Medicine
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Lung ultrasound has been extensively used to diagnose many types of lung disease. This study aimed to evaluate the pulmonary reasons for long-term oxygen dependence (LTOD) in premature infants using lung ultrasound. Lung ultrasound was routinely performed in 50 premature infants clinically diagnosed with bronchopulmonary dysplasia (BPD). ⋯ The oxygen dependence of the babies either completely resolved or significantly decreased following appropriate treatments. More than one-third of the cases of LTOD in premature babies were caused by either BPD alone or diseases other than BPD. Lung ultrasound plays an important role in differentiating pulmonary causes of LTOD in patients with BPD, and the results of our study suggest that modifying the diagnostic criteria for BPD may be necessary.
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The objective of this study is to estimate the prevalence, treatment, and control of high blood pressure, hypertension (HBP) in Panama and assess its associations with sociodemographic and biologic factors. A cross-sectional, descriptive study was conducted in Panama by administering a survey on cardiovascular risk factors to 3590 adults and measuring their blood pressure 3 times. A single-stage, probabilistic, and randomized sampling strategy with a multivariate stratification was used. ⋯ Of those found to have HBP, 65.6% were aware of having HBP and taking medications, and of these, 47.2% had achieved control (<140/90 mm Hg). HBP is the most common cardiovascular risk factor among Panamanians and consequently an important public health problem in Panama. The health care system needs to give a high priority to HBP prevention programs and integrated care programs aimed at treating HBP, taking into consideration the changes in behavior that have been brought about by alterations in nutrition and sedentary lifestyles.
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Many of the treatment strategies for sigmoid diverticulitis are actually focusing on nonoperative and minimally invasive approaches. The aim of this systematic review was to evaluate the actual role of damage control surgery (DCS) in the treatment of generalized peritonitis caused by perforated sigmoid diverticulitis. A literature search was performed in PubMed and Google Scholar for articles published from 1960 to July 2013. ⋯ Two surgical different approaches were highlighted: limited resection of the diseased colonic segment with or without stoma or reconstruction in situ, and laparoscopic washing and drainage without colonic resection. Despite the heterogeneity of patient groups, clinical settings, and interventions included in this review, DCS appears to be a promising strategy for the treatment of Hinchey III and IV diverticulitis, complicated by septic shock. A tailored approach to each patient seems to be appropriate.
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Multicenter Study
Predictors of mortality in patients with interstitial lung disease treated with corticosteroids: results from a cohort study.
Interstitial lung disease (ILD) has a heterogeneous clinical presentation and establishing prognosis for these patients is challenging. We investigated the clinical characteristics and outcome of patients with idiopathic interstitial pneumonias (IIPs) and patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). We conducted a multicenter prospective study on 104 patients diagnosed with IIPs and 29 patients diagnosed with CTD-ILD, which were newly diagnosed and treated with corticosteroids initially. ⋯ Significant predictors for mortality in patients with IIPs at baseline were lower for performance status and definite usual interstitial pattern (UIP) on HRCT. Patients with UIP experienced worse survival than those with non-UIP. A definite UIP on HRCT and lower baseline performance status have important prognostic implications in patients with IIPs.
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Review Case Reports
Pulmonary tumor thrombotic microangiopathy: report of 3 cases and review of the literature.
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare clinical entity where tumor cell embolisms in pulmonary circulation induce thrombotic microangiopathy (TMA), respiratory failure, and subacute cor pulmonale. We describe 3 cases of PTTM that presented as the initial manifestation of metastatic gastric adenocarcinoma with TMA and pulmonary infiltrates. All 3 cases had similar clinical and laboratory features, which included moderate thrombocytopenia without renal failure, hemolysis with extremely high serum lactate dehydrogenase levels, leukoerythroblastosis in peripheral blood smear, altered coagulation tests, lymphadenopathies, and interstitial pulmonary infiltrates. ⋯ One patient had bone marrow infiltration by malignant cells. Autopsies revealed PTTM associated with gastric disseminated adenocarcinoma (signet-ring cell type in 2 patients and poorly differentiated type in 1). PTTM should be considered in the differential diagnosis of patients with fulminant microangiopathic hemolytic anemia, such as atypical thrombotic thrombocytopenic purpura, mainly those with pulmonary infiltrates, disseminated intravascular coagulation, or Trousseau syndrome.