Internal medicine
-
Rapidly progressive interstitial lung disease (ILD) is associated with dermatomyositis (DM) and has a high mortality rate even with immunosuppressive agents. For such cases, there is no evidence on the combined effect of direct hemoperfusion with a Polymyxin B immobilized fiber column and intravenous immunoglobulin. We herein report a case of 61-year-old woman who presented with respiratory failure. She showed ILD associated with DM which did not improve with immunosuppressive agents, but was improved with the addition of both direct hemoperfusion with a Polymyxin B immobilized fiber column and intravenous immunoglobulin.
-
The Importance of Stabilizing PaCO2 during Long-term Non-invasive Ventilation in Subjects with COPD.
In subjects with chronic obstructive pulmonary disease (COPD), the effect of partial pressure of CO2 (PaCO2) alterations during long-term non-invasive ventilation (NIV) on continuance remains uncertain. We herein investigated the utility of PaCO2 stability during long-term NIV as a prognostic outcome. ⋯ A lower 6 m-PaCO2 and a lower annual alteration of PaCO2 during long-term NIV are significant predictive variables for patients with COPD.
-
Case Reports
Endobronchial ultrasound-guided transbronchial needle aspiration in a patient with pericardial mesothelioma.
Pericardial mesothelioma is a very rare pericardial tumor. Diagnosing pericardial disease can be challenging, and obtaining an antemortem diagnosis of pericardial mesothelioma is particularly difficult. We herein report the case of a 60-year-old man with pericardial mesothelioma diagnosed on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). ⋯ No uptake was noted on (18)F-fluorodeoxy glucose positron emission tomography, other than in the pericardial mass. The results of histological and immunohistochemical examinations indicated the features of malignant mesothelioma. We therefore diagnosed the patient with pericardial mesothelioma, which was subsequently confirmed at autopsy.
-
A 17-year-old teen was hospitalized with bilateral pneumothorax. After the bilateral lungs were expanded using catheter tubes, he fully recovered and he was discharged from our hospital. ⋯ This is the first report of bilateral pneumothorax caused by EDS type IV. Clinicians should consider EDS type IV in the differential diagnosis for bilateral pneumothorax in conjunction with distinct previous histories and radiological findings.
-
This retrospective study evaluated the long-term efficacy of sitagliptin and the factors contributing to its glucose-lowering effect. ⋯ Sitagliptin has a long-term hypoglycemic effect in type 2 diabetes patients. A patient's ΔHbA1c at 3 months may be a predictor of their ΔHbA1c at 24 months.