Chest
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Sarcoidosis staging primarily has relied on the Scadding chest radiographic system, although chest CT imaging is finding increased clinical use. ⋯ In this study, CT scan features explained additional variability in lung function beyond Scadding stage, with some CT scan features obviating the associations between lung function and Scadding stage. Whether CT scan features, phenotypes, or endotypes could be useful for treating patients with sarcoidosis needs more study.
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Sepsis is common and expensive, and evidence suggests that sepsis order sets may help to improve care. Very incomplete evidence exists regarding the effects of sepsis order sets on the value of care produced by hospitals or the societal costs of sepsis care. ⋯ Receipt of the sepsis order set was associated with improved value of care, from both a hospital and societal perspective.
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A 53-year-old man was admitted with complaints of recurrent cough, mucopurulent phlegm, and fever for 10 days. These symptoms started in his youth, and he had experienced three or more acute attacks per year in the past 3 years. Persistent nasal obstruction was noticed. ⋯ The patient was married for 30 years and had a son. He had never used tobacco products or alcohol. A family history indicated that his parents were consanguineously married, and one of his sisters died of bronchiectasis coinfection.
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Case Reports
A 54-Year-Old Man With High-Grade Fever, Cough, Dyspnea, and Vesiculobullous Skin Eruptions.
A 54-year-old Egyptian man with a 5-day history of worsening cough, high-grade fever, and progressive dyspnea was referred to our hospital. A 3-day course of ceftriaxone provided in an outpatient setting showed no clinical improvement. Medical history was unremarkable, except for bilateral pulmonary embolism diagnosed 3 years earlier. ⋯ Five weeks before the actual presentation, he had traveled to Egypt. One of his children showed symptoms of a respiratory infection approximately 2 weeks before that. His only regular medication was rivaroxaban.
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A 52-year-old woman with a history of leiomyoma uteri and tobacco-use disorder in remission presented with 2 months of progressive back pain. Her pain was located between her shoulder blades and was described as constant with intermittent sharp, stabbing sensation. It was nonradiating and aggravated by inspiration. ⋯ She underwent a total hysterectomy 13 years ago for benign uterine fibroid tumors. She had a 15-pack-year history but quit smoking 3 years ago. Family history was notable for colon and pancreatic cancer in her father and breast cancer in her maternal aunt.