Respiratory medicine CME最新文献_第6页

Pulmonary fibrosis predating microscopic polyangiitis by seven years 肺纤维化比显微镜下多血管炎早7年

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.12.005

Angeliki M. Tsimogianni, Magda Stratiki, Grigoris Stratakos, Spyros Zakynthinos, Paraskeyi Katsaounou

{"title":"Pulmonary fibrosis predating microscopic polyangiitis by seven years","authors":"Angeliki M. Tsimogianni, Magda Stratiki, Grigoris Stratakos, Spyros Zakynthinos, Paraskeyi Katsaounou","doi":"10.1016/j.rmedc.2009.12.005","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.12.005","url":null,"abstract":"<div><p>A 63-year-old man, ex-smoker with renal failure of recent onset was admitted at the respiratory department with massive haemoptysis. Previous X-rays and CT scans showed pulmonary fibrosis of seven-year duration. Subsequently, he developed high fever, large haemoptysis, new infiltrates and respiratory failure despite broad-spectrum antibiotic treatment. Antineutrophilic antibodies of the perinuclear type with specificity against myeloperoxidase were detected and microscopic polyangiitis was diagnosed. Immunosuppressive treatment with methylprednisolone pulses and cyclophosphamide was started with initially favorable response, but later the patient developed a hospital-acquired pneumonia which was treated successfully with meropenem. As pulmonary haemorrhage recurred, he was transferred to intensive care for plasmapheresis which was considered the last treatment option. Unfortunately he died from septic shock.</p></div><div><h3>Conclusion</h3><p>Asymptomatic pulmonary fibrosis can predate microscopic polyangiitis by several years and is associated with unfavorable prognosis of the vasculitis. Appreciation of this finding would lead to faster diagnosis and better management of these patients.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 4","pages":"Pages 207-210"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.12.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137088177","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: 1

Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literature 成人呼吸道和非呼吸道疾病咳嗽的药物和非药物干预:文献系统综述

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2010.11.001

A. Molassiotis , G. Bryan , A. Caress , C. Bailey , J. Smith

{"title":"Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literature","authors":"A. Molassiotis , G. Bryan , A. Caress , C. Bailey , J. Smith","doi":"10.1016/j.rmedc.2010.11.001","DOIUrl":"https://doi.org/10.1016/j.rmedc.2010.11.001","url":null,"abstract":"<div><p>The management of cough in adults with respiratory and non-respiratory illnesses is suboptimal and based mostly on clinical opinions rather than evidence. A systematic review was carried out assessing all trials in adult patients with respiratory and non-respiratory diseases (excluding cancer) that had chronic cough as primary or secondary outcome. A total of 1177 trials were retrieved and 75 met the criteria for inclusion in the review. The vast majority were in patients with asthma and chronic obstructive pulmonary disease (COPD). Cough was the primary outcome in less than one-quarter of the studies. The measurement of cough was variable, mostly using unvalidated scales or being part of an overall ‘symptoms’ score. Positive results were overall seen with the use of corticosteroids, leukotriene receptor antagonists, mast cell stabilizers, ipratropium bromide, neltenexine, iodinised glycerol and lidocaine. Speech pathology training and symptom monitoring through SMS messages (accompanied by treatment adjustments) have also shown promise. Evidence for established anti-tussive agents such as codeine was scarce, with positive studies from the 1960s, whilst more recent studies showed no effect in patients with COPD. Many studies had conflicting results. It is imperative that the management of cough and its evidence base be improved, using higher quality research designs and with cough being the primary outcome of trials.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 4","pages":"Pages 199-206"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2010.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137088178","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

Thoracic-abdominal MDCT: A one-stop-shop procedure for diagnosis of lymphangioleiomyomatosis 胸腹MDCT:诊断淋巴管平滑肌瘤病的一站式程序

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.12.003

N. Sverzellati , P. Spagnolo , S. Harari , M. De Filippo , M. Zompatori , C. Rossi

引用次数: 0

Fatal adenovirus serotype 21 infection associated with hemophagocytic lymphohistiocytosis and multiorgan failure 致命性21型腺病毒感染与噬血细胞、淋巴组织细胞增多症和多器官功能衰竭有关

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.11.003

Tim Lahm , Helena N. Spartz , Dean A. Hawley , Diane S. Leland , Karen M. Wolf , Homer L. Twigg III , Michael D. Ober

{"title":"Fatal adenovirus serotype 21 infection associated with hemophagocytic lymphohistiocytosis and multiorgan failure","authors":"Tim Lahm , Helena N. Spartz , Dean A. Hawley , Diane S. Leland , Karen M. Wolf , Homer L. Twigg III , Michael D. Ober","doi":"10.1016/j.rmedc.2009.11.003","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.11.003","url":null,"abstract":"<div><p>Recent reports describe an increase in the incidence of fatal adenovirus infections. Several severe cases have been linked to adenovirus serotype 21. The exact etiology for this unexpectedly high mortality remains unknown. We report the case of a patient with severe adenovirus serotype 21 pneumonia resulting in hemophagocytic lymphohistiocytosis (HLH) with acute respiratory distress syndrome and rapidly progressive multiorgan dysfunction syndrome (MODS). HLH describes a cytokine storm due to uncontrolled accumulation of activated T-lymphocytes and activated histiocytes. This results in organ infiltration with these cells, and subsequent hemophagocytosis of erythrocytes, leukocytes and platelets. In its most severe form, HLH leads to a sepsis-like picture and MODS. The association between adenovirus 21 and HLH may at least in part explain the recently observed increase in incidence of fatal adenoviral infections. We suggest that HLH should be considered in cases of severe adenoviral infection. If HLH is present, aggressive treatment is warranted.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 4","pages":"Pages 223-225"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137088182","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: 3

An unusual accessory fissure in the right upper lobe 右上肺叶有一个不寻常的副裂

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.04.007

K. Gowrinath , Rahul Magazine , Chandrakant M. Shetty , Paresh Desai

引用次数: 2

Empyema thoracic presenting as low back ache 胸廓脓胸表现为腰痛

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.02.005

Mohammad Shameem , Nazish Fatima , Jamal Akhtar , Asrar Ahmad

引用次数: 0

Aspergilloma in a hydatid cavity 在包虫腔内的曲菌瘤

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.02.002

Sameh M'saad , Lobna Ayedi , Mohamed Abdennader , Najla Bahloul , Abdessalem Hentati , Chouki Dabbech , Imed Frikha , Tahia Boudawara , Abdelkhader Ayoub

{"title":"Aspergilloma in a hydatid cavity","authors":"Sameh M'saad , Lobna Ayedi , Mohamed Abdennader , Najla Bahloul , Abdessalem Hentati , Chouki Dabbech , Imed Frikha , Tahia Boudawara , Abdelkhader Ayoub","doi":"10.1016/j.rmedc.2009.02.002","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.02.002","url":null,"abstract":"<div><p>Aspergilloma is a saprophytic infection that consists of masses of fungal mycelium that occurs in pre-existing cavities usually due to tuberculosis, bronchestasis or pulmonary infraction. However, few cases of aspergilloma within hydatid cyst have been reported in literature.</p><p>We describe two patients with aspergilloma formed within cyst hydatid. Both patients consulted because of recurrent hemoptysis. In a 52-year-old woman, diagnosis was established by a transthoracic CT biopsy. Treatment consisted of postero-lateral thracotomy with wedge resection of tow aspergilloma in the left upper lobe. In a 56-year-old man, thoracotomy with lower right lobectomy was performed at emergency because of massive hemoptysis. In both cases, patients progressed favourably without antifungal therapy.</p><p>Aspergilloma is an unusual complication of hydatid cyst. It results from the deterioration of local defence against opportunistic infections. Prognosis appears to be better than aspergilloma within tuberculosis cavities.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 1","pages":"Pages 29-32"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136554841","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: 8

Severe Shwachman-Diamond syndrome and associated CF carrier mutations 严重的Shwachman-Diamond综合征和相关的CF携带者突变

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.02.001

Fauziya Hassan , Craig Byersdorfer , Samya Nasr

引用次数: 1

Alveolar hemorrhage due to erlotinib in non-small-cell lung cancer resistant to gefitinib 对吉非替尼耐药的非小细胞肺癌因厄洛替尼引起肺泡出血

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.02.010

Yano Shuichi

引用次数: 0

Sauropus androgynus-associated bronchiolitis obliterans of mother and daughter – autopsy report 母女与雌雄同体相关的闭塞性细支气管炎——尸检报告

Respiratory medicine CME Pub Date : 2010-01-01 DOI: 10.1016/j.rmedc.2009.11.005

Michiru Sawahata , Takashi Ogura , Akihiro Tagawa , Hiroshi Takahashi , Takuya Yazawa , Masaaki Matsuura , Tamiko Takemura

{"title":"Sauropus androgynus-associated bronchiolitis obliterans of mother and daughter – autopsy report","authors":"Michiru Sawahata , Takashi Ogura , Akihiro Tagawa , Hiroshi Takahashi , Takuya Yazawa , Masaaki Matsuura , Tamiko Takemura","doi":"10.1016/j.rmedc.2009.11.005","DOIUrl":"https://doi.org/10.1016/j.rmedc.2009.11.005","url":null,"abstract":"<div><p><em>Sauropus androgynus</em> (SA) is a vegetable that causes constrictive bronchiolitis obliterans (BO) with consequent findings classified into injury, inflammation and fibrosis, according to clinical factors including amount of SA exposure, period of SA exposure, and individual predisposition. We reported mother and daughter SABO autopsy cases with similar clinical course, including 11 month SA exposure and Aspergillosis infection after high dose prednisolone therapy. Their major differences were in the amount of SA exposure (mother: 1440 g, daughter: 2190 g) and the survival period post exposure (mother: 21 months, daughter: 32 months). The histopathological comparison between them showed a statistical difference in the density of foamy macrophage accumulation of moderately obstructed airways, but not in the extent of fibrosis, elastic lamina destruction, or smooth muscle hyperplasia. Foamy macrophages tend to accumulate relatively early in the course of SABO at the site with severe damage, accelerating BO formation for as long as the patient survives.</p></div>","PeriodicalId":89478,"journal":{"name":"Respiratory medicine CME","volume":"3 4","pages":"Pages 214-217"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedc.2009.11.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137088179","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: 6