Septic Pulmonary Embolism

By Dr Deepu
Septic Pulmonary Emboli.
GOLDEN POINT: The most common sources of septic pulmonary emboli are infected venous catheters, including pacemaker wires, tricuspid valve endocarditis, septic thrombophlebitis and indwelling prosthetic devices. The diagnosis is usually established by positive blood cultures and the presence of an infected source for the emboli.
Watch the HRCT video showing septic emboli.

GOLDEN PEARL: The usual radiographs and CT scan demonstrate multiple pulmonary opacities. The opacities may occur in any portion of the lungs but are usually maximal in the lower zones. The lesions are usually either round in shape or show the shape of a pulmonary infarct, namely a wedge-shaped density base on the pleura and pointing to the hilum. They may have any size and frequently cavitate, a feature more easily recognized on CT. Air-bronchograms are frequently seen, particularly on CT, in all types of opacity, including the nodular lesions. The combination of multiple peripheral nodules or wedge-shaped consolidations, some of which are cavitated, and a distinct feeding vessel in the appropriate clinical setting is highly suggestive of the diagnosis of septic emboli.

Bronchoscopic removal of leech from airways

By Dr Deepu
Watch the video showing the removal of the leeches From the respiratory tract. Two leeches were in the respiratory tract, video shows removal of one live leech from the airway, the other can be seen in the airway at the later part of video.

Nasal swab may be used to confirm lung cancer after a CT scan, study suggests

By Dr Deepu

“researchers now say it may someday be possible to quickly confirm” lung cancer “after a CT scan, by using a simple nasal swab.” The investigators “identified a pattern of 30 genes that were active in a different way in people confirmed to have lung cancer from those who were not.” The findings were published in the Journal of the National Cancer Institute.

They identified 535 genes that were differentially expressed in the nasal epithelium of AEGIS-1 patients diagnosed with lung cancer vs those with benign disease after one year of follow-up . Using bronchial gene expression data from the AEGIS-1 patients, they found statistically significant concordant cancer-associated gene expression alterations between the two airway sites . Differentially expressed genes in the nose were enriched for genes associated with the regulation of apoptosis and immune system signaling.

Study finds connection between dysfunctional breathing, poor asthma control

By Dr Deepu

Study published in Respiratory Medicine states that , “dysfunctional breathing has strong connections to poor asthma control and can be misdiagnosed in clinical settings when asthma patients have co-existing issues with dysfunctional breathing (DB).”

The study examined all patients referred consecutively over a 12-months period for specialist assessment of asthma at the Respiratory Outpatient Clinic at Bispebjerg Hospital in Copenhagen. All patients were examined with the Nijmegen questionnaire with a DB defined as a score ≥23 and the ACQ questionnaire.  Asthma was defined as asthma symptoms and a positive asthma test.

Asthmatic patients with co-existing DB had a poorer asthma control compared to asthmatics without DB . A regression analysis showed that the effect of DB on asthma control was independent of airway hyperresponsiveness or airway inflammation in patients with DB.

Fruits, vegetables may reduce COPD risk for smokers, study suggests

By Dr Deepu

According to a study published in Thorax, “each additional daily serving of fruits and vegetables that smokers and former smokers eat is associated with a 4 to 8% lower risk of their developing chronic obstructive pulmonary disease.” The Times says the study “looked at more than 44,000 Swedish men, ages 45 to 79, who completed detailed health and dietary questionnaires.” The study found that “men who ate five or more servings of fruits and vegetables a day were 35% less likely to develop lung disease than those who ate two servings or less.” Meanwhile, the study found no benefit for nonsmokers.