RESUMO
Recent evidence suggests that lung cancer screening with low-dose chest CT (LDCT) has a moderate net benefit on lung cancer mortality when applied to a high-risk population. This review article examines this evidence in light of the earlier failures of lung cancerscreening using chest radiography and/or sputum cytology. Harms associated with LDCT lung cancer screening include false positive results, false negative results, incidental findings, radiation exposure, and overdiagnosis. A number of issues related to implementation are unresolved.
Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Ensaios Clínicos como Assunto , Detecção Precoce de Câncer , Medicina Baseada em Evidências , Humanos , Neoplasias Pulmonares/mortalidade , Programas de Rastreamento/métodos , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Interpretação de Imagem Radiográfica Assistida por Computador , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/efeitos adversosRESUMO
Coccidioidomycosis, although endemic to southwest regions of United States, has sporadic cases which can be encountered outside of the endemic areas. Clinicians must be aware of usual and unusual presentations of this disease entity and should keep a high level of suspicion for the diagnosis. We discuss an uncommon presentation for pulmonary coccidioidomycosis in a patient with a history of HIV/AIDS, who presented with pneumothorax due to a ruptured coccidioidal cavity. This report also illustrates the high importance of travel history in investigating rare disease presentations.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Coccidioidomicose/diagnóstico , Pneumopatias/diagnóstico , Pneumotórax/etiologia , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Antifúngicos/uso terapêutico , Líquido da Lavagem Broncoalveolar/microbiologia , Coccidioidomicose/complicações , Coccidioidomicose/tratamento farmacológico , Humanos , Pneumopatias/complicações , Pneumopatias/tratamento farmacológico , Masculino , Pneumotórax/diagnóstico por imagem , RadiografiaRESUMO
Idiopathic unilateral diaphragmatic paralysis is a rare condition that typically causes minimal symptoms, especially during exercise. Several reports indicated progressive improvement or even complete recovery to normal function of diaphragmatic paralysis that complicated various thoracic and extrathoracic conditions. In this case we describe a 57-year-old male with spontaneous recovery of idiopathic right hemidiaphragm paralysis and review reported cases of reversible diaphragmatic dysfunction.
Assuntos
Paralisia Respiratória/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Remissão Espontânea , Testes de Função Respiratória , Paralisia Respiratória/diagnóstico por imagem , Paralisia Respiratória/fisiopatologia , EspirometriaRESUMO
The author presents a case of diffuse alveolar hemorrhage in a woman consuming Ginkgo biloba extract and ginseng. The patient had no illnesses or exposures that would predispose to diffuse alveolar hemorrhage, and an extensive evaluation revealed no etiology. The patient has had no further bleeding since discontinuing Ginkgo biloba extract and ginseng 1 year ago.