Pulmonary/Critical Care

Is Vasopressin Indicated in the Management of Cardiac Arrest?

February 2, 2011
Is Vasopressin Indicated in the Management of Cardiac Arrest?

By Brandon Oberweis, MD

Faculty Peer Reviewed

Case Report:

A 65-year-old male with a past medical history significant for NYHA class IV heart failure was found by his wife to be unresponsive.  Emergency Medical Services was subsequently called and upon arrival, initiated chest compressions and defibrillation for cardiac arrest secondary to ventricular fibrillation.  Intravenous access was obtained and despite two episodes of defibrillation, the patient remained in ventricular fibrillation.  The patient was given one dose of 40 U of vasopressin followed by 1 mg …

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Breaking News: Lung Cancer Screening Shows Mortality Benefit

November 5, 2010
Breaking News: Lung Cancer Screening Shows Mortality Benefit

By David Hormozdi, MD

The weather outside may be cooling off but the debate surrounding lung cancer screening is heating up once again as preliminary results released from The National Lung Screening Trial (NLST) showed 20% fewer lung cancer deaths in individuals that underwent screening with low-dose helical CT scans compared to chest X-ray. This is the first study to show a mortality benefit from lung cancer screening and could impact millions of people considered high-risk for lung cancer.  The study’s initial findings were released …

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Mystery Quiz- The Answer

July 9, 2010

Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The answer to the mystery quiz is pleural effusion that is loculated in both the horizontal and right oblique fissures. Pleural effusion is seen as blunting of the right costophrenic angle and tracking of fluid laterally (Image 3, arrowhead). The horizontal fissure thickens due to fluid which becomes an ovoid density more medially (Image 3, arrow). This ovoid density, representing loculated fluid in the horizontal fissure, is often referred to as a pseudotumor. It …

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Mystery Quiz

July 4, 2010
Mystery Quiz

Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The patient is a 61 year old man presenting with one month of worsening shortness of breath. The patient has a history of alcoholism and was diagnosed with atrial fibrillation during a hospital admission for detox three years earlier. Warfarin therapy was not begun due to a history of poor medication compliance. One year prior to admission an echocardiogram showed a normal global ejection fraction and mild mitral regurgitation. One month prior to admission, …

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Antimicrobial Therapy Geared at Pseudomonas aeruginosa for Bronchiectasis

April 7, 2010
Antimicrobial Therapy Geared at Pseudomonas aeruginosa for Bronchiectasis

Diana Hubulashvili, Pharm.D.

Edited by Tania Ahuja, Pharm.D., BCPS

Faculty peer reviewed

Bronchiectasis is an uncommon condition that is characterized by irreversible dilation of the bronchi. Chronic pulmonary infections and airway inflammation cause bronchial damage through destruction of the muscular and elastic layer of the bronchial wall leading to bronchiectasis. Bronchiectasis is associated with serious pulmonary infections, inflammation, chronic cough, and increased sputum production...

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How Easily is Tuberculosis Spread?

March 31, 2010
How Easily is Tuberculosis Spread?

Molly Cason

Faculty peer reviewed

In a city of over 8 million people, New York City has an annual tuberculosis case rate of 11.4 per 100,000 people, which is more than twice the national average.  Seventy-one percent of these cases occur in people who were born outside the United States.1 As a student, I had a patient (Y) who was being evaluated for active tuberculosis because he is a household contact of a person (X) known to have active multi-drug resistant tuberculosis. I wondered what …

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Mystery Quiz- The Answer

March 28, 2010
Mystery Quiz- The Answer

Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The answer to the mystery quiz is progressive massive fibrosis. This condition is a severe form of silicosis. The chest radiograph (Image 3) shows bullous disease of the right upper lobe, increased density of the right hilum, increased density and upward retraction of the left hilum (also seen in Image 4), increased density in peripheral areas of both lungs, and an air crescent sign in the left upper lobe (also seen in Image 5). …

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Mystery Quiz

March 17, 2010
Mystery Quiz

Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The patient is a 39yo male followed in pulmonary clinic for chronic breathlessness and intermittent sputum production, sometimes blood tinged. Symptoms were first noted eleven years earlier at which time pulmonary function testing revealed mixed obstructive and restrictive defects. The patient experienced some improvement with bronchodilators, occasional courses of oral steroids and antibiotics, but was never entirely free of his symptoms. Over an interval of ten years, the patient required several hospitalizations for treatment …

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