scholarly journals Characteristics of Chest X-Ray in Patients with Cancer at the Dharmais Cancer Hospital Emergency Room during the COVID-19 Pandemic

2021 ◽  
Vol 15 (4) ◽  
pp. 195
Author(s):  
Bima Taruna Sakti ◽  
Rosalina Rosalina ◽  
Jaka Pradipta
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Pleural Effusion ◽  
Pleural Effusions ◽  
Hospital Emergency ◽  
X Ray ◽  
Patients With Cancer ◽  
Cancer Hospital ◽  
Hospital Emergency Room ◽  
Chest X Ray

Background: Conventional chest X-ray (chest X-ray) in Dharmais Cancer Hospital emergency room (ER) is still the primary modality to diagnose patients with cancer with dyspnoea complaints. Chest X-ray was also carried out to screen inpatients at the Dharmais Cancer Hospital ER at the beginning of the COVID-19 pandemic in Indonesia. It was essential because patients in the Dharmais Cancer Hospital ER were patients with cancer, with low immunity and a high risk of being exposed to various infections. Thus, the purpose of this study was to determine the characteristics of chest X-rays in patients with cancer at the Dharmais Cancer Hospital ER during the COVID-19 pandemic in February-May 2020. Methods: This was a descriptive study. The population involved was all patients at the Dharmais Cancer Hospital ER who received chest X-ray support, with the inclusion criteria for diagnosing lung cancer, breast cancer, cervical cancer, colorectal cancer, and blood cancer (Leukemia) from February to May 2020. Data analysis employed univariate analysis by utilizing tables and graphs in presenting the data.Results: 289 samples met the research criteria. The highest visits were patients with breast cancer (41.2%). The most common thoracic images were pleural effusion (34.3%), followed by bronchopneumonia (31.1%), normal lung (16.6%), lung mass (7.6%), pneumonia (5.2%), and others (5.2%), consisting of atelectasis, bronchitis, fibrosis/chronic pulmonary process, pulmonary emphysema, cardiomegaly, and specific process. Besides, the chest x-ray bronchopneumonia was 31.1% (90 samples), accompanied by pleural effusion of 44.4%. From the chest X-ray, pleural effusions were 34.3% (99 samples), with lung cancer being the most common with pleural effusions (48.4%).Conclusions: More than 80% of chest x-ray performed in the ER are abnormal. Also, breast cancer is the highest in the Dharmais Cancer Hospital ER cases, with the highest chest x-ray of pleural effusion.

scholarly journals Markers in Breast and Lung Cancer

1982 ◽  
Vol 19 (4) ◽  
pp. 263-268 ◽  
Author(s):  
R C Coombes ◽  
D P Dearnaley ◽  
Morag L Ellison ◽  
A M Neville
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Biochemical Markers ◽  
Breast Cancer Cells ◽  
Liver Function Tests ◽  
X Ray ◽  
Large Molecular Weight ◽  
Chest X Ray ◽  
Sensitive Method

We have investigated the role of biochemical markers in breast and lung cancer but have found that currently available tests have little role in management. In breast cancer, for example, we have found that the most sensitive method for routine screening for metastases is by using chest x-ray and clinical examination, liver function tests, and carcinoembryonic antigen measurements. We are now examining other methods for detecting metastases using immunocytochemistry in cytological preparations of bone marrow and attempting to raise monoclonal antibodies to breast cancer cells. In lung cancer, the major effort has been directed towards characterisation of large-molecular-weight ectopic hormones, particularly calcitonin.

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

scholarly journals Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation

2013 ◽  
Vol 53 (1) ◽  
pp. 6
Author(s):  
Indah Nurhayati ◽  
Muhammad Supriatna ◽  
Kamilah Budhi Raharjani ◽  
Eddy Sudijanto
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Study ◽  
Pleural Effusion ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Patient Outcomes ◽  
Morbidity And Mortality ◽  
Chi Square ◽  
X Ray ◽  
Chest X Ray

Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonarydisease as underlying conditions. Mechanical ventilation may beused to limit morbidity and mortality in children with respiratoryfailure.Objective To assess a correlation between chest x-ray findingsand outcomes of patients with mechanical ventilation.Methods This retrospective study was held in Dr. KariadiHospital, Semarang, Indonesia. Data was collected from themedical records of children admitted to the PICU from Januaryto December 2010, who suffered from respiratory distress andused mechanical ventilation. We compared chest x-ray findings tothe outcomes of patients. Radiological expertise was provided byradiologists on duty at the time. Chi-square and logistic regressiontests were used for statistical analysis.Results There were 63 subjects in our study, consisting of 28 malesand 35 females. Patient outcomes were defined as survived or died,43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-rayfindings revealed the following conditions: bronchopneumonia48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;95%CI 0.03 to 7 .62). None of the chest x-ray findings significantlycorrelated to patient outcomes.Conclusion Chest x-ray findings do not correlate to patientoutcomes in pediatric subjects with mechanical ventilation inthe PICU of Dr. Kariadi Hospital, Semarang, Indonesia.

scholarly journals Is Routine Chest X-ray After Ultrasound and Intracavitary Electrocardiogram Guided Peripherally Inserted Central Catheter Insertion Choosing Wisely? A Population-based Retrospective Study of 2857 Patients With Cancer

2021 ◽  
Author(s):  
Yan-Fen Shen ◽  
Jing Dong ◽  
Xin-Peng Wang ◽  
Xiao-Zheng Wang ◽  
Yuan-Yuan Zheng ◽  
...  
Keyword(s):  
Venous Access ◽  
Population Based ◽  
X Ray ◽  
Patients With Cancer ◽  
Potential Risk Factors ◽  
Catheter Tip ◽  
Chest X Ray ◽  
Clinical Records ◽  
The Cost ◽  
Routine Chest

Abstract Background: In China, routine chest X-ray (CXR) is generally required for peripherally inserted central venous catheters (PICC) to determine the position of the catheter tip. The aim of this study is to assess the value of a routine post-procedural CXR in the era of ultrasound and intracavitary electrocardiography(IC-ECG) -guided PICC insertion. Methods: A retrospective population-based cohort study was conducted to review the clinical records of all patients who had PICCs in the Venous Access Center of Beijing Cancer Hospital between January 1, 2019 and June 30, 2020. The incidence of catheter misplacement after insertion was measured. A logistic regression analysis was performed to examine potential risk factors associated with PICC-related complications and a cost analysis to assess the economic impact of the use of CXR.Results: There were 2,857 samples from 2,647 patients included. The overall incidence of intraoperative and postoperative catheter misplacement was 7.4% (n=210) and 0.67% (n=19), respectively. There was a high risk of postoperative catheter misplacement when the left-arm was chosen for placement (OR: 10.478; 95% CI: 3.467-31.670; p<0.001). The cost of performing CXR for screening of PICC-related complications was $23,808 per year, and that of using CXR to diagnose one case of catheter misplacement was $1253.Conclusion: This study confirms that misplacement of PICCs guided by ultrasound and IC-ECG is rare and that postoperative CXR is very costly. In our setting, routine postoperative CXR is unnecessary and not a wise option.

scholarly journals Associations between general practice characteristics and chest x-ray rate: an observational study

2021 ◽  
pp. BJGP.2021.0232
Author(s):  
Stephen H Bradley ◽  
Matthew Barclay ◽  
Benjamin Cornwell ◽  
Gary A Abel ◽  
Matthew Callister ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Patient Satisfaction ◽  
Observational Study ◽  
Population Characteristics ◽  
Substantial Variation ◽  
X Ray ◽  
Patient Satisfaction Scores ◽  
Improved Outcomes ◽  
Chest X Ray ◽  
General Practices

Background: Chest x-ray (CXR) is the first-line test for lung cancer in many settings. Previous research has suggested that higher utilisation of CXR is associated with improved outcomes. Aim: To explore the associations between characteristics of general practices and frequency of investigation with CXR. Design & Setting: Retrospective observational study of English general practices. Method: We constructed a database of English general practices containing number of CXRs requested and data on practices for 2018, including patient & staff demographics, smoking prevalence, deprivation and patient satisfaction indicators. Mixed effects Poisson modelling was used to account for variation due to chance and to estimate the amount of remaining variation that could be attributed to practice and population characteristics. Results: There was substantial variation in GP CXR rates (median 34 per 1000 patients, IQR 26-43). Only 18% of between-practice variance in CXR rate was accounted for by recorded characteristics. Higher practice scores for continuity and communication skills and higher proportions of smokers, Asian and mixed ethnic groups, and patients aged >65 were associated with increased CXR rates. Higher patient satisfaction scores for access and with greater proportions of male and patients of black ethnicity were associated with lower CXR rates. Conclusion: Substantial variation was found in CXR rates beyond that expected by chance, which could not be accounted for by practices’ recorded characteristics. Since other research has indicated that increasing CXR rates can lead to earlier detection, supporting practices which currently investigate infrequently could be an effective strategy to improve lung cancer outcomes.

Differential diagnosis of hemoptysis

2021 ◽  
pp. 47-55
Author(s):  
Petr Arkadievich Ilyin
Keyword(s):  
Infectious Disease ◽  
Computed Tomography ◽  
Lung Cancer ◽  
Differential Diagnosis ◽  
Correct Interpretation ◽  
Diagnostic Investigation ◽  
Detailed History ◽  
X Ray ◽  
Chest X Ray ◽  
Upper Gastrointestinal

Blood expectoration or hemoptysis is the coughing up of sputum with blood from the larynx, bronchi or lungs. Hemoptysis is most often caused by diseases of the respiratory tract and lungs — bronchitis or pneumonia, as well as lung cancer, aspergilloma, tuberculosis, bronchiectasis, pulmonary embolism, etc. In the diagnostic investigation of the cause of hemoptysis, it is important to take a detailed history (in the case of an epidemiological history, a laboratory analysis of the secreted sputum for the detection of the causative agent of an infectious disease is necessary), to make the correct interpretation of the patient’s complaints and an assessment of the nature of the sputum (differential diagnosis with bleeding from the upper gastrointestinal tract). A chest X-ray is performed and, then, if indicated, computed tomography, bronchoscopy, and other studies are made. The article presents an algorithm for differential diagnostic investigation of hemoptysis in a patient

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