Cahillhayes6826
Reexpansion pulmonary edema is a rare but fatal clinical condition that develops during the treatment of pneumothorax, pleural effusion and collapsed lung after atelectasis. A 31-year-old male patient was referred to our clinic with the complaint of stinging back pain that started 3 days ago and dyspnea developed during the last 24 hours. Physical examination and radiologic examinations revealed total pneumothorax in the right hemithorax. After tube thoracostomy, his general condition deteriorated and bilateral reexpension edema developed in the lungs. The patient was admitted to the intensive care unit and was discharged on the 5th day after medical treatment. Our case is the first case of bilateral reexpansion pulmonary edema seen after unilateral spontaneous pneumothorax when literature review is performed. In order to emphasize the importance of rapid diagnosis and treatment, it is presented in the light of the literature.We present a case of tendon rupture and subcutaneous bleeding after administration of gemifloxacin for the treatment of lower respiratory tract infection. Fluoroquinolone-induced tendinopathy is a rare but increasingly acknowledged adverse effect of this group of antibiotics. Most of the cases occur in the Achilles tendon and can lead to tendon rupture. Possible predisposing risk factors include steroid use, patients with renal failure or kidney transplantation, old age and being an athlete.Arnold Chiari malformation (ACM) is herniation of brain stem structures, especially cerebellar tonsils, from the foramen magnum into the cervical spinal canal. Sleep-related respiratory disorders are reported at a higher rate in this patient group than the general population, at about 60-75%. A 43-year-old male patient was diagnosed with ACM type 1.5 at the center where he applied with complaints of weakness in the extremities, speech disorder and syncope triggered by coughing, and a decompression of posterior fossa (PFD) was applied to the patient. Since 2018, the apnea attacks, which were able to be 6-7 times a night every night, last in 30 seconds, with eyes open, inactivity and bruising, have started in the patient, so in all night-time polysomnography (PSG) examination for diagnostic purpose, apnestic breathing including continuous, central and mixed type apneas in sleep and wakefulness was detected. Different modes (CPAP, BPAP-S/T, ASV) were tried with the cannula placed on the tracheostomy in the PSG performed for non-invasive mechanical ventilation therapy, but none alone was effective. In the patient, whom IVAPS/AVAPS mode was tried, all abnormal breathing events, irregular apnetic breathing pattern and oxygen desaturations were effectively controlled in all positions, wakefulness and all sleep stages with pressure support, respiratory rate and tidal volume support. PFD is recommended as the first-line treatment for the treatment of obstructive or central type apneas in ACM; Information on non-invasive mechanical ventilation therapy is insufficient. In this case, we aimed to present the difficulties in the diagnosis and treatment of sleep-related respiratory disorders in a patient whom ACM diagnosed, PFD was applied but underwent permanent trachoestomy due to bilateral vocal cord paralysis.In recent years, high flow nasal cannula (HFNC) is a respiratory support system that has become prominent in the treatment of respiratory failure. HFNC provides higher concentration and flow of oxygen, resulting in decreasing anatomic dead space by preventing rebreathing and ensure positive end-expiratory. However, in COVID-19, the usage of HFNC is much controversial due to concerns about the benefits and risk of aerosol-dispersion. Considering the debates about the use of HFNC, we reviewed the literature related to the usage of HFNC in COVID-19. The available reports suggest that HFNC provides high concentrations of oxygen to the patients, who can not reach with conventional devices. HFNC can reduce the requiring of intubation in patients with COVID-19, and it can decrease the length of intensive care unit stay, and complications related to mechanical ventilation. Also HFNC can in achieving apneic oxygenation in patients during airway management. Besides that, the use of high-flow oxygen cannulas can produce aerosols. So, HFNC treatment should be carried out in a negative pressure room; when it is not possible, devices should be undertaken in a single room.Novel coronavirus disease 2019 (COVID-19) which is caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) was first identified in December 2019 in Chinese town Wuhan and considered as a pandemic by World Health Organization. The disease has variety of symptoms including fever, shortness of breath, cough, fatigue, loss of smell and taste and diarrhea. While the majority of cases have mild symptoms, some progress to viral pneumonia, multi-organ failure, or cytokine storm and mortality is mostly caused by hypoxemic respiratory failure. Until now, more than 3.5 million people worldwide were infected and more than 240.000 mortality has been occurred. Thus, there is now evidence the disease may affect variety of organs according to accumulating biopsy and autopsy studies. Such pathological studies have potential role on the understanding of clinical outcomes and in the development of novel targeted therapeutic approaches. Given these aforementioned data, in the current manuscript we have summarized the pathological features of COVID-19 derived from biopsy and autopsy series.Randomized controlled studies have shown that anti-IL-5 treatments reduce the need for oral corticosteroids, annual asthma exacerbation and hospitalization rates, blood eosinophil count and increase FEV1 values, asthma control, and quality of life in patients with eosinophilic severe asthma. Although the number of real-life studies with anti-IL-5 is limited, there are 10 real life studies with mepolizumab, one real life study with benralizumab and one real life study with reslizumab in the current literature. Similar to randomized controlled trials, real-life studies reported that a reduction in the need for oral corticosteroids, annual asthma exacerbation and hospitalization rates, and blood eosinophil counts and increase FEV1 values, asthma control test and quality of life scores, Response criteria were defined in some of the real-life studies and although different response rates were given according to these criteria, most of the patients with severe eosinophilic asthma showed high response rates to anti-IL-5 treatments. In real-life studies evaluating the safety of anti-IL-5 treatments, the most common adverse effect is mild local injection site reaction that does not require treatment, in conclusion, real-life studies suggest that all three anti-IL-5 treatments in clinical practice are effective and well tolerated.There are limited data about the coexistence of asthma and the Coronavirus disease-2019 (COVID-19). The COVID-19 pandemic is a new disease for the whole world. In this study, we aimed to examine the published case series with the COVID-19 and asthma coexistence, by reviewing existing studies and other publications. We discussed the suggestions of guidelines such as The Global Initiative for Asthma (GINA), The National Institute for Health and Care Excellence (NICE), and the Canadian Respiratory Guideline about the management of asthma during the COVID-19 pandemic and the experiences of different countries. We analyzed the publications, reports, and expert opinions about asthma and COVID-19, that were released and expressed from the onset of the disease in Wuhan. In this review, we aimed to summarize the approach to patients with asthma during the pandemic and to make recommendations concerning it.Coronavirus disease 2019 (COVID-19) is an infectious disease that causes important mortality and morbidity all over the world caused by SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2), which started in China at the end of 2019. It spreads rapidly, mainly through droplets, and especially for all healthcare workers involved in aerosol producing procedures are at high risk. During COVID-19 pandemic , the health systems worldwide, along with the practice of chest diseases daily were affected. In our article, we aimed to give some clinical suggestions related to sleep practices according to current data.
Sarcoidosis and tuberculous lymphadenitis are granulomatous inflammatory diseases. Differentiating lymph node involvement in these two diseases can be challenging. This study evaluated whether elemental analysis of tissue samples could facilitate the differentiation of these histopathologically and clinically similar diseases.
A total of 152 tissue samples were included 57 caseating granulomatous inflammation, 58 non-caseating granulomatous inflammation, and 37 reactive lymph node specimens. The tissue samples were analyzed for calcium, magnesium, iron, copper, zinc, chrome, molybdenum, nickel and selenium with inductively coupled plasma-optical emission spectroscopy (ICP-OES).
Comparison of element levels in the three groups revealed that caseating granulomatous inflammation had higher calcium content (662.6 ± 4.6 ppm, p< 0.001) and lower iron content (48.7 ± 83 ppm, p< 0.001) compared to non-caseating granulomatous inflammation. Compared to reactive lymph tissue, caseating granulomatous inflammal supportive evidence for differential diagnosis.
Programmed death ligand 1 (PD-L1) is a marker that widely used for prediction of response to immunotherapy. Dynamic alteration of PD-L1 expression are the major problems for reflection of the actual status of the PD-L1. So, we aimed to investigate the factors that may be associated with PD-L1 expression in lung cancer.
The patients diagnosed with non-small cell lung cancer were enrolled, retrospectively. The patients were stratified according to PD-L1 expression level as ≥ 50% and < 50%.
Totally, 217 patients were enrolled. The clinicopathologic features were similar between two groups, except the amount of cigarette consumption. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and systemic immune-inflammmotry index were found significantly lower in PD-L1 ≥ 50% (p< 0.001, p= 0.006 and p= 0.003, respectively) and also negatively correlated with PD-L1 level (rho= -0.255, p< 0.001; rho= -0.17, p= 0.013; rho= - 0.185, p= 0.006, respectively).
According to the results of our study, peripheral blood parameters can be used to the prediction of the high PD-L1 expression and can be used for reflection of current PD-L1 expression.
According to the results of our study, peripheral blood parameters can be used to the prediction of the high PD-L1 expression and can be used for reflection of current PD-L1 expression.
First step is to evaluate the quality of the test in interpreting spirometries. International societies have defined the acceptability criteria for spirometric tests. With this study, it was aimed to evaluate spirometric tests in terms of compliance with international acceptability criteria and to determine error types.
Spirometric manoeuvres held at a tertiary chest diseases hospital were evaluated as to whether the acceptability criteria of "American Thoracic Society/European Respiratory Society (ATS/ERS)" guideline were maintained or not. Errors determined were classified as unexplosive start of expiration, submaximal effort, cough, closure of glottis, missing closure of the loop ring and early termination of expiration.
Among tests evaluated (n= 510), 276 (54.1%) belonged to female and 234 (45.9%) to male subjects. Average age of subjects was 56.1 ± 15.0 years. It was noted that 318 (62.4%) of the tests met acceptability criteria, whereas 192 (37.6%) did not. selleck chemicals The most frequently noted error type is submaximal effort by 30.
