ABSTRACT
A 26-year-old woman presented with a 15-year history of non-progressive dyspnoea. Chest imaging showed bilateral apical pleural and parenchymal scarring, pleural thickening and bronchiectasis. Pulmonary function tests showed a moderate restrictive defect. Non-invasive workup was non-revealing; therefore, the patient was referred for video-assisted thoracic surgery and lung biopsy. Histopathology revealed pleural thickening and, subpleural parenchymal fibrosis and elastic tissue deposition. Lung parenchyma further away from the pleura was well preserved. Based on these findings, the patient was diagnosed with pleuroparenchymal fibroelastosis (PPFE). Since PPFE is a progressive disorder without effective medical therapies, and given our patient's worsening symptoms, she underwent bilateral lung transplantation. It has been almost 4 years since the lung transplantation, our patient continues to do well. To the best of our knowledge, to date, this is the longest follow-up reported for a PPFE patient undergoing lung transplantation.
Subject(s)
Parenchymal Tissue/pathology , Pleural Diseases/diagnosis , Pulmonary Fibrosis/surgery , Adult , Biopsy , Dyspnea/etiology , Elastic Tissue/pathology , Female , Humans , Lung Transplantation , Parenchymal Tissue/diagnostic imaging , Pleural Diseases/pathology , Pleural Diseases/surgery , Respiratory Function Tests , Thoracic Wall/abnormalities , Thoracic Wall/surgery , Treatment OutcomeABSTRACT
Several studies from the United States and Europe showed that physicians' religiosity is associated with their approach to end-of-life care beliefs. No such studies have focused exclusively on Hindu physicians practicing in the United States. A 34-item questionnaire was sent to 293 Hindu physicians in the United States. Most participants believed that their religious beliefs do not influence their practice of medicine and do not interfere with withdrawal of life support. The US practice of discussing end-of-life issues with the patient, rather than primarily with the family, seems to have been adopted by Hindu physicians practicing in the United States. It is likely that the ethical, cultural, and patient-centered environment of US health care has influenced the practice of end-of-life care by Hindu physicians in this country.
Subject(s)
Hinduism , Physicians/statistics & numerical data , Terminal Care , Adult , Attitude of Health Personnel/ethnology , Culture , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , United StatesSubject(s)
Diuretics/administration & dosage , Furosemide/administration & dosage , Heart Failure/drug therapy , Inpatients , Mannitol/administration & dosage , Aged , Dose-Response Relationship, Drug , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Infusions, Intravenous , Male , Treatment OutcomeABSTRACT
A 25-year-old male, who was a known case of oculocutaneous albinism presented to us with right inguinal swellings of six months' duration. He gave a preceding history of a similar lump in the right thigh, which was excised at the Chennai Government Hospital. He was diagnosed to have oculocutaneous albinism with actinic keratoses, with multiple squamous cell carcinomas (with metastatic deposits in the right inguinal region) and cutaneous horns. The case is reported to highlight preventive aspects in the management of albinos.
