The American journal of the medical sciences
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Repeated thoracenteses is indicated in patients with refractory, symptomatic transudative effusions. However, their effect on cytokines and fibrinolytic activity in pleural transudates remains unclear. ⋯ Repeated thoracenteses may induce local release of proinflammatory cytokines, VEGF and PAI-1, which may result in fibrin deposition and impair resolution of pleural transudates.
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Elevated blood lead levels, a risk factor for cardiovascular disease, have been reported among patients with end-stage renal disease. We evaluated whether these higher levels are due to release of lead from the skeleton because of uremic bone disease. Fifty-one African-American patients with end-stage renal disease were recruited from 3 Tulane University dialysis programs between January and July 2005. ⋯ There were no differences in tibia and blood lead across levels of serum calcium, serum phosphorus, and the calcium phosphorus product (all P > 0.40). The high blood lead levels observed among dialysis patients do not appear to be the result of increased bone turnover. The causes of higher blood lead levels for these patients need to be identified and attenuated.
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Review Case Reports
Plasma cell granuloma: a case report of multiple lesions in the lung and review of the literature.
Although plasma cell granuloma is a rare tumor in the lung, it must be considered in the differential diagnosis of lung cancer. It typically presents as a solitary lesion. Involvement with multiple lesions can be a presenting picture of plasma cell granuloma; however, the incidence is much lower than that of a solitary lesion. ⋯ Multiple lung nodules or masses can be a presenting manifestation of plasma cell granuloma. It should be differentiated from metastatic neoplasm. Surgery resection is the treatment of choice.
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Because liver enzymes elevation (LEE) complicates antiretroviral (ARV) therapy, and because the strongest risk factor for ARV-related LEE is HBV/HCV coinfection, it is speculated that ARV-related LEE may be a form of immune reconstitution disease. This study summarizes the relation between immune reconstitution, ARV-induced LEE, and HBV/HCV coinfection. ⋯ A more robust immune restoration was observed among HBV/HCV coinfected subjects who developed liver enzyme elevation after antiretroviral initiation compared with other groups. This finding suggests that ARV-related liver enzyme elevation may be related in part to immune reconstitution, as measured by changes in CD4 T-cell counts.
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A major burden of morbidity and mortality due to respiratory diseases can be directly related to the cardiovascular (CV) complications of these disorders. Evidence from cross-sectional and longitudinal studies link reduced lung function and cardiovascular diseases. However, the underlying pathogenic mechanisms are unclear. ⋯ However, the exact contribution of SDB, including obstructive and central sleep apneas, to the development of cardiovascular diseases is not fully understood. In this context, the contribution of the new large, prospective, Jackson Heart Study could be significant in that it is designed to answer several of these questions, specifically in the African American population. This review examines the current evidence that links both reduced lung function and SDB to CV diseases.