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Atypical carcinoid belongs to a spectrum of neuroendocrine tumors that can present as central airway obstruction. We treated a 58-year-old female who presented with recurrent pneumonia. Flexible bronchoscopy showed complete obstruction of the tumor in the right lower lobe. The tumor was excised by electrocautery snare followed by laser and argon plasma coagulation (APC). Endobronchial biopsy showed atypical carcinoid with lymph node metastasis. Succeeding bronchoscopic management, the patient’s symptoms improved. In our patient, bronchoscopy with laser and APC was performed to prevent tumor recurrence after resection and reduce the risk of recurrent postobstructive pneumonia. Surveillance computed tomography at six months showed no evidence of recurrence. Bronchoscopic management should be considered in poor surgical candidates or patients with metastatic disease.
Andrew Talon; Melinda Wang; Ali Saeed. Bronchoscopic Management of Endobronchial Atypical Carcinoid With Argon Plasma Coagulation and Laser: A Rare Case With Literature Review. Cureus 2021, 13, 1 .
AMA StyleAndrew Talon, Melinda Wang, Ali Saeed. Bronchoscopic Management of Endobronchial Atypical Carcinoid With Argon Plasma Coagulation and Laser: A Rare Case With Literature Review. Cureus. 2021; 13 (3):1.
Chicago/Turabian StyleAndrew Talon; Melinda Wang; Ali Saeed. 2021. "Bronchoscopic Management of Endobronchial Atypical Carcinoid With Argon Plasma Coagulation and Laser: A Rare Case With Literature Review." Cureus 13, no. 3: 1.
Cytokine storm syndrome in patients with COVID-19 is mediated by pro-inflammatory cytokines resulting in acute lung injury and multiorgan failure. Elevation in serum ferritin and D-dimer is observed in COVID-19 patients. To determine prognostic values of optimal serum cutoff with trajectory plots for both serum ferritin and D-dimer in COVID-19 patients with invasive ventilator dependence and in-hospital mortality. We used retrospective longitudinal data from the Cerner COVID-19 de-identified cohort. COVID-19 infected patients with valid repeated values of serum ferritin and D-dimer during hospitalization were used in mixed-effects logistic-regression models. Among 52,411 patients, 28.5% (14,958) had valid serum ferritin and 28.6% (15,005) D-dimer laboratory results. Optimal cutoffs of ferritin (714 ng/mL) and D-dimer (2.1 mg/L) revealed AUCs ≥ 0.99 for in-hospital mortality. Optimal cutoffs for ferritin (502 ng/mL) and D-dimer (2.0 mg/L) revealed AUCs ≥ 0.99 for invasive ventilator dependence. Optimal cutoffs for in-house mortality, among females, were lower in serum ferritin (433 ng/mL) and D-dimer (1.9 mg/L) compared to males (740 ng/mL and 2.5 mg/L, respectively). Optimal cutoffs for invasive ventilator dependence, among females, were lower in ferritin (270 ng/mL) and D-dimer (1.3 mg/L) compared to males (860 ng/mL and 2.3 mg/L, respectively). Optimal prognostic cutoffs for serum ferritin and D-dimer require considering the entire trajectory of laboratory values during the disease course. Females have an overall lower optimal cutoff for both serum ferritin and D-dimer. The presented research allows health professionals to predict clinical outcomes and appropriate allocation of resources during the COVID-19 pandemic, especially early recognition of COVID-19 patients needing higher levels of care.
Fares Qeadan; Benjamin Tingey; Lily Gu; Ashley Packard; Esther Erdei; Ali Saeed. Prognostic Values of Serum Ferritin and D-Dimer Trajectory in Patients with COVID-19. Viruses 2021, 13, 419 .
AMA StyleFares Qeadan, Benjamin Tingey, Lily Gu, Ashley Packard, Esther Erdei, Ali Saeed. Prognostic Values of Serum Ferritin and D-Dimer Trajectory in Patients with COVID-19. Viruses. 2021; 13 (3):419.
Chicago/Turabian StyleFares Qeadan; Benjamin Tingey; Lily Gu; Ashley Packard; Esther Erdei; Ali Saeed. 2021. "Prognostic Values of Serum Ferritin and D-Dimer Trajectory in Patients with COVID-19." Viruses 13, no. 3: 419.