Radiological findings and clinical features for the diagnosis of adenoid hypertrophy: a study from Iraq

Introduction. We performed a retrospective study to evaluate demographics, clinical course, outcome, and radiological findings of children with respiratory syncytial virus (RSV) infection. Methods. Four hundred patients admitted between October 2013 and May 2016 were enrolled. Clinical and radiographic trends were evaluated for association with severity of RSV presentation. Severity was defined as hospitalization >2 days, pediatric intensive care unit admission, or need for mechanical ventilation. Results. Common clinical findings included fever (78.5%), coughing (97%), rhinorrhea/congestion (93%), and hypoxia (44.8%). Hypoxia was seen in 64.7% of the severe group compared with 32.0% in the nonsevere group ( P < .001). Airspace opacification was seen in 49.2% of chest X-rays of the severe group compared with 26.4% in the nonsevere group ( P < .001). Conclusion. Higher incidence of hypoxia or airspace opacification on chest X-ray may be predictors of poorer outcomes for patients with RSV infection.

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Klajoklio nervo krūtininės dalies neurilemoma: klinikinis atvejis

Lietuvos chirurgija ◽

10.15388/lietchirur.2014.3892 ◽

2014 ◽

Vol 13 (3) ◽

pp. 200-203

Author(s):

Renatas Aškinis ◽

Arnoldas Krasauskas ◽

Sigitas Zaremba ◽

Saulius Cicėnas

Keyword(s):

Rare Disease ◽

Clinical Case ◽

Clinical Symptoms ◽

Chest Ct ◽

Vagal Nerve ◽

Surgical Removal ◽

Radiological Findings ◽

X Ray ◽

Chest X Ray

Neurilemoma – periferinių nervų dangalų auglys. Jis auga lėtai ir pradžia dažniausiai būna besimptomė. Pasiekęs kritinį dydį auglys, priklausomai nuo atsiradimo vietos, pasireiškia spaudimo į aplinkinius organus klinika. Neurilemomos dažniausiai atsiranda galūnėse 30–50 gyvenimo metais nepriklausomai nuo lyties. Klajoklio nervo neurilemoma yra nedažna patologija, o krūtininės klajoklio nervo dalies neurilemoma pasitaiko itin retai. Diagnozuojant svarbiausi yra radiologiniai tyrimo metodai. Gydymas – chirurginis auglio pašalinimas. Pateikiame krūtininės klajoklio nervo dalies neurilemomos, nustatytos 39 metų moteriai, klinikinį atvejį. Auglys aptiktas radiologiniais tyrimais (krūtinės rentgeno, kompiuterinės tomografijos ir tarpuplaučio magnetinio branduolių rezonanso), pašalintas naudojant vaizdo torakoskopinę (VATS) metodiką. Diagnozė galutinai patvirtinta histologiniu tyrimu. Aštuntą parą po operacijos ligonė išrašyta į namus.Reikšminiai žodžiai: neurilemoma, klajoklis nervas, operacija Neurilemoma of intrathoracal vagal nerve: clinical caseRenatas Aškinis, Arnoldas Krasauskas, Sigitas Zaremba, Saulius Cicėnas Neurilemoma is a tumour of peripleurical nervous tissues. It grows slowly and has an asymptomatic manifestation. During tumour enlargement, depending on localisation, clinical symptoms appear because of the tumour pressure to the surrounding tissues. Mostly neurilemomas appear in extremities of patients aged 30–50 years. N. vagus neurilemoma is a very rare disease. The diagnosis is made using radiology. The treatment is surgical removal. We present a clinical case of intrathoracal n. vagus neurilemoma in a 39-year-old woman. The diagnosis was made using radiological findings (chest X-ray, chest CT, and the MRI of the mediastinum). The removal of the tumour was made by VATS. The diagnosis was proved morphologically. After 8 days, the patient was discharged from the hospital.Key words: neurilemoma, vagal nerve, operation

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A Case Report on the Child with Two Coins Ingested Foreign Bodies in the Esophagus During the Lockdown in COVID 19 Pandemic

Journal of Clinical Case Studies Reviews & Reports ◽

10.47363/jccsr/2020(2)143 ◽

2020 ◽

Vol 2 (4) ◽

pp. 1-2

Author(s):

Rabia Arora ◽

◽

Satinder Pal Singh ◽

Arvinder Singh ◽

◽

...

Keyword(s):

Foreign Bodies ◽

Pediatric Population ◽

Age Groups ◽

Acute Onset ◽

Endoscopic Examination ◽

Lateral View ◽

X Rays ◽

Cervical Oesophagus ◽

X Ray ◽

Low Threshold

A 4-year-old child presented to the emergency department with an acute onset of dysphagia and vomiting. A plain X-ray soft tissue neck lateral view revealed a double circular opacity in the cervical oesophagus consistent with an ingestion of multiple foreign bodies. Preoperative planning and SARS-CoV2 testing is of particular importance for the pediatric population and if testing cannot be performed, patients in all age groups should be handled as though they are positive for COVID-19, and appropriate precautions should be taken. The child was taken to the theatre for rigid pharyngo-oesophagoscopy and removal of the coins. After the first coin was removed subsequent endoscopic examination revealed a second coin at the same location. This extremely rare case of two ingested coins becoming impacted with perfect radiological alignment, we would therefore advocate having a low threshold for performing a ‘second look’ endoscopy after removal of the first foreign body with postoperative X-rays.

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Early Onset Favipiravir Saves Lives

10.21203/rs.3.rs-142868/v1 ◽

2021 ◽

Author(s):

Ercan KARATAS ◽

Lacin Aksoy ◽

Pinar Elbir Kilic ◽

Arzu Dogru ◽

Ersin Ozaslan

Keyword(s):

Oral Treatment ◽

Clinical Findings ◽

Treatment Resistant ◽

Radiological Findings ◽

Start Time ◽

Laboratory Findings ◽

X Ray ◽

Chest X Ray ◽

New Type ◽

Clinical Worsening

Abstract Background Favipiravir, an antiviral recommended for use in patients with tachypnea (respiratory rate 30 / min) in COVID-19 pneumonia, with SpO2 level below 90% in room air and with bilateral diffuse pneumonia on chest X-ray or tomography, or patients with treatment-resistant fever, is a new type of RNA-dependent RNA polymerase (RdRp) inhibitor. After the administration of Favipiravir, it contributed significantly to reducing mortality in patients with severe COVID-19 positive disease. We performed this study to determine the start time in Favipiravir's covid pneumonia. Material and Method: We evaluated the effect of a total of 5 days of oral treatment as a 2 × 1600 mg loading dose and a 2 × 600 mg maintenance dose of Favipiravir added to the standard COVID-19 treatment received by patients with laboratory-radiology-clinical findings who have advanced or severe COVID 19 pneumonia. Results 180 patients hospitalized at Tuzla State Hospital and given Favipiravir treatment between 20/3/2020 and 30/5/2020 were examined. As of hospitalization, 17 of 101 patients (17%) who were given Favipiravir treatment in ≤ 3 days died, 30 of 79 patients (38%) who were given Favipiravir treatment for in > 3 days died (p:0.002). 33 of 47 patients (70%) who died were > 65 years old. Only 5 of the 47 (11%) patients who died had no comorbid disease. 35 had two or more comorbid diseases. Conclusion Patients with radiological findings indicating that COVID-19 will be severe and laboratory findings at the time of the first 3 days should be initiated with an effective dose of Favipiravir treatment without waiting for the clinical worsening.

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Klajoklio nervo krūtininės dalies neurilemoma: klinikinis atvejis

Lietuvos chirurgija ◽

10.15388/lietchirur.2012.3.2864 ◽

2012 ◽

Vol 11 (3-4) ◽

pp. 89-92

Author(s):

Renatas Aškinis ◽

Arnoldas Krasauskas ◽

Sigitas Zaremba ◽

Saulius Cicėnas

Keyword(s):

Case Report ◽

Clinical Case ◽

Clinical Symptoms ◽

Chest Ct ◽

Vagal Nerve ◽

Surgical Removal ◽

Radiological Findings ◽

X Ray ◽

Chest X Ray ◽

Nervus Vagus

Neurilemoma – periferinių nervų dangalų auglys, kuris auga lėtai ir jo pradžia dažniausiai būna besimptomė. Pasiekę kritinį dydį augliai, priklausomai nuo atsiradimo vietos, pasireiškia spaudimo į aplinkinius organus klinika. Neurilemomos dažniausiai atsiranda galūnėse 30–50-ais gyvenimo metais ir nuo lyties nepriklauso. Klajoklio nervo neurilemoma yra nedažna patologija, o krūtininės klajoklio nervo dalies neurilemoma pasitaiko itin retai. Diagnostikai svarbiausi yra radiologiniai tyrimo metodai. Gydymas – chirurginis auglio šalinimas. Pateikiame krūtininės klajoklio nervo dalies neurilemomos, nustatytos 39 metų moteriai, klinikinį atvejį. Auglys aptiktas radiologiniais tyrimais (krūtinės rentgeniniu, kompiuterinės tomografijos ir tarpuplaučio magnetinio branduolių rezonanso), pašalintas naudojant vaizdo torakoskopinę metodiką. Diagnozė galutinai patvirtinta histologiniu tyrimu. Aštuntą parą po operacijos ligonė išrašyta į namus.Reikšminiai žodžiai: neurilemoma, klajoklis nervas, operacija.Neurilemoma of intrathoracal vagal nerve: case report Neurilemoma is a tumour of peripleurical nervous tissues. It grows slowly and has an asymptomatic manifestation. During tumour enlargement, depending on its localization, clinical symptoms appear due to the tumour pressure to surrounding tissues. Neurilemomas mostly appear in the extremities of patients aged 30–50 years. N. vagus neurilemoma is a very rare disease. The diagnosis is made using radiology. Its treatment is surgical removal. We present a clinical case of intrathoracal nervus vagus neurilemoma in a 39-y woman. The diagnosis was based on radiological findings (chest X-ray, chest CT, and mediastinum MRI). The removal of the tumour was made by the VATS method. The diagnosis was proven morphologically. After 8 days the patient was discharged from the hospital.Key words: neurilemoma, vagal nerve, operation.

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Congenital Complete Esophageal Diaphragm: A Rare Variant of Esophageal Stenosis

Journal of Neonatal Surgery ◽

10.21699/jns.v7i3.764 ◽

2018 ◽

Vol 7 (3) ◽

pp. 37

Author(s):

Nahla Kechiche ◽

Rabeb Farhani ◽

Badii Hmida ◽

Rachida Lamiri ◽

Aziza Ezzi ◽

...

Keyword(s):

Clinical Symptoms ◽

Esophageal Stenosis ◽

Endoscopic Examination ◽

X Ray ◽

Esophageal Lumen ◽

Esophageal Web ◽

Chest X Ray ◽

Management Challenge ◽

The Web ◽

Endoscopic Incision

Congenital esophageal web is a rare disorder that presents a diagnostic and management challenge. In a female infant born at 31 weeks of gestation, significant secretions and respiratory distress were noted at birth. Chest X-ray demonstrated the nasogastric tube in the esogastric junction with no distal bowel gas. Esophagogram showed a congenital web near the esogastric junction. An endoscopic examination under general anesthesia showed a complete, thick membrane on the distal esophageal lumen. Endoscopic incision and cauterization of the web through the midline were performed, improving the clinical symptoms and esophageal stenosis.

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A Study on the Use of Abdominal X-Ray in an Emergency Department

Hong Kong Journal of Emergency Medicine ◽

10.1177/102490790200900105 ◽

2002 ◽

Vol 9 (1) ◽

pp. 30-33 ◽

Cited By ~ 1

Author(s):

Sy Choi ◽

Tw Wong ◽

Cc Lau ◽

E Liang ◽

Yk Fu ◽

...

Keyword(s):

Emergency Department ◽

Clinical Features ◽

Demographic Data ◽

Univariate Analysis ◽

Abdominal Distension ◽

Clinical Findings ◽

Bowel Sound ◽

X Rays ◽

Clinical Predictors ◽

X Ray

Objective 1) To study the current use of abdominal X-rays (AXR) in our emergency department (ED). 2) To evaluate the clinical predictors for positive AXR findings. Methods During the 40 days study period, all patients who had taken abdominal X-rays were included. The attending doctor filled in a questionnaire on demographic data, clinical features and outcome. The three radiologists who participated in this study reported the films and consultant emergency physicians then commented on the appropriateness of the request. The clinical features, which were predictive of positive radiological findings, were sorted out using univariate analysis. Results 64 patients were included in the 40 days study period. The rate for AXR request was 3.4 per 1000 patients. The most common presenting complaints were abdominal pain (85.9%) and constipation (45.3%). The most frequent clinical findings were abdominal distension (35.9%) and hyperactive bowel sound (31.3%). Only two of the clinical features, including vomiting and rebound tenderness, were found to have significant correlation with positive X-ray findings. Most of the AXR requests and interpretations by ED doctors were considered to be appropriate.

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Aetiology, diagnosis and treatment of chronic rhinosinusitis: a study in a teaching hospital in Telangana

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20160062 ◽

2016 ◽

Vol 2 (1) ◽

pp. 14 ◽

Cited By ~ 3

Author(s):

Harika Surapaneni ◽

Shalini Singh Sisodia

Keyword(s):

Ct Scan ◽

Chronic Rhinosinusitis ◽

Paranasal Sinuses ◽

Chronic Sinusitis ◽

Clinical History ◽

Endoscopic Examination ◽

Lateral View ◽

Upper Respiratory Tract ◽

Deviated Nasal Septum ◽

X Ray

Background: Chronic rhinosinusitis is one of the common problems in ENT Department which can be caused due to infections or anatomical blockage or allergy. We performed this study to assess the cause, clinical features and the effect of treatment on rhinosinusitis.Methods: 60 patients of chronic sinusitis with symptoms persisting beyond three months, Nasal Endoscopic findings with Polyps/Discharge/edematous mucosa were included in the study. A detailed clinical history, with complete Ear, Nose, Throat, and Head and Neck examination, blood tests like complete blood picture, Blood sugar levels, ESR and Hepatitis profile. X ray of paranasal sinuses, (water’s view) and lateral view, Chest x-ray –PA View and CT scan of paranasal sinuses (axial and coronal section with 3mm cuts at OMC) was done for all patients. Diagnostic Nasal Endoscopic examination (DNE) for detection of polyps / discharge / edematous mucosa in middle meatus was also done for the patients where it was necessary. The patients were given medical or surgical treatment according to the symptom and followup was done for 3 months for all patients. Results: Over 75% of the patients had incidence of sinusitis in the age group of 16 – 45 years. The most common etiology was sinusitis caused by infections (26 – 44%) followed by anatomical obstruction (22 – 36%). Of the 22 anatomical obstruction the most common was Deviated nasal septum in 14 (62%) of the cases followed by 4 (19%) CB, 3 (15%) pradixical MT and 1 (4%) prominent aggernasi. The most common sign and symptom was headache and polypoidal changes observed in 36 patients each (60%), followed by nasal obstruction in 35 patients (50%). 12 (20%) of the patients were treated with polypectomy + FESS while 14 (23%) of them were treated with septoplasty + FESS. 34 (57%) were treated with only FESS.Conclusions: Chronic sinusitis doesnot affect a particular age or sex and is more common among patietns with an upper respiratory tract infection. CT scan of the paranasal sinuses is the most useful tool in diagnosing the disease and FESS is the treatment of choice.

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Serum surfactant protein A and D may be novel biomarkers of COVID-19 pneumonia severity

10.21203/rs.3.rs-29567/v1 ◽

2020 ◽

Author(s):

Atsushi Saito ◽

KOJI KURONUMA ◽

Keigo Moniwa ◽

Kentaro Kodama ◽

Satoshi Takahashi ◽

...

Keyword(s):

Clinical Symptoms ◽

Early Stage ◽

Protein A ◽

Laboratory Data ◽

Serum Levels ◽

Surfactant Protein ◽

Clinical Findings ◽

Radiological Findings ◽

Specific Serum ◽

Severity Scores

Abstract Background: COVID-19 is currently undergoing a pandemic worldwide, including in Japan, and many lives have been lost. So, there is an urgent need to develop new biomarkers for estimating progression or prognosis of COVID-19 patient. Lung-specific serum biomarkers, SP-A, SP-D and KL-6 have been used clinically for diagnosis of interstitial lung disease (ILDs), but their use in COVID-19 has not been investigated. To determine whether serum levels of SP-A, SP-D and KL-6 correlate with the severity of COVID-19 as indicated by clinical symptoms and radiological findings. Methods: In a cohort of 46 consecutive COVID-19 patients, laboratory data including serum SP-A, SP-D and KL-6 concentrations of 82 blood samples were analyzed and compared between severe and non-severe cases. In addition, the disease severity as indicated by these markers and chest HRCT images were compared.Results: Serum SP-A was significantly elevated from the early stage of pneumonia. In addition, serum SP-A and SP-D were significantly higher in severe than in non-severe cases. KL-6 was also significantly higher in severe-cases, but its mean was below the cut-off level for ILDs. AUC and their cut-off levels to detect severe cases in patients with COVID-19 infection were 0.796 for 94.9 ng/ml of SP-A, 0.827 for 116 ng/ml of SP-D and 0.640 for 275 U/ml of KL-6. HRCT image severity scores showed moderate correlations with SP-A (ρ=0.5996, p<0.001), SP-D (ρ=0.6268, p<0.001), and weak with KL-6 (ρ=0.3489, p<0.001). In the typical course of patients whose pneumonia worsened from non-severe to severe, the serum SP-A and SP-D levels increased nearly in parallel with clinical findings and HRCT images.Conclusions: Lung-specific serum SP-A and SP-D level increased with symptom and radiological findings. These elevations can be detected from relatively early pneumonia. These results indicated that these might become a novel biomarker in COVID-19 pneumonia.

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Klajoklio nervo krūtininės dalies neurilemoma: klinikinis atvejis

Lietuvos chirurgija ◽

10.15388/lietchirur.2014.3.3892 ◽

2014 ◽

Vol 13 (3) ◽

pp. 200-203

Author(s):

Renatas Aškinis ◽

Arnoldas Krasauskas ◽

Sigitas Zaremba ◽

Saulius Cicėnas

Keyword(s):

Rare Disease ◽

Clinical Case ◽

Clinical Symptoms ◽

Chest Ct ◽

Vagal Nerve ◽

Surgical Removal ◽

Radiological Findings ◽

X Ray ◽

Chest X Ray

Neurilemoma – periferinių nervų dangalų auglys. Jis auga lėtai ir pradžia dažniausiai būna besimptomė. Pasiekęs kritinį dydį auglys, priklausomai nuo atsiradimo vietos, pasireiškia spaudimo į aplinkinius organus klinika. Neurilemomos dažniausiai atsiranda galūnėse 30–50 gyvenimo metais nepriklausomai nuo lyties. Klajoklio nervo neurilemoma yra nedažna patologija, o krūtininės klajoklio nervo dalies neurilemoma pasitaiko itin retai. Diagnozuojant svarbiausi yra radiologiniai tyrimo metodai. Gydymas – chirurginis auglio pašalinimas. Pateikiame krūtininės klajoklio nervo dalies neurilemomos, nustatytos 39 metų moteriai, klinikinį atvejį. Auglys aptiktas radiologiniais tyrimais (krūtinės rentgeno, kompiuterinės tomografijos ir tarpuplaučio magnetinio branduolių rezonanso), pašalintas naudojant vaizdo torakoskopinę (VATS) metodiką. Diagnozė galutinai patvirtinta histologiniu tyrimu. Aštuntą parą po operacijos ligonė išrašyta į namus.Reikšminiai žodžiai: neurilemoma, klajoklis nervas, operacija Neurilemoma of intrathoracal vagal nerve: clinical caseRenatas Aškinis, Arnoldas Krasauskas, Sigitas Zaremba, Saulius Cicėnas Neurilemoma is a tumour of peripleurical nervous tissues. It grows slowly and has an asymptomatic manifestation. During tumour enlargement, depending on localisation, clinical symptoms appear because of the tumour pressure to the surrounding tissues. Mostly neurilemomas appear in extremities of patients aged 30–50 years. N. vagus neurilemoma is a very rare disease. The diagnosis is made using radiology. The treatment is surgical removal. We present a clinical case of intrathoracal n. vagus neurilemoma in a 39-year-old woman. The diagnosis was made using radiological findings (chest X-ray, chest CT, and the MRI of the mediastinum). The removal of the tumour was made by VATS. The diagnosis was proved morphologically. After 8 days, the patient was discharged from the hospital.Key words: neurilemoma, vagal nerve, operation

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