Background: Shared medical appointments (SMAs) have shown promise in the care of patients with conditions such as diabetes; however, the impact of lifestyle medicine-based SMAs on the overall health status of cancer survivors remains poorly understood. Materials and Methods: This cross-sectional survey of patients was conducted to study the impact of a unique lifestyle medicine-based survivorship program on cancer survivors. Results: A total of 64 patients were telephonically contacted for the survey, out of which 39 (60.9%) patients responded. All patients (39 of 39, 100%) found the program to be helpful in some way; 26 patients (66.7%) found SMAs to be significantly helpful, while 13 patients (33.3%) found SMAs as only somewhat helpful. The majority noted feeling a great sense of support (35 of 39, 89.7%), followed by improvement in appetite (21 of 39, 54%) and improvement in pain (14 of 39, 35.9%). All patients reported at least some improvement in subjective well-being (SWB); patients who attended >3 appointments reported significant/very significant improvement in SWB ( P = .03). Conclusion: SMAs offer promise in the effective delivery of lifestyle medicine-focused care to cancer survivors. Further prospective studies are needed to validate these findings.

BackgroundAlthough the incidence of post-COVID-19 organizing pneumonia (OP) is low, the mortality and morbidity in select patients appear to be high. Anticipating specific populations who may be at higher risk and initiating treatment earlier could reduce mortality. Research questionDoes treatment with high dose, standard dose, or no glucocorticoids for COVID-19 infection impact the incidence and clinical outcome in COVID-19-induced OP? Study design and methodsThis was a single-center, retrospective, observational cohort study conducted from 03/01/2020 to 06/30/2021 in hospitalized patients over the age of 18 with confirmed COVID-19 infection and computed tomography (CT) scan evidence of OP. Institutional review board (IRB) approval was obtained from the institution (STUDY00002241). Patients' demographics and oxygen requirements at the time of diagnosis, at the time of discharge, and at one, three, six, 10, and 12 months post-discharge were obtained. The dose, duration, and choice of glucocorticoid therapy were recorded for each subject, as well as oxygen requirements during hospitalization. Despite radiological evidence of OP, patients on minimal supplemental oxygen requirements did not receive high-dose or long-duration glucocorticoid therapy. ResultsA total of 881 patients were admitted with COVID-19, of which 42 met the study criteria. Three patients underwent a lung biopsy to confirm the diagnosis of organizing pneumonia. All other patients were diagnosed based on CT imaging and clinical presentation. Of the patients, 17% did not receive any steroid treatment, while 36% received dexamethasone and 43% received prednisone. The most common oxygen requirement at the time of discharge for steroid-treated patients was nasal cannula (55%) and room air (29%). The incidence of OP in this patient population was 0.05 with a mortality rate of 14%.

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Isolated unilateral absence of pulmonary artery (IUAPA) is a rare vascular anomaly mainly affecting men. Clinical presentation may range from no symptoms to shortness of breath and frequent respiratory tract infections, adversely impacting the quality of life. Here we report a middle-aged asymptomatic male diagnosed with IUAPA on an elective preoperative examination. CASE PRESENTATION:We present a fifty-nine-year-old male with history of hypertension and rheumatoid arthritis who was admitted to the hospital for an elective tracheostomy and composite resection of recently diagnosed squamous cell carcinoma of the right tonsil. Apart from localized jaw pain and restriction of movements, patient denied any other symptoms, like shortness of breath, chest pain, palpitations, orthopnea, fatigue, snoring, chronic cough, and hemoptysis. Patient states he can climb flights of stairs and perform daily activities without any difficulty. Of note, he was also a competitive swimmer in college. Patient's preoperative revised cardiac risk index score was 0, indicating a 3.9% 30-day risk of death, myocardial infarction, or cardiac arrest. ARISCAT post-operative pulmonary complications score was 34, indicating an intermediate risk with 13.3% complications rate. Arozullah respiratory failure index was 11-19 points with a 1.8% risk of respiratory failure. Electrocardiography was unremarkable. Chest x-ray showed collapse of the right lung with shift of the cardiomediastinal silhouette and trachea to the right along with hyperinflated left hemithorax and prominent left pulmonary artery as seen in figure 1. CT chest revealed absence of the right pulmonary artery with compensatory enlargement of the main and left pulmonary artery and hyper expansion of the left lung as seen in figure 2. Patient has successfully undergone the surgery with no post-operative complications.DISCUSSION: With a prevalence of 0.0005%, IUAPA is a rare anomaly that could present as an incidental finding in asymptomatic adults. It should also be considered in the presence of recurrent respiratory infections, decreased exercise intolerance, hemoptysis, or pulmonary hypertension in the absence of other known causes [1]. Plain films show contracted lung with mediastinal and tracheal shift, hemidiaphragm elevation, absent hilar shadow and pulmonary vascular markings [2]. A CT or MR angiography of chest can establish the diagnosis. Cardiac catheterization should be reserved for recurrent hemoptysis for embolization or during consideration of revascularization surgery [3].CONCLUSIONS: Despite being an alarming finding, asymptomatic IUAPA in adulthood should simply be watched carefully and shouldn't be a hindrance for undergoing surgical interventions. However, educating patients on potential adverse events, like hemoptysis, can help them to seek medical attention faster and thereby possibly prevent poor or even fatal outcomes.