Pulmonary cystic lung disease is an uncommon manifestation of systemic autoimmune disorders. Rheumatoid arthritis (RA) is most often associated with interstitial lung disease, whereas pulmonary involvement in autoimmune hepatitis (AIH) is rare. We describe an 82-year-old woman with longstanding RA and AIH who demonstrated progressive bilateral pulmonary cystic disease over a 15-year period, complicated by acute hypoxemic respiratory failure and the new identification of a pulmonary arteriovenous malformation. Interval imaging revealed progression of thin-walled pulmonary cysts and fibrotic changes compared with prior studies. This case highlights a rare overlap of autoimmune conditions associated with cystic lung disease and emphasizes the importance of longitudinal imaging, medication review, and multidisciplinary management in patients with complex autoimmune disease presenting with dyspnea.

Fibrodysplasia ossificans progressiva (FOP) is an autosomal dominant rare disease characterized by progressive episodic multi-focal heterotopic ossification of skeletal muscle, ligaments, tendons, and fascia, associated with congenital malformation of the great toes. Progressive thoracic deformity with scoliosis is present in approximately 65% of patients, causing restrictive lung disease, respiratory failure, and premature death. We report 3 children who developed severe scoliosis and sleep-disordered breathing with nocturnal hypoventilation, and were treated with long-term noninvasive ventilation (NIV) at home. Despite a non-optimal correction of nocturnal alveolar hypoventilation due to the severity of the disease, tolerance and compliance with NIV were excellent, with an improvement in sleep quality, a reduction in acute respiratory exacerbations requiring hospitalization, the maintenance of a good quality of life, and long-term survival. In conclusion, patients with FOP should be screened for nocturnal hypoventilation and recurrent or severe respiratory exacerbations, in order to propose long-term NIV, which may be associated with a better quality of life, and may eventually prolong life expectancy, even in case of uncomplete correction of nocturnal gas exchange.

Cartap hydrochloride (CH) is a Class II hazardous pesticide that causes toxicity by inhibiting post-synaptic nicotinic acetylcholine receptors and affecting calcium release in the sarcoplasmic reticulum. While mortality is generally low, severe cases can lead to respiratory failure. A 25-year-old male presented to the emergency department six hours after intentionally consuming approximately 12 g of 50% CH. He exhibited vomiting, drowsiness (Glasgow Coma Score [GCS]: 13/15), and bradycardia (HR: 52/min). Initial arterial blood gas (ABG) analysis revealed mixed acidosis (pH: 7.296, pCO2: 60.8, pO2: 102.8, Lactate: 4.2, and HCO3: 20.3). Notably, serum pseudo-cholinesterase levels and other laboratory findings were within normal limits. The patient was treated with non-invasive ventilation (NIV) for respiratory acidosis and administered a loading dose of N-acetylcysteine (NAC) (150 mg/kg) along with symptomatic management. His sensorium and ABG parameters normalized within six hours of treatment. He remained asymptomatic and was discharged after three days. Human toxicity from CH is rarely reported, and cases involving mixed acidosis are particularly sparse in literature. This case highlights the importance of recognizing CH poisoning, which can mimic organophosphate toxicity. Vigilant monitoring for acidosis via ABG and early intervention with NAC and supportive care, such as NIV, are crucial for successful clinical outcomes.

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma; however, primary involvement of the small intestine is uncommon. Acute bowel perforation is a rare and life-threatening presentation that may mimic more common causes of acute abdomen. We report the case of a 78-year-old woman who presented with worsening abdominal pain, nausea, vomiting, and obstipation. Computed tomography demonstrated pneumoperitoneum concerning for hollow viscus perforation. Exploratory laparotomy revealed a perforated terminal ileal mass, and segmental small bowel resection was performed. Histopathologic evaluation demonstrated diffuse transmural infiltration by large atypical lymphoid cells with diffuse CD20 positivity and MUM1 nuclear positivity, consistent with DLBCL, non-germinal center B-cell subtype by the Hans algorithm (CD10-negative, BCL6-positive, MUM1-positive). The postoperative course was complicated by sepsis, respiratory failure, and prolonged ileus. This case highlights the importance of considering primary gastrointestinal lymphoma in the differential diagnosis of bowel perforation and acute surgical abdomen, particularly in elderly patients presenting emergently.

Extracorporeal membrane oxygenation (ECMO) has become an increasingly vital intervention for patients with severe cardiac and respiratory failure, significantly improving short-term survival rates. However, there is growing recognition of the importance of long-term outcomes, including health-related quality of life (HRQoL), functional recovery, and psychological well-being. This narrative review synthesizes clinical studies, systematic reviews, and cohort analyses from the past 20 years using PubMed and Google Scholar, focusing on adult ECMO survivors. Studies consistently demonstrate that although many survivors achieve functional independence, a significant proportion experience persistent limitation. Common long-term sequelae include reduced physical capacity, depression, anxiety, cognitive impairment, and challenges in social reintegration such as returning into employment. Outcomes vary by ECMO modality: Veno venous (VV) ECMO survivors typically report better HRQoL than those receiving Veno arterial (VA) ECMO, although depression appears more prevalent among VV ECMO survivors. Significant complications including neurological injury, limb ischemia, and bleeding remain major contributors to morbidity, particularly in VA ECMO cohorts. The differences reflect variation in underlying disease and complication burden between the 2 modalities. Rehabilitation strategies emphasizing early physiotherapy, structured discharge planning, and comprehensive long-term follow-up are associated with improved functional and psychosocial outcomes. Despite rising survival, existing literature reveals considerable heterogeneity, a lack of standardized outcome measures, and limited prospective multicenter data. Future research should focus on innovations in ECMO circuit design, safer anticoagulation protocols, and the development of standardized rehabilitation pathways. Incorporating long-term functional, psychological, and social outcomes into ECMO care paradigms, is essential to move beyond survival towards meaningful recovery, ultimately optimizing quality of life for ECMO survivors.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and its progression is closely linked to mitochondrial dysfunction in cardiomyocytes. Given the high energy demands of the heart, precise regulation of mitochondrial homeostasis, including oxidative phosphorylation, reactive oxygen species balance, calcium handling, and mitophagy, is essential for maintaining cardiac function. Emerging evidence has identified mitochondrial-associated long non-coding RNAs (mito-lncRNAs) as important regulators of these processes. Mito-lncRNAs comprise both nuclear-encoded transcripts that translocate to mitochondria and mitochondrial genome-encoded lncRNAs that function within the organelle. These molecules modulate mitochondrial gene expression, respiratory chain stability, metabolic flux, and stress responses, thereby influencing the pathogenesis of acute myocardial infarction, heart failure, diabetic cardiomyopathy, pulmonary hypertension, and cardiac remodeling. In this review, we categorize mito-lncRNAs based on their genomic origin and mitochondrial localization and summarize their mechanistic roles in cardiovascular physiology and disease. Moreover, the review highlights context-dependent effects of key transcripts such as LIPCAR, MALAT1, RMRP, H19, and lncND5. We further discuss the emerging value of mito-lncRNAs as circulating biomarkers and examine the major challenges that currently limit therapeutic translation, including cardiac- and mitochondrial-specific delivery, mechanistic ambiguity, species conservation, and technical limitations in detection. A deeper understanding of mito-lncRNA biology may provide new insights into mitochondrial regulation in the heart and inform the development of novel diagnostic and therapeutic strategies for CVDs.