scholarly journals Acute Respiratory Distress Revealing an Unrecognized Tracheostomy Cannula at the Bronchial Level in the Pandemic COVID Era

2021 ◽  
Vol 3 (3) ◽  
pp. 72-74
Author(s):  
Mohamed Chehbouni ◽  
Othmane Benhoummad
Keyword(s):  
Postoperative Complications ◽  
Respiratory Distress ◽  
Ct Scan ◽  
Total Laryngectomy ◽  
Elderly Subject ◽  
Rare Case ◽  
Long Period ◽  
Thoracic Ct ◽  
Dementia Syndrome ◽  
Thoracic Ct Scan

The tracheostomy is a surgical opening of the trachea which is made at the level of its anterior face, 2 cm above the sternal fork permitting the placement of a tracheostomy cannula in a temporary or definitive way and this according to the indication of its realization. The tracheostomy is the surgical connection of the trachea to the skin. The prolonged wearing of a tracheostomy cannula at the level of the tracheostomy orifice can expose to certain complications which can prove to be serious. It presents risks of postoperative complications, especially late ones. The most frequent are granulomas, tracheal stenosis, infections, and fistulas. Tracheal or tracheobronchial migration of the tracheostomy cannula remains exceptional. We present a very rare case of an elderly subject followed for Parkinson's disease with a dementia syndrome, who underwent a total laryngectomy 3 years ago with prolonged placement of a tracheostomy cannula at the tracheostomy orifice. The patient presented to the emergency room with progressively worsening respiratory distress and desaturation, evolving in a febrile context, suggesting a sars cov19 infection in the current epidemiological context. A thoracic CT scan rectified the diagnosis by showing a pneumopathy on an unrecognized tracheotomy cannula at the tracheobronchial level. Indeed, this complication is secondary to the embrittlement of the cannula following poor maintenance. The use of a tracheostomy cannula for a long period of time requires a regular and particular surveillance, a rigorous maintenance and care of the cannula to avoid the occurrence of complications which can be seriousThe tracheostomy is a surgical opening of the trachea which is made at the level of its anterior face, 2 cm above the sternal fork permitting the placement of a tracheostomy cannula in a temporary or definitive way and this according to the indication of its realization. The tracheostomy is the surgical connection of the trachea to the skin. The prolonged wearing of a tracheostomy cannula at the level of the tracheostomy orifice can expose to certain complications which can prove to be serious. It presents risks of postoperative complications, especially late ones. The most frequent are granulomas, tracheal stenosis, infections, and fistulas. Tracheal or tracheobronchial migration of the tracheostomy cannula remains exceptional. We present a very rare case of an elderly subject followed for Parkinson's disease with a dementia syndrome, who underwent a total laryngectomy 3 years ago with prolonged placement of a tracheostomy cannula at the tracheostomy orifice. The patient presented to the emergency room with progressively worsening respiratory distress and desaturation, evolving in a febrile context, suggesting a sars cov19 infection in the current epidemiological context. A thoracic CT scan rectified the diagnosis by showing a pneumopathy on an unrecognized tracheotomy cannula at the tracheobronchial level. Indeed, this complication is secondary to the embrittlement of the cannula following poor maintenance. The use of a tracheostomy cannula for a long period of time requires a regular and particular surveillance, a rigorous maintenance and care of the cannula to avoid the occurrence of complications which can be serious.

Thoracic CT Scan vs PET-TC Imaging in the Diagnosis of Patients Suffering Exudative Pleural Effusions with Suspicion of Malignancy

2019 ◽  
Vol 55 (10) ◽  
pp. 546
Author(s):  
Marc Simó ◽  
Esther Pallisa ◽  
Alberto Jaúregui ◽  
Bruno Montoro ◽  
Ana Vázquez ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pleural Effusions ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

scholarly journals Impact of emergency physician experience on decision-making in patients with suspected community-acquired pneumonia and undergoing systematic thoracic CT scan

2019 ◽  
Vol 36 (8) ◽  
pp. 485-492
Author(s):  
Josselin Le Bel ◽  
Thierry Pelaccia ◽  
Patrick Ray ◽  
Charles Mayaud ◽  
Anne-Laure Brun ◽  
...  
Keyword(s):  
Ct Scan ◽  
Emergency Physician ◽  
Patient Management ◽  
Univariate Analysis ◽  
Community Acquired Pneumonia ◽  
Emergency Physicians ◽  
Thoracic Ct ◽  
Thoracic Ct Scan ◽  
Adjudication Committee ◽  
Diagnosis Classification

ObjectivesTo determine whether the impact of a thoracic CT scan on community-acquired pneumonia (CAP) diagnosis and patient management varies according to emergency physician’s experience (≤10 vs >10 years).MethodsEarly thoracic CT Scan for Community-Acquired Pneumonia at the Emergency Department is an interventional study conducted from November 2011 to January 2013 in four French emergency departments, and included suspected patients with CAP. We analysed changes in emergency physician CAP diagnosis classification levels before and after CT scan; and their agreement with an adjudication committee. We performed univariate analysis to determine the factors associated with modifying the diagnosis classification level to be consistent with the radiologist’s CT scan interpretation.Results319 suspected patients with CAP and 136 emergency physicians (75% less experienced with ≤10 years, 25% with >10 years of experience) were included. The percentage of patients whose classification was modified to become consistent with CT scan radiologist’s interpretation was higher among less-experienced than experienced emergency physicians (54.2% vs 40.2%; p=0.02). In univariate analysis, less emergency physician experience was the only factor associated with changing a classification to be consistent with the CT scan radiologist’s interpretation (OR 1.77, 95% CI 1.01 to 3.10, p=0.04). After CT scan, the agreement between emergency physicians and adjudication committee was moderate for less-experienced emergency physicians and slight for experienced emergency physicians (k=0.457 and k=0.196, respectively). After CT scan, less-experienced emergency physicians modified patient management significantly more than experienced emergency physicians (36.1% vs 21.7%, p=0.01).ConclusionsIn clinical practice, less-experienced emergency physicians were more likely to accurately modify their CAP diagnosis and patient management based on thoracic CT scan than more experienced emergency physicians.Trial registration numberNCT01574066

Chondrosarcoma in Mafucci’s syndrome – an interdisciplinary approach to a rare disease

2012 ◽  
Vol 153 (26) ◽  
pp. 1035-1038 ◽  
Author(s):  
Balázs Forgács
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Multidisciplinary Approach ◽  
Pulmonary Metastases ◽  
Interdisciplinary Approach ◽  
Thoracic Ct ◽  
Upper And Lower Extremities ◽  
The Right ◽  
Thoracic Ct Scan ◽  
Very High

Mafucci’s syndrome is a rare genetic but non-hereditary disorder, characterized by multiple enchondromas (enchondromatosis), hemangiomas and, rarely, lymphangiomas. The risk for malignant transformation of enchondromas is very high, and chondrosarcomas can develop which mainly metastatize to the lungs. A case report of a 61-years-old male, whose enchondromatosis developed at his age of 10 years, is described. The initial diagnosis had been Ollier’s disease at that time, and it was modified to Mafucci’s syndrome only in 1995 when hemangiomatosis developed on the right hand. He had a unilateral disorder affecting his right upper and lower extremities. In 2010, a chondrosarcoma developed on his right leg and amputation was performed. In 2012, a thoracic CT scan revealed pulmonary metastases on both sides. This case report underlines the importance of the multidisciplinary approach and cooperation between various specialties in diagnosing and early detecting this type of cancer. Orv. Hetil., 2012, 153, 1035–1038.

scholarly journals Pulmonary Artery Diameter on Thoracic CT Scan and Its Relationship to Pulmonary Artery Pressure

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 823A
Author(s):  
Mohammad Khalid ◽  
Sarfraz Saleemi ◽  
Abdullah AlDalaan ◽  
Mohammad Zeitouni ◽  
Abdullah Mobeireek ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Ct Scan ◽  
Pulmonary Artery Pressure ◽  
Artery Pressure ◽  
Thoracic Ct ◽  
Thoracic Ct Scan ◽  
Pulmonary Artery Diameter

Direct Access Thoracic CT Scan: Impact of Change in Pathway on Wait Times

CHEST Journal ◽  
2015 ◽  
Vol 148 (4) ◽  
pp. 557A
Author(s):  
Jayanth Bhat ◽  
Javed Ibrahim ◽  
Subashini Chandrapalan ◽  
Ashwin Rajhan ◽  
Nick Watson ◽  
...  
Keyword(s):  
Ct Scan ◽  
Direct Access ◽  
Wait Times ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan?

1995 ◽  
Vol 152 (2) ◽  
pp. 524-530 ◽  
Author(s):  
F Brunet ◽  
D Jeanbourquin ◽  
M Monchi ◽  
J P Mira ◽  
L Fierobe ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ct Scan ◽  
Blood Gases ◽  
Lung Mechanics ◽  
Thoracic Ct ◽  
Thoracic Ct Scan

scholarly journals Circulating Vitamin D levels status and clinical prognostic indices in COVID-19 patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Ricci ◽  
Alessandra Pagliuca ◽  
Michela D’Ascanio ◽  
Marta Innammorato ◽  
Claudia De Vitis ◽  
...  
Keyword(s):  
Vitamin D ◽  
T Lymphocytes ◽  
Immune Responses ◽  
Ct Scan ◽  
Vitamin D Deficiency ◽  
Plasma Levels ◽  
Cd8 T Lymphocytes ◽  
Thoracic Ct ◽  
Vitamin D Levels ◽  
Thoracic Ct Scan

Abstract Background Several immune mechanisms activate in COVID-19 pathogenesis. Usually, coronavirus infection is characterized by dysregulated host immune responses, interleukine-6 increase, hyper-activation of cytotoxic CD8 T lymphocytes. Interestingly, Vitamin D deficiency has been often associated with altered immune responses and infections. In the present study, we evaluated Vitamin D plasma levels in patients affected with different lung involvement during COVID-19 infection. Methods Lymphocyte phenotypes were assessed by flow cytometry. Thoracic CT scan involvement was obtained by an image analysis program. Results Vitamin D levels were deficient in (80%) of patients, insufficient in (6.5%) and normal in (13.5%). Patients with very low Vitamin D plasma levels had more elevated D-Dimer values, a more elevated B lymphocyte cell count, a reduction of CD8 + T lymphocytes with a low CD4/CD8 ratio, more compromised clinical findings (measured by LIPI and SOFA scores) and thoracic CT scan involvement. Conclusions Vitamin D deficiency is associated with compromised inflammatory responses and higher pulmonary involvement in COVID-19 affected patients. Vitamin D assessment, during COVID-19 infection, could be a useful analysis for possible therapeutic interventions. Trial registration: 'retrospectively registered'.

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