Chest
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It is unclear whether thoracoscopic (video-assisted thoracoscopic surgery [VATS]) pneumonectomy improves outcomes compared with open approaches. ⋯ Attempting thoracoscopic pneumonectomy at an experienced center appears safe but does not yield the early pain/complication reductions observed for VATS lobectomy. There may be long-term pain/survival advantages for certain stages that warrant further study and refinement of this approach.
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Hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) are involved in the pathogenesis of various lung diseases. This study was designed to determine the possible interactions of these growth factors in the development of COPD. ⋯ Upregulated HGF probably compensated for the reduced levels of VEGF and preserved the pulmonary function in smokers without COPD. By contrast, both HGF and VEGF levels were decreased in smokers with COPD, which likely led to the development of COPD. Thus, the level of HGF relative to that of VEGF may be a reliable indicator of the risk for COPD.
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Neuroborreliosis can cause multiple cranial and peripheral neuropathies; however, involvement of both recurrent laryngeal nerves is rare. We report the case of a 90-year-old man who presented with dysphonia and right upper and lower extremity weakness. His course was complicated by bilateral vocal cord paralysis and respiratory failure requiring tracheostomy. ⋯ The patient received IV ceftriaxone for 2 weeks, followed by complete recovery of motor and vocal function over 2 months. Our case is the third report of bilateral vocal cord paralysis in the literature, and the first one, to our knowledge, presenting with respiratory failure requiring an artificial airway. Physicians should be aware of this unusual complication of neuroborreliosis.