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Article ; Online: Management of pneumothorax: an update.

Aragaki-Nakahodo, Alejandro

2021 Volume 28, Issue 1, Page(s) 62–67

Abstract: Purpose of review: Pneumothorax is a global health problem. To date, there is still significant variation in the management of pneumothorax. For the past few years, there have been significant developments in the outpatient management of both primary ... ...

Abstract	Purpose of review: Pneumothorax is a global health problem. To date, there is still significant variation in the management of pneumothorax. For the past few years, there have been significant developments in the outpatient management of both primary and secondary spontaneous pneumothorax (SSP). We will review the latest evidence for the management of nontraumatic pneumothorax (spontaneous and iatrogenic) to include pneumothorax associated with COVID-19 infection. Recent findings: Outpatient management of both primary and SSP may be safe and feasible. Summary: Outpatient management of both primary and SSP should be included in treatment options discussion with patients.
MeSH term(s)	COVID-19 ; Humans ; Pneumothorax/therapy ; SARS-CoV-2
Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1285505-4
ISSN	1531-6971 ; 1070-5287 ; 1078-1641
ISSN (online)	1531-6971
ISSN	1070-5287 ; 1078-1641
DOI	10.1097/MCP.0000000000000839
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Article ; Online: Recurrent Pneumomediastinum Treated With Endobronchial Valve Placement After Source Detection by Bilateral Medical Thoracoscopy.

Flora, Arjan S / Aragaki-Nakahodo, Alejandro A / Benzaquen, Sadia

Journal of bronchology & interventional pulmonology

2020 Volume 27, Issue 2, Page(s) e24–e27

MeSH term(s)	Adult ; Aftercare ; Chest Tubes ; Humans ; Male ; Mediastinal Emphysema/diagnostic imaging ; Mediastinal Emphysema/pathology ; Mediastinal Emphysema/surgery ; Prostheses and Implants ; Recurrence ; Suction/methods ; Thoracoscopy/methods ; Tomography, X-Ray Computed/methods ; Treatment Outcome
Language	English
Publishing date	2020-03-25
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2478320-1
ISSN	1948-8270 ; 1944-6586
ISSN (online)	1948-8270
ISSN	1944-6586
DOI	10.1097/LBR.0000000000000662
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Article ; Online: Endobronchial Valve Placement for Persistent Air Leaks Secondary to Pulmonary Infections.

Flora, Arjan S / Aragaki-Nakahodo, Alejandro / Benzaquen, Sadia

Journal of bronchology & interventional pulmonology

2020 Volume 28, Issue 1, Page(s) 47–52

Abstract: Background: Pneumothoraces associated with infectious diseases have a higher rate of treatment failure and longer length of hospital stay than those associated with obstructive lung diseases and malignancy. Little is mentioned in the medical literature ... ...

Abstract	Background: Pneumothoraces associated with infectious diseases have a higher rate of treatment failure and longer length of hospital stay than those associated with obstructive lung diseases and malignancy. Little is mentioned in the medical literature concerning the use of endobronchial 1-way valves in treating alveolar-pleural fistulae (APF) caused by pulmonary infections. Methods: A 7-year, single-center, retrospective analysis of patients consented for exempted off-label use of the Olympus Spiration Implantable Endobronchial Valve system to control prolonged air leaks at the University of Cincinnati Medical Center. Results: Nineteen consecutive patients had 22 separate APF events from pulmonary infections during which a total of 101 valves were placed over 23 procedures (average 4.4±2.8 valves per procedure). The average time from the first chest tube placement to valve placement was 23.4±20.8 days (range, 2 to 84 d). Chest tubes were successfully removed in 19 (86.4%) of 22 APF events without further intervention. In events not including chest tubes remaining solely for empyema treatment after cessation of air leak (n=14), the average time from valve placement to the removal of all chest tubes was 12.8±20.2 days (1 to 81 d). Thirty and ninety day all-cause mortality was 15.8%. On average, valves were removed 64.1±27.1 days (range, 38 to 135 d) after placement. Conclusion: Based on our institutional experience, endobronchial valves may be a treatment option for select patients with persistent air leaks caused by pulmonary infections. Further standardized and comparative studies are required to fully understand the risks and benefits of this treatment.
MeSH term(s)	Bronchoscopy ; Chest Tubes ; Humans ; Pleural Diseases/surgery ; Pneumothorax/etiology ; Pneumothorax/surgery ; Retrospective Studies
Language	English
Publishing date	2020-05-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2478320-1
ISSN	1948-8270 ; 1944-6586
ISSN (online)	1948-8270
ISSN	1944-6586
DOI	10.1097/LBR.0000000000000689
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Article ; Online: Women Presenting With Asthma and Persistent Wheezing: A Case Series.

Benzaquen, Sadia / Kaini, Navin / Gupta, Ena / Litwin, Dianne / Wikenheiser-Brokamp, Kathryn A / Aragaki-Nakahodo, Alejandro

Chest

2021 Volume 159, Issue 4, Page(s) e267–e275

Language	English
Publishing date	2021-04-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2020.11.075
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Article ; Online: Bronchoscopic modalities to diagnose sarcoidosis.

Benzaquen, Sadia / Aragaki-Nakahodo, Alejandro Adolfo

Current opinion in pulmonary medicine

2017 Volume 23, Issue 5, Page(s) 433–438

Abstract: Purpose of review: Several studies have investigated different bronchoscopic techniques to obtain tissue diagnosis in patients with suspected sarcoidosis when the diagnosis cannot be based on clinicoradiographic findings alone. In this review, we will ... ...

Abstract	Purpose of review: Several studies have investigated different bronchoscopic techniques to obtain tissue diagnosis in patients with suspected sarcoidosis when the diagnosis cannot be based on clinicoradiographic findings alone. In this review, we will describe the most recent and relevant evidence from different bronchoscopic modalities to diagnose sarcoidosis. Recent findings: Despite multiple available bronchoscopic modalities to procure tissue samples to diagnose sarcoidosis, the vast majority of evidence favors endobronchial ultrasound transbronchial needle aspiration to diagnose Scadding stages 1 and 2 sarcoidosis. Transbronchial lung cryobiopsy is a new technique that is mainly used to aid in the diagnosis of undifferentiated interstitial lung disease; however, we will discuss its potential use in sarcoidosis. Summary: This review illustrates the limited information about the different bronchoscopic techniques to aid in the diagnosis of pulmonary sarcoidosis. However, it demonstrates that the combination of available bronchoscopic techniques increases the diagnostic yield for suspected sarcoidosis.
Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1285505-4
ISSN	1531-6971 ; 1070-5287 ; 1078-1641
ISSN (online)	1531-6971
ISSN	1070-5287 ; 1078-1641
DOI	10.1097/MCP.0000000000000398
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Article ; Online: The use of transbronchial cryobiopsy for diffuse parenchymal lung disease in critically ill patients with acute hypoxemic respiratory failure-A case series.

Matta, Atul / Gupta, Ena / Swank, Zulma / Aragaki-Nakahodo, Alejandro / Cooley, Joseph / Caudell-Stamper, Danielle N / Benzaquen, Sadia

The clinical respiratory journal

2021 Volume 15, Issue 7, Page(s) 788–793

Abstract: Objectives: Accurate diagnosis and management of undifferentiated diffuse parenchymal lung disease (DPLD) in critically ill patients is challenging. Transbronchial forceps biopsies have limited utility and surgical lung biopsies can be detrimental for ... ...

Abstract	Objectives: Accurate diagnosis and management of undifferentiated diffuse parenchymal lung disease (DPLD) in critically ill patients is challenging. Transbronchial forceps biopsies have limited utility and surgical lung biopsies can be detrimental for critically ill patients. Transbronchial cryobiopsy (TBC) has shown increased diagnostic yield compared to conventional forceps biopsy in DPLD. However, TBC has not been studied in intensive care unit (ICU) patients. In this case series, we describe our experience with TBC for diagnosis of DPLD in ICU patients with acute hypoxemic respiratory failure. Methods: This case series includes critically ill patients who underwent TBC at two different tertiary care hospitals. Procedures were performed by the same interventional pulmonologist using the two therapeutic bronchoscopes with a 2.8-mm working channel, and a 1.9- or 2.4-mm cryoprobe. Results: We performed TBC in 17 patients of which 12 (70.1%) were performed at bedside in ICU without fluoroscopic guidance. Pathological diagnosis was made in 15 (88%) patients which resulted in changes in management in most of these patients. Six patients (35.3%) developed pneumothorax post-procedure with 5 (29.4%) requiring a chest tube. Moderate bleeding was noted in one (6%) patient and no severe or fatal bleeding occurred. Our 30-day ICU mortality was 47% (n = 8); however, no deaths were directly attributable to the procedure. Conclusions: TBC is a feasible technique with an acceptable complication rate and a fairly high histopathological yield in ICU patients with DPLD and acute hypoxemic respiratory failure. Appropriate diagnosis can be crucial in making management decisions for these patients.
MeSH term(s)	Biopsy ; Bronchoscopy ; Critical Illness ; Humans ; Lung ; Lung Diseases, Interstitial ; Respiratory Insufficiency/diagnosis ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2021-03-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2442214-9
ISSN	1752-699X ; 1752-6981
ISSN (online)	1752-699X
ISSN	1752-6981
DOI	10.1111/crj.13362
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Article: Coinfection by Nocardia beijingensis and Nocardia arthritidis in an immunocompromised patient diagnosed by endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA).

Aragaki-Nakahodo, Alejandro / Benzaquen, Sadia / Kirschner, Michelle

Respiratory medicine case reports

2014 Volume 12, Page(s) 22–23

Abstract: 2 different strains of Nocardia were isolated from a lung mass in a post kidney-pancreas transplant patient through convex endobronchial ultrasound transbronchial needle aspiration (EBUS-TNBA). TBNA cultures (16S rRNA gene-targeted PCR sequencing) ... ...

Abstract	2 different strains of Nocardia were isolated from a lung mass in a post kidney-pancreas transplant patient through convex endobronchial ultrasound transbronchial needle aspiration (EBUS-TNBA). TBNA cultures (16S rRNA gene-targeted PCR sequencing) subsequently grew Nocardia beijingensis and Nocardia arthritidis.
Language	English
Publishing date	2014-03-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2666110-X
ISSN	2213-0071
ISSN	2213-0071
DOI	10.1016/j.rmcr.2013.11.001
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Article ; Online: The complimentary role of transbronchial lung cryobiopsy and endobronchial ultrasound fine needle aspiration in the diagnosis of sarcoidosis.

Aragaki-Nakahodo, Alejandro Adolfo / Baughman, Robert P / Shipley, Ralph T / Benzaquen, Sadia

Respiratory medicine

2017 Volume 131, Page(s) 65–69

Abstract: Purpose: Transbronchial lung cryobiopsy (TBLC) is a novel technique that has proved to be useful in diagnosing various interstitial lung diseases (ILD). The use of TBLC to diagnose sarcoidosis in an unselected patient population is unknown, and could be ...

Abstract	Purpose: Transbronchial lung cryobiopsy (TBLC) is a novel technique that has proved to be useful in diagnosing various interstitial lung diseases (ILD). The use of TBLC to diagnose sarcoidosis in an unselected patient population is unknown, and could be complimentary to endobronchial ultrasound fine needle aspiration (EBUS-FNA). Methods: A retrospective analysis of 36 patients in a single, tertiary-care, academic medical center was conducted to describe the yield of both EBUS-FNA and TBLC in the diagnosis of suspected sarcoidosis over a three year period. A grading system to evaluate the presence and extent of specific radiographic features on computed tomography chest imaging studies was compared to the results of EBUS-FNA and TBLC. Complications associated with the procedures were also noted. Results: The overall diagnostic yield in our cohort (all pathologic diagnosis considered) was 80.6% (29 out of 36 patients had a definite pathologic diagnosis). Eighteen patients referred for possible sarcoidosis had a positive bronchoscopic specimen confirming the diagnosis of sarcoidosis. For those patients with a pathologic diagnosis of sarcoidosis, the diagnostic yield for EBUS-FNA and TBLC was 66.7% each (12 out of 18 patients), while the combined diagnostic yield for EBUS-FNA and TBLC increased to 100%. For all cases, the pneumothorax rate was 11.1%. Conclusions: TBLC appears to be a safe and complimentary technique to diagnose sarcoidosis and could be considered part of the diagnostic armamentarium in bronchoscopic centers.
MeSH term(s)	Biopsy/methods ; Bronchoscopy/methods ; Cohort Studies ; Cryosurgery/methods ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods ; Female ; Humans ; Lung/diagnostic imaging ; Lung/pathology ; Male ; Middle Aged ; Retrospective Studies ; Sarcoidosis, Pulmonary/diagnostic imaging ; Sarcoidosis, Pulmonary/pathology ; Tomography, X-Ray Computed
Language	English
Publishing date	2017
Publishing country	England
Document type	Journal Article
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2017.08.003
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Article ; Online: Safety of performing transbronchial lung cryobiopsy on hospitalized patients with interstitial lung disease.

Cooley, Joseph / Balestra, Rick / Aragaki-Nakahodo, Alejandro A / Caudell Stamper, Danielle N / Sriprasart, Thitiwat / Swank, Zulma / Baughman, Robert P / Benzaquen, Sadia

Respiratory medicine

2018 Volume 140, Page(s) 71–76

Abstract: Introduction: Transbronchial lung cryobiopsy (TBLC) has become a popular option for tissue diagnosis of interstitial lung disease (ILD), however reports vary regarding the safety of this procedure. Herein, we evaluate the safety of transbronchial ... ...

Abstract	Introduction: Transbronchial lung cryobiopsy (TBLC) has become a popular option for tissue diagnosis of interstitial lung disease (ILD), however reports vary regarding the safety of this procedure. Herein, we evaluate the safety of transbronchial cryobiopsy in hospitalized patients, comparing adverse events to outpatient procedures. Methods and measurements: This is a single center, retrospective chart review of all TBLC performed for suspected ILD between November 2013 and March 2017. Biopsies were performed by a board certified interventional pulmonologist or interventional pulmonology fellow using a two-scope technique. Results: One hundred fifty-nine cryobiopsies were performed for the diagnosis of ILD. Rates of adverse events are as follows: pneumothorax 11%, persistent air leak 1.3%, moderate-severe bleeding 3.8%, ICU transfer within 48 h 3.1%, and all cause 30-day mortality 1.9%. No deaths were attributed to the procedure. Comparing adverse events between hospitalized patients and outpatients, rates of pneumothorax were 24% vs 9.9%, persistent air leak 5.9% vs 0.7%, ICU transfer 12% vs 2.1%, and 30-day mortality 5.9% vs 1.4%. However, no differences were statistically significant. Conclusion: Practitioners should recognize that while cryobiopsies are a high-yield, safe, and cost-effective alternative to surgical lung biopsy, not all procedures carry the same risk profiles. Hospitalized patients may have a greater propensity for pneumothorax, persistent air leak, transfer to the ICU, and 30-day mortality.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy/adverse effects ; Biopsy/methods ; Bronchoscopy/adverse effects ; Bronchoscopy/methods ; Comorbidity ; Cryosurgery/adverse effects ; Cryosurgery/methods ; Female ; Hospitalization ; Humans ; Lung/pathology ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/pathology ; Male ; Middle Aged ; Pneumothorax/etiology ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult
Language	English
Publishing date	2018-05-25
Publishing country	England
Document type	Evaluation Studies ; Journal Article
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2018.05.019
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Article ; Online: Sequential Bronchoscopic Cryobiopsy and Cryotherapy.

Benninger, Lauryn A / Medepalli, Kantha / Aragaki-Nakahodo, Alejandro / Benzaquen, Sadia / Ong, Philip G / Gilles Debiane, Labib / Casal, Roberto F

Annals of the American Thoracic Society

2017 Volume 14, Issue 6, Page(s) 1036–1040

MeSH term(s)	Biopsy/methods ; Bronchi/diagnostic imaging ; Bronchial Neoplasms/diagnosis ; Bronchial Neoplasms/therapy ; Bronchoscopy/methods ; Cryotherapy/methods ; Female ; Granular Cell Tumor/diagnosis ; Granular Cell Tumor/therapy ; Humans ; Middle Aged
Language	English
Publishing date	2017-08-26
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.201701-046CC
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