scholarly journals Sidero-Siliko Tuberkulosis pada Penderita Efusi Pleura Masif Dekstra yang Awalnya Dicurigai Keganasan

2019 ◽  
Vol 3 (3) ◽  
pp. 81
Author(s):  
Winariani Koesoemoprodjo ◽  
Hapsari Paramita Narendrani
Keyword(s):  
Pleural Effusion ◽  
Fiber Material ◽  
Lung Field ◽  
X Rays ◽  
Work History ◽  
Silica Dust ◽  
The Right ◽  
Tissue Reactions ◽  
Pathological Reaction ◽  
Chest Ct Scan

Background: Pneumoconiosis defined as the accumulation of dust in the lungs and causes tissue reactions to mineral materials from various industries that affect the respiratory system. Among the causes of pneumoconiosis are silica dust (silicosis) and iron dust (ciderosis). Pneumoconiosis provides a pathological reaction in lung tissue due to inhaled deposition of mineral particulate dust or persistent fiber material. The risk of infection with tuberculosis is higher in patients with pneumoconiosis, especially silicosis. Most cases of pleural effusion are found in malignancies or infections such as tuberculosis but can also be a complication of pneumoconiosis. Case: A man, 55 years old, reported with a 2-week congested complaint that was getting worse, with a cough for almost 1 month. Patients with work history as iron lathers for 25 years with comorbid diabetes mellitus. From the results of our chest x-rays we get a picture of massive pleural effusion with a total evacuation of approximately 9 liters, whereas on the chest CT scan get a solid mass picture in the right lung field with multiple nodules in the liver. The results of bronkoalveolar rinses obtained silica and iron content, and obtained Mycobacterium tuberculosis culture in pleural fluid culture. Conclusion: Illustration of a case report of a 55-year-old man diagnosed as a sidero-silico-tuberculosis with a periodic picture of tuberculosis and pleural effusion in the right lung undergoing resolution with OAT treatment.

scholarly journals The relationship between pleural effusion index and mortality in children with dengue shock syndrome

2012 ◽  
Vol 52 (4) ◽  
pp. 239
Author(s):  
Novianti Hawarini ◽  
Muhammad Sholeh Kosim ◽  
Mohammad Supriatna ◽  
Yusrina Istanti ◽  
Eddy Sudjanto
Keyword(s):  
Pleural Effusion ◽  
Pediatric Intensive Care ◽  
Dengue Shock Syndrome ◽  
X Rays ◽  
Chi Square ◽  
Cross Sectional ◽  
Lateral Decubitus ◽  
The Right ◽  
The Relationship ◽  
Regression Tests

Background Dengue shock syndrome (DSS) mortality rate is stillhigh. The extent of plasma effusion in dengue shock syndromecan be identified in the right lateral decubitus position on chestx􀁃ray, and quantified by the pleural effusion index (PEl). It isthought that PEl value can be used to predict DSS mortality inchildren. Pleural effusion in DSS patients can cause respiratoryfailure and death.Objective To determine the relationship bet ween PEl andmortality in children \\lith DSS.Methods This cross􀁃sectional, retrospective study was held in theDr. Kariadi Hospital, Semarang, Indonesia. Data was taken frommedical records of pediatric intensive care unit (PICU) patientswith DSS from January 2009 to January 2011. DSS diagnosiswas confirmed by clinical and radiological manifestations. PEldiagnosis was established by the presence of fluid in the pleuralcavity on pulmonary radiological examinations. X􀁃rays wereinterpreted by the radiologist on duty at the time. Chi square andlogistic regression tests were used to analyze the data.Results There were 48 subjects with DSS, consisting of 18 males(37.5 %), and 30 females (62.5%). Twenty􀁃nine subjects (60.4%)survived and 19 (39.6%) died. One patient (2.1 %) had PEl <6%,4 (8.3%) had PEl 6-15%, 17 (35.4%) had PEl 15-30%, and26 (54.2%) had PEl> 30% on their x􀁃rays. The mortality rateof DSS with PEl 15-30% was 11.8% (95% CI 0.021 to 0.564;P<0.005) and PEl >30% was 65.4 % (95% CI 3,581 to 99,642;P <0.005).Cone-lution PEl> 15% was a risk factor for mortality in childrenwith DSS. [Paediatr lndanes. 2012;52:239-42].

scholarly journals Problem Terapeutik pada Empiema Terlokulasi karena Tuberkulosis

2020 ◽  
Vol 4 (3) ◽  
pp. 86
Author(s):  
Isnin Anang Marhana ◽  
Amelia Tantri Anggraeni
Keyword(s):  
Pleural Effusion ◽  
Early Stage ◽  
Secondary Infection ◽  
Bronchopleural Fistula ◽  
Superior Lobe ◽  
Immunocompromised Individual ◽  
Systemic Factors ◽  
Mortality Case ◽  
The Right ◽  
Chest Ct Scan

Background: Pleural effusion is the most common complication of pulmonary tuberculosis (TB). Some coexist with secondary infection could worsen clinical presentation as empyema. The incidence of pleural effusion in the early stage of empyema due to TB infection is about 31%. Somehow, untreated empyema increased in-hospital mortality. Case: A woman with unregulated diabetes mellitus was referred with organized empyema. The etiology of empyema is based on a specific process of TB infection with the ADA value of empyema fluid was 128 mg/dl. We decided to perform decortication with the result loculated empyema and bronchopleural fistula 2 cm in the inferior lobe of the right lung. The patient did not recover well. Unfortunately, fluidopneumothorax was found on a chest CT scan with contrast. Thoracotomy was performed and another bronchopleural fistula was found which length was about 1 cm in superior lobe of the right lung. Discussion: The worsening condition of the patient was caused by the occurrence of postoperative bronchopleural fistula. It was visualized as pulmonary TB with perforation of cavity nessessity. On the other hand, the condition could be worsened by the hyperglycemic state in an immunocompromised individual. Summary: Loculated empyema is a condition caused by bronchopleural fistula, the presence of a connecting cavity between pleural and bronchus which occurred less than 48 hours. Local and systemic factors might explain the development of bronchopleural fistula. Well management of the loculated empyema by knowing the etiology could improve the life survival of the patient.

MINIMIZING THE EXPOSURE TO THE EYE LENS OF RADIOLOGIC TECHNOLOGISTS ASSISTING PATIENTS DURING CHEST X RAYS: A PHANTOM STUDY

2021 ◽  
Vol 193 (1) ◽  
pp. 43-54
Author(s):  
Yasuda Mitsuyoshi ◽  
Funada Tomoya ◽  
Sato Hisaya ◽  
Kato Kyoichi
Keyword(s):  
Radiation Protection ◽  
Phantom Study ◽  
International Commission ◽  
Eye Lens ◽  
Radiological Protection ◽  
X Rays ◽  
Radiologic Technologists ◽  
Maximum Reduction ◽  
The Right

Abstract As chest x rays involve risks of patients falling, radiologic technologists (technologists) commonly assist patients, and as the assistance takes place near the patients, the eye lenses of the technologists are exposed to radiation. The recommendations of the International Commission on Radiological Protection suggest that the risk of developing cataracts due to lens exposure is high, and this makes it necessary to reduce and minimize the exposure. The present study investigated the positions of technologists assisting patients that will minimize exposure of the eye lens to radiation. The results showed that it is possible to reduce the exposure by assisting from the following positions: 50% at the sides rather than diagonally behind, 10% at the right side of the patient rather than the left and 40% at 250 mm away from the patient. The maximum reduction with radiation protection glasses was 54% with 0.07 mmPb and 72% with 0.88 mmPb.

Shrinking lung syndrome in pediatric systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110103
Author(s):  
Alfonso Ragnar Torres Jimenez ◽  
Nayma Ruiz Vela ◽  
Adriana Ivonne Cespedes Cruz ◽  
Alejandra Velazquez Cruz ◽  
Alma Karina Bernardino Gonzalez
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pleural Effusion ◽  
Pulmonary Function ◽  
Lupus Erythematosus ◽  
Pulmonary Function Tests ◽  
Age At Diagnosis ◽  
X Rays ◽  
Systemic Lupus ◽  
Function Tests ◽  
Restrictive Pattern

Shrinking Lung Syndrome (SLS) is a rare and little known complication associated with Systemic Lupus Erythematosus (SLE), characterized by progressive and unexplainable dyspnea, pleuritic pain, small pulmonary volumes and elevation of the diaphragm on chest X-rays as well as restrictive pattern on pulmonary function tests. Objective To describe clinical, radiological and treatment characteristics in pediatric patients with SLS. Material and methods This is a descriptive and retrospective study in patients under 16 years old with the diagnosis of SLE complicated by SLS at the General Hospital. National Medical Center La Raza. Clinical, radiological and treatment variables were analyzed. Results are shown in frequencies and percentages. Results Data from 11 patients, 9 females and 2 males were collected. Mean age at diagnosis of SLS was 12.2 years. Age at diagnosis of SLE was 11.1 years. SLEDAI 17.3. Renal desease 72%, hematological 91%, lymphopenia 63%, mucocutaneous 72%, neurological 9%, arthritis 54%, serositis 91%, fever 81%, secondary antiphospholipid syndrome, low C3 72%, low C4 81%, positive ANA 91%, positive anti-DNA 91%. Regarding clinical manifestations of SLE: cough 81%, dyspnea 91%, hipoxemia 81%, pleuritic pain 71%, average oxygen saturation 83%. Chest X-rays findings: right hemidiaphragm affection 18%, left 63%, bilateral 18%. Elevated hemidiaphragm 91%, atelectasis 18%, pleural effusion 91%, over one third of the cardiac silhouette under the diphragm 36%, bulging diaphragm 45%, 5th. anterior rib that crosses over the diaphragm 91%. M-mode ultrasound: diaphragmatic hypomotility 100%, pleural effusion 63%. Pulmonary function tests: restrictive pattern in 45% of the cases. Treatment was with supplementary oxygen 100%, intubation 18%, antibiotics 100%, steroids 100%, intravenous immunoglobulin 54%, plasmapheresis 18%, cyclophosphamide 54% and rituximab 18%. The clinical course was favorable in 81%. Conclusions SLS should be suspected in patients with SLE and active disease who present hipoxemia, pleuritic pain, cough, dyspnea, pleural effusion and signs of restriction on chest X-rays. Therefore, a diaphragmatic M-mode ultrasound should be performed in order to establish the diagnosis.

scholarly journals P046 Pointing the finger: an unusual presentation of dactylitis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Natalia Cernovschi - Feasey ◽  
Julekha Wajed
Keyword(s):  
Pleural Effusion ◽  
Soft Tissue ◽  
Middle Finger ◽  
Joint Involvement ◽  
Long Bones ◽  
History Of ◽  
Systemic Symptoms ◽  
The Right ◽  
Hands And Feet ◽  
Radiographic Changes

Abstract Background/Aims  Dactylitis is commonly associated with psoriatic arthritis, and regularly presents at Rheumatology clinics. We discuss a case where progressive systemic symptoms lead to the consideration of alternate diagnoses. Methods  A 46-year-old Nepalese woman presented to the Rheumatology department with a 3 month history of diffuse swelling of the right middle finger proximal interphalangeal joint, with the appearance of dactylitis. There was pain on movement, but no other joint involvement. Simultaneously she noticed blurred and decreased vision, which on review by the ophthalmologists, was diagnosed with bilateral uveitis. There was no history of psoriasis, inflammatory bowel disease, or other past medical history of note. There was no travel history in the past 12 months. A diagnosis of a presumed inflammatory arthritis was made. Results  Blood tests showed elevated c-reactive protein 55 (normal &lt;4 mg/l), erythrocyte sedimentation rate 138 (normal 0-22 mm/hr) and an iron deficiency anaemia. Rheumatoid factor and Anti-CCP antibody were negative. Hand radiographs were reported as normal. MRI of the third digit confirmed an enhancing soft tissue collection at the proximal phalanx of the right middle finger. She was referred for a biopsy of this lesion. Interestingly over the subsequent few months, she developed progressive breathlessness. Chest radiograph showed a left pleural effusion. Further tests showed negative serum ACE, Lyme and Toxoplasma screen. Quantiferon test was negative. Pleural aspirate showed a transudate with negative Acid-fast bacillus (AFB) test and culture. CT chest and abdomen showed a persistent pleural effusion, inflammatory changes in the small bowel and thickening of the peritoneum and omentum. In view of the systemic involvement, a peritoneal tissue biopsy was performed. This confirmed chronic granulomatous inflammation with positive AFB stain for mycobacterium tuberculosis. Our patient was started on quadruple anti- TB antibiotics for 6 months. Her systemic symptoms and dactylitis have improved, although there is on-going treatment for her ocular involvement. Conclusion  Approximately 10% of all cases of extrapulmonary TB have osteoarticular involvement. Dactylitis is a variant of tuberculous osteomyelitis affecting the long bones of the hands and feet. It occurs mainly in young children; however adults may be affected also. The first manifestation is usually painless swelling of the diaphysis of the affected bone followed by trophic changes in the skin. The radiographic changes are known as spina ventosa, because of the ballooned out appearance of the bone, although this was not seen in our case. Fibrous dysplasia, congenital syphilis, sarcoidosis and sickle cell anaemia may induce similar radiographic changes in the metaphysis of long bones of hands and feet, but do not cause soft tissue swelling or periosteal reaction. This case highlights the importance of testing for TB, especially in atypical cases of dactylitis, with other systemic features. Disclosure  N. Cernovschi - Feasey: None. J. Wajed: None.

scholarly journals Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report

2020 ◽  
Vol 11 ◽  
pp. 215145932096938
Author(s):  
Yuki Suzuki ◽  
Toshihiko Kasashima ◽  
Kazutoshi Hontani ◽  
Yasuhiro Yamamoto ◽  
Kanako Ito ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Screening Method ◽  
Oxygen Demand ◽  
Japanese Woman ◽  
Trauma Patients ◽  
Lung Field ◽  
Old Japanese ◽  
Femoral Intertrochanteric Fracture ◽  
Novel Coronavirus ◽  
The Right

Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

scholarly journals The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

2005 ◽  
Vol 63 (2) ◽  
Author(s):  
B. Uskul ◽  
H. Turker ◽  
C. Ulman ◽  
M. Ertugrul ◽  
A. Selvi ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Clinical Findings ◽  
X Rays ◽  
Biochemical Tests ◽  
Pleural Thickening ◽  
Group I ◽  
Immunological Mechanisms ◽  
Tuberculosis Pleurisy

Selvi, A. Kant, S. Arslan, M. Ozgel. Background: Residual pleural thickening (RPT) still occurs in most patients with tuberculosis pleurisy despite advances in the treatment of tuberculosis. The aim of this study was to evaluate the significance of RPT in tuberculosis pleurisy with the patients clinical findings, biochemical and microbiological properties of pleural effusion and with the total adenosine deaminase (ADA) and isoenzymes levels. Methods: 121 tuberculosis pleurisy patients were evaluated retrospectively. According to posteroanterior chest x-rays, the 63 (52%) cases with the thickness 2 mm or more in lower lateral hemithorax were grouped as I and the 58 (48%) cases without pleural thickness were grouped as II. The amount of pleural effusion was classified into small, medium or massive according to their chest x-rays. In both groups; sex, age, symptoms score, bacteriological and biochemical tests and ADA levels were recorded. Results: 81 (67%) male and 40 (33%) female, overall 121 patients were enrolled into the study. RPT was found higher in males (p=0.014) and the increase ran parallel with the amount of cigarette smoking (p=0.014). RPT was found to be lower in small effusions (p=0.001). The group with RPT, the serum albumin was found lower (p=0.002), pleural fluid total protein (p=0.047) and the ratio of pleural fluid protein to serum protein (p=0.002) were found higher. In group I, total ADA: 69.5±38.9 IU/L and ADA2: 41.3±31.6 IU/L were higher than the cases without RPT (p=0.032, p=0.017, respectively). Conclusions: We suggest that the immunological mechanisms are effective in the development of pleural thickening.

scholarly journals A Case with Severe Endometriosis, Ovarian Hyperstimulation Syndrome, and Isolated Unilateral Pleural Effusion after IVF

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Negjyp Sopa ◽  
Elisabeth Clare Larsen ◽  
Anders Nyboe Andersen
Keyword(s):  
Pleural Effusion ◽  
Ovarian Hyperstimulation Syndrome ◽  
Common Finding ◽  
Ovarian Hyperstimulation ◽  
Pleural Effusions ◽  
Luteal Support ◽  
Vitro Fertilization ◽  
Fluid Production ◽  
The Right

We present a very rare case of right-sided isolated pleural effusion in a patient with severe endometriosis who, in relation to in vitro fertilization (IVF), developed ovarian hyperstimulation syndrome (OHSS). Earlier laparotomy showed grade IV endometriosis including endometriotic implants of the diaphragm. The patient had no known risk factors for OHSS and only a moderate number of oocytes aspirated. She received, however, repeated hCG injections for luteal support. The patient did not achieve pregnancy but was hospitalized due to pain in the right side of the chest and dyspnoea. A chest computed tomography (CT) showed a pleural effusion on the right side. Total of 1000 ml of pleural fluid was drained after a single thoracentesis. After three days, the symptoms and fluid production ceased. Ascites is a common finding in OHSS, but pleural effusions are rare. Further, isolated pleural effusions have not previously been described in a patient with endometriosis. We suggest that the repeated hCG injections induced effusions from the endometriotic lesions at the diaphragm and as a consequence this patient developed isolated hydrothorax.

CHARACTERISTICS OF SOFT TISSUE MASS IN THE HAND BY ULTRASONOGRAPHIC EXAMINATION

2005 ◽  
Vol 09 (01) ◽  
pp. 45-51
Author(s):  
Alexander Blankstein ◽  
Aharon Chechick ◽  
Abraham Adunski ◽  
Uri Givon ◽  
Yigal Mirovski ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Mass ◽  
Wrist Joint ◽  
Imaging Modality ◽  
Routine Practice ◽  
X Rays ◽  
Diagnostic Challenge ◽  
Tissue Mass ◽  
Soft Tissue Masses ◽  
The Right

Soft tissue masses are amongst the commonest complaints encountered in orthopedic practice. Of these, masses found in the hand and the wrist are presented at higher frequency. They are often painful and may cause limitation of movement. This work describes the prevalence and the nature of soft tissue masses in the hand and wrist encountered in routine practice. This work was performed to assess the characteristics of soft tissue mass in the hand and the effectiveness of ultrasonography in the diagnosis of soft tissue masses and their differentiation from other lesions in the hand and wrist. Orthopedic surgical conditions that involve soft tissue in the hand and wrist may remain a diagnostic challenge when clinical diagnosis is uncertain and standard X-rays are non-diagnostic. High resolution ultrasound is widely available, non-invasive, without damage of radiation, imaging modality that can help the diagnosis. We reviewed retrospectively 25 patients with soft tissue masses. We compared the ultrasound findings with the histological findings in seven operated patients. A substantial majority of these lesions occurred in the right hand: 79% of the lesions were in the dorsal aspect of the hand, of which 37% were distal to the wrist joint, among them 42% at wrist either radial or ulnar; and 21% of the lesions were found in the volar aspect, among them 17% at wrist aspect, either radial or ulnar side. No predisposing factors could be found. The findings of this study reaffirm the utility of ultrasonography as primary diagnostic tool in routine orthopedic practice.

Metastatic choriocarcinoma with multiple neoplastic intracranial microaneurysms

2008 ◽  
Vol 108 (5) ◽  
pp. 1014-1017 ◽  
Author(s):  
In Bok Chang ◽  
Byung Moon Cho ◽  
Se Hyuck Park ◽  
Dae Young Yoon ◽  
Sae Moon Oh
Keyword(s):  
Ct Scan ◽  
Cerebral Arteries ◽  
Lung Field ◽  
Necrotizing Vasculitis ◽  
Cerebral Angiogram ◽  
Lower Lung Field ◽  
Metastatic Lesions ◽  
Middle Cerebral Arteries ◽  
Lower Lung ◽  
Chest Ct Scan

✓The authors report on a case of a metastatic choriocarcinoma that mimicked systemic necrotizing vasculitis on a cerebral angiogram. A 35-year-old woman presented with right hemiplegia and a drowsy mental state. A computed tomography (CT) scan revealed an intracerebral hemorrhage in the left frontal region. A cerebral angiogram showed multiple microaneurysms arising from the bilateral anterior cerebral arteries and middle cerebral arteries, and the renal angiogram showed multiple microaneurysms arising from the left distal renal artery. A chest CT scan revealed multiple metastatic lesions in the left lower lung field. The hematoma and microaneurysms were surgically removed. Choriocarcinoma was diagnosed after histological examination. Despite receiving postoperative chemotherapy, the patient died 1 month after the operation.

Sign in / Sign up

Export Citation Format

Share Document