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Jornal Brasileiro de Pneumologia :... 2015To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease.
OBJECTIVE
To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease.
METHODS
We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors.
RESULTS
In 8 patients (36.4%), the clinical and tomographic findings were consistent with "crack lung", those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each.
CONCLUSIONS
Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings.
Topics: Adult; Brazil; Cocaine; Cocaine-Related Disorders; Female; Humans; Lung Injury; Male; Middle Aged; Tomography, Spiral Computed; Young Adult
PubMed: 26398752
DOI: 10.1590/S1806-37132015000000025 -
Respirology (Carlton, Vic.) Jul 2018
PubMed: 30011423
DOI: 10.1111/resp.13366 -
Clinical and Applied... Aug 2011Venous thromboembolism (VTE), which includes pulmonary embolism (PE) and deep vein thrombosis (DVT), is a common occurrence in patients undergoing surgery and is a...
Venous thromboembolism (VTE), which includes pulmonary embolism (PE) and deep vein thrombosis (DVT), is a common occurrence in patients undergoing surgery and is a potentially fatal complication. Especially after lung transplantation, vascular complications can compromise the function of the allograft and limit survival. Typically, the risk of pulmonary infarction after PE in lung transplant recipients is high because the absence or poor development of the collateral bronchial circulation may predispose lung transplant recipients to pulmonary infarction. This article reports 2 cases of PE with associated pulmonary infarction after lung transplantation with significant morbidity.
Topics: Female; Humans; Lung Transplantation; Male; Middle Aged; Pulmonary Embolism; Pulmonary Infarction; Risk Factors; Tomography Scanners, X-Ray Computed
PubMed: 20547546
DOI: 10.1177/1076029610371474 -
Internal Medicine (Tokyo, Japan) Jan 2021A 55-year-old man treated with polycythemia vera visited our hospital, complaining of left abdominal pain and dyspnea. He had received minocycline infusions three weeks...
A 55-year-old man treated with polycythemia vera visited our hospital, complaining of left abdominal pain and dyspnea. He had received minocycline infusions three weeks earlier for mycoplasma pneumonia. Contrast-enhanced computed tomography revealed pulmonary embolism and splenic infarction. Ultrasonography of the vein in the forearm revealed a thrombus filling the distal brachial veins to the radial veins on both sides. His condition improved after anticoagulant therapy, and right and left shunts were detected on transesophageal echocardiography. This suggested that thrombus in the forearm may have been the source of the embolism.
Topics: Humans; Male; Middle Aged; Minocycline; Polycythemia Vera; Pulmonary Embolism; Splenic Infarction; Thrombosis
PubMed: 32921692
DOI: 10.2169/internalmedicine.5635-20 -
The Lancet. Respiratory Medicine Jun 2021The emergent 21st century betacoronaviruses, including SARS-CoV-2, lead to clinicopathological manifestations with unusual features, such as early-onset chest pain,... (Review)
Review
The emergent 21st century betacoronaviruses, including SARS-CoV-2, lead to clinicopathological manifestations with unusual features, such as early-onset chest pain, pulmonary infarction, and pulmonary and systemic thromboembolism that is pathologically linked to extensive capillary, arteriolar, and venular thrombosis. Early ground glass opacities detected by CT, which are reminiscent of lung infarcts associated with pulmonary embolism, point to a novel vascular pathology in COVID-19. Under physiological conditions, normal parenchymal oxygenation is maintained by three sources: the alveolus itself and dual oxygen supply from the pulmonary and bronchial artery circulations. We propose a model in which these three components are disrupted in COVID-19 pneumonia, with severe viral alveolitis and concomitant immunothrombotic obstruction of the pulmonary and bronchiolar circulation. Tricompartmental disruption might have two main consequences: systemic clot embolisation from pulmonary vein territory immunothrombosis, and alveolar-capillary barrier disruption with systemic access of thrombogenic viral material. Our model encompasses the known pathological and clinical features of severe COVID-19, and has implications for understanding patient responses to immunomodulatory therapies, which might exert an anti-inflammatory effect within the vascular compartments.
Topics: COVID-19; Humans; Lung; Models, Biological; Oxygen Consumption; Pulmonary Circulation; Pulmonary Embolism; SARS-CoV-2
PubMed: 34000237
DOI: 10.1016/S2213-2600(21)00213-7 -
Pediatrics and Neonatology Mar 2022
Topics: Humans; Mycoplasma; Pulmonary Embolism; Splenic Infarction; Tomography, X-Ray Computed
PubMed: 34742676
DOI: 10.1016/j.pedneo.2021.09.004 -
BMC Infectious Diseases Jul 2019This study aims to investigate the pathogen distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial...
BACKGROUND
This study aims to investigate the pathogen distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection.
METHODS
From August 2015 to December 2017, 172 pathogenic bacterial strains from patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection in our hospital were identified, and the drug sensitivity was analyzed.
RESULTS
Among these 172 strains of pathogenic bacteria, gram negative bacteria was the main cause of pulmonary infection in hospitalized patients with acute cerebral infarction, accounting for 75.6% of all pathogens. Furthermore, 80% of diabetic patients with cerebral infarction had lung infection induced by gram negative bacteria, which was significantly higher than that in non-diabetic patients (72.2%). Moreover, the drug resistance rate in the diabetic group (68.3%) was significantly higher than that in the non-diabetic group (54.3%). Gram positive bacteria accounted for 19.1% of all pathogenic bacteria. The infection rate of gram-positive bacteria in diabetic patients with cerebral infarction was 14.7%, which was lower than that in the non-diabetic group (22.6%). The drug-resistance rate was higher in the diabetic group (45.5%) than in the non-diabetic group (28.2%). Furthermore, the fungal infection rate in patients with lung infection in these two groups was 5.3 and 5.2%, respectively, and fungi presented with high sensitivity to commonly used antifungal agents.
CONCLUSION
In patients with acute cerebral infarction complicated with diabetes mellitus and nosocomial pulmonary infection, the majority of pathogens are multidrug-resistant gram negative bacilli. Pathogen culture should be conducted as soon as possible before using antibiotics, and antimicrobial agents should be reasonably used according to drug sensitivity test results.
Topics: Acute Disease; Anti-Infective Agents; Bacteria; Cerebral Infarction; Cross Infection; Diabetes Complications; Drug Resistance, Microbial; Female; Fungi; Humans; Male; Microbial Sensitivity Tests; Pneumonia
PubMed: 31291896
DOI: 10.1186/s12879-019-4142-9 -
BMC Cardiovascular Disorders Jan 2020Both acute myocardial infarction and acute pulmonary embolism are distinct medical urgencies while they may conincide. Leriche's syndrome is a relatively rare aortoiliac... (Review)
Review
BACKGROUND
Both acute myocardial infarction and acute pulmonary embolism are distinct medical urgencies while they may conincide. Leriche's syndrome is a relatively rare aortoiliac occlusive disease characterized by claudication, decreased femoral pulses, and impotence. We present the first case of concomitant acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome.
CASE PRESENTATION
A 56-year-old male with a history of intermittent claudication was admitted for evaluating the sudden onset of chest pain. Elevated serum troponin level, sustained high D-dimer level, ST-T wave changes on electrocardiogram, and segmental wall motion abnormality of the left ventricle on transthoracic echocardiography were noted. Pulmonary Computed Tomography Angiogram revealed multiple acute emboli. Aortic Computed Tomography Angiogram spotted complete obstructions of the subrenal aorta and bilateral common iliac arteries with collateral circulation, maintaining the vascularization of internal and external iliac arteries. We stated the diagnosis of acute pulmonary embolism and Leriche syndrome and initiated oral anticoagulation. However, Q waves on electrocardiogram and wall motion abnormality on echocardiography persisted after embolus dissolved successfully. Coronary computed tomography angiogram found coronary arterial plaques while myocardial Positron Emission Tomography detected decreased viable myocardium of the left ventricle. We subsequently ratified the diagnosis of concurrent acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome. The patient was discharged and has been followed up at our center.
CONCLUSION
We described the first concurrence of acute pulmonary embolism, acute myocardial infarction, and Leriche syndrome.
Topics: Administration, Oral; Anticoagulants; Humans; Leriche Syndrome; Male; Middle Aged; Myocardial Infarction; Pulmonary Embolism; Treatment Outcome
PubMed: 31952498
DOI: 10.1186/s12872-019-01288-0 -
British Heart Journal Nov 1969
Topics: Anticoagulants; Blood Pressure; Diagnosis, Differential; Electrocardiography; Female; Heart Failure; Heparin; Humans; Male; Myocardial Infarction; Pulmonary Artery; Pulmonary Embolism; Radiography; Radionuclide Imaging; Respiratory Function Tests
PubMed: 5358145
DOI: 10.1136/hrt.31.6.667 -
Proceedings of the Royal Society of... Mar 1964
Topics: Anemia, Sickle Cell; Bicarbonates; Blood Protein Electrophoresis; Cesarean Section; Female; Humans; Infarction; Mesenteric Vascular Occlusion; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Pulmonary Embolism; Splenectomy; Sulfates
PubMed: 14130864
DOI: No ID Found