1/6. bronchiectasis: the 'other' obstructive lung disease.bronchiectasis belongs to the family of chronic obstructive lung diseases, even though it is much less common than asthma, chronic bronchitis, or emphysema. Clinical features of these entities overlap significantly. The triad of chronic cough, sputum production, and hemoptysis always should bring bronchiectasis to mind as a possible cause. Chronic airway inflammation leads to bronchial dilation and destruction, resulting in recurrent sputum overproduction and pneumonitis. Once the diagnosis is confirmed, any potential predisposing conditions should be aggressively sought. The relapsing nature of bronchiectasis can be controlled with antibiotics, chest physiotherapy, inhaled bronchodilators, proper hydration, and good nutrition. In rare circumstances, surgical resection or bilateral lung transplantation may be the only option available for improving quality of life. prognosis is generally good but varies with the underlying syndrome.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. Unilateral bronchiectasis and esophageal dysmotility in congenital adult tracheoesophageal fistula.Tracheoesophageal fistulas (TEF) in adults are most commonly neoplastic, and very rarely congenital in nature. We report a 45-year-old Hispanic male with TEF and initial presentation of minimal hemoptysis. The patient had radiographic evidence of unilateral upper lobe (RUL) bronchiectasis, massive esophageal dilatation, and dysmotility. However, there was no evidence of esophageal malignancy, achalasia, or Chagas' disease. bronchoscopy revealed a large TEF in the posterior wall of trachea, which was not visualized on esophagram or esophagoscopy. bronchoalveolar lavage (BAL) cultures grew mycobacterium avium complex (MAC). Our report illustrates that idiopathic, or congenital, TEF can be associated with esophageal dysmotility, adulthood bronchiectasis, and atypical mycobacterial superinfection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/6. Unusual aero-digestive foreign bodies: tribulations and tragedies.Aero-digestive foreign bodies are a common occurrence in infants and children. The manifestations, hazards and consequences depend upon the location, nature of the foreign body and the time lapse. This communication reports a series of four cases with unusual course and consequences of aero-digestive foreign bodies. These were generalized tetanus, hypernatremia and metabolic acidosis with intra-cranial hemorrhage and severe pneumonia and empyema. awareness of these consequences would help treating doctors to take appropriate steps in devising preventive and therapeutic strategies.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. Bronchopulmonary involvement in ulcerative colitis.We report two cases of pulmonary involvement in ulcerative colitis. The first patient, a 37-year-old woman, had bilateral basal bronchiectasis full of mucopurulent secretion, with a marked improvement of pulmonary function and roentgenographic appearance after a conservative approach. The second patient had severe pulmonary fibrosis of autoimmune nature and died owing to a pulmonary infection. In the second patient, a sulfasalazine reaction as an etiologic factor was excluded, while in the first this possibility seemed unlikely. Therefore, we take these two cases as examples of the extraintestinal manifestations of ulcerative colitis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. Familial congenital bronchiectasis: Williams-Campbell syndrome.Williams-Campbell syndrome was first described in 1960 as a rare form of bronchiectasis. Its pathogenesis is characterized by the absence or markedly diminished cartilage around the bronchi. Although the familial nature was postulated early on, only one possible familial occurrence has been reported in the literature. We present two family members in whom respiratory symptoms developed within the first year of life and were found to have histopathologic changes consistent with Williams-Campbell syndrome. This world lend further support of a developmental origin for this type of bronchiectasis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/6. Serial sputum cell counts in the management of chronic airflow limitation.This case study illustrates the usefulness of serial induced sputum cell counts from cytospins to investigate the nature of airway inflammation in a patient presumed to have prednisone-dependent asthma for 30 yrs. She had bronchiectasis and chronic airflow limitation. Exacerbations of breathlessness were associated with an increase in chronic airflow limitation with little or no sputum. Induced sputum showed elevated total cell and neutrophil counts at each exacerbation with no increase in the proportion of eosinophils. Pathogenic bacteria were cultured at each flare-up. The dose of prednisone was reduced progressively and each exacerbation was treated with an appropriate antibiotic without increasing the dose of prednisone, as was the case previously. The infections were associated with bronchiectasis of the right upper lobe which was removed. Examination of the specimen confirmed neutrophilic infiltration and did not show the usual airway structural changes of asthma. These results provide further evidence of the value of sputum cell counts in practice, in this case to prevent overtreatment with prednisone in a patient with recurrent deteriorations in airflow which were due to recurrent infections.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |