Purpose:As the pandemic continues,many complications,previously recognized as rare,are now being reported as more than frequent complications of Covid-19 pneumonia.Of those,pneumomediastinum and pneumothorax are gaini...Purpose:As the pandemic continues,many complications,previously recognized as rare,are now being reported as more than frequent complications of Covid-19 pneumonia.Of those,pneumomediastinum and pneumothorax are gaining attention.Their mechanism of occurrence/trigger is not fully understood,but the timing at which they occur is unclear.Methods:This is a case series of 11 Covid-19 patients with pneumomediastinum;retrospectively,we shed light on some of the patients’characteristics,the role of mechanical ventilation,and the timing of pneumomediastinum after initiation of mechanical ventilation.Results:We found that despite following the lung-protective strategy and despite keeping a plateau pressure at an acceptable range,most of our patients had an acute event around the same timing of mechanical ventilation.Conclusions:The similar timing raises questions about other risk factors that remain unknown.Timing and steroids can contribute to the higher incidence of these complications.展开更多
Background:Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy.NSCLC is a heterogeneous group of diseases that...Background:Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy.NSCLC is a heterogeneous group of diseases that differs in cytology and includes adenocarcinoma,squamous cell carcinoma,bronchioloalveolar carcinoma,and poorly differentiated carcinoma.Usually,NSCLC,in contrast to SCLC,spreads locally,and the doubling time of squamous cell carcinoma is 133 days which classifies it as a relatively slow-growing tumor.Case presentation:We present the case of a 72-year-old male,recently diagnosed with squamous cell carcinoma in the right upper lobe along with secondary deposits.Few days after diagnosis,the patient had severe respiratory distress.This endobronchial tumor has increased significantly in size upon bronchoscopic visualization causing a complete obstruction of his right main bronchus and hypoxemic respiratory failure requiring intubation.Conclusion:To our knowledge,there are few reported cases where lung adenocarcinoma progressed rapidly over days.Squamous cell carcinoma usually takes 3 to 6 months to double in size,but in our case,the progression was very fast.In the last decade,it was confirmed that the doubling time of a tumor is an independent factor in the prognosis of lung cancer patients.On the other hand,further studies are needed to identify genes associated with rapid progression and a worse prognosis for lung squamous cell carcinoma.Hence,this aggressive tumor is a“rapid killer.”展开更多
文摘Purpose:As the pandemic continues,many complications,previously recognized as rare,are now being reported as more than frequent complications of Covid-19 pneumonia.Of those,pneumomediastinum and pneumothorax are gaining attention.Their mechanism of occurrence/trigger is not fully understood,but the timing at which they occur is unclear.Methods:This is a case series of 11 Covid-19 patients with pneumomediastinum;retrospectively,we shed light on some of the patients’characteristics,the role of mechanical ventilation,and the timing of pneumomediastinum after initiation of mechanical ventilation.Results:We found that despite following the lung-protective strategy and despite keeping a plateau pressure at an acceptable range,most of our patients had an acute event around the same timing of mechanical ventilation.Conclusions:The similar timing raises questions about other risk factors that remain unknown.Timing and steroids can contribute to the higher incidence of these complications.
文摘Background:Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy.NSCLC is a heterogeneous group of diseases that differs in cytology and includes adenocarcinoma,squamous cell carcinoma,bronchioloalveolar carcinoma,and poorly differentiated carcinoma.Usually,NSCLC,in contrast to SCLC,spreads locally,and the doubling time of squamous cell carcinoma is 133 days which classifies it as a relatively slow-growing tumor.Case presentation:We present the case of a 72-year-old male,recently diagnosed with squamous cell carcinoma in the right upper lobe along with secondary deposits.Few days after diagnosis,the patient had severe respiratory distress.This endobronchial tumor has increased significantly in size upon bronchoscopic visualization causing a complete obstruction of his right main bronchus and hypoxemic respiratory failure requiring intubation.Conclusion:To our knowledge,there are few reported cases where lung adenocarcinoma progressed rapidly over days.Squamous cell carcinoma usually takes 3 to 6 months to double in size,but in our case,the progression was very fast.In the last decade,it was confirmed that the doubling time of a tumor is an independent factor in the prognosis of lung cancer patients.On the other hand,further studies are needed to identify genes associated with rapid progression and a worse prognosis for lung squamous cell carcinoma.Hence,this aggressive tumor is a“rapid killer.”
