Primary pulmonary amoebiasis mimicking lung tumour in immunocompromised patient: A case report.

Amoebiasis is the most common protozoan disease caused by Entamoeba histolytica. The second most frequent extraintestinal infection, behind amoebic liver abscess, is pulmonary amoebiasis. We present the case of an immunocompromised 40-year-old man. He complained of cough for 1 month, shortness of breath, and fever. Chest x-ray demonstrated left paracardial consolidation, possibly pneumonia or a mass. Chest CT scans with contrast revealed the presence of an abscess-mimicking tumour. CT-guided TTB and histology examinations indicated the presence of trophozoites of E. histolytica. This patient was diagnosed with pulmonary amoebiasis. Diagnostic criteria for pulmonary amoebiasis include clinical manifestations, radiography, and microscopic examination. There was an improvement in clinical response after a 10-day course of antibiotics. Amoebiasis of the lungs is treatable with medicines and drainage when necessary. Early diagnosis and treatment are imperative to decrease mortality and morbidity.

The burden of systemic corticosteroid use in asthma management in Asia.

For most patients, asthma can be effectively managed using inhaled medications. However, patients who have severe and/or uncontrolled asthma, or who experience exacerbations, may require systemic corticosteroids (SCSs) to maintain asthma control. Although SCS are highly effective in this regard, even modest exposure to these medications can increase the risk for long-term, adverse health outcomes, such as type 2 diabetes, renal impairment, cardiovascular disease and overall mortality. Clinical and real-world data from studies investigating asthma severity, control and treatment practices around the globe have suggested that SCS are overused in asthma management, adding to the already substantial healthcare burden experienced by patients. Throughout Asia, although data on asthma severity, control and SCS usage are limited and vary widely among countries, available data strongly suggest a pattern of overuse consistent with the broader global trend. Coordinated changes at the patient, provider, institutional and policy levels, such as increasing disease awareness, promoting better adherence to treatment guidelines and increasing availability of safe and effective alternatives to SCS, are likely necessary to reduce the SCS burden for patients with asthma in Asia.

Birt-Hogg-Dubé syndrome in an Indonesian patient with folliculin gene mutation.

Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal dominant disorder that affects the skin, kidney, and lungs. Affected individuals have an increased risk of developing multiple cysts in the lungs and a spontaneous pneumothorax. Germline mutations in the folliculin (FLCN) gene have been confirmed as the aetiology of BHD syndrome. A 51-year-old Indonesian female presented with recurrent spontaneous pneumothorax, multiple cysts in both lungs, and a renal cyst on magnetic resonance imaging (MRI). Blood sampling was performed to extract genomic DNA from peripheral blood leucocytes. We identified an aberrant band in the DNA fragment derived from FLCN exon 6. Moreover, direct sequencing of FLCN exon 6 by denaturing high-performance liquid chromatography (DHPLC) showed a pathogenic mutation, which caused premature termination of folliculin protein translation. This is the first reported case of BHD syndrome in an Indonesian patient confirmed by detection of a FLCN exon 6 mutation.

The prevalence and patient characteristics of chronic obstructive pulmonary disease in non-smokers in Vietnam and Indonesia: An observational survey.

BACKGROUND AND OBJECTIVE: An estimated 25-40% of patients with chronic obstructive pulmonary disease (COPD) have never smoked. We investigated the prevalence and patient characteristics of COPD in non-smokers from Vietnam and Indonesia. METHODS: This population-based cross-sectional survey of participants from urban and rural Vietnam and Indonesia used a stratified multistage cluster sampling design, with sample and population weights applied to ensure representativeness. Participants were female or male (recruited in the ratio 2:1) non-smokers, 40 years or older and able to perform a spirometry test. Spirometry was performed at a single study visit. Other clinical information was collected via standardized questionnaires. RESULTS: The 1506 evaluable participants were approximately equally distributed between Vietnam and Indonesia, and rural and urban areas. Overall prevalence of COPD was found to be 6.9% (95% confidence interval (CI): 5.7-8.3), with almost three times higher prevalence in men than women (12.9% (95% CI: 9.1-18.0) vs 4.4% (95% CI: 3.0-6.5)). We found higher rates of COPD in Vietnam than Indonesia (8.1% (95% CI: 5.8-11.3) vs 6.3% (95% CI: 4.8-8.3)), with a particularly high prevalence in urban Vietnam (11.1% (95% CI: 8.1-15.1)). Very few participants (6%) diagnosed to have COPD during the study had been previously diagnosed with COPD. Respiratory symptoms and lower health-related quality of life were more common in participants with COPD. CONCLUSIONS: The prevalence of COPD in non-smoking individuals from rural and urban Vietnam and Indonesia was 6.9%, of which a significant proportion (94%) were previously undiagnosed.

EGFR activating aberration occurs independently of other genetic aberrations or telomerase activation in adenocarcinoma of the lung.

The prognosis of lung cancer remains poor, and biological heterogeneity is largely responsible, especially in adenocarcinoma. We previously found that only one third of non-small cell lung cancer (NSCLC) but most small cell lung cancer (SCLC) tissues have strong telomerase activity, representing the difference in the history of multiple clonal selections. To reveal the genes differentially involved in telomerase activation mechanisms, we analyzed the relationship between common genetic aberrations and telomerase activity in 83 lung cancer tissues. We found that half (7 of 14) of lung adenocarcinomas with high telomerase activity showed neither TP53 nor RB1 deletion, while all squamous cell carcinomas and SCLCs with high telomerase activity showed loss of heterozygosity of at least one, if not both, of these suppressor oncogenes, indicating that these genetic aberrations are not required in activation of telomerase in a unique subset of adenocarcinoma. Furthermore, whereas the aberrations in TP53, RB1 and 1p34-pter were mutually related in 42 adenocarcinoma tissues, EGFR aberrations showed no relationship to either of them. These findings indicate that EGFR activating aberrations occur independently of other common genetic aberrations or telomerase activation mechanisms in lung adenocarcinoma, and that the distinct subset of lung adenocarcinoma with high telomerase activity without any common genetic aberrations may possibly have arisen from a telomerase-positive or telomerase-competent normal cell.