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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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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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.
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Idiopathic pulmonary fibrosis is characterized by progressive fibrosis of the lung and poor prognosis. This is the case report of a patient with idiopathic pulmonary fibrosis that highlights many of the controversies inherent in the diagnosis and treatment of this disease.
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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.