Cystic fibrosis, pleural effusion, methemoglobinemia, penetrating lung damage from a blank bullet, and lung complications from silicone implants are just a few of the unique case studies that will be covered in the next one. CHEST Annual Meeting 2015. The conference, which will take place October 24-28 at the Palais des congrÃ¨s de MontrÃ©al in Canada, is expected to bring together doctors and researchers from around the world to discuss unique cases of lung and sleep disorders as well as intensive care, as announced. speak American College of Thoracic Physicians in a press release.
Two rare cases of methemoglobinemia due to the use of the recreational drug known as “jungle juice” or “popper” will be presented on Monday October 26 by doctors from the New York University Langone Medical Center. The drug became popular in the 1960s and contains acetone and isobutyl nitrate. The case study details a 33-year-old woman and her 39-year-old husband, both emergency doctors, who arrived in the emergency room after ingesting toxic drugs.
The women began to have vomiting, diarrhea, and convulsions, and both suffered from severe cyanosis and were hypotensive and hypoxemic despite high oxygen flow. Doctors later realized that the couple had methemoglobinemia, a disease characterized by an altered state of hemoglobin unable to discharge oxygen due to oxidation of ferrous iron. The disease can cause tissue hypoxia, but after being treated with IV methylene blue and hydration, symptoms disappeared within six hours.
The investigators of the Konya Education and Research Hospital, Turkey, will also be at the conference to host a presentation on a case report of penetrating lung injury caused by a shot from a blank cartridge pistol at close range. The presentation is called “Invisible Balls” and will take place on Tuesday October 27th. The patient highlighted in the case study was a 17-year-old man who entered the hospital with a chest injury – a single chest injury and no exit injury. The patient suffered from left hemopneumothorax, lacerations and contusions of the left lung, and was subjected to a left thoracotomy with wedge resection of the lingular segment of the upper lobe.
The purpose of this case study is to draw attention to the dangers of blank cartridges, which do not contain a bullet but are powerful enough to penetrate soft tissue and bone at close range. The cartridges were originally created for military training, but are now used for other purposes including by criminals due to their low price and easy accessibility. Despite the fact that the patient in question was released nine days later without further complaints, the cartridges can cause serious injury, including to the lungs when fired at close range, and even death.
A rare case of parasitic infection called trichinellosis will be presented by researchers from UC Davis Medical Center in Sacramento, which will host the presentation on Wednesday, October 28. The patient in the case is a 47-year-old man who experienced a week of worsening fevers, edema and myalgia, progressing to hypercapnic respiratory failure. As the disease worsened, the patient was transferred to intensive care and provided with non-invasive ventilation. Doctors also observed that the patient had decreasing lung volumes, reduced bilateral excursion, and deep leukocytosis in his blood count.
Trichinellosis is a disease caused by a parasite that may be present in raw meat that results in decreased diaphragmatic function associated with the number of larvae, duration of infection, and inflammatory response to infection. Investigators later learned that the patient was a hunter and had caught and ate a wild bear three weeks earlier. Parasite evaluation confirmed the antibodies to Trichinella and the patient was treated with albendazole and prednisone. In addition, samples of bear meat were then confirmed by microscopy and PCR to be T spiralis.
In addition, three very different cases related to complications from silicone implants will be presented at the conference. The first of these will be led by a research team from Kansas City University School of Medicine, Tuesday October 27. A 36-year-old patient diagnosed with cystic fibrosis (CF) entered the hospital with partial bowel obstruction and reported that she had had a right upper lobe lobectomy eight months previously and bilateral breast augmentation 13 years earlier. Doctors treated the obstruction with medication and the patient was supposed to come out when she noticed her right breast implant was missing.
Slippage of the breast implant had already occurred in the patient and the implant had always been repositioned using a Valsalva maneuver. However, this time the entire implant from the right beast had migrated into the right chest cavity with a small right pleural effusion, which could have caused the implant to leak. Doctors gave him exploratory surgery which confirmed the implant was intact in the right pleural space and noticed a 5 x 3 cm defect in the chest wall that allowed the implant to migrate. Investigators have solved the problem and are now asking other doctors to consider this risk for their CF patients. Since patients with cystic fibrosis are particularly at risk for body image disturbances, this may lead them to seek cosmetic procedures more frequently that may have unintended consequences such as the one highlighted in this case study.
The case presented by the Jersey City Medical Center Tuesday October 27. The case of a 44-year-old woman presents a rare cause for the development of pleural effusion. The patient entered the center with chest pain on the left side with worsening shortness of breath for three weeks. She did not have a cough, sputum production, fever or chills, but had had bilateral mastectomy and breast augmentation surgery with silicone implants six weeks previously. Doctors confirmed the diagnosis of left pleural effusion and began treatment with empiric antibiotics.
Doctors suspected a foreign body reaction to the ruptured or infected implants or implants and requested an analysis by a breast surgeon. They performed exploratory surgery and observed significant inflammation and a slight collection of fluid, but no rupture. After the procedure, the patient’s symptoms improved significantly, while mesothelial cells, macrophages and lymphocytes, without malignant cells, were observed on cytological examination.
The third case of lung complications from silicone implants will be presented by researchers at John H. Stroger Jr. Hospital in Chicago on Tuesday, October 27. A 29-year-old woman had a rare but serious complication of buttock augmentation after entering hospital with worsening dyspnea, chest pain and a dry cough. The patient had been showing symptoms for five days and denied that he smoked, used illicit drugs, recently traveled or had any sick contacts.
The woman was gravely ill with crackles scattered throughout all areas of the lungs, high levels of white blood cells, and extensive airspace opacities. Her condition worsened and she was transferred to the intensive care unit, where she was treated with daily intravenous methylprednisolone and non-invasive ventilation. Three days later, her condition improved significantly and she was released on supplemental oxygen and a decreasing dose of prednisone. The researchers are also aiming to draw attention to the risk of silicone pulmonary embolism, which has the rare but existing consequence of acute pneumonitis syndrome.
The American College of Chest Physicians, publisher of the journal CHEST, is holding its annual meeting for the 81st time. The association is a global leader in accelerating innovative thoracic medical education, clinical research and care to improve patient outcomes. The main goal of the American College of Chest Physicians, which has 18,700 members worldwide, is to advance the prevention, diagnosis and treatment of lung conditions.
In September, the Irving, Texas-based company Reata Pharmaceuticals, Inc, also announced that it will present initial data evaluating bardoxolone methyl in patients with pulmonary arterial hypertension (HAP) who are on stable DMARD at the 2015 American College of Chest Physicians Annual Meeting. Bardoxolone methyl is an experimental, oral once-daily (AIM) antioxidant inflammation modulator that has received orphan drug designation for the treatment of PAH by the United States Food and Drug Administration (FDA).