Respiratory medicine CME最新文献_第10页

Pulmonary fibrosis in systemic sclerosis: Diagnosis & management 系统性硬化症中的肺纤维化:诊断与治疗

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.09.016

Howard M. Branley

引用次数: 3

A 19–year–old man with severe obstructive lung disease 一名患有严重阻塞性肺病的19岁男子

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.09.009

Abubakr A. Bajwa, Faisal Usman , Danny Pulido , James D. Cury , Luis Laos

{"title":"A 19–year–old man with severe obstructive lung disease","authors":"Abubakr A. Bajwa, Faisal Usman , Danny Pulido , James D. Cury , Luis Laos","doi":"10.1016/j.rmedc.2009.09.009","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.09.009","url":null,"abstract":"<div><p>A 19-year-old boy presented to ambulatory clinic with shortness of breath after walking two blocks. He denied any cough, orthopnea, chest pain or hemoptysis. Ten months prior to admission he was admitted to the medical intensive care unit with respiratory failure and was diagnosed with Goodpasture syndrome. He was treated with cyclophosphamide and steroids. He was discharged home after recovering. Patient subsequently developed dyspnea on minimal exertion. Spirometry showed severe obstructive lung disease and HRCT of chest showed diffuse micronodular disease with patchy ground-glass opacities, mild bronchiectasis and bronchiolectasis. Serologies for goodpasture syndrome were normal. A diagnosis of post-Goodpasture syndrome constrictive bronchiolitis was made. Due to severity of symptoms he was treated with azithromycin. His FEV1 doubled in 3 months and in addition to significant clinical improvement the HRCT findings also improved. This is the first described case of constrictive bronciolitis developing as an aftermath of Goodpasture syndrome.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 3","pages":"Pages 153-155"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.09.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91958503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmacodynamics and tolerability of high-dose, prolonged infusion carbapenems in adults with cystic fibrosis – A review of 3 cases 3例成人囊性纤维化患者大剂量、长时间输注碳青霉烯类药物的药效学和耐受性

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.09.011

Catharine C. Bulik , Richard Quintiliani Jr. , J. Samuel Pope , Joseph L. Kuti , David P. Nicolau

{"title":"Pharmacodynamics and tolerability of high-dose, prolonged infusion carbapenems in adults with cystic fibrosis – A review of 3 cases","authors":"Catharine C. Bulik , Richard Quintiliani Jr. , J. Samuel Pope , Joseph L. Kuti , David P. Nicolau","doi":"10.1016/j.rmedc.2009.09.011","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.09.011","url":null,"abstract":"<div><p>Cystic fibrosis (CF) is a disease marked by repeated acute pulmonary exacerbations of infections, often caused by <em>Pseudomonas aeruginosa</em> and <em>Burkholderia cepacia</em>. As antibiotic susceptibility declines, dose optimization must be considered to provide adequate pharmacodynamic exposure. We report three cases of CF exacerbations in adults caused by multi-drug resistant <em>P. aeruginosa</em> and <em>B. cepacia.</em> Each case required dosing strategies greater than currently recognized in package inserts: meropenem 3000mg every 8h (3-hour infusion) and doripenem 2000mg every 8h (4-hour infusion). Pharmacokinetic analyses demonstrated that targeted pharmacodynamic exposures were achieved against most of the organisms, resulting in clinical improvements despite laboratory reported resistance. The high-dose, prolonged infusion regimens were well tolerated demonstrating that pharmacodynamically optimized carbapenem regimens may be used safely and effectively in patients with limited conventional treatment options.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 3","pages":"Pages 146-149"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.09.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91958507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

Congenital lobar emphysema in adult: A rare case report 成人先天性肺气肿1例报告

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.09.010

M. Khalid, S. Saleemi, B. Khan

引用次数: 8

Diffuse alveolar hemorrhage with chronic thyroiditis in an advanced-age adult 弥漫性肺泡出血并发慢性甲状腺炎1例

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.04.006

Masanori Fujii, Nobuaki Miyahara, Yasushi Tanimoto, Nagio Takigawa, Masahiro Tabata, Arihiko Kanehiro, Katsuyuki Kiura, Mitsune Tanimoto

引用次数: 5

Squamous cell carcinoma of the lungs arising in recurrent respiratory papillomatosis 复发性呼吸道乳头状瘤病引起的肺部鳞状细胞癌

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.09.021

Dalia Hammoud, Boutros El Haddad

引用次数: 4

A case of cryptococcal pneumonia with false-positive [18F]fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) image mimicking lung metastatic cancer 隐球菌性肺炎1例假阳性[18F]氟-2-脱氧-d-葡萄糖正电子发射断层扫描(FDG-PET)图像模拟肺转移癌

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.04.005

Cheng Ji , Chunhua Ling , Bin Zhang , Haodong Xu

{"title":"A case of cryptococcal pneumonia with false-positive [18F]fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) image mimicking lung metastatic cancer","authors":"Cheng Ji , Chunhua Ling , Bin Zhang , Haodong Xu","doi":"10.1016/j.rmedc.2009.04.005","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.04.005","url":null,"abstract":"<div><h3>Background</h3><p>There is an increasing use of positron emission tomography with [<sup>18</sup>F]fluoro-2-deoxy-<span>d</span>-glucose (FDG-PET) for differential diagnosis between lung malignancy and other pulmonary diseases such as infection. However, false-positive FDG-PET images mimicking lung cancer can occur in pulmonary infection.</p></div><div><h3>Objective</h3><p>This study was to describe a case of cryptococcal pneumonia with false-positive FDG-PET image mimicking metastatic lung cancer.</p></div><div><h3>Patient and results</h3><p>We analyzed the clinical features and chest CT and FDG-PET characteristics of a case of pulmonary cryptococcosis that was initially suspected to have lung metastasis of gastric cancer and treated by surgery. During a follow-up, the 49 years old, female patient with a 7-year history of gastric adenocarcinoma showed a 1.0-cm nodule in the right lower lobe of lung on her chest CT scan with an accumulation of FDG (SUV=4.5) on her PET image. With a clinical diagnosis of suspected lung metastatic cancer, the lung wedge resection was then performed. Histological analysis of the resected nodule confirmed a diagnosis of cryptococcal pneumonia.</p></div><div><h3>Conclusion</h3><p>The FDG-PET image is not particularly helpful in segregating pulmonary infection from lung malignancy in certain cases. Surgical resection is recommended for both diagnosis and treatment of pulmonary cryptococcosis.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 2","pages":"Pages 93-94"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137159047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lymphocytopenia-associated sarcoidosis: CD4+ T-cell hypo-responsiveness to IL-2 and lectin 淋巴细胞减少相关结节病:CD4+ t细胞对IL-2和凝集素的低反应性

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.04.001

Nathalie Freymond , Christophe Malcus , Yves Pacheco , Gilles Devouassoux

{"title":"Lymphocytopenia-associated sarcoidosis: CD4+ T-cell hypo-responsiveness to IL-2 and lectin","authors":"Nathalie Freymond , Christophe Malcus , Yves Pacheco , Gilles Devouassoux","doi":"10.1016/j.rmedc.2009.04.001","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.04.001","url":null,"abstract":"<div><p>Despite classical identification of immune response impairment in sarcoidosis, such as anergy to delayed skin tests, the characterization of contributing mechanisms are still uncertain and infectious events complicating the course of the disease are unfrequent. Rarely, additional quantitative T-cell defects are reported in association with the disease. Although mechanisms of lymphocyte disorders are unknown, lymphocytopenia is usually revealed by an opportunistic infection.</p><p>We report the case of an 18-year-old man, with pulmonary sarcoidosis, treated by corticoids, who developed cryptococcal meningitis. A CD4+ T-cell defect was simultaneously discovered, which was not influenced by corticoid arrest, persisted following infection resolution and control of sarcoidosis. <em>In vitro</em> experiments were performed in parallel, demonstrating a restricted CD4+ T-cell proliferation hypo-responsiveness to both IL-2 and lectin. In addition, rhIL-2 subcutaneously administrated failed to restore peripheral T-cell count.</p><p>A multi-visceral sarcoidosis associated to CD4-lymphocytopenia is rarely reported and highly demonstrative of the related risk for an opportunistic infection development. In context, the absence of lectin and IL-2 effects on <em>in vitro</em> CD4+ T-cell proliferation assays and the inefficiency of <em>in vivo</em> rhIL-2 on T-cell count have been infrequently reported and suggested the presence of a defective intracellular signaling pathway, responsible for T cell defect.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 2","pages":"Pages 113-115"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137158511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Bleeding diathesis due to vitamin K deficiency in an infant with cystic fibrosis 囊性纤维化婴儿维生素K缺乏引起的出血性素质

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.09.004

Antonia Popova , Jessica Foley , Samya Z. Nasr

引用次数: 0

Giant hydatid lung cysts: About two paediatric cases 巨大棘球蚴肺囊肿:约2例儿科病例

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.09.001

L. Ghedira Besbes , S. Haddad , Ch. Ben Meriem , S. Hammami , A. Nouri , M.N. Gueddiche

引用次数: 7