The prevalence of pneumothorax in human immunodeficiency virus patients. A single center study.

OBJECTIVES: To assess the prevalence, risk factors, and associated complications of pneumothorax that are present in patients with human immunodeficiency virus (HIV) at our institution and to provide an updated local study addressing the association between pneumothorax and HIV. METHODS: This retrospective cohort study examined 161 patients who were admitted with a diagnosis of HIV from June 2017 to May 2022. They were divided into 2 groups depending on the presence of pneumothorax during their stay. Multiple variables were studied, including age, gender, tuberculosis infection, pneumocystis jiroveci pneumonia (PJP)infection, bacterial pneumonia, and pneumothorax type and treatment course. RESULTS: There were 11 patients diagnosed with pneumothorax (prevalence rate: 6.8%). Bacterial lung infection was found in 9 (81.8%) of these patients, while fungal infection was found in 6 (54.5%) (p<0.001, 0.010). The MTB was found in 3 (27.3%) patients (p=0.728), while none were infected with PJP. Intercostal tube insertion was attempted in 9 (81.8%) patients, the mean duration of tube stay was 39.3±30.7 days, and the mortality rate was 72.7% (p=0.007). CONCLUSION: Pneumothorax in patients with HIV is a manifestation of the progression of the disease and its poor outcome. It has a complicated treatment course and a high mortality rate.

A rare case of carcino-sarcoma of the esophagus with huge intrathoracic metastasis.

Carcinosarcoma of the esophagus constitutes only 0.5%-2.8% of all malignant esophageal cancers. It is identified by the presence of both carcinomatous and sarcomatous components. A clear regimen of treatment has not been established due to the limited understanding of the disease. We present a case of carcinosarcoma of the esophagus with rapid recurrence and invasion to the intrathoracic cavity only 6 weeks after esophagectomy. Carcinosarcoma carries a poor prognosis, as it has a late tendency of hematogenous spread with a high growth rate.

Advanced Diagnostic Technique for Alzheimer's Disease using MRI Top-Ranked Volume and Surface-based Features.

Background: Alzheimer's disease (AD) is the most dominant type of dementia that has not been treated completely yet. Few Alzheimer's patients are correctly diagnosed on time. Therefore, diagnostic tools are needed for better and more efficient diagnoses. Objective: This study aimed to develop an efficient automated method to differentiate Alzheimer's patients from normal elderly and present the essential features with accurate Alzheimer's diagnosis. Material and Methods: In this analytical study, 154 Magnetic Resonance Imaging (MRI) scans were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, preprocessed, and normalized by the head size for extracting features (volume, cortical thickness, Sulci depth, and Gyrification Index Features (GIF). Relief-F algorithm, t-test, and one way-ANOVA were used for feature ranking to obtain the most effective features representing the AD for the classification process. Finally, in the classification step, four classifiers were used with 10 folds cross-validation as follows: Gaussian Support Vector Machine (GSVM), Linear Support Vector Machine (LSVM), Weighted K-Nearest Neighbors (W-KNN), and Decision Tree algorithm. Results: The LSVM classifier and W-KNN produce a testing accuracy of 100% with only seven features. Additionally, GSVM and decision tree produce a testing accuracy of 97.83% and 93.48%, respectively. Conclusion: The proposed system represents an automatic and highly accurate AD detection with a few reliable and effective features and minimum time.

Improving coordination of lung cancer care at a tertiary healthcare center in Saudi Arabia.

OBJECTIVES: To evaluate the impact of coordination of care of lung cancer in a tertiary care center. METHODS: A retrospective study was carried out on all patients diagnosed with lung cancer between 2016-2017 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Data were collected from medical records, which included demographic data, the interval between cancer suspicion and definitive therapy, multidisciplinary tumor board (MTB) data, and palliative care. RESULTS: A total of 60 (41 males and 19 females) cases of lung cancer were analyzed. The majority of patients had adenocarcinoma (63.3%) and stage IV (70%) lung cancer. A total of 32 (76.2%) of stage IV patients were referred to palliative care. Only 40 (66.7%) of the patients were presented in the MTB, of whom new findings were found in 15 (37.5%) patients including pathology findings in 3 (7.5%), radiology findings in 7 (17.5%), and staging data in 5 (12.5%). Multidisciplinary tumor board discussion had impacted the management in 14 (35%) of patients presented. CONCLUSION: Discussion of lung cancer cases in MTB had a positive influence on the coordination of patients' care.

Granular cell tumor of the bronchus: A case report.

INTRODUCTION AND IMPORTANCE: Pulmonary granular cell tumor (GCT) is a very rare neoplasm that originates from Schwann cells. CASE PRESENTATION: Our case report describes a symptomatic benign pulmonary GCT found during follow-up CT imaging and was eventually excised with a good outcome. CLINICAL DISCUSSION: GCT are mostly benign tumors. Pulmonary GCTs mostly occur in the endobronchial region and can be symptomatic or discovered incidentally. CONCLUSION: Treatment options for pulmonary GCT are either conservative treatment or surgical resection depending on the size of the tumor and the presence of tracheal wall invasion.

Spontaneous rupture of trachea treated conservatively: A case report.

INTRODUCTION AND IMPORTANCE: Spontaneous rupture of the trachea is a rare, life-threatening condition. Spontaneous rupture associated with corticosteroid use has been rarely reported in the literature. CASE PRESENTATION: We report a case of a 17-year-old male, a known case of nephrotic syndrome managed by corticosteroid treatment, who presented with diffuse neck and chest swelling after forceful coughing resulting in a spontaneous rupture of the trachea. The diagnosis was established using radiological imaging. The patient was managed conservatively with significant improvement and was discharged shortly. CLINICAL DISCUSSION: Prolonged use of corticosteroids may lead to spontaneous rupture of the trachea due to tracheal wall weakness. Radiological imaging followed by bronchoscopy can be used to confirm the diagnosis. Management can either be conservative or surgical, depending on the case. CONCLUSION: Conservative treatment by pain relief, intravenous fluids, and antibiotics should be considered an alternative to surgery in selected patients.