Tension Pneumoperitoneum Associated with Nasopharyngeal Catheter Oxygen Delivery during Bronchoscopy Karim El-Kersh, Hala Karnib Am J Respir Crit Care Med 2017 Published on 29-June-2017 as 10.1164/rccm.201701-0181IM A 61-year-old female with chronic lymphocytic leukemia was undergoing bronchoscopy with bronchoalveolar lavage. The patient never smoked and she did not have any underlying chronic gastric disease. The bronchoscopy was performed in supine position under conscio...

Images in Clinical Medicine Calcium Oxalate Crystals in Ethylene Glycol Toxicity Mohamad Hanouneh, Teresa K. Chen N Engl J Med 2017; 377: 1467 An 80-year-old man with a remote history of alcohol-use disorder presented to the emergency department with altered mental status after a fall at home. He was somnolent and unable to provide any further history. Serum studies revealed a creatinine level of 2.4 mg per deciliter (212 μmol per liter; reference range, 0....

JAMA Diagnostic Test Interpretation September 26, 2017 Aspergillus Galactomannan for Diagnosing Invasive Aspergillosis Marisa H. Miceli, Carol A. Kauffman JAMA. 2017;318(12):1175-1176. doi:10.1001/jama.2017.10661 A 67-year-old man with granulomatous polyangiitis (Wegener granulomatosis) complicated by end-stage renal disease requiring hemodialysis and mild pulmonary fibrosis, was hospitalized with a 2-week history of worsening dyspnea and dry cough. He was taking ...

Viewpoint October 3, 2017 Research Integrity, Academic Promotion, and Attribution of Authorship and Nonauthor Contributions Spyros D. Mentzelopoulos, Spyros G. Zakynthinos JAMA. 2017;318(13):1221-1222. doi:10.1001/jama.2017.11790 Guidelines for the academic promotion of university faculty members are essential for the achievement and maintenance of high academic quality. However, these guidelines and criteria vary widely around the world and in the United States, with ...

Images in Clinical Medicine Pulmonary Foreign-Body Granulomatosis Dustin A. Staloch, J. Stephen Hedley N Engl J Med 2017; 377: 1273 A 31-year-old woman who was receiving long-term total parenteral nutrition after having undergone Roux-en-Y gastric bypass that was complicated by small-bowel resection presented to the pulmonology clinic with exertional dyspnea that had progressed over the course of 1 year. She had normal oxygen saturation while breathing ambient air and was...

Aberrant Right Subclavian Artery on EBUS Nicholas M. Mark, David K. Madtes Am J Respir Crit Care Med 2017 Published on 06-July-2017 as 10.1164/rccm.201704-0706IM A 70 year old man underwent bronchoscopy under general anesthesia for biopsy of mediastinal adenopathy due to suspected lymphoma. The airways appeared normal, however on endobronchial ultrasound (EBUS) examination, a thick walled pulsatile mass posterior to the trachea was visualized (A). Doppler ultrasound (B) re...

IMAGES IN CLINICAL MEDICINE Eosinophilic Bronchitis Yanhong Ren, M.D., Ph.D., and Huaping Dai, M.D. N Engl J Med 2017; 377:873 DOI: 10.1056/NEJMicm1616156 A 43-year-old woman presented with an 8-month history of progressively worsening nonproductive cough. She had been treated with antibiotic agents for presumed bronchitis, but her cough continued to worsen. Her vital signs were normal, the pulmonary examination was notable for wheezing in both lungs, and the white-cell c...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 问题5. Which of the following is accurate about the treatment of heat stroke?有关热射病的治疗，以下说法哪个是准确的？ A. Patients with EHS should be admitted to the hospital for 24 hours, but patients with NEHS typically do not require hospitalization EHS患者应住院24小时，但NEHS患者通常无需住院治疗 B. Cooling of athle...

Drugs & Diseases > Fast Five Quizzes Fast Five Quiz: Are You Familiar With Key Elements Regarding Heat Stroke? Richard H. Sinert, DO August 02, 2017 问题4. Which of the following is accurate regarding the workup of heat stroke? 有关热射病实验室检查的以下说法哪个是准确的？ A. Hypoglycemia is more common in patients with NEHS than in patients with EHS NEHS患者低血糖较EHS患者更常见 B. Aminotransferase levels typically peak at 48 hours, but may take as long as 2 weeks...

Imaging in Intensive Care Medicine Fat embolism syndrome Anselmo Caricato, Giovanni Russo, Daniele Guerino Biasucci, Maria Giuseppina Annetta Intensive Care Med 2017; 43: 1411-1412 A 19-year-old man was admitted to our emergency department after a road accident. He presented with bilateral femoral fractures that were promptly treated with external fixators. After surgery, he was monitored in ICU. Twenty-four hours after admission, fever, tachycardia, dyspnea, and hypoxia a...