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https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#1
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27888824/clinico-radiological-parameters-predicting-early-diagnosis-of-foreign-body-aspiration-in-children
#2
Pradipta Kumar Parida, Nirmal Shanmugasundaram, Surianarayanan Gopalakrishnan
OBJECTIVES: This study aims to investigate clinical and radiological findings to make early diagnosis of foreign body (FB) aspiration in children. PATIENTS AND METHODS: This prospective study was conducted on 45 children younger than 12 years with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy between September 2010 and May 2014. The results of 37 children (22 males, 15 females; mean age 2.6 years; range 1 to 12 years) with positive for FB on bronchoscopy were analyzed...
September 2016: Kulak Burun Boğaz Ihtisas Dergisi: KBB, Journal of Ear, Nose, and Throat
https://www.readbyqxmd.com/read/27882737/neonatal-bowel-strangulation-rare-presentation-of-congenital-diaphragmatic-hernia
#3
Salvatore Arena, Gianfranco Scalfari, Nunzio Turiaco, Lucia Marseglia, Patrizia Perrone, Eloisa Gitto, Carmelo Romeo
We report a case of congenital diaphragmatic hernia (CDH) with perinatal bowel strangulation requiring intestinal resection. Ten hours after birth, the newborn started to be lethargic and developed bilious emesis. X-ray documented distended loops of bowel with air fluid levels in the abdomen and a gasless, non-homogeneous opacity of the left hemithorax, a right mediastinal shift and loss of the sharp left hemidiaphram line. On gastrographin enema the left colon was above the adjacent left diaphragm. Emergency surgery was performed at 16 h of age...
November 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27871562/anesthetizing-a-child-for-a-large-compressive-mediastinal-mass-with-distraction-techniques-and-music-therapies-as-the-sole-agents
#4
Adam C Adler, Emily R Schwartz, Jennifer M Waters, Paul A Stricker
Anesthetic management of the child with an anterior mediastinal mass is challenging. The surgical/procedural goal typically is to obtain a definitive tissue diagnosis to guide treatment; the safest approach to anesthesia is often one that alters cardiorespiratory physiology the least. In severe cases, this may translate to little or no systemic sedatives/analgesics. Distraction techniques, designed to shift attention away from procedure-related pain (such as counting, listening to music, non-procedure-related talk), may be of great benefit, allowing for avoidance of pharmaceuticals...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27852660/massive-symptomatic-right-sided-bochdalek-hernia-in-an-adult-man
#5
Naman Kohli, Goran Mitreski, Cheng-Hon Yap, Matthew Leong
A 22-year-old man presented to a rural hospital in Australia with right-sided pleuritic chest pain, right shoulder pain and dyspnoea. The patient had been receiving chronic asthma therapy without improvement. CT of the chest was performed after an abnormal X-ray, incidentally revealing one of the largest documented right-sided diaphragmatic hernias, with left lung compression due to mediastinal shift. The patient was definitively managed with thoracotomy alone. The contents of the hernia sac included colon and multiple loops of small bowel with a 10 cm neck...
November 15, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27785539/computed-tomography-and-upper-gastrointestinal-series-findings-of-esophageal-bronchi-in-infants
#6
Gabrielle C Colleran, Ciara E Ryan, Edward Y Lee, Brian Sweeney, David Rea, Clare Brenner
BACKGROUND: Esophageal bronchus is a rare form of communicating bronchopulmonary foregut malformation and a rare but important cause of an opaque hemithorax on chest radiography. A higher incidence of esophageal bronchus is associated with esophageal atresia, tracheo-esophageal fistula (TEF) and VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) association. In the presence of these conditions, the pediatric radiologist may be the first to consider the diagnosis of esophageal bronchus or esophageal lung...
October 26, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27765746/heart-lung-interaction-in-a-model-of-copd-importance-of-lung-volume-and-direct-ventricular-interaction
#7
William S Cheyne, Alexandra M Williams, Megan I Harper, Neil D Eves
Chronic obstructive pulmonary disease (COPD) is associated with dynamic lung hyperinflation (DH), increased pulmonary vascular resistance (PVR), and large increases in negative intrathoracic pressure (nITP). The individual and interactive effect of these stressors on left ventricular (LV) filling, emptying, and geometry and the role of direct ventricular interaction (DVI) in mediating these interactions have not been fully elucidated. Twenty healthy subjects were exposed to the following stressors alone and in combination: 1) inspiratory resistive loading of -20 cmH2O (nITP), 2) expiratory resistive loading to cause dynamic hyperinflation (DH), and 3) normobaric-hypoxia to increase PVR (hPVR)...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27509663/-fetal-therapy-intrauterine-thoraco-amniotic-shunting-in-macrocystic-type-cystic-adenomatoid-malformation-of-the-lung-review-of-the-literature-and-case-report
#8
REVIEW
P Chaveeva, V Stratieva, H Shivachev, S Aktash, M Panova, A Shterev
ABSTRACT OBJECTIVE: To present a case of macrocystic type cystic adenomatoid malformation of the lung (CCAM) treated with thoraco-amniotic shunt and to review the published data to evaluate the efficiency of thoraco-amniotic shunts for drainage of (CCAM). MATERIALS AND METHODS: This wass case reported of a fetus with a large thoracic cyst, major mediastinal shift and polyhidramnion treated with thoraco-amniotic shunting. We identified 8 cases diagnosed with CCAM and only one case met the criteria for fetal surgery...
2016: Akusherstvo i Ginekologii︠a︡
https://www.readbyqxmd.com/read/27492202/cardiac-and-respiration-induced-motion-of-mediastinal-lymph-node-targets-in-lung-cancer-patients-throughout-the-radiotherapy-treatment-course
#9
Mai Lykkegaard Schmidt, Lone Hoffmann, Marianne Marquard Knap, Torben Riis Rasmussen, Birgitte Holst Folkersen, Jakob Toftegaard, Ditte Sloth Møller, Per Rugård Poulsen
BACKGROUND AND PURPOSE: Involved mediastinal lymph nodes (LNs) are often included in the radiotherapy target for lung cancer patients. Their motion may differ from the primary tumor motion, possibly undermining the loco-regional control. This study determines the detailed differential target motion throughout the treatment course. MATERIAL AND METHODS: Ten lung cancer patients with 2-4 fiducial markers implanted in LN targets received IMRT with a daily pre-treatment cone-beam CT (CBCT) scan...
August 2, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27489957/thoracoamniotic-shunts-in-macrocystic-lung-lesions-case-series-and-review-of-the-literature
#10
Magdalena Litwińska, Ewelina Litwińska, Katarzyna Janiak, Anna Piaseczna-Piotrowska, Ewa Gulczyńska, Krzysztof Szaflik
OBJECTIVE: To evaluate the efficiency of thoracoamniotic shunts for drainage of macrocystic-type congenital cystic adenomatoid malformation (CCAM). SUBJECTS AND METHODS: This was a retrospective study of 12 fetuses with a large thoracic cyst treated with thoracoamniotic shunting between 2004 and 2014 in a tertiary fetal therapy center. Medline was searched to identify cases of CCAM treated with thoracoamniotic shunting. RESULTS: In all cases the thoracic cyst was associated with major mediastinal shift, the CCAM volume ratio (CVR) was >1...
August 5, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27390546/multidetector-ct-findings-and-differential-diagnoses-of-malignant-pleural-mesothelioma-and-metastatic-pleural-diseases-in-korea
#11
Yoon Kyung Kim, Jeung Sook Kim, Kyung Won Lee, Chin A Yi, Jin Mo Koo, Soon-Hee Jung
OBJECTIVE: To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). MATERIALS AND METHODS: The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque...
July 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/27381542/congenital-lobar-emphysema-a-rare-cause-of-hypertension
#12
Tuğçe Tural-Kara, Halil Özdemir, Ergin Çiftçi, Erdal İnce
Congenital lobar emphysema is a rare disease, which is characterized by pulmoner hyperinflation. Depending on the degree of bronchial obstruction, the clinical presentation may be variable. We report a rare case with congenital lobar emphysema in a 38-days-old male infant who presented with severe respiratory distress and hypertension. Air trapping in the left upper lung and significant mediastinal shift to the right were observed on the chest x-ray. Emphysematous changes were detected on the thorax computed tomography and considered as congenital lobar emphysema...
July 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27379852/-cardiac-herniation-and-torsion-after-transpericardial-pneumonectomy
#13
W Schummer, A Hottenrott, C Nissel
This article presents the case of a 43 year old woman with right-sided lung cancer. She underwent transpericardial pneumonectomy. After an uneventfull surgery, the patient was transferred to the intensive care unit for postoperative monitoring. She was hemodynamically stable and had already been extubated in the OR.On postoperative chest X‑ray a mediastinal shift to the operated side as well as a herniation of the heart into the right chest cavity was detected. While the patient remained hemodynamically stable a computed tomography of the chest was performed which confirmed the diagnosis of cardiac herniation and torsion...
July 5, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27329694/forensic-features-of-lethal-late-presenting-diaphragmatic-hernias
#14
Melissa Thompson, Stephen Wills, Roger W Byard
Diaphragmatic defects are a relatively common and benign finding in adults which may be congenital or secondarily acquired. The case files at Forensic Sciences South Australia were reviewed over a 10-year period from July 2005 to June 2015 for all adult (>17 years) cases in which diaphragmatic hernias were identified at postmortem examination that had either caused or contributed to death. Five cases were found: age range 49-90 years (average 67.2 years); male:female ratio 2:3. Herniated organs included the stomach (N = 3), small (N = 3) and large intestines (N = 2)...
September 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27306388/current-controversies-in-lung-cancer-staging
#15
Brett W Carter, Myrna C B Godoy, Carol C Wu, Jeremy J Erasmus, Mylene T Truong
Lung cancer remains the leading cause of cancer-related mortality in the United States, and accurate staging of disease plays an important role in the formulation of treatment strategies and optimization of patient outcomes. The International Association for the Study of Lung Cancer has recently proposed changes to the upcoming eighth edition of the tumor, node, and metastasis (TNM-8) staging system used for lung cancer. This revised classification is based on significant differences in patient survival identified on analysis of a new large international database of lung cancer cases...
July 2016: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/27293949/progressive-dyspnea-in-a-40-year-old-man-caused-by-giant-mediastinal-thymolipoma
#16
Mohammad Vaziri, Kamelia Rad
Thymolipomas are rare tumors of the anterior mediastinum containing both thymic stroma and an abundance of fat. We present a 40-year-old man with no underlying disease who presented with cough and progressive dyspnea. Clinical evaluation revealed a giant mass of lipid density filling almost the entire left hemithorax with mediastinal shift. Total excision of the 40 × 33 × 8 cm mass weighing 4 kg was performed via a left thoracotomy and the histopathologic diagnosis of the mass was reported as thymolipoma...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27286785/esophageal-necrosis-after-endovascular-repair-for-ruptured-aortic-dissection
#17
Shintaro Koizumi, Seiichi Yamaguchi, Soichi Asano, Hisanori Fujita, Tomonori Sueta, Shigeyasu Takeuchi
A 78-year-old man presented with back pain and shock and was transferred to our hospital. Computed tomography showed a ruptured aortic dissection in which the false lumen was thrombosed with an ulcer-like projection, and the mid-esophagus was shifted to the right due to a mediastinal hematoma. He underwent emergency thoracic endovascular aortic repair of the descending thoracic aorta. One week later, esophageal necrosis occurred, and he died of mediastinitis and sepsis on postoperative day 16. Although esophageal necrosis is a rare and fatal complication after thoracic endovascular aortic repair, a management strategy has not yet been established...
June 9, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27247208/tension-pneumothorax-due-to-perforated-colon
#18
Muhammad Abdullah, Paul Stonelake
A very rare case of traumatic diaphragmatic hernia is reported in a 65-year-old woman who presented 46 years after her initial thoracoabdominal injury with tension faecopneumothorax caused by a perforated colon in the chest cavity. She presented in a critical condition with severe respiratory distress, sepsis and acute kidney injury. She had a long-standing history of bronchial asthma with respiratory complications and had experienced progressive shortness of breath for the past year. A recent CT scan had excluded the presence of a diaphragmatic hernia but showed a significantly raised left hemidiaphragm...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27206777/a-rare-case-of-unilateral-severe-bullous-emphysema-in-a-32-year-old-female
#19
Hui Jun Lim, Chong Hee Lim
Congenital bullous emphysema is defined as large bullae involving at least one-third of a hemithorax. We describe the case of a 32-year-old female who presented with increasing shortness of breath. Radiological investigations revealed severe emphysema with hyperexpansion of the right lung and a mediastinal shift to the left. A lung perfusion scan showed reduced perfusion in the right lung. The patient underwent a right pneumonectomy with a diagnosis of congenital bullous emphysema. She was doing well 6 years later...
July 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27174294/thoracoamniotic-shunting-for-fetal-hydrothorax-predictors-of-intrauterine-course-and-postnatal-outcome
#20
Michael R Mallmann, Viola Graham, Bettina Rösing, Ingo Gottschalk, Andreas Müller, Ulrich Gembruch, Annegret Geipel, Christoph Berg
OBJECTIVE: To assess predictors for survival and complications among a relatively large cohort of fetuses with hydrothorax treated by thoracoamniotic shunting. METHODS: All cases with hydrothorax treated by thoracoamniotic shunting in a 10-year period (2002-2011) in two centers were retrospectively reviewed. RESULTS: A total of 78 fetuses with hydrothorax treated with thoracoamniotic shunting were included in the study. Mean gestational age at diagnosis was 25...
May 13, 2016: Fetal Diagnosis and Therapy
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