scholarly journals Peculiarities of radiological and laboratory values in patients with community-acquired pneumonia during COVID-19 pandemic

2021 ◽  
Vol 9 (4) ◽  
pp. 15-22
Author(s):  
V.I. Trykhlib ◽  
K.P. Bieliaieva ◽  
N.R. Tsyurak ◽  
L.O. Palatna
Keyword(s):  
Age Groups ◽  
Left Lung ◽  
Lower Lobe ◽  
Personal Data ◽  
Severe Form ◽  
Community Acquired Pneumonia ◽  
Lower Lung ◽  
The Right ◽  
Almost All ◽  
Frequent Localization

Literature and personal data on community-acquired pneumonia during the epidemic of a new coronavirus infection COVID-19 are presented. It was found that men and patients with moderately to severe form were treated for community-acquired pneumonia more often. The most common localizations were as follows (in descending frequency): bilateral multisegmental, right-sided lower lobe, left-sided lower lobe. Men as compared to women more often had the following localization of pneumonia: right-sided lower lobe pneumonia at the age of 20–30, 51–60; right-sided multisegmental in all age groups; left-sided lower lobe pneumonia at the age of 51–60, left-sided upper lobe pneumonia at the age of 20–50; left-sided multisegmental pneumonia in all age groups; slightly more frequent bilateral lower lobe pneumonia in different age groups; bilateral multisegmental pneumonia at the age of 20–30 and over 60. Conversely, the most common localization in women was as follows: right-sided lower lobe pneumonia at the age 31–50, right-sided upper lobe pneumonia at the age 20–30, left-sided lower lobe pneumonia at the age 20–50 and over 60, left-sided upper lobe pneumonia at the age over 60, bilateral lower lobe pneumonia at the age 31–40, bilateral multisegmental pneumonia at the age 41–60. Right-sided lower lobe pneumonia was equally often registered irrespective of gender in persons older than 60 years old. Right-sided upper lobe pneumonia was not registered in patients aged 31–40 and 41–50 years, and over 60 years old. The most frequent localization of pneumonia in mild form was left-sided lower lobe (35.3 %), right-si­ded lower lobe (20.6 %), and bilateral lower lobe (14.7 %). The least frequent were upper lobe localization of pneumonia in the right, left, and both lungs (2.94 % each), and left multisegmental pneumonia was not observed at all. The most frequent localization of pneumonia in the moderate form was the lower lobes of the right lung (29.4 %), left lung (18.3 %), and multisegmental in both lungs (28.8 %). It was least frequently registered in the upper lobe of the right lung (2.6 %), left lung (3.9 %) but was not registered in the upper lobes of both lungs. The most frequent localization of pneumonia in severe form was bilateral multisegmental (37.5 %). Right-sided multisegmental, left-sided lower lung and bilateral lower lung were the least common — 12.5 % for each. Subfebrile fever was registered more frequently in almost all localizations. More often normal or subfebrile temperature was registered in all localizations, except for right-sided upper lobe pneumonia, in which higher (febrile, pyretic) temperature was registered more often. In all localizations within three days after hospitalization most patients had normal leukocyte count, leukopenia was slightly more frequent in left-sided lower lobe pneumonia, leukocytosis — in the bilateral upper lobe, bilateral lower lobe, and right-sided upper lobe. In general, leukocytosis in community-acquired pneumonia was registered in 38.8 % of patients. In the first three days after hospitalization, a normal amount of lymphocytes was registered in the majority of patients, lymphopenia was observed in one-third of patients with right-sided upper and left-sided lower lobe localization.

scholarly journals Comorbidity between Klinefelter syndrome and diaphragmatic hernia. A case report

2014 ◽  
Vol 132 (5) ◽  
pp. 311-313
Author(s):  
Carolina Melendez Valdez ◽  
Stephan Philip Leonhardt Altmayer ◽  
Adyr Eduardo Virmond Faria ◽  
Aline Weiss ◽  
Jorge Alberto Bianchi Telles ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Ultrasound Examination ◽  
Klinefelter Syndrome ◽  
Age Groups ◽  
Left Lung ◽  
Left Lobe ◽  
Imaging Studies ◽  
Left Hemithorax ◽  
Prenatal Imaging ◽  
The Right

CONTEXT: Intrathoracic cystic lesions have been diagnosed in a wide variety of age groups, and the increasing use of prenatal imaging studies has allowed detection of these defects even in utero.CASE REPORT: A 17-year-old pregnant woman in her second gestation, at 23 weeks of pregnancy, presented an ultrasound with evidence of a cystic anechoic image in the fet al left hemithorax. A morphological ultrasound examination performed at the hospital found that this cystic image measured 3.7 cm x 2.1 cm x 1.6 cm. Polyhydramnios was also present. At this time, the hypothesis of cystic adenomatoid malformation was raised. Fet al echocardiography showed only a dextroposed heart. Fet al magnetic resonance imaging produced an image compatible with a left diaphragmatic hernia containing the stomach and at least the first and second portions of the duodenum, left lobe of the liver, spleen, small intestine segments and portions of the colon. The stomach was greatly distended and the heart was shifted to the right. There was severe volume reduction of the left lung. Fet al karyotyping showed the chromosomal constitution of 47,XXY, compatible with Klinefelter syndrome. In our review of the literature, we found only one case of association between Klinefelter syndrome and diaphragmatic hernia.CONCLUSIONS: We believe that the association observed in this case was merely coincidental, since both conditions are relatively common. The chance of both events occurring simultaneously is estimated to be 1 in 1.5 million births.

scholarly journals Quick diagnostic and management community acquired pneumonia at Sumbawa hospital: a case report

2018 ◽  
Vol 7 (1) ◽  
pp. 297
Author(s):  
Muhammad Ahmad Syammakh ◽  
Elim Jusri ◽  
Gede Agung Setya ◽  
Made Aryadi Sukartika
Keyword(s):  
Emergency Department ◽  
Lung Ultrasound ◽  
Lower Lobe ◽  
Symptomatic Treatment ◽  
Community Acquired Pneumonia ◽  
Pulmonary Parenchyma ◽  
The Right ◽  
Hospital Acquired ◽  
B Lines ◽  
Good Oxygenation

Pneumonia is most common cause of respiratory distress an infection of the pulmonary parenchyma. Despite being the cause of significant morbidity and mortality, it is often misdiagnosed, mistreated, and underestimated. Pneumonia historically was Typically classified as community-acquired (CAP), hospital-acquired (HAP), or ventilator-associated (VAP). A 68-year-old male was sent to the emergency department from clinic with an oxygen saturation of 86%. She has fevers with cough and generalized weakness for one week. She had been evaluated by her primary care provider on day two of illness and was started empirically on cefixime without improvement of her symptoms. The patient arrived febrile, tachycardic, tachypneic, and hypoxic on room air with right-sided crackles on exam. Lung Ultrasound of the right lower lobe demonstrates lung hepatization, a classic finding for pneumonia. In addition, a shred sign is present with both air bronchograms and focal B lines-all suggestive of poorly aerated, consolidated lung. Authors critically evaluate the evidence for the use lung ultrasound for rapid diagnostic. It is important to understand this disease, rapid diagnostic with ultrasound and when treated promptly and effectively, these patients will rapidly recovery. Good oxygenation, intravenous Antibiotic, intravenous fluids and symptomatic treatment which should be started within minutes of the patients’ arrival to emergency department.

scholarly journals COVID - 19 AS A “SIGNIFICANT CIRCUMSTANCE” FOR RISK ASSESSMENT IN LIFE INSURANCE (IN AND AFTER THE PANDEMIC)

2021 ◽  
Author(s):  
Željka Primorac
Keyword(s):  
Risk Assessment ◽  
Health Status ◽  
Life Insurance ◽  
Personal Data ◽  
Severe Form ◽  
Insurance Contract ◽  
Hospital Treatment ◽  
Legal Norms ◽  
Legal Standards ◽  
The Right

The data on the health status of a policyholder represent a significant circumstance for risk assessment and concluding a life insurance contract, and are also legally relevant circumstances for exercising the rights from that contract. The author starts from a theoretical analysis of the perception of data on the health status of policyholders as personal data, comparing the right to confidentiality of such data with the duty to report them (before concluding a life insurance contract) in terms of reporting all circumstances relevant to the insurance risk assessment. In order to properly fulfil the obligation of pre-contractual nature, the paper analyses the legal norms governing this issue and also provides a comparative overview of the Croatian and German insurance legislation with special emphasis on the scope of health data that the insurer is authorised to require, the clarity of legal standards and legal insurance norms contained in the insurance questionnaires and the life insurance offer. Presenting the importance of COVID-19 infection and possible chronic consequences for human health, the author indicates the extent to which COVID-19 infection (mild or severe form of disease, possible need for hospital treatment) will have an impact on the design of new insurance questionnaires and the relevance of genetic testing results in the context of concluding future life insurance contracts.

scholarly journals Plaučių chondrohamartomų diagnostika

2004 ◽  
Vol 2 (3) ◽  
pp. 0-0
Author(s):  
Aba Vitėnas
Keyword(s):  
Correct Diagnosis ◽  
Left Lung ◽  
Lower Lobe ◽  
X Ray ◽  
Eosinophilic Infiltrate ◽  
Long Time ◽  
Pulmonary Hamartoma ◽  
Specific Reactions ◽  
The Right ◽  
Typical Localization

Aba VitėnasVšĮ Vilniaus universiteto ligoninės "Santariškių klinikos"Centro filialas, Radiologijos skyrius,Žygimantų g. 3, LT–01102, VilniusEl. paštas [email protected] Įvadas / tikslas Plaučių disontogeniniai navikai – hamartomos – yra dažniausi iš visų periferinių nepiktybinių rutulinių plaučių darinių. Endobronchinė centrinė hamartoma (epistoma) pasitaiko labai retai. Kremzlinės struktūros plaučių hamartomos – chondrohamartomos ir osteochondrohamartomos – yra dažniausios. Darbo tikslas – apibūdinti plaučių hamartomas, sukonkretinti jų rentgenologinius diferencinės diagnostikos žymenis ir tuo remiantis – klasifikaciją. Ligoniai ir metodai Plaučių hamartomos buvo nustatytos 43 ligoniams – 16–78 metų 28 vyrams ir 15 moterų. Visiems ligoniams atliktas kompleksinis radiologinis tyrimas – polipozicinė rentgenoskopija, rentgenografija, tomografija, skaitmeninė fluorografija, kompiuterinė tomografija. Bronchoskopija ir biopsija padaryta 31 ligoniui. Buvo atliekami ir kiti tyrimai: ultragarsinis, funkciniai plaučių mėginiai, specifinės laboratorinės reakcijos diferencinei diagnostikai nuo plaučių tuberkuliozės, kolagenozės, echinokokozės, alergozės. Rezultatai 42 ligoniams diagnozuota periferinė ir vienam – centrinė hamartoma. Tipinė plaučių hamartomos lokalizacija – dešiniojo plaučio apatinė skiltis (21 ligonis, arba 49%). Centrinė endobronchinė hamartoma diagnozuota 42 metų ligoniui, ilgai sirgusiam lėtiniu bronchitu ir dažnai plaučių uždegimu. Operuota 30 ligonių. Devyni ligoniai iš 13 neoperuotųjų stebėti nuo 1 iki 14 metų. Periferinės hamartomos dažniausiai buvo besimptomės. 23 ligoniams hamartoma nustatyta atsitiktinai profilaktiškai tiriant plaučius dėl įvairių pilvo organų ligų arba atliekant fluorografinį tyrimą. Kitiems tirtiesiems hamartoma buvo diagnozuota sergant plaučių ligomis, tuberkulioze, alergoze, kolagenoze, įvairiais navikais. Dvylikai ligonių nepiktybinio plaučių naviko, arba hamartomos, diagnozė buvo tiksliai nustatyta poliklinikoje. Devyniems buvo įtartas pirminis vėžys arba metastazė, šešiems – specifinis infiltratas arba tuberkuloma, vienam – eozinofilinis infiltratas, vienam – echinokokas. Hamartoma 31 ligoniui buvo dešiniajame, 12 – kairiajame plautyje. Rentgenogramoje periferinė hamartoma buvo matoma apskritos formos ir ryškių kontūrų. Jos rentgenologinė struktūra buvo nevienoda. Šviesi (nekalcifikuota) hamartoma buvo matoma 14 ligonių. Kitiems 28 ligoniams diagnozuota kalcifikuota (inkrustuota arba tamsi) hamartoma, t. y. hamartochondroma (chondrohamartoma, osteochondrohamartoma). Išvados Nors plaučių hamartomos auga labai lėtai, pasitaiko labai greitai progresuojančių: 3 ligoniams, arba 7%, hamartomos per metus padidėjo iki 50%. Dažniausias jų variantas – hamartochondroma (chondrohamartoma). Piktybinių hamartomų nediagnozuota. Pagal neoplazinės kalcinozės laipsnį plaučių hamartomos radiologiškai skirstomos į tris variantus: šviesas, inkrustuotas ir tamsias. Radiologai gali diferencijuoti dažniausius plaučių hamartomų variantus, tarp jų chondrohamartomas ir osteochondrohamartomas. Reikšminiai žodžiai: disontogeniniai plaučių navikai, disembriomos, periferiniai plaučių navikai, hamartomos, hamartochondromos, neoplazinė kalcinozė, rentgenodiagnostika Diagnostics of pulmonary chondrohamartomas Aba Vitėnas Background / objective Hamartomas, as dysontogenic tumours, are most common among all peripheral non-malignant "spheral" pulmonary formations. Endobronchial central hamartoma is rare and is usually diagnosed as "epystoma" (bronchial obturator). Among peripheral hamartomas, tumours of cartilaginous structure (chondrohamartomas and ostheochondrohamartomas) are particularly common. The objective of the work was to describe pulmonary hamartomas and to concretize most common variations of hamartoma and their different radiological signs. Patients and methods Forty-three patients were diagnosed with pulmonary hamartoma (28 males and 15 females, 16–78 years old). In the hospital, clinical and laboratory tests were performed for all patients; complex radiological examination: polypositional X-ray radioscopy, radiography, tomography, digital fluorography, computed tomography. Thirty-one patients underwent bronchoscopy and biopsy, sonoscopy, functional lung tests, specific reactions. Results Forty-two patients had peripheral and one central hamartoma. The most typical localization of pulmonary hamartoma was the lower lobe of the right lung (21 patients, 49%). A central endobronchial hamartoma was diagnosed for a 42-year-old patient who had been ill for a long time with chronic bronchitis and frequent pneumonias. 30 pacients were operated one. From 13 non-operated patients, 9 were followed up in dynamics for 1–14 years. Peripheral hamartoma usually was asymptomatic. Twenty-three patients were diagnosed occasionaly during preventive pulmonary evaluation in case of different abdominal diseases or during fluorography. The others diagnosed as having hamartoma were ill with lung diseases, TBC, alergosis, collagenosis, different tumours. In out-patient settings, correct diagnosis of benign tumour or hamartoma was established for 12 patients, 9 were suspected as having cancer or metastases, 6 – specific infiltrate (tuberculoma), 1 – eosinophilic infiltrate and 1 – echinococcus; 31 patient had the tumour in the right, and 12 patients in the left lung. Radiologically, hamartoma is a spheric tumour with clear margins. As to the structure of the tumour, 14 patients had non-calcificated, "light" hamartoma, 28 had calcificated, "inlaid" and "hard" hamartochondroma. Thus, neoplastic calcinosis is characteristic of chondrohamartomas (osteochondrohamartomas) and occurs twice as often as hamartomas of other types. Conclusions Althought hamartomas grow very slowly, there were rapidly increasing ones: for 3 patients (7%) the volume of hamartoma increased by 50% in a year. The most common type was hamartochondroma (chondrohamartoma). There were no malignant hamartomas. Therefore radiologists can diagnose most common variations of hamartomas as "light", "inlaid" and "hard" ones. Keywords: dysontogenous pulmonary tumours, dysembriomas, peripheral pulmonary tumours, hamartomas, hamartochondromas, neoplastic calcinosis, radiological diagnostics

scholarly journals Pulmonary Gangrene - Severe And Rare Complication Of Pneumonia

2014 ◽  
Vol 7 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Guergana Petrova ◽  
Penka I. Perenovska ◽  
Dimitrinka Miteva ◽  
Radost T. Kabakchieva ◽  
Ognyan G. Brankov ◽  
...  
Keyword(s):  
Rare Complication ◽  
Left Lung ◽  
Lower Lobe ◽  
Good Health ◽  
Surgical Department ◽  
Intravenous Antibiotics ◽  
Histology Result ◽  
Severe Infections ◽  
The Right ◽  
Surgery Department

SummaryPneumonia is an inflammatory lung disorder characterized by consolidation due to presence of exudates in the alveolar spaces. Most pneumonias can be effectively treated with appropriate oral antibiotics, with intravenous antibiotics being reserved for those with severe infections. We present two cases of girls admitted in our clinic with pneumonia where our conventional therapy was not sufficient. Case 1: A 15-year-old girl with cystic fibrosis, with left lobular pneumonia, for which an aggressive conservative treatment was initiated. After significant improvement, sudden detorioration and pneumothorax of the left lung occurred. She was transferred to the surgical department for intervention. Due to failure to respond to initial drainage she underwent thoracotomy and resection of the left lower lobe of the lung. The histology result confirmed gangrene. Case 2: A four-year old girl was treated for pneumonia in the right lung with aggressive intravenous antibiotic. After temporary improvement sudden deterioration was observed. The patient was transferred to the surgery department, where pulmonary gangrene was confirmed. After the lower lobe of the right lung was resected, she was discharged in good health. The careful follow up, accurate diagnosis and correct medication choice are crucial for reducing the complications of “common” pneumonia.

scholarly journals Relationship between Radiological Findings with Bacterial Etiology of Community Acquired Pneumonia in Pediatric Population

2021 ◽  
Author(s):  
Nidhi Pandey ◽  
Garima Mittal ◽  
Nitika Agarwal ◽  
Barnali Kakati ◽  
R.K. Agarwal
Keyword(s):  
Sample Size ◽  
Tertiary Care ◽  
Radiological Finding ◽  
Clinical Signs ◽  
Lower Lobe ◽  
Community Acquired Pneumonia ◽  
World Health ◽  
Care Hospital ◽  
Number Of Patients ◽  
The Right

Pneumonia continues to be a major cause of morbidity and mortality in children. Pneumonia is the leading killer of children worldwide. For the diagnosis of pneumonia, the World Health Organization has introduced guidelines for the management of cases to reduce the mortality of these diseases on the basis of simple clinical signs followed by the empirical treatment with antibiotics. More than 99% of deaths related to pneumonia among children occur in countries having a low and middle income. To study the Radiological finding of Community-Acquired Pneumonia (CAP) in children. Across sectional study was conducted in which the sample size for the study was calculated from the expected prevalence of CAP based on other studies (74%). The sample size calculated by the required criterion for this study is 96. I was able to cover 118 patients as per the inclusion criteria in this study. The Patients of pediatric age groups and either sex attending tertiary care hospital with complaints suggestive of CAP. In this study total number of patients are 118 included who presented with the signs and symptoms suggestive of pneumonia. The findings of chest X-Ray of Right Lung with respect to different bacterial agents. Consolidation of the Right upper lobe is found to be statistically significant with respect to Streptococcus pneumonia and consolidation of the right lower lobe is found to be statistically significant with respect to bacteria Staphylococcus aureus whereas there is no statistically significant association with respect to other bacteria. The radiological finding of CAP in children attending pediatric OPD was observed that there was no association with any other bacteria.

scholarly journals VATS-resection of the lower lobe of the left lung as a result of treatment of the long-term consequences of postponed foreign body aspiration in the child’s airways: Clinical case

2020 ◽  
pp. 90-95
Author(s):  
M. Opanasenko ◽  
◽  
L. Levanda ◽  
A. Tereshkovich ◽  
I. Liskina ◽  
...  
Keyword(s):  
Foreign Body ◽  
Respiratory Tract ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Correct Diagnosis ◽  
Left Lung ◽  
Lower Lobe ◽  
Physical Exertion ◽  
Recurrent Pneumonia ◽  
The Right

Introduction. Foreign bodies in the airways are a very urgent problem that occurs at any age and quite often requires an urgent and sometimes urgent assessment of the situation, examination, and making the right decision. According to statistics, most often foreign body in airway are found in childhood. In about 95–98% of cases, this pathology is recorded in children aged 1.5 to 3 years. This is due to the behavior of children, their anatomical and physiological characteristics and underdevelopment of protective reflexes. Among all cases of foreign body in airway, foreign bodies of the larynx are found in 12%, trachea – in 18%, bronchus – in 70% of cases. In 80% of cases, CTs enter the right bronchus, as it is a broader and more direct continuation of the trachea. The correct diagnosis is established early after CT aspiration in 40–57% of patients. The mortality rate varies, according to different authors, from 2 to 15%. Clinical case. The boy V., born in 2008. was admitted to the Department of Pediatric Pulmonology on May 30, 2019, with complaints of frequent unproductive cough, mainly daytime, increasing with physical exertion, sometimes subfibril body temperature, weakness, lethargy, decrease appetite. These complaints have been observed for the third time in the last six months. Diagnosis: Foreign body B10 of the left lung. Conclusions. Aspiration of a foreign body into the respiratory tract most often occurs in early childhood (1–3 years). The clinical picture in the early stages is asymptomatic, and over time it leads to the development of inflammatory changes in the lungs, are treated conservatively. Given the complexity of diagnosis, aspiration of a foreign body can lead to frequent recurrent pneumonia, the formation of bronchiectasis in the lower parts of the lungs, which may require surgical treatment. The gold standard of diagnostics is fibrobronchoscopy and spiral computed tomography of the thoracic cavity (SCT OGK), with the help of which, early after aspiration, a foreign body can be detected and subsequently excluded from the respiratory tract. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution.The informed consent of the child’s parents was obtained from the studies. No conflict of interest was declared by the authors. Key words: child, lungs, foreign body.

scholarly journals RARE CARDIO-RESPIRATORY FINDINGS IN GOLDENHAR SYNDROME (case report)

2017 ◽  
Vol 4 (4) ◽  
pp. 188-193
Author(s):  
M. Gonchar ◽  
O. Pomazunovska ◽  
O. Logvinova ◽  
A. Kosenko
Keyword(s):  
Left Lung ◽  
Lower Lobe ◽  
Facial Asymmetry ◽  
Branchial Arch ◽  
Speech Disorders ◽  
Severe Form ◽  
Psychomotor Development ◽  
Goldenhar Syndrome ◽  
Intermediate Form ◽  
Facial Skeleton

The Goldenhar Syndrome is the rare congenital abnormalities that include Facio-Auriculo-Vertebral Spectrum, First and Second Branchial Arch Syndrome, Oculo-Auriculo-Vertebral Spectrum, oculo-auriculo-vertebral disorder. Oculo-auriculo-vertebral disorder (OAVD) represents the mildest form of the disorder, while Goldenhar syndrome presents frequently as the most severe form. Hemifacial microstomia appears to be an intermediate form. Goldenhar Syndrome includes patients with facial asymmetry to very severe facial defects (resulting from unilateral facial skeleton hypoplasia) with abnormalities of skeleton and/or internal organs. The most significant are epibulbar dermoids, dacryocystitis, auricular abnormalities, preauricular appendages, preauricular fistulas and hypoplasia of the malar bones, mandible, maxilla and zygomatic arch. Some patients are found to have oculo-auriculo-vertebral disorder, namely low height, delayed psychomotor development, retardation (more frequently seen with cerebral developmental anomalies and microphthalmia), speech disorders (articulation disorders, rhinolalia, different voice disorders, unusual timbre), psycho-social problems, autistic behaviors. The authors describe the clinical case of Goldenhar Syndrome in boy a 3-months-year-old.  This case demonstrates a rarely described association of oculo-auriculo-vertebral disorders, malformation of respiratory system (hypoplasia of the lower lobe of the left lung with relaxation of the left cupula of the diaphragm), heart abnormality (atrium septa defect).Key words: Goldenhar Syndrome, children, diagnostic РІДКІСНІ КАРДІОРЕСПІРАТОРНІ ЗНАХІДКИ ПРИ СИНДРОМІ ГОЛДЕНХАРА.Гончар М.О., Помазуновська О.П., Логвінова О.Л., Тригуб Ю.В., Косенко А.М.Синдром Гольденхара є рідкісною вродженою аномалією, яка включає перший і другий синдром Бінья, окуло-аурикуло-вертебральний спектр, окуло-аурикуло-хребетний синдром. Окуло-аурикула-хребетний синдром є самою м'якою формою розладу, тоді як синдром Гольденхара часто протікає важко. Хеміфаціальная мікростомія - проміжна форма. Синдром Гольденхара включає як пацієнтів з лицьової асиметрією так і з дуже важкими дефектами лицьового черепа (в результаті односторонньої гіпоплазії лицьового скелета) з відхиленнями в будові скелета і / або внутрішніх органів. Найбільш значущими є епібульбарной дермоіди, дакріоцистит, аурікулярні аномалії, предорікулярні придатки, предорікулярні фістули, гіпоплазію нижньої щелепи, верхньої щелепи і щелепної дуги. У деяких пацієнтів виявляється окуло-аурикуло-хребетний синдром, а саме низькорослість, уповільнене психомоторне розвиток, аномалії розвитку мозку і мікрофтальмії, розлад мови, порушення артикуляції, алалия, різні порушення мови, незвичайний тембр голосу і психосоціальні порушення, аутизм. Автори описують клінічний випадок синдрому Гольденхара у хлопчика 3-місячного віку. Цей випадок демонструє асоціацію окуло-аурикула-хребетних розладів які рідко зустрічаються в практиці, мальформацию дихальної системи (гіпоплазію нижньої частки лівої легені з релаксацією лівого купола діафрагми), аномалію серця (дефект міжпредсердної перегородки).Ключові слова: синдром Гольденхара, діти, діагностика РЕДКИЕ КАРДИОРЕСПИРАТОРНЫЕ НАХОДКИ ПРИ СИНДРОМЕ ГОЛДЕНХАРА.Гончарь М.А., Помазуновская Е.П., Логвинова О.Л., Тригуб Ю.В., Косенко А.М.Синдром Голденхара представляет собой редкие врожденные аномалии, которые включают первый и второй синдром Биньяла, окуло-аурикуло-вертебральный спектр, окуло-аурикуло-позвоночный синдром. Окуло-аурикуло-позвоночный синдром (OAVD) представляет собой самую мягкую форму расстройства, тогда как синдром Голденхара часто протекает тяжело. Хемифациальная микростомия представляется промежуточной формой. Синдром Голденхара включает как пациентов с лицевой асимметрией так и с очень тяжелыми дефектами лицевого черепа (в результате односторонней гипоплазии лицевого скелета) с отклонениями в строении скелета и / или внутренних органов. Наиболее значимыми являются эпибульбарные дермоиды, дакриоцистит, аурикулярные аномалии, предорикулярные придатки, предорикулярные фистулы, гипоплазия скуловых костей, нижней челюсти, верхней челюсти и скуловой дуги. У некоторых пациентов выявляется окуло-аурикуло-позвоночный синдром, а именно низкорослость, замедленное психомоторное развитие, аномалии развития мозга и микрофтальмии, расстройство речи, нарушения артикуляции, ринолалия, различные нарушения речи, необычный тембр голоса и психосоциальные нарушения, аутизм. Авторы описывают клинический случай синдрома Голденхара у мальчика 3-месячного возраста. Этот случай демонстрирует редко встречаемую ассоциацию окуло-аурикуло-позвоночных расстройств, мальформацию дыхательной системы (гипоплазию нижней доли левого легкого с релаксацией левого купола диафрагмы), аномалию сердца (дефект перегородки атриума).Ключевые слова: синдром Голденхара, дети, диагностика

Breathing frequency responses to pulmonary CO2 in an isolated lobe of the canine lung

1979 ◽  
Vol 47 (6) ◽  
pp. 1201-1206 ◽  
Author(s):  
J. O. Nilsestuen ◽  
R. L. Coon ◽  
F. O. Igler ◽  
E. J. Zuperku ◽  
J. P. Kampine
Keyword(s):  
Airway Pressure ◽  
Left Lung ◽  
Lower Lobe ◽  
Stretch Receptor ◽  
Left Lower Lobe ◽  
Breathing Frequency ◽  
Frequency Responses ◽  
Mechanical Effects ◽  
Frequency Changes ◽  
The Right

Recent studies have indicated that the breathing frequency responses to inspired CO2 in part result from changes in pulmonary stretch receptor activity. Pulmonary CO2 may alter frequency by direct inhibition of stretch receptor discharge, or secondarily, by changes in airway mechanics. The vascularly isolated left lower lobe (LLL) of the canine lung was used to determine the effect of hypocapnic airway constriction on the pulmonary CO2 reflex. The upper and middle lobes of the left lung were removed and the right vagus nerve sectioned. Blood was recirculated through the LLL. Diaphragm electromyogram was used as an index of respiratory center activity and to trigger ventilation of the left lower lobe. Lobar hypocapnia increased peak airway pressure and reduced respiratory rate. However, infusion of isoproterenol or the use of a mechanical overflow system to block the airway pressure response prevented the frequency changes associated with CO2. Although both the direct and mechanical effects of CO2 on stretch receptors may contribute to the reflex, in the LLL preparation the mechanical effects predominate.

scholarly journals Successful one-lung ventilation by blocking the right intermediate bronchus in a 7-year-old child: a case report

2019 ◽  
Vol 47 (6) ◽  
pp. 2740-2745
Author(s):  
Seung Youp Baek ◽  
Jin Hwan Kim ◽  
Goo Kim ◽  
Jin Ho Choi ◽  
Chang Young Jeong ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Main Bronchus ◽  
Left Lung ◽  
Lung Ventilation ◽  
Surgical Excision ◽  
One Lung Ventilation ◽  
Lower Lung ◽  
Endobronchial Blocker ◽  
Surgical Field ◽  
The Right

A 7-year-old child underwent surgical excision of a benign mesothelioma of the pleura near the right lower lung. Although insertion of a wire-reinforced endotracheal tube through the left main bronchus was attempted for one-lung ventilation to secure the surgical field of view, the attempt failed. Therefore, an endotracheal tube was inserted into the trachea, and an Arndt endobronchial blocker (Cook Medical, Bloomington, IN, USA) was placed in the right intermediate bronchus under bronchoscopic guidance to selectively block the right lower and middle lobes. The surgery was performed while ventilating the right upper lobe and left lung, and no specific intraoperative adverse events occurred.

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