ABSTRACT
A 73-year-old former smoker with previous occupational exposure to asbestos presented with a pneumothorax that was initially managed by simple aspiration. Despite this, it re-accumulated and a bronchopleural fistula was suspected. A video-assisted thoracoscopic procedure was performed and revealed an abnormally thickened pleura that turned out to be a mesothelioma. All persistent pneumothoraces should be investigated.
Subject(s)
Hydropneumothorax/diagnosis , Hydropneumothorax/prevention & control , Mesothelioma/diagnosis , Pleural Neoplasms/diagnosis , Aged , Asbestos/toxicity , Diagnosis, Differential , Humans , Hydropneumothorax/etiology , Male , Mesothelioma/etiology , Occupational Exposure , Pleural Neoplasms/etiology , Recurrence , Thoracic Surgery, Video-Assisted , Tomography, X-Ray ComputedABSTRACT
The fact that exercise-induced bronchoconstriction (EIB) may be both over- and underdiagnosed in athletes has led to calls for widespread screening for the condition. This article assesses such a strategy by employing the standard framework used when evaluating any screening policy. This approach highlights a number of concerns and allows recommendations to help optimize the success of such a strategy if it were to be implemented.
Subject(s)
Asthma, Exercise-Induced/epidemiology , Asthma, Exercise-Induced/prevention & control , Mass Screening/standards , Sports/standards , Humans , Policy Making , PrevalenceABSTRACT
A 25-year-old pregnant patient developed life-threatening asthma refractory to all standard treatment including anaesthetic agents. Ventilatory pressures continued to rise with impending cardio-respiratory arrest. The introduction of nebulised endotracheal DNase however resulted in a rapid and dramatic improvement with good clinical outcome.
