A 72-year-old man with progressive dyspnea was referred to our hospital for evaluation of diffuse lung disease. His medical history was unremarkable except for a 20-year history of smoking 20 cigarettes per day. Abnormal findings were first identified on a chest radiograph during a routine medical checkup 11 months earlier. Chest CT scan showed diffuse ground-glass opacities with basilar predominant distribution and some areas of alveolar consolidation predominantly in the lower lobes. Based on clinical and radiographic findings, the patient was initially diagnosed with interstitial lung disease and treated with IV methylprednisolone pulse followed by oral prednisolone, but his condition did not improve. To exclude the possibility of infectious lung disease, empirical antibiotics were administered; however, the patient showed no clinical improvement. Subsequent treatments, including additional methylprednisolone pulses and immunosuppressive agents such as tacrolimus and cyclophosphamide, also failed to yield any significant benefit. His dyspnea progressively worsened, and home oxygen therapy was initiated 4 months before referral. Because of his deteriorating condition despite maximal medical therapy, he was referred to our hospital for comprehensive evaluation.

Acute aortic dissection is a rare and life-threatening emergency, with fatal outcomes often resulting from delayed or missed diagnoses. Type A aortic dissection, which typically presents with acute chest pain radiating to the back, is the most common cause of death associated with aortic lesions and requires urgent surgical intervention. We present an unusual case of type A aortic dissection that manifested solely with sudden paralysis and tingling of the right lower limb, without chest or back pain. Despite timely diagnosis in the emergency department, emergency surgical intervention failed to save the patient's life.

Low-tidal-volume ventilation (LTVV) improves outcomes in critically ill patients, but its impact in patients with acute brain injuries (ABIs) is less certain.

There is considerable variation in clinicians' approaches to decisions to withhold or withdraw life sustaining treatment (LST) across US hospitals. These differences are not explained by patient preferences alone and are likely influenced by other factors (eg, hospital policies, hospital culture, state laws, medical society guidelines).