Chest
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A 41-year-old man presented to our institution with shortness of breath for 1 day, and nausea, vomiting, and diarrhea for 10 days. He has a medical history of gastroesophageal reflux disease, migraines, and anxiety. He is a 10 pack-year former cigarette smoker and an active vaper. ⋯ He had recently traveled to Texas and had a sick contact with his 18-month-old daughter. She recently recovered from a diarrheal illness of presumed viral origin. Prior to admission, the subject tested negative for influenza and completed outpatient antibiotic treatment, with no improvement.
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A 49-year-old man was seen in the pulmonary clinic for evaluation of postcoital hemoptysis. His medical history was significant for nonischemic cardiomyopathy and hypertension. He had red-yellow sputum with streaks of blood associated with dyspnea and wheezing for 5 years. ⋯ He had no constitutional symptoms or symptoms concerning for malignancy or autoimmune disease, including joint or skin complaints. His medications included aspirin, atorvastatin, carvedilol, furosemide, lisinopril, and spironolactone, and he endorsed adherence. He denied herbal or over-the-counter drugs use and denied illicit drug use.
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Screening current and former heavy smokers 55 to 80 years of age for lung cancer (LC) with low-dose chest CT scanning has been recommended by the United States Preventive Services Task Force since 2013. Although the number of screening facilities in the United States has increased, screening uptake has been slow. ⋯ It is recommended to calculate accessibility using subcounty geographies and to examine variation regionally and within states. A foundation geographic accessibility layer can be integrated with other variables to identify geographic disparities in access to screening and to focus on areas for interventions. Identifying areas of greatest need can inform state and local officials and healthcare organizations when planning and implementing LC screening programs.
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A 53-year-old man presented to the ED at a time of low severe acute respiratory syndrome coronavirus 2, also known as coronavirus disease 2019 (COVID-19), prevalence and reported 2 weeks of progressive shortness of breath, dry cough, headache, myalgias, diarrhea, and recurrent low-grade fevers to 39°C for 1 week with several days of recorded peripheral capillary oxygen saturation of 80% to 90% (room air) on home pulse oximeter. Five days earlier, he had visited an urgent care center where a routine respiratory viral panel was reportedly negative. ⋯ He reported a past medical history of gastroesophageal reflux disease that was treated with famotidine. Travel history included an out-of-state trip 3 weeks earlier, but no recent international travel.
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There is limited information about survival of stage I lung cancer diagnosed by screening. ⋯ Long-term lung cancer-specific survival of stage I lung cancer was greater with low-dose CT imaging than with CXR screening or in the general population, for smaller primary tumor size, and with surgical treatment.