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Lung abscesses are usually caused by anaerobic or mixed bacterial infection of the lower respiratory tract. Conservative treatment with broad-spectrum antibiotics is established as the therapy of choice for most patients, with 80-95% responding to antimicrobial therapy. Conservative management failure, manifested by sepsis persistence and/or abscess complications, requires drainage with invasive techniques (percutaneous, endoscopic or surgical) or open surgical removal of the affected lung tissue (segmentectomy, lobectomy or rarely pneumonectomy) in patients with good performance status and sufficient respiratory reserve. Although surgical intervention is accompanied by relatively high mortality rates (11%-28%), it remains the most effective method in preventing complications or future relapses. [ABSTRACT FROM AUTHOR]

Acquired diaphragmatic paralysis may compromise lung mechanics and cause dyspnoea and/or lead to respiratory failure in the long term. A 76 year-old female patient presented with progressive worsening of dyspnoea and spirometric indices, and imaging studies revealed elevation of the left hemidiaphragm. Surgical correction was carried out by diaphragmatic plication technique, through a mini-thoracotomy approach. Immediate alleviation (within days) of her symptoms was observed, while improvement of radiological and pulmonary function tests occurred some weeks later. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) has been shown to be associated with increased risk for cardiovascular events. The wide distribution of beta-adrenergic receptors in the respiratory and cardiovascular systems frequently discourages clinicians from using beta-blockers in patients with COPD or inhaled beta2-agonists in those with cardiovascular comorbidities. Evidence in the current literature suggests that inhaled short- and long-acting beta2-agonists can be considered safe in patients without significant cardiac disease or with clinically stable disease (arrhythmia, coronary artery disease or heart failure). In these situations COPD treatment should be initiated or adjusted rationally, provided that worsening of respiratory symptoms is not associated with decompensated heart failure or an acute coronary event. Cardioselective beta-blockers in usual doses should not be withheld from patients with COPD who have mild to severe airway obstruction, in whom their definite therapeutic benefits in the management of myocardial infarction and chronic heart failure outweigh the danger of possible induction of bronchospasm. Further research is necessary on the safety of beta-blockers in very severe stages of COPD (FEV1 <30% pred.) and the use of non-cardioselective beta-blockers in subjects with partially reversible airway obstruction. [ABSTRACT FROM AUTHOR]

A 57 year-old male smoker presented with weight loss and hypertrophic osteoarthropathy. Imaging studies revealed a solid mass (maximum diameter 4.2 cm) located in the left lung and left upper lobectomy was carried out. Histopathology showed low differentiated adenocarcinoma and the patient received adjuvant chemotherapy. Bronchoscopy performed 3 years later to exclude specific infection revealed complete obstruction of the posterior segment of the right upper lobe by a highly vascular, smooth margined mass. At thoracotomy the frozen section was negative for malignancy and histopathological examination revealed a typical carcinoid tumour. The excellent prognosis of this histological type of tumour allowed avoidance of a major surgical procedure and the lesion was resected by bronchotomy with reconstruction of the bronchial gap. Pneumon 2012, 25(4):428-431. [ABSTRACT FROM AUTHOR]