Current opinion in pulmonary medicine
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The demand for expedient diagnosis of suspected obstructive sleep apnea (OSA) has increased due to improved awareness of sleep disorders. Polysomnography (PSG) is the current preferred diagnostic modality but is relatively inconvenient, expensive and inefficient. Portable monitoring has been developed and is widely used in countries outside the United States as an alternative approach. A portable monitor records fewer physiologic variables but is typically unattended and can be performed in the home. ⋯ It is anticipated that portable monitoring as a diagnostic modality for OSA will be used more frequently in the United States following the Centers for Medicare and Medicaid Services ruling. Physicians and others considering the use of portable monitors should thoroughly understand the advantages and limitations of this technology.
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Review Case Reports
Diffuse pulmonary ossification: an unusual interstitial lung disease.
Diffuse pulmonary ossification is a rare disease characterized by diffuse small bone fragments in the lung tissue. It can be idiopathic or associated with underlying chronic pulmonary or heart diseases. The majority of cases had been diagnosed on autopsy. This review collects present knowledge of diffuse pulmonary ossification with the purpose of understanding and considering the entity in the differential diagnosis of interstitial lung diseases better. ⋯ Diffuse pulmonary ossification is still underrecognized during life. Its relevance concerning the increasing age of population and longer survival of patients with chronic diseases is underrated. A timely diagnosis will enable a better understanding of pathogenesis and natural course of disease thus paving the way to new therapeutic strategies.
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To examine recent advancements in the clinical characteristics, treatment and prognosis of diffuse parenchymal disease and pulmonary hypertension due to idiopathic pulmonary fibrosis, scleroderma and sarcoidosis. ⋯ Lung fibrosis by any cause can be a debilitating disease. Not all current medical options are equally effective under randomized-controlled trials. Further studies with novel therapies are needed to control symptoms. The compounding presence of pulmonary hypertension will further limit the patient activity, quality of life and survival. As it has been reviewed, not all pulmonary hypertension-specific agents effectively work in these three subset groups.
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Hypersensitity pneumonitis, caused by inhalation of various antigens, is characterized by interstitial mononuclear cell infiltration, nonnecrotizing granulomas, cellular bronchiolitis, and fibrosis. The pathological picture of chronic hypersensitivity pneumonitis is, however, complicated; it is sometimes difficult to differentiate chronic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis/usual interstitial pneumonia, nonspecific interstitial pneumonia, and connective-tissue-related lung disease. The clinical, radiological, and pathological features of chronic hypersensitivity pneumonitis have recently been described. This study reviews the previously reported information and provides new insights into the pathological features of chronic hypersensitivity pneumonitis. ⋯ The present review focuses on the pathological features of chronic hypersensitivity pneumonitis and presents that centrilobular fibrosis and bridging fibrosis are the important hallmarks of chronic hypersensitivity pneumonitis, even with a usual interstitial pneumonia-like pattern.