severe bullous disease in #COPD | Figure 1

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severe bullous disease in #COPD

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Emphysema in autopsy lung](https://app.figure1.com/case-detail/094420aa-ab5f-4b05-b0d3-07a051cb7c00)



Studying the lungs last week was very interesting! COPD lungs are the lungs on the top of the picture-very spongy and big compared to the firm healthy lungs. COPD heart was also enlarged](https://app.figure1.com/case-detail/1942413f-15a3-4755-9303-03494c3705b1)



30 years old male, smoker with smoking index 100
what's your diagnosis](https://app.figure1.com/case-detail/23d583f4-8c9c-4f68-bd40-3b56c09dc25e)

[ ¿Hay que interrumpir el montelukast en pacientes pediátricos con eventos neuropsiquiátricos? Eventos neuropsiquiátricos con el inicio de montelukast versus un agonista beta de acción prolongada para el asma. Existe un debate acerca de si el uso de antagonistas de leucotrienos en niños y adolescentes está vinculado a un aumento de eventos neuropsiquiátricos (EPN). Aunque estudios observacionales a gran escala han encontrado una posible asociación con un mayor riesgo, esto podría deberse a un mal control del asma en los pacientes que necesitan iniciar este tratamiento. Un reciente estudio basado en datos nacionales de Suecia comparó a nuevos usuarios de montelukast con aquellos que comenzaron tratamiento con agonistas beta de acción prolongada (LABA), con el fin de reducir este tipo de sesgos. Los resultados mostraron que los efectos adversos neuropsiquiátricos fueron poco comunes y prácticamente iguales en ambos grupos (2,39 vs. 2,41 por cada 100 pacientes-año; razón de riesgos instantáneos: 0,99). Estos hallazgos ofrecen tranquilidad tanto a los médicos como a los cuidadores de quienes requieren estos fármacos. Wintzell, V., Brenner, P., Halldner, L., Rhedin, S., Gong, T., & Almqvist, C. (2025). Montelukast Use and the Risk of Neuropsychiatric Adverse Events in Children. JAMA Pediatrics, 179(4). doi.org.

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A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)