Chest
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Critical Care Case Report PostersSESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Hashimoto's encephalopathy (HE) is a rare neuropsychiatric syndrome which has been controversial due to its unknown pathogenesis and variable clinical course. It is defined by signs of encephalopathy with high thyroid antibody levels demonstrating good responsiveness to glucocorticoid therapy. We report a case of initially steroid responsive HE which became resistant, but responded well to plasmapheresis. ⋯ This case illustrates that although HE is a rare syndrome, it should be considered in patients presenting with acute encephalopathy or in patients with psychosis with an intermittent course. If steroid resistance is noted, plasmapheresis should be considered. Because the symptoms often respond to treatment, prompt diagnosis and treatment are imperative.Reference #1: Lord et al. Hashimoto's disease and encephalopathy. Lancet 1966; 2:512-514DISCLOSURE: The following authors have nothing to disclose: Anita Rajagopal, John LuciaNo Product/Research Disclosure Information.
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Critical Care Posters IISESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Standard textbooks still report conventional classification charts for the shock states. New modalities such as stroke volume variability and pulse pressure variability in addition to the widespread availability and use of ultrasound in modern intensive care units should be included in the schematics for shock management. ⋯ The following authors have nothing to disclose: Ramakant sharma, William McGee, Adam AdlerNo Product/Research Disclosure Information.
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ILD Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: The Antisynthetase syndrome is a rare entity, its comprises of a triad of inflammatory myopathy, diffuse interstitial lung disease, and small joint involvement. Serum auto antibodies to aminoacyl transfer RNA synthetases (anti-ARS) especially anti Jo-1 antibody present in most of the cases. Interstitial lung disease is an important diagnostic criteria and a major determinant of mortality of this syndrome. We are reporting a case of ASSCASE PRESENTATION: 48 year old female patient presented in OPD with complained of persistent dry cough and grade III dyspnea on exertion, generalised muscular pain and weakness. On examination she had mild anaemia, Pulse rate 96/mt BP 140/90 no lymphadenopathy, no clubbing. Respiratory system examination revealed crepitation in infrascapular area on both the side.Her hand were rough with creaky skin, crease of palm were dark suggestive of classical mechanics hand (figure 1). The movements of both the thumb were restricted .She was giving the history of joint pain and of Reynaud phenomenon.Investigations revealed,Hb 9.5 % gm, serum ANA was positive, Anti Ds DNA was negative, and C3 C4 and Rheumatoid factor was also negative. Transbronchial lung biopsy revealed nonspecific fibrosis and no evidence of granulomatus disorders. HRCT scan thorax was suggestive of bilateral lower lobe interstitial fibrosis in form of septal thickening, traction bronchieactasis and early honeycombing (figure 3&4). Spirometry revealed restrictive pattern . In the serum anti JO-1 was strongly positive. X-ray of the hand revealed subluxations of metacarpophalengeal joints in both the hand and progressive ankylosis of the same joint (figure2). Clinic radiological findings and serological findings were suggestive of interstitial lung disease due to AAS. ⋯ The Antisynthetase syndrome is a rare clinical entity, having multisystem involvement .It is comprises of a triad of inflammatory myopathy, diffuse interstitial lung disease, and small joint involvement. If this clinical entity diagnosed on time and treated adequately , then irreversible changes can be prevented.Reference #1: Love LA, Leff RH, Fraser DD , Targoff IN, Dalakas M, Plotz PH. Miller FW.A new approach to the classification of idiopathic inflammatory myopathy:myositis-specific autoantibody define useful homogeneous patient groups.Medicine(Baltimore) 70:360-74;1991Reference #2: Marguerie C, Bunn CC, Beynon HL, Bernstein RM, Hughes JM, So AK et al. Polymyositis, pulmonary fibrosis and autoantibodies to aminoacyl-Trna synthetase enzymes. Q J Med 1990; 77(282):1019-38.Reference #3: Chinoy H, Salway F, Fertig N, Shephard N, Tait BD, Thomson W et al. In adult onset myositis, the presence of interstitial lung disease and myositis specific/associated antibodies are governed by HLA class II haplotype, rather than by myositis subtype. Arthritis Res Ther 2006; 8(1):R13DISCLOSURE: The following authors have nothing to disclose: Ashok Singh, Raghvendra JaiswalNo Product/Research Disclosure Information.
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Bronchiectasis PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Low spirometry values are associated with increased risk for an exacerbation in patients with Chronic Obstructive Pulmonary Disease. There is paucity of data regarding patients with non-CF bronchiectasis. We endeavored to examine the possible relation between non-CF bronchiectasis exacerbations and pulmonary function tests. ⋯ The following authors have nothing to disclose: Evangelos Balis, Eugenios Metaxas, Joseph Papaparaskevas, Despina Chrysovergi, Nikos Spanakis, Athanasios Tsakris, Georgios TatsisNo Product/Research Disclosure Information.
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Pediatric PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Neonatal respiratory distress is any difficulty in breathing during the first 28 days of life. Clinical manifestations include a wide range depending on gestational age and its triggering causes. ⋯ The following authors have nothing to disclose: Manuela Cucerea, Monika Rusneac, Marta Simon, Carmen MovileanuNo Product/Research Disclosure Information.