ABSTRACT
BACKGROUND: Pulmonary artery sarcoma (PAS) is a rare malignant neoplasm with an aggressive behavior and often difficult to distinguish from pulmonary thromboembolic disease. AIM: To assess the demographic, clinical, and radiological characteristics of PAS and clinical course. DESIGN AND METHODS: We retrospectively identified and analyzed all patients with PAS seen at Mayo Clinic in Rochester, Minnesota, between January 1, 1996 and July 31, 2015. RESULTS: Of nine patients (5 women and 4 men; median age 55 years [range, 24-74 years]), eight were diagnosed while alive with surgical ( n = 6) or catheter-based endovascular biopsy ( n = 2); the remaining patient was diagnosed at postmortem examination. All tumors manifested on CT as filling defect in the main, right or left pulmonary artery and were not associated with peripheral filling defects in seven patients. Seven patients were initially treated with anticoagulant therapy for presumed PE; two patients were suspected to have tumor based on constrictive or expanding effect seen on CT. Five patients died after a mean duration of 2.1 years (10 months-4.25 years) after diagnosis. Two patients are alive with recurrence and metastases of the disease 23 and 27 months after diagnosis, respectively; one remaining patient is alive and disease-free 116 months after diagnosis. CONCLUSIONS: Although PAS is associated with a poor prognosis, long-term survival is possible and can be improved by early diagnosis and prompt surgical resection. Atypical appearance on CT including central mass-like lesion without peripheral emboli and constrictive or expanding effect should raise suspicion of PAS.
Subject(s)
Pulmonary Artery/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Sarcoma/diagnostic imaging , Vascular Neoplasms/diagnostic imaging , Adult , Aged , Combined Modality Therapy , Diagnosis, Differential , Endarterectomy , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Sarcoma/therapy , Tomography, X-Ray Computed , Vascular Neoplasms/therapy , Young AdultSubject(s)
Lung Diseases, Interstitial , Lung/pathology , Prednisone/administration & dosage , Sjogren's Syndrome/complications , Anti-Inflammatory Agents/administration & dosage , Biopsy/methods , Diagnosis, Differential , Female , Humans , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/drug therapy , Lung Diseases, Interstitial/etiology , Lung Diseases, Interstitial/pathology , Lung Diseases, Interstitial/physiopathology , Middle Aged , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
BACKGROUND: The association between admission serum magnesium (Mg) levels and risk of acute respiratory failure (ARF) in hospitalised patients is limited. The aim of this study was to assess the risk of developing ARF in all hospitalised patients with various admission Mg levels. METHODS: This is a single-center retrospective study conducted at a tertiary referral hospital. All hospitalised adult patients who had admission Mg available from January to December 2013 were analysed in this study. Admission Mg was categorised based on its distribution into six groups (less than 1.5, 1.5-1.7, 1.7-1.9, 1.9-2.1, 2.1-2.3 and greater than 2.3 mg/dl). The primary outcome was in-hospital ARF occurring after hospital admission. Logistic regression analysis was performed to obtain the odds ratio of ARF of various admission Mg levels using Mg of 1.7-1.9 mg/dl as the reference group. RESULTS: Of 9780 patients enrolled, ARF occurred in 619 patients (6.3%). The lowest incidence of ARF was when serum Mg within 1.7-1.9 mg/dl. A U-shaped curve emerged demonstrating higher incidences of ARF associated with both hypomagnesemia (< 1.7) and hypermagnesemia (> 1.9). After adjusting for potential confounders, both hypomagnesemia (< 1.5 mg/dl) and hypermagnesemia (> 2.3 mg/dl) were associated with an increased risk of developing ARF with odds ratios of 1.69 (95% CI: 1.19-2.36) and 1.40 (95% CI: 1.02-1.91) respectively. CONCLUSION: Both admission hypomagnesemia and hypermagnesemia were associated with an increased risk for in-hospital ARF.
Subject(s)
Magnesium/blood , Respiratory Distress Syndrome/blood , Adult , Aged , Biomarkers/blood , Female , Hospitalization/statistics & numerical data , Humans , Hypercalciuria/complications , Incidence , Male , Middle Aged , Nephrocalcinosis/complications , Odds Ratio , Regression Analysis , Renal Tubular Transport, Inborn Errors/complications , Respiratory Distress Syndrome/epidemiology , Respiratory Distress Syndrome/etiology , Retrospective Studies , Risk Factors , Young AdultABSTRACT
BACKGROUND: The reported risk of depression in patients with hypomagnesaemia is controversial. AIM: The objective of this meta-analysis was to assess the association between depression and hypomagnesaemia. METHODS: A literature search was performed using MEDLINE, EMBASE, Cochrane Database and clinicaltrials.gov from inception through October 2014. Studies that reported odds ratios, relative risks or hazard ratios comparing the risk of depression in patients with hypomagnesaemia were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. RESULTS: Six observational studies (three cohort studies, two cross-sectional studies and a case-control study) with a total of 19,137 patients were identified and included in the data analysis. The pooled RR of depression in patients with hypomagnesaemia was 1.34 (95% CI, 1.01-1.79, I(2) = 33%). The association between depression and hypomagnesaemia was marginally insignificant after the sensitivity analysis including only cohort and case-control studies, with a pooled RR of 1.38 (95% CI, 0.92-2.07, I(2) = 24%). CONCLUSION: Our study demonstrates a potential association between hypomagnesaemia and depression. Further studies assessing the benefits of treatment of hypomagnesaemia in patients with depression are needed.
