Fatal Giant Aortic Thrombus Presenting With Pulmonary Edema in a Patient With Chronic Obstructive Pulmonary Disease

2007 ◽  
Vol 14 (4) ◽  
pp. 486-488 ◽  
Author(s):  
Ibrahim Sari ◽  
Vedat Davutoglu ◽  
Nazan Bayram ◽  
Serdar Soydinc
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Thrombus Formation ◽  
Cardiopulmonary Arrest ◽  
Rare Event ◽  
Diagnostic Methods ◽  
Chronic Obstructive ◽  
Low Back ◽  
Obstructive Pulmonary Disease ◽  
Aortic Thrombus

Thrombus formation in a morphologically normal a aorta is a very rare event. A 50-year-old man with a his- s tory of chronic obstructive pulmonary disease, pre- e sented to the emergency department with pulmonary C edema. Transthoracic and transesophageal echocardio- t graphy revealed a highly mobile, pedunculated floating c thrombus in the descending thoracic aorta 3-4 cm dis- t tal to the origin of the left subclavian artery. The orig- t inal lumen of the aorta was almost obliterated by the thrombus. The aortic wall was free of any atheroma. Thrombolytic treatment was administered, but 3 hours d after starting streptokinase, he developed sudden and severe low-back pain accompanied by loss of lower-extremity pulses which were patent on admission. Cardiopulmonary arrest developed within an hour and the patient died despite resuscitation. The potential causes of aortic thrombus, the clinical spectrum that the patients may present, diagnostic methods, and therapeutic options are discussed.

scholarly journals Diagnosis of small airway dysfunction in patients with chronic obstructive pulmonary disease

2020 ◽  
Vol 48 (5) ◽  
pp. 307-315
Author(s):  
A. V. Cherniak ◽  
O. I. Savushkina ◽  
T. L. Pashkova ◽  
E. V. Kryukov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Vital Capacity ◽  
Small Airway ◽  
Diagnostic Methods ◽  
Chronic Obstructive ◽  
Impulse Oscillometry ◽  
Body Plethysmography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Small airway dysfunction (SAD) is a functional hallmark of chronic obstructive pulmonary disease (COPD). However, SAD prevalence and its role in COPD pathophysiology are not yet sufficiently studied.Background: Small airway dysfunction (SAD) is a functional hallmark of chronic obstructive pulmonary disease (COPD). However, SAD prevalence and its role in COPD pathophysiology are not yet sufficiently studied.Aim: To assess the prevalence of SAD in COPD patients by various functional diagnostic methods, such as spirometry, body plethysmography, and impulse oscillometry (IOS).Materials and methods: This was an cross-sectional study. Spirometry, body plethysmography and IOS were used in 132 COPD patients in remission under standard anti-COPD treatments. The presence of SAD was confirmed by at least one of the following criteria or their combination: 1) by spirometry: the difference between vital capacity (VC) and forced vital capacity (FVC) > 10%; 2) the presence of air trapping by body plethysmography; 3) identification of the frequency dependence of the resistive resistance at 5 to 20 Hz (R5 - R20 > 0.07 kPa x s/l), as assessed by IOS.Results: Mean forced expiratory volume in 1 s (FEV1) was 42.9% of predicted. Depending on the severity of the obstruction, the patients were divided into 4 groups: 7 patients (group 1) had the obstruction corresponding to GOLD 1 stage, 37 (group 2) to GOLD 2, 49 (group 3) to GOLD 3, and 39 (group 4) to GOLD 4. SAD was found in 96% of COPD patients, whereas in those with severe obstruction (GOLD 3-4), it was present in 100% of the cases. By spirometry, SAD was identified only in 67% of COPD patients, by body plethysmography in 75% of COPD patients (in those with severe obstruction (GOLD 3 and 4) in 88 and 97%, respectively). With IOS, it was possible to identify SAD in 94% of patients and in 100% of those with severe obstruction (GOLD 3-4).Conclusion: With deterioration of obstructive pulmonary ventilation abnormalities in COPD patients, there is a progressive increase in small airway dysfunction. Impulse oscillometry seems to be the most effective method for diagnosis of small airway dysfunction, as it helped to identify SAD in 94% of COPD patients and in 100% of those with severe and very severe obstruction.

scholarly journals Competency Assessment: Diagnostic Methods for Detection of Cryptosporidium, Microsporidia, and Toxoplasma in Bronchoalveolar Lavage Samples

2021 ◽  
Vol 13 (12) ◽  
Author(s):  
Zahra Eslamirad ◽  
Abdolatif Moini ◽  
Mojtaba Didehdar ◽  
Reza Hajihossein ◽  
Ali Arash Anoushiravani
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Bronchoalveolar Lavage ◽  
Pulmonary Disease ◽  
Diagnostic Method ◽  
Direct Methods ◽  
Diagnostic Methods ◽  
Chronic Obstructive ◽  
Competency Assessment ◽  
Obstructive Pulmonary Disease ◽  
Gold Standard Method

Background: Protozoa have the ability to replace the human lung. Over recent years, the incidence of pulmonary infections caused by these microorganisms has increased, particularly in individuals with an immunodeficiency. The use of appropriate diagnostic methods is particularly important in the identification of parasites in pulmonary secretions. Objectives: The present study aimed to evaluate and compare PCR-based diagnostic methods with the gold standard method to detect three pathogenic protozoa, including Toxoplasma, Cryptosporidium, and Microsporidia in bronchoalveolar lavage (BAL) samples obtained from immunocompromised patients with chronic obstructive pulmonary disease. Methods: A BAL sample of immunodeficient patients suffering from chronic obstructive pulmonary disease (COPD) was examined by direct microscopy and PCR methods. Results: In this study, we examined 64 patients with immunodeficiency accompanied by COPD. Microsporidia were not identified in the samples. Direct methods identified three and nine cases of Toxoplasma and Cryptosporidium, respectively. However, the molecular method identified two and two cases of pulmonary infection with these parasites. Conclusions: Determining the standard diagnostic method for parasites is dependent on factors, such as the type of specimen and the type of parasite. Based on the results of the present study, the direct microscopic method is the optimal diagnostic method for Toxoplasma and Cryptosporidium in BAL samples.

scholarly journals COVID-19 and chronic obstructive pulmonary disease: what is known about the unknown

2021 ◽  
Vol 99 (2) ◽  
pp. 6-15
Author(s):  
E. S. Ovsyannikov ◽  
S. N. Avdeev ◽  
A. V. Budnevskiy ◽  
E. S. Drobysheva ◽  
A. Ya. Kravchenko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Thrombus Formation ◽  
Study Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Angiotensin Converting Enzyme 2 ◽  
Cell Dysfunction ◽  
Copd Patients ◽  
Key Aspects

The article reviews 60 publications and addresses key aspects of concurrent COVID-19 and chronic obstructive pulmonary disease (COPD). It presents data stating that COPD patients have higher expression of the receptor of angiotensin-converting enzyme 2 in the lungs and this may contribute to a greater susceptibility to COVID-19. In COPD, signs of endothelial cell dysfunction and tendency to thrombus formation have been identified which can present the risk of unfavorable outcomes of COVID-19. Cohort study data do not confirm that COPD patients are more susceptible to SARS-CoV-2 infection, but their clinical outcomes of COVID-19 appear to be worse including the need for mechanical ventilation and lethality. There is no clinical evidence about the role of inhaled glucocorticosteroids used to manage COPD in the development and course of COVID-19.

scholarly journals In vivo endomicroscopic features of distal airways in chronic bronchitis and chronic obstructive pulmonary disease

2018 ◽  
Vol 9 (4) ◽  
pp. 15-24
Author(s):  
O. V. Danilevskaya ◽  
A. V. Averyanov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Bronchitis ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Diagnostic Methods ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Relevance: Probe-based confocal laser endomicroscopy (CLE) of distal airways is a unique technology that allows real-time visualization of structures containing natural fluorophores, which are emitted by exposure to laser radiation with a wavelength of 488 nm, in vivo. To date, the endomicroscopic features of the distal respiratory tract have not been adequately studied in lung diseases, including chronic obstructive pulmonary disease and chronic bronchitis. The goal of the present study is to describe the endomicroscopic signs of the distal parts of the respiratory system in chronic inflammatory lung diseases such as chronic obstructive pulmonary disease and chronic bronchitis. Methods: A total of 21 patients with emphysematous and bronchitic phenotypes of chronic obstructive pulmonary disease and chronic bronchitis were examined. All the patients have undergone CLE of distal airways or alveoloscopy during bronchoscopy. The most pathognomonic changes were evaluated on the obtained endomicroscopic images. Results: For each studied nosological form of chronic inflammatory lung diseases, by careful morphometric analysis of a significant number of informative images, the most specific endomicroscopic changes were identified with the release of CLE patterns. Conclusions: CLE of distal airways in patients with chronic inflammatory lung diseases allows visualizing changes in the elastic framework of the acini, as well as identifying pathological intraluminal contents, which can be attributed to valuable additional tools in a row of diagnostic methods of respiratory medicine.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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