Chest
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A 46-year-old woman presented with worsening dyspnea and palpitations for 3 days following an episode of left shoulder pain. The patient had received a diagnosis of patent ductus arteriosus with Eisenmenger syndrome in childhood but had been inconsistently taking digoxin and diuretics since then. She was married but had never been pregnant. ⋯ She had developed bilateral leg edema. Three days prior to admission, she noticed an episode of severe, sharp pain in her left shoulder that was nonradiating but associated with palpitations and sweating and that lasted for about 20 min. The shoulder pain subsided spontaneously but her dyspnea worsened significantly, which prompted her to present to the ED.
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Letter Case Reports
Diffuse alveolar hemorrhage secondary to apixaban administration.
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Histologic classification of lung adenocarcinoma subtype has a prognostic value in most studies. However, lung adenocarcinoma characteristics differ across countries. Here, we aimed at validating the prognostic value of this classification in a large French series of lung adenocarcinoma. ⋯ IASLC/ATS/ERS classification of lung adenocarcinomas predicts survival in French population. Histologic grade correlates with clinical, pathologic and molecular parameters suggesting different oncogenic pathways.
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Simple spirometry and body plethysmography have been routinely used in children aged > 5 years. New techniques based on physiologic concepts that were first described almost 50 years ago are emerging in research and in clinical practice for measuring pulmonary function in children. These techniques have led to an increased understanding of the pediatric lung and respiratory mechanics. ⋯ This method can be used to assess obstruction in the large and small peripheral airways and has been used to measure bronchodilator response and bronchoprovocation testing. New data suggest that IOS may be useful in predicting loss of asthma control in the pediatric population. This article reviews the clinical applications of IOS, with an emphasis on the pediatric setting, and discusses appropriate coding practices for the clinician.
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The medical community has used implantable mechanical circulatory support devices at increasing rates for patients dying from heart failure and cardiogenic shock. Newer-generation devices offer a more durable and compact option when compared with bulky early-generation devices. This article is a succinct introduction and overview of the hemodynamic principles and complications after device implantation for ICU clinicians. We review the concepts of device physiology, clinical pearls for perioperative management, and common medical complications after device implantation.