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Indian J Radiol Imaging 2019 Jan-Mar;29(1):77-80

Internal Medicine Department, Hospital Universitario de Torrejón, Calle Mateo Inurria s/n, Torrejón de Ardoz, Spain.

Introduction: Simultaneous subcutaneous emphysema, spontaneous pneumothorax, and pneumomediastinum are complications rarely observed synchronously during an acute exacerbation of bronchial asthma. Although spontaneous pneumothorax has already been reported in asthma patients in the literature, its concurrence with subcutaneous emphysema and pneumomediastinum is extremely rare except for iatrogenic conditions.

Case Study: We describe a patient who presented to the emergency room with progressive dyspnea and chest pain. Read More

Lancet Respir Med 2019 Apr 15. Epub 2019 Apr 15.

Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, Quebec, Canada.

Background: Inherited mutations in SERPINA1 coding for the alpha-1 antitrypsin (A1AT) protein is the only well established cause of hereditary emphysema. We aimed to identify the genetic ecause of early-onset emphysema in a five-generation French-Canadian family free of A1AT deficiency.

Methods: Between Dec 1, 2014, and April 1, 2017, we investigated 63 individuals from a single pedigree, including 55 with DNA available. Read More

Respir Res 2019 Apr 18;20(1):77. Epub 2019 Apr 18.

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.

Background: Decreased airway lumen size and increased lung volume are major structural changes in chronic obstructive pulmonary disease (COPD). However, even though the outer wall of the airways is connected with lung parenchyma and the mechanical properties of the parenchyma affect the behaviour of the airways, little is known about the interactions between airway and lung sizes on lung function and symptoms. The present study examined these effects by establishing a novel computed tomography (CT) index, namely, airway volume percent (AWV%), which was defined as a percentage ratio of the airway tree to lung volume. Read More

Toxicol Appl Pharmacol 2019 Apr 15. Epub 2019 Apr 15.

Department of Environmental Medicine, New York University School of Medicine, New York, NY 10010, USA. Electronic address:

Cadmium (Cd) is a known human lung carcinogen. In addition, Cd exposure is associated with several lung diseases including emphysema, chronic obstructive pulmonary disease (COPD), asthma and fibrosis. Although earlier studies have identified several processes dysregulated by Cd exposure, the underlying mechanisms remain unclear. Read More

PLoS One 2019 18;14(4):e0215303. Epub 2019 Apr 18.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: The clinical course of IPF varies. This study sought to identify phenotyping with quantitative computed tomography (CT) fibrosis and emphysema features using a cluster analysis and to assess prognostic impact among identified clusters in patient with idiopathic pulmonary fibrosis (IPF). Furthermore, we evaluated the impact of fibrosis and emphysema on lung function with development of a descriptive formula. Read More

J Thorac Dis 2019 Mar;11(Suppl 3):S329-S330

Institut d´Investigació Sanitària de les Illes Balears (IdISBa), Palma de Mallorca, Spain.

Respirol Case Rep 2019 Jul 5;7(5):e00423. Epub 2019 Apr 5.

Department of Radiology Charité Universitätsmedizin Berlin Berlin Germany.

A 21-year old female with diabetes mellitus type 1 presented to our hospital's emergency department having suffered from shortness of breath, mild chest pain, and vomiting following her arrival after a long-distance flight two days earlier. Symptoms had since subsided and physical examination was normal. Blood analysis revealed increased D-dimers and diabetic ketoacidosis. Read More

Intern Med 2019 Apr 17. Epub 2019 Apr 17.

Department of Chest Surgery, Aso Iizuka Hospital, Japan.

Eur Respir Rev 2019 Jun 17;28(152). Epub 2019 Apr 17.

Dept of Pulmonary diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

The results of the randomised controlled trials investigating the bronchoscopic lung volume reduction treatment using endobronchial valves (EBV) are promising, and have led to their inclusion in treatment guidelines, US Food and Drug Administration approval and inclusion in routine care in an increasing number of countries. The one-way valve treatment has advanced and is now a regular treatment option. However, this new phase will lead to new challenges in terms of implementation. Read More

Curr Opin Anaesthesiol 2019 Apr 15. Epub 2019 Apr 15.

Department of Anesthesiology, Nagasaki University School of Medicine, Nagasaki, Japan.

Purpose Of Review: Peroral endoscopic myotomy (POEM) was developed in Japan as a less invasive treatment for esophageal achalasia requiring general anesthesia under positive pressure ventilation. In 2018, the Japan Gastroenterological Endoscopy Society published the first guidelines describing the standard care for POEM. Based on these guidelines, we discuss the typical approach to anesthesia during POEM for the management of esophageal achalasia in Japan. Read More

J Pharm Pharmacol 2019 Apr 16. Epub 2019 Apr 16.

Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Objectives: Effect of alpha-linolenic acid (ALA) against ovalbumin (OVA)-induced inflammation, oxidant/antioxidant imbalance and pathological features was examined in rat.

Methods: Total and differential WBC count and oxidant/antioxidant levels in BALF (bronchoalveolar lavage fluid) as well as lung pathological features were investigated in five groups of rats including controls (group C), rats sensitized with OVA (group S) and S treated with either ALA (0.2 and 0. Read More

Mol Cell Biochem 2019 Apr 15. Epub 2019 Apr 15.

Department of Biochemistry, Panjab University, Chandigarh, 160014, India.

In our previous study, we have shown that PARP-1 inhibition (genetic or pharmacological) ameliorates elastase-induced inflammation and emphysema. Since matrix metalloproteinases (MMPs) particularly MMP-2 and MMP-9 are known to play a critical role in emphysema development, the present work was designed to evaluate the effects of PARP-1 inhibition on their expression utilizing elastase-induced mouse model of emphysema. Our data show that olaparib administration at a dose of 5 mg/kg b. Read More

Med Klin Intensivmed Notfmed 2019 Apr 16. Epub 2019 Apr 16.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.

An 86-year-old woman was scheduled for surgical treatment of a periprosthetic femoral fracture after a fall. Because of a known difficult airway due to multiple surgeries and radiation for cancer in the orofacial area, awake fiberoptic intubation was planned. During the fiberoptic maneuver the patient experienced a massive bout of coughing which resulted in large soft tissue emphysema and double-sided pneumothorax. Read More

Respir Investig 2019 Apr 12. Epub 2019 Apr 12.

Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan. Electronic address:

Lung phenotype was reported as a novel phenotype in patients with mutations in the filamin A gene (FLNA) in 2011. FLNA mutations can result in pulmonary hyperinflation during the neonatal period or early infancy with progressive respiratory failure, culminating in a diagnosis of FLNA-associated progressive lung disease, particularly if the patient has periventricular nodular heterotopia and cardiac complications, such as patent ductus arteriosus, atrial septal defect, and pulmonary hypertension. We report the first Japanese case of FLNA-associated progressive lung disease caused by a microdeletion in Xq28 encompassing the FLNA gene with a polymorphic inversion. Read More

Am J Respir Cell Mol Biol 2019 Apr 15. Epub 2019 Apr 15.

Brigham and Women's Hospital, 1861, Boston, Massachusetts, United States.

Pediatr Ann 2019 Apr;48(4):e169-e174

Congenital lung malformations (CLM) comprise a spectrum of anatomical anomalies of the lungs and respiratory tree. The prenatal growth pattern of CLMs is unpredictable with larger lesions causing life-threatening complications, such as hydrops fetalis, and smaller lesions remaining asymptomatic and potentially regressing. The most common CLMs are congenital pulmonary adenomatoid malformations, bronchopulmonary sequestrations, congenital lobar emphysema, and bronchogenic cysts. Read More

Cells 2019 Apr 11;8(4). Epub 2019 Apr 11.

Department of Clinical Medicine, Laboratory of Experimental Therapeutics/LIM-20, School of Medicine of University of Sao Paulo, Sao Paulo 01246-903, Brazil.

Changes in extracellular matrix (ECM) components in the lungs are associated with the progression of respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS). Experimental and clinical studies have revealed that structural changes in ECM components occur under chronic inflammatory conditions, and these changes are associated with impaired lung function. In bronchial asthma, elastic and collagen fiber remodeling, mostly in the airway walls, is associated with an increase in mucus secretion, leading to airway hyperreactivity. Read More

J Natl Cancer Inst 2019 Apr 12. Epub 2019 Apr 12.

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.

Lengthening the annual low-dose computed tomography (CT) screening interval for individuals at lowest risk of lung cancer could reduce harms and improve efficiency. We analyzed 23,328 participants in the National Lung Screening Trial who had a negative CT screen (no ≥ 4mm nodules) to develop an individualized model for lung-cancer risk after a negative CT. The Lung Cancer Risk Assessment Tool + CT (LCRAT+CT) updates "pre-screening risk" (calculated using traditional risk factors) with selected CT features. Read More

Can J Ophthalmol 2019 Apr 31;54(2):e87-e90. Epub 2018 Aug 31.

Stein Eye Institute, Division of Orbital and Ophthalmic Plastic Surgery, University of California-Los Angeles, Los Angeles, Calif.. Electronic address:

AJR Am J Roentgenol 2019 Apr 11:1-11. Epub 2019 Apr 11.

1 Department of Respiratory Medicine, Toho University Omori Medical Center, Ota-ku Omori nisi 6-11-1, Tokyo 143-8541, Japan.

Objective: The lung is one of the organs possibly involved in microscopic polyangiitis (MPA), and myeloperoxidase (MPO) antineutrophil cytoplasmic antibody (ANCA) is commonly found in patients with MPA. The aim of this study was to assess pulmonary lesions in Japanese patients with MPA.

Subjects And Methods: This prospective study was based on 144 patients with MPA who were enrolled in the Remission Induction Therapy in Japanese Patients With ANCA-Associated Vasculitis and Rapidly Progressive Glomerulonephritis Study and who underwent chest high-resolution CT (HRCT) imaging at the time of diagnosis during 2011-2014. Read More

J Belg Soc Radiol 2019 Apr 4;103(1):21. Epub 2019 Apr 4.

Department of Radiology, Uludag University Faculty of Medicine, Bursa, TR.

Background: Bleeding in the biopsy tract has been studied for its ability to decrease the risk of pneumothorax with indefinite results in the previous studies.

Purpose: To investigate the risk factors for needle-tract bleeding (NTB) and the possible effect of NTB on the pneumothorax and resultant chest tube placement after CT-guided cutting needle biopsy (CT-CNB) of pulmonary lesions.

Methods: Predictive variables for NTB and the effect of NTB on the development of pneumothorax and consequent chest tube placement were retrospectively determined in 416 patients who had undergone an 18-gauge non-coaxial CT-CNB (338 men and 78 women; average age, 59. Read More

Biol Open 2019 Apr 10. Epub 2019 Apr 10.

Department of Clinical Medicine, Laboratory of Experimental Therapeutics (LIM-20), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil

Macrophages play a pivotal role in the development of emphysema and depending on the microenvironment stimuli can be polarized into M1- or M2-like macrophage phenotypes. To compare macrophage polarizations in cigarette smoke (CS)- and porcine pancreatic elastase (PPE)-induced emphysema models. C57BL/6 mice were subdivided into four experimental groups. Read More

N Engl J Med 2019 Apr;380(15):e20

UNC Health Care System, Chapel Hill, NC

J Radiat Res 2019 Apr 10. Epub 2019 Apr 10.

Department of Radiation Oncology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, P.R. China.

A large portion of patients with early-stage non-small-cell lung cancer (NSCLC) who are receiving stereotactic body radiation therapy (SBRT) are medically inoperable due to compromised pulmonary function, and among these patients pulmonary emphysema (PE) is common. However, the relationship between PE and radiation-induced lung injuries remains unclear. In this study, we aimed to describe the full spectrum of computed tomography (CT) features after SBRT for NSCLC, and to explore their relationship with variables, including PE and dosimetric factors. Read More

Am J Respir Cell Mol Biol 2019 Apr 9. Epub 2019 Apr 9.

University of Tsukuba, 13121, Respiratory Medicine, Tsukuba, Japan.

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by peripheral airways inflammation and emphysema. Emerging evidence indicates a contribution of both innate and adaptive immune cells to the development of COPD. Transcription factor T-bet modulates the function of immune cells and therefore might be involved in the pathogenesis of COPD. Read More

Am J Respir Crit Care Med 2019 Apr 9. Epub 2019 Apr 9.

University Birmingham NHS Foundation Trust, Lung Investigation Unit, Birmingham, West Midlands, United Kingdom of Great Britain and Northern Ireland.

Rationale: Augmentation therapy with intravenous alpha-1 antitrypsin (AAT) is the only specific therapy for individuals with pulmonary disease from AAT deficiency (AATD). The recommended standard dose (SD; 60 mg/kg/week) elevates AAT trough serum levels to around 50% of normal; however, outside of slowing emphysema progression, its effects in other clinical outcomes have not been rigorously proven.

Objective: To evaluate the biological effects of normalizing AAT trough levels with double dose therapy (DD; 120 mg/kg/week) in subjects with AATD already receiving SD therapy. Read More

J Thorac Dis 2019 Feb;11(2):535-541

Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

Background: At present, we have many diagnostic methods, but there are no specific guidelines on the diagnosis and treatment of bilateral multiple pulmonary nodules (BMPNs). Clinically, one-stage video-assisted thoracic surgery (VATS) for BMPNs is not the usual treatment.

Methods: We retrospectively analyzed the clinical data of 18 patients with bilateral pulmonary nodules who underwent one-stage VATS from January 2016 to Jun 2018 in the Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, at the Huazhong University of Science & Technology. Read More

J Thorac Dis 2019 Feb;11(2):382-385

Department of Medicine, David Geffen School of Medicine at UCLA, and the VA Greater LA Health Care System, Los Angeles, CA, USA.

Am J Respir Cell Mol Biol 2019 Apr 8. Epub 2019 Apr 8.

University of Alabama at Birmingham, 9968, Birmingham, Alabama, United States ;

Chronic obstructive pulmonary disease (COPD) is a major cause of worldwide mortality and is characterized by an excessive airway neutrophilic response. The neutrophil chemoattractant proline-glycine-proline (PGP) and its more potent acetylated form (acPGP) have been found to be elevated in COPD patients and act via CXCR2. Here, we investigate the impact of neutralizing PGP peptides in a murine model for emphysema. Read More

Cureus 2019 Jan 28;11(1):e3971. Epub 2019 Jan 28.

Internal Medicine, Jersey Shore University Medical Center, Neptune City, USA.

Introduction Chronic obstructive pulmonary disease (COPD) is most commonly caused by smoking tobacco or cigarettes. However, alpha-1 antitrypsin deficiency (AATD) is the only genetic disorder known to cause COPD and these patients often present with emphysema earlier in life and with more severe disease. Additionally, AATD patients are often misdiagnosed with other lung disorders, and the diagnosis is often delayed for up to a decade. Read More

BMJ Open Respir Res 2019 12;6(1):e000391. Epub 2019 Feb 12.

Division of Pulmonary and Critical Care and Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Introduction: Inhaled marijuana has been infrequently identified as a potential risk factor for the development of spontaneous pneumomediastinum (SPM), a rare finding of free air in the mediastinum likely caused by barotrauma during breathing manoeuvres. The mechanism of inhalation drug use is often not ascertained by physicians, thus little is known about how different smoking techniques precipitate pulmonary injury. We aimed to evaluate the frequency of marijuana use in patients with non-traumatic pneumomediastinum over a 12-month period, identifying additional relevant clinical features or risk factors, and determining the extent to which clinicians record smoking techniques. Read More

Eur Respir J 2019 Apr 7. Epub 2019 Apr 7.

Excellence Cluster Cardiopulmonary System, University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Justus-Liebig-University, Giessen, Germany

Chronic obstructive pulmonary disease (COPD) which comprises the phenotypes of chronic bronchitis and emphysema is often associated with pulmonary hypertension (PH). However, currently no approved therapy exists for PH-COPD. Signalling of the nitric oxide/cyclic guanoside monophosphate (NO-cGMP) axis plays an important role in PH and COPD. Read More

Chest 2019 Apr;155(4):e97-e100

Division of Respiratory, Critical Care, & Occupational Pulmonary Medicine, University of Utah, Salt Lake City, UT; George E. Wahlen VA Medical Center, Salt Lake City, UT.

Case Presentation: A 73-year-old man presented to the ED of an outside hospital with asymptomatic chest wall swelling 10 h after discharge from our hospital. Four days earlier, he had presented to our hospital with increased dyspnea, cough, and sputum production. His history was notable for severe COPD with bullous emphysema. Read More

Med Clin North Am 2019 May 14;103(3):453-461. Epub 2019 Mar 14.

Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, 7th Floor Parkinson Pavilion, Philadelphia, PA 19140, USA.

Chronic obstructive pulmonary disease (COPD) is a leading cause of death nationally and worldwide. Cigarette smoking is the most common risk factor in the development of COPD. Disease course is variable with some patients having a high degree of obstruction and minimal symptoms, whereas others with better lung function have a greater symptoms burden. Read More

Allergy 2019 Apr 7. Epub 2019 Apr 7.

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Uniersität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy-Centre, Department of Dermatology and Allergy, member of GA2LEN, Berlin, Germany.

Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including health professionals. Read More

Pharmacol Res 2019 Apr 3;144:1-7. Epub 2019 Apr 3.

Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, 16 Medical Drive, 117600, Singapore; Immunology Program, Life Science Institute, National University of Singapore, 28 Medical Drive, 117456, Singapore; Singapore-HUJ Alliance for Research and Enterprise (SHARE), National University of Singapore, 1 CREATE Way, Innovation Wing, 138602, Singapore. Electronic address:

Autophagy is an evolutionary conserved process that is responsible for maintaining cellular homeostasis through lysosome-dependent degradation of damaged proteins, lipid and organelles. When autophagy is dysregulated by factors such as cigarette smoking, environmental insults and ageing, it can lead to formation of aggresome-bodies and enhanced production of reactive oxygen species (ROS), of which contribute to the pathogenesis of chronic obstructive pulmonary disease (COPD). This review will aim to decipher the pathogenic process of autophagy that is dysregulated by the various risk factors of COPD, leading to either cell death or senescence and COPD progression. Read More

Clin Sci (Lond) 2019 Apr 5. Epub 2019 Apr 5.

Thoracic Medicine and Surgery, Temple University, 1157 MERB, 3500 N Broad Street, 3500 N Broad Street, Philadelphia, Pennsylvania, 19140, United States

Rhinovirus (RV), which is associated with acute exacerbations, also causes persistent lung inflammation in patients with chronic obstructive pulmonary disease (COPD), but the underlying mechanisms are not well-known.   Recently, we demonstrated that RV causes persistent lung inflammation with accumulation of a subset of macrophages (CD11b+/CD11c+), and CD8+ T cells, and progression of emphysema.  In this study, we examined the mechanisms underlying the RV-induced persistent inflammation and progression of emphysema in mice with COPD phenotype. Read More

J Pharmacol Exp Ther 2019 Apr 5. Epub 2019 Apr 5.

Brown University

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease with progressive airflow limitation and lung function decline. The pathogenic mechanisms for this disease include oxidative stress, inflammatory responses, disturbed protease/anti-protease equilibrium, apoptosis/proliferation imbalance, senescence, autophagy, metabolic reprogramming, and mitochondrial dysfunction. Wnt signaling pathway is an evolutionarily conserved signaling pathway, which is abnormal in COPD, including chronic bronchitis and pulmonary emphysema. Read More

J Allergy Clin Immunol 2019 Apr 2. Epub 2019 Apr 2.

MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France; Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and UPMC Sorbonne Université, Medical School Saint Antoine, Paris, France; INSERM U 1168, VIMA : Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France and Euforea, Brussels, Belgium. Electronic address:

Background: Mobile health may be used to generate innovative insights into optimizing treatment to improve allergic rhinitis control.

Objectives: A cross-sectional real world observational study was undertaken in 22 countries to complement a pilot study and bring novel information on medication use, disease control and work productivity in everyday life of patients with allergic rhinitis.

Methods: A mobile phone app (Allergy Diary, freely available Google Play and Apple stores) was used to collect data of daily visual analogue scales (VAS) for (i) overall allergic symptoms, (ii) nasal, ocular and asthma symptoms, (iii) work, as well as (iv) medication use using a treatment scroll list including all allergy medications (prescribed and over-the-counter (OTC)) customized for 22 countries. Read More

Vet Ital 2019 Mar 31;55(1):47-56. Epub 2019 Mar 31.

Department of Pathology, School of Veterinary Medicine, Razi University, Kermanshah, Iran

This study was conducted with the objective of identifying the types of gross and histopathological lesions in lungs of sheep slaughtered between March 2013 to February 2014 at Kermanshah abattoir, west of Iran. A total of 1200 slaughtered sheep lungs was inspected during the study period. Pulmonary lesions were detected in 445 (37. Read More

Am Surg 2019 Mar;85(3):e137-e138

BMC Pulm Med 2019 Apr 4;19(1):73. Epub 2019 Apr 4.

Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-shi, Niigata, 951-8510, Japan.

Background: The presence of emphysema on computed tomography (CT) is associated with an increased frequency of lung cancer, but the postoperative outcomes of patients with pulmonary emphysema are not well known. The objective of this study was to investigate the association between the extent of emphysema and long-term outcomes, as well as mortality and postoperative complications, in early-stage lung cancer patients after pulmonary resection.

Methods: The clinical records of 566 consecutive lung cancer patients who underwent pulmonary resection in our department were retrospectively reviewed. Read More

Respiration 2019 Apr 4:1-7. Epub 2019 Apr 4.

Department of Respiratory and Critical Care Medicine of Peking University First Hospital, Beijing, China,

Background: Bronchoscopic therapies are less invasive alternatives of surgical lung volume reduction for severe emphysema. Bending of lung tissue by implanting metallic coils into bronchi is one of the procedures. A new-designed device with a similar rationale, Reverser, has been developed with some improvements. Read More

Adv Med Sci 2019 Apr 1;64(2):285-291. Epub 2019 Apr 1.

Department of Chest Disease, Ankara University School of Medicine, Ankara, Turkey.

Purpose: Combined pulmonary fibrosis and emphysema (CPFE) has emerged as a new syndrome with characteristics of both fibrosis and emphysema. We determined the impacts of radiologic emphysema severity on pulmonary function tests (PFTs), exercise capacity and mortality.

Patients And Methods: IPF patients (n = 110) diagnosed at the Chest Diseases Clinic between September 2013 and January 2016 were enrolled in the study and followed up until June 2017. Read More

J Craniofac Surg 2019 Mar 28. Epub 2019 Mar 28.

Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine.

Retrobulbar emphysema is a rare condition compared to the more common orbital emphysema. It is often associated with medial orbital wall fracture with rupture of the periosteum. In some severe patients, retrobulbar emphysema can increase the intraorbital pressure and lead to orbital compartment syndrome. Read More

J Clin Invest 2019 Apr 4;130. Epub 2019 Apr 4.

The lung is a specialized barrier organ that must tightly regulate interstitial fluid clearance and prevent infection in order to maintain effective gas exchange. Lymphatic vessels are important for these functions in other organs, but their roles in the lung have not been fully defined. In the present study, we addressed how the lymphatic vasculature participates in lung homeostasis. Read More

Clin Exp Emerg Med 2019 Apr 3. Epub 2019 Apr 3.

Surgical Department, Clinical Center Fuerth, Fuerth, Germany.

Emergency physicians in the field are sometimes confronted with cases wherein patients cannot be intubated and ventilated. In some cases, cricothyrotomy, the method of choice for securing an emergency airway, may not have a successful outcome. We report a rare case of a 35-yearold male patient with avulsion of the larynx and a comminuted fracture of the jawbone, due to entrapment in a dung excavator. Read More

Thorax 2019 Apr 2. Epub 2019 Apr 2.

National Heart and Lung Institute, Imperial College London, London, UK.

Chronic obstructive pulmonary disease (COPD) is a major global health concern with few effective treatments. Widespread destruction of alveolar tissue contributes to impaired gas exchange in severe COPD, and recent radiological evidence suggests that destruction of small airways is a major contributor to increased peripheral airway resistance in disease. This important finding might in part explain the failure of conventional anti-inflammatory treatments to restore lung function even in patients with mild disease. Read More

Chest 2019 Mar 30. Epub 2019 Mar 30.

Respiratory Institute, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH.

Background: The main goal in the evaluation of a pulmonary nodule (PN) is to expedite treatment of malignant nodules and minimize procedures for benign nodules. Available validated risk prediction models are most accurate when used within populations similar to those in which they were developed. The goal of this study was to develop a malignancy risk prediction model that estimates the probability of malignancy for PNs considered high enough risk to recommend biopsy. Read More