The American journal of the medical sciences
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A 69-year-old patient presented with episodic, acute hypoxia and an increasing oxygen requirement. His hemoglobin oxygenation reached its nadir in the 80% to 85% range as measured by pulse oximetry while he was sitting upright. ⋯ He was found to have a large secundum atrial septal defect with bidirectional intracardiac shunting, left hemidiaphragmatic dysfunction, a dilated ascending aorta and a prominent Eustachian valve. The patient was stabilized with oxygen therapy, and the cardiology service provided definitive treatment via percutaneous shunt closure with a septal occluder.
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Idiopathic pulmonary fibrosis (IPF) is the most common form of the idiopathic interstitial pneumonias and remains a disease with a poor prognosis. Familial interstitial pneumonia (FIP) occurs when 2 or more individuals from a given family have an idiopathic interstitial pneumonia. ⋯ However, dysfunctional aspects of the pathways that are involved with these genes are present in sporadic forms of IPF even in the absence of mutations, suggesting common underlying disease mechanisms. By serving as a resource for identifying the current and future genetic links to disease, FIP families hold great promise in defining IPF pathogenesis, potentially suggesting targets for the development of future therapies.
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Randomized Controlled Trial
Electromyographic assessment of dexamethasone in treatment of post-tonsillectomy pain: randomized, placebo-controlled trial.
Surface electromyographic (sEMG) study of post-tonsillectomy swallow-evoked muscular reactions was performed to assess analgesic properties of dexamethasone. ⋯ If dexamethasone is administered, the reduction of the postoperative pain could be secondary to the reduction of edema. The sEMG might be used for quantitative evaluation of analgesics via assessment of neuromuscular reactions to analgesia.
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Tuberculosis (TB) is a major global health problem and often coincides with nutritional deficiency. In fact, vitamin D deficiency has been reported among TB patients, and vitamin D receptor polymorphisms are associated with susceptibility to Mycobacterium tuberculosis. ⋯ Vitamin D also induced the expression of cathelicidin, which is involved in the first line of defense in TB patients. Thus, vitamin D may have a role in TB treatment, and further investigation is needed.
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Idiopathic pulmonary fibrosis (IPF) is characterized by progressive dyspnea, interstitial infiltrates in lung parenchyma and restriction on pulmonary function testing. IPF is the most common and severe of the idiopathic interstitial pneumonias, with most individuals progressing to respiratory failure. ⋯ Although the nature of injurious events and processes involved in aberrant repair of the alveolar epithelium are not well understood, ongoing investigations provide hope to better understand mechanisms by which AECs maintain homeostasis or contribute to fibrosis. These strategies may hold promise for developing novel treatment approaches for IPF.