in hospitalized patients is unclear. Our objective was to describe the clinical characteristics and outcomes of HRV positivity in a heterogeneous population of hospitalized children, compared to those positive for another respiratory virus and those where no respiratory virus was detected.

Methods: A retrospective case-control study of children hospitalized between January 2014 to April 2015 who had a respiratory viral specimen collected. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):226-229

Department of Cardiothoracic Surgery, Limoges Teaching Hospital, Limoges, France.

Context: To date, there is no gold standard technique for sternum replacement. Current techniques rely on metallic prosthesis, meshes and bars, or bone grafts. However, they have several pitfalls. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):220-225

The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Background: Polysubstance dependence, stress, and sleep disturbances are inter-related by shared physiological pathways. No study has investigated the relationship between sleep and concurrent use of alcohol and khat.

Objectives: The aim of the study was to assess the effect of the concurrent use of alcohol and khat as well as concurrent alcohol, khat, and tobacco smoking on sleep patterns. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):212-219

Department of Medicine, Division of Respiratory Diseases and Tuberculosis, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To ascertain: (i) if elderly patients with fixed airflow obstruction (FAO) due to asthma and chronic obstructive pulmonary disease (COPD) have distinct airway morphologic and physiologic changes; (ii) the correlation between the morphology of proximal/peripheral airways and respiratory impedance.

Methods: Twenty-five asthma cases with FAO and 22 COPD patients were enrolled. High-resolution computed tomography was used to measure the wall area (WA) and lumen area (LA) of the proximal airway at the apical segmental bronchus of the right upper lobe (RB1) adjusted by body surface area (BSA) and bronchial wall thickening (BWT ) of the peripheral airways and extent of expiratory air trapping (AT ). Read More

Ann Thorac Med 2018 Oct-Dec;13(4):205-211

Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.

Bronchial Thermoplasty is a procedure that involves the delivery of radiofrequency energy during bronchoscopy to airways in order to selectively ablate airway smooth muscles. Bronchial Thermoplasty was approved by the FDA in 2010 and remains the only device based non-pharmacological treatment approach for severe asthma. We appraise the trials leading to the approval of Bronchial Thermoplasty in light of the FDA approval process. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):198-204

Department of Medicine, Pulmonary, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Background: While lung cancer is the leading cancer cause of death, it is largely preventable. Furthermore, early diagnosis enhances the chance of cure. Therefore, we developed guidelines for lung cancer prevention and early detection. Read More

Ann Thorac Med 2018 Oct-Dec;13(4):197

Thoracic Surgery, Saint Thomas Health, TN, USA.

Ann Thorac Med 2018 Jul-Sep;13(3):195

Division of Internal Medicine, Sesto San Giovanni Hospital, Milan, Italy.

Ann Thorac Med 2018 Jul-Sep;13(3):193-194

Department of Internal Medicine, Division of Pneumology, Memorial Hermann Southwest Hospital, Houston, Texas.

Chronic cough is associated with repetitive injury to the upper airway and trachea, which can lead to an underdiagnosed pathology known as "cough-induced" laryngotracheitis (CILT). In this report, we describe a case of CILT that responded well to dual therapy. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):190-192

Department of Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.

is a parasitic infection that affects many people worldwide. However, pulmonary Schistosomiasis is very rare entity which defined as pulmonary involvement develops in persons living or travelling in endemic areas. We report a rare case of 23-year-old Yamani patient admitted as an emergency with a 1-week history of productive cough, hemoptysis, and chest pain. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):182-189

Department of Chest Diseases, Dr. Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.

Purpose: The purpose of this study is to investigate the effect of homogeneous/heterogeneous (necrotic) involvement and maximum standardized uptake value (SUVmax) value of the lesion on positron emission tomography-computed tomography (PET-CT) of patients who underwent fiberoptic bronchoscopy (FOB) for prediagnosis of lung cancer and biopsy for endobronchial lesion on the diagnostic success of biopsy procedure.

Methods: Between January 2014 and December 2016, patients with final diagnosis of pulmonary malignancy as determined by FOB biopsy and patients who failed to be diagnosed by FOB biopsy and diagnosed with pulmonary malignancy by a different diagnostic method were examined. These patients were divided into two groups as those with diagnosis by FOB biopsy (Group 1) and those who failed to be diagnosed by this method and diagnosed with pulmonary malignancy by a different diagnostic method (Group 2). Read More

Ann Thorac Med 2018 Jul-Sep;13(3):175-181

Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Introduction: Restless legs syndrome (RLS) is etiologically divided into primary and secondary syndromes. However, a comparative description of both types is lacking in the literature. We compared primary and secondary RLS with respect to demographic determinants, associated risk factors, and comorbidities. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):168-174

Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.

Introduction: Recently, sleeping disorders and snoring are being recognized as a public health concern with various risk factors and health consequences. The main objective of the present study was to determine the prevalence of snoring and sleep apnea among adults (20-60 years) in Sharjah (United Arab Emirates, UAE) and assess the major risk factors as well as the general knowledge among the population.

Methods: A self-administrated Questionnaire of five sections including both Berlin questionnaire (BQ) and the Epworth Sleepiness Scales (ESS) were given to a randomly selected population in Sharjah between the ages of 20-60 years. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):163-167

Department of Pathology, Faculty of Medicine, Biruni University, İstanbul, Turkey.

Objective: The aim of the present study was to report our patients with pulmonary siderosis (PS) who were exposed to iron oxide and diagnosed with the minimally invasive surgical technique (video-assisted thoracic surgery [VATS]), and to provide a discussion of the relevant literature.

Methods: Hospital records of seven patients who were diagnosed with PS by VATS between 2008 and 2016 were retrospectively reviewed. VATS was performed for seven patients for whom no definitive diagnosis could be made with other diagnostic techniques. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):156-162

Department of Respiratory Medicine, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan.

Background: It is unclear whether inhaled corticosteroids (ICS) have chemopreventive effect on lung cancer (LC) development in humans. We investigated the association between the ICS use in asthma patients and the risk of LC.

Methods: We conducted a nationwide, population-based retrospective cohort study using the National Health Insurance database. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):150-155

King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.

Context And Aim: The skeleton is a frequent site for metastasis in patients with breast, lung, and prostate cancer. Bone metastasis compromises skeletal integrity leading to skeletal-related events (SREs). This study aims at estimating the prevalence of bone metastasis in lung cancer and describing types of bone involvement, management, outcomes, and overall survival. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):144-149

Department of Respiratory Medicine, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.

The prevalence of chronic obstructive pulmonary disease in Saudi Arabia is 4.2% among the general population and 14.2% among smokers. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):127-143

College of Medicine, Peadiatric Department, King Saud University, Riyadh, Saudi Arabia.

Bronchiolitis is the leading cause of admissions in children less than two years of age. It has been recognized as highly debated for many decades. Despite the abundance of literature and the well-recognized importance of palivizumab in the high risk groups, and despite the existence of numerous, high-quality, recent guidelines on bronchiolitis, the number of admissions continues to increase. Read More

Ann Thorac Med 2018 Jul-Sep;13(3):125-126

Division of Neonatology and NICU, S. Anna Obstetrics and Neonatology Hospital, Torino, Italy.

Ann Thorac Med 2018 Apr-Jun;13(2):123

Cardiovascular Specialist Centre, Dammam, Kingdom of Saudi Arabia E-mail:

Ann Thorac Med 2018 Apr-Jun;13(2):122-123

Department of Internal Medicine, Interventional Ultrasound Section, Unit of Internal Medicine, IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy E-mail:

Ann Thorac Med 2018 Apr-Jun;13(2):117-121

Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

Hepatic hydrothorax (HH) is a transudative pleural effusion that complicates advanced liver cirrhosis. Cases refractory to medical treatment in the form of salt restriction and diuretics are labeled refractory hepatic hydrothorax (RHH) and may require transjugular intrahepatic portosystemic shunts (TIPSS) or even liver transplantation. Renal impairment is common in advanced liver disease, worsens its prognosis, and makes the management of HH more challenging. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):114-116

Department of Thoracic Surgery, Ospedale Regionale Bellinzona Valli, Bellinzona, Switzerland.

Trans-esophageal endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is widely used to assess mediastinal masses. Common complications are self-limiting bleeding or pain, but occasionally, more serious accidents have been reported. A 54-year-old woman with a huge mass located in the left middle mediastinum presented 2 days after an EUS-FNA with dyspnea and chest pain. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):108-113

Department of Medicine, College of Medicine, Al Imam Mohammad IBN Saud Islamic University, Riyadh, Saudi Arabia.

Background: Inferior vena cava (IVC) filter is indicated in patients with acute venous thromboembolism (VTE) in whom therapeutic anticoagulation is contraindicated. While prophylactic insertion of an IVC filter may be considered for patients at high risk of VTE, there are significant differences between clinical guidelines on the role of IVC filters. These discrepancies have arisen predominantly because of the paucity of data on the efficacy and safety of IVC filters. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):101-107

Department of Pulmonology, Allergology and Respiratory Oncology, University of Medical Sciences, Poznan, Poland.

Introduction: Radical surgical treatment is the preferred action for patients with early-stage non-small cell lung cancer (NSCLC). Qualification for surgical treatment should consider a risk associated with the effect of comorbidities on the general condition of the patient. The aim of this article was an attempt to identify the risk factors for postoperative complications in patients treated for NSCLC, with a special focus on the coexisting diseases. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):92-100

Department of Internal Medicine, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi Arabia.

Aims: The aim of the study was to evaluate the clinical utility and safety of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with mediastinal and hilar lymphadenopathy and to explicitly describe the utility of this procedure in patient's outcome.

Methods: A retrospective review and analysis was conducted on 52 patients with mediastinal or hilar lymphadenopathy who underwent EBUS-TBNA from June 2012 to June 2016. All the patients were evaluated by computed tomography (CT) chest with contrast before EBUS examination. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):86-91

Division of Otolaryngology, Sleep Surgery, and Sleep Medicine, Tripler Army Medical Center, HI, USA.

Introduction: Treatment-emergent central sleep apnea (TECSA) is observed in some patients when they are treated with positive airway pressure (PAP) after significant resolution of the preexisting obstructive events in patients with obstructive sleep apnea. The objective of this study was to systematically review the literature for studies describing the natural history of TECSA.

Methods: PubMed, Medline, Scopus, Web of Science, and Cochran Library databases were searched through June 29, 2017. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):82-85

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Objectives: Aspiration of foreign bodies into the tracheobronchial tree is a common accident in children. This study aimed to evaluate the safety and outcome of foreign body removal by flexible bronchoscopy using a retrieval basket in children.

Methods: This was a retrospective study of children treated for foreign bodies in the airway via flexible bronchoscopy using a retrieval basket at a tertiary hospital in Korea between February 2014 and October 2017. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):76-81

Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University, Detroit, Michigan, USA.

Introduction: Survival from lung cancer is improving. There are limited data on the causes of death in 5-year survivors of lung cancer. The aim of this study is to explore the causes of death in long-term survivors of non-small cell lung cancer (NSCLC) and describe the odds of dying from causes other than lung cancer in this patient population. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):72-75

University Sleep Disorders Center and National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia.

Islamic civilization between the 7 and the 15 centuries made great contributions to the development of science and medicine, and discoveries made during this time formed the basis for the emergence of the European Renaissance. Muslims view sleep as one of the great signs of , and a number of Muslim scholars studied and wrote on sleep and dreams. However, Muslim scholars' contributions to this topic have not been adequately represented in modern scholarship. Read More

Ann Thorac Med 2018 Apr-Jun;13(2):67-71

Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Policies addressing limitations of medical therapy in patients with advanced medical conditions are typically referred to as Code Status (No Code) policies or Do-Not-Resuscitate (DNR) status polices. Inconsistencies in implementation, understanding, decision-making, communication and management of No Code or DNR orders have led to delivery of poorer care to some patients. Several experts have called for a change in the current approach. Read More

Ann Thorac Med 2018 Jan-Mar;13(1):63-65

Department of Intensive Care, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.