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782. A 37-Year-Old Man With Nonresolving Pneumonia and Endobronchial Lesion.
A previously healthy, immunocompetent 37-year-old man was hospitalized with a 3-month history of intermittent fevers and cough with mucopurulent sputum preceded by flu-like symptoms. Five episodes of similar symptoms had prompted two hospitalizations and three courses of outpatient antibiotics. The fever would subside with treatment but intermittent dry cough persisted. There was no history of weight loss, night sweats, wheezing, arthralgia, skin rash, hemoptysis, recent travel, sick contacts, or high-risk sexual behavior. He was a nonsmoker with no alcohol or recreational drug use. He was an accountant in the military with no history of significant organic or inorganic dust exposures.
783. An 18-Year-Old Woman With Snoring and Refractory Epilepsy.
An 18-year-old woman with a history of refractory complex partial epilepsy presented for evaluation of snoring and episodes of gasping for air during sleep. She had uncontrolled epilepsy since the age of 8 years despite trial of multiple antiepileptic medications. She eventually underwent an implantation of a vagus nerve stimulator (VNS) device (model 103; Cyberonics Inc) with gradual adjustment of the VNS settings for better seizure control.
784. A 72-Year-Old Woman With Previous Pulmonary Metastasis and New Peripheral Nodule.
作者: Giovanni Maria Comacchio.;Chiara Giraudo.;Nazarena Nannini.;Alessandro Rebusso.;Roberta Polverosi.;Federico Rea.;Fiorella Calabrese.
来源: Chest. 2015年148卷2期e42-e47页
A 72-year-old female nonsmoker was admitted to our Thoracic Surgery Unit in 2013 because of a lesion detected on chest CT scan during oncologic follow-up. Her medical history was significant for the development of a single pulmonary metastasis discovered 1 year after sigmoidectomy for colic adenocarcinoma. At that time, the patient was treated with six cycles of neoadjuvant chemotherapy followed by left lower lobectomy. Histologic examination demonstrated a pulmonary metastasis of colic adenocarcinoma with diffuse necrotic areas. The patient underwent subsequent adjuvant chemotherapy with capecitabine and was followed annually with biohumoral oncologic screening (carcinoembryonic antigen, carbohydrate antigen 19-9), chest-abdomen CT scan, and colonoscopy.
786. Use of Lenalidomide in 5q-Myelodysplastic Syndrome Provides Novel Treatment Prospects in Management of Pulmonary Sarcoidosis.
We present the case of a 71-year-old woman with a long-standing history of refractory pulmonary sarcoidosis, who, upon commencement of treatment with lenalidomide for her newly diagnosed 5q-myelodysplastic syndrome, showed a remarkable, immediate, unexpected response and recovery of her sarcoidosis-related symptoms, improvement of her vital capacity, and complete clearance of her bibasal alveolor infiltrates. To our knowledge, this is the first case to report on the significant and immediate efficacy of lenalidomide in the management of pulmonary sarcoidosis. It provides a potential role for the use of lenalidomide as a novel therapeutic agent in patients with refractory pulmonary sarcoidosis.
797. Short- and Long-term Pulmonary Outcome of Palivizumab in Children Born Extremely Prematurely.
作者: Dario Prais.;Eytan Kaplan.;Gil Klinger.;Huda Mussaffi.;Meir Mei-Zahav.;Ephraim Bar-Yishay.;Patrick Stafler.;Guy Steuer.;Lea Sirota.;Hannah Blau.
来源: Chest. 2016年149卷3期801-8页
Palivizumab reduces the severity of respiratory syncytial virus infection in premature infants, but whether there is a protective effect beyond the preschool age is unknown. This study sought to assess the short- and long-term effects of palivizumab immunization on respiratory morbidity and pulmonary function at school age in children born extremely prematurely.
798. COPD Exacerbations Are Associated With Proinflammatory Degradation of Hyaluronic Acid.
作者: Eleni Papakonstantinou.;Michael Roth.;Ioannis Klagas.;George Karakiulakis.;Michael Tamm.;Daiana Stolz.
来源: Chest. 2015年148卷6期1497-1507页
COPD is characterized by chronic airway inflammation and remodeling, with serious modifications of the extracellular matrix (ECM). Hyaluronic acid (HA) is an abundant ECM molecule in the lung with various biologic functions that depend on its molecular weight (MW). High-MW HA exhibits antiinflammatory and immunosuppressive effects, whereas low-MW HA is proinflammatory. In this study, we investigated whether acute exacerbations of COPD (AECOPDs), which affect patient quality of life and survival, are associated with altered HA turnover in BAL.
799. Acute Exacerbations of COPD Are Associated With Increased Expression of Heparan Sulfate and Chondroitin Sulfate in BAL.
作者: Eleni Papakonstantinou.;Ioannis Klagas.;Michael Roth.;Michael Tamm.;Daiana Stolz.
来源: Chest. 2016年149卷3期685-95页
Acute exacerbations of COPD (AECOPDs) are associated with accelerated aggravation of clinical symptoms and deterioration of pulmonary function. The mechanisms by which exacerbations may contribute to airway remodeling and declined lung function are poorly understood. We investigated whether AECOPDs are associated with differential expression of glycosaminoglycans in BAL in a cohort of 97 patients with COPD.
800. Biomarker Profiles in Asthma With High vs Low Airway Reversibility and Poor Disease Control.
作者: William W Busse.;Stephen T Holgate.;Sally W Wenzel.;Paul Klekotka.;Yun Chon.;JingYuan Feng.;Edward P Ingenito.;Ajay Nirula.
来源: Chest. 2015年148卷6期1489-1496页
High bronchodilator reversibility in adult asthma is associated with distinct clinical characteristics. This analysis compares lung function, biomarker profiles, and disease control in patients with high reversibility (HR) and low reversibility (LR) asthma.
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