The Internet Journal of Pulmonary Medicine最新文献

{"title":"Palpable lung cancer: Unusual manifestation of Lung Cancer","authors":"Tuhina Raman, B. Vahid","doi":"10.5580/1888","DOIUrl":"https://doi.org/10.5580/1888","url":null,"abstract":"A 37 year old gentleman who had noted an anterior chest wall mass which had gradually increased over the past year. He had some discomfort at the site but no complaints of shortness of breath, cough, hemoptysis or wheeze. He had a weight loss of 20 lbs over the past year. He was a smoker. The mass was palpable on physical examination as a hard indurated structure fixed to skin and underlying muscle. There was no palpable axillary lymphadenopathy. The rest of his exam was normal. A diagnosis of non small cell lung cancer (NSCLC) had been made 6 months earlier by transthoracic needle biopsy. The pathology was consistent with poorly differentiated carcinoma. He was treated with local radiation therapy and dual agent chemotherapy including paclitaxel and carboplatin. Unfortunately his tumour did not respond to any of these treatments. Below is a non contrast chest computed tomography scan image (Figure 1). The image shows obvious erosion of the NSCLC through the anterior chest wall into the subcutaneous tissue mimicking actinomycosis. Figure 1 Figure 1: Noncontrast CT scan of chest showing an infiltrative left lung mass with erosion through the anterior chest wall into the subcutaneous tissue. CORRESPONDENCE TO Bobbak Vahid, MD 700 Fredrick Street Suite 203 Santa Cruz, CA 95062 Tel: 831 4251908 Email: bobbak_vahid@yahoo.com References Palpable lung cancer: Unusual manifestation of Lung Cancer 2 of 2 Author Information Tuhina Raman, MD Department of pulmonary and critical care medicine, Thomas Jefferson University Hospital Bobbak Vahid, MD Department of pulmonary and critical care medicine, Thomas Jefferson University Hospital","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117274716","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 Emboli with an epidural abscess","authors":"Aşkin Uysal, Balaji Datti, M. Tapolyai, M. Boktor, C. Lang","doi":"10.5580/2783","DOIUrl":"https://doi.org/10.5580/2783","url":null,"abstract":"Septic emboli (SPE) is a rare disorder that is associated with bone infections, infective endocarditis, sinusitis, orbital cellulitis, femoral thrombophlebitis, urinary tract infections, central venous catheter infections, prosthetic cardiac valve infections and pacemaker infections. Some of the causative organisms include Klebsiella. pneumonia, viridans streptococci staphylococcal aureus . Some of the predisposing factors include of SPE include diabetes mellitus,intravenous drug use. These patients with suspected septic emboli should best be empirically treated with antibiotics such as vancomycin. We present a 56 year old man with septic emboli with methicillin resistant staphylococcal aureus bacteremia and was started on IV vancomycin with clinical improvement. His MRI of his lower back revealed an epidural abscess. We discuss a case of septic emboli with associated epidural abscess. Epidural abscess is a rare condition that can result in permanent neurological deficits. We discuss the diagnosis,associated risk factors and treatment of septic emboli and epidural abscess.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131320487","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":"Pneumonia in Pregnancy: Pneumocystis Jiroveci Pneumonia","authors":"S. Aleyas, B. Vahid","doi":"10.5580/e87","DOIUrl":"https://doi.org/10.5580/e87","url":null,"abstract":"The incidence of pneumonia in pregnancy is not different from that in non-pregnant adults 20 to 40 year-old and has been reported in 1.1 to 2.7 per 1,000 deliveries. We report about a 36 year old African American woman presented to the emergency department with 2 week history of dry cough and increasing dyspnea on exertion. The differential diagnoses of severe CAP in this setting encompass both infectious and noninfectious etiologies. Considerations are atypical bacterial pneumonia, viral pneumonia, Pneumocystis jiroveci (Pneumocystic carinii) pneumonia, aspiration pneumonitis, sarcoidosis, hypersensitivity pneumonitis, and acute eosinophilic pneumonia.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125271025","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":"A Study Of Epidemiological Factors Related To Acute Respiratory Infection (ARI) In Under Five Children Attending The Immunization Clinic Of Calcutta National Medical College And Hospital","authors":"S. Chatterjee","doi":"10.5580/2597","DOIUrl":"https://doi.org/10.5580/2597","url":null,"abstract":"Infection of the respiratory tract are among the most common of human ailments. They are a substantial cause of increased morbidity and mortality rates in young children in less developed countries like India. The WHO World Health Report 1999(Making a Difference-Report of Director General, WHO) indicates that incidence rate of Acute Respiratory Infection (ARI) in developing countries like those in the Indian subcontinent is comparable to developed countries. But cause specific mortality due to ARI is 10-50 times higher in developing countries than developed countries. Every year ARI in young children is responsible for an estimated 4.1 million deaths worldwide. In India ARI constitute a major public health problem and is the most important contributory to mortality and morbidity in under 5 accounting for (15-34)% of all childhood deaths(according to the WHO bulletin, Health Situation in South East Asia Region 1994-1997, Regional office for SEAR, New Delhi, 1999). India accounted for 28% of the mortality and 30% of Disability Adjusted Life Years (DALYs) lost due to ARIs as stated in the WHO World Health Report, 1995, Bridging The Gaps. In relative values, ARI mortality is highest in the postneonatal period. ARI, mainly pneumonia, accounts for about 18% of underlying causes of death in developing countries. Pneumonia and other ARI are frequent complications of measles and pertussis. ARI is also commonly found after other infections and in association with severe malnutrition. Virtually no data are available in developing countries to provide final estimates of the role of ARI in mortality of children aged under 5 years. However, the WHO figure of 1 out of 3 deaths due to--or associated with--ARI may be close to the real range of the ARIproportional mortality in children of developing countries.[1] Incidence of pneumonia in developing countries like India range between (20-30)%. This is due to high prevalence of malnutrition, low birth weight, and indoor air pollution in developing countries. ARI is an important cause of morbidity and mortality in children under 5 years of age who suffer about 5 episodes of ARI per year, thus averaging 238 million attacks consequently. Thus I conducted my study with the objective of a) estimating the attack rate of ARI among under 5 children attending the Immunisation Clinic of Calcutta National Medical College and Hospital. b) To find out socio-economic, environmental and cultural factors related to Children suffering from ARI. A Study Of Epidemiological Factors Related To Acute Respiratory Infection (ARI) In Under Five Children Attending The Immunization Clinic Of Calcutta National Medical College And Hospital 2 of 6 Study Design: Cross sectional, observational, clinic based study. Study Setting: Immunization clinic under aegis of the Department of Community Medicine, Calcutta National Medical College and Hospital. Study Population: Under-5 children attending the Immunisation Clinic(exclusion criteria-children bel","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124042764","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":"Idiopathic pulmonary hemosiderosis in an adult female patient","authors":"Aşkin Uysal, M. Boktor, M. Tapolyai","doi":"10.5580/35e","DOIUrl":"https://doi.org/10.5580/35e","url":null,"abstract":"Idiopathic pulmonary hemosiderosis (IPH) is a rare condition that is rarely seen in the adult population 1. It is more common in younger patient between the ages of 1 to 171. It can present with onset of anemia, hemoptysis, dyspnoea and presence of opacifications on cat scan (CT) of the chest. The patient is a 40 year old female who presented to the hospital with gradual onset of dyspnoea and cough as well as hemoptysis that developed over the course of several weeks. Her vital signs were stable on admission to the hospital. She had intensive work up of her condition which led to a bronchoscopy and an open lung biopsy. These findings were consistent with diagnosis of IPH. The patient once diagnosed was started on corticosteroid therapy. She was sent home with clinic appointment. Pathogenesis, presentation and diagnosis of IPH are reviewed for this rare presentation in an adult patient.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130151981","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":"Pulmonary Fungal Involvement in HIV-positive patients in an inner city hospital in New York","authors":"G. Díaz-Fuentes, C. Shin, E. Sy, M. Niazi, L. Menon","doi":"10.5580/14cb","DOIUrl":"https://doi.org/10.5580/14cb","url":null,"abstract":"Study objective: Pulmonary fungal infections are being recognized with increasing frequency in AIDS patients. The goal of our study was to determine the incidence at autopsy of fungal and non-fungal pneumonia in HIV patients, compare these two groups and evaluate possible risk factors for fungal infection. Patients: This was a retrospective review of all HIV positive patients that died and had autopsy performed between January 1993 and June 1996. Results: There were 5,925 pneumonia events reported by discharge billing codes in 2903 HIV positive adult patients at the Bronx-Lebanon Hospital Center in New York City from 1993 to 1996. During the 42 month study period, 688 (24%) of the patients died. Ninety (13%) patients underwent autopsy at our institution; 70 (77%) of those patients were found to have pneumonia at autopsy. Fungal pneumonia was present in 29 (41%) patients: Candida (14), Aspergillus (8), Histoplasma (4) and Cryptococcus (3). Three patients were being treated for fungal infection premortem, 2 Cryptococcus meningitis and 1 disseminated histoplasmosis. In the 41 cases with non-fungal pneumonia, bacterial infections, Pneumocystis jirovecii and CMV were most frequently found organisms. Neutropenia was seen in 41% of the patients with fungal pneumonia compared with 15% in the non-fungal pneumonia group. This was a statistically significant difference (p=0.05). Neutropenia was associated most commonly with pulmonary candidiasis. Cavitary lung disease was found only in patients with Aspergillosis and tuberculosis. Infection with multiple organisms was frequently found. Conclusion: Pulmonary fungal infections in AIDS patients are a common and under diagnosed problem. Neutropenia is an important risk factor for pulmonary candidiasis. Our study highlights the need for a high index of clinical suspicion and early aggressive diagnostic intervention in AIDS patients with neutropenia and pneumonia, especially in those patients with cavitary or alveolar patterns on CXR.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128547466","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":"Isolated Left Upper Lobe Aplasia And Lower Lobe Hypoplasia With Bronchial Asthma","authors":"R. Kushwaha, S. Verma, V. Mahajan, Ragini Singh, R. Prasad","doi":"10.5580/178","DOIUrl":"https://doi.org/10.5580/178","url":null,"abstract":"Congenital malformations like hypoplasia or aplasia of the lung with bronchial asthma are rare clinical conditions. Here we are reporting such type of case in a 36 years old non smoker male.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132311502","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":"Bronchiectasis as a cause of unexplained breathlessness in HIV infected patient","authors":"R. Prasad, R. Garg, Sanjay","doi":"10.5580/151b","DOIUrl":"https://doi.org/10.5580/151b","url":null,"abstract":"Human immunodeficiency virus (HIV) infection has been associated with a wide spectrum of pulmonary disease. Here we report a case of 32 year old, HIV seropositive male having cough and progressive breathlessness for one year. Progressive breathlessness was diagnosed to be due to unusually rapid airway obstruction associated with bronchiectasis in this patient.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131050209","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":"An interesting case of haemoptysis","authors":"Suryakant, S. Mehra","doi":"10.5580/a2e","DOIUrl":"https://doi.org/10.5580/a2e","url":null,"abstract":"Haemoptysis is a common symptom that can occur in a variety of respiratory and cardiovascular diseases. Here we describe an interesting case of haemoptysis who was first mistook as pulmonary tuberculosis and then as bronchogenic carcinoma before being referred to us and was ultimately found to have aortic dissection. It is an unusual presentation of a rare condition associated with a grave prognosis and even death if not diagnosed and managed promptly.","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131111960","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":"ARI And Indoor Air Pollution: Its Burden And Correlation","authors":"Santosh Kumar, S. Mehra","doi":"10.5580/269e","DOIUrl":"https://doi.org/10.5580/269e","url":null,"abstract":"Most of the disease burden in India is due to the respiratory disorders namely acute respiratory infections (ARI), asthma, chronic obstructive pulmonary disease (COPD), tuberculosis (TB) and lung cancer. These diseases are mainly attributed with exposure to indoor pollution, solid-cooking fuels, smoking, poor housing and malnutrition. NATIONAL BURDEN OF DISEASE (NBD) Those disease categories that cause at least 1% of the NBD or at least 1% of all deaths constitute the national burden. Although commonly used, number of deaths is not a very informative indicator of ill health. Better is some measure of the loss of healthy life such as the disability adjusted life year (DALY), which basically indicates the amount of healthy life expectancy lost because of a disease, including both mortality and morbidity. It can be seen that it is the children less than five years, who bear the largest overall illhealth burden of any age group with the major contribution made by ARI. Respiratory diseases such as ARI,TB, COPD and Cancer all contribute to atleast 1% of DALYs and Deaths1. ARI is the largest contributor to the NBD with 12% DALYs and 13% deaths1. INDOOR AIR POLLUTION Four components of indoor pollution are combustion products, chemicals, radon, and biologic agents. Out of the four components, combustion-generated pollutants, principally those from solid-fuel (wood, charcoal, crop residues, dung, and coal) cooking and heating stoves, have been the major culprit. Thus the major source of indoor air pollution is exposure to biomass fuel cooking2It is considered positive if the individual gives the history of regularly cooking at home. STATUS OF HOUSEHOLD FUEL USE IN INDIA The types of cooking fuels used at home included liquefied petroleum gas (LPG), kerosene, or the solid fuels i.e. coal, dried wood, dung and other products of animal or plant origin (biomass fuels). Degree of pollution strongly depends on type of fuel used. . Solid fuels are substantially more polluting per meal than the liquid and gaseous fuels further up on the ‘‘energy ladder.’‘ The amount of important health-damaging pollutants (e.g., PM10, CO, PAH, HCHO, VOC) breathed by a cook during a typical meal is about 2 orders of magnitude lower when burning bottled gas than burning wood or crop residues. Thus, as a first approximation, the use of unprocessed solid fuels in the household is an indicator of the potential for excessive air pollution exposures. In this way, access to clean fuels is parallel to the often-cited statistic on access to clean water as an indicator of disease risk. MAGNITUDE OF PROBLEM Air pollution has become a major concern in India in recent years both because it is now clear that large parts of the Indian urban population are exposed to some of the highest pollutant levels in the world. Annual concentrations reported at urban monitors in India for PM10, particles less than 10 microns in diameter, is of range 90–600 μg/m3, with a population mean of about 200 μg/m3. T","PeriodicalId":284620,"journal":{"name":"The Internet Journal of Pulmonary Medicine","volume":"13 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127018668","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}