A 19-year-old woman presented with shortness of breath, dry cough, and pleuritic chest pain of unknown duration. Her medical history included endometriosis, a benign ovarian cyst,
Journal Of Respiratory Diseases
A 74-year-old woman with a history of breast cancer and cutaneous sarcoidosis was admitted after a fall from bed that resulted in a left hip fracture.
Cocaine and amphetamine intoxication continue to be common causes of emergency department and hospital admissions.
What are the most effective ways to reduce the incidence of acute exacerbations of chronic obstructive pulmonary disease (COPD)?
p>Drug-induced lung disease (DILD) can be caused by a variety of agents, including chemotherapeutic drugs, antiarrhythmic agents, antibiotics, and NSAIDs. The clinical syndromes associated with DILD include alveolar hypoventilation, acute bronchospasm, organizing pneumonia, and hypersensitivity reactions. Amiodarone lung toxicity often manifests as a chronic fibrosing alveolitis, characterized by an insidious onset of cough, dyspnea, and weight loss. Important components of the workup include chest radiography, pulmonary function testing, and bronchoscopy with bronchoalveolar lavage (BAL). BAL is particularly helpful in identifying eosinophilic pneumonia and diffuse alveolar hemorrhage and in ruling out infectious causes. Management includes drug withdrawal and, in some cases, corticosteroid therapy. Before starting corticosteroids, it is important to rule out infectious causes of lung disease, particularly in patients receiving chemotherapy. (J Respir Dis. 2009;30(1))
Although the common cold is usually benign, it can lead to exacerbations of asthma and chronic obstructive pulmonary disease, and it is a leading cause of missed school and work. Strategies for prevention have been directed at interruption of viral transmission between persons, as with the use of virucidal agents or disinfectants, and prevention of infection after acquisition of the pathogen. Hand washing continues to be recommended, but there is no proof that hand sanitizers or virucidal tissues are effective in preventing colds. Prophylactic therapies that have been considered include vitamin C, vitamin E, zinc, Echinacea, ginseng, and probiotics. Although some evidence may suggest possible benefits with zinc and probiotics, for example, overall, the data are insufficient to recommend any of these as prophylaxis for the common cold. (J Respir Dis. 2009;30)
A 47-year-old man with HIV infection presented with progressive dyspnea and worsening productive cough for the past 3 weeks. He also reported increasingly purulent sputum production. The patient reported being adherent to his antiretroviral regimen, and he had an admission CD4+ cell count of 550/μL. He did not have any previous opportunistic infections, and he denied any drug or tobacco use, recent travel, and ill contacts.
ABSTRACT: The treatment of pulmonary arterial hypertension
(PAH) is directed at the underlying cause, such as diastolic
heart failure or chronic thromboembolic disease. Patients with
idiopathic PAH or PAH associated with connective-tissue disease
who have World Health Organization (WHO) functional
class II or III PAH should receive a trial of oral bosentan, ambrisentan,
and/or sildenafil; inhaled iloprost is an alternative or
an additive agent. If patients fail to respond to these interventions
or if they have WHO functional class IV PAH, consider
subcutaneous or intravenous treprostinil or epoprostenol. The
use of these latter agents is much more complicated and may
be difficult to initiate in elderly patients. (J Respir Dis. 2008;
Actinomyces odontolyticus is
a rare cause of pleuropericardial
infection, with only 1 case
identified in the literature. In
that instance, the infection
was believed to be secondary
to gastric surgery. We present a
patient with pericarditis and
pericardial tamponade caused
by A odontolyticus. The infection
occurred after an ultrasound-
bronchoscopic needle biopsy
performed for a suspicious mediastinal
mass found on a CT
scan of the chest. We describe
the case presentation, the microbiology
and treatment of A
odontolyticus infection, and
the classic features of pericarditis
and cardiac tamponade.
ABSTRACT: Patients with obstructive sleep apnea (OSA) are at increased
risk for motor vehicle crashes as a result of excessive
sleepiness. However, a number of factors complicate risk assessment.
For example, self-reported sleepiness and the severity
of OSA do not appear to be good predictors of accident risk.
Many persons with OSA do not accurately perceive their level
of drowsiness-self-reported sleepiness does not correlate well
with objective measures, such as results of the Multiple Sleep
Latency Test. Moreover, it is not clear whether objective tests
can reliably predict accident risk in the real world, as opposed
to during simulated driving. The indications for-and benefits
of-restricting driving in patients with OSA have not been established.
However, there is good evidence that the use of continuous
positive airway pressure significantly reduces the risk
of crashes in these patients. (J Respir Dis. 2008;29(12):459-464)