Arch Intern Med
-
Intra-alveolar hemorrhage is a known complication of lupus erythematosus (LE), but its cause is controversial. Some authors have shown immune complexes (ICs) deposited at various sites in the alveolar septae and postulated that these deposits result in pulmonary hemorrhage (PH). ⋯ Reviewing the literature, we show that IC deposits in the lung are nonspecific and are not correlated with PH. We propose that classification schemes that differentiate between IC-mediated PH and idiopathic PH are arbitrary, and that patients thought to have idiopathic PH should be followed up prospectively to monitor the development of possible immunologic disease.
-
Randomized Controlled Trial Clinical Trial
Spurious hypertension in the obese patient. Effect of sphygmomanometer cuff size on prevalence of hypertension.
We used standard, large adult, and thigh-size cuffs in random order to take BPs in 470 patients. The prevalences of definite high BP [( HBP]), greater than or equal to 160/95 mm Hg) and borderline HBP [( BHBP ], greater than or equal to 140/90 less than 160/95 mm Hg) were the same with all three cuffs in patients with an arm circumference less than 35 cm, a body mass index less than 34, and a weight of less than 95 kg. ⋯ The prevalences of HBP and BHBP were twofold greater with the standard cuff than with the large adult or thigh cuffs in obese patients (arm circumference greater than or equal to 35 cm or body mass index greater than or equal to 34 or weight greater than or equal to 95 kg). Routine use of the large adult cuff will provide accurate BP measurement and avoid unneeded evaluation and treatment.