Rasmussen’s aneurysm: a rare and potentially fatal cause of hemoptysis

Rasmussen’s aneurysm is a rare and fatal cause of hemoptysis secondary to infection with pulmonary tuberculosis. The most commonly involved vessels include the bronchial arteries, but rarely can involve the pulmonary artery.We report the case of a 62-year-old female from the Philippines with undiagnosed pulmonary tuberculosis who presented with massive hemoptysis. After hemodynamic stabilization, Rasmussen’s aneurysm was diagnosed by computed tomography of the chest with angiography, confirmed with invasive angiography. She was treated definitively with glue embolization of the affected artery

A rare case of community acquired serratia lung abscess in a patient with cardiac bronchus

  The incidence of lung abscess caused by Serratia marcescens is extremely low and is only reported in the immunocompromised population. We present a previously healthy woman with Serratia lung abscess in close proximity with an accessory cardiac bronchus. The patient was treated with appropriate antibiotics which led to complete resolution of the lesion. Our case highlights that individuals without medical co-morbidities may develop atypical lung infections like Serratia when associated with anatomic anomalies.

Prevalence and predictors of readmissions among adults with cystic fibrosis in the United States

Introduction: Patients with Cystic Fibrosis (CF) have increasing rates of hospitalization. We analyzed the burden and predictorsof thirty-day readmission among patients with CF in the U.S. Material and methods: Nationwide Readmission Database (NRD) 2013 was used to identify adults with CF who were hospitalized.These individuals were followed to determine the prevalence of readmission within thirty days of index discharge. Coxproportional hazard regression was used to identify independent predictors of readmission. Results: There were 14,616 index admissions of adults with CF in 2013. Of these, 2,606 (17.8%) patients were readmitted within30 days of discharge. Female sex and chronic anemia were independent predictors of readmission. The most common causes ofreadmission were pulmonary exacerbation (31%), lung transplant complications (5.2%), and septicemia (3.4%). Conclusion: Readmissions are frequent among adults with CF and contribute to significant healthcare burden and cost amongthis population

Częstość readmisji i jej predyktory u chorych na mukowiscydozę w Stanach Zjednoczonych

WSTĘP: Częstość hospitalizacji chorych na mukowiscydozę rośnie. Przeprowadziliśmy analizę częstości zjawiska 30-dniowych readmisji i jego predyktorów u chorych na mukowiscydozę w Stanach Zjednoczonych. MATERIAŁ I METODY: Wykorzystano dane bazy readmisji NRD (Nationwide Readmission Database) z 2013 roku w celu identyfikacji dorosłych chorych na mukowiscydozę leczonych w szpitalu. Pacjenci byli poddani obserwacji prospektywnej w celu oceny występowania readmisji w ciągu 30 dni od dnia wypisu. Wykorzystano analizę regresji w celu identyfikacji niezależnych predyktorów readmisji. WYNIKI: Współczynnik przyjęć do szpitala dorosłych chorych na mukowiscydozę w 2013 roku wynosił 14 616. Spośród chorych hospitalizowanych 2606 pacjentów (17,8%) przyjęto ponownie w ciągu 30 dni od wypisu. Płeć żeńska i przewlekła niedokrwistość były niezależnymi predyktorami readmisji. Najczęstsze przyczyny readmisji stanowiły zaostrzenia oddechowe (31%), powikłania po przeszczepieniu płuca (5,2%) oraz bakteriemia (3,4%). WNIOSKI: Readmisje są częste u dorosłych chorych na mukowiscydozę i przyczyniają się do obciążenia systemu ochrony zdrowia i zwiększenia kosztów leczenia.WSTĘP: Częstość hospitalizacji chorych na mukowiscydozę rośnie. Przeprowadziliśmy analizę częstości zjawiska 30-dniowych readmisji i jego predyktorów u chorych na mukowiscydozę w Stanach Zjednoczonych. MATERIAŁ I METODY: Wykorzystano dane bazy readmisji NRD (Nationwide Readmission Database) z 2013 roku w celu identyfikacji dorosłych chorych na mukowiscydozę leczonych w szpitalu. Pacjenci byli poddani obserwacji prospektywnej w celu oceny występowania readmisji w ciągu 30 dni od dnia wypisu. Wykorzystano analizę regresji w celu identyfikacji niezależnych predyktorów readmisji. WYNIKI: Współczynnik przyjęć do szpitala dorosłych chorych na mukowiscydozę w 2013 roku wynosił 14 616. Spośród chorych hospitalizowanych 2606 pacjentów (17,8%) przyjęto ponownie w ciągu 30 dni od wypisu. Płeć żeńska i przewlekła niedokrwistość były niezależnymi predyktorami readmisji. Najczęstsze przyczyny readmisji stanowiły zaostrzenia oddechowe (31%), powikłania po przeszczepieniu płuca (5,2%) oraz bakteriemia (3,4%). WNIOSKI: Readmisje są częste u dorosłych chorych na mukowiscydozę i przyczyniają się do obciążenia systemu ochrony zdrowia i zwiększenia kosztów leczenia

Rzadki przypadek ropnia płuca pochodzenia środowiskowego wywołanego przez Serratia marcescens u pacjentki z dodatkowym oskrzelem sercowym

Ropień płuca spowodowany przez Serratia marcescens występuje niezwykle rzadko i tylko u osób mających obniżoną odporność. Przedstawiono przypadek uprzednio zdrowej kobiety z ropniem płuca wywołanym przez Serratia, położonym blisko dodatkowego oskrzela sercowego (cardiac bronchus). Pacjentka była leczona odpowiednimi antybiotykami, co doprowadziło do całkowitego wyleczenia zmiany. Opisany przypadek pokazuje, że u osób chorych na schorzenia współistniejące mogą występować nietypowe zakażenia płuc wywołane przez Serratia, związane z odchyleniami anatomicznymi.Ropień płuca spowodowany przez Serratia marcescens występuje niezwykle rzadko i tylko u osób mających obniżoną odporność. Przedstawiono przypadek uprzednio zdrowej kobiety z ropniem płuca wywołanym przez Serratia, położonym blisko dodatkowego oskrzela sercowego (cardiac bronchus). Pacjentka była leczona odpowiednimi antybiotykami, co doprowadziło do całkowitego wyleczenia zmiany. Opisany przypadek pokazuje, że u osób chorych na schorzenia współistniejące mogą występować nietypowe zakażenia płuc wywołane przez Serratia, związane z odchyleniami anatomicznymi

Case Report Central Venous Line Insertion Revealing Partial Anomalous Pulmonary Venous Return: Diagnosis and Management

Central venous line malposition is a well-known complication of line insertion. Rarely, it can be mal-positioned in an anomalous pulmonary vein. We present an unusual case of a 56-year-old woman that was found to have partial anomalous pulmonary venous return on central venous line insertion. In this report, we describe a systematic approach to diagnosis and management of this unusual situation

Prevalence and Characteristics of Self-Reported Hypothyroidism and Its Association with Nonorgan-Specific Manifestations in US Sarcoidosis Patients: A Nationwide Registry Study

Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis. We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with nonorgan-specific manifestations. 14% of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multiorgan sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal gland involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR) 1.3, 95% CI 1.01–1.6), antidepressant use (aOR 1.3, 95% CI 1.1–1.7), obesity (aOR 1.7, 95% CI 1.4–2.1), sleep apnoea (aOR 1.7, 95% CI 1.3–2.2), chronic fatigue syndrome (aOR 1.5, 95% CI 1.2–2) and was borderline associated with fibromyalgia (aOR 1.3, 95% CI 1–1.8). Physical impairment was more common in patients with hypothyroidism. Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multiorgan sarcoidosis, fatigue and depression

Analytical view of statistics and probability curriculum standards in Qatar

Ten years ago, Qatar initiated an education reform based on curriculum standards that draw on international expectations of what students should know, understand, and be able to do at each stage of their schooling. The mathematics curriculum being developed according to this reform is based on four major standards (strands): reasoning and problem solving, numbers and algebra, geometry and measure, and data handling and probability. Therefore, statistics is one of the major focus areas of the new mathematics curriculum in Qatar. This paper employs a comparative analysis approach in highlighting the mathematics national curriculum standards related to statistics and probability in Qatar. Content analysis for these standards is made and compared to the recent common international expectations of learning statistics and probability as presented at the major international conference for teaching statistics in the USA in 2014. The rationale of this study is based on the importance of the discipline of statistics and probability, which has been receiving increasing attention due to its relevance to all scientific fields, as well as daily life. Employers today are looking for people who have the skills to assess data from many areas of work and daily life; hence, statistics education—including curriculum, teaching, and learning—has become a strong focus area of international research. The results presented here suggest that the necessary development of statistics and probability education in Qatar is being implemented. Comparing statistics and probability in the old and new mathematics curricula (before and after 2004) reveals many significant changes. For example, students start studying statistics and probability according to the new standards in first grade, instead of starting statistics in the middle school and probability in secondary school. Also, many statistics concepts and procedures that were not included in the old curriculum are represented in the new standards’ statements, with instructions requiring students to, for example, “specify the problem,” “implement a plan,” “collect data from a variety of sources,” “deal with real data,” “represent data,” “evaluate results,” and “interpret data”. In spite of this progress in line with the international approach regarding statistics and probability education for reasoning and problem solving, some weakness was found in the standards being developed in Qatar. For example the important idea of “variation” is not considered properly; there is an absence of the words “variation” and “variability” and of measures of variation in the National Mathematics Scope. This paper therefore provides some recommendations, the most important of which is the need for an awareness that the fundamental issue in statistics, and thus statistics education, is variability. Indeed, this is the reason that statistics exists as a science; without variation, sources of variation, and attempts to measure and control variation, statistics would not ever have been invented. Considering that very few studies have looked at teaching and learning statistics and probability in Arab countries, including Qatar, it is hoped that this paper will activate research regarding the issue of variability and its place in statistics and probability education by a reconsideration of the standards being developed.qscienc

Rasmussen’s Aneurysm: A Rare and Potentially Fatal Cause of Hemoptysis

Rasmussen’s aneurysm is a rare and fatal cause of hemoptysis secondary to infection with pulmonary tuberculosis. The most commonly involved vessels include the bronchial arteries, but rarely can involve the pulmonary artery. We report the case of a 62-year-old female from the Philippines with undiagnosed pulmonary tuberculosis who presented with massive hemoptysis. After hemodynamic stabilization, Rasmussen’s aneurysm was diagnosed by computed tomography of the chest with angiography, confirmed with invasive angiography. She was treated definitively with glue embolization of the affected artery

A novel technique of needle setting for curvilinear endobronchial ultrasound: Improved efficiency with no cost

Background: Standard instructions for biopsy using the convex curvilinear endobronchial ultrasound scope include visualization and adjustment of the sheath housing the biopsy needle before every puncture. In our practice, we pre-set this relationship before inserting the endobronchial ultrasound scope and leave it fixed for every puncture. Objective: We postulated that this approach is more efficient than repeated re-adjustment and aimed to show that it would not increase the frequency of endobronchial ultrasound scope damage. Methods: Retrospective review of every biopsy using the endobronchial ultrasound scope over a 6-year period with documentation of damages and costs. Results: There were 15 scope damages out of 1792 procedures (0.8%). Eight damages were determined to be due to needle damage, one due to patient bite, three due to Williams airway abrasions, and three were camera failures. All damages occurred during the first 5 years of the study. Costs totaled US$138,725, for an average of US$23,120 per year. This rate of damages appears to be similar to or lower than that reported when standard instructions are followed. Conclusion: Pre-setting of the biopsy needle when the endobronchial ultrasound scope is used leads to greater efficiency and no increase in scope damages