Respiratory care
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Benign metastasizing leiomyoma (BML) was initially used to describe single or multiple pulmonary nodules composed of proliferating smooth muscle cells (lacking cellular atypia) in premenopausal females 3 months to 20 y after hysterectomy for uterine leiomyoma. The lung is the most commonly involved site, thus including many malignant and benign entities in the differential diagnosis. The present case refers to a 47-y-old premenopausal woman with a history of subtotal hysterectomy for a uterine leiomyoma presenting with bilateral cavitating pulmonary nodules. ⋯ The histological findings in correlation with the immunohistochemical results were consistent with the diagnosis of BML. A bilateral salpingo-oophorectomy was performed, combined with complete removal of the remaining cervix. One year later, the subject remains asymptomatic, and the pulmonary nodules are stable with regard to number, size, location, and morphology.
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Comparative Study Controlled Clinical Trial
Testing a novel method for measuring sleeping metabolic rate in neonates.
Sleeping metabolic rate (SMR) is used as a proxy for basal metabolic rate in infants, when measurement while awake is not practical. Measuring SMR via indirect calorimetry (IC) can be useful for assessing feeding adequacy especially in compromised neonates. Standard IC equipment, including a hood placed over the head, is not designed for the smallest of patients. Our aim was to determine whether a nonstandard smaller hood measures SMR in neonates similarly compared with a standard large hood. ⋯ SMR measured with a small hood yields results similar to those measured with a large hood in healthy neonates without affecting testing time or other aspects of the IC procedure. Furthermore, results in compromised infants suggest that a smaller hood may facilitate SMR testing in this population.
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Comparative Study Controlled Clinical Trial
Comparison of usual and alternative methods to measure height in mechanically ventilated patients: potential impact on protective ventilation.
Protective ventilation implementation requires the calculation of predicted body weight (PBW), determined by a formula based on gender and height. Consequently, height inaccuracy may be a limiting factor to correctly set tidal volumes. The objective of this study was to evaluate the accuracy of different methods in measuring heights in mechanically ventilated patients. ⋯ Our results demonstrate that significant variability exists between the different methods used to measure height in bedridden patients on mechanical ventilation. Alternative methods based on lower leg and forearm measurements are potentially interesting solutions to facilitate the accurate application of protective ventilation.