Posterior Thoracic Stab Wounds: Evaluating the Value of Commonly Used Radiologic Modalities

2018 ◽  
Vol 84 (8) ◽  
pp. 1363-1367
Author(s):  
William M. Brigode ◽  
Michael Masteller ◽  
Rishi Chaudhuri ◽  
Ryan Sullivan ◽  
Amir Vafa
Keyword(s):  
Injury Severity ◽  
Demographic Data ◽  
Inclusion Criteria ◽  
Stab Wounds ◽  
X Ray ◽  
Asymptomatic Patients ◽  
Data Points ◽  
Chest X Ray ◽  
Posterior Mediastinal ◽  
Stab Injuries

This study was performed to assess our institution's experience with stab injuries to the posterior mediastinal box. We examine the value of performing CT of the chest and esophagram in conjunction with a chest X-ray (CXR) over performing CXR(s) alone in evaluating this group of patients. We performed a retrospective study covering a 10-year period consisting of patients with stab wounds to the posterior mediastinal box. Age, gender, and injury severity score as demographic data points were collected. CXR, CT, and esophagram results; identified injuries; and subsequent interventions were analyzed. Of 78 patients who met the inclusion criteria, a total of 55 patients underwent esophagram, one had a false-positive result, and zero had their course altered by the study. Sixty-six patients underwent CT imaging, and there were nine missed findings on initial CXR. Five of these were clinically insignificant and the remaining four were managed with a chest tube alone. There were no tracheobronchial, esophageal, cardiac, or great vessel injuries. Hemodynamically stable, asymptomatic patients with stab wounds to the posterior mediastinal box do not require routine CT and esophagram in the absence of CXR and cardiac ultrasonographic abnormalities.

scholarly journals Is routine preoperative chest X-ray: An underutilized tool in asymptomatic patients!

2018 ◽  
Vol 21 (4) ◽  
pp. 460
Author(s):  
Swati Jindal ◽  
Satinder Gombar ◽  
Kompal Jain
Keyword(s):  
X Ray ◽  
Asymptomatic Patients ◽  
Chest X Ray ◽  
Preoperative Chest

scholarly journals GAMBARAN FOTO TORAKS PADA PENDERITA BATUK KRONIK DI BAGIAN/SMF RADIOLOGI FK UNSRAT/RSUP PROF. DR. R.D. KANDOU MANADO PERIODE JULI – SEPTEMBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Divertt Tamaweol ◽  
Ramli H. Ali ◽  
Martin L. Simanjuntak
Keyword(s):  
Chronic Cough ◽  
Medical Records ◽  
Smoking Habit ◽  
Radiological Diagnosis ◽  
Radiology Department ◽  
Common Symptom ◽  
Inclusion Criteria ◽  
X Ray ◽  
X Ray Imaging ◽  
Chest X Ray

Abstract: Chronic cough is defined as cough that lasts 8 weeks or more. Chronic cough itself is not a disease, but a symptom of other diseases. Chronic cough is the most common symptom that occurs among outpatients and is the main cause of morbidity which was reported by 3-40% population. Chronic cough can be caused by some diseases such as pneumonia, tuberculosis, asthma, chronic bronchitis, emphysema, and lung fibrosis. Chronic cough is closely associated with smoking habit which is one of the predisposing factors. Chest x-ray is one of the seed examination for chronic cough because it is very helpful in diagnosing diseases especially pulmonary diseases and others that may cause chronic cough. Objective: To identify the chest x-ray imaging in chronic cough patients. Methods: This study using retrospective description data in November 2015.  Sample is obtained from all the medical records of patients with radiological diagnosis chronic cough who undertook a chest x-ray examination in the Radiology Department of the Medical Faculty of Sam Ratulangi University / Prof. Dr. R. D. Kandou Central General Hospital Manado during July – September 2015. Data was collected from chest x-ray request form and the results show 178 cases of chronic cough that fit the inclusion criteria. The results showed that there was 178 cases of chronic cough based on the radiological diagnosis. The most frequent cases were chronic cough caused by pulmonary tuberculosis (97 patients; 54.49%). Most patients were male (107 patients; 60.11%), and the most frequent age group was 20-49 years (60 patients; 33.71%). Keywords: chronic cough, chest x-ray  Abstrak: Batuk kronik adalah batuk yang berlangsung selama 8 minggu atau lebih. Batuk kronik sendiri bukanlah penyakit, tetapi merupakan suatu gejala dari penyakit-penyakit lain. Batuk kronik merupakan gejala yang paling umum terdapat pada orang dewasa yang melakukan pengobatan rawat jalan dan penyebab utama morbiditas yang dilaporkan oleh 3-40% populasi. Batuk kronik dapat disebabkan oleh beberapa penyakit seperti pneumonia, tuberculosis, asma, bronchitis kronik, emfisema, dan fibrosis paru. Batuk kronik erat hubungannya dengan kebiasaan merokok dimana merokok merupakan salah satu faktor predisposisi. Foto toraks adalah salah satu pemeriksaan pilihan untuk batuk kronik karena sangat bermanfaat dalam mendiagnosis penyakit terutama penyakit paru dan gangguan lain yang dapat menyebabkan batuk kronik. Penelitian ini bertujuan untuk mengetahui gambaran foto toraks pada penderita batuk kronik. Penelitian ini menggunakan metode deskriptif retropektif yang dilakukan pada bulan November 2015. Sampel diambil dari semua data catatan medik pasien dengan diagnosis radiologis batuk kronik yang melakukan foto toraks di Bagian/SMF Radiologi FK Unsrat/RSUP Prof. Dr. R. D. Kandou Manado periode Juli – September 2015. Data diperoleh melalui lembaran permintaan pemeriksaan foto toraks dan didapatkan sebanyak 178 kasus batuk kronik yang masuk dalam kriteria inklusi. Hasil penelitian memperlihatkan 178 kasus batuk kronik berdasarkan diagnosis radiologis. Kasus terbanyak ialah batuk kronik akibat tuberkulosis paru sebanyak 97 orang (54,49%), penderita terbanyak ialah laki-laki yaitu 107 orang (60,11%), dan golongan umur terbanyak ialah 20-49 tahun yaitu 60 penderita (33,71%). Kata kunci: batuk kronik, foto toraks

scholarly journals MO846THE SPECTRUM OF CLINICAL AND SEROLOGICAL FEATURES OF COVID-19 IN URBAN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Elena Gomá-Garcés ◽  
Teresa Stock da Cunha ◽  
Alejandro Avello ◽  
Monica Pereira ◽  
Sebastian Mas-Fontao ◽  
...  
Keyword(s):  
Troponin I ◽  
Hemodialysis Patients ◽  
Limited Evidence ◽  
Chain Reaction ◽  
X Ray ◽  
Asymptomatic Patients ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Treatment Responses ◽  
Overall Mortality

Abstract Background and Aims The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. Method Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units. Results In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status. Conclusion COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies.

scholarly journals Comparative outcomes of inpatients with lung collapse managed by bronchoscopic or conservative means

2019 ◽  
Vol 6 (1) ◽  
pp. e000427 ◽  
Author(s):  
Omesh Gopal Toolsie ◽  
Muhammad Adrish ◽  
Syed Arsalan Akhter Zaidi ◽  
Gilda Diaz-Fuentes
Keyword(s):  
Primary Outcome ◽  
Fibreoptic Bronchoscopy ◽  
Inclusion Criteria ◽  
Lung Collapse ◽  
X Ray ◽  
Conservative Group ◽  
Number Of Patients ◽  
Significant Pathology ◽  
Chest X Ray

BackgroundAlthough the incidence and prevalence of atelectatic lung collapse is unknown, such events are common among inpatients, and there are no guidelines for optimally instituting bronchoscopic techniques. The aim of this study was to evaluate the outcomes of patients with complete or near-complete lung collapse managed via interventional flexible fibreoptic bronchoscopy or a conservative approach.MethodsRetrospective analysis of all adult patients admitted to BronxCare Health System between January 2011 and October 2017 with a diagnosis of lung collapse/atelectasis. The primary outcome was radiological resolution. Timing of bronchoscopy relative to radiological resolution and mortality served as secondary outcomes.ResultsOf the 177 patients meeting inclusion criteria, 149 (84%) underwent bronchoscopy and 28 (16%) were managed through conservative measures only. A significantly greater number of patients in the bronchoscopy group achieved complete or near-complete resolution on chest X-ray, compared with the conservative group (p=0.007). Timing of bronchoscopy had no impact on the rate of radiological resolution, and mortality in the two groups was similar. New endobronchial malignancies were identified in 21 patients (14%).ConclusionsOur data support the central role of bronchoscopy in instances of complete or near-complete lung collapse, ensuring better radiological outcomes. Judicious use of conservative management is warranted to avoid missing significant pathology. A prime consideration in this setting is obstructive malignancy.

scholarly journals An Unusual Histology for a Lung Nodule: A Case Report of Primary Pulmonary Paraganglioma

2021 ◽  
Vol 8 ◽  
Author(s):  
Alessandra Mazzucco ◽  
Eleonora Poirè ◽  
Andrea Leporati ◽  
Matteo Chiari ◽  
Laura Moneghini ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Incidental Finding ◽  
Lung Nodule ◽  
Pulmonary Tissue ◽  
Case Presentation ◽  
X Ray ◽  
Asymptomatic Patients ◽  
Chest X Ray

Introduction: Primary pulmonary paraganglioma is a rare tumor with few cases reported in literature and unspecific clinical presentation.Case Presentation: A 49-year-old woman presented to our department with an incidental finding of a pulmonary mass at chest X-ray and no associated clinical symptom. The CT scan and the FDG-PET showed mild uptake of contrast, but a definitive diagnosis was only possible after surgery through histopathological examination.Conclusion: Paragangliomas originating in the pulmonary tissue are generally non-functioning masses discovered incidentally in otherwise asymptomatic patients. Surgery appears to be the best treatment option, with only radiologic follow-up necessary afterwards.

scholarly journals Clinical Course and Disease`s Outcome Aspects of COVID-19 Pediatric Patients in Ibn Al-Khateeb Isolation Hospital

2021 ◽  
Vol 17 (2) ◽  
pp. 84-90
Author(s):  
Abbas Oweid Oleiw ◽  
Kholod Dhaher Habib ◽  
Kadhim Abed Mohammed ◽  
Oday Yassen Abbas ◽  
Zainab Ali Jaber
Keyword(s):  
Medical Records ◽  
Pediatric Patients ◽  
Virus Disease ◽  
Communicable Disease ◽  
Imaging Techniques ◽  
Demographic Data ◽  
White Blood Cells ◽  
Age Group ◽  
X Ray ◽  
Chest X Ray

Background: Corona virus disease 2019 (COVID-19) is a communicable disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, China, and has since spread globally, leading to an ongoing pandemic. Aim of study: to review the clinical, lab investigation and imaging techniques, in pediatric age group affected COVID-19 to help medical experts better understand and supply timely diagnosis and treatment. Subjects and methods: this study is a retrospective descriptive clinical study. The medical records of patients were analyzed. Information’s recorded include demographic data, exposure history, symptoms, signs, laboratory findings, chest x- ray, and chest computed tomographic (CT) scans. Data were obtained with data collection forms from paper medical records. Results:  there were 76 COVID-19 pediatric patients, 46.1% of those patients were within the age group 6 -10 years. The female to male ratio was 1:1, and 92.1% of them were living within the urbane area. About 60.5% of patients were pupils. Seventy-one (93.4%) patients of them had no comorbidity. Twenty (26.3%) patients were asymptomatic.  Regarding the duration of hospital stay, 39(51.31) patients had <7 days. All of the patients were nonsmokers. All patients had recovered and discharged from hospital after 2 negative real technique-polymerase chain reaction (RT-PCR) tests, no death was reported. Only 16(21.1%) patients had severe symptoms. Conclusions: the most common symptoms were fever, Cough, Loss of appetite, Shortness of breath & Fatigue. There was a statistically significant association between white blood cells counts, neutrophil number, Chest X-Ray results, with case severity and a statistically significant association between form of treatment in patients who received Oxygen, Oseltamivir, Azithromycin, Paracetamol, Dexamethasone, and case severity.

scholarly journals Large posterior mediastinal goiter post total cervical thyroidectomy: a case report

2020 ◽  
Vol 7 (8) ◽  
pp. 2722
Author(s):  
Maria Fesatidou ◽  
Vasiliki Fesatidou ◽  
Georgios Tsoulfas ◽  
Ioannis T. Fessatidis
Keyword(s):  
Computed Tomography ◽  
Mediastinal Mass ◽  
Thyroid Tissue ◽  
Ct Guided ◽  
X Ray ◽  
Surgical Safety ◽  
Chest X Ray ◽  
Posterior Mediastinal ◽  
Lateral Thoracotomy ◽  
Mediastinal Goiter

Thoracotomy approach is indicated for a complete and safe posterior mediastinal goitre removal. A 68 years old male was hospitalized due to a right mediastinal mass found in a chest X-ray and confirmed by computed tomography. The patient had undergone total cervical thyroidectomy thirty years ago. A computed tomography (CT) guided percutaneous needle biopsy of the mass revealed thyroid tissue. Subsequently, the mass was completely resected through a right posterolateral thoracotomy. The histopathology confirmed a large mediastinal goitre with no signs of malignancy. The patient had an uncomplicated recovery. We present a relatively rare case of a successful resection of a posterior mediastinal goitre, occurring thirty years post-total cervical thyroidectomy. We advocate lateral thoracotomy to achieve a broad operative field and enhance surgical safety.

scholarly journals Solitary Pulmonary Hematoma Radiographically Indistinguishable from Mediastinal Tumor

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Teruya Komatsu ◽  
Naoki Date ◽  
Takuji Fujinaga ◽  
Akira Hara ◽  
Tatsuo Kato
Keyword(s):  
Blunt Chest Trauma ◽  
Mediastinal Tumor ◽  
Chest Trauma ◽  
Callus Formation ◽  
Wedge Resection ◽  
Lower Lobe ◽  
X Ray ◽  
Pulmonary Tumor ◽  
Chest X Ray ◽  
Posterior Mediastinal

Solitary pulmonary hematoma is a rare consequence of blunt chest trauma. Moreover, there has been no reported case of solitary pulmonary hematoma radiographically diagnosed as a posterior mediastinal tumor. We present the case of a 63-year-old man who was referred for an oval-shaped opacity at the left paraspinal area on a chest X-ray. Chest computed tomography showed a well-circumscribed posterior mediastinal tumor on the left paraspinal lesion with extrapleural sign and callus formation on the left ribs posteriorly (7th to 11th ribs). The tumor was thoracoscopically confirmed to be a subpleural pulmonary tumor of the left lower lobe, and wedge resection was performed. Histological examination confirmed the diagnosis of pulmonary hematoma. On reviewing the callus formation of the ribs, which was suggestive of rib fractures, the pulmonary hematoma was determined to be traumatic in origin. The postoperative course was uneventful. We reviewed a rare case of pathologically proven traumatic solitary pulmonary hematoma. The rarity of this case is enhanced because the hematoma initially appeared to be a posterior mediastinal tumor.

scholarly journals Artificial Intelligence and COVID-19 Using Chest CT Scan and Chest X-ray Images: Machine Learning and Deep Learning Approaches for Diagnosis and Treatment

2021 ◽  
Vol 11 (10) ◽  
pp. 993
Author(s):  
Roberta Fusco ◽  
Roberta Grassi ◽  
Vincenza Granata ◽  
Sergio Venanzio Setola ◽  
Francesca Grassi ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Deep Learning ◽  
Standard Deviation ◽  
Mean Value ◽  
Learning Approaches ◽  
Inclusion Criteria ◽  
X Ray ◽  
Standard Deviation Range ◽  
Chest X Ray

Objective: To report an overview and update on Artificial Intelligence (AI) and COVID-19 using chest Computed Tomography (CT) scan and chest X-ray images (CXR). Machine Learning and Deep Learning Approaches for Diagnosis and Treatment were identified. Methods: Several electronic datasets were analyzed. The search covered the years from January 2019 to June 2021. The inclusion criteria were studied evaluating the use of AI methods in COVID-19 disease reporting performance results in terms of accuracy or precision or area under Receiver Operating Characteristic (ROC) curve (AUC). Results: Twenty-two studies met the inclusion criteria: 13 papers were based on AI in CXR and 10 based on AI in CT. The summarized mean value of the accuracy and precision of CXR in COVID-19 disease were 93.7% ± 10.0% of standard deviation (range 68.4–99.9%) and 95.7% ± 7.1% of standard deviation (range 83.0–100.0%), respectively. The summarized mean value of the accuracy and specificity of CT in COVID-19 disease were 89.1% ± 7.3% of standard deviation (range 78.0–99.9%) and 94.5 ± 6.4% of standard deviation (range 86.0–100.0%), respectively. No statistically significant difference in summarized accuracy mean value between CXR and CT was observed using the Chi square test (p value > 0.05). Conclusions: Summarized accuracy of the selected papers is high but there was an important variability; however, less in CT studies compared to CXR studies. Nonetheless, AI approaches could be used in the identification of disease clusters, monitoring of cases, prediction of the future outbreaks, mortality risk, COVID-19 diagnosis, and disease management.

scholarly journals The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients

2020 ◽  
Vol 9 (7) ◽  
pp. 2264
Author(s):  
Teresa Stock da Cunha ◽  
Elena Gomá-Garcés ◽  
Alejandro Avello ◽  
Mónica Pereira-García ◽  
Sebastian Mas-Fontao ◽  
...  
Keyword(s):  
Troponin I ◽  
Hemodialysis Patients ◽  
Limited Evidence ◽  
Chain Reaction ◽  
X Ray ◽  
Asymptomatic Patients ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Treatment Responses ◽  
Overall Mortality

Introduction: The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. Material and Methods: Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units. Results: In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status. Conclusions: COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies.

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