Introduction Pasteurella multocida colonizes the oropharynx of various domestic and wild animals. In humans, respiratory tract P. multocida infection is the second most frequent localization and usually manifests as pneumonia. Unilateral absence of pulmonary artery (UAPA) is a very rare congenital anomaly. Adult patients with UAPA are usually asymptomatic or their symptoms are nonspecific. Case report We report a female patient with hemoptysis admitted to our clinic where we isolated P. multocida in sputum. The organism was also isolated from nasopharyngeal swab of her dog. During hospitalization, she was also diagnosed with UAPA and chronic obstructive pulmonary disease (COPD). Discussion Respiratory P. multocida infection develops more commonly through contact with animal secretions. It occurs most often in immunocompromised patients and in individuals with comorbidities. Hemoptysis very rarely follows P. multocida infection while it is common in cases of UAPA due to existing developed collateral circulation especially in older patients.Conclusions Ceased hemoptysis after adequate treatment and no recurrence of it over six years of following up the patient led us to conclude that the cause of hemoptysis was P. multocida infection and not UAPA which was more likely to be the case.

BackgroundThe influence of the diaphragm motion to the accuracy of postoperative lung function prediction after the lung resction is still debatable.MethodsProspective study that included 27 patients who underwent a lung resection for cancer. Diaphragm movements were assessed radiographically and by ultrasonography before the operation and postoperatively, with the lung fully expanded. The relationship between the diaphragm movements and differences between ppo FEV1 and measured postoperative FEV1, was analysed by expressing diaphragm movements as preoperative diaphragm amplitudes, preoperative-postoperative amplitude differences or in relation to fixed intrathoracic distances.ResultsThe mean difference between preoperative and postoperative diaphragm amplitudes of the diseased side was 2.42 ± 1.25 cm and 2.11 ± 2.04 cm when measured radiographically and by ultra sound respectively (p > 0.05). A significant positive correlation was found for the entire group only between the patients’ height and the differences ppo FEV1 - actual FEV1: the prediction was more unprecise in taller patients. With the cut-off value of 550 ml for differences between ppo FEV1 and actual FEV1, a significant inverse correlation was found only if the preoperative ipsilateral diaphragm amplitude was presented as a percentage of the preoperative apex-base distance in inspiration. For right-sided tumours, the greater the difference between preoperative and postoperative ipsilateral diaphragm amplitudes, the greater discrepancy between predicted and actual postoperative FEV1. For left-sided tumours, inverse correlation existed if the preoperative diaphragm amplitude was presented as a percentage of the preoperative distance apex-base.ConclusionDiaphragm movements influence the accuracy of the postoperative lung function prediction.

BackgroundIn spite of the progress made in neoadjuvant therapy for operable non small‐cell lung cancer (NSCLC), many issues remain unsolved, especially in locally advanced stage IIIA.MethodsRetrospective data of 163 patients diagnosed with stage IIIA NSCLC after surgery was analyzed. The patients were divided into two groups: a preoperative chemotherapy group including 59 patients who received platinum‐etoposide doublet treatment before surgery, and an upfront surgery group including 104 patients for whom surgical resection was the first treatment step. Adjuvant chemotherapy or/and radiotherapy was administered to 139 patients (85.3%), while 24 patients (14.7%) were followed‐up only.ResultsThe rate of N2 disease was significantly higher in the upfront surgery group (P < 0.001). The one‐year relapse rate was 49.5% in the preoperative chemotherapy group compared to 65.4% in the upfront surgery group. There was a significant difference in relapse rate in relation to adjuvant chemotheraphy treatment (P = 0.007). The probability of relapse was equal whether radiotherapy was applied or not (P = 0.142). There was no statistically significant difference in two‐year mortality (P = 0.577). The median survival duration after two years of follow‐up was 19.6 months in the preoperative chemotherapy group versus 18.8 months in the upfront surgery group (P = 0.608 > 0.05).ConclusionThere was significant difference in preoperative chemotherapy group regarding relapse rate and treatment outcomes related to the lymph node status comparing to the upfront surgery group. Neoadjuvant/adjuvant chemo‐therapy is a part of treatment for patients with stage IIIA NSCLC, but further investigation is required to determine optimal treatment.

Introduction/aim Clinical signs and symptoms of pulmonary embolism (PE) are non-specific, which is why it is commonly not diagnosed on time or sometimes not diagnosed at all. We are presenting a case of pulmonary embolism manifesting with syncope as a dominant symptom. Case report A 74-year-old female patient was hospitalized at the Clinic for Pulmonary Diseases with PE manifested with syncope. At admission, she was afebrile, tachypneic, with normal cardiac function and normal blood tension. Upon auscultation, breathing was muffled with late inspiration crackles above the base of the left lung. There were no other significant findings. The chest X-ray recorded at admission showed a non-homogenous shadow towards the base of the left lung and minimal pleural effusion. The ECG and echocardiography findings were normal. Partial respiratory insufficiency was verified by the acid-base balance analysis. Inflammatory markers were significantly elevated, with erythrocyte sedimentation rate of 30mm/h, fibrinogen of 8.62g/l and D-dimer of 18.6mg/l. Anticardiolipin IgG and IgM antibodies were negative, as well as beta-2 GPI IgG and IgM antibodies. An MDCT lung angiography was performed because of the elevated values of D-dimer and tachypnea, which showed multiple emboli of various sizes in the distal part of the right pulmonary artery and all lobar branches, as well as an embolus in the lobar branch for the lower lobe of the left lung. After a neurology consult, a head CT was ordered because the patient had suffered from loss of consciousness, but there were no pathological densities in the brain. Colour Doppler Ultrasonography of the blood vessels in the lower extremities showed organized thrombosis of the left femoral vein. A vascular surgeon was consulted and he prescribed anticoagulant therapy and an elastic compressive stocking, with control Colour Doppler Ultrasonography to be performed in six months. Conclusion Although syncope is an easily detectable symptom, it is still an unregulated crossroad of many an internal and neurological disease.

Introduction: Branchial cleft anomalies are considered to develop from the branchial apparatus that did not completely obliterate during the embryogenesis of the head and neck. These anomalies pose a significant challenge in terms of surgical management, particularly followed by misdiagnosis due to its rarity. The aim of this case report was to present the review of literature and treatment of a rare anomaly such as a second branchial cleft cyst with a particular focus on clinical as well as histopathological aspects. Case report: A 24-year-old woman was admitted to the otolaryngology department with a three-month history of painless right-sided neck swelling, following a previously resolved upper respiratory infection. The patient underwent complete excision of the cystic mass, with excellent cosmetic results and no signs of recurrence after a one-year follow-up. Conclusion: Therefore, surgery should always be the gold standard of treatment. In patients aged over 40 years, cystic metastasis from the occult head and neck primary carcinoma must be considered.