Internal Medicine

Donohue JF et al. Ensifentrine as a novel, inhaled treatment for patients with COPD. Int J Chron Obstruct Pulmon Dis 2023 Jul 28; 18:1611. (https://doi.org/10.2147/COPD.S413436)

Population:

• Patients with moderate-to-severe Chronic Obstructive Pulmonary Disease (COPD).

• Approximately 1500 participants involved in the trials (ENHANCE-1 and ENHANCE-2).
  

Intervention:

• Administration of Ensifentrine (Ohtuvayre), a novel phosphodiesterase 3 and 4 inhibitor, via nebulizer.

Early home discharge in low-risk PE patients, as identified by validated triage tools (sPESI and Hestia), is safe with very low incidences of adverse events and mortality. However, patients with cancer, elevated troponin, or elevated NT-proBNP have a higher risk of adverse events and may require closer monitoring.

Safety of treating acute pulmonary embolism at home: an individual patient data meta-analysis | European Heart Journal | Oxford Academic (oup.com)

A 42-year-old man with progressive cough, fever, and shortness of breath for three weeks. Here are the key points and findings:

• Medical Conditions: Hyperlipidemia and hypertension.

• Medications: Atorvastatin 20 mg daily, lisinopril 10 mg daily.

• Lifestyle: Non-smoker.

• Recent Activity: Recently placed mulch in his yard.

Physical Examination:

Dupilumab for COPD with Blood Eosinophil Evidence of Type 2 Inflammation | New England Journal of Medicine (nejm.org)

42-year-old man with progressive cough, fever, and shortness of breath for three weeks. He recently placed mulch in his backyard.

Patient History:

• Medical Conditions: Hyperlipidemia and hypertension.

• Medications: Atorvastatin 20 mg daily, lisinopril 10 mg daily.

• Lifestyle: Non-smoker.

• Recent Activity: Recently placed mulch in his yard.

Symmetric diffuse, bilateral pulmonary infiltrates with mediastinal and bilateral hilar lymphadenopathy. DDx?

What do you want to do next?

Determining CD4+/CD8+ ratio can be helpful in the diagnosis of sarcoidosis. Sarcoidosis is characterized by an increased CD4/CD8 ratio (>3.5), compared with other interstitial lung diseases.