1363. Echocardiographic Image of Extracorporeal Membrane Oxygenation Cannula-Associated Inferior Vena Cava Thrombosis and Filter Implantation.
作者: Liu Jingquan.;Zhang Fan.;Shao Ziqiang.;Lai Jifu.;Lin Zongbin.;Yang Xianghong.;Sun Renhua.;Hong Jun.
来源: Chest. 2023年163卷6期e275-e279页 1364. A 75-Year-Old Man With Irregular Solid Components Within an Emphysematous Bulla.
作者: Yanhua Li.;Caili Su.;Ying Yan.;Zheng Wang.;Xuan Wei.;Zhenchang Wang.
来源: Chest. 2023年163卷6期e265-e273页
A 75-year-old man presented to our hospital with cough and sputum for more than a year. Eight months previously, the patient was admitted to a local hospital, and his symptoms were relieved after symptomatic treatment (expectorants and antitussives). Three months ago, he was admitted to our hospital, and his symptoms improved with antiinflammatory therapy. He had a 30-pack-years history of smoking (20 cigarettes/day) and a history of drinking (200 g liquor per day). The patient had no history of genetic disorders or cancer. He did not present with fever, dyspnea, hemoptysis or chest distress, and there was no history of weight loss since onset.
1365. A 40-Year-Old Man With Multiple Pulmonary Nodules and Mediastinal Lymphadenopathy With Positive Anti-Neutrophil Cytoplasmic Antibody Reveals an Unexpected Diagnosis.
A 40-year-old man with no significant medical history presented to the ED with a 2-day history of right-sided chest pain accompanied by night sweats and chills. These symptoms were accompanied by a dry, nonproductive cough without hemoptysis. The patient worked as an air traffic controller, with a side business of buying, renovating, and selling houses. He takes part in the remodeling work himself but denies any exposure to animal droppings, bird droppings, or mold. He denied chronic sinus disease, rash, or arthralgias. A resident of Platte City, Missouri, he had recently traveled to Salt Lake City, Utah. At the time of presentation, the patient denied any fever or shortness of breath. He had no history of nicotine, alcohol, or illicit substance use and denied any recent weight loss.
1366. A 56-Year-Old Man With Cough, Bloody Sputum, and Lithoptysis.
作者: Yinzhen Han.;Wenzhuo Guan.;Ling Zhao.;Min Liu.;Guowu Zhou.;Yanhong Ren.;Huaping Dai.
来源: Chest. 2023年163卷6期e255-e258页
A 56-year-old Chinese man, who did not smoke, presented with a 2-month history of cough and bloody sputum. He also complained of fatigue, night sweats, chest pain, and shortness of breath, with no chills or loss of weight. He previously worked as a veterinarian and had been infected with Brucella 30 years ago. Additionally, he had been diagnosed with tuberculous pleurisy and completed a 1-year anti-TB treatment. Subsequently, he had been well until 2 months before the current admission. A chest CT scan showed a cruciform calcification in the mediastinum and some tree-in-bud changes. The results of the purified protein derivative skin test and interferon-gamma release assay for TB were negative. Brucella agglutination test was also negative. On the night of admission, the patient coughed up two silver-white-colored shiny stones and had a fever of up to 38.5 °C on the following days.
1367. Potassium Chloride-Induced Phlebitis via a Malpositioned Central Venous Catheter.
We present a case of potassium chloride-induced phlebitis with severe, burning, left-sided chest pain when infused via a malpositioned central venous catheter. Using a malpositioned central venous catheter requires careful consideration, but this novel case prompts the need for additional review before its use for the infusion of potentially irritating medications.
1372. Untangling Treatment Effect From Patient Factors: The Challenge of the Use of Observational Studies to Investigate the Impact of Positive Airway Pressure Therapy on Medical Costs.1380. Update on Biomarkers for the Stratification of Indeterminate Pulmonary Nodules.
作者: Rafael Paez.;Michael N Kammer.;Nicole T Tanner.;Samira Shojaee.;Brent E Heideman.;Tobias Peikert.;Meridith L Balbach.;Wade T Iams.;Boting Ning.;Marc E Lenburg.;Christopher Mallow.;Lonny Yarmus.;Kwun M Fong.;Stephen Deppen.;Eric L Grogan.;Fabien Maldonado.
来源: Chest. 2023年164卷4期1028-1041页
Lung cancer is the leading cause of cancer-related deaths. Early detection and diagnosis are critical, as survival decreases with advanced stages. Approximately 1.6 million nodules are incidentally detected every year on chest CT scan images in the United States. This number of nodules identified is likely much larger after accounting for screening-detected nodules. Most of these nodules, whether incidentally or screening detected, are benign. Despite this, many patients undergo unnecessary invasive procedures to rule out cancer because our current stratification approaches are suboptimal, particularly for intermediate probability nodules. Thus, noninvasive strategies are urgently needed. Biomarkers have been developed to assist through the continuum of lung cancer care and include blood protein-based biomarkers, liquid biopsies, quantitative imaging analysis (radiomics), exhaled volatile organic compounds, and bronchial or nasal epithelium genomic classifiers, among others. Although many biomarkers have been developed, few have been integrated into clinical practice as they lack clinical utility studies showing improved patient-centered outcomes. Rapid technologic advances and large network collaborative efforts will continue to drive the discovery and validation of many novel biomarkers. Ultimately, however, randomized clinical utility studies showing improved patient outcomes will be required to bring biomarkers into clinical practice.
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