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https://www.readbyqxmd.com/read/29782482/trauma-patients-are-safe-to-fly-72-hours-after-tube-thoracostomy-removal
#1
David Zonies, Joel Elterman, Christopher Burns, Vincent Paul, John Oh, Jeremy Cannon
BACKGROUND: Current recommendations for safe air travel following traumatic pneumothorax are 2-3 weeks after radiographic resolution. These recommendations are based on several small observational studies and expert consensus which cite a theoretical risk of recurrence and hypoxia due to decreased oxygen tension at altitude. We sought to systematically study the timing of chest drain removal after traumatic pneumothorax and risk of recurrence in relation to air travel. METHODS: A retrospective cohort study of consecutively admitted patients who sustained a traumatic chest injury treated with tube thoracostomy over a 5-year period was undertaken...
May 18, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29780633/deep-learning-aided-decision-support-for-pulmonary-nodules-diagnosing-a-review
#2
REVIEW
Yixin Yang, Xiaoyi Feng, Wenhao Chi, Zhengyang Li, Wenzhe Duan, Haiping Liu, Wenhua Liang, Wei Wang, Ping Chen, Jianxing He, Bo Liu
Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29780243/effect-of-starting-oral-intake-on-weekends-on-the-clinical-course-of-patients-with-aspiration-pneumonia
#3
Tsuneaki Kenzaka, Ayako Kumabe, Koki Kosami, Yuki Ueda, Takeshi Takahashi, Yuya Yamamoto, Yurika Hayashi, Akihito Kitao, Masanobu Okayama
Purpose: The aim of this study was to investigate whether the day of starting oral intake affects the clinical course of patients with aspiration pneumonia. Results: We conducted a retrospective cohort study of 392 patients who were hospitalized for aspiration pneumonia but tolerated oral intake. Patients were divided into two groups according to the day of starting oral intake: Monday to Friday (midweek group) and Saturday or Sunday (weekend group). Underlying diseases, severity of pneumonia, time to oral intake, hospital duration, discontinuation of oral intake, and death during hospitalization were compared between the groups...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29779593/assessing-diaphragm-function-in-chest-wall-and-neuromuscular-diseases
#4
REVIEW
Taro Minami, Kamran Manzoor, F Dennis McCool
Diaphragm dysfunction is defined as the partial or complete loss of diaphragm muscle contractility. However, because the diaphragm is one of only a few skeletal muscles that is not amenable to direct examination, the tools available for the clinician to assess diaphragm function have been limited. Traditionally, measures of lung volume, inspiratory muscle strength, and radiographic techniques such as fluoroscopy have provided the major method to assess diaphragm function. Measurement of transdiaphragmatic pressure provides the most direct means of evaluating the diaphragm, but this technique is not readily available to clinicians...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29779492/pretreatment-chest-x-ray-severity-and-its-relation-to-bacterial-burden-in-smear-positive-pulmonary-tuberculosis
#5
S E Murthy, F Chatterjee, A Crook, R Dawson, C Mendel, M E Murphy, S R Murray, A J Nunn, P P J Phillips, Kasha P Singh, T D McHugh, S H Gillespie
BACKGROUND: Chest radiographs are used for diagnosis and severity assessment in tuberculosis (TB). The extent of disease as determined by smear grade and cavitation as a binary measure can predict 2-month smear results, but little has been done to determine whether radiological severity reflects the bacterial burden at diagnosis. METHODS: Pre-treatment chest x-rays from 1837 participants with smear-positive pulmonary TB enrolled into the REMoxTB trial (Gillespie et al...
May 21, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29777760/peripheral-intravenous-volume-assessment-piva-for-quantitating-volume-overload-in-patients-hospitalized-with-acute-decompensated-heart-failure-a-pilot-study
#6
Merrick Miles, Bret D Alvis, Kyle Hocking, Franz Baudenbacher, Christy Guth, JoAann Lindenfeld, Colleen Brophy, Susan Eagle
BACKGROUND: To determine the feasibility of Peripheral Intravenous Volume Assessment (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF). METHODS: Venous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis...
May 16, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29777243/comparison-of-formulae-for-orotracheal-intubation-depth-in-the-paediatric-population
#7
Jen Heng Pek, Elizabeth Mj Tan, Ying Hao, Gene Yk Ong
INTRODUCTION: Multiple formulae have been proposed for calculating orotracheal depth for paediatric intubation. However, literature on the validation of these formulae in the emergency department setting is limited. Three methods described in the local Advanced Paediatric Life Support curriculum include the Broselow tape, endotracheal tube (ETT) size x 3, and the age-based formula of age divided by 2, add 12. We aimed to determine their accuracy. MATERIALS AND METHODS: Patients with intubation performed in the Children's Emergency from 1 January 2009 to 31 December 2013 were included in this retrospective observational study...
April 2018: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/29775966/an-enigmatic-case-presentation-of-budd-chiari-syndrome-with-pulmonary-embolism-an-unusual-syndrome-with-an-uncommon-complication
#8
A M Al-Sharydah, A H Al-Abdulwahhab, H A Abu AlOla
INTRODUCTION: In patients with a hypercoagulable state, such as patients with pulmonary embolism and/or Budd-Chiari syndrome, the complications from multiple gene mutations are more numerous than those from a single mutation. The authors present a woman with no major prior medical history who presented with pulmonary embolism and Budd-Chiari syndrome; this enigmatic co-occurrence has never been solely reported without underlying aetiology in a patient without prior medical conditions...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29771962/progression-of-the-radiologic-severity-index-predicts-mortality-in-patients-with-parainfluenza-virus-associated-lower-respiratory-infections
#9
Ajay Sheshadri, Dimpy P Shah, Myrna Godoy, Jeremy J Erasmus, Juhee Song, Liang Li, Scott E Evans, Roy F Chemaly, Burton F Dickey, David E Ost
BACKGROUND: Radiologic severity may predict adverse outcomes after lower respiratory tract infection (LRI). However, few studies have quantified radiologic severity of LRIs. We sought to evaluate whether a semi-quantitative scoring tool, the Radiologic Severity Index (RSI), predicted mortality after parainfluenza virus (PIV)-associated LRI. METHODS: We conducted a retrospective review of consecutively-enrolled adult patients with hematologic malignancy or hematopoietic stem cell transplantation and with PIV detected in nasal wash who subsequently developed radiologically-confirmed LRI...
2018: PloS One
https://www.readbyqxmd.com/read/29768297/pediatric-esophageal-foreign-body-possible-role-for-digital-tomosynthesis
#10
Andrew Johansen, Gregory P Conners, Jacob Lee, Amie L Robinson, William L Chew, Sherwin S Chan
OBJECTIVES: Foreign body (FB) ingestion is a common reason for emergency department visits, affecting more than 80,000 children in the United States annually. Whereas most ingested FBs are coins or other radiopaque objects, some are radiolucent FBs such as food. Digital tomosynthesis (DTS) is a radiographic technique that produces cross-sectional images with in-plane resolution similar to that of traditional radiographs. Our pilot study evaluated the sensitivity and specificity of DTS to detect FB in comparison to esophagram and clinical impression...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29766672/ribcage-deformity-and-the-altered-breathing-pattern-in-children-with-osteogenesis-imperfecta
#11
Antonella LoMauro, Paolo Fraschini, Simona Pochintesta, Marianna Romei, Maria G D'Angelo, Andrea Aliverti
AIM: Osteogenesis Imperfecta (OI) is a genetic disease characterized by bones fragility and progressive deformity. Life expectancy is reduced in the non-lethal most severe type III form before the age of 10 years. The main cause of death in OI is respiratory insufficiency resulting from impaired thoracic function worsened by ribcage deformity and scoliosis. METHODS: We used opto-electronic plethysmography to study chest geometry, the ventilatory, and the thoraco-abdominal pattern at rest in supine position in children younger than 10 years...
May 15, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29764909/ohio-pediatric-asthma-repository-opportunities-to-revise-care-practices-to-decrease-time-to-physiologic-readiness-for-discharge
#12
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29764714/bronchoscopic-resection-of-a-tracheobronchial-leiomyoma-in-a-pregnant-patient
#13
K Falce, E Guy, D Hyman, T Hotze, D Lazarus, V Bandi, J Parchem, C Davidson, U Munnur
Flexible bronchoscopy, therapeutic bronchoscopy and other procedures requiring anesthesia are generally avoided in pregnancy and postponed until after delivery if possible. We report a case of a parturient with an abnormal chest radiograph and mild obstructive symptoms of unknown etiology. At bronchoscopy, a tumor associated with post-obstructive suppuration was found and excised using electrocautery snare and cryotherapy, for restoration of airway patency. Coordination between pulmonary, obstetric, anesthesia, neonatology and thoracic surgery services was essential in ensuring success and the safety of the mother and fetus...
April 10, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29762925/association-between-myxomatous-mitral-valve-disease-and-skeletal-back-abnormalities
#14
Alireza Movahed, David Majdalany, Marc Gillinov, William Schiavone
BACKGROUND: Myxomatous mitral valve disease (MMVD) is one of the most prevalent valvular heart diseases, while back pain, neck pain and upper-extremity numbness are some of the most common complaints in outpatient settings. Decreased thoracic kyphosis (straight back) is a known cause of hastening back or neck problems, radiculopathy, or even myelopathy. The study aim was to examine the relationship between MMVD, straight back, and the need for cervical fusion. METHODS: In this single-center retrospective study, patients who underwent mitral valve repair or replacement due to MMVD (cases) based on age, gender and body mass index (BMI), were matched with patients who underwent coronary artery bypass grafting (CABG) surgery and had no history of mitral valve disease (controls)...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29760925/methimazole-induced-anca-associated-vasculitis-with-diffuse-alveolar-haemorrhage
#15
Naoki Arai, Kenji Nemoto, Shuji Oh-Ishi, Mizu Nonaka, Kenji Hayashihara, Takefumi Saito
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) caused by methimazole (MMI) is known to be relatively rare; therefore, the optimal therapeutic approach for these cases remains to be established. A 59-year-old man who was treated with MMI for a diagnosis of Graves' disease was referred to our hospital because of progressive haemoptysis. The patient was diagnosed with diffuse alveolar haemorrhage (DAH) secondary to AAV based on increased inflammatory reactions with positive myeloperoxidase-ANCA in the serum and the results of bronchoalveolar lavage fluid...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29752289/interventions-to-reduce-over-utilized-tests-and-treatments-in-bronchiolitis
#16
Amy Tyler, Paige Krack, Leigh Anne Bakel, Kimberly O'Hara, Douglas Scudamore, Irina Topoz, Julia Freeman, Angela Moss, Renee Allen, Angela Swanson, Lalit Bajaj
OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis...
May 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29748750/clinical-and-laboratory-features-of-children-with-community-acquired-pneumonia-are-associated-with-distinct-radiographic-presentations
#17
Oana G Falup-Pecurariu, Javier Diez-Domingo, Susanna Esposito, Adam Finn, Fernanda Rodrigues, Vana Spoulou, George A Syrogiannopoulos, Vytautas Usonis, David Greenberg
Chest radiographs from children with community-acquired pneumonia (CAP) were categorized into three distinct presentations and each presentation was correlated to clinical and laboratory findings. Children < 59 months with CAP presenting to pediatric emergency rooms during two years were enrolled prospectively in eight centers across Europe. Clinical and laboratory data were documented and radiographs obtained from patients. Of the 1107 enrolled patients, radiographs were characterized as 74.9% alveolar CAP, 8...
May 11, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29746705/a-new-method-for-ct-dose-estimation-by-determining-patient-water-equivalent-diameter-from-localizer-radiographs-geometric-transformation-and-calibration-methods-using-readily-available-phantoms
#18
Da Zhang, Georgeta Mihai, Larry G Barbaras, Olga R Brook, Matthew R Palmer
PURPOSE: Water equivalent diameter (Dw) reflects patient's attenuation and is a sound descriptor of patient size, and is used to determine size specific dose estimator from a CT exam. Calculating Dw from CT localizer radiographs makes it possible to utilize Dw before actual scans, and minimizes truncation errors due to limited to utilize Dw before actual scans, and minimizes truncation errors due to limited reconstructed fields of view. One obstacle preventing the user community from implementing this useful tool is the necessity to calibrate localizer pixel values so as to represent water equivalent attenuation...
May 10, 2018: Medical Physics
https://www.readbyqxmd.com/read/29746377/risk-factors-for-severe-community-acquired-pneumonia-among-children-hospitalized-with-cap-younger-than-5-years-of-age
#19
Wei Shan, Ting Shi, Kaile Chen, Jian Xue, Yin Wang, Jia Yu, Genming Zhao, Jianmei Tian, Tao Zhang
BACKGROUND: CAP causes great morbidity and mortality as well as enormous economic burden worldwide. This study intended to describe the clinical characteristics of CAP and explore the risk factors of severe CAP among children in downtown Suzhou, China. METHODS: This was a retrospective study of childhood hospitalizations in Soochow University Affiliated Children's Hospital (SCH) from January 1, 2010 to December 31, 2014. Children who were residents of downtown Suzhou, 29 days to <5 years of age, with discharge diagnosis codes (ICD-10) J09 to J18 and J20 to J22 were included...
May 9, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29744246/comparative-study-of-three-methods-for-depth-of-central-venous-catheter-placement-in-children-an-observational-pilot-study
#20
Vaishali Chaskar, Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Objective: Central venous cannulation of the internal jugular vein is difficult in paediatric patients because of the small size of the vein and anatomic variations. Many studies have shown the accuracy of various formulae for calculating the depth of placement. The aim of this study was to assess the most reliable method for central venous catheter (CVC) tip placement in paediatric patients. Methods: Sixty-nine patients in the age groups from 0 to 12 years were divided in three groups for three published techniques for catheter tip placement...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
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