Increased muscle enzyme activity after yoga breathing during an exacerbation of asthma.

The case is reported of a yoga practitioner who, during an exacerbation of asthma, developed a substantial increase in serum muscle enzymes. This was related to his yoga breathing exercises, which he used to enhance the delivery of aerosolised bronchodilators. As his condition improved and the use of these yoga manoeuvres diminished, the muscle enzyme levels fell to normal.

Occult mucous airway obstruction in diabetic ketoacidosis.

Four patients with diabetes mellitus and no underlying clinical pulmonary disease were found to have extensive unilateral mucous occlusion of a major central bronchus. None of the patients had significant auscultatory findings suggestive of pulmonary secretions, and chest roentgenographic films were normal. Arterial blood gas evaluation failed to reveal the usual hypocapnia during ketoacidosis, thus prompting bronchoscopic examination or deep airway suctioning. These interventions disclosed and resolved the mucous obstruction of the compromised bronchus. Antibiotic therapy, based upon bronchial secretion Gram stain and culture, was successfully instituted in all patients. Lethargy and autonomic neuropathy are proposed as contributing factors responsible for occult mucous plugging in diabetic patients in ketoacidosis. The absence of hypocapnia in this setting may be the only clue to silent mucous plugging of airways.

Moxalactam disodium-induced pulmonary hemorrhage.

Fatal pulmonary hemorrhage occurred on the eighth day of moxalactam therapy. No other pharmacologic agent or obvious cause could be attributed to the hemoptysis. Moxalactam-induced pulmonary hemorrhage should be included in the differential diagnosis of an infiltrate when moxalactam is being administered.