Current Issue : July - September Volume : 2018 Issue Number : 3 Articles : 5 Articles
Background. Asthma is common in elite athletes. In this study, we examined the use of asthma medication and asthma control in\nendurance athletes in Sweden and compared the findings with those in a reference group of patients with asthma. Methods. The\nAsthma Control Test (ACT) and a questionnaire on asthma, respiratory symptoms, and medication use were posted to endurance\nathletes (n 711) and the reference group of patients with asthma (n 1026). Four hundred and sixty-nine athletes (66%)\nresponded, of whom 141 (20%) reported physician-diagnosed asthma. In the reference group, 397 (39%) responded. Results.\nSeventy-seven percent of the athletes with asthma reported using asthma medication during the previous year; 39% used\nshort/long-acting �²2-agonists, 31% used inhaled corticosteroids, and 31% used both daily. According to the ACTscores, 19%, 24%,\nand 58% of athletes with asthma had uncontrolled, partially controlled, or well-controlled asthma, respectively. After adjustment,\nthere was no difference in ACTscores or daily use of asthma medication between the study groups. Conclusions. Many endurance\nathletes had uncontrolled or partially controlled asthma, and one-third used inhaled corticosteroids and long-acting �²2-agonists\ndaily. Their adjusted ACT scores and use of asthma medication were similar to the values in the reference population....
Wheezing and cough are common case scenarios that pediatricians encountered in their office practices. Although a bronchogenic\ncyst is an uncommon condition, it is essential to be considered in the differential diagnosis of a chronic cough and wheezing\namong young children who fail to respond to appropriate medical treatment. A 28-month-old girl was referred to our pediatric\npulmonology clinic with persistent symptoms of a cough and wheeze unresponsive to standard asthma therapy. This presentation\nprompted us to undertake a detailed diagnostic evaluation. The evaluation exposed a cystic mass in the middle mediastinum\ncompressing the trachea and left main bronchus. The cyst was excised and confirmed pathologically to be a benign bronchogenic\ncyst. Subsequently, the patient recovered well and had been free of respiratory symptoms during follow-up visits. This report\nhighlights one of the rare causes of wheezing and cough in young children and emphasizes the importance of considering it in the\ndifferential diagnosis of a child presenting with refractory asthma-like symptoms. This is important for early diagnosis and\nmanagement and to avoid unpredictable complications of this treatable condition....
Background: Tuberculosis is currently the world�s leading cause of death arising\nfrom a single infectious condition. While T cell mediated immunity is\nrecognized to have a major contribution to tuberculosis activation, the present\ninvestigation confirmed that TB was more prevalent among patients with\nacute myeloid rather than lymphoid leukemia and such association was frequently\noverlooked. The primary objective of this study is to estimate the diagnostic\ndelay of tuberculosis among patients with acute myeloid leukemia\n(AML) and compare it to the general population in Qatar. Secondary objective\nis to study the clinical and epidemiologic characteristics of tuberculosis in\npatients with AML. Methods: This is a retrospective study of tuberculosis cases\ndiagnosed in subjects with AML during the period from January 2008 till\nDecember 2016. Results: Among 215 subjects with AML identified during the\nstudy period, 12 (5.58%) received the diagnosis of tuberculosis. The estimated\nincidence of tuberculosis among AML cases was 7.14 cases per 1000 per year.\nThe mean delay in diagnosis of tuberculosis was 64.2 days (95% CI: 26.8 -\n101.5) and the median was 45 days (interquartile range; Q1 - Q3, 29.5 - 97.5).\nProlonged fever was the most common presentation (100% of cases). Parenchymal\nlung involvement was the most common radiologic abnormality\n(83.3% of cases). Three patients (25%) died and 8 patients completed 9 to 12\nmonths of anti-tuberculous treatment with clinical and radiological remission.\nConclusion: Infections caused by Mycobacterium tuberculosis are not uncommon in patients with AML especially in patients from tuberculosis endemic\nregions. It constitutes a diagnostic challenge so high index of suspicion\nis of paramount importance....
CONTEXT: Adenocarcinoma already comprises half the cases of lung cancer.\nIts insidious clinical evolution contributes to the fact that, in absolute numbers,\nlung tumor is the cancer with the highest mortality in the world. When\nstill in situ , the adenocarcinoma is even quieter, making its typical presentation\non the computerized tomography of an irregular semisolid nodule smaller\nthan 3.0 cm. It is often diagnosed in a finding of examination in an asymptomatic\npatient. The prevalence of in situ adenocarcinoma (ISA) is less than\n5% of pulmonary malignancies and its radiological presentation with a diffuse\nmosaic paving pattern is even more unusual, mimicking other conditions\nmore frequent to this finding. CASE REPORT: We describe the case of a\n44-year-old male patient with a history of chronic smoking admitted to the\nemergency room at a referral hospital in SÃ?£o Paulo on 12/16/2016 with a\ncomplaint of progressive dyspnea associated with dry cough for 3 months, intermittent\nfever and weight loss of 8 kg in 2 months. A chest X-ray and computed\ntomography showed discrete focal points of peribroncovascular consolidation,\npredominantly central, areas with frosted glass attenuation associated\nwith smooth thickening of the interlobular septa, sometimes interspersed\nwith areas of preserved parenchyma, giving an aspect of ââ?¬Å?crazing pavingââ?¬Â\nwith diffuse distribution by the pulmonary parenchyma. The patient underwent\na biopsy with the anatomicopathological diagnosis of primary Adenocarcinoma\nin situ of the lung. CONCLUSION: We emphasize that the\nââ?¬Å?crazing pavingââ?¬Â of adenocarcinoma in situ pulmonary should be considered\nand known by the radiologist, because although isolated it is a rare condition,\nits early distrust in cases of atypical evolution of the most common injuries\ncan avoid a diagnosis in phases more advanced and higher mortality....
Asthma is a chronic disease of airway inflammation with a large global burden. Despite established, guideline-based stepwise\ntherapy, a significant proportion of patients remain symptomatic and poorly controlled. As such, there is a need for additional\nsafe, effective, convenient, and cost-effective therapies that can be broadly applied across a range of asthma phenotypes. Tiotropium\nis a long-acting muscarinic antagonist (LAMA) that leads to bronchodilation by blocking endogenous acetylcholine\nreceptors in the airways. Tiotropium has long been approved for the treatment of chronic obstructive pulmonary disease, and it\nhas recently been recognized for its safety and efficacy in improving lung function and controlling asthma. Evidence from several\nPhase III trials in the adult and paediatric population has shown that tiotropium is well tolerated and significantly improves\na range of endpoints as an add-on treatment to ICS therapy, regardless of baseline characteristics and clinical phenotypes.\nConsequently, regulatory authorities worldwide have recently licensed tiotropium as the only LAMA approved for the treatment\nof asthma. This review provides an overview of safety and efficacy data and discusses the use of tiotropium in patients across the\nrange of asthma severities, ages, and phenotypes....
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