Small Heart with “White Out” on a Chest Radiograph

2020 ◽  
pp. 141-147
Keyword(s):  
2016 ◽  
Vol 1 (3) ◽  
pp. 138-144
Author(s):  
Ina Edwina ◽  
Rista D Soetikno ◽  
Irma H Hikmat

Background: Tuberculosis (TB) and diabetes mellitus (DM) prevalence rates are increasing rapidly, especially in developing countries like Indonesia. There is a relationship between TB and DM that are very prominent, which is the prevalence of pulmonary TB with DM increased by 20 times compared with pulmonary TB without diabetes. Chest X-ray picture of TB patients with DM is atypical lesion. However, there are contradictories of pulmonary TB lesion on chest radiograph of DM patients. Nutritional status has a close relationship with the morbidity of DM, as well as TB.Objectives: The purpose of this study was to determine the relationship between the lesions of TB on the chest radiograph of patients who su?er from DM with their Body Mass Index (BMI) in Hasan Sadikin Hospital Bandung.Material and Methods: The study was conducted in Department of Radiology RSHS Bandung between October 2014 - February 2015. We did a consecutive sampling of chest radiograph and IMT of DM patients with clinical diagnosis of TB, then the data was analysed by Chi Square test to determine the relationship between degree of lesions on chest radiograph of pulmonary TB on patients who have DM with their BMI.Results: The results showed that adult patients with active pulmonary TB with DM mostly in the range of age 51-70 years old, equal to 62.22%, with the highest gender in men, equal to 60%. Chest radiograph of TB in patients with DM are mostly seen in people who are obese, which is 40% and the vast majority of lesions are minimal lesions that is equal to 40%.Conclusions: There is a signifcant association between pulmonary TB lesion degree with BMI, with p = 0.03


Thorax ◽  
2001 ◽  
Vol 56 (8) ◽  
pp. 617-621
Author(s):  
D G Kiely ◽  
S Ansari ◽  
W A Davey ◽  
V Mahadevan ◽  
G J Taylor ◽  
...  

BACKGROUNDThere is no technique in general use that reliably predicts the outcome of manual aspiration of spontaneous pneumothorax. We have hypothesised that the absence of a pleural leak at the time of aspiration will identify a group of patients in whom immediate discharge is unlikely to be complicated by early lung re-collapse and have tested this hypothesis by using a simple bedside tracer gas technique.METHODSEighty four episodes of primary spontaneous pneumothorax and 35 episodes of secondary spontaneous pneumothorax were studied prospectively. Patients breathed air containing a tracer (propellant gas from a pressurised metered dose inhaler) while the pneumothorax was aspirated percutaneously. Tracer gas in the aspirate was detected at the bedside using a portable flame ioniser and episodes were categorised as tracer gas positive (>1 part per million of tracer gas) or negative. The presence of tracer gas was taken to imply a persistent pleural leak. Failure of manual aspiration and the need for a further intervention was based on chest radiographic appearances showing either failure of the lung to re-expand or re-collapse following initial re-expansion.RESULTSA negative tracer gas test alone implied that manual aspiration would be successful in the treatment of 93% of episodes of primary spontaneous pneumothorax (p<0.001) and in 86% of episodes of secondary spontaneous pneumothorax (p=0.01). A positive test implied that manual aspiration would either fail to re-expand the lung or that early re-collapse would occur despite initial re-expansion in 66% of episodes of primary spontaneous pneumothorax and 71% of episodes of secondary spontaneous pneumothorax. Lung re-inflation on the chest radiograph taken immediately after aspiration was a poor predictor of successful aspiration, with lung re-collapse occurring in 34% of episodes by the following day such that a further intervention was required.CONCLUSIONSNational guidelines currently recommend immediate discharge of patients with primary spontaneous pneumothorax based primarily on the outcome of the post-aspiration chest radiograph which we have shown to be a poor predictor of early lung re-collapse. Using a simple bedside test in combination with the post-aspiration chest radiograph, we can predict with high accuracy the success of aspiration in achieving sustained lung re-inflation, thereby identifying patients with primary spontaneous pneumothorax who can be safely and immediately discharged home and those who should be observed overnight because of a significant risk of re-collapse, with an estimated re-admission rate of 1%.


Author(s):  
Bradley S. Rostad ◽  
Jay H. Shah ◽  
Christina A. Rostad ◽  
Preeti Jaggi ◽  
Edward J. Richer ◽  
...  

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