Fatal E-cigarette or Vaping Product Use-associated Lung Injury Secondary to Empyema.

Empyema caused by in e-cigarette or vaping product use-associated lung injury (EVALI) can result in fatal outcomes. Empyema as a presentation of EVALI is rarely reported. is a known causative pathogen in empyema, typically associated with the elderly and immunocompromised states.

Pharmacoeconomic inequalities in access to antifibrotic treatment for interstitial lung disease in the Asia-Pacific region.

Antifibrotic drugs, available for the best part of the last decade in many parts of the world, has improved outcomes in patients with idiopathic pulmonary fibrosis and progressive pulmonary fibrosis. However, it is unclear whether patients suffering from these devastating conditions have timely and adequate access to antifibrotic therapy in the Asia Pacific region (APAC). In this mixed-methods narrative review of 12 APAC countries, integration of questionnaire-based insights of 31 regional clinical experts in interstitial lung disease (ILD) with publicly available pharmaco-economic information has been used to understand how country-specific challenges impact on antifibrotic accessibility.

Brown-Colored Malignant Pleural Fluid With High Bilirubin Levels: A Case Series.

Brown-colored pleural effusion is rare and may result from high bilirubin levels such as bilothorax (often described as a pleural fluid-to-serum bilirubin ratio of > 1.0). We describe four patients with malignant pleural effusion that appeared macroscopically brown with a pleural fluid-to-serum bilirubin ratio between 3.

Dry Medical Thoracoscopy with Artificial Pneumothorax Induction Using Veress Needle.

Background: In the absence of significant pleural effusion, conventional medical thoracoscopy (MT) is often not feasible due to the risk of lung injury. Dry MT mitigates these risks by inducing artificial pneumothorax through needle insufflation or blunt dissection. Although the Veress needle is commonly used by surgeons to create pneumoperitoneum before laparoscopic surgeries, its application in dry MT has not been widely reported in recent times.

Feasibility of Cryobiopsy Specimen Retrieval Through Standard Guide Sheath for Peripheral Pulmonary Lesions Without Bronchoscope Removal.

Background: Transbronchial cryobiopsy is a promising technique for biopsy of peripheral pulmonary lesions (PPL). However, cryobiopsy specimen retrieval can pose problems due to the risk of bleeding during the blind period when the bronchoscope and cryoprobe are removed en bloc. Artificial airways and prophylactic balloon placement are risk-reducing measures, but the latter is challenging in upper lobe PPL.

The utility of endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC) for the diagnosis of mediastinal lymphoma.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a revolutionary tool for the diagnosis and staging of mediastinal disorders. Nevertheless, its diagnostic capability is reduced in certain disorders such as lymphoproliferative diseases. EBUS-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC) is a novel technique that can provide larger samples with preserved tissue architecture, with an acceptable safety profile.

Fatal COVID-19-Associated Pulmonary Aspergillosis Due to Complicated By Pneumothorax: A Case Report.

COVID-19-associated pulmonary aspergillosis (CAPA) carries high mortality. is not commonly associated with CAPA. A middle-aged woman presented with cough, fever, and dyspnea for ten days and was subsequently diagnosed with COVID-19.

Early experience of endobronchial ultrasound-guided transbronchial nodal cryobiopsy: a case series from Sabah, Malaysia.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an established minimally invasive method for the diagnosis of benign and malignant conditions. Continuous efforts are underway to improve the material adequacy of EBUS-TBNA, including the introduction of a new technique called EBUS-guided transbronchial nodal cryobiopsy (EBUS-TBNC). This method allows for the retrieval of larger and well-preserved histologic samples from the mediastinum.

The Vanishing Act: Post-pericardiocentesis Pericardial-pleural Fistula in Secondary Hyperparathyroidism.

Pericardial-pleural fistula (PPF) may complicate between 0.8-6% of echocardiography-guided pericardiocentesis procedures, but reports are sporadic. A 22-year-old male presented to the general medical ward with underlying end-stage renal disease complicated by secondary hyperparathyroidism with worsening left pleuritic chest pain and shortness of breath for one week.

Exploring the optimal freeze time and passes of the ultrathin cryoprobe in transbronchial cryobiopsy of peripheral pulmonary lesions.

https://bit.ly/49cbmbW.

Determinants of Willingness to Undergo Lung Cancer Screening among High-Risk Current and Ex-smokers in Sabah, Malaysia: A Cross-Sectional Pilot Study.

Background: Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer.

Methods: A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia.

Pulmonary extra-nodal mucosa-associated lymphoid tissue (MALT) lymphoma: A rare cause of persistent lung consolidation.

Pulmonary extra-nodal marginal zone B-cell lymphoma, also known as extra-nodal mucosa-associated lymphoid tissue (MALT) lymphoma, is rare among all non-Hodgkin lymphomas and generally among all pulmonary malignancies. We present a 46-year-old lady with persistent right lower lung consolidation despite earlier treatment efforts with intravenous antibiotics for community acquired pneumonia. Apart from initial presentation with a short 3-day history of fever, cough and shortness of breath, she had remained largely asymptomatic throughout the follow-up period.

Peripheral transbronchial needle aspiration-guided pinpoint cryobiopsy of lung nodule without bronchus sign: A case report.

Peripheral transbronchial needle aspiration (pTBNA) allows the access of pulmonary nodules without bronchus sign but is limited to cytological examination. A 39-year-old man with left parotid carcinoma presented with an incidental lung nodule. Target localisation was performed with manual airway mapping, virtual bronchoscopic navigation, and pTBNA.

Point-of-care ultrasound in pre-bronchoscopy assessment of acute dyspnea: A case of concurrent massive pulmonary embolism and deep vein thrombosis.

Point-of-care ultrasound (POCUS) leads to efficient real-time diagnosis in a wide range of medical specialties. We describe the use of cardiac, lung and lower limb POCUS to rapidly diagnose massive pulmonary embolism and deep vein thrombosis in a 64-year-old patient presenting with acute dyspnea prior to elective bronchoscopy. Left femoral vein thrombus and features of increased right heart pressure on POCUS led to the decision to administer fibrinolytic therapy, with subsequent CT pulmonary angiogram confirming bilateral PE.

Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited.

Trichobezoars are usually formed due to ingestion of hair or hair-like fibres and present with a wide spectrum of clinical manifestations. We report a case of Rapunzel's syndrome associated with trichotillomania in a 16-year-old girl who presented to our Haematology unit with complaints of fatigue, abdominal distention, and early satiety. Initial evaluation demonstrated anaemia, thrombocytosis, and a left hypochondrial mass suggestive of splenomegaly.

Pulmonary tuberculosis and COVID-19 coinfection: Hickam's Dictum revisited.

COVID-19 and pulmonary tuberculosis (PTB) coinfection is associated with increased mortality and presents a unique diagnostic challenge to the clinician. We describe three cases of newly diagnosed PTB in COVID-19 patients treated at our centre and their clinical and radiological features. The challenges associated with diagnosis and management are also explored.

The more you give, the worse it gets.

https://bit.ly/385VU2Q.

Feasibility of manual bronchial branch reading technique in navigating conventional rEBUS bronchoscopy in the evaluation of peripheral pulmonary lesion.

Background: Although radial endobronchial ultrasound (rEBUS) is an important verification tool in guided bronchoscopy, a navigational route was not provided. Manual airway mapping allows the bronchoscopist to translate the bronchial branching in computed tomography (CT) into a comparable bronchoscopic road map. We aimed to explore the feasibility of this technique in navigating conventional rEBUS bronchoscopy in the localisation of peripheral pulmonary lesion by determining navigation success and diagnostic yield.

Combination of 1.1 mm flexible cryoprobe with conventional guide sheath and therapeutic bronchoscope in biopsy of apical upper lobe solitary pulmonary nodule.

Background: Lung cancer is frequently situated peripherally in the upper lobes of the lung. Acquiring adequate tissue from this difficult-to-reach area remains a challenge. Transbronchial cryobiopsy (TBCB) has the ability to acquire larger specimens, but the rigidity of the standard 1.