Chest
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Meta Analysis
Association of Non-Obstructive Chronic Bronchitis with All-Cause Mortality: A Systematic Literature Review and Meta-Analysis.
The effect of nonobstructive chronic bronchitis (CB) on mortality is unclear. ⋯ Nonobstructive CB is associated with increased all-cause mortality, and this association seems to be present only in current and former smokers. Further research should investigate whether this high-risk population may benefit from early therapeutic intervention.
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Severe pulmonary hypertension (PH) is prognostically highly relevant in patients with COPD. The criteria for severe PH have been defined based on hemodynamic thresholds in right heart catheterization. ⋯ In patients with COPD, the combination of echocardiography, NT-proBNP level, and PA to Ao diameter ratio predicts severe PH with high sensitivity and specificity. The contribution of severe PH and severe airflow limitation to impaired survival is comparable.
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A 28-year-old man with a history of congenital HIV sought treatment at the ED with a chief symptom of generalized malaise and confusion of 3 days' duration. He had mild dyspnea, but no respiratory distress, and he reported no fever, chest pain, or headache. We were unable to obtain past medical, family, or social history because of encephalopathy and we had no available contact person. ⋯ He was prescribed Stribild (elvitegravir-cobicistat-emtricitabine-tenofovir disoproxil fumarate) and darunavir; however, pharmacy records revealed he did not fill the prescriptions. He underwent no further clinic follow-up examinations. He grew up in California and moved to upstate New York 5 years previously.
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Case Reports
A 70-Year-Old Man With Relapsed CNS Lymphoma Has Incidental Finding of Right Atrial Mass.
A 70-year-old man was admitted to the hospital for planned chemotherapy for recently diagnosed CNS lymphoma. His medical history included follicular lymphoma (achieved remission 1 year prior with chemotherapy) and tonic-clonic seizure 1 month prior to admission, which led to his eventual biopsy-confirmed diagnosis of CNS lymphoma. Physical examination revealed temperature 36.4 °C, heart rate of 60 beats/min, BP of 160/81 mm Hg, and 98% oxygen saturation on room air. ⋯ Review of systems noted progressive and intermittent confusion prior to his seizure. He denied any shortness of breath, dyspnea on exertion, orthopnea, lower extremity edema, palpitations, or syncope. Laboratory data were unremarkable.