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A 35-year-old African American female with a 40 pack-year historyof smoking reported to the emergency department with a chief complaintof bilateral extremity swelling. She denied any history of shortness of breath,cough, chest pain, nausea, vomiting, abdominal pain, dizziness, or fainting. She also denied any chest injury while working as a flight attendant last year. She had been asymptomatic until coming to the ED with bilateralupper extremity edema, numbness, and tingling of both hands. She had been seenat the local urgent care 3 days ago where her symptoms were said to be "a littlebetter" and were prescribed Ibuprofen 800mg TID by her physician. She did not "havemuch relief" with the medication. She had no history of fever, rhinorrhea, sneezing, or nasal congestion. There were no appreciable cervical lymph nodes or edema of the face. Her bodily appearance was normal. Vital signs were normal. There were no identification tattoos. The patient denied having any social or sexual contacts. There was no significant past medical history. Her only medication was atorvastatin 30mg daily. She was a middle school educator. No chronic illness, surgeries, or allergies were reported. She did not have any form of alcohol or other drug abuse.
At the time of this study, all of our subjects were medically stable and had aresults of spirometry that were satisfactory for inclusion in theefficacy portion of the clinical trial. In general, subjects were characterized as having mild or moderate impairment of lung function. In one case of a child presenting with a respiratory infection, lung function testing revealed a consistent right to left shunt (Table 2). d2c66b5586