The Internet Journal of Pulmonary Medicine最新文献

{"title":"A Long-Term Survival Of Small Cell Lung Cancer Developed Diffuse Large B-Cell Lymphoma","authors":"D. Feng, David Laib, Edward F. Santos, M. Korkmaz","doi":"10.5580/2cf6","DOIUrl":"https://doi.org/10.5580/2cf6","url":null,"abstract":"We are reporting a rare case of a patient with a long-term survival of a small cell lung cancer (SCLC) who later developed a diffuse large B-cell lymphoma in the left neck. The patient was a smoker, and at age 50, was diagnosed with limited-stage small cell lung cancer. He was treated with chemotherapy and concurrent radiation therapy, and received prophylactic cranial irradiation resulting in a complete remission. Now, eight years later, he has developed an 8 cm mass at the supraclavicular lymph node. Biopsy confirmed a diffuse large B-cell lymphoma. His bone marrow was not involved. With treatment of intense chemotherapy and involved field radiation of the left neck, he is now in complete remission. Long-term survivors of SCLC may develop a second cancer including high-grade lymphoma. Thus, closely following up patients with SCLC is essential.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131356049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opaque Hemithorax: Re-Visiting The Causes","authors":"S. Bharty, B. Prakash, M. Agarwal, A. Bhatnagar","doi":"10.5580/2cf7","DOIUrl":"https://doi.org/10.5580/2cf7","url":null,"abstract":"Background: Whitening out of half of the lung field on a chest x-ray is known as Opacification of a hemithorax and its presence usually indicates a significant disease in patient. This study was done with an aim of finding different etiologies as the cause of complete opacification of a hemithorax on chest radiograph.Methods: A prospective study of patients whose Chest radiograph had opaque hemithorax were included and after clinical and laboratory investigation of these patients the diagnosis responsible for the complete opacification of half the lung field in chest X-ray was recorded.Results: A Total of 104 patients (69 males and 34 females) were enrolled for the study. Out of 100 patients 62 involved left and 42 involved right hemithorax. 74 patients had massive pleural effusion, 19 had destroyed lung secondary to tuberculosis, 8 had lung consolidation and 3 had collapse due to lung mass. Of 74 patients of pleural effusion 46 were diagnosed as empyema, 22 as malignant effusions and 6 as tubercular pleural effusion. Mediastinal shift to contra lateral side was seen only in 40 out of 74 patients having massive pleural effusion.Conclusion: Massive pleural effusion was found as most common etiology in our study. Other rarer causes that may present as opaque hemithorax could not be found in our study. A larger study may be done to find out the prevalence of these rare differential diagnoses of opaque hemithorax in chest radiograph","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115783513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity is Associated with Asthma in Patients from an Underserved Low Physician to Patient Ratio Area in a New York Pediatric Emergency Department","authors":"H. U. Malik, Krishan Kumar, J. Fogel, M. Frieri","doi":"10.5580/2c62","DOIUrl":"https://doi.org/10.5580/2c62","url":null,"abstract":"Objective: To determine the degree of association between asthma and obesity based on body mass index (BMI) percentile categories in a low physician to patient ratio setting.Methods: Data were studied for children with asthma (n=75) and control group (n=75). Body mass index (BMI) percentile categories were classifed into underwight, normal, overweight, and obese. Multivariate logistic regression was used to determine association of body mass index (BMI) percentile categories along with relevant covariates for a diagnosis of asthma. Results: Those with asthma had 48.0% classified as obese. The obese BMI percentile category was significantly associated with a diagnosis of asthma (OR:6.34, 95% CI: 2.60, 15.44, p<0.001). Also, younger age was significantly associated with a diagnosis of asthma (OR:0.89, 95% CI:0.83, 0.96, p=0.001)Conclusion: Obesity is associated with a diagnosis of asthma. Public health interventions should target low physician to patient ratio settings to address the potentially negative relationship of obesity to asthma.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125614119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septic Shock Due To Pneumocystis Pneumonia In HIV Infected Patients- Is The Virulence Of Pneumocystis Jiroveci Changing?","authors":"Vimala Rapaka, V. Daniel, Venkatram Sindhaghatta, G. Díaz-Fuentes","doi":"10.5580/2ca7","DOIUrl":"https://doi.org/10.5580/2ca7","url":null,"abstract":"Pneumocystis jiroveci pneumonia is the most common pulmonary opportunistic infection in patients with human immunodeficiency virus. The mortality for those patients that develop acute respiratory failure requiring mechanical ventilation is as high as 50%. The development of septic shock in those patients is usually due to a superimposed bacterial infection or the presence of other opportunistic infection like Aspergillus, Cryptococcus, systemic Candidiasis or toxoplasmosis. We report a unique case series of four patients with Pneumocystis jiroveci pneumonia with acute respiratory failure and hemodynamic consistent with septic shock. Despite extensive investigation, the sole etiology for the shock was Pneumocystis jiroveci. The mortality for those patients was higher that the reported for a similar population with shock due to bacterial infections. We speculate that this could reflect increasing virulence of Pneumocystis jiroveci, which induce a greater deraignment of the pro and inflammatory system.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124827287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Different Clinical Expressions of the Aspergillus/Host Interactions in Humans","authors":"A. Huaringa, Sanaz Malek","doi":"10.5580/2aa1","DOIUrl":"https://doi.org/10.5580/2aa1","url":null,"abstract":"Aspergillus is very ubiquitous. It is a highly aerobic fungus and found as mold on surfaces. It spreads most commonly through spores in the air that are not detected with the naked eye. These spores get into the respiratory tract where they colonize and often cause different kinds of reactions. Human beings respond to these inhalations in several ways depending upon the status of one’s immune system. In fact some of these responses are diametrically opposed from each other to the point that we decided to report our experience of the different expressions of the Aspergillus/human interaction in a spectral fashion. We have represented these findings in a parabola pictured below where to the right of the parabola from 0 to 90, we included the interactions of Aspergillus with an immune deficient host, and to the left of the parabola from 90 to 180, we considered the interactions of Aspergillus with a host of a hyperergic immune system.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121938903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Patients Admitted with Hemoptysis to an Inner City Hospital","authors":"V. Sahasranaman, G. Díaz-Fuentes, Venkatram Sindhaghatta","doi":"10.5580/2c93","DOIUrl":"https://doi.org/10.5580/2c93","url":null,"abstract":"Introduction: Hemoptysis is defined as the expectoration of blood from the lungs or tracheobronchial tree. There is a wide variation in its severity and etiology. In this study we aimed to determine the characteristics of patients admitted with hemoptysis to an inner city hospital.Methods: This was a retrospective review of all patients admitted to Bronx-Lebanon Hospital Center from January 2006 to July 2009 with the diagnosis of hemoptysis. Data regarding demographic characteristics, severity and etiology of hemoptysis and management of those patients was obtained.Results: 95 patients with hemoptysis were identified, 22 were excluded due to incomplete data and 73 were included in the final analysis. Males accounted for 48% of the cohort. Common comorbid diseases found were hypertension (60%), obstructive airway disease (47%), HIV infection (26%) and diabetes mellitus (17%). Twenty-three (32%) patients had normal chest imaging, either chest roentgenogram (CXR) or CXR and chest CT. Forty-six patients underwent CXR and chest CT, in 37% of those, either/both test revealed some findings. In 19 (51%) of patient who underwent CXR and chest CT for hemoptysis evaluation, the CXR was normal and the chest CT revealed abnormalities. Mild hemoptysis was seen in 79% of the patients with only one patient presenting with severe hemoptysis. Etiology was identified in 85% of the cases, infectious etiology being the most common (75%). Pneumocystis jiroveci was identified as a cause in 5.5% of the cases and no source in 15%. Invasive procedures were performed in 35% of patients, including flexible fiberoptic bronchoscopy in 23(31%) patients, bronchial artery embolization in 2(3%) patients and thoracotomy in one. Bronchoscopy identified source in 30% patients. Conclusion: Mild hemoptysis was the most common presentation in our inner city cohort. In patients presenting with hemoptysis and a normal CXR, chest CT should be considered as it is more sensitive to detect abnormalities leading to bleeding. In addition, infectious etiologies remain the most common etiology for hemoptysis. Clinicians should be aware that infection with Pneumocystis jiroveci can present with hemoptysis in HIV infected patients.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121893316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoptysis With Normal Chest Roentgenogram In A Former Smoker","authors":"J. Akella, M. Anwer, M. Niazi, S. Venkatram","doi":"10.5580/a","DOIUrl":"https://doi.org/10.5580/a","url":null,"abstract":"Tracheal papillomas are rare tracheal tumors. These tumors are usually benign and present with signs and symptoms of air way obstruction and hemoptysis. This is a disease predominantly seen in infants and children and is usually associated with laryngeal papillomatosis. The clinical manifestations are diverse and the disease is rarely considered in the differential in adult patients with hemoptysis. We present a rare case of isolated tracheal papillomatosis presenting with hemoptysis and a brief review of literature.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114963330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET avid lung mass in a neurofibromatosis patient: a case report","authors":"Y. Homsi, N. Milojkovic","doi":"10.5580/37b","DOIUrl":"https://doi.org/10.5580/37b","url":null,"abstract":"The differential diagnosis of a lung mass in a neurofibromatosis patient includes benign or malignant neurogenic neoplasm. Benign neurogenic neoplasms can transform to malignant and since this transformation is a major cause of mortality, the prognosis will depend on early detection. Computed tomography scans, magnetic resonance imaging and positron emission tomography are not able to differentiate benign from malignant neurogenic neoplasm. Needle biopsy has poor sensitivity and malignant neurogenic neoplasm can be misinterpreted as benign. We address these issues in the case of a 48 year old man with neurofibromatosis type 1 who incidentally was found to have a right apex lung mass. The needle biopsy showed spindle cell lesion of probable neurogenic origin. Given the concern about the adequacy of needle biopsy in providing an accurate diagnosis, a positron emission tomography scan was done and it showed high uptake within the lesion. The mass was resected and confirmed as neurofibroma","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114657605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study To Assess Factors Contributing To Compliance Of Aerosol Therapy In Bronchial Asthma.","authors":"B. Bhushan, G. Gaude","doi":"10.5580/1168","DOIUrl":"https://doi.org/10.5580/1168","url":null,"abstract":"Objectives of the studyTo study the compliance of aerosol therapy in asthmatics.To know the factors contributing to noncompliance. Methodology:A total of 100 patients were studied. Once included in the study, patient’s follow up was done for one to three months. Percentage compliance on aerosol therapy was calculated. Results: 100 patients of bronchial asthma who were started on aerosol therapy over duration of one year were included in the study. At the end of 3 months it was observed that among 100 patients, only 31 patients (31%) had regular compliance and 69 patients (69%) were non-compliant to aerosol therapy for bronchial asthma. Level of learning status of the individual had an important role for non-compliance, four times daily or multiple drugs, dislike of medication and distant pharmacies. Non-Drug factors include fears about side effects, anger about condition or its treatment, forgetfulness or complacency and attitudes toward ill health. To improve the compliance, whenever there were defaults various strategies were employed, through the patient’s educational techniques, which included verbal praise, interactive communication skills tailoring the medications to the patient’s routine and answering to the family’s worry. This was done by a psychologist. After employing the various strategies of patient’s education, the compliance increased in 23 patients (34.3%) among the earlier defaulted patients, while the remaining 44 patients (65.7%) were found to be noncompliant even after various educational techniques.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"129 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121420202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noinvasive Ventilation in Relapse of Acute Respiratory Failure outside ICU","authors":"K. B. Claudett, Mónica Briones Claudett, M. C. Sang, Hector Alajo Maiguashca, Diego Alexander Cruz Pico, Michelle Grunauer Andrade, A. Rodríguez, G. G. Díaz","doi":"10.5580/21ab","DOIUrl":"https://doi.org/10.5580/21ab","url":null,"abstract":"The transfer of patients to the ICU from the general ward could be a frequent issue of major concern in many hospitals around the world. We accessed the effectiveness of NIMV protocol outside ICU in subgroup of patients with relapse of acute respiratory failure and we also determined the factors associated with ICU transfer. This work is a prospective observational study. A total of 525 patients were treated of acute respiratory failure during this period of three years study. Of this, 353 (67.2%) were managed with standard therapy and 46 (8.7%) were presented with relapse and required NIMV outside ICU. The most frequent diagnoses were: COPD 22 (47.8%), CAP 13 (28.3%), CHF 5 (10.9%), asthma 4 (8.7), and diffuse interstitial pulmonary disease 2 (4.3%). Levels of IPAP were 13.5 ± 2.1 and EPAP 6.1 ± 0.8. Respiratory acidosis, the most recent finding, was (82.6%); transfer to the ICU, 5 (10.9%), and need for endotracheal intubation, 3 (6.5%). 2 (4.3%) patients in the study died and 44 (95.7%) patients were alive. The variables associated with transfer to the ICU were: IPAP level (p = 0.005), EPAP level (p = 0.03), antibiotic regimen changes (p = 0.01), and elevated HR (p = 0.04) and acidbase disorders (p = 0, 10). Cumulative survival at 13 months was 86% and in 36 months it was 73% by the Kaplan-Meier method. We identified a sub-group of patients who can benefit from the early application of NIMV protocol outside ICU after the relapse of acute respiratory failure. However, a multicentre study that involves a greater number of patients with these characteristic could be required","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126294027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}