Chest
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Observational Study
Diaphragmatic thickness and excursion in infants born preterm with bronchopulmonary dysplasia compared to term or near term infants: a prospective observational study.
Diaphragmatic atrophy associated with mechanical ventilation is reported in pediatric and adult patients, but a similar association has not been described in preterm infants with bronchopulmonary dysplasia (BPD). ⋯ In infants with BPD, DTexp was significantly lower, whereas DTF and DE were significantly higher, compared with healthy, age-matched control participants. Future studies are required and should focus on describing the evolution of diaphragmatic dimensions in preterm infants with and without BPD.
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A 53-year-old woman with a history of pulmonary embolism treated with rivaroxaban came to the ED after 4 days of acutely worsening dyspnea and chest pressure. On arrival, her temperature was 36.7 °C; heart rate, 71 beats/min; BP, 98/59 mm Hg; respiratory rate, 22 breaths/min; and Spo2 95% on room air. Her WBC count was elevated at 15,770/μL; hemoglobin, 13.3 g/dL; platelets, 280,000/μL; INR (international normalized ratio), elevated at 1.66; and partial thromboplastin time, elevated at 18.8 s. Serum chemistry results were unremarkable, and pro-brain natriuretic peptide was slightly elevated at 530 pg/mL (normal, < 300 pg/mL).
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A 44-year-old woman with a history of dyslipidemia and chronic anemia from uterine fibroids was admitted to the general medicine department of a tertiary hospital for a prolonged fever of 2 months' duration. The patient reported multiple visits to her local general practitioner, with tympanic temperatures up to 38.2 °C, where she was treated with 2 courses of broad-spectrum antibiotics in view of associated sore throat, nonproductive cough, and generalized lethargy. Although her respiratory symptoms abated within a few days of her initial presentation, her fever and lethargy persisted. ⋯ Subsequent CT scan of the thorax, abdomen, and pelvis detected an enlarged subcarinal lymph node measuring 3.7 cm × 1.7 cm and a mildly enlarged pre-carinal lymph node measuring 2.0 × 1.5 cm, with a mean attenuation of 66-77 Hounsfield Units (HU), and no central necrosis or calcification. No significant abnormalities were detected in the abdomen or pelvis. The patient was then referred to the respiratory department for further evaluation.
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Case Reports
A 25-Year-Old Patient With Chest Wall Erythema and Tenderness Who Was Ventilated Mechanically.
A 25-year-old man with cerebral palsy, scoliosis, and ventilator dependence since SARS-CoV-2 infection 11 months earlier presented with a 2-week history of chest redness and swelling. The area of erythema and edema was located on the left side of the anterior chest and had grown to approximately 9 cm in diameter over the 2 weeks. It was tender to palpation. ⋯ He did have increased, thick, yellow secretions from his tracheostomy, but no fevers. He was born in the Dominican Republic and moved to the United States as a child. He had not traveled anywhere outside the United States in more than a decade.
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A 44-year-old man was admitted to the hospital because of chest pain located around his lower thoracic spine with deep inspiration for 6 months. He denied having any cough, dyspnea, fever, or weight loss. ⋯ He was a nonsmoker, without any other personal or familial medical history. He had been examined at some hospitals, but the cause had not been determined.