Dynamic vascular changes following intravenous antibiotics in patients with cystic fibrosis.

Background: Adults with cystic fibrosis (CF) have altered large artery haemodynamics which is associated with a persisting systemic inflammatory state. We hypothesized that a short-term intervention favorably influencing the inflammatory status may modify their haemodynamic state.

Methods: Adult patients with CF were studied immediately preceding and following 2 weeks of intravenous antibiotics.

Recurrent hydropneumothorax as a presenting feature of malignant mesothelioma.

A 73-year-old former smoker with previous occupational exposure to asbestos presented with a pneumothorax that was initially managed by simple aspiration. Despite this, it re-accumulated and a bronchopleural fistula was suspected. A video-assisted thoracoscopic procedure was performed and revealed an abnormally thickened pleura that turned out to be a mesothelioma.

Nebulised DNase in the treatment of life threatening asthma.

A 25-year-old pregnant patient developed life-threatening asthma refractory to all standard treatment including anaesthetic agents. Ventilatory pressures continued to rise with impending cardio-respiratory arrest. The introduction of nebulised endotracheal DNase however resulted in a rapid and dramatic improvement with good clinical outcome.

An unusual case of abdominal pain in a patient with cystic fibrosis.

We report the case of a 19 year old man with cystic fibrosis (CF) who presented with atypical abdominal pain precipitated by pressing his ribs. This was subsequently discovered to be referred pain from an intercostal schwannoma. Surgical resection led to a resolution of his symptoms.

A novel approach to the management of persistent postpneumonectomy bronchopleural fistula.

A 69-year-old man who had a left pneumonectomy for nonsmall cell lung cancer had a bronchopulmonary fistula develop that recurred after surgical closure. He had multiple organ failure develop precluding further operative intervention. Successful resolution of the fistula was achieved using a novel application of a covered expandable metallic stent.

Early haemodynamic benefit of sildenafil in patients with coexisting chronic thromboembolic pulmonary hypertension and left ventricular dysfunction.

Sildenafil, a phosphodiesterase type-5 inhibitor, offers potential to treat pulmonary hypertension associated with a variety of conditions. We assessed the early impact of sildenafil on a cohort of patients referred to our unit who had severe pulmonary hypertension secondary to chronic thromboembolic disease which was not amenable to pulmonary thromboendarterectomy and who also had coexisting left ventricular dysfunction. Six patients were studied.