Evaluation of the Acid-Base Status in Patients Admitted to the ICU Due to Severe COVID-19: Physicochemical versus Traditional Approaches.

Background: Stewart's approach is known to have better diagnostic accuracy for the identification of metabolic acid-base disturbances compared to traditional methods based either on plasma bicarbonate concentration ([HCO]) and anion gap (AG) or on base excess/deficit (BE). This study aimed to identify metabolic acid-base disorders using either Stewart's or traditional approaches in critically ill COVID-19 patients admitted to the ICU, to recognize potential hidden acid-base metabolic abnormalities and to assess the prognostic value of these abnormalities for patient outcome.

Methods: This was a single-center retrospective study, in which we collected data from patients with severe COVID-19 admitted to the ICU.

From Karl Wurm and Guy Scadding's staging to F-FDG PET/CT scan phenotyping and far beyond: perspective in the evading history of phenotyping in sarcoidosis.

Sarcoidosis is an inflammatory granulomatous disease of unknown etiology involving any organ or tissue along with any combination of active sites, even the most silent ones clinically. The unpredictable nature of the sites involved in sarcoidosis dictates the highly variable natural history of the disease and the necessity to cluster cases at diagnosis based on clinical and/or imaging common characteristics in an attempt to classify patients based on their more homogeneous phenotypes, possibly with similar clinical behavior, prognosis, outcome, and therefore with therapeutic requirements. In the course of the disease's history, this attempt relates to the availability of a means of detection of the sites involved, from the Karl Wurm and Guy Scadding's chest x-ray staging through the ACCESS, the WASOG Sarcoidosis Organ Assessment Instruments, and the GenPhenReSa study to the F-FDG PET/CT scan phenotyping and far beyond to new technologies and/or the current "omics.

COVID-19 in patients with pulmonary alveolar proteinosis: a European multicentre study.

https://bit.ly/3M0wKnZ.

Vedolizumab-induced acute interstitial lung injury in a 39-year-old male with ulcerative colitis.

Vedolizumab, an anti-integrin antibody, is effective for moderate to severe ulcerative colitis and Crohn's disease treatment with a good safety profile due to its gut selective mechanism of action. Upper respiratory tract vedolizumab adverse events are common; however, they are mild and do not require treatment withdrawal. Herein, we present a 39-year-old patient under vedolizumab treatment for ulcerative colitis who presented acute severe interstitial lung injury that necessitated vedolizumab withdrawal and systemic steroids administration.

Inspiratory effort and breathing pattern change in response to varying the assist level: A physiological study.

Aim: To describe the response of breathing pattern and inspiratory effort upon changes in assist level and to assesss if changes in respiratory rate may indicate changes in respiratory muscle effort.

Methods: Prospective study of 82 patients ventilated on proportional assist ventilation (PAV+). At three levels of assist (20 %-50 %-80 %), patients' inspiratory effort and breathing pattern were evaluated using a validated prototype monitor.

Patient-Ventilator Dyssynchrony.

In mechanically ventilated patients, assisted mechanical ventilation (MV) is employed early, following the acute phase of critical illness, in order to eliminate the detrimental effects of controlled MV, most notably the development of ventilator-induced diaphragmatic dysfunction. Nevertheless, the benefits of assisted MV are often counteracted by the development of patient-ventilator dyssynchrony. Patient-ventilator dyssynchrony occurs when either the initiation and/or termination of mechanical breath is not in time agreement with the initiation and termination of neural inspiration, respectively, or if the magnitude of mechanical assist does not respond to the patient's respiratory demand.

Paraneoplastic nephritic syndrome and concurrent solitary mediastinal lymph node metastasis from mesothelioma of testis diagnosed by endobronchial ultrasound: Unusual manifestations of an extremely rare tumor.

Malignant mesothelioma is most commonly found in the pleura, peritoneum and pericardium, whereas mesothelioma of the tunica vaginalis testis is exceedingly rare. The usual sites of metastasis are inguinal nodes, retroperitoneal lymph nodes and lung. Herein, we describe a patient with mesothelioma of testis, who presented with paraneoplastic glomerulopathy and asymptomatic solitary mediastinal lymphadenopathy on serial computed tomography imaging after radical orchiectomy.

Bronchoscopic drainage of a malignant lung abscess.

Bronchoscopic drainage of a pyogenic lung abscess is an established therapeutic approach in selected patients in whom conventional antibiotic therapy fails. This intervention has also been undertaken in patients with abscess owing to underlying lung cancer and prior combined radiochemotherapy. However, this procedure has rarely been performed in cavitary lesions of advanced tumor origin before initiating any chemotherapy/radiotherapy scheme.

Evaluation of acid-base status in patients admitted to ED-physicochemical vs traditional approaches.

Background: The aim of this study is to evaluate the value of physicochemical, base excess (BE), and plasma bicarbonate concentration ([HCO3(-)]) approaches on the assessment of acid-base status in patients presented to the emergency department (ED).

Methods: Upon presentation at ED, patients whose arterial blood was deemed in need of analysis were studied. Arterial blood gases, serum electrolytes, and proteins were measured and used to derive [HCO3(-)], BE, anion gap (AG), AG adjusted for albumin (AGadj), strong ion difference, strong ion gap (SIG) and SIG corrected for water excess/deficit (SIGcor).

Unilateral primary lung hypoplasia diagnosed in adulthood.

Unilateral primary pulmonary hypoplasia is rare in adulthood. It is usually present in the neonatal period or in early childhood, and is characterized by a decreased number of bronchial segments and decreased/absent alveolar air space. Most patients have recurrent episodes of wheezing or pneumonia and severe respiratory distress leading to chronic respiratory failure, whereas some patients may occasionally be asymptomatic.