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461. The Association Between Air Pollution and Lung Function in Sarcoidosis and Implications for Health Disparities.
作者: Ali M Mustafa.;Kevin J Psoter.;Kirsten Koehler.;Nancy Lin.;Meredith McCormack.;Edward Chen.;Robert A Wise.;Michelle Sharp.
来源: Chest. 2025年167卷2期507-517页
Sarcoidosis is a granulomatous disease with varying courses of disease progression. Environmental exposures are thought to be contributors to disease onset. Exposure to air pollutants such as fine particulate matter of 2.5 μm diameter or smaller (PM2.5) and nitrogen dioxide (NO2) have been identified as contributors to health disparities in lung diseases; little is known about these environmental exposures' associations with disease outcomes in sarcoidosis.
462. Implications of Global Lung Function Initiative Spirometry Reference Equations in Northeast Asian Patients With COPD.
作者: Joon Young Choi.;Chang-Hoon Lee.;Hyonsoo Joo.;Yun Su Sim.;Jaechun Lee.;Hyun Lee.;Kwang Ha Yoo.;Seoung Ju Park.;Ju Ock Na.;Yet Hong Khor.
来源: Chest. 2025年167卷2期414-424页
Accurate spirometry interpretation is critical in the diagnosis and management of COPD. With increasing efforts for a unified approach by the Global Lung Function Initiative (GLI), this study evaluated the application of race-specific 2012 GLI and race-neutral 2022 GLI reference equations compared with Choi's reference equations, which are derived and widely used in South Korea, for spirometry interpretation in Northeast Asian patients with COPD.
468. A 70-Year-Old Man With an Encapsulated Mediastinal Fluid Collection.
A 70-year-old man was diagnosed with mid-thoracic esophageal squamous cell carcinoma (distance from incisors, 27-30 cm) because of progressive dysphagia and underwent thoracic laparoscopic esophagectomy at a local hospital. He was transferred from the ICU 4 days after surgery; however, a large amount of purulent fluid exuded from the neck incision after oral drinking, which was consistent with cervical anastomotic leakage. Later, the patient experienced difficulty breathing and expelling sputum; he was then transferred back to the ICU for treatment. A CT scan showed massive fluid collection in the mediastinum and left pleural cavity. Thoracentesis yielded yellowish fluid, and the patient's general condition gradually improved after placement of a closed chest drainage system. The patient's cervical anastomotic fistula persisted and did not heal, and he was subsequently transferred to our medical center with the closed chest drainage system left in place.
469. A 76-Year-Old-Man With Dyspnea and Abnormal Oximetry Run.
作者: Veronica Williams.;Franck F Rahaghi.;Ian R Drexler.;Lewjain Sakr.
来源: Chest. 2024年166卷3期e83-e87页
A 76-year-old male Vietnam veteran with a medical history of OSA on CPAP, mild COPD, Parsonage-Turner syndrome (a rare neurologic syndrome manifesting with shoulder and arm pain), hypertension, gastroesophageal reflux, hiatal hernia, and prior endocarditis presented with 1 year duration progressive exertional dyspnea with minimal activity by referral from an outside pulmonologist. The patient reported possible exposure to Agent Orange during his service but was otherwise without significant occupational or environmental exposures. His exercise tolerance was well-maintained up until the last 12 months. Aside from marginal cigarette use, he denied any recreational drug use or any anorectic use. The patient provided records from a recent right heart catheterization (RHC) months earlier for review.
470. Syncope in an Otherwise Healthy 74-Year-Old Woman.
作者: Zein Kattih.;Mateus Fernandes.;Miguel A Alvarez Villela.;Stephen Machnicki.;Erica Altschul.
来源: Chest. 2024年166卷3期e79-e82页
A 74-year-old woman with a history of hypertension and peripheral artery disease and a reported diagnosis of sarcoidosis presents for an episode of syncope and shortness of breath. She had a history of sarcoidosis diagnosed on chest radiography that showed lymphadenopathy. There were no associated symptoms, and she was not previously treated for sarcoidosis. She previously smoked and had quit smoking 9 years earlier.
471. Chylothorax in a Young Woman With Crohn Disease.
Chylothorax, which accounts for 1% to 3% of pleural effusions, typically results from either surgery (traumatic) or underlying malignancy (nontraumatic). Less common causes of nontraumatic chylothorax are numerous and include congenital lymphatic abnormalities, connective tissue diseases, cirrhosis, and infection, among others.1 We describe what appears to be the first reported case of chylothorax caused by chylous ascites in Crohn disease. This case highlights the importance of using diagnostic evidence to link new symptoms to preexisting diseases whenever possible, as well as the systemic nature of Crohn disease.
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