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Syed Mohammad Asad Zaidi, Shifa Salman Habib, Bram Van Ginneken, Rashida Abbas Ferrand, Jacob Creswell, Saira Khowaja, Aamir Khan
The introduction of digital CXR with automated computer-aided interpretation, has given impetus to the role of CXR in TB screening, particularly in low resource, high-burden settings. The aim of this study was to evaluate the diagnostic accuracy of CAD4TB as a screening tool, implemented in the private sector in Karachi, Pakistan. This study analyzed retrospective data from CAD4TB and Xpert MTB/RIF testing carried out at two private TB treatment and diagnostic centers in Karachi. Sensitivity, specificity, potential Xperts saved, were computed and the receiver operator characteristic curves were constructed for four different models of CAD4TB...
August 17, 2018: Scientific Reports
Kay Choong See, Venetia Ong, Yi Lin Tan, Juliet Sahagun, Juvel Taculod
BACKGROUND: Lung ultrasound may be a reasonable alternative to chest radiography for the identification of acute respiratory distress syndrome (ARDS), but the diagnostic performance of lung ultrasound for ARDS is uncertain. We therefore analyzed the clinical outcomes of ARDS diagnosed according to the Berlin Definition, using either chest radiography (Berlin-CXR) or lung ultrasound (Berlin-LUS) as an alternative imaging method. METHODS: This was a retrospective observational study in a 20-bed medical intensive care unit (ICU)...
August 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
Hwee Weng Dennis Hey, Chloe Xiaoyun Chan, Ying Mei Wong, Jonathan Weizhong Sng, Han Yang Ong, Chuen Seng Tan, Gabriel Ka-Po Liu, Hee-Kit Wong, Swee-Tian Quek
STUDY DESIGN: A prospective radiographic comparative study. OBJECTIVE: To compare full body EOS with conventional chest X-ray (CXR) for use in the preoperative evaluation of the chest in patients undergoing spine operations. SUMMARY OF BACKGROUND DATA: The full body EOS reproduces an image of the chest similar to a routine CXR. The potential for the former replacing the latter is plausible. This is especially applicable in spine patients who would routinely have a preoperative full body EOS performed...
August 14, 2018: Spine
Shu-Yi Lin, Zheng-Hao Huang, Hsiang-Cheng Chen, Deh-Ming Chang, Chun-Chi Lu
INTRODUCTION: Multidrug-resistant Acinetobacter baumannii (MDRAB) pneumonia with severe sepsis in a patient with rheumatoid arthritis (RA), who is predisposed after treatment with tumor necrosis factor inhibitor (TNFI), is a rare severe infection and can be successfully treated with prompt antibiotics. CASE PRESENTATION: A 75-year-old woman was diagnosed with RA >30 years previously. After inadequate treatment responses to conventional disease-modifying antirheumatic drugs (DMARDs), she developed progressive RA, including swollen joints in both hands, and had a high disease activity score of 4...
August 2018: Medicine (Baltimore)
Jennifer L Anderson, Matthew C Hall, Jennifer K Meece
Asymptomatic blastomycosis infections are rarely identified or described in the literature, but are believed to comprise 50% of cases. In this report we describe five sporadic cases of blastomycosis in asymptomatic patients. All of these cases were initially identified as incidental findings of lung nodules on CXR or CT. To our knowledge, these are the first detailed descriptions of asymptomatic blastomycosis, occurring as sporadic disease, in the literature.
September 2018: Medical Mycology Case Reports
R C Koesoemadinata, K Kranzer, R Livia, N Susilawati, J Annisa, N N M Soetedjo, R Ruslami, R Philipsen, B van Ginneken, R D Soetikno, R van Crevel, B Alisjahbana, P C Hill
BACKGROUND: Diabetes mellitus is a significant risk factor for tuberculosis (TB). We evaluated the performance of computer-aided detection for tuberculosis (CAD4TB) in people living with diabetes mellitus (PLWD) in Indonesia. METHODS: PLWD underwent symptom screening and chest X-ray (CXR); sputum was examined in those with positive symptoms and/or CXR. Digital CXRs were scored using CAD4TB and analysed retrospectively using clinical and microbiological diagnosis as a reference...
September 1, 2018: International Journal of Tuberculosis and Lung Disease
Alessandro Riccardi, Maria Beatrice Spinola, Valeria Ghiglione, Marco Licenziato, Roberto Lerza
Blunt thoracic injury (BTI) constitutes a common presentation in emergency department: rib fractures are the most common injuries. Chest X-ray (CXR) has a limited sensitivity to identify rib fractures. We perform this retrospective study in our emergency department collecting all patients with BTI during an 18-month period. PoCUS was performed prior to acquire CXR or CT. We evaluated 1672 patients with BTI, and we reported rib fractures in 689 patients (41.21%). PoCUS was performed in 190 patients. PoCUS in emergency medicine has an increasing role, especially in BTI, but less clear is its role in detecting ribs fracture...
July 31, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Robert E Luceri, Nina E Glass, Joanelle A Bailey, Ziad C Sifri, Anastasia Kunac, Stephanie L Bonne, Peter P Yonclas, Anne C Mosenthal, David H Livingston
BACKGROUND: Prior to routine CT scanning, first rib fractures (FRFs) were considered a harbinger of great vessel injuries. We hypothesized FRFs identified on screening CXR have significant associated injuries, while those identified on CT alone do not. METHODS: We reviewed adult blunt thoracic trauma patients 2014-2015 to identify all FRFs and then tabulated demographics, injury characteristics, and outcomes. RESULTS: Of 429 patients with chest trauma, 56 had a FRF...
July 24, 2018: American Journal of Surgery
Enyo A Ablordeppey, Anne M Drewry, Daniel L Theodoro, LinLin Tian, Brian M Fuller, Richard T Griffey
PURPOSE: Although routine chest radiographs (CXR) to verify correct central venous catheter (CVC) position and exclude pneumothorax is commonly performed, emerging evidence suggests that this practice can be replaced by point of care ultrasound (POCUS). POCUS is advantageous over CXR because it avoids radiation while verifying correct placement and lack of pneumothorax without delay. We hypothesize that a knowledge translation gap exists in this area. We aim to describe the current clinical practice regarding POCUS alone for CVC position confirmation and pneumothorax exclusion as compared to chest radiography...
July 25, 2018: Shock
Randa A El-Zein, Carol J Etzel, Reginald F Munden
Background: Despite the promising results of the National Lung Screening Trial in reducing lung cancer mortality among high risk smokers, several challenges remain to be addressed. These include the high false positive rates and the large number of smokers screened in order to prevent one lung cancer death. In addition, host genetic susceptibility has not been integrated into selection of who should be screened. These challenges highlight the need to develop robust ways to identify susceptible smokers for appropriate screening...
June 2018: Translational Lung Cancer Research
M Ominde, J Sande, M Ooko, C Bottomley, R Benamore, K Park, J Ignas, K Maitland, T Bwanaali, F Gleeson, A Scott
BACKGROUND: Radiologically-confirmed pneumonia (RCP) is a specific end-point used in trials of Pneumococcal Conjugate Vaccine (PCV) to estimate vaccine efficacy. However, chest radiograph (CXR) interpretation varies within and between readers. We measured the repeatability and reliability of paediatric CXR interpretation using percent agreement and Cohen's Kappa and the validity of field readings against expert review in a study of the impact of PCV on pneumonia. METHODS: CXRs were obtained from 2716 children admitted between 2006 and 2014 to Kilifi County Hospital, Kilifi, Kenya, with clinically-defined severe or very-severe pneumonia...
2018: PloS One
Joseph S Colla, Pavitra Kotini-Shah, Savannah Soppet, Yi-Fan Chen, Robert Molokie, Puja Prajapati, Heather M Prendergast
BACKGROUND: Acute chest syndrome (ACS) is the leading cause of death for patients with sickle cell disease (SCD). Early recognition of ACS improves prognosis. OBJECTIVE: Investigate the use of bedside lung ultrasound (BLU) in identification of early pulmonary findings associated with ACS in SCD patients. METHODS: Prospective, observational study of a convenience sample of SCD patients presenting to the Emergency Department (ED) for a pain crisis...
July 3, 2018: American Journal of Emergency Medicine
Jonas Jögi, Mariam Al-Mashat, Göran Rådegran, Marika Bajc, Håkan Arheden
AIMS: Pulmonary congestion remains a diagnostic challenge in patients with heart failure (HF). The recommended method, chest X-ray (CXR), lacks in accuracy, whereas quantitative tomographic lung scintigraphy [ventilation/perfusion single-photon emission computed tomography (V/P SPECT)] has shown promising results but needs independent validation. The aim of this study is to evaluate V/P SPECT as a non-invasive method to assess and quantify pulmonary congestion in HF patients, using right heart catheterization as reference method...
July 17, 2018: ESC Heart Failure
Peter Korsten, Eirini Mavropoulou, Susanne Wienbeck, David Ellenberger, Daniel Patschan, Michael Zeisberg, Radovan Vasko, Björn Tampe, Gerhard A Müller
RATIONALE: Central venous catheter (CVC) placement is a standard procedure in critical care. Ultrasound guidance during placement is recommended by current guidelines, but there is no consensus on the best method for evaluating the correct CVC tip position. Recently, the "rapid atrial swirl sign" (RASS) has been investigated in a limited number of studies. OBJECTIVES: We performed a prospective diagnostic accuracy study of focused echocardiography for the evaluation of CVC tip position in our medical ICU and IMC units...
2018: PloS One
Caroline S Watnick, Donald H Arnold, Richard Latuska, Michael O'Connor, David P Johnson
OBJECTIVES: Implementation of an asthma clinical practice guideline did not achieve desired chest radiograph (CXR) usage goals. We attempt to use quality improvement methodology to decrease the percentage of CXRs obtained for pediatric patients with acute asthma exacerbations from 29.3% to <20% and to evaluate whether decreases in CXR use are associated with decreased antibiotic use. METHODS: We included all children ≥2 years old at our children's hospital with primary billing codes for asthma from May 2013 to April 2017...
August 2018: Pediatrics
Alexey A Novikov, Dimitrios Lenis, David Major, Jiri Hladuvka, Maria Wimmer, Katja Buhler
The success of deep convolutional neural networks (NNs) on image classification and recognition tasks has led to new applications in very diversified contexts, including the field of medical imaging. In this paper, we investigate and propose NN architectures for automated multiclass segmentation of anatomical organs in chest radiographs (CXRs), namely for lungs, clavicles, and heart. We address several open challenges including model overfitting, reducing number of parameters, and handling of severely imbalanced data in CXR by fusing recent concepts in convolutional networks and adapting them to the segmentation problem task in CXR...
August 2018: IEEE Transactions on Medical Imaging
L Berteloot, O Marcy, B Nguyen, V Ung, M Tejiokem, B Nacro, S Goyet, B Dim, S Blanche, L Borand, P Msellati, C Delacourt
OBJECTIVE: To evaluate inter-reader agreement and diagnostic accuracy of chest radiography (CXR) in the diagnosis of tuberculosis (TB) in children with human immunodeficiency virus (HIV) infection. DESIGN: HIV-infected children with clinically suspected TB were enrolled in a prospective study conducted in Burkina Faso, Cambodia, Cameroon and Viet Nam from April 2010 to December 2014. Three readers-a local radiologist, a paediatric pulmonologist and a paediatric radiologist-independently reviewed the CXRs...
August 1, 2018: International Journal of Tuberculosis and Lung Disease
Timothy Cheung, Harry Harianto, Manfred Spanger, Alan Young, Vikas Wadhwa
Accurate chest X-ray (CXR) interpretation is an essential skill in clinical practice. Previous studies have shown poor accuracy and confidence rates (CR) of CXR interpretation by junior doctors and medical students. We presented 10 chest radiographs via an online questionnaire to Australian medical students and junior doctors, who were asked to identify the radiographic abnormality from a list of 15 options and to rate their confidence for each answer. Of 67 complete responses, junior doctors achieved a mean score of 57...
July 2018: Internal Medicine Journal
Cheng-Hao Chuang, Jui-Feng Hsu, Yu-Ting Shen, Chih-Jen Yang
An abscopal effect refers to distant tumor regression after localized irradiation. The mechanism is thought to be via local radiotherapy triggering the immune system which then attacks distant tumor sites. Only several cases of solid tumors with an abscopal effect have been reported in the past few decades, and whether an abscopal effect can cross the blood-brain barrier is still unknown. Herein, we present a female patient who was admitted due to unsteady gait and dyspnea. Chest X-ray (CXR) and chest CT showed a huge lung mass with left lung collapse and multiple liver masses...
July 8, 2018: Asia-Pacific Journal of Clinical Oncology
Marco Chiappetta, Elisa Meacci, Alfredo Cesario, Andrea Smargiassi, Riccardo Inchingolo, Leonardo Petracca Ciavarella, Stefania Lopatriello, Andrea Contegiacomo, Maria Teresa Congedo, Stefano Margaritora
The aim of this study was to analyze the information from post-operative chest ultrasound (CU) to evaluate the possibility to use this method instead of chest X-ray (CXR) after thoracic surgery. Patients who underwent thoracic surgery were evaluated with CU blinded to CXR after surgery, deciding if it was useful or CU was exhaustive. Twenty-four patients were enrolled prospectively. The CU allowed a further discrimination of the lung abnormalities, discriminating between atelectasis, infections or hematoma...
July 3, 2018: Ultrasound in Medicine & Biology
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