Chest
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Case Reports
A 38-Year-Old Man With a 2-Month History of Fever, Cough, Palpitations, and Weight Loss.
A 38-year-old man of Indian origin, who migrated to Greece 13 years prior to presentation, was admitted to our hospital with a 2-month history of nonprogressive, intermittent (mostly evening), low-grade (up to 38.5°C) fever, accompanied by night sweats, dry cough, mild dyspnea on exertion (modified Medical Research Council Dyspnea Scale grade 1), anorexia, fatigue, and weight loss of 10 kg. He also experienced continuous palpitations, which were regular, not associated with chest pain or dizziness, and aggravated on exertion. ⋯ He was a nonsmoker, had a history of past alcohol dependence, and had been hospitalized twice for acute pancreatitis due to hypertriglyceridemia. He had also been diagnosed with diabetes mellitus, presumably poorly controlled because he mentioned not taking any medication or having regular follow-up.
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Multicenter Study Comparative Study Observational Study
Long-Term Outcomes in Systemic Sclerosis-Associated Pulmonary Arterial Hypertension From the Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma Registry (PHAROS).
Pulmonary arterial hypertension (PAH) is a leading cause of death in patients with systemic sclerosis (SSc). The purpose of this study was to assess long-term outcomes in patients with SSc-PAH. ⋯ Overall survival in PHAROS was higher than other SSc-PAH cohorts. PAH accounted for more than one-half of deaths and primarily within the first few years after PAH diagnosis. Optimization of treatment for those at greatest risk of early PAH-related death is crucial.
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Comparative Study
Tumor Spread Through Air Spaces Identifies a Distinct Subgroup With Poor Prognosis in Surgically Resected Lung Pleomorphic Carcinoma.
Tumor spread through air spaces (STAS) has recently been reported as a novel form of lung adenocarcinoma invasion that can negatively affect survival; however, its role in pleomorphic carcinoma remains unclear. The goal of this study was to characterize tumor STAS in pleomorphic carcinoma, including its association with clinicopathologic features and prognosis. ⋯ In this first study of its kind, tumor STAS in patients with pleomorphic carcinoma was shown to be associated with high recurrence rates and poor survival after surgical resection. Hence, tumor STAS can serve as a predictor of postoperative survival; this information will enable better risk stratification and more effective clinical management of patients with this rare type of tumor.
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Observational Study
Effect of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplantation Outcome.
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) has an expected median survival of 3 months. Lung transplantation is a potentially lifesaving therapy for AE-IPF. However, the current knowledge of transplantation outcomes during AE-IPF is limited to a few small retrospective studies, reporting only 1-year post-transplantation survival. ⋯ Patients with IPF transplanted during AE-IPF had significantly worse short-term and long-term survival compared with patients transplanted during stable IPF. Patients with AE-IPF and very high LAS may not experience the survival advantage expected from lung transplantation.
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As seen in this CME online activity (available at http://courses.elseviercme.com/730), COPD is the third leading cause of death in the United States among people 65 years of age and older and the fourth leading cause of death among people 45 to 65 years of age. A recent survey reported that about 12 to 15 million people in the United States have physician-diagnosed COPD. However, COPD is significantly underdiagnosed, and data suggest as many as 12 million people in the United States have undiagnosed COPD. ⋯ This CME-certified webcast provides insights into new approaches to identifying patients with undiagnosed COPD, the importance of early initiation of pharmacologic treatment in a guideline-congruent manner, and the importance of repeated patient training in correct inhaler techniques to improve adherence and patient outcomes. Additionally, the online program is part of a larger learning platform (available at https://copd.elsevierresource.com/) that provides free access to the latest clinical information related to the diagnosis and management of COPD. The COPD Learning Center is a freely accessible platform that aims to increase clinical knowledge by providing CME activities, research articles, and resources for health-care providers who treat patients with COPD.