Chest
-
Asthma is increasingly recognized as an underlying risk factor for severe respiratory disease in patients with coronavirus disease 2019 (COVID-19), particularly in the United States. Here, we report the postmortem lung findings from a 37-year-old man with asthma, who met the clinical criteria for severe acute respiratory distress syndrome and died of COVID-19 less than 2 weeks after presentation to the hospital. ⋯ The presence of diffuse alveolar damage is similar to descriptions of autopsy lung findings from patients with severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus, and the absence of a neutrophil-rich acute bronchopneumonia differs from the histologic changes typical of influenza. The relative contribution of mucus plugging to his hypoxemia is unknown.
-
Competence in point-of-care ultrasound (PoCUS) is widely recommended by several critical care societies. Despite numerous introductory short courses, very few doctors attain PoCUS competence because of the challenges in establishing longitudinal competence programs. ⋯ Ther is very little high-quality evidence on PoCUS competence. To help frame policy guidelines to improve PoCUS education, there is a need for well-designed longitudinal studies on PoCUS competence.
-
Tobacco smoke exposure adversely affects respiratory health. However, the effects of exposure on adolescents without asthma are not well known. ⋯ Detectable serum cotinine levels and self-reported home exposure were distinctively associated with decreased pulmonary function and increased health-care utilization.
-
Comparative Study
Comparison of risk of silicosis in metal mines and pottery factories: A 44-year cohort study.
Little is known about the different risk of silicosis in metal mines and pottery factories. We aimed to compare the silicosis risks among silica-exposed workers in different industrial circumstances. ⋯ The risk of silicosis in metal miners is higher than that in pottery workers when exposed to the same level of silica dust. The silica dust exposed years should be under 10 years for metal miners and 40 years for pottery workers at 0.05 mg/m3 to keep lifetime risk within 0.1%. Current exposure limits should take into account differences in various industrial circumstances. Smoking cessation could help reduce silicosis risk for silica-exposed workers.
-
Case Reports
Nintedanib in Bronchiolitis Obliterans Syndrome After Allogeneic Hematopoietic Stem Cell Transplantation.
Bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic cell transplantation (allo-HCT) usually confers poor prognosis and high mortality. Currently, therapeutic options are limited. ⋯ Then he started nintedanib treatment, and the symptoms of nonproductive cough and dyspnea were alleviated gradually. His pulmonary function test revealed increased FEV1 compared to baseline.