Complications of chronic necrotizing pulmonary aspergillosis: review of published case reports

Chronic necrotizing pulmonary aspergillosis (CNPA), a form of chronic pulmonary aspergillosis (CPA), affects immunocompetent or mildly immunocompromised persons with underlying pulmonary disease. These conditions are associated with high morbidity and mortality and often require long-term antifungal treatment. The long-term prognosis for patients with CNPA and the potential complications of CNPA have not been well documented. The aim of this study was to review published papers that report cases of CNPA complications and to highlight risk factors for development of CNPA. The complications in conjunction associated with CNPA are as follows: pseudomembranous necrotizing tracheobronchial aspergillosis, ankylosing spondylarthritis, pulmonary silicosis, acute respiratory distress syndrome, pulmonary Mycobacterium avium complex (MAC) disease, superinfection with Mycobacterium tuberculosis, and and pneumothorax. The diagnosis of CNPA is still a challenge. Culture and histologic examinations of bronchoscopically identified tracheobronchial mucus plugs and necrotic material should be performed in all immunocompromised individuals, even when the radiographic findings are unchanged. Early detection of intraluminal growth of Aspergillus and prompt antifungal therapy may facilitate the management of these patients and prevent development of complications

SEVERE PNEUMONIA CAUSED BY ANTIPSIHOTIC DRUGS-WHAT DOES NOT SUIT, THE PATIENT OR THE DRUG?

Introduction: Antipsychotic drugs are generally categorized as typical antipsychotics (sometimes referred to as first-generation or conventional antipsychotics, or neuroleptics) and atypical antipsychotics; both are approved for the treatment of acute and chronic psychoses (i.e, schizophrenia), mania, agitation, and other psychiatric disorders. In 2005 the US Food and Drug Administration issued a warning about the increased risk of all-cause mortality associated with atypical antipsychotic use in elderly patients with dementia. Community acquired pneumonia (CAP) was one of the most frequently reported causes of death. The same warning was extended to typical antipsychotics in 2008 with extension to people with or without dementia. Case report: We present a 65-year-old Caucasian woman who was admitted to hospital due to massive pneumonia. She was suffered forschisophrenia15-years and at moment of admission she was in remission. She had continuously high fever up to 40 degrees. All collected cultures (blood, sputum, urine,smear of aspirating catheter) were negative. She was treated with various antibiotics without improvement. After changing antipsychotic drugs, she showed slow improvement until total recovery after 3 months. Discussion and conclusion: Antipsychotic-associated CAP seems to be a clinically relevant issue in frail elderly patients, as consistently documented in several epidemiologic investigations. No clear evidence exists for an increased risk of pneumonia in younger patients treated with antipsychotics. In elderly populations, the increase in risk is dose-dependent, and is more pronounced in the early phases of treatment. Future studies should better define the mechanism underlying antipsychotic-induced pneumonia and identify subgroups of antipsychotic users at higher risk of developing pneumonia

Duvan chvarci : product characterization and comparison between traditional and industrial production

Research Areas: Food Science & TechnologyThis research aimed to investigate and compare traditional products called “duvan chvarci” produced using pork meat and fat, originated from local households and industries. Physical and chemical analysis demonstrated differences among the examined products, mostly in total chloride content and TBARS values. Samples collected at local households showed finer color (higher lightness and yellowness) and sensory properties (rated as “extremely acceptable”), while industrial products were rated between “very acceptable” and “extremely acceptable“. Microbiological analysis exhibited that enterobacteria, coagulase-positive staphylococci, Salmonella spp., Shigella spp., and fungi were absent from all meat products. Dominant microbiota was identified as Lactobacillus spp. and Staphylococcus spp. All tested isolates showed γ-haemolysis on blood agar plates. Tested Staphylococcus spp. were sensitive to novobiocin while Lactobacillus isolates demonstrated sensitivity to ampicillin, chloramphenicol, clindamycin, erythromycin, tetracycline, gentamycin, and streptomycin. None of the tested isolates showed full resistance to antibiotics. Overall, results indicated that duvan chvarci is a microbiologically safe product and provided the initial evidence regarding the physical, chemical, technological, and sensory properties of this widely consumed product in the Balkans.info:eu-repo/semantics/publishedVersio

Quality and autochthonous microbiota of dry-cured sheep ham from western Balkans

Dry-cured sheep ham is a traditional product of Western Balkans. It is prepared by dry curing specially treated whole sheep carcasses which are smoked for a short time and spontaneously fermented in air under uncontrolled conditions. Lactic acid bacteria (LAB) play a key role in defining the quality and organoleptic characteristics of dry-cured sheep ham. The aim of this research was to investigate the chemical parameters of drycured sheep ham quality as well as the isolation and preliminary categorization of LAB. To this end, samples of dry-cured sheep ham were obtained from nine sheep of average age of about five years, from three households from the geographical area Sjenica (Western Serbia). Physicochemical analysis has determined the content of water, protein, fat, mineral matter, water activity and pH values in the product. Phenotypic characterization of LAB isolated from dry-cured sheep ham was based on the general morphology of the cell, physiological tests and sugar fermentation patterns of LAB isolates. 124 isolates of LAB were preliminary identified as Lactobacillus curvatus , Lactobacillus sakei and Enterococcus faecium . Chemical analysis confirmed a harmonious relationship between the quality parameters of dry-cured sheep ham.Publishe

TUBERCULOUS PLEURAL EFFUSION IN THE PREVIOUSLY HEALTHY MAN-CASE REPORT AND REVIEW OF THE LITERATURE

Introduction: Although pleural effusion is a common clinical manifestation, the differential diagnosis of the cause of the pleural effusion is often challenging, especially in the early differentiation of tuberculous pleurisy (TP) from other pleural effusion. Case report: We present a previously healthy man who had no contagious or TB contact but developed massive tuberculous pleural effusion which eventually was unexpected tuberculous. He started with therapy per protocol and feeling well. The purpose of this case and review of literature was to remind the physicians that tuberculosis is not a sickening illness, but on the contrary, it is in the expansion. Discussion: When a patient presents with new pleural effusion, the diagnosis of tuberculous pleuritis should be considered. The patient is at great risk for developing pulmonary or extra pulmonary TB if the diagnosis is not made properly. Between 3% and 25% of patients with TB will have TB pleuritic or more in immunocompromised patients.The treatment for TB pleuritis is the same as that for pulmonary TB. Conclusion:The gold standard for the diagnosis of tuberculous pleural effusion remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli

PULMONARY THROMBOEMBOLISM AND ROLE OF FACTOR V LEIDENIN ITS DEVELOPMENT-REVIEW OF LITERATURE

Pulmonary embolism (PE) and deep vein thrombosis (DVT) are associated with considerable morbidity and mortality, and for as much as twenty-five percent of PE patients the primary clinical appearance is unexpected death. Diagnosis of PE is based on clinical suspicious at first, but sometimes its diagnostics can be extremely difficult. Newly increased interest in an inherited thrombophilic states has been provoked by the discovery of several common inherited abnormalities, i.e. the prothrombin (PT) gene G20210A, Factor V Leiden (FVL) mutation (Arg506Gln), hyperhomocystenemia and homocysteiuria, Wein-Penzing defect, Sticky Platelet Syndrome (SPS), Quebec platelet disorder (QPD) and Sickle Cell Disease (SCD). PE incidence rates increase in recent years. The only explanation at this moment is increased awareness of PE, especially after any kind of surgery, immobile state or unexplained shorthness of breath

PHANTOM TUMOR OF THE LUNG IN PATIENT WITH PNEUMONIA

Introduction: Localized interlobar effusions in congestive heart failure (phantom or vanishing lung tumor/s) are infrequent, but widely recognized entities. Case report: A 80-years-old woman affected by progressive dyspnea over the previous three months, with productive cough. She was treated hypertension and had a pace maker implanted due to bradycardia. Chest X ray has shown right side pneumonia with high positive inflammatory markers. After resolution of pneumonia, phantom tumor of the lung was revealed, which disappear with intensive loop diuretics. Conclusions: The diagnosis of the phantom tumor ought to be pondered as a possibility in any patient with congestive heart failure and lung mass. The patient at hand featured no prior history of congestive heart failure, hence indicating that phantom tumor may occur in non-chronic heart failure patients. Albeid the reliable diagnosis of the phantom tumor through the utilization of imaging modalities in patients without congestive heart failure can be rather challenging, such possibility must be considered in a patient with a lung mass in the major fissure of the lungs. Due to accelerated expansion of the geriatric population and subsequent spread of the congestive heart failure, a rise in the incidence of vanishing tumors of the lung may be anticipated

Sport-specific influences on respiratory patterns in elite athletes

ABSTRACT OBJECTIVE: To examine differences in lung function among sports that are of a similar nature and to determine which anthropometric/demographic characteristics correlate with lung volumes and flows. METHODS: This was a cross-sectional study involving elite male athletes (N = 150; mean age, 21 4 years) engaging in one of four different sports, classified according to the type and intensity of exercise involved. All athletes underwent full anthropometric assessment and pulmonary function testing (spirometry). RESULTS: Across all age groups and sport types, the elite athletes showed spirometric values that were significantly higher than the reference values. We found that the values for FVC, FEV1, vital capacity, and maximal voluntary ventilation were higher in water polo players than in players of the other sports evaluated (p < 0.001). In addition, PEF was significantly higher in basketball players than in handball players (p < 0.001). Most anthropometric/demographic parameters correlated significantly with the spirometric parameters evaluated. We found that BMI correlated positively with all of the spirometric parameters evaluated (p < 0.001), the strongest of those correlations being between BMI and maximal voluntary ventilation (r = 0.46; p < 0.001). Conversely, the percentage of body fat correlated negatively with all of the spirometric parameters evaluated, correlating most significantly with FEV1 (r = −0.386; p < 0.001). CONCLUSIONS: Our results suggest that the type of sport played has a significant impact on the physiological adaptation of the respiratory system. That knowledge is particularly important when athletes present with respiratory symptoms such as dyspnea, cough, and wheezing. Because sports medicine physicians use predicted (reference) values for spirometric parameters, the risk that the severity of restrictive disease or airway obstruction will be underestimated might be greater for athletes