Chest
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Prevalence and potential risk contributors of sleep-disordered breathing (SDB) in adolescents and younger adults remain unclear. We hypothesized that SDB prevalence in younger Hispanic adults is higher than the limited evidence indicates. ⋯ The risk of SDB is highly prevalent in younger adults, even in females, and increases with age and BMI. The high prevalence and low awareness justify active screening and treatment of SDB in this population.
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Case Reports
A Woman in Her 30s Whose Family Becomes Distrustful After an Initial Prognosis Proves Inaccurate.
A woman in her 30s with alcoholic liver disease presented with an intracerebral hemorrhage with intraventricular extension, hydrocephalus, and an intracerebral hemorrhage score of 3. In the ICU, she was comatose with a flexion withdrawal as a best motor response. The ICU team, after 6 days of care, informed the family that the prognosis for any recovery of meaningful neurological function was dismal and that the family should consider withdrawal of life support. The family resisted any consideration of limitation of care, citing religious beliefs.
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A white woman in her 80s presented to the ED with nonproductive cough, fever, and 2 weeks of progressive generalized weakness. Previously ambulatory, she now was so weak she required assistance out of bed.
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Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon disease that is the most serious complication associated with unresolved pulmonary embolism. This disease has several risk factors, but no familial pattern has been described. ⋯ We describe a 54-year-old woman and her maternal aunt who both underwent pulmonary thromboendarterectomy for CTEPH. This represents the first description of familial CTEPH.
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Bronchial thermoplasty has been found to be a safe and effective therapy for severe asthma. We report the case of a mediastinal hematoma and hemothorax developing in a 66-year-old woman several days after an uneventful bronchial thermoplasty of the right lower lobe. ⋯ Pseudoaneuryms have been reported in association with other procedures involving the therapeutic application of thermal energy, and a single case of hemoptysis requiring bronchial artery embolization occurred in a clinical trial of bronchial thermoplasty. However, bronchial artery pseudoaneurysm with hemomediastinum and hemothorax has not previously been reported after bronchial thermoplasty.