Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 8 Articles
Background. Endobronchial lipomas are a particularly rare form of benign lung neoplasms, with an incidence of 0.1-0.4%. They are\noften clinically silent, though present with nonspecific symptoms that can result in extensive workup or significant delay prior to\ndiagnosis, as presented in this case. Case Presentation. A 61-year-old male presented with chronic productive cough and occasional\ndyspnea and a 10-year history of clinically diagnosis of intermittent, exercise-induced asthma, nonresponsive to bronchodilators,\nand with normal pulmonary function tests. A chest ray showed a band-like opacity in the right middle lobe of the lung and a CT of\nthe chest showed right lung atelectasis with a soft tissue mass in the right main bronchus. The patient underwent bronchoscopy\nwith biopsy, which demonstrated an endobronchial myxoid spindle cell lipoma. The lesion was subsequently removed by a\nbronchoscopic snare. The patientâ??s asthmatic-like symptomatology resolved after the mass was excised. Conclusion. Though\nrare, endobronchial lipomas characteristically present with nonspecific signs and symptoms and thus can be easily mistaken for\nother medical conditions, delaying diagnosis and prolonging symptoms....
Achalasia is a neurodegenerative motor disease of the esophagus resulting mainly from a loss of function of the lower esophageal\nsphincter, the pathophysiology of which is still poorly understood. Its incidence is rare-it is 1.6 per 100,000-and its occurrence in\nthe context of paraneoplastic syndrome has been rarely described in the literature. We report a rare case of paraneoplastic achalasia\nassociated with lung cancer....
Asthma patients experience impairments in health-related quality of life (HRQL). Interventions are\navailable to improve HRQL. EQ-5D-5L is a common generic tool used to evaluate health interventions. However,\nthere is debate over whether the use of this measure is adequate in asthma patients.\nMethods: We used data from 371 asthma patients participating in a pulmonary rehabilitation (PR) program from\nthe EPRA randomized controlled trial. We used four time points: T0 randomization, T1 start PR, T2 end PR, T3 3\nmonths follow-up. We calculated floor and ceiling effects, intra-class correlation (ICC), Cohenâ??s d, and regression\nanalysis to measure the sensitivity to changes of EQ-5D-5 L (EQ-5D index and Visual Analog Scale (VAS)) and the\ndisease-specific Asthma Quality of Life Questionnaire (AQLQ). Furthermore, we estimated the minimally important\ndifference (MID). Based on the Asthma Control Test (ACT) scores, we defined three groups...................
Tumor necrosis factor inhibitors contribute to a greater susceptibility to infection\nor reactivation of Mycobacterium tuberculosis . Endobronchial tuberculosis\nhas non-specific symptoms, which may delay the diagnosis. We report\na case of a 21-year-old woman, with Crohnâ??s disease, medicated with adalimumab.\nThe patient presented with a 2-week history of fever, dry cough,\npleuritic chest pain and weight loss of 2 kg. Chest imaging showed bilateral\nnodular opacities, at the right pulmonary apex. Bronchoscopy revealed a tumorous\nlesion in the right upper bronchus. Bronchial biopsies were suggestive\nof chronic granulomatous inflammation. Bronchoalveolar lavage produced\na positive for acid-fast bacilli smear and culture for Mycobacterium\ntuberculosis. We assumed the diagnosis of tuberculosis with endobronchial\nmanifestations. Nowadays this is a rare manifestation. Empirical treatment\nfor tuberculosis was initiated, with steroids as an adjunct therapy to prevent\nbronchostenosis, with clinical and radiological improvement....
Postpartum pulmonary hypertension (PPPHT) is an extremely rare disorder, with few reported cases. Late diagnosis and treatment\nare associated with significant morbidity and mortality. We present an 18-year-old female patient who presented four-week\npostpartum with a typical submissive pulmonary embolism picture subsequently diagnosed as postpartum pulmonary\nhypertension. The patient had an excellent response to treatment, with a dramatic improvement in her functional status. The\nauthors aim to urge physicians to keep this rare disorder in mind as timely and accurate diagnosis is crucial for\nmanagement-additionally, the importance of counseling patients about the imminent risks associated with planned future\npregnancies....
Since the appearance of the E-Cigarette in the early 2000s, its industry, popularity, and prevalence have risen dramatically. In the\npast, E-Cigarette use with the vaping of nicotine or cannabis products had been associated with a few reported cases of lung injury.\nHowever, in 2019, thousands of cases of E-Cigarette or vaping product use-associated lung injury (EVALI) were reported in the\nUnited States. Evidence linked this outbreak with vaping of tetrahydrocannabinol (THC). We report two confirmed cases of\nEVALI and their associated clinical, radiologic, and pathologic features. This report supports the growing body of information\nregarding EVALI. It also discusses various substances, particularly vitamin E acetate, which has been suggested as a causative agent....
Objective: To explore the close relationship between respiratory syncytial virus\n(RSV) infection and acute attack of childhood asthma. Methods: A computer-\nbased search of database from Pumbed, CNKI, Wanfang, Baidu Scholar,\nChongqing VIP, GeenMedica was performed to screen the articles about\nrespiratory syncytial virus infection and childhood asthma. Then the literatures\nwere screened out by the selection criteria. The RevMan5.3 software was\nused to test the heterogeneity and effect values of each study, analyze the sensitivity\nand publication bias of the literature, and draw on Meta forest plot\nand Funnel plot. Results: 5 articles conformed to the selection criteria. There\nwere totally 881 cases in the case group, 826 cases in the control group. The\nresults of heterogeneity test showed no heterogeneity between each study......................
Identification of pathologic features is helpful for the management of nonresolving acute respiratory\ndistress syndrome (ARDS). Transbronchial lung cryobiopsy (TBLC) is a novel biopsy technique that may have\ncomparable utility to surgical biopsy. The aim of this study was to assess the value of TBLC in patients with\nnonresolving ARDS.\nMethods: All patients with nonresolving ARDS who underwent TBLC from January 2019 to August 2019 in a\ntertiary medical ICU were included. In addition, a literature search of TBLC for ARDS was performed by searching\nPubMed, EMBASE, ATS/ERS/APSR meeting abstracts, ClinicalTrials.gov, and Google Scholar. Data on complications,\nhistologic diagnosis, management changes, and outcomes were analysed.\nResults: Five patients (three women and two men) underwent TBLC. None of the patients developed pneumothorax,\nalthough two patients developed massive bleeding, which was controlled by continuous occlusion using bronchial\nblockers. There were no procedure-related deaths. Diffuse alveolar damage (DAD) and alternative histologic patterns\nwere found in two and three patients, respectively, resulting in management changes in all cases. The literature search\nyielded four studies, which together with the present study comprised data from 25 cases in which TBLC was used in\nnonresolving ARDS. The summary diagnostic yield was 92% (23/25). Only 44% (11/25) of cases were proven to be DAD.\nTBLC contributed to management changes in 80% of patients (20/25). Procedure-related complications consisted of\npneumothorax (16%, 4/25), significant bleeding (12%, 3/25), and persistent air leaks (8%, 2/25). There were no\nprocedure-related deaths. The follow-up survival rate was 61.9% (13/21).\nConclusions: The complications of TBLC in selected patients with nonresolving ARDS may be acceptable. The\nprocedure may have a high diagnostic yield and can lead to a re-evaluation of the diagnosis as well as changes in\npatient management. Further investigations with larger sample sizes are required....
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