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Hemoptysis: Clinicians’ Perspectives RESULTS
15 Apr2011
The demographic characteristics of participants and their responses to questions about mild hemoptysis in ambulatory outpatients and life-threatening hemoptysis in critically ill individuals were recorded. Responses were entered on as many as 118 keypads, with a mean±SD of 104 ±9.1 responses per question. Seventy-nine individuals responded to over 80 percent of questions. Data from all respondents are reported. When analysis was limited solely to those who answered more than 80 percent of questions, the relative distributions of answers were similar to those of the entire group.
- In: Main
- Tags: Clinicians' Perspectives, Hemoptysis
Hemoptysis: Clinicians’ Perspectives METHODS
14 Apr2011
Physicians attending an interactive session at the 1988 Annual Scientific Assembly of the ACCP answered a series of questions about the diagnosis and management of patients with hemoptysis. Responses were recorded by computer, and the proportions of answers to multiple-choice questions were tabulated for immediate feedback to the audience. Participants selected a single best answer most consistent with their personal views. In addition to an overall summary, the responses entered from individual data entry keypads could be recorded and related to one another. Thus, with the assumption that each keypad represented the views of a single physician, the approaches of clinicians with particular characteristics could be compared. Read the rest of this entry »
- In: Main
- Tags: Clinicians' Perspectives, Hemoptysis
Hemoptysis: Clinicians’ Perspectives
13 Apr2011
Temoptvsis is a symptom and sign commonly evaluated by chest clinicians. Despite considerable emphasis upon the approaches to this problem and its diverse presentations, several questions remain: the selection of ambulatory patients for bronchoscopy and other diagnostic studies, the optimum approaches to the emergency support of individuals with life-threatening bleeding, and the best applications of increasing technologic resources have all been undefined. Moreover, published guidelines for management of patients with hemoptysis are based predominantly upon retrospective studies, uncontrolled anecdotal observations, and case reports, most of which have originated from tertiary centers. It is unclear how this information is synthesized and applied by the physician who is primarily responsible for care of patients presenting with hemoptysis.
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- Tags: Clinicians' Perspectives, Hemoptysis
Diagnosis: Chondrosarcoma with emboli metastatic to lung
Following the open lung biopsy, a radiologic survey of the lower extremities revealed a small lesion in the right hip which showed the calcification pattern typical of chondrosarcoma. In this patient, invasion of local venous structures, intravascular growth of tumor, and subsequent embolization led to obstruction of a large part of the pulmonary arterial vascular bed by tumor.
- In: Disease
- Tags: Bilateral Pleural
A 55-year-old white woman presented with a two- month history of increasing dyspnea and dry cough. The week prior to admission, the patient noted the onset of pleuritic chest pain without associated fever, chills, sputum production or hemoptysis. She had no significant occupational exposures, travel or smoking history. Five months prior to admission, the patient had noted mild “arthritic” pain in her right hip which had resolved entirely with aspirin therapy, which she had since discontinued.
- In: Disease
- Tags: Bilateral Pleural
We treated all CMV seronegative recipients irrespective of donor serology with anti-CMV immunoglobulins from the day of transplantation. Arguments for this strategy were that the CMV serology of the donor is not always available at the time of transplantation and that CMV unscreened (although bufly coat poor) blood is used during open heart surgery. Moreover, in the majority (65 percent) of the CMV seronegative heart transplant recipients rejections are treated in the first three months after transplantation, and therefore, these patients will become high risk for CMV disease.
- In: Main
- Tags: Cytomegalovirus Seronegative, Heart Transplant
In Table 1, the characteristics of the 77 heart transplant recipients are shown. A total of 41 of 77 (53 percent) patients were CMV seropositive at the time of transplantation. Twenty of the 36 CMV seronegative patients received an allograft from a seropositive donor. One CMV seronegative patient received two allografts, the first from a CMV seronegative and the second from a CMV seropositive donor. Six out of the 77 patients died within 14 days after transplantation because of a noninfectious complication and were excluded from further analysis. In 46 (65 percent) of the remaining patients, at least one antirejection therapy was instituted. Fifteen patients were treated with RATG.
The follow-up in the 71 patients was six to 39 (median 19) months after transplantation. A total number of 221 infusions of anti-CMV immunoglobulin was given in 32 patients. In two patients, during the sixth and seventh infusion respectively, a rash necessitated discontinuation of the globulin treatment. No hemodynamic side-effects were recorded. In the other 30 patients, no side-effects were observed.
- In: Main
- Tags: Cytomegalovirus Seronegative, Heart Transplant