Stuart M. Garay

Pulmonary Complications of the Acquired Immunodeficiency Syndrome: Report of a National Heart, Lung, and Blood Institute Workshop

Under the sponsorship of the Division of Lung Diseases of the National Heart, Lung, and Blood Institute, a two-day workshop on the pulmonary complications of the acquired immunodeficiency syndrome ...

Hermansky-Pudlak syndrome. Pulmonary manifestations of a ceroid storage disorder.

The Hermansky-Pudlak syndrome is a form of oculocutaneous albinism, characterized by a qualitative platelet defect and deposition of ceroid-like material throughout the reticuloendothelial system. During a 16 month period five patients with Hermansky-Pudlak syndrome presented with symptoms, chest films and pulmonary function studies consistent with restrictive pulmonary disease. In two patients, lung biopsies revealed diffuse interstitial fibrosis. However, light and electron microscopy demonstrated ceroid-like material within alveolar macrophages. In addition, two patients presented with inflammatory bowel disease with deposition of ceroid-like material in the colon. This disorder appears to be more common than is currently recognized and should be considered in the differential diagnosis of diffuse interstitial pulmonary disease and inflammatory bowel disease. A relationship between the deposition of ceroid-like material and pulmonary fibrosis is discussed in light of recent research concerning inflammatory processes. In view of the serious pulmonary, gastrointestinal and hematologic consequences of this syndrome, there is a need for genetic counseling of these patients.

AIDS associated bronchiectasis : CT features

The occurrence of bronchiectasis has only rarely been noted among the protean manifestations of HIV infection in the lungs. We retrospectively identified bronchiectasis on CT scans in 12 HIV + and/or AIDS patients in the absence of either documented mycobacterial infection or a history of prior recurrent pyogenic infection. Pneumonitis was documented in 10 of 12 cases. In eight cases, bronchiectasis was associated with episodes of pyogenic infection; four of these patients also had documented opportunistic infections, including three cases of Pneumocystis carinii pneumonia (PCP). Two patients had infection due solely to PCP. In two cases, bronchiectasis was found in association with one case each of lymphocytic interstitial pneumonitis and nonspecific interstitial pneumonitis, respectively. Although the true incidence of bronchiectasis in this population remains to be established, in our experience bronchiectasis should be considered among the varied pulmonary manifestations of HIV infection. Furthermore, the seemingly rapid development and extent of bronchiectasis in this population suggest an accelerated form of the disease.

Hermansky-Pudlak syndrome: A clinicopathologic study

The Hermansky-Pudlak syndrome is a rare disease characterized by multisystemic involvement. Seven families with the disorder were identified in the Puerto Rican population of one municipal hospital, suggesting that the incidence in the Puerto Rican community is sufficient to warrant both dissemination of information about the disease and further investigation. The present study was an attempt to achieve both of these goals.

Management of Solitary Pulmonary Nodules

The workup and management of the solitary pulmonary nodule is an increasingly common and confounding clinical problem for which a uniformly accepted approach has yet to be established. Conventional radiologic literature has suggested a number of imaging characteristics of nodules such as size, cavitation, growth rate, and margin morphology to guide the physician in clinical management. More recent literature emphasizes nodule attenuation, as well as size, growth, etc., in correlation with patient risk factors for disease to guide the most appropriate course of follow-up. Risk factors include age greater than 35 years, smoking history, occupational exposures, and history of malignancy. In this chapter, based on a review of the established recommendations and the authors’ clinical experiences, an approach to the management of the solitary pulmonary nodule is put forth.

Don't Forget AIDS at Any Age

Sanchez-Craig M: Level of alcohol use for the onset of early-stage problem drinking, in Chang NC, Chao HM (eds): Early Identification of Alcohol Abuse, Proceeding of a Workshop sponsored by the National Institute on Alcohol Abuse and Alcoholism in Cooperation with the World Health Organization and the Pan American Health Organization, 1985, pp 339-347 Vestal RE, McGuire EA, Tobin JT, et al: Aging and ethanol metabolism. Clin Pharmacol Ther 21:343, 1976 Linnoila M, Erwin CW, Ramm D, et al: Effects of age and alcohol on psychomotor performance of men. J Stud Alcohol 41:488,1980 Atkinson RM: Substance use and abuse in late life, in Atkinson RM (ed): Alcohol and Drug Abuse in Old Age. Washington, D.C., American Psychiatric Press, 1984, pp 2 2 1 37~310-316, 1989 Recognition of Alcohol Dependence in the Elderly