RESUMEN
Background: Lung sequestration is a subtype of congenital lung malformations; it is infrequently diagnosed in adults and is a rare cause of hemoptysis. The typical management of symptomatic lung sequestration is usually surgical, though intra-arterial embolization is becoming an acceptable alternative. Case Presentation. We report a case of a 36-year-old female patient who presented for an acute onset of hemoptysis. CT chest showed an intralobar sequestration of the right lower lobe lung segment. In addition to the sequestration, the chest imaging also revealed a number of associated abnormalities including double superior vena cava communicating through a bridge, absence of brachiocephalic venous trunk, cardiac dextroposition, and agenesis of the right middle lobe. Outcome and Discussion. The transarterial embolization was selected for being mini-invasive and effective. It successfully controlled the bleed and led to complete regression of the sequestered lung on the follow-up CT chest several months later. Conclusion: Successful management and complete regression are possible with mini-invasive intra-arterial embolization of lung sequestration. Although it is not uncommon to have associated congenital cardiopulmonary abnormalities with lung sequestration, however the exceptional abnormalities described in this case have never been reported before.
RESUMEN
Purpose: The objective of this study was to investigate the feasibility and pretest the effectiveness of an educational and telemonitoring program in a sample of Lebanese COPD patients to inform the design of a randomized study. Patients and Methods: This study recruited a convenient sample of 15 patients from the pulmonology departments of four hospitals. Validated questionnaires were adapted to meet the context of this study in terms of adequacy, acceptability, adoption, fidelity, and cost. The impact of this program on quality of life and anxiety was measured by the COPD Assessment Test (CAT), the COPD Clinical Questionnaire (CCQ), and the Hospital Anxiety and Depression Scale (HADS). All measurements were performed before and after the intervention. Results: All 15 participants who agreed to participate in this intervention found the program adequate and acceptable for addressing COPD-related issues. Regarding adoption, all participants declared having no difficulty explaining to others the content of the education sessions and that they would suggest this program to other COPD patients. In terms of effectiveness, six patients had improving in quality of life scores, and five patients had lower anxiety and depression scores compared to baseline measures. A knowledge assessment was done at the end of each session, showing an increase in knowledge for all participants. Skills were also assessed at the end of the program. Participants made no errors that had an impact on their health. Regarding the cost, it was difficult to evaluate the relative cost of this intervention given the economic situation in the country. Conclusion: This study is the first to evaluate the application of telehealth to optimize COPD management in Lebanon. The approach proposed gave insights into the different obstacles and facilitating factors for implementing such a project to allow a large-scale work on the adaptation of the COPD patient to his disease in Lebanon.