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Cough Syncope

Although cough is a common clinical symptom, the vasomotor effects on the heart and systemic circulation are often underappreciated. A healthy 42-year-old man without significant medical history presented with repetitive episodes of syncope during coughing. His examination, electrocardiogram, laboratory studies, and echocardiography results were normal, and carotid massage did not provoke any adverse response. During […]

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Recurrent Pneumothoraces: Making the Link to Catamenial Pneumothorax

A 44-year-old woman with history of endometriosis on ovulatory suppressant therapy and right spontaneous pneumothorax treated with tube thoracostomy 2 months prior, presented with dyspnea and pleuritic chest pain. Physical examination was remarkable for decreased breath sounds and hyperresonance over the right hemithorax. Her labs were unremarkable. Chest radiography revealed a right pneumothorax (Figure 1). Her […]

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Foreign Body in External Ear Canal: An Unusual Cause of Chronic Cough

Many cases of earwax impaction (or foreign body presence) and the relationship to chronic cough may go unrecognized. The routine incorporation of examination of the external auditory canal in patients with chronic cough may reveal a number of patients with impacted earwax.1 The literature suggests that 2% to 6% of the general population have impacted earwax.1 Patients […]

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The Missing Antibody: The Pitfalls of ANCA Testing

A 44-year-old white woman presented to the hospital with acute shortness of breath while on a flight back to England from a holiday in Turkey. She denied having a productive cough, hemoptysis, or chest or calf pain. She was asthmatic, and her symptoms were improved by repeated administration of her salbutamol inhaler during the flight. […]

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Menthol-Flavored Cigarettes: Potentially a Strong Trigger of Acute Eosinophilic Pneumonia

Menthol-flavored cigarettes recently have received significant attention. Lower quit rates and higher relapse rates of smoking in people who smoke menthol-flavored cigarettes have been demonstrated.1 Additional disadvantages of menthol cigarettes also might exist. We present a lesson learned from a case we experienced: Menthol cigarette smoking might be a stronger trigger of acute eosinophilic pneumonia compared […]

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