scholarly journals Case report: A bulla mistaken for a pneumothorax

2020 ◽  
Author(s):  
Avinash Aujayeb
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Surgical Techniques ◽  
Tension Pneumothorax ◽  
Chronic Obstructive Lung Disease ◽  
The Body ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Asymptomatic Patients ◽  
Giant Bulla

Abstract Introduction:Vanishing lung syndrome, also known as giant bullous emphysema is a condition usually reported in young male thin smokers. There are numerous case reports that have added to the body of evidence. There are also case reports of the giant bulla being misinterpreted for a pneumothoraxCase report:A 61 year old male with severe chronic obstructive lung disease presented to Accident and Emergency with progressive breathlessness. A chest radiograph showed a giant right sided bulla that was initially misinterpreted as a tension pneumothorax. Further review of his imaging and lung function pointed to him having vanishing lung syndrome. He was referred for a cardiothoracic opinion but was eventually managed conservatively.Discussion:Vanishing lung syndrome is characterised by a slowly enlarging upper lobe bulla that compresses normal lung parenchyma and causes mediastinal shift, with the patients experiencing increasing dyspnoea and reduced exercise tolerance. Smoking cessation is the mainstay of treatment. If they are relatively asymptomatic, patients are managed conservatively. Otherwise a variety of lung volume reduction techniques can be consideredConclusion:A large bulla can look the same as a pneumothorax but the former does not have a lung edge and has a more rounded appearance. A CT scan is very useful in differentiating between the two pathologies. Bullae are predominantly caused by smoking. Bullae will cause high total lung volumes and residual volumes, but low alveolar volumes. Bullae can be observed or treated by surgical techniques

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

2020 ◽  
Vol 15 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Asha K. Rajan ◽  
Ananth Kashyap ◽  
Manik Chhabra ◽  
Muhammed Rashid
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Rare Case ◽  
Case Reports ◽  
Multidrug Resistant ◽  
The Body ◽  
Prior History ◽  
Skin Reactions ◽  
Rare Case Report ◽  
Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

Organs-on-a-Chip

Bioprinting ◽  
2021 ◽  
pp. 155-182
Author(s):  
Kenneth Douglas
Keyword(s):  
Lung Tissue ◽  
Obstructive Lung Disease ◽  
Inflammatory Diseases ◽  
Chronic Obstructive Lung Disease ◽  
Heart Tissue ◽  
Normal Lung ◽  
Small Scale ◽  
Chronic Obstructive ◽  
Unexpected Result ◽  
Household Dust

Abstract: This chapter explores organs-on-a-chip, miniaturized bioprinted organ tissues enclosed in a microfluidic housing (microfluidics refers to very small-scale plumbing) that can mimic functions of human physiology or disease and are particularly effective when multiple tissue types—for example, lung, heart, and liver—can interact on the same chip. The chapter sets forth the historical evolution of organs-on-a-chip and instances several studies. In one investigation, experimenters found a totally unexpected result in which a drug produced an inflammation of lung tissue that in turn led to toxic results in nearby heart tissue. In another inquiry, researchers focused on a bioprinted, functional, airway-on-a-chip to characterize inflammatory diseases such as asthma and chronic obstructive lung disease and vet potential medications for their treatment. Their work included quantitative comparisons of normal lung tissue and asthmatic lung tissue to a variety of insults, including household dust mites.

scholarly journals Predictive Modelling of Lung Function using Emphysematous Density Distribution

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kuo-Lung Lor ◽  
Cheng-Pei Liu ◽  
Yeun-Chung Chang ◽  
Chong-Jen Yu ◽  
Cheng-Yi Wang ◽  
...  
Keyword(s):  
Lung Function ◽  
Predictive Model ◽  
Lung Volume ◽  
Model Fitting ◽  
Chronic Obstructive Lung Disease ◽  
Correlation Study ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Normal Lung ◽  
Chronic Obstructive

AbstractTarget lung tissue selection remains a challenging task to perform for treating severe emphysema with lung volume reduction (LVR). In order to target the treatment candidate, the percentage of low attenuation volume (LAV%) representing the proportion of emphysema volume to whole lung volume is measured using computed tomography (CT) images. Although LAV% have shown to have a correlation with lung function in patients with chronic obstructive pulmonary disease (COPD), similar measurements of LAV% in whole lung or lobes may have large variations in lung function due to emphysema heterogeneity. The functional information of regional emphysema destruction is required for supporting the choice of optimal target. The purpose of this study is to develop an emphysema heterogeneity descriptor for the three-dimensional emphysematous bullae according to the size variations of emphysematous density (ED) and their spatial distribution. The second purpose is to derive a predictive model of airflow limitation based on the regional emphysema heterogeneity. Deriving the bullous representation and grouping them into four scales in the upper and lower lobes, a predictive model is computed using the linear model fitting to estimate the severity of lung function. A total of 99 subjects, 87 patients with mild to very severe COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I~IV) and 12 control participants with normal lung functions (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) > 0.7) were evaluated. The final model was trained with stratified cross-validation on randomly selected 75% of the dataset (n = 76) and tested on the remaining dataset (n = 23). The dispersed cases of LAV% inconsistent with their lung function outcome were evaluated, and the correlation study suggests that comparing to LAV of larger bullae, the widely spread smaller bullae with equivalent LAV has a larger impact on lung function. The testing dataset has the correlation of r = −0.76 (p < 0.01) between the whole lung LAV% and FEV1/FVC, whereas using two ED % of scales and location-dependent variables to predict the emphysema-associated FEV1/FVC, the results shows their correlation of 0.82 (p < 0.001) with clinical FEV1/FVC.

scholarly journals Sarcopenia in COPD: relationship with COPD severity and prognosis

2015 ◽  
Vol 41 (5) ◽  
pp. 415-421 ◽  
Author(s):  
Tatiana Munhoz da Rocha Lemos Costa ◽  
Fabio Marcelo Costa ◽  
Carolina Aguiar Moreira ◽  
Leda Maria Rabelo ◽  
César Luiz Boguszewski ◽  
...  
Keyword(s):  
Lean Mass ◽  
Smoking Status ◽  
Airflow Obstruction ◽  
Chronic Obstructive Lung Disease ◽  
The Body ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Gold Stage ◽  
Copd Patients

Objective: To evaluate the prevalence of sarcopenia in COPD patients, as well as to determine whether sarcopenia correlates with the severity and prognosis of COPD. Methods: A cross-sectional study with COPD patients followed at the pulmonary outpatient clinic of our institution. The patients underwent dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was made on the basis of the skeletal muscle index, defined as appendicular lean mass/height2 only for low-weight subjects and adjusted for fat mass in normal/overweight subjects. Disease severity (COPD stage) was evaluated with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The degree of obstruction and prognosis were determined by the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index. Results: We recruited 91 patients (50 females), with a mean age of 67.4 ± 8.7 years and a mean BMI of 25.8 ± 6.1 kg/m2. Sarcopenia was observed in 36 (39.6%) of the patients, with no differences related to gender, age, or smoking status. Sarcopenia was not associated with the GOLD stage or with FEV1 (used as an indicator of the degree of obstruction). The BMI, percentage of body fat, and total lean mass were lower in the patients with sarcopenia than in those without (p < 0.001). Sarcopenia was more prevalent among the patients in BODE quartile 3 or 4 than among those in BODE quartile 1 or 2 (p = 0.009). The multivariate analysis showed that the BODE quartile was significantly associated with sarcopenia, regardless of age, gender, smoking status, and GOLD stage. Conclusions: In COPD patients, sarcopenia appears to be associated with unfavorable changes in body composition and with a poor prognosis.

scholarly journals Native lung hyperinflation after single lung transplantation – case report and literature review

2021 ◽  
Author(s):  
Kajetan Kiełbowski ◽  
Nikola Ruszel ◽  
Seweryn Skrzyniarz ◽  
Maria Piotrowska ◽  
Tomasz Grodzki ◽  
...  
Keyword(s):  
Case Report ◽  
Lung Transplantation ◽  
World Literature ◽  
Case Reports ◽  
Pulmonary Diseases ◽  
Chronic Obstructive ◽  
Single Lung Transplantation ◽  
Lung Hyperinflation ◽  
Native Lung ◽  
End Stage

Introduction: Single lung transplantation (SLuTx) is a challenging operation for patients with end-stage chronic pulmonary diseases. After surgery, native lung hyperinflation (NLH) and a mediastinal shift may develop, which changes the anatomical position of the lungs and heart and may lead to graft compression. Aim: We present a case report of a patient who developed NLH after SLuTx. We discuss the treatment methods and compare the outcomes with other case reports and analysis from world literature. Case study: A 56-year-old female patient was diagnosed with end-stage chronic obstructive pulmonary disease (FEV1 < 30%) and qualified for right SLuTx. After the procedure, spirometry revealed gradual loss in FEV1. Radiological images confirmed NLH and compression of the graft. Therefore, a native lung pneumonectomy was performed with positive outcomes. Results and discussion: NLH is a known complication of SLuTx. Typically, lung volume reduction surgery is performed to reduce the compression and a pneumonectomy is a rare treatment, even in centres with extensive experience with SLuTx. Conclusions: Despite SLuTx being a common approach in many pulmonary diseases, NLH should be always taken into consideration. Hyperinflation could cause a dangerous loss of respiratory efficiency and require invasive surgeries for lung transplant recipients.

scholarly journals Long-lasting severe knee pain in a SLE patient after renal transplantation: what is the reason? A case report and literature review

2021 ◽  
Author(s):  
Anna Masiak ◽  
Iga Kościńska ◽  
Beata Rutkowska ◽  
Zbigniew Zdrojewski
Keyword(s):  
Kidney Transplantation ◽  
Case Report ◽  
Knee Pain ◽  
Case Reports ◽  
Immunosuppressive Treatment ◽  
The Body ◽  
Review Of The Literature ◽  
Letters To The Editor ◽  
Appropriate Treatment ◽  
The Right

AbstractMusculo-skeletal complaints in a patient suffering from systemic lupus, with co-existing chronic renal failure, undergoing immunosuppressive treatment after kidney transplantation, can have a varied etiology. The aim of this work was to present a case based review of differential diagnosis of knee pain in such a patient. A literature search was carried out using MEDLINE/PubMed, Google Scholar and EBSCO, with no time limit. We undertook a systematic review of the literature published in English, limited to full-text publications of original articles, letters to the editor, and case reports in peer-reviewed journals, for a discussion and analysis of studies reporting arthralgia in patients with lupus after kidney transplantation. We present a case report of a 45-year-old woman with lupus nephritis, after kidney transplantation, who started to complain of increasing pain in the knees, most pronounced at night and after physical activity approximately 2 years after transplantation. Extensive causal diagnostics were carried out, which revealed bilateral extensive regions of bone infarction in the femur and tibia, chondropathy, degenerative changes of medial meniscuses in the body and posterior horn as well as chondromalacia of the patella. Establishing the right diagnosis is crucial for implementing appropriate treatment.

scholarly journals Gait patterns in COPD: the Rotterdam Study

2015 ◽  
Vol 46 (1) ◽  
pp. 88-95 ◽  
Author(s):  
Lies Lahousse ◽  
Vincentius J.A. Verlinden ◽  
Jos N. van der Geest ◽  
Guy F. Joos ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Chronic Obstructive Lung Disease ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Gait Velocity ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Rotterdam Study ◽  
Obstructive Pulmonary Disease ◽  
Global Initiative

Gait disturbances in patients with chronic obstructive pulmonary disease (COPD) may lead to disability and falls. As studies assessing gait kinematics in COPD are sparse, we investigated associations of COPD with various gait domains and explored a potential link with falling.Gait was measured within the prospective, population-based Rotterdam Study (age ≥55 years) using an electronic walkway and summarised into seven gait domains: Rhythm, Variability, Phases, Pace, Tandem, Turning and Base of Support. Rhythm is a temporal gait aspect that includes cadence and reflects how quickly steps are taken.Persons with COPD (n=196) exhibited worse Rhythm (−0.21 sd, 95% CI −0.36– −0.06 sd) compared with persons with normal lung function (n=898), independent of age, sex, height, education, smoking or analgesic use, especially when dyspnoea and severe airflow limitation or frequent exacerbations (Global Initiative for Chronic Obstructive Lung Disease group D: −0.83 sd, 95% CI −1.25– −0.41 sd) were present. A lower forced expiratory volume in 1 s was associated with worse Rhythm and Pace, including lower cadence and gait velocity, respectively. Importantly, fallers with COPD had significantly worse Rhythm than nonfallers with COPD.This study demonstrates that persons with COPD exhibit worse Rhythm, especially fallers with COPD. The degree of Rhythm deterioration was associated with the degree of airflow limitation, symptoms and frequency of exacerbations.

scholarly journals Case report: Pulmonary amyloidosis in two patients with chronic obstructive lung disease (COPD)

2019 ◽  
Vol 28 ◽  
pp. 100897
Author(s):  
Haya Mardahayev ◽  
Sara Mohammed ◽  
Khalid Moddathir Mohmmed ◽  
Hala Rizalla ◽  
James Hayes
Keyword(s):  
Case Report ◽  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Pulmonary Amyloidosis
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