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Daniel G French, Madelaine Plourde, Harry Henteleff, Aneil Mujoomdar, Drew Bethune
Air leaks are the most common complication after pulmonary resection. Enhanced recovery after surgery (ERAS) programs must be designed to manage parenchymal air leaks. ERAS programs should consider two components when creating protocols for air leaks: assessment and management. Accurate assessment of air leaks using traditional analogues devices, newer digital drainage systems, portable devices and chest X-rays (CXR) are reviewed. Published data suggests that digital drainage systems result in a more confident assessment of air leaks...
November 2018: Journal of Thoracic Disease
Amina Saqib, Uroosa Ibrahim, Rabih Maroun
Thoracostomy tubes are indicated for management of air or fluid in the pleural cavity. Pigtail catheters have emerged as an effective and less morbid alternative to traditional large bore chest tubes for evacuation of pleural air or fluid. However, they do not come without complications which commonly include pneumothorax and hemothorax. Rare complications in the literature such as left ventricular penetration, subclavian artery laceration and cerebral air embolism have been reported. We report a case of a 72-year-old male who presented with dyspnea and was found to have a right-sided pleural effusion requiring thoracentesis and subsequent pigtail catheter placement because of re-accumulation of the fluid...
October 2018: Journal of Thoracic Disease
Masego Candy Mokotedi, Lukas Lambert, Lucie Simakova, Michal Lips, Michal Zakharchenko, Jan Rulisek, Martin Balik
Background: Chest drain (CD) migration in the pleural cavity may result in inadequate drainage of pneumothorax. The aim of this study was to assess several parameters that might help in diagnosing CD migration on chest X-ray (CXR). Methods: Patients with a CD inserted from the safe triangle with a subsequent supine CXR and CT scan performed less than 24 hours apart were assessed for CD foreshortening, angle of inclination of the CD, and CD tortuosity. CD foreshortening was expressed as a ratio between CD length measured in coronal plane only and CD length inside the pleural cavity measured on CT...
October 2018: Journal of Thoracic Disease
Toribiong Uchel, Shahniwaz Labana, Stephanie Tancer, Victoria Gonzalez, Daniel Kapadia, Zain Kulairi, Muhammad Kashlan
BACKGROUND Lymphatic circulation in the thorax enters the systemic blood flow at the subclavian vein. Instances where diversion occurs leads to complications such as pleural effusion. A rare complication of lymphatic diversion results in fluid accumulation in the bronchial tree, causing plastic bronchitis. The following case is the first ever report of plastic bronchitis presenting with pneumopericardium. CASE REPORT A 24-year-old female presented to our Emergency Department with an asthma exacerbation. After initiating bronchodilators, a chest radiograph (CXR) showed extensive subcutaneous emphysema, pneumomediastinum, and pneumothorax with atelectasis of the left lung...
December 3, 2018: American Journal of Case Reports
Chasen J Greig, Amaris M Keiser, Muriel A Cleary, David H Stitelman, Emily R Christison-Lagay, Doruk E Ozgediz, Daniel G Solomon, Michael G Caty, Robert A Cowles
BACKGROUND: Postnatal evaluation of prenatally identified congenital lung malformations (CLMs) often includes a chest x-ray (CXR) and neonatal intensive care unit (NICU) admission for observation. With current efforts aimed at prioritizing value and resource utilization, we sought to assess the utility of this practice in infants with known CLMs. We hypothesized that CXR and NICU admission are overused and could be deferred in the majority of cases. METHODS: Clinical and radiographic data for infants with CLM from 2007 to 2016 were reviewed with IRB approval...
November 6, 2018: Journal of Pediatric Surgery
Stephen H Bradley, Martyn P T Kennedy, Richard D Neal
Significant advances in the management of both early and advanced stage lung cancer have not yet led to the scale of improved outcomes which have been achieved in other cancers over the last 40 years. Diagnosis of lung cancer at the earliest stage of disease is strongly associated with improved survival. Therefore, although recent advances in oncology may herald breakthroughs in effective treatment, achieving early diagnosis will remain crucial to obtaining optimal outcomes. This is challenging, as most lung cancer symptoms are non-specific or are common respiratory symptoms which usually represent benign disease...
November 29, 2018: Advances in Therapy
Kim M G Smeijsters, Ronald M Bijkerk, Johannes M A Daniels, Peter M van de Ven, Armand R J Girbes, Leo M A Heunks, Jan Jaap Spijkstra, Pieter R Tuinman
Background: Atelectasis frequently develops in critically ill patients and may result in impaired gas exchange among other complications. The long-term effects of bronchoscopy on gas exchange and the effects on respiratory mechanics are largely unknown. Objective: To evaluate the effect of bronchoscopy on gas exchange and respiratory mechanics in intensive care unit (ICU) patients with atelectasis. Methods: A retrospective, single-center cohort study of patients with clinical indication for bronchoscopy because of atelectasis diagnosed on chest X-ray (CXR)...
2018: Frontiers in Medicine
Yoichiro Shimizu, Junji Morishita, Yusuke Matsunobu, Yongsu Yoon, Yasuo Sasaki, Shigehiko Katsuragawa, Hidetake Yabuuchi
The temporal subtraction (TS) technique requires the same patient's chest radiographs (CXRs) acquired on different dates, whereas the similar subtraction (SS) technique can be used in patients who have no previous CXR, using similar CXRs from different patients. This study aimed to examine the depiction ability of SS images with simulated nodules in comparison with that of TS images with 2- and 7-year acquisition intervals. One hundred patients were randomly selected from our image database. The most recently acquired images of the patients were used as target images for subtraction...
November 20, 2018: Radiological Physics and Technology
S Rajaraman, S Candemir, Z Xue, P O Alderson, M Kohli, J Abuya, G R Thoma, S Antani
Chest x-ray (CXR) analysis is a common part of the protocol for confirming active pulmonary Tuberculosis (TB). However, many TB endemic regions are severely resource constrained in radiological services impairing timely detection and treatment. Computer-aided diagnosis (CADx) tools can supplement decision-making while simultaneously addressing the gap in expert radiological interpretation during mobile field screening. These tools use hand-engineered and/or convolutional neural networks (CNN) computed image features...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Shobhit Sandeep Jaipurkar, Wang Jie, Zeng Zeng, Teo Sin Gee, Bharadwaj Veeravalli, Matthew Chua
According to a study [1] by the Ministry of Health in Singapore, since 2009, cancer, ischaemic heart disease and pneumonia together accounted for approximately 60% of the total causes of death. It has been 9 years, and Pneumonia and other Acute Upper Respiratory Infections still is one of the top 10 conditions of hospitalization. In cases of respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD), it has been found that close to 55% of cases are misdiagnosed. This is shocking as, an early diagnosis of respiratory diseases can lead to an earlier treatment intervention, ultimately lessening symptoms, slowing the progression, and improving overall quality of life...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Hyun Uk Lee, Deokwon Kang, Jae Chul Lee, Sung-Woo Choi, Hae-Dong Jang, Jahyung Kim, Byung-Joon Shin
RATIONALE: Pneumomediastinum and pneumopericardium refer to conditions in which air exists within the mediastinum and pericardium, respectively. There is the communication between the mediastinum, pericardium, and retroperitoneum. We present the first report of rare complications (pneumomediastinum and pneumopericardium) after retroperitoneal transpsoas lateral lumbar interbody fusion (LLIF) surgery. PATIENT CONCERNS: A 73-year-old female who underwent LLIF using the retroperitoneal approach complained of dysphagia but no other abnormal symptom after surgery...
November 2018: Medicine (Baltimore)
Xiaoyun Wang, Yan Tian
Introduction: The signs and symptoms of influenza B are commonly ignored. Therefore, very few clinical reports are available. This study is an attempt to evaluate the clinical features and characteristics of influenza B virus-associated pneumonia patients. Objective: The aim of this study is to investigate the microbiological and characteristics of influenza B virus-associated pneumonia patients. Methodology: Patients with <16 years old with a clinical diagnosis of influenza B virus infection and who had chest radiography within 2 days were enrolled...
July 2018: Indian Journal of Medical Microbiology
Ariunbold Natsagdorj, Kouji Izumi, Kaoru Hiratsuka, Kazuaki Machioka, Hiroaki Iwamoto, Renato Naito, Tomoyuki Makino, Suguru Kadomoto, Kazuyoshi Shigehara, Yoshifumi Kadono, Wen-Jye Lin, Aerken Maolake, Atsushi Mizokami
Understanding the mechanism of chemoresistance and disease progression in patients with prostate cancer is important for developing novel treatment strategies. In particular, developing resistance to cabazitaxel is a major challenge in patients with docetaxel- and castration-resistant prostate cancer (CRPC) because cabazitaxel is often administered as a last resort. However, the mechanism by which cabazitaxel resistance develops is still unclear. C-C motif chemokine ligands (CCLs) were shown to contribute to castration resistance of prostate cancer cells via an autocrine mechanism...
November 13, 2018: Cancer Science
Beatrix Hyemin Choi, Kamalou Yaya, Vinay Prabhu, Nancy Fefferman, Beverly Mitchell, Keith A Kuenzler, Howard B Ginsburg, Jason C Fisher, Sandra Tomita
PURPOSE: The purpose of this study was to reduce radiation exposure during pediatric central venous line (CVL) placement by implementing a radiation safety process including a radiation safety briefing and a job-instruction model with a preradiation time-out. METHODS: We reviewed records of all patients under 21 who underwent CVL placement in the operating room covering 22 months before the intervention through 10 months after 2013-2016. The intervention consisted of a radiation safety briefing by the surgeon to the intraoperative staff before each case and a radiation safety time-out...
October 5, 2018: Journal of Pediatric Surgery
Cary Ma, L Cynthia Gunaratnam, Austin Ericson, Andrea L Conroy, Sophie Namasopo, Robert O Opoka, Michael T Hawkes
Globally, pneumonia is the leading cause of death among children younger than 5 years old, with most deaths occurring in low-income countries. Rapid bedside tools to assist practitioners to accurately triage and risk-stratify these patients may improve clinical care and patient outcomes. We conducted a prospective cohort study of children with pneumonia admitted to two Ugandan hospitals to examine the predictive value of a single point-of-care lactate measurement using a commercially available handheld device, the Lactate Scout Analyzer...
November 5, 2018: American Journal of Tropical Medicine and Hygiene
Suleman Aktaa, Kavi Fatania, Claire Gains, Hazel White
Permanent pacemaker (PPM) implantation is an increasingly common procedure with complication rate estimated between 3% and 6%. Cardiac perforation by pacemaker lead(s) is rare, but a previous study has shown that it is probably an underdiagnosed complication. We are presenting a case of a patient who presented 5 days after PPM insertion with new-onset pleuritic chest pain. She had a normal chest X-ray (CXR), and acceptable pacing checks. However, a CT scan of the chest showed pneumopericardium and pneumothorax secondary to atrial lead perforation...
October 25, 2018: BMJ Case Reports
Weibo Yang, Yuliang Wang, Zewu Qiu, Xuewen Huang, Maoxia Lv, Bin Liu, Dingzhou Yang, Zhenhan Yang, Tingshan Xie
Objective: The aim of this study was to assess the diagnostic accuracy of lung ultrasonography (LUS) for high-altitude pulmonary edema (HAPE). Background: LUS has proven to be a reliable tool for the diagnosis of pulmonary diseases, including pneumonia, acute respiratory distress syndrome (ARDS), and pneumothorax. LUS also has potential for the diagnosis of HAPE. However, the actual diagnostic value of LUS for HAPE is still unknown. Our objective was to determine the feasibility of using LUS for the diagnosis of HAPE...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Xiaoling Gao, Lihua Guo, Jianqiang Li, Hnin Ei Thu, Zahid Hussain
Lung cancer (LC) is the second most prevalent type of cancer and primary cause of mortality among both men and women, worldwide. The most commonly employed diagnostic modalities for LC include chest X-ray (CXR), magnetic-resonance-imaging (MRI), computed tomography (CT-scan), and fused-positron-emitting-tomography-CT (PET-CT). Owing to several limitations associated with the use of conventional diagnostic tools such as radiation burden to the patient, misleading diagnosis ("missed lung cancer"), false staging and low sensitivity and resolution, contemporary diagnostic regimen needed to be employed for screening of LC...
October 22, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
Choi Fung Tse, Yuet Yan Fiona Chan, Kin Ming Poon, Chun Tat Lui
OBJECTIVE: To derive a clinical prediction rule to predict pneumonia in patients with acute febrile respiratory illness to emergency departments. METHOD: This was a prospective multicentre study. 537 adults were recruited. Those requiring resuscitation or were hypoxaemic on presentation were excluded. Pneumonia was defined as new onset infiltrates on chest X-ray (CXR), or re-attendance within 7 days and diagnosed clinically as having pneumonia. A predictive model, the Acute Febrile Respiratory Illness (AFRI) rule was derived by logistic regression analysis based on clinical parameters...
October 20, 2018: American Journal of Emergency Medicine
J A Shaw, D P Smit, S Griffith-Richards, C F N Koegelenberg
BACKGROUND: Tuberculosis (TB) and sarcoidosis commonly present with pulmonary and ocular involvement. Routine chest radiography (CXR) is recommended in the workup for suspected intraocular TB (IOTB) or intraocular sarcoidosis (IOS); however, data on the utility of CXR in this setting are lacking. METHODS: A post-hoc analysis was performed of a prospectively collected data set comprising 104 patients with uveitis of unknown cause. A pulmonologist and thoracic radiologist, blinded to the final diagnosis, independently reported these CXRs as being in keeping with TB or sarcoidosis...
November 1, 2018: International Journal of Tuberculosis and Lung Disease
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