Chest
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Comment Letter Meta Analysis
Meta-analysis of Frequency-to-Tidal Volume Ratio: Conflating Extubatability With Weanability.
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An 87-year-old woman with a medical history of stroke, paroxysmal atrial fibrillation, type 2 diabetes mellitus, diastolic heart failure, and chronic bilateral lymphedema presents with 1 week of shortness of breath. The patient had a 20-pack-year smoking history and at baseline was able to ambulate freely without assistance. Her symptoms of dyspnea were mostly exertional and progressively worsening for 1 week before admission, despite compliance with her home furosemide. ⋯ On physical examination, the patient was tachypneic at rest, and auscultation of the lungs revealed minimal breath sounds on the left side. Admission laboratory test results were notable for leukocyte count of 11.67 × 109/L (82.2% neutrophils, 8.3% monocytes, 6.4% lymphocytes, and 2.1% eosinophils). Results of HIV screening tests were negative.
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A 30-year-old man presents with dry cough and dyspnea on exertion (modified Medical Research Council dyspnea scale of 3), with progressive worsening over several months. He denies other respiratory or cardiac symptoms such as wheezing, hemoptysis, thoracalgia, palpitations, or leg swelling. ⋯ He had no personal history of respiratory diseases or TB. Relevant family history included an aunt with nonspecified interstitial lung disease and lung transplant.