Chest
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Critical Care Case Report PostersSESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Hashimoto's encephalopathy (HE) is a rare neuropsychiatric syndrome which has been controversial due to its unknown pathogenesis and variable clinical course. It is defined by signs of encephalopathy with high thyroid antibody levels demonstrating good responsiveness to glucocorticoid therapy. We report a case of initially steroid responsive HE which became resistant, but responded well to plasmapheresis. ⋯ This case illustrates that although HE is a rare syndrome, it should be considered in patients presenting with acute encephalopathy or in patients with psychosis with an intermittent course. If steroid resistance is noted, plasmapheresis should be considered. Because the symptoms often respond to treatment, prompt diagnosis and treatment are imperative.Reference #1: Lord et al. Hashimoto's disease and encephalopathy. Lancet 1966; 2:512-514DISCLOSURE: The following authors have nothing to disclose: Anita Rajagopal, John LuciaNo Product/Research Disclosure Information.
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Critical CareSESSION TYPE: Slide PresentationsPRESENTED ON: Monday, March 24, 2014 at 10:45 AM - 11:45 AMPURPOSE: Arterial blood gases are routinely obtained to monitor adequacy of oxygenation, ventilation , and acid-base status in patients undergoing mechanical ventilation. A novel respiratory index, the Integrated Pulmonary Index, (IPI™), was developed to provide a simple and accurate tool to assess respiratory status and to assist in determining if an intervention is necessary. Through a mathematical algorithm that integrates respiratory rate (RR), end-tidal CO2 (etCO2), pulse rate (PR), and pulse oxygen saturation (SpO2), the IPI is continuously displayed as a number between 1 and 10, where 8 to 10 indicates a normal overall respiratory status, 5 to 7 indicates needs for assessment and possible intervention, and 1 to 4 calls for prompt intervention. Although IPI has been shown to correlate well with respiratory status in adults and children undergoing procedural sedation, it has not yet been correlated with arterial blood gas parameters obtained in the intensive care unit (ICU). This study evaluated the clinical correlation between the IPI and results from arterial blood gases routinely obtained in the ICU. ⋯ Ruben Restrepo: Grant monies (from industry related sources): Received funding from Covidien to complete this investigator-initiated project The following authors have nothing to disclose: Adil AlotaibiAlthough the equipment used for monitoring capnography and pulse oximetry (Capnostream), the IPI is still under investigation for vaildation as a pulmonary index.
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Cancer Case Report Posters ISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Bronchioloalveolar carcinoma is a subtype of adenocarcinoma characterized by peripheral location, good histological differentiation, lepidic growth pattern and potential for aerogenous and lymphatic dissemination. We report the case of a patient with a diffuse variant of bronchioloalveolar carcinoma (BAC) which is confused with interstitial conditions such as hypersensitivity pneumonitis, atypical pneumonia, idiopathic interstitial pneumonitis or respiratory bronchiolitis. ⋯ The variable characteristics of bronchioloalveolar carcinoma and its diffuse presentation make confusion with a number of diseases probable, including interstitial lung diseases. Therefore we consider it advisable to obtain histopathological confirmation in those patients with atypical presentations or slow progression, and to consider bronchioloalveolar carcinoma as a diagnostic alternativeReference #1: Howar J West. Bronchioloalveolar carcinoma, including adenocarcinoma in situ. Wolters Kluwer Health. Up to date Review Juny 2013Reference #2: American thoracic society/european respiratory society international multidiciplinary classification of lung adenocarcinoma. Jthorac Oncol 2011; 6:244Reference #3: H. Bronchioloalveolar carcinoma masquerading as pneumonia. Respir Care 2004; 49:1349DISCLOSURE: The following authors have nothing to disclose: Julián Ceballos Gutiérrez, Juan Cruz Rueda, Cintia Merinas López, Ana Dolores Romero OrtizNo Product/Research Disclosure Information.
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Sleep PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Obstructive Sleep Apnea (OSA) diagnosis by using simplied methods such as home respiratory polygraphy (HRP) are only recommended in patients with a high pre-test probability. At present patients without high pretest probability or with co-morbidity are even more prevalent and other diagnosis approaches than to polysomnography (PSG) are needed. Three consecutive HRP may be useful. ⋯ The following authors have nothing to disclose: Arnoldo Guerrero, Juan F. Masa, Cristina Embid, Jose M. MontserratNo Product/Research Disclosure Information.
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ILD Case Report Posters IISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Lymphomatoid granulomatosis is a rare lymphoproliferative angio destructive disease associated systemic Epstein-Barr virus infection, characterized by predominant pulmonary involvement and extrapulmonary too, with uncertain malignant potential. ⋯ This disease is usually progressive and fatal. The mortality rate varies from 63-90% at 5 years, however the clinical course is variable reported prolonged disease and spontaneous resolutionReference #1: Lymphocytic interstitial pneumonia and other lymphoproliferative Disorders in the long run. Nicholson AG Semin Respir Crit Care Med. 2001 22 (4): 409)DISCLOSURE: The following authors have nothing to disclose: Alina Pirvu, Claudia Toma, Ionela Belaconi, Miron Alexandru BogdanNo Product/Research Disclosure Information.