scholarly journals The role of thoracoscopic lung biopsy in the management of children with solid organ malignancies and suspected lung metastases in a developing country

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Mark Wagener ◽  
Nasheeta Peer ◽  
Mahomed Hoosen Sheik-Gafoor
Keyword(s):  
Developing Country ◽  
Lung Biopsy ◽  
Lung Metastases ◽  
Tertiary Hospital ◽  
Metastatic Tumour ◽  
Solid Organ ◽  
Negative Consequences ◽  
Computed Tomographic ◽  
Reactive Lymph Node ◽  
Lung Biopsies

Abstract Background Accurate diagnosis of lung lesions appearing on computed tomographic (CT) imaging in children with solid organ malignancies can be difficult. Therefore, this study aimed to determine, in a developing country setting, (1) the utility of thoracoscopic lung biopsy for assessment of suspected lung metastases in solid organ malignancies, and (2) the pathology of biopsied lesions suspected to be malignancies. The electronic records of all patients with solid organ malignancies who underwent thoracoscopic lung biopsies for suspected metastases at a tertiary hospital in South Africa between January 2012 and December 2017 were analysed retrospectively. Results A total of 29 thoracoscopic biopsies were taken from 25 patients. In eight biopsies (27.6%), viable metastatic tumour was identified; in one, a completely necrotic tumour was found. Seven patients (28.0%) were found to have infective aetiologies which required alternative therapies: of these, three patients had tuberculosis; three had bronchopneumonia and one had a fungal lung infection. Other findings included haemorrhagic infarction (n = 1); non-specific fibrosis (n = 1) and reactive lymph node (n = 1). In ten biopsies (34.5%), no lesion was found on thoracoscopy. Conclusions Thoracoscopy was found to improve the management of children with solid organ malignancies and suspected metastases. Thoracoscopy enabled many patients to avoid additional chemotherapy and radiotherapy and its negative consequences and enabled therapy for specific benign pathologies including infections.

Pattern of Presentation of Mammography in a Developing Country

2020 ◽  
Vol 10 (2) ◽  
pp. 33-37
Author(s):  
Birendra Raj Joshi
Keyword(s):  
Breast Cancer ◽  
Developing Country ◽  
Tertiary Hospital ◽  
Dense Breast ◽  
Advanced Stage ◽  
Cancer Death ◽  
Convenience Sampling

Introduction: Breast cancer is the second commonest cancer (7.2%) in Nepal and almost 54%of patients present in the advanced stage. It is the leading cause of cancer death in females.The objective of the study was to determine the type of mammography, composition of breastdensity and BIRADS category.Methods: The study was conducted in a tertiary hospital from Jan 1st to Oct 30th of 2019according to non-probability convenience sampling. A total of 388 persons were included inthe study. The mammographic findings were assessed by categories based on the BIRADSsystem.Results: Mammography for screening was 38 percent and diagnostic was 68 percent. Commonbreast compositions were B and C. More frequent BIRADS categories were seen in 1 and 2.Conclusion: Dense breast is common in mammography. BIRADS categories 1 and 2 weremore common than other categories.

scholarly journals Starting Laparoscopic Inguinal Hernia in a Tertiary Hospital of a Developing Country

2019 ◽  
Vol 6 (2) ◽  
pp. 52-57
Author(s):  
Binod Bade Shrestha ◽  
Sujan Shrestha ◽  
Mikesh Karmacharya ◽  
Pradeep Ghimire
Keyword(s):  
Inguinal Hernia ◽  
Developing Country ◽  
Tertiary Hospital ◽  
Laparoscopic Inguinal Hernia

scholarly journals Contribution of CAD to the Sensitivity for Detecting Lung Metastases on Thin-Section CT – A Prospective Study with Surgical and Histopathological Correlation

2019 ◽  
Vol 192 (01) ◽  
pp. 65-73 ◽  
Author(s):  
Christian Meybaum ◽  
Mareike Graff ◽  
Eva Maria Fallenberg ◽  
Gunda Leschber ◽  
Dag Wormanns
Keyword(s):  
Thin Section ◽  
Lung Metastases ◽  
Ct Scans ◽  
Pulmonary Metastasectomy ◽  
Computed Tomographic ◽  
Cad System ◽  
Histopathological Correlation ◽  
Experienced Radiologist ◽  
Key Points ◽  
A Prospective Study

Purpose To assess the sensitivity of radiologists and a CAD system for the detection of lung metastases on thin-section computed tomographic (CT) scans prior to pulmonary metastasectomy. Materials and Methods All patients scheduled for resection of lung metastases were eligible for this prospective single-center trial. 95 patients with 115 surgical procedures (pulmonary metastasectomy using thoracotomy) were included. An experienced radiologist examined the CT scans for pulmonary metastases and documented his findings. A commercial CAD system was used as a second reader; additional CAD findings were recorded. A comparison of the sensitivity of the radiologist alone and with CAD was performed. Intraoperatively surgeons tried to identify the documented lesions and resected them as well as additionally palpable lesions. The standard of reference consisted of surgery and histopathology. Follow-up information for radiologically detected lesions missed during surgery was sought. Results 693 lesions (262 metastases) were detected radiologically or surgically, 646 of them were resected. The sensitivity of radiologists without CAD was 67.5 % for all lesions (87.4 % for metastases). CAD highly significantly (p < 0.001) increased the sensitivity to 77.9 % (92.7 %). During surgery, 143 additional lesions (19 metastases) were detected. 49 radiologically detected lesions were not palpable during surgery: 4 metastases, 5 benign lesions, and 40 lesions of an unknown nature. Conclusion CAD provides significant additional sensitivity for detecting lung metastases using MDCT compared to the performance of a radiologist alone. CT reveals a relevant number of non-palpable pulmonary lesions. Key Points:  Citation Format

Serial Computed Tomographic Scans Document Healing of Solid Organ Injury in a Trauma Patient with Multiple Injuries

2006 ◽  
Vol 61 (3) ◽  
pp. 765
Author(s):  
Fulvio Tagliabue ◽  
Gianmaria Confalonieri ◽  
Antonio Romelli ◽  
Maria Emanuela Limonta ◽  
Sabina Terragni ◽  
...  
Keyword(s):  
Trauma Patient ◽  
Organ Injury ◽  
Multiple Injuries ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Computed Tomographic

The Effect of Needle Gauge on the Risk of Pneumothorax and Chest Tube Placement After Percutaneous Computed Tomographic (CT)-Guided Lung Biopsy

2015 ◽  
Vol 38 (6) ◽  
pp. 1595-1602 ◽  
Author(s):  
Joshua D. Kuban ◽  
Alda L. Tam ◽  
Steven Y. Huang ◽  
Joe E. Ensor ◽  
Asher S. Philip ◽  
...  
Keyword(s):  
Chest Tube ◽  
Lung Biopsy ◽  
Tube Placement ◽  
Ct Guided ◽  
Chest Tube Placement ◽  
Computed Tomographic

scholarly journals Performance Characteristics of the Platelia Aspergillus Enzyme Immunoassay for Detection of Aspergillus Galactomannan Antigen in Bronchoalveolar Lavage Fluid

2008 ◽  
Vol 15 (12) ◽  
pp. 1760-1763 ◽  
Author(s):  
S. Husain ◽  
C. J. Clancy ◽  
M. H. Nguyen ◽  
S. Swartzentruber ◽  
H. Leather ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Enzyme Immunoassay ◽  
Bronchoalveolar Lavage Fluid ◽  
Organ Transplant ◽  
Lavage Fluid ◽  
Solid Organ ◽  
Computed Tomographic ◽  
Transplant Patients ◽  
Galactomannan Antigen ◽  
Positive Results

ABSTRACT We have evaluated the Platelia Aspergillus enzyme immunoassay for detection of galactomannan in bronchoalveolar lavage (BAL) specimens in solid organ transplant patients with aspergillosis. The precision and reproducibility in serum or BAL to which galactomannan was added were similar. Sensitivity was 81.8% in patients with aspergillosis, and specificity was 95.8% in lung transplant patients who underwent BAL for surveillance for infection or rejection. Among transplant controls, positive results were more common in patients (i) who underwent diagnostic BAL performed for evaluation of symptoms or chest computed tomographic abnormalities, (ii) who had undergone lung transplantation, or (iii) who were colonized with Aspergillus. Galactomannan testing in BAL is useful for diagnosis of aspergillosis in transplant patients. The significance of positive results in patients without confirmed aspergillosis requires further evaluation.

scholarly journals Post-Biopsy Pneumothorax Incidence in Patients Treated with Biosentry Plug Device

2021 ◽  
Vol 14 ◽  
pp. 153-155
Author(s):  
Hythem Abouodah ◽  
Gregg Werner ◽  
Thomas Fahrbach ◽  
Cameron Fox ◽  
Jared Mazurek ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Lung Biopsy ◽  
Retrospective Cohort ◽  
Degrees Of Freedom ◽  
Smoking Status ◽  
P Value ◽  
Single Institution ◽  
Chi Squared ◽  
Race Ethnicity ◽  
Lung Biopsies

Introduction: This study aimed to determine if Biosentry Plug Device (BP), a prophylactic sealant used to prevent pneumothorax after lung biopsies, reduced post-lung biopsy pneumothorax rates and other complications compared to no device utilization. Methods: This single institution, retrospective cohort study included patients who received a lung biopsy in the department of interventional radiology from May 1, 2015 to August 31, 2017. Data such as sex, race, ethnicity, COPD status, degree of lung bullae if present, smoking status, and use of BP were recorded. Decisions to use BP were based on operator preference. A chi squared analysis was used with a p value <0.05 considered significant. Results: The study included 521 patients who underwent a lung biopsy during the study timeframe. Of these, 74 (14.2%) received the BP device, while 447 (85.8%) did not. One-hundred ninety (36.4%) had a pneumothorax within 1 month of the lung biopsy. Of the total 190 that experienced pneumothorax, 36.7% of non-BP biopsies resulted in pneumothorax, while 35.1% of BP biopsies resulted in pneumothorax, p-value = 0.7970, degrees of freedom = 1. Conclusions: These findings indicate that BP may not reduce pneumothorax incidence nor limit the severity of complications in patients.

scholarly journals Clinical Profile, Drug Utilization Pattern and Adverse Drug Reactions of Anti-tubercular Drugs at DOTS Center in a Tertiary Hospital

2020 ◽  
Vol 22 (3) ◽  
pp. 158-166
Author(s):  
Aswani Chaudhary ◽  
DP Sarraf ◽  
NR Bhattarai ◽  
A Chaudhary ◽  
GP Rauniar
Keyword(s):  
Drug Utilization ◽  
Adverse Drug Reactions ◽  
Tertiary Hospital ◽  
Clinical Profile ◽  
Negative Consequences ◽  
Drug Reactions ◽  
Utilization Pattern ◽  
Pulmonary Tb ◽  
Urine Color ◽  
Monthly Visit

Most of anti-tubercular drugs (ATD) cause various adverse drug reactions (ADRs) leading to significant morbidity which may have negative consequences on drug adherence and treatment outcome. The objectives of the study were to know the clinical profile of patients receiving ATD, to identify the pattern of ADRs caused by ATD and to know the drug utilization pattern (DUP) in different types of tuberculosis (TB). A prospective observational study was conducted among patients diagnosed with TB at DOTS center in BPKIHS from June 2017 to May 2018 and occurrence of any ADRs were detected during their monthly visit. Descriptive statistics were used to analyze the data. A total of 126 tuberculosis patients were on ATD therapy during the study period. Seventy five patients (59.5%) were male. Most of the patients (44.4%) belonged to age group 21-40 year. Pulmonary TB (66.7%) was more common than extra-pulmonary TB. Multi-drug resistant TB was detected in 4 patients (3.2%). Seventy one patients (56.3%) were found to be smear positive for acid fast bacilli. First line ATD was given to 122 patients (96.8%). Out of 126 patients, 116 (92.1%) reported occurrence of at least one ADR. A higher number of ADRs were observed in male (68.3%). Change in urine color was the most common ADR (92.9%) followed by nausea and vomiting (39.7%). Further studies covering different regions of Nepal are needed to generalize the findings.

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