Chest
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Case Reports
A 54-Year-Old Man With High-Grade Fever, Cough, Dyspnea, and Vesiculobullous Skin Eruptions.
A 54-year-old Egyptian man with a 5-day history of worsening cough, high-grade fever, and progressive dyspnea was referred to our hospital. A 3-day course of ceftriaxone provided in an outpatient setting showed no clinical improvement. Medical history was unremarkable, except for bilateral pulmonary embolism diagnosed 3 years earlier. ⋯ Five weeks before the actual presentation, he had traveled to Egypt. One of his children showed symptoms of a respiratory infection approximately 2 weeks before that. His only regular medication was rivaroxaban.
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Observational Study
Associations Between Air Pollution and the Onset of Acute Exacerbations of COPD: A Time-Stratified Case-Crossover Study in China.
Associations between air pollution and the acute exacerbations (AEs) of COPD have been established primarily in time-series studies in which exposure and health data were at the aggregate level, limiting the identification of susceptible populations. ⋯ This study provides robust evidence that short-term exposure to fine particulate matter and inhalable particulate matter was associated with higher odds of AEs of COPD onset. Individuals who are young, have severe COPD, or whose first diagnosis of COPD was made when they were between 20 and 50 years of age and experience an exacerbation during the cooler seasons may be particularly susceptible.
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Sepsis is common and expensive, and evidence suggests that sepsis order sets may help to improve care. Very incomplete evidence exists regarding the effects of sepsis order sets on the value of care produced by hospitals or the societal costs of sepsis care. ⋯ Receipt of the sepsis order set was associated with improved value of care, from both a hospital and societal perspective.
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Patients with OSA are at increased risk of postoperative cardiorespiratory complications and death. Attempts to stratify this risk have been inadequate, and predictors from large, well-characterized cohort studies are needed. ⋯ These findings provide a basis for better identifying high-risk patients with OSA and determining appropriate postoperative care.
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The eighth edition of lung cancer nodal staging assignment includes the location of lymph node metastasis, but does not include single-nodal and multiple-nodal descriptors. ⋯ Patients with NSCLC with one metastatic lymph node, whether in N1 or N2 stations, showed better survival than those with more than one lymph node involved. Patients with NSCLC with a single-skip N2 lymph node metastasis showed survival similar to patients with multiple N1 lymph nodes, and the number of lymph nodes involved in N1 resections up to four or more was sequentially prognostic.