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1.
BMC Pulm Med ; 20(1): 244, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928157

RESUMO

BACKGROUND: Since the beginning of SARS-CoV-2 outbreak in China, severe acute respiratory syndrome has been widely descripted. Hemoptysis has rarely been observed in SARS-CoV-2 infection. We report here a case of severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection and managed in a referral center. CASE PRESENTATION: A 58-year-old man was admitted to our intensive care unit for severe hemoptysis with history of post-tuberculosis bronchiectasis. At ICU admission the patient had fever and severe acute respiratory failure requiring high flow oxygen therapy. Respiratory tract sampling was positive for SARS-CoV-2. Multi-detector computed tomography angiography pointed out localized bronchiectasis on the left lower lobe and enlarged left bronchial and phrenic arteries; bronchial arteriography with distal embolization was performed with favorable outcome and no bleeding recurrence. CONCLUSIONS: To our knowledge, this is the first case of acute exacerbation of bronchiectasis related to SARS-CoV-2 infection and complicated by severe hemoptysis. Whether the virus may play a role in the dysregulation of airway haemostasis, and contribute to episodes of hemoptysis in patients with chronic pulmonary diseases and predisposing factors might be investigated.


Assuntos
Bronquiectasia/complicações , Infecções por Coronavirus/complicações , Hemoptise/etiologia , Pneumonia Viral/complicações , Tuberculose Pulmonar/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Índice de Gravidade de Doença
2.
BMC Pulm Med ; 20(1): 247, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938417

RESUMO

BACKGROUND: Computed tomography-guided transthoracic needle biopsy (CT-TNB) is a widely used method for diagnosis of lung diseases; however, CT-TNB-induced bleeding is usually unexpected and this complication can be life-threatening. The aim of this study was to develop and validate a predictive model for hemoptysis following CT-TNB. METHODS: A total of 436 consecutive patients who underwent CT-TNB from June 2016 to December 2017 at a tertiary hospital in China were divided into derivation (n = 307) and validation (n = 129) cohorts. We used LASSO regression to reduce the data dimension, select variables and determine which predictors were entered into the model. Multivariate logistic regression was used to develop the predictive model. The discrimination capacity of the model was evaluated by the area under the receiver operating characteristic curve (AUROC), the calibration curve was used to test the goodness-of-fit of the model, and decision curve analysis was conducted to assess its clinical utility. RESULTS: Five predictive factors (diagnosis of the lesion, lesion characteristics, lesion diameter, procedure time, and puncture distance) selected by LASSO regression analysis were applied to construct the predictive model. The AUC was 0.850 (95% confidence interval [CI], 0.808-0.893) in the derivation, and 0.767 (95% CI, 0.684-0.851) in the validation. The model showed good calibration consistency (p > 0.05). Moreover, decision curve analysis indicated its clinical usefulness. CONCLUSION: We established a predictive model that incorporates lesion features and puncture parameters, which may facilitate the individualized preoperative prediction of hemoptysis following CT-TNB.


Assuntos
Hemoptise/etiologia , Biópsia Guiada por Imagem/efeitos adversos , Pulmão/patologia , Modelos Teóricos , Tomografia Computadorizada por Raios X , Idoso , Feminino , Previsões , Hemoptise/epidemiologia , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco/métodos
5.
Am J Cardiol ; 128: 161-162, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32650913

RESUMO

We describe an 84-year-old man who presented with hemoptysis and acute blood loss anemia due to a pulmonary artery pseudoaneurysm (PAP). The etiology of his PAP was thought to be an abandoned epicardial defibrillator patch that was implanted at age 55. To our knowledge, PAP has never been reported as a possible complication of an abandoned epicardial defibrillator patch.


Assuntos
Falso Aneurisma/diagnóstico por imagem , Desfibriladores Implantáveis , Corpos Estranhos/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Idoso de 80 Anos ou mais , Anemia/etiologia , Anemia/terapia , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Angiografia Digital , Transfusão de Sangue , Procedimentos Endovasculares , Corpos Estranhos/complicações , Hemoptise/etiologia , Hemoptise/cirurgia , Humanos , Masculino , Artéria Pulmonar/cirurgia , Tomografia Computadorizada por Raios X
8.
Med Clin North Am ; 104(3): 455-470, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32312409

RESUMO

Respiratory symptoms are common in patients living with serious illness, both in cancer and nonmalignant conditions. Common symptoms include dyspnea (breathlessness), cough, malignant pleural effusions, airway secretions, and hemoptysis. Basic management of respiratory symptoms is within the scope of primary palliative care. There are pharmacologic and nonpharmacologic approaches to treating respiratory symptoms. This article provides clinicians with treatment approaches to these burdensome symptoms.


Assuntos
Tosse/terapia , Estado Terminal/terapia , Dispneia/terapia , Hemoptise/terapia , Derrame Pleural Maligno/tratamento farmacológico , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Secreções Corporais/efeitos dos fármacos , Terapia Combinada/métodos , Tosse/epidemiologia , Tosse/etiologia , Tosse/patologia , Dispneia/epidemiologia , Dispneia/etiologia , Dispneia/patologia , Hemoptise/epidemiologia , Hemoptise/etiologia , Hemoptise/patologia , Humanos , Mortalidade/tendências , Cuidados Paliativos/normas , Derrame Pleural Maligno/epidemiologia , Derrame Pleural Maligno/mortalidade , Prevalência , Sistema Respiratório/efeitos dos fármacos , Sistema Respiratório/fisiopatologia , Fatores de Risco
10.
Ann R Coll Surg Engl ; 102(6): e133-e135, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32233849

RESUMO

Ganglioneuroma is a rare benign neoplasm. Patients with ganglioneuroma show no symptoms. We describe a rare case of giant ganglioneuroma with scoliosis in a 35-year-old woman, who presented to our hospital for haemoptysis. We combined with neurosurgeons to remove the tumour successfully. After 16 months of follow-up, there is no evidence of tumour recurrence.


Assuntos
Ganglioneuroma/cirurgia , Hemoptise/etiologia , Neoplasias do Mediastino/cirurgia , Escoliose/diagnóstico , Vértebras Torácicas/cirurgia , Adulto , Feminino , Ganglioneuroma/complicações , Ganglioneuroma/diagnóstico , Ganglioneuroma/patologia , Humanos , Imagem por Ressonância Magnética , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/patologia , Invasividade Neoplásica/diagnóstico por imagem , Escoliose/complicações , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Carga Tumoral
11.
Am J Emerg Med ; 38(7): 1544.e1-1544.e3, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32312574

RESUMO

Recent retrospective studies from Wuhan, China suggest Novel Coronavirus Disease 2019 (COVID-19) may be associated with a hypercoagulable state and increased risk for venous thromboembolism. The overlap in the signs and symptoms of COVID-19 associated Acute Respiratory Distress Syndrome (ARDS) and COVID-19 with concurrent pulmonary embolism creates a diagnostic challenge for emergency medicine physicians in patients already at risk for renal impairment. However, identifying features atypical for COVID-19 alone may play a role in the judicious use of Computed Tomography Angiography among these patients. Hemoptysis is seen in roughly 13% of pulmonary embolism cases and infrequently reported among COVID-19 infections. Additionally, the presence of right heart strain on electrocardiography (EKG) is a well described clinical presentations of pulmonary embolism not reported commonly with COVID-19 infections.


Assuntos
Infecções por Coronavirus/complicações , Hemoptise/etiologia , Pneumonia Viral/complicações , Embolia Pulmonar/virologia , Tromboembolia Venosa/virologia , Doença Aguda , Adulto , Betacoronavirus , Angiografia por Tomografia Computadorizada , Infecções por Coronavirus/diagnóstico , Eletrocardiografia , Humanos , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Embolia Pulmonar/diagnóstico por imagem , Tromboembolia Venosa/diagnóstico por imagem
13.
Korean J Radiol ; 21(5): 537-540, 2020 05.
Artigo em Inglês | MEDLINE | ID: covidwho-8676

RESUMO

Recently, some global cases of 2019 novel coronavirus (COVID-19) pneumonia have been caused by second- or third-generation transmission of the viral infection, resulting in no traceable epidemiological history. Owing to the complications of COVID-19 pneumonia, the first symptom and imaging features of patients can be very atypical and early diagnosis of COVID-19 infections remains a challenge. It would aid radiologists and clinicians to be aware of the early atypical symptom and imaging features of the disease and contribute to the prevention of infected patients being missed.


Assuntos
Infecções por Coronavirus/complicações , Hemoptise/etiologia , Pneumonia Viral/complicações , Tomografia Computadorizada por Raios X , Betacoronavirus , Técnicas de Laboratório Clínico , Coronavirus , Infecções por Coronavirus/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico
14.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(3): 223-227, 2020 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-32164093

RESUMO

Objective: To investigate the efficacy and safety of transcatheter embolization for the treatment of pulmonary artery pseudoaneurysms (PAPs) with massive hemoptysis via both arterial and venous access. Methods: The clinical data of 15 patients of pulmonary tuberculosis presenting with massive hemoptysis, who were confirmed by CTA/DSA with PAPs at the Second Affiliated Hospital of Hainan Medical University from January 2016 to February 2018, were retrospectively analyzed. The imaging presentation, technical and clinical success of endovascular treatment, and recurrence of hemoptysis within 1 year was recorded. Results: A total of 15 PAPs were involved. Fourteen PAPs were confirmed by pulmonary CTA and one by angiography. Six PAPs were visualized during bronchial artery angiography, 4 PAPs during pulmonary artery angiography, and 4 PAPs both. One PAP was not shown during catheter-directed angiography. Except for one patient who died of asphyxia due to severe hemoptysis undergoing embolization, hemoptysis relapse was achieved in 14 patients after endovascular treatment. During 12 months follow-up, one patient underwent surgical resection because of recurrent hemoptysis 2 weeks after embolization, and another patient with recurrence hemoptysis 3 months after embolization received repeated intervention and hemoptysis relapsed. Conclusion: Transcatheter embolization via dual access is effective and feasible for the treatment of PAPs with massive hemoptysis in patients with pulmonary tuberculosis, but still some risks.


Assuntos
Falso Aneurisma , Embolização Terapêutica , Hemoptise , Tuberculose Pulmonar , Falso Aneurisma/complicações , Falso Aneurisma/terapia , Angiografia , Artérias Brônquicas , Hemoptise/etiologia , Hemoptise/terapia , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/complicações
15.
Korean J Radiol ; 21(5): 537-540, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32174057

RESUMO

Recently, some global cases of 2019 novel coronavirus (COVID-19) pneumonia have been caused by second- or third-generation transmission of the viral infection, resulting in no traceable epidemiological history. Owing to the complications of COVID-19 pneumonia, the first symptom and imaging features of patients can be very atypical and early diagnosis of COVID-19 infections remains a challenge. It would aid radiologists and clinicians to be aware of the early atypical symptom and imaging features of the disease and contribute to the prevention of infected patients being missed.


Assuntos
Infecções por Coronavirus/complicações , Hemoptise/etiologia , Pneumonia Viral/complicações , Tomografia Computadorizada por Raios X , Betacoronavirus , Técnicas de Laboratório Clínico , Coronavirus , Infecções por Coronavirus/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico
16.
Chest ; 157(3): e79-e84, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32145821

RESUMO

CASE PRESENTATION: A 78-year-old Chinese man presented in March 2019 with a 2-day history of small-volume hemoptysis. He did not report any associated chronic cough, sputum production, epistaxis, night sweats, unintentional weight loss, or fever. He was an ex-smoker of 10 pack years. His medical history was significant for ischemic heart disease on aspirin, as well as hospitalizations in 2016 and 2017 for hemoptysis. The patient's evaluation for hemoptysis was only notable for a right middle lobe nodule on chest CT imaging and Klebsiella pneumoniae on sputum cultures, for which he was treated with antibiotics.


Assuntos
Actinomicose/complicações , Hemoptise/etiologia , Pneumopatias/complicações , Nódulo Pulmonar Solitário/etiologia , Actinomicose/diagnóstico , Actinomicose/tratamento farmacológico , Actinomicose/patologia , Idoso , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Biópsia , Líquido da Lavagem Broncoalveolar , Broncoscopia , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pneumopatias/diagnóstico , Pneumopatias/tratamento farmacológico , Pneumopatias/patologia , Masculino , Penicilina G/uso terapêutico , Recidiva , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/patologia , Tomografia Computadorizada por Raios X
17.
Rev Mal Respir ; 37(3): 275-279, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32171443

RESUMO

INTRODUCTION: Haemangiomas are vascular malformations, frequently cutaneous, hepatic and splenic. Respiratory involvement and multiple localisations are uncommon. CASE REPORT: We present a rare case of multiple cavernous haemangiomas in a 35 year old woman presenting with repeated haemoptysis. Thoracic CT scanning showed a mass in the left lower lobe associated with lymph node enlargement above and below the diaphragm, heterogeneous splenomegaly and a single spinal lesion without hypermetabolism on PET scanning. Enbronchial ultrasound-guided trans-bronchial needle aspiration was not contributory. Histopathological diagnostic was made firstly by splenectomy with lumbar-aortic curettage and then by lobectomy for haemostasis. A final diagnosis of multiple cavernous haemangiomas involving lung, lymph nodes, spleen and bone was made. CONCLUSIONS: Bronchopulmonary cavernous haemangiomas associated with extra-thoracic lesions are exceptionally rare and their presentation, suggesting, a malignant cause, often leads to surgical resection for diagnostic and, eventually, therapeutic management. We report an original case of cavernous haemangiomas involving lung, lymph nodes, spleen and bone.


Assuntos
Neoplasias Ósseas/diagnóstico , Hemangioma Cavernoso/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Esplênicas/diagnóstico , Adulto , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Feminino , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/cirurgia , Hemoptise/diagnóstico , Hemoptise/etiologia , Hemoptise/cirurgia , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Imagem por Ressonância Magnética , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Esplenectomia/efeitos adversos , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Esplenomegalia/etiologia , Esplenomegalia/cirurgia , Tomografia Computadorizada por Raios X
20.
Chest ; 157(2): e31-e35, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32033658

RESUMO

CASE PRESENTATION: A 24-year-old man was admitted for a new episode of hemoptysis. He reported 3 episodes of hemoptysis in the past 2 years. He had no other medical history and was a nonsmoker. As a Vietnamese person born and living in Vietnam, he was at risk for TB, but had not had contact with those having TB in his family or workplace, was never imprisoned nor homeless, and never traveled abroad. He never experienced pneumonia. He coughed up a small amount of fresh with air red blood (around 5 mL each time) several time for 3 days. He had no dyspnea, no chest pain, no fever, no asthenia, and no anorexia.


Assuntos
Sequestro Broncopulmonar/complicações , Hemoptise/etiologia , Pulmão/irrigação sanguínea , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/cirurgia , Humanos , Imageamento Tridimensional , Masculino , Recidiva , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios X , Adulto Jovem
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