Hereditary Amyloidosis with Recurrent Lung Infiltrates.

BACKGROUND Amyloidosis is a protein conformational disorder characterized by extracellular deposition of amyloid fibrils in extracellular tissue. Lung involvement is most commonly caused by secondary AL amyloidosis. The familial autosomal-dominant senile transthyretin (ATTR) disease manifests mainly as polyneuropathy and restrictive cardiomyopathy denoting the name familial amyloidotic polyneuropathy (FAP).

Efficacy and adverse effects of drugs used to treat adult cystic fibrosis.

Introduction: Cystic fibrosis (CF) is an autosomal recessive disease and is the most commonly seen monogenetic disease in Caucasians. The disease has various manifestations resulting from the abnormal thick secretions, most common being chronic lung infection and airway obstruction. Many new promising drugs have appeared on the horizon over the years.

Chlorhexidine bathing to reduce central venous catheter-associated bloodstream infection: impact and sustainability.

Background: Chlorhexidine bathing has been associated with reductions in healthcare-associated bloodstream infection. To determine the impact and sustainability of the effect of chlorhexidine bathing on central venous catheter-associated bloodstream infection, we performed a prospective, 3-phase, multiple-hospital study.

Methods: In the medical intensive care unit and the respiratory care unit of a tertiary care hospital and the medical-surgical intensive care units of 4 community hospitals, rates of central venous catheter-associated bloodstream infection were collected prospectively for each period.

Cardiac sarcoidosis: a comprehensive review.

Sarcoidosis is a multisystem granulomatous disease of unknown etiology characterized by noncaseating granulomas in involved organs. Organs involved with sarcoidosis include lymph nodes, skin, lung, central nervous system, and eye. Only 40-50% of patients with cardiac sarcoidosis diagnosed at autopsy have the diagnosis made during their lifetime.

Lung cancer: the importance of early intervention.

Lung cancer is the leading cause of cancer death in the United States. Fifteen percent of patients are asymptomatic at diagnosis. Symptoms usually indicate advanced disease.

Association of lung volumes with nocturnal oxygen saturation in obese persons: a possible role for therapeutic continuous positive airway pressure.

We investigated the association among obesity, nocturnal oxygen saturation, and pulmonary function in 31 obese women and 17 obese men scheduled for bariatric surgery who underwent nocturnal polysomnography and pulmonary function testing. Pearson correlation coefficients showed a significant association between expiratory reserve volume percent and average oxygen saturation (P = 0.027), between body mass index and lowest oxygen saturation (P = 0.

Hyponatremia and cerebrovascular spasm in aneurysmal subarachnoid hemorrhage.

Background: Hyponatremia develops in approximately a third of patients with aneurysmal subarachnoid hemorrhage (SAH). Studies have been conflicting about the association between hyponatremia and cerebrovascular spasm (CVS).

Aims: To investigate whether hyponatremia can signal the onset of CVS.

Prediction of moderate or severe pulmonary hypertension by main pulmonary artery diameter and main pulmonary artery diameter/ascending aorta diameter in pulmonary embolism.

We investigated the accuracy of computed tomographic measurements of main pulmonary artery diameter (MPAD) and of MPAD/ascending aorta diameter (AAD) in predicting moderate or severe pulmonary hypertension in 190 patients with acute pulmonary embolism. A pulmonary artery systolic pressure of > or = 50 mm Hg measured by Doppler echocardiography was considered moderate or severe pulmonary hypertension. A MPAD of > 28.

Prevalence of left ventricular hypertrophy in persons with and without obstructive sleep apnea.

We investigated the prevalence of left ventricular hypertrophy (LVH) in persons with and without obstructive sleep apnea (OSA). Fifty-three persons had a nocturnal polysomnogram to diagnose OSA and 2-dimensional echocardiograms to measure left ventricular mass. OSA was considered mild if the respiratory disturbance index (RDI) was 5 to 15, moderate if the RDI was 15 to 30, and severe if the RDI was >30.

Association of reduced carbon monoxide diffusing capacity with moderate or severe left ventricular diastolic dysfunction in obese persons.

Study Objectives: To determine the association of reduced diffusing capacity of the lung for carbon monoxide (D(LCO)) with moderate or severe left ventricular diastolic dysfunction (LVDD) in obese persons.

Design: We investigated the association of D(LCO) with LVDD in 105 patients with a mean +/- SD body mass index of 49 +/- 5 kg/m2. An abnormal D(LCO) was < 80%.

Efficacy of unfractionated heparin for thromboembolism prophylaxis in medical patients.

A common mode of deep vein thrombosis prophylaxis in medical inpatients is unfractionated heparin 5000 U subcutaneously (s.q.) twice daily.

Role of the 12-lead electrocardiogram in diagnosing pulmonary embolism.

We investigated the role of the standard 12-lead electrocardiogram (ECG) to improve the pretest probability of pulmonary embolism before performing computed tomographic (CT) pulmonary angiography. A retrospective chart analysis was performed on patients who underwent CT pulmonary angiography at a tertiary care hospital during a 30-month period. Comparison of 15 ECG parameters was made between those with CT pulmonary angiograms positive for pulmonary embolism and a matched control group with negative CT pulmonary angiograms.

Natural history of colonization with vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus, and resistant gram-negative bacilli among long-term-care facility residents.

Objective: To determine the natural history of colonization with vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and resistant gram-negative bacilli among long-term-care facility (LTCF) residents.

Design: Observational cohort study.

Setting: A 355-bed LTCF with a ventilator unit and a subacute unit.

Cardiovascular consequences of sleep-related breathing disorders.

Sleep-related breathing disorders (SRBDs) represent a spectrum of abnormalities that range from simple snoring to upper airway resistance syndrome to sleep apnea. The clinical presentation may include obesity, snoring, neuropsychological dysfunction, and daytime hypersomnolence and tiredness. The acute hemodynamic alterations of obstructive sleep apnea include systemic and pulmonary hypertension, increased right and left ventricular afterload, and increased cardiac output.