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Less Common Lung and Bronchial Tumours; Bronchiolo-Alveolar Ca., Carcinoids, Hamartomas, Reticuloses, Protein Disorders, Lung Deposits and Leukaemia.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Although the main clinical presentations are with cough, chest pain, dyspnoea, haemoptysis or weight loss, other have peripheral thrombophlebitis, vague symptoms, secondary lung infection, or little or no symptoms. The often described 'bronchorrhoea' i.e. copious frothy or gelatinous sputum is an uncommon manifestation, occurring in 10% or less of patients. The clinical course of the disease is also very variable, from weeks after presentation to several years. The latter tends to occur when there is one or more localised areas of consolidation. The author has seen some patients survive three to four years, and one for eight. Another (a man of 77) presented with gross nodules throughout both lungs, but these remained almost static for about ten years. A biopsy proven case, treated with radiotherapy, has shown no suggestion of recurrence over five years. Arany (1958) reported one patient surviving 12 years with no symptoms from the disease.
Analyzing Radiographs for COVID-19 Using Artificial Intelligence
Published in Fadi Al-Turjman, AI-Powered IoT for COVID-19, 2020
Manpreet Sirswal, Ekansh Chauhan, Deepak Gupta, Ashish Khanna, Fadi Al-Turjman
A MERS- (Middle East respiratory syndrome) infected patient was analyzed in Ref. [7]. MERS is very closely related to the coronavirus family. The patient was 30 years old and had symptoms like diarrhea and abdominal pain. Authors gave an analysis of treatment of infected persons with chest X-ray. Further, they applied this model on a collected dataset of chest X-ray and CT images and received improved results. In Ref. [8], chest CT scans of 21 patients suffering from COVID-19 in Wuhan were analyzed. The main focus of the paper was to demonstrate the effect of the coronavirus on lungs. Finally, in Ref. [9], 50 COVID-19 positive patients were distributed into two categories of good and poor recovery. Identification of risk factor of weak recovery and lung infection was done. At the end, it was concluded that 58% patients have very poor chances of recovery.
Fever in Respiratory Diseases
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Anaerobic lung infection should be suspected in febrile patients with predisposition to aspiration either from impaired consciousness (alcoholism, drug addiction, diabetic coma, seizures, general anesthesia, stroke, dental procedures) or esophageal (swallowing) dysfunction (achalasia, scleroderma, neurologic deficits, and strictures).
Layer-by-layer coated hybrid nanoparticles with pH-sensitivity for drug delivery to treat acute lung infection
Published in Drug Delivery, 2021
Ji Luo, Xiaobo Li, Siyuan Dong, Peiyao Zhu, Wenke Liu, Shuguang Zhang, Jiang Du
In this study, inspired by the acidic microenvironment at the infection site (Zhang et al., 2019; Ma et al., 2020; Chen et al., 2021), we developed a hybrid nanoparticle based on liposome and polymer through an extrusion and LbL processes for delivery of antibiotics to treat the acute lung infection (Figure 1). Here, spectinomycin is selected as a model antibiotic (Lee et al., 2014), and was encapsulated into the liposomal core through the pH-gradient method. The liposomes were prepared based on 1, 2-distearoyl-sn-glycero-3-phospho-(1′-rac-glycerol) (DSPG) and hydrophobic cholesterol (Chol) with good biocompatibility. The polycationic polymer poly(β-amino ester) (PBAE), widely used as drug delivery carriers with pH sensitivity, was used as a functional layer for pH-triggered drug release performance (Zhang et al., 2014; Kaczmarek et al., 2016; Huang et al., 2017; Li et al., 2018; Men et al., 2020). The polyanionic sodium alginate (NaAIg) layer is successively deposited on the surface of NPs via the LbL process (Jain and Bar-Shalom, 2014; Ilgin et al., 2020), resulting in Spe-loaded liposome-polymer hybrid NPs (Spe@HNPs). The physicochemical properties of Spe@HNPs, including hydrodynamic diameter, surface charge, drug loading content, and release performance are thoroughly investigated. The antibacterial efficacy and cytotoxicity in vitro are assessed. The therapeutic efficacy against acute lung infection in vivo is evaluated. This designed Spe@HNPs might be a promising nanomedicine for anti-infection.
New visceral manifestations of fibrinogen alpha-chain amyloidosis
Published in Amyloid, 2020
Arnaud Lionet, Jean-Baptiste Gibier, Viviane Gnemmi, Celine Lebas, Marc Hazzan
Since the descriptions by Gillmore et al. [1] and Stangou et al. [2] it is established that AFib is a systemic disease not limited to the kidney. Heart and large vessels deposits are frequent and associated with a poor prognosis. In this report, we show that AFib deposits can also be found in the digestive tract, the abdominal fat tissue and the prostate, but exclusively in the small vessels walls. The vascular tropism of AFib could be related to presence of high concentration levels in the blood compartment of the mutated amyloidogenic protein. However the presence of massive AFib deposits within the bronchial submucosa was unexpected. Without prior lung examination, it is impossible to precise the time of onset of the pulmonary involvement. However, lung infection might be a trigger. Indeed, fibrinogen is an acute phase protein (ACP) and its expression in the bronchial epithelium is induced during a Pneumocystis jirovecii infection [3]. We hypothesise that the infection could induce fibrinogen production by the bronchial epithelium and promote local amyloid deposition. Moreover, serum amyloid A, another inducible ACP in the bronchial epithelia, binds fibrinogen in vitro and may have promoted amyloid formation even though it was not a major constituent of the deposits by MS [4]. Despite those histologically-proven systemic deposits of AFib, our patient recovered after the treatment of the infection. He has no more evidence of lung or digestive symptoms but cardiac and macrovascular manifestations of AFib are still concerning.
Inhalable dry powders of rifampicin highlighting potential and drawbacks in formulation development for experimental tuberculosis aerosol therapy
Published in Expert Opinion on Drug Delivery, 2020
Kai Berkenfeld, Jason T. McConville, Alf Lamprecht
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. M. tuberculosis is gram-negative bacterial species of the ubiquitous mycobacteriaceae family, showing slow growth (generation time is typically about 24 h), complex cell envelopes, and intracellular pathogenesis. Depending on the patient’s immune status, it may remain dormant for several years, which leads to delayed development of clinical symptoms [1]. The main site of infection is the lungs, though infections can secondarily spread to other organs (e.g. liver), and eventually generalize. Characteristic symptoms after lung infection, which typically occurs after exposition to bacteria conveying aerosols, include cough, fever, and hemoptysis, as well as anorexia and weight loss [2]. In 2018, approximately 10 million cases of TB were registered, making it the ninth leading cause of death globally and the leading cause of death from a single infectious agent [3]. Standard therapies of drug-susceptible strains include administration of four first-line antibiotics, i.e. rifampicin (rifampin, RIF), isoniazid (INH), ethambutol, and pyrazinamide over a period of at least 26 weeks [4].