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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
Blood-stained sputum (haemoptysis) can have many aetiologies (Table 6.1). Ask about onset (acute or insidious), duration (days, weeks, months), whether it is mixed with sputum, and quantity (e.g. in teaspoons or cupfuls). Haemoptysis in a smoker should be investigated to exclude bronchial carcinoma.
Pulmonary Medicine
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
Hemoptysis: Hemoptysis is the term that refers to coughing with the expectoration of blood or blood-tinged sputum. It is worth noting that the normal trachealbronchial tree should not bleed even in the presence of a coagulopathy. Thus, hemoptysis even in the setting of anticoagulation should be considered a pathological finding.
The Surgical Management of Tuberculosis and Its Complications
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Hemoptysis may be small and repeated or dramatic and life-threatening, and may result from an area of bronchiectasis or destroyed lung, or an uncomplicated cavity. Hemoptysis is much more common and far more problematical when the cavity has been colonized by a fungal ball. Although CT scanning is valuable to demonstrate the presence of fungal colonization of a small cavity (Figure 17.16),25 this is usually obvious on the chest radiograph with large cavities (Figure 17.17). Cough is then also more persistent and especially debilitating when the patient is supine at night.
The bleeding risk and safety of multiple treatments by bronchoscopy in patients with central airway stenosis
Published in Expert Review of Respiratory Medicine, 2023
Congcong Li, Yanyan Li, Faguang Jin, Liyan Bo
In this study, we quantified the bleeding risk and evaluated the safety associated with therapeutic bronchoscopy for central airway obstruction, especially in patients who received multiple rounds of treatment. By comparing the incidence of the major complication between the first treatment and retreatment, we found that therapeutic bronchoscopy had a total complication rate of 3.31%, and the incidence of major complications in the retreatment group was significantly lower than that in the first treatment group, thus indicating that retreatment of CAO via bronchoscopy was not more dangerous than the first treatment and may be safer. The incidence of hemoptysis was also recorded. We also analyzed the factors that influenced the incidence of hemorrhage and found that a short interval time, more treatment times, and general anesthesia were related to a lower incidence of hemorrhage. However, for patients who were previously bleeding, the incidence of hemorrhage was significantly higher than the incidence in the non-bleeding patients, thus indicating that caution should be used when retreating the patients who were previously bleeding during previous therapeutic bronchoscopy.
New lung cancer diagnosis after emergency department presentation in a tertiary hospital: patient characteristics and outcomes
Published in Hospital Practice, 2022
Navin Niranjan, Krishna Bajee Sriram
The 209 patients who presented to the ED were considered as the cohort of interest for the purposes of this study. Patient characteristics are presented in Table 1. There was almost equal representation of males (N = 105) and females (N = 104). Mean (± standard deviation) age of the study cohort was 70 (±11) years of age. The most common reasons for presentation to ED was dyspnea alone (38%), chest pain and dyspnea (15%), anorexia and weight loss (13%), cough and dyspnea (11%), and CNS symptoms (10%). Fourteen patients (7%) presented with hemoptysis. An overwhelming majority of patients, 186 (89%) were admitted to hospital from ED. The median (interquartile range) for the duration of hospital admission was 6 (3–11) days. A total of 1,633 bed days were utilized in the care of these patients or approximately 544 bed days per year. Based on data provided by the Independent Hospital Pricing Authority Report in the National Hospital Data Collection Cost Report, this would amount to approximately AUD$ 1.2 million.
Invasive mucinous adenocarcinoma of the lung arising in a type 1 congenital pulmonary airway malformation in a 68-year-old patient: a case report
Published in Acta Chirurgica Belgica, 2021
A. E. Frick, H. Decaluwé, B. Weynand, M. Proesmans, D. Van Raemdonck
The development of a congenital parenchymatous lung disorder, known as congenital pulmonary airway malformation (CPAM), has previously been described as congenital cystic adenomatoid malformation (CCAM) with an estimated incidence at 1:25,000–1:35,000 births. The classification by Stocker et al. in 1977 originally described 3 different subtypes and was later expanded and renamed into 5 subtypes on the basis of clinical and pathological features [1–3]. Most congenital CPAMs are uncommon and primarily identified in infants and in adults. Depending on the type of CPAM, clinical presentation and prognosis are different. Typical symptoms are recurrent pulmonary infection, productive cough, and hemoptysis. Some patients remain asymptomatic [4]. A number of reports have been published describing the association of adenocarcinoma with type 1 CPAM. The occurrence of rhabdomyosarcoma or pleuropulmonary blastoma arising in a CPAM has also been rarely documented [5,6].