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Which came first, interstitial pneumonia or collagen vascular disease?
The group looked at 111 records retrospectively of patients who had been diagnosed with interstitial pneumonia (IPF) from 1990 to 2007 (PLoS ONE 9:e94775). Ten of these patients subsequently were diagnosed with collagen vascular disease (CVD), being rheumatoid arthritis (4), microscopic polyangitis (4), systemic sclerosis (1) and systemic sclerosis and Sjorgeren's syndrome (1). The average time to the diagnosis of CVD was 3.9±2.4 years. None of the patients had any CVD-positive autoantibodies at the time of diagnosis, though half had a positive antinuclear antibody (ANA). The presenting features were analysed to see what factors predicted the development of IPF. These were being significantly younger and female. Cox regression analysis showed being female and having the presence of lymphoid aggregates with germinal centres on biopsy were significantly associated with the occurrence of CVD in patients initially diagnosed with IPF.
Other ways of treating vocal cord dysfunction
Vocal cord dysfunction can be difficult to treat. This paper from Australia (Respirology 2014;19:531–7) describes a series of 11 patients who had a total of 24 injections of botulinum toxin to a unilateral vocal cord. …