Endotracheal Pipe Cuff Force Monitor: An expensive System or perhaps Required Device inside Intensiv

Author : Suhr MacGregor | Published On : 18 Apr 2025

The genetic disorder alpha 1 antitrypsin deficiency (AATD) results in reduced levels of alpha 1 antitrypsin (AAT) in the lung and an imbalance between AAT anti-protease activity and the activity of proteases that degrade elastin and connective tissues. This imbalance commonly leads to the excessive proteolysis of structural tissue of the alveoli, causing chronic obstructive pulmonary disease (COPD)/emphysema. While patients with AATD are encouraged to make lifestyle changes, including stopping smoking, and can be treated with alpha 1 antitrypsin therapy (AAT therapy) to slow progression of COPD/emphysema, damage to the lungs is irreparable, and therefore, lung transplantation is required in severe cases. However, following lung transplant, the genetic cause of AATD-related COPD/emphysema remains, and patients may continue to be at risk of redeveloping COPD/emphysema. Recurrence of COPD/emphysema was observed in a patient with AATD 2 years after initial successful lung transplantation and cessation of AAT therapy who recommenced smoking after no signs of disease at the 1-year assessment. This case demonstrates that smoking cessation is critical in patients with AATD, even after lung transplant, and it highlights that patients with AATD may benefit from AAT therapy post-lung transplant.
Voice training induced spontaneous pneumothorax is seldom reported in the literature. This study reports a case of middle-aged man without comorbidities who presented with spontaneous pneumothorax following voice training and made a complete recovery after CT guided needle thoracostomy.

This is a case of a middle-aged male non-smoker with ectomorphic build who presented with chest pain of sudden onset and difficulty in breathing following voice training. The chest pain was central, radiated to the left shoulder and aggravated by lying supine. Chest auscultation revealed reduced breath sounds on the left middle and lower lung zones posteriorly.An initial diagnosis of chest pain of unknown origin was made. Chest radiograph done revealed a left sided pneumothorax, with no background lung pathology seen. Chest CT was done to rule out any underlying pathology, to quantify the pneumothorax and to plan for CT guided needle thoracostomy at our institution.Complete resolution of the left sided pneumothorax was seen after the procedure.

Voice training is a rare cause of primary spontaneous pneumothorax. In the absence of any other lung pathology, it can be effectively managed by CT guided needle thoracostomy as seen in the index patient.It is essential for emergency physicians to include voice training as a potential cause for primary spontaneous pneumothorax.
Voice training is a rare cause of primary spontaneous pneumothorax. In the absence of any other lung pathology, it can be effectively managed by CT guided needle thoracostomy as seen in the index patient.It is essential for emergency physicians to include voice training as a potential cause for primary spontaneous pneumothorax.Paragonimiasis, or Oriental lung fluke is a parasitic infestation seen in Asia, Africa and South America which is spread by the consumption of crabs and crayfish. To date four cases have been reported from Nepal. Here, we report a case of paragonimiasis in a young male from Kathmandu valley who presented with symptoms of fever, on and off for 1 month, shortness of breath and cough. https://www.selleckchem.com/products/marimastat.html He was found to have pleural effusion. Sputum examination did not reveal acid fast bacilli, However, based on clinical features, he was started on antitubercular treatment. There was initial improvement, but later, he continued to have cough and hemoptysis over the next 2 years and on subsequent High-Resolution Computerized Tomography (HRCT) he was found to have a cavitary lung lesion in the superior segment of lower lobe of left lung. A possibility of aspergillosis was considered for which he underwent a lobectomy. The gross examination of the lung showed a small cavity measuring 5 mm which revealed on histology a parasitic structure with serous glands within it. In addition, there were many foreign body granulomas with ova within them. A diagnosis of paragonimiasis was made and the patient was started on Praziquantal. He recovered well and is currently asymptomatic. We can learn from this case that the signs and symptoms of paragonimiasis mimic that of tuberculosis and the mistaken diagnosis can lead to unnecessary treatment, prolonged morbidity and loss of time and resources.Collision tumors are rare entities that consist of at least two or more histologically and ontologically distinct tumor types within the same organ. It is still not well understood how collision tumors form; yet, three main theories have been proposed to explain the pathogenesis, including the "random collision effect," "field cancerization," and "tumor-to-tumor carcinogenesis." Collision tumors have been encountered in various body organs, including the lung. They either consist of a metastasizing tumor colliding with primary cancer or distinct primary or metastatic cancers colliding together. Here, we describe a rare case of collision tumors of the lung that consists of two metastatic carcinomas, namely renal cell carcinoma and urothelial carcinoma of the bladder. We propose that the urothelial carcinoma disseminated into several pre-existing pulmonary metastases of renal cell carcinoma with heterotopic bone formation. The possible mechanisms underlying the development of this peculiar tumor are discussed.
Bone involvement in Multiple Myeloma results from increased osteoclast formation and activity that occurs in proximity to myeloma cells. The role of Alkaline Phosphatse (ALP) in this process and the diagnostic significance of plasma levels in patients with MM are unclear.

To compare plasma ALP levels in patients with MM and solid cancers and metastatic lesions to the bone.

In this observational retrospective study we enrolled 901 patients were enrolled 440 patients (49%) with Multiple Myeloma, 461 (51%) with solid cancers. All 901 patients had bone lesions. Among patients with Multiple Myeloma, ALP values were mainly in the range of normality than those observed in patients with solid cancers and bone lesions. This difference is independent of stage, number and type of bone lesions.

This study suggests that plasma ALP has a different clinical significance in MM than in other neoplasms and could be used as a discriminating marker in presence of bone lesions. In particular, lower or normal values, should suggest further investigations such as urinary and serum electrophoresis, associated with bone marrow aspirate in case of the presence of a monoclonal component, in order to confirm or exclude a MM diagnosis.