[Comment on article “Diagnostic rentability of close pleural biopsy: Tru-cut vs. Cope”].

In this letter to the editor it is discussed the use of Tru-cut needle in pleural biopsy and its profitability for the diagnosis of mesothelioma; it is exposed as well its usefulness, having the appropriate training, to obtain guiding results in obese people.

[Benign recurrent subcutaneous emphysema of the upper limbs in a teenager].

Background: The physiological properties of the interstitial subcutaneous tissue of the limbs could bring the abnormal distribution of air coming from superficial trauma of the skin. We present the case of a young woman who developed subcutaneous emphysema after a superficial trauma and discussed the differential diagnosis and treatment.

Clinical Case: A teenager woman 13 years old had subcutaneous emphysema in the left arm, following the scratch produced by her cat, of two months of evolution, without signs suggestive of local or systemic infection, it was resolved spontaneously during the period of observation.

[Pneumomediastinum associated with hyperemesis gravidarum: a case report].

Background: The hyperemesis gravidarum is a severe illness of nauseas and vomit that is present in the first trimester of the pregnancy, it has an incidence of 0.3 to 2%, it has been associated to weight loss, electrolytic disturbances, ketonuria, dehydration and in very seldom cases spontaneous pneumomediastinum.

Clinical Case: A 21 years old female patient, primigest, in the first trimester of gestation, she started her disease with nauseas and vomiting more than 15 times during 6 hours period, odynophagia, dysphonia and pain in the cervical region, loss of 5 kilograms in the last month.

Acquired Tracheal Diverticulum as an Unexpected Cause of Endotracheal Tube Cuff Leak.

Introduction: Tracheal diverticulum has been associated with problems during endotracheal intubation but there are no reports concerning air leakage around an endotracheal tube (ETT).

Case Report: The case of an elderly woman under mechanical ventilatory support because an exacerbation of chronic obstructive pulmonary disease (COPD) is reported. She presented with an inexplicably air leak around the endotracheal tube not attributed to structural defects.

Immunoadjuvant Therapy and Noninvasive Ventilation for Acute Respiratory Failure in Lung Tuberculosis: A Case Study.

Acute respiratory failure caused by pulmonary tuberculosis is a rare event but with a high mortality even while receiving mechanical ventilatory support. We report the case of a young man with severe pulmonary tuberculosis refractory to conventional therapy who successfully overcame the critical period of his condition using noninvasive ventilation and immunoadjuvant therapy that included three doses of etanercept 25 mg subcutaneously. We conclude that the use of etanercept along with antituberculosis treatment appears to be safe and effective in patients with pulmonary tuberculosis presenting with acute respiratory failure.

Chronic progressive disseminated histoplasmosis in a Mexican cockfighter.

We present illustrative images from a Mexican 58-year-old man who had the occupation of cockfighting from childhood and presented with chronic progressive disseminated histoplasmosis with primarily cutaneous manifestations.

Thoracic empyema due to migrated gallstones.

Hepatobiliary conditions should be considered in the differential diagnosis of right pleural effusion. Here we present the illustrative images of thoracic empyema due to migrated gallstones in a woman who was treated for laparoscopic cholecystectomy one year before. The gallstones were obtained unexpectedly during a thoracentesis with aid of an Abrams needle.

The overused airway: lessons from a young trumpet player.

Young trumpet players are predisposed to certain performance-related health risks. Nevertheless, the published experience with specific disorders is considered confusing and anecdotal. In the context of a review of the literature, we analyze a case report of a young patient who presented with two different disorders typically related to trumpet playing.