Introduction:Exertional-induced bronchoconstriction is a condition in which the physical activity causes constriction of airways in patients with airway hyper- responsiveness. In this study, we tried to study and evaluate any relationship between the findings of cardiopulmonary exercise testing (CPET) and the response to methacholine challenge test (MCT) in patients with dyspnea after activity.Materials and Methods:Thirty patients with complaints of dyspnea following activity referred to “Lung Clinic” of Baqiyatallah Hospital but not suffering from asthma were entered into the study. The subjects were excluded from the study if: Suffering from any other pulmonary diseases, smoking more than 1 cigarette a week in the last year, having a history of smoking more than 10 packets of cigarettes/year, having respiratory infection in the past 4 weeks, having abnormal chest X-ray or electrocardiogram, and cannot discontinue the use of medicines interfering with bronchial provocation. Baseline spirometry was performed for all the patients, and the values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV/FVC were recorded. The MCT and then the CPET were performed on all patients.Results:The mean VO2 (volume oxygen) in patients with positive methacholine test (20.45 mL/kg/min) was significantly lower than patients with negative MCT (28.69 mL/kg/min) (P = 0.000). Respiratory rates per minute (RR) and minute ventilation in the group with positive MCT (38.85 and 1.636 L) were significantly lower than the group with negative methacholine test (46.78 and 2.114 L) (P < 0.05). Also, the O2 pulse rate in the group with negative methacholine test (116.27 mL/beat) was significantly higher than the group with positive methacholine test (84.26 mL/beat) (P < 0.001).Conclusion:Pulmonary response to exercise in patients with positive methacholine test is insufficient. The dead space ventilation in these patients has increased. Also, dynamic hyperinflation in patients with positive methacholine test causes the reduced stroke volume and O2 pulse in these patients.
Background: Aneurysmal Bone Cysts (ABCs) are benign destructive tumors. Their diagnosis is sometimes challenging, and their treatment in unusual sites, especially in the pediatric age group is difficult, too. This study aims to support the paraclinical measures along proper consultation to approach the pelvic ABC. Methods: We present a 9-year-old female who suffered from pain in the left hip 3 months before the referral. A pelvic mass was diagnosed and unfortunately misdiagnosed with an ovarian mass. It was led to a wrong operation with a wrong approach by a general surgeon and result in intra-operative bleeding and delay in diagnosis and treatment. the final diagnosis was massive ABC in the supra-acetabular area with extension to the ilium and pubic. Conclusion: Pelvis is one of the most challenging sites for the diagnosis and treatment of bone tumors. Large ABC tumors in the hip are unusual and may be presented by non-specific signs and symptoms. Therefore complete clinical and radiological evaluations should be done before any attempt to surgically remove the pelvic mass. Prognosis is excellent if the pelvic mass remove wisely by an experienced hip surgeon
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