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6501. A 42-Year-Old Woman With Abnormal Chest CT Scan and Chylous Ascites.
作者: Tanmay S Panchabhai.;Debabrata Bandyopadhyay.;Ruchi Yadav.;Andrea V Arrossi.;Atul C Mehta.;Jihane A Faress.
来源: Chest. 2016年149卷1期e25-8页
A 42-year-old white woman presented to the pulmonary clinic for evaluation of abnormal chest imaging. Twenty years prior to presentation, she was noted to have an abnormal chest radiograph during a routine preemployment evaluation. A subsequent bronchoscopy was nondiagnostic. She was followed up with annual imaging, which demonstrated little or no progression of her disease. She remained symptom free throughout this period. A year before her visit to the pulmonary clinic, she developed abdominal discomfort and was found to have ascites. Subsequently, she underwent three paracenteses with analysis revealing chylous fluid. She was a nonsmoker without a history of exposures or travel.
6502. Patient With Slow-Growing Mediastinal Mass Presents With Chest Pain and Dyspnea.
作者: Abhishek Biswas.;Daniel Urbine.;Ashish Prasad.;Eric S Papierniak.;Michelle Weber.;Paras Malhotra.;Peruvemba S Sriram.
来源: Chest. 2016年149卷1期e17-23页
A 52-year-old white woman presented with severe pain over the right upper abdomen and nonpleuritic, right-sided, lower chest-wall pain. Her pain had progressively gotten more frequent and severe over the last 5 months. It was also associated with a nonexertional, pressure-like sensation in the central chest. The patient denied any shortness of breath, fevers, cough, or any sputum production. She was taking levothyroxine for hypothyroidism and was a 30-pack-year current smoker; there was no history of drug abuse or occupational exposure. Previous chest radiographs dating back to 5 years consistently showed an elevated right-sided hemidiaphragm without any infiltrates or effusions; cardiomediastinal structures were unremarkable. She had not had a previous workup for these abnormal findings.
6504. Lung Transplantation in Gaucher Disease: A Learning Lesson in Trying to Avoid Both Scylla and Charybdis.
作者: Geertje M de Boer.;Laura van Dussen.;Leon M van den Toorn.;Michael A den Bakker.;Rogier A S Hoek.;Dennis A Hesselink.;Carla E M Hollak.;Peter Th W van Hal.
来源: Chest. 2016年149卷1期e1-5页
Gaucher disease (GD), a lysosomal storage disorder, may result in end-stage lung disease. We report successful bilateral lung transplantation in a 49-year-old woman with GD complicated by severe pulmonary hypertension and fibrotic changes in the lungs. Before receiving the lung transplant, the patient was undergoing both enzyme replacement therapy (imiglucerase) and triple pulmonary hypertension treatment (epoprostenol, bosentan, and sildenafil). She had a history of splenectomy, severe bone disease, and renal involvement, all of which were related to GD and considered as relative contraindications for a lung transplantation. In the literature, lung transplantation has been suggested for severe pulmonary involvement in GD but has been reported only once in a child. To our knowledge, until now, no successful procedure has been reported in adults, and no reports deal with the severe potential posttransplantation complications specifically related to GD.
6507. Relationship Between OSA Clinical Phenotypes and CPAP Treatment Outcomes.
作者: Frédéric Gagnadoux.;Marc Le Vaillant.;Audrey Paris.;Thierry Pigeanne.;Laurence Leclair-Visonneau.;Acya Bizieux-Thaminy.;Claire Alizon.;Marie-Pierre Humeau.;Xuan-Lan Nguyen.;Béatrice Rouault.;Wojciech Trzepizur.;Nicole Meslier.; .
来源: Chest. 2016年149卷1期288-90页 6517. Children With Chronic Wet or Productive Cough--Treatment and Investigations: A Systematic Review.
作者: Anne B Chang.;John J Oppenheimer.;Miles Weinberger.;Bruce K Rubin.;Richard S Irwin.
来源: Chest. 2016年149卷1期120-42页
Systematic reviews were conducted to examine two related key questions (KQs) in children with chronic (> 4 weeks' duration) wet or productive cough not related to bronchiectasis: KQ1-How effective are antibiotics in improving the resolution of cough? If so, what antibiotic should be used and for how long? KQ2-When should they be referred for further investigations?
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