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Lung auscultation

Christian Geier, Jessica Davis, Marc Siegel
A previously healthy 66-year-old woman living in the Mid-Atlantic USA presented to the hospital with lethargy, ataxia and slurred speech. 2 weeks prior she had removed a tick from her right groin. She reported malaise, fevers, diarrhoea, cough and a rash. Physical examination revealed a maculopapular rash on her chest, and lung auscultation revealed bi-basilar rales. Laboratory tests were remarkable for hyponatraemia, leucopenia and thrombocytopenia. Chest X-ray demonstrated bilateral pleural effusions with pulmonary oedema...
October 6, 2016: BMJ Case Reports
Christoph Beck, Julius Georgiou
In this Letter, the authors describe the characterisation design and development of the authors' wearable, multimodal vitals acquisition unit for intelligent field triage. The unit is able to record the standard electrocardiogram, blood oxygen and body temperature parameters and also has the unique capability to record up to eight custom designed acoustic streams for heart and lung sound auscultation. These acquisition channels are highly synchronised to fully maintain the time correlation of the signals. The unit is a key component enabling systematic and intelligent field triage to continuously acquire vital patient information...
September 2016: Healthcare Technology Letters
Carlos Ac Pereira, Andréa Gimenez, Lilian Kuranishi, Karin Storrer
Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies...
2016: Journal of Asthma and Allergy
Claudia Torino, Luna Gargani, Rosa Sicari, Krzysztof Letachowicz, Robert Ekart, Danilo Fliser, Adrian Covic, Kostas Siamopoulos, Aristeidis Stavroulopoulos, Ziad A Massy, Enrico Fiaccadori, Alberto Caiazza, Thomas Bachelet, Itzchak Slotki, Alberto Martinez-Castelao, Marie-Jeanne Coudert-Krier, Patrick Rossignol, Faikah Gueler, Thierry Hannedouche, Vincenzo Panichi, Andrzej Wiecek, Giuseppe Pontoriero, Pantelis Sarafidis, Marian Klinger, Radovan Hojs, Sarah Seiler-Mussler, Fabio Lizzi, Dimitrie Siriopol, Olga Balafa, Linda Shavit, Rocco Tripepi, Francesca Mallamaci, Giovanni Tripepi, Eugenio Picano, Gérard Michel London, Carmine Zoccali
BACKGROUND AND OBJECTIVES: Accumulation of fluid in the lung is the most concerning sequela of volume expansion in patients with ESRD. Lung auscultation is recommended to detect and monitor pulmonary congestion, but its reliability in ESRD is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a subproject of the ongoing Lung Water by Ultra-Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk ESRD Patients with Cardiomyopathy Trial, we compared a lung ultrasound-guided ultrafiltration prescription policy versus standard care in high-risk patients on hemodialysis...
September 22, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Satoshi Adachi, Hiroshi Nakano, Hiroshi Odajima, Chikako Motomura, Yukiko Yoshioka
BACKGROUND: Chest auscultation is commonly performed during respiratory physical therapy (RPT). However, the changes in breath sounds in children with atelectasis have not been previously reported. The aim of this study was to clarify the characteristics of breath sounds in children with atelectasis using acoustic measurements. METHOD: The subjects of this study were 13 children with right middle lobe atelectasis (3-7 years) and 14 healthy children (3-7 years). Lung sounds at the bilateral fifth intercostal spaces on the midclavicular line were recorded...
2016: PloS One
Tina Stibane, Helmut Sitter, Despina Neuhof, Helena Wiechens, Andrea Schönbauer, Stefan Bösner, Erika Baum
Clinical skills such as history taking, diagnostic reasoning, therapy planning, and giving advice are even more complex than practical skills like lung auscultation and have to be applied in complex clinical situations. We judged this competence in an interdisciplinary formative OSCE conducted with students of Marburg University. Results of 218 students passing 643 OSCE stations composed of 37 different scenarios were analyzed. As a competence based examination that reflects the practical skills gained during clinical training, the here presented analysis serves also as a feedback instrument for clinical teachers, their respective disciplines and the medical faculty as a whole...
2016: GMS Journal for Medical Education
Ricardo Coentre, Amílcar Silva-Dos-Santos, Miguel Cotrim Talina
We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires' disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum...
2016: Case Reports in Psychiatry
Marc P Berry, Joan-Daniel Martí, George Ntoumenopoulos
BACKGROUND: Clinicians often use numerous bedside assessments for secretion retention in participants who are receiving invasive mechanical ventilation. This study aimed to evaluate inter-rater agreement between clinicians when using standard clinical assessments of secretion retention and whether differences in clinician experience influenced inter-rater agreement. METHODS: Seventy-one mechanically ventilated participants were assessed by a research clinician and by one of 13 ICU clinicians...
October 2016: Respiratory Care
Ruban Nersisson, Mathew M Noel
Breath and cardiac sounds are two major bio sound signals. In this, heart sounds are produced by movement of some body parts such as heart valve, leaflets and the blood flow through the vessels, whereas lung sounds generates due to the air in and out flow through airways during breathing cycle. These two signals are recorded from chest region. These two signals have very high clinical importance for the patient who is critically ill. The lung functions and the cardiac cycles are continuously monitored for such patients with the help of the bio sound signal captured using suitable sensing mechanism or with auscultation techniques...
July 15, 2016: Journal of Medical Engineering & Technology
Altay Atalay, Ayse Nedret Koc, Gulsah Akyol, Nuri Cakir, Leylagul Kaynar, Aysegul Ulu-Kilic
A 66-year-old female patient with multiple myeloma (MM) was admitted to the emergency service on 29.09.2014 with an inability to walk, and urinary and faecal incontinence. She had previously undergone autologous bone marrow transplantation (ABMT) twice. The patient was hospitalized at the Department of Haematology. Further investigations showed findings suggestive of a spinal mass at the T5-T6-T7 level, and a mass lesion in the iliac fossa. The mass lesion was resected and needle biopsy was performed during a colonoscopy...
June 1, 2016: Le Infezioni in Medicina
Jovan Lovrenski, Slobodanka Petrović, Svetlana Balj-Barbir, Radoica Jokić, Gordana Vilotijević-Dautović
OBJECTIVE: To compare lung ultrasound (LUS) with auscultation findings in children with clinical suspicion of pneumonia. PATIENTS AND METHODS: A prospective study including 95 patients (age: from 2 months to 17.5 years; mean age: 5.1 y, SD 4.5 y) with referral diagnosis of suspected pneumonia. In all patients LUS and auscultatory examinations were performed within an hour. These findings were compared separately in each hemithorax. The radiologist performing LUS was blinded to the patient's clinical information...
May 2016: Acta Medica Academica
MinKi Son, Sangjun Lee, Sang Hyun Lee, Taewan Lim, Soo Kyung Lee, Kook Hyun Lee
Massive hemoptysis is respiratory compromise which should be managed as a life-threatening condition. In our case, the bronchial blocker played a role in hemostasis of tracheal bleeding very close to the carina and prevented further spillage into the contralateral lung. Right-sided one-lung isolation in an 87-year-old female, who received cardiopulmonary resuscitation due to myocardial infarction, was requested due to hemoptysis. Right-sided bronchial bleeding was suspected on auscultation, but esophageal and tracheal bleeding due to violent intubation with a stylet was also considered...
June 2016: Korean Journal of Anesthesiology
Ferran Morell, Ana Villar, Iñigo Ojanguren, Xavier Muñoz, María-Jesús Cruz
This review presents an update of the currently available information related to hypersensitivity pneumonitis, with a particular focus on the contribution of several techniques in the diagnosis of this condition. The methods discussed include proper elaboration of a complete medical history, targeted auscultation, detection of specific immunoglobulin G antibodies against the most common antigens causing this disease, skin tests, antigen-specific lymphocyte activation assays, bronchoalveolar lavage, and cryobiopsy...
June 2016: Seminars in Respiratory and Critical Care Medicine
U Koehler, O Hildebrandt, S Kerzel, C Urban, L Hoehle, A Weissflog, W Nikolaizik, J Koehler, K Sohrabi, V Gross
Auscultation of the lung is an inexpensive, noninvasive and easy-to-perform tool. It is an important part of the physical examination and is help ful to distinguish physiological respiratory sounds from pathophysiological events. Computerized lung sound analysis is a powerful tool for optimizing and quantifying electronic auscultation based on the specific lung sound spectral characteristics. The automatic analysis of respiratory sounds assumes that physiological and pathological sounds are reliably analyzed based on special algorithms...
June 2016: Pneumologie
Brandy N Cichocki, Danielle R Dugat, Timothy A Snider
CASE DESCRIPTION A 7-year-old castrated male Italian Greyhound (dog 1) and an approximately 1-year-old female Labrador Retriever (dog 2) were evaluated because of respiratory distress 8 and 10 days, respectively, after a tornado. CLINICAL FINDINGS No obvious external injuries were identified auscultation revealed decreased bronchovesicular sounds in the affected hemithorax of both dogs. Clinicopathologic changes were mild, with evidence of inflammation in both dogs. Thoracic radiography of both dogs revealed pneumothorax and pleural effusion with effacement of the diaphragm; findings on CT included severe pulmonary atelectasis of affected lung lobes with normal bronchial tree configurtion and no evidence of diaphragmatic hernia...
June 1, 2016: Journal of the American Veterinary Medical Association
F A Kaiksow, D Bhatnagar
A 26-year-old woman with no prior medical history presented post-partum with altered mental status. She had no complications during pregnancy and had a spontaneous vaginal delivery at term one week prior. On post-partum day five, she began complaining of headaches, initially responsive to ibuprofen but eventually worsened with no relief. On the evening of admission, her boyfriend noted strange behavior and movements consistent with a tonic-clonic seizure. On the way to the hospital, she had two more similar seizures witnessed by emergency medical serevices (EMS)...
May 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Hasse Melbye, Luis Garcia-Marcos, Paul Brand, Mark Everard, Kostas Priftis, Hans Pasterkamp
BACKGROUND: The European Respiratory Society (ERS) lung sounds repository contains 20 audiovisual recordings of children and adults. The present study aimed at determining the interobserver variation in the classification of sounds into detailed and broader categories of crackles and wheezes. METHODS: Recordings from 10 children and 10 adults were classified into 10 predefined sounds by 12 observers, 6 paediatricians and 6 doctors for adult patients. Multirater kappa (Fleiss' κ) was calculated for each of the 10 adventitious sounds and for combined categories of sounds...
2016: BMJ Open Respiratory Research
Jean-François Cordier
Idiopathic pulmonary fibrosis usually develops after 60 years of age, especially in men, leading to progressive exercise dyspnea. Median survival is about 3 years after diagnosis. This disease emerged in the middle of the last century and is linked to smoking. Mutations of genes encoding surfactant proteins and the telomerase complex may occasionally be present. International diagnostic criteria based on histopathology and computed tomography (CT) define the diagnosis as definite, probable or possible. Recent treatments (pirfenidone and nintedanib) have proven beneficial...
October 2014: Bulletin de L'Académie Nationale de Médecine
Raphael Naves, Bruno H G Barbosa, Danton D Ferreira
BACKGROUND AND OBJECTIVE: Lung sound auscultation is one of the most commonly used methods to evaluate respiratory diseases. However, the effectiveness of this method depends on the physician's training. If the physician does not have the proper training, he/she will be unable to distinguish between normal and abnormal sounds generated by the human body. Thus, the aim of this study was to implement a pattern recognition system to classify lung sounds. METHODS: We used a dataset composed of five types of lung sounds: normal, coarse crackle, fine crackle, monophonic and polyphonic wheezes...
June 2016: Computer Methods and Programs in Biomedicine
Ana Méndez-Echevarría, Teresa Del Rosal, Elena Pérez-Costa, Rebeca Rodríguez-Pena, Alejandro Zarauza, Antonio Ferreira-Cerdán, Maria Bravo, María José Mellado, Eduardo López-Granados
BACKGROUND: Survival of children with combined immunodeficiency is strongly related to patient's age and clinical situation at the time of hematopoietic stem cell transplantation (HSCT). We describe the clinical features before HSCT or enzyme replacement therapy (ERT) in a cohort of children treated in a National Reference Unit. METHODS: A retrospective study of children with CIDs treated in our Hospital during a 20-year period (1995-2014) was performed, analyzing their clinical situation before HSCT/ERT...
July 2016: Pediatric Infectious Disease Journal
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