Chest
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Comparative Study
Differences in Health-related Quality of Life Between New Mexican Hispanic and Non-Hispanic White Smokers.
Smoking is associated with impaired health-related quality of life (HRQL) across all populations. Because decline in lung function and risk for COPD are lower in New Mexican Hispanic smokers compared with their non-Hispanic white (NHW) counterparts, the goal of this study was to ascertain whether HRQL differs between these two racial/ethnic groups and determine the factors that contribute to this difference. ⋯ New Mexican Hispanic smokers have clinically relevant, lower HRQL than their NHW counterparts. A perception of diminished physical functioning and impairment in daily life activities contribute to the poorer HRQL among Hispanic subjects.
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A 66-year-old man presented with dry cough and shortness of breath on exertion of 6 months' duration. There were no complaints of fever and hemoptysis. His history was significant for recurrent episodes of respiratory tract infections over the previous 4 years. ⋯ He was a nonsmoker and did not drink alcohol, and there was no history of environmental or occupational exposure. He had been known to have diabetes for 10 years. He had negative results for the presence of HIV and hepatitis B surface antigen.
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Extrapulmonary tuberculosis refers to Mycobacterium tuberculosis involving organs other than the lungs (eg, pleura, lymph nodes, genitourinary tract, abdomen, skin, joints and bones, or meninges). In non-HIV-endemic areas, where reactivation is the predominant mechanism of tuberculosis, pleural involvement occurs in 4% of cases. We present an extremely rare case of a 62-year-old immunocompetent patient with pleural tuberculosis confirmed by surgical pleural biopsies, who presented with a large mediastinal mass and evidence of pulmonary artery invasion on CT scanning and endobronchial ultrasonography imaging, highlighting a unique and malignant-like character of the disease.
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Cystic fibrosis (CF) patients are at risk for life-threatening hemoptysis, sometimes necessitating bronchial arterial embolization (BAE). Spinal artery embolization and pulmonary infarction are commonly cited procedural risks, yet respiratory failure and death are underappreciated. We conducted a retrospective institutional review of our outcomes after BAE for hemoptysis in CF and present three cases highlighting this complication. ⋯ Nonsurvivors had significantly lower baseline FEV1 values than survivors (21.8% vs 52.6%, P < .05). BAE as a treatment for life-threatening hemoptysis may precipitate respiratory failure in end-stage CF and should accelerate the evaluation for lung transplantation. Institutions should reevaluate their BAE practices to ensure preservation of the bronchial circulation, which contributes to gas exchange in these patients.