ABSTRACT
Ultrasound is increasingly being used in examination of the thorax. The sonographic features of normal aerated lung, abnormal lung, pneumothorax, and intrapleural fluid have been published. The sonographic features of uncommon intrathoracic syndromes are less known. Hydropneumothorax is an uncommon process in which the thoracic cavity contains both intrapleural air and water. Few published examples of the sonographic findings in hydropneumothorax exist. We present 3 illustrative cases of the sonographic features of hydropneumothorax with comparative imaging and a literature review of the topic.
Subject(s)
Hydropneumothorax/diagnostic imaging , Lung/diagnostic imaging , Ultrasonography/methods , Aged , Female , Humans , Middle AgedABSTRACT
Non-small-cell lung cancer (NSCLC) is a growing concern worldwide, and its incidence continues to increase in developing countries. It has a strong association with smoking. Lung cancer remains the leading cause of cancer-related deaths in most industrialized countries and in the United States. In the last 10 years, there have been significant advancements in the understanding of molecular oncogenes and how they play a role in driving lung cancer to both grow and metastasize. Understanding this rapidly expanding field has the potential to extend life, and it is an important field for all providers to conceptualize if they are treating patients with lung cancer. Currently, > 50% of all NSCLC is linked to 1 of several known genetic driver mutations. Using online databases, expert opinion, and practice-changing trials, we review the current standards of molecular testing of NSCLC and the expanding evidence of oncogenic drivers in nonsquamous NSCLC.
Subject(s)
Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Molecular Targeted Therapy , Proto-Oncogenes/drug effects , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/drug therapy , Adenocarcinoma/genetics , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/genetics , ErbB Receptors/genetics , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/genetics , Proto-Oncogene Proteins/drug effects , Proto-Oncogene Proteins/genetics , Proto-Oncogene Proteins B-raf/drug effects , Proto-Oncogene Proteins B-raf/genetics , Proto-Oncogene Proteins c-met/drug effects , Proto-Oncogene Proteins c-met/genetics , Proto-Oncogene Proteins c-ret/drug effects , Proto-Oncogene Proteins c-ret/genetics , Proto-Oncogene Proteins p21(ras) , Proto-Oncogenes/genetics , Tomography, X-Ray Computed , ras Proteins/drug effects , ras Proteins/geneticsABSTRACT
Tachycardia induced cardiomyopathy is a potentially lethal cause of heart failure generally because of atrial tachycardia and less frequently ventricular tachycardia. We present two cases of Marines with severe traumatic blast injuries secondary to improvised explosive device attacks whose hospital courses included amputation, massive blood transfusions, and multiple surgeries. Both patients had prolonged sinus tachycardia averaging >110 beats per minute and developed depressed left ventricular function, which recovered when treated with ß blockers. Sinus tachycardia is often considered a physiological response to stress, and the purpose of this manuscript is to describe the cardiac injury apparently related to a prolonged stress response. In addition, the literature does not clearly recommend controlling heart rates in trauma patients with persistent sinus tachycardia, but it is a therapeutic option that should be considered by providers.
Subject(s)
Blast Injuries/complications , Blast Injuries/therapy , Cardiomyopathies/etiology , Tachycardia, Sinus/etiology , Adrenergic beta-Antagonists/therapeutic use , Adult , Cardiomyopathies/drug therapy , Echocardiography , Humans , Male , Military Personnel , Multiple Trauma , Stroke Volume , Tachycardia, Sinus/drug therapyABSTRACT
Combat medical care provides unique challenges and opportunities for military medical teams. The austerity of the environment severely limits access to many diagnostic and therapeutic tools. Because of their compact size, handheld ultrasound (US) machines are increasingly being used in these constrained environments. A growing body of literature documents the diagnostic utility of handheld US for trauma encountered in the battlefield. Furthermore, US guidance may assist in the performance of some procedures performed in battlefield medical care. This review will provide an overview of the history, current status, limitations and potential future of US utility for the battlefield.
Subject(s)
Military Medicine , Point-of-Care Systems , Traumatology/instrumentation , Ultrasonography/instrumentation , Wounds and Injuries/diagnostic imaging , HumansABSTRACT
Lung disease in advanced stages is often accompanied by multiple comorbidities. Often, these processes lead to significant morbidity and occasionally mortality. Symptoms of pulmonary comorbidities, including pulmonary embolus, pulmonary hypertension, sleep-disordered breathing, and lung malignancy, may be intertwined with symptoms of advancing lung disease. However, the occurrence of extrapulmonary processes, including depression, diabetes mellitus, osteoporosis, and gastroesophageal reflux disease, may be subtle. Clinicians caring for advanced lung disease should be aware of the many comorbid processes that may accompany advancing lung disease.
