Chest
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Case Reports
Endobronchial Ultrasound: A New Technique of Pericardiocentesis in Posterior Loculated Pericardial Effusion.
Diagnostic and therapeutic pericardiocentesis is traditionally carried out via the transthoracic route under ultrasound or echocardiographic guidance. Posteriorly located loculated pericardial effusion cannot be safely drained using the standard subxiphoid or apical, intercostal approach. In the presence of clinically significant loculated effusion or effusion requiring diagnostic pericardiocentesis where an echocardiographic approach is not feasible, patients are usually referred for surgery. We here present a novel minimally invasive endobronchial ultrasound-guided approach for the aspiration of posteriorly loculated pericardial effusion that may obviate the need for surgery and its related complications.
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Case Reports
A 32-Year-Old-Man With a Severe Headache, Visual Loss, and Nodular Pulmonary Opacities.
A 32-year-old man presented with severe headache, vomiting, and painless loss of vision of 5 days' duration. He had no seizures, other neurologic deficits, or fever. Two months prior to presentation, he had an episode of hemoptysis of 30 to 50 mL, which resolved spontaneously; there was no recurrence. ⋯ He had no known comorbid illness, prior surgeries, dental procedures, or blood transfusions. He denied any history of substance abuse. He observed that his father and brother also had recurrent self-limited episodes of epistaxis.
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Lung cancer screening recommendations have been developed, but none are focused on veterans. We report the results of the lung cancer screening program at our Veterans Affairs medical center and compare them with historic results. ⋯ Implementation of lung cancer screening in the veteran population leads to detection of an increased number and proportion of early-stage lung cancers. Lung cancer screening in veterans may also increase the rate of lung cancer diagnoses in the immediate postimplementation period.
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A 7-year-old boy was referred for evaluation of loud nightly snoring. Snoring started suddenly 2 weeks prior to presentation and grew progressively worse. Currently, the parents witnessed breathing pauses and gasping at night. ⋯ The parents noticed a sudden change in the child's voice and described it as "muffled, like speaking with cotton balls in his mouth." His school performance did not change. He had had a viral illness 2 weeks prior to presentation that was diagnosed as viral pneumonia. He was not on medications.