ABSTRACT Background: Asthma is a chronic inflammatory disease in adults, in which systemic inflammation plays a key pathogenic role. The platelet-to-high-density lipoprotein ratio (PHR) has emerged as a biomarker of systemic inflammation. Although studied in relation to asthma, its association with adult asthma remains inadequately characterized, and evidence from large-scale epidemiological studies is limited. Objective: This study aimed to investigate the association between the PHR and asthma in adults, using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. Methods: A cross-sectional analysis was performed on 22,617 adult participants from NHANES. Asthma status was defined based on self-report, and PHR was calculated as platelet count (1,000/μL) divided by high-density lipoprotein cholesterol (mg/dL). We used multivariable logistic regression to examine the association between PHR (analyzed as both continuous and categorical variables by quartiles) and asthma. Nonlinearity was assessed using restricted cubic splines, and the robustness of findings was evaluated through a series of sensitivity analyses, including weighted regression and multiple imputation for missing data. Results: Using multivariable logistic regression, we found a significant positive association between PHR and adult asthma (OR = 1.03, 95% CI: 1.01–1.05; P = 0.009). When PHR was divided into quartiles, the Q2 and Q4 groups had higher asthma risk than Q1 (risk ratios of 1.19 and 1.20, respectively). Asthma prevalence increased significantly across PHR quartiles ( P for trend <0.001). Restricted cubic spline analysis indicated a linear relationship, with the odds of asthma rising as PHR increased. These results remained robust in both weighted and sensitivity analyses. Conclusions: Our findings show that higher PHR is associated with an increased prevalence of asthma, suggesting that higher PHR may be linked to asthma diagnosis in US adults.
ABSTRACT Background: Pulmonary involvement in lymphoma is uncommon and often mimics more prevalent respiratory diseases such as tuberculosis, pneumonia, or malignant pleural effusion, leading to delayed diagnosis. This study aimed to describe the clinical, radiological, and diagnostic characteristics of lymphoma patients presenting primarily with respiratory manifestations. Methods: We conducted a retrospective observational study of histologically confirmed lymphoma cases diagnosed in the Department of Pulmonary Medicine at a tertiary care center between 2023 and 2024. Clinical presentation, imaging findings, pleural fluid characteristics, diagnostic procedures, histopathological subtypes, and time to diagnosis were analyzed. Results: Ten patients (7 males, 3 females; mean age 47.7 years) were included. Breathlessness was the most common presenting symptom (50%), followed by fever (30%), chest pain (10%), and haemoptysis (10%). Four patients (40%) had been empirically treated with antitubercular therapy before diagnosis. Pleural effusion was the predominant radiological finding, occurring in 8 patients, with unilateral effusion in 62% of cases. Mean pleural fluid adenosine deaminase (ADA) level was 149.7 U/L; however, except for one outlier, all values were below 70 U/L. Radiological presentations included mediastinal masses, pulmonary consolidations, hilar masses, pleural thickening, and diffuse infiltrative lesions. Diagnostic confirmation was achieved through medical thoracoscopy ( n =3), transbronchial lung biopsy with endobronchial ultrasound-guided transbronchial needle aspiration ( n =1), lymph node excision biopsy ( n =1), endobronchial biopsy ( n =1), and CT/USG-guided biopsies ( n =4). Three patients had primary pulmonary lymphoma, while seven had secondary pulmonary involvement. The median time to diagnosis was 75 days. Conclusion: Lymphoma can present with diverse respiratory manifestations, frequently masquerading as tuberculosis or other pulmonary disorders. Persistent pleural effusions, non-resolving pulmonary consolidations, mediastinal masses, or atypical thoracic lesions should prompt consideration of lymphoma. Early tissue diagnosis, repeat biopsies when initial samples are inconclusive, and avoidance of prolonged empirical therapy are essential for timely diagnosis and management.
ABSTRACT Silicone tracheal stents are widely used in the management of benign airway stenosis; however, long-term positioned stents may lead to delayed complications. We report a case of a 28-year-old man who underwent silicone tracheal stent placement 12 years back for post-intubation tracheal stenosis at another centre. The patient subsequently was lost to follow-up, and he was referred to our centre for surgical removal of the stent. However, the patient was unwilling for surgery considering its complex nature. Current bronchoscopy revealed a silicone stent in the upper trachea with extensive granulation tissue, resulting in significant airway obstruction. The patient was taken up for bronchoscopic stent removal under general anaesthesia using suspension laryngoscopy. The adherent stent necessitated the use of rigid endoscopic scissors to cut the anterior aspect of the stent in order to dislodge it, following which the stent was removed using rigid forceps. This case demonstrates that even long-standing silicone stents with extensive granulation tissue can be safely removed using a carefully planned multimodal bronchoscopic approach.
