Patient case (clinical description): A 30-year-old man who is a computer scientist came to the clinic with the lab result stating azoospermia.  The patient is sexually active with his wife and does not use any contraception methods.  They have been trying to conceive for the past year with no success.  The patient has a past medical history of recurrent pneumonia, shortness of breath, and  persistent cough that produces large amounts of thick sputum. The patient had multiple lung infections during childhood. He does not smoke, use illicit drugs or alcohol.  The patient has no history of other medical conditions including allergies or any kind of surgery.  On physical examination, the digits show clubbing.  An ultrasound shows bilateral absence of the vas deferens, and FEV1 was 75% on the respiratory function test.

Patient's own account: I'm a 30-year-old computer scientist. I did some lab tests that came back quite alarming, stating that I have azoospermia?! I'm sexually active with my wife and we don't use contraception. We've been trying to have a child for the past year. I have a medical history of pneumonia and shortness of breath and regular wet cough. I had several lung infections when I was a kid. That's why I'm very careful and don't smoke, do drugs, or drink. I don't have other medical conditions including allergies or any kind of surgery. The doctor did the clubbing test on my fingers, which was positive. I also did an ultrasound and it showed that I'm missing the tubes that carry sperm around. I also had a 75% for my respiratory function test.

Clinical trial: Dexamethasone Dyspnea Study

Eligibility criteria:
Inclusion Criteria:

          1. Diagnosis of cancer

          2. Dyspnea with an average intensity level >3/10 on the numeric rating scale over the
             past week

          3. Clinical or radiologic history of lung/pleural involvement (primary or metastatic),
             lymphangitic carcinomatosis or airway involvement secondary to tumor infiltration

          4. Outpatients at MD Anderson Cancer Center seen by the Supportive Care, Rehabilitation
             Service, Thoracic Oncology or Pulmonary Medicine

          5. Able to communicate in English

          6. Karnofsky performance status >=40%

          7. Age 18 or older

          8. Permission from the attending medical oncologist if the patient is currently on an
             interventional cancer therapy trial.

        Exclusion Criteria:

          1. Delirium (i.e. Memorial delirium rating scale >13)

          2. Oxygen saturation <90% despite supplemental oxygen >6L/min

          3. Previous allergic reactions to dexamethasone

          4. Uncontrolled hyperglycemia as defined by any blood glucose of >300 mg/dl in the past
             two weeks

          5. Severe anemia (Hb <7g/L) not corrected prior to study enrollment (bloodwork is not
             required if patient did not have recent chemotherapy within last 2 weeks)

          6. Post-surgical open wound that has not been healed at the time of enrollment

          7. Any infection requiring parenteral antibiotics within the past 2 weeks

          8. Major surgery within the past 2 weeks

          9. Megestrol use at the time of study enrollment

         10. Neutropenia (absolute neutrophil count < 1.0) (bloodwork is not required if patient
             did not have recent chemotherapy within last 2 weeks)

         11. Currently on or expected to start cytotoxic chemotherapy with in 1 week of study
             enrollment

         12. Chronic obstructive pulmonary disease (COPD) exacerbation at the time of study
             enrollment

         13. Heart failure exacerbation at the time of study enrollment

         14. Chronic systemic corticosteroid use (>14 days) at the time of study enrollment

         15. Unwilling to provide informed consent
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Contradiction