Respirology : official journal of the Asian Pacific Society of Respirology
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Case Reports
Severe bullous emphysema and hypercapnia successfully treated by bronchoscopic lung volume reduction.
Patients with severe COPD may develop hypercapnic respiratory failure requiring mechanical ventilation and are at risk of becoming ventilator-dependent. We describe a patient with uncontrollable hypercapnic respiratory failure on mechanical ventilation whose respiratory condition and life were improved after bronchoscopic lung volume reduction. Further discussion of the possibility of bronchoscopic lung volume reduction in patients who require mechanical ventilation due to hypercapnic respiratory failure is warranted.
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Previous studies have indicated a high incidence of lung cancer in IPF, and some have identified its risk factors. However, those studies were retrospective and the clinical characteristics of IPF patients developing lung cancer were evaluated only when those patients had developed the cancer. The true cumulative incidence of lung cancer after the diagnosis of IPF and its predictive factors at the initial diagnosis of IPF remain unknown. The present study was conducted to elucidate the cumulative incidence and risk factors for lung cancer in IPF patients by retrospective longitudinal cohort analysis. ⋯ The cumulative incidence of lung cancer increased over time and age at diagnosis of IPF was independently associated with development of lung cancer.
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The lung age of smokers is greater than their real age. We have had the clinical impression that the lung age of non-smokers might be older than their real age and that obese subjects with decreased VC and FEV1 would also have an increased lung age. This cross-sectional study investigated the relationships between lung age and smoking status, and lung age and BMI. ⋯ Lung age could be used to motivate lifestyle change in obese individuals.
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Paradoxical vocal fold motion dysfunction (PVFMD) is a disorder of the larynx characterized by adduction of the vocal cords during the respiratory cycle leading to symptoms of extrathoracic airway obstruction. PVFMD mimics asthma and patients with PVFMD (PVFMD+) are often diagnosed incorrectly as refractory asthma and receive unnecessary treatment. This study determined the prevalence of PVFMD in asthma patients and described the relationship between asthma and PVFMD. ⋯ Asthma seems to facilitate the formation of the paradoxical dysfunction in the larynx as the prevalence of PVFMD in asthma patients is significantly higher than in patients with out asthma.
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A Chinese woman presented with a spontaneous pneumothorax and a family history suggestive of the autosomal dominant transmission of pneumothorax. The patient also had skin fibrofolliculomas and folliculin gene deletion, compatible with Birt-Hogg-Dube (BHD) syndrome. The importance of BHD syndrome and other familial spontaneous pneumothoraces is discussed.