scholarly journals Lung Ultrasound in Patients With Dyspnea From Infective Lung Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Pierluigi Bracciale ◽  
Salvatore Bellanova ◽  
Cristiana Cipriani
Keyword(s):  
Pleural Effusion ◽  
Lung Disease ◽  
Lung Diseases ◽  
Lung Ultrasound ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Cross Sectional ◽  
X Ray ◽  
Significant Difference ◽  
Chest X Ray

Infective lung disease is a spectrum of pulmonary disorders with high prevalence in clinical practice. In the last decade, many studies focused on the clinical usefulness of lung ultrasound (LUS) in the management of patients presenting with dyspnea from infective lung disease. We report data on the methodological and standardized use of bedside LUS in the differential diagnosis of patients with acute dyspnea from infective lung diseases. We performed a cross-sectional study in 439 patients (160 women and 279 men, mean age 64.2 ± 11.5 years, age range 23–91 years) with infective lung diseases. A bedside LUS with a convex probe and chest X-ray were performed in all subjects. Chest CT was performed in a subgroup of patients, as clinically needed. We observed a statistically significant difference in the percentage of pleural effusion and pulmonary consolidation assessed by LUS, compared to X-ray (52.7 vs. 20%, respectively, p < 0.05; 93.6 vs. 48.2%, p < 0.001). The majority of the consolidations detected by LUS were mixed, hypo- and hyperechoic, lesions, with air bronchogram in 40% of cases. All findings assessed by LUS were confirmed by chest CT, when performed. We describe the actual role of LUS in the assessment of patients with infective lung disease. It has higher sensitivity compared to chest X-ray in the detection of pleural effusion. Consolidations from infective lung disease have mostly mixed echogenicity by LUS.

CLINICAL CORRELATION AND AGREEMENT BETWEEN THE CHEST CT SCAN AND CHEST X-RAY FINDINGS IN TUBERCULIN-POSITIVE CHILDREN: A PROSPECTIVE CROSS SECTIONAL STUDY

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 40S
Author(s):  
Beverly D. Delacruz ◽  
Nerissa A. Deleon ◽  
Milagros S. Bautista ◽  
Fernando Ayuyao ◽  
Teresita Deguia
Keyword(s):  
Ct Scan ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Clinical Correlation ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

scholarly journals Correlation between Chest X-Ray Severity in COVID-19 and Age in Mexican-Mestizo Patients: An Observational Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Arturo Albrandt-Salmeron ◽  
Ruby Espejo-Fonseca ◽  
Ernesto Roldan-Valadez
Keyword(s):  
Age Groups ◽  
Rank Correlation ◽  
Cross Sectional Study ◽  
European Population ◽  
Cross Sectional ◽  
Mexican Mestizo ◽  
X Ray ◽  
Significant Difference ◽  
Chest X Ray ◽  
Males And Females

Introduction. Chest X-ray (CXR) is used for the initial triage of patients with suspected COVID-19. Studies of CXR scoring in the European population found a higher score in males than in females and significantly correlated with age. Because there have not been studies in the Mexican-mestizo community, we aimed to compare the differences in CXR scores between males and females and their correlation with age after controlling comorbidities like diabetes and hypertension. Materials and Methods. A retrospective study of 1000 CXR of Mexican-mestizo patients with SARS-CoV-2 infection, confirmed by RT-PCR. Significant differences between age, age groups, symptoms, comorbidities, and CXR scores between males and females used the Mann–Whitney U , Chi-square tests ( χ 2 ), and Kruskal–Wallis tests. The relationship between the total CXR score and age was measured with the Spearman rank correlation coefficient (Rs); partial correlation analysis controlled the effect of symptoms, risk factors, and comorbidities. Results. The total CXR score did not show a difference between males and females grouped by age. There was a positive, low correlation between the total CXR score and age in males, Rs = 0.260 , p < 0.001 ( N = 616 ), and in females, Rs = 0.170 , p = 0.001 ( N = 384 ). Age only explained a <9% variance of CXR severity. Rs decreased its magnitude (from Rs = 0.152 to Rs = 0.046 ) and lost its significance (change in p value from p < 0.001 to p = 0.145 ) after controlling the effect of hypertension. Conclusions. There is no significant difference in CXR score between males and females in the Mexican-mestizo population grouped by age. Hypertension cancels the significance of CXR severity with age pointing to its role in the pathophysiology of COVID-19. Further research using stratified groups by age and gender in other populations needs to be published.

scholarly journals Sputum smear positivity grade and chest X-ray findings in tuberculosis: A cross-sectional study

2021 ◽  
Author(s):  
R. Behzadmehr ◽  
E. Nejadkehkha
Keyword(s):  
Cross Sectional Study ◽  
Health Concern ◽  
Sputum Smear ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
X Ray ◽  
High Prevalence ◽  
Chest X Ray

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively.  In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.

scholarly journals Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Joanitah Nalunjogi ◽  
Frank Mugabe ◽  
Irene Najjingo ◽  
Pastan Lusiba ◽  
Francis Olweny ◽  
...  
Keyword(s):  
Screening Tool ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Case Detection ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Number Needed To Screen ◽  
Screening Algorithm ◽  
Chest X Ray

The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.

Comparison of granulomatosis with polyangiitis clinical features in patients depending of involvement or absence of kidney involvement

2021 ◽  
Vol 17 ◽  
Author(s):  
Mateusz Puchala ◽  
Andrzej Rydzewski ◽  
Ilona Kowalik ◽  
Małgorzata Wisłowska
Keyword(s):  
Clinical Features ◽  
Crescentic Glomerulonephritis ◽  
Immunosuppressive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Small Vessels ◽  
Kidney Involvement ◽  
Chest X Ray ◽  
The Mean

Background: GPA is a necrotizing inflammation of the small vessels with granulomas. Kidney involvement deteriorated its prognosis. Objective: Comparison of GPA patients with kidney (KI) and without kidney involvement (nKI). Material and methods: We conducted a cross-sectional study of 50 consecutive adult GPA patients, 25 KI from Nephrology and 25 nKI from Rheumatology Department of Central Clinical Hospital Ministry of Interior in Warsaw. We analyzed clinical features, organ involvement, laboratory, serological, imaging, histopathological data, BVAS, treatment. Results: The mean age of KI patients was statistically older then nKI (67.3±9.5 vs 55.1±15.9, p=0.002). Generalized, severe, resistance disease was observed respectively in 92% vs 44%, p<0.001. The number of red blood cells (3.47 vs 4.41T/l, p<0.001), hemoglobin (10.0 vs 12.9g/dl, p<0.001) was lower in KI, higher mean serum creatinine (3.95 vs. 0.89mg/dl, p<0.001), lower GFR (20.1 vs. 79.3, p<0.001), higher CRP (median: 43.4 vs 2.0mg/l, p<0.001), BVAS (16.6±4.4 vs 10.1±6.2, p<0.001), c-ANCA (median: 119.0 vs 15.2CU, p=0.017). Nodules in 28% KI, in 4% nKI (p=0.048) in chest X-ray, infiltration in 43.5% KI, in 15% nKI (p=0.042) in HRCT were observed. Skin granulomas were found in 61.5% nKI vs 18.2% KI, (p=0.047). Renal biopsy revealed in KI patients focal segmental glomerulonephritis in 11.8%, crescentic glomerulonephritis in 17.6%, pauci-immune crescentic glomerulonephritis in 70.6%. Conclusions: In patients with KI more frequently we found generalized, severe, resistant GPA, higher BVAS in comparison in patients without KI. The results of laboratory parameters, were worse in patients with KI. Aggressive immunosuppressive treatment is often used in KI group.

scholarly journals Ventilator-associated pneumonia in neonates: the role of point of care lung ultrasound

2020 ◽  
Vol 180 (1) ◽  
pp. 137-146
Author(s):  
Nora Tusor ◽  
Angela De Cunto ◽  
Yousef Basma ◽  
John L. Klein ◽  
Virginie Meau-Petit
Keyword(s):  
Lung Disease ◽  
Chronic Lung Disease ◽  
Lung Ultrasound ◽  
Clinical Laboratory ◽  
Control Group ◽  
Ventilator Associated Pneumonia ◽  
Lung Pathology ◽  
Rater Agreement ◽  
X Ray ◽  
Chest X Ray

AbstractNo consensus exists regarding the definition of ventilator-associated pneumonia (VAP) in neonates and reliability of chest X-ray (CXR) is low. Lung ultrasound (LU) is a potential alternative diagnostic tool. The aim was to define characteristics of VAP in our patient population and propose a multiparameter score, incorporating LU, for VAP diagnosis. Between March 25, 2018, and May 25, 2019, infants with VAP were identified. Clinical, laboratory and microbiology data were collected. CXRs and LU scans were reviewed. A multiparameter VAP score, including LU, was calculated on Day 1 and Day 3 for infants with VAP and for a control group and compared with CXR. VAP incidence was 10.47 episodes/1000 ventilator days. LU and CXR were available for 31 episodes in 21 infants with VAP, and for six episodes in five patients without VAP. On Day 1, a VAP score of > 4, and on Day 3 a score of > 5 showed sensitivity of 0.94, and area under the curve of 0.91 and 0.97, respectively. AUC for clinical information only was 0.88 and for clinical and CXR 0.85.Conclusion: The multiparameter VAP score including LU could be useful in diagnosing VAP in neonates with underlying lung pathology. What is Known:• Ventilator associated pneumonia (VAP) is common in infants on the neonatal unit and is associated with increased use of antibiotics, prolonged ventilation and higher incidence of chronic lung disease.• Commonly used definitions of VAP are difficult to apply in neonates and interpretation of chest X-ray is challenging with poor inter-rater agreement in patients with underlying chronic lung disease. What is New:• The multiparameter VAP score combining clinical, microbiology and lung ultrasound (LU) data is predictive for VAP diagnosis in preterm infants with chronic lung disease.• LU findings of VAP in neonates showed high inter-rater agreement and included consolidated lung areas, dynamic bronchograms and pleural effusion.

scholarly journals (F)utility of computed tomography of the chest in the presence of pleural effusion

2017 ◽  
Vol 2 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Tilak Pathak ◽  
Malvinder S. Parmar
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Ct Scan ◽  
Clinical Management ◽  
Chest Ct ◽  
X Ray ◽  
Contrast Enhanced ◽  
Plain Chest ◽  
Chest X Ray ◽  
Chest Ct Scan

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.

scholarly journals Cross-sectional imaging of the torso reveals occult injuries in asymptomatic blunt trauma patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Gregory J. Roberts ◽  
Lewis E. Jacobson ◽  
Michelle M. Amaral ◽  
Courtney D. Jensen ◽  
Louis Cooke ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Chest Ct ◽  
Physical Exam ◽  
Trauma Patients ◽  
Cross Sectional ◽  
X Ray ◽  
Cross Sectional Imaging ◽  
Normal Chest ◽  
Chest X Ray ◽  
Sectional Imaging

Abstract Background High morbidity and mortality rates of trauma injuries make early detection and correct diagnosis crucial for increasing patient’s survival and quality of life after an injury. Improvements in technology have facilitated the rapid detection of injuries, especially with the use of computed tomography (CT). However, the increased use of CT imaging is not universally advocated for. Some advocate for the use of selective CT imaging, especially in cases where the severity of the injury is low. The purpose of this study is to review the CT indications, findings, and complications in patients with low Injury Severity Scores (ISS) to determine the utility of torso CT in this patient cohort. Methods A retrospective review of non-intubated, adult blunt trauma patients with an initial GCS of 14 or 15 evaluated in an ACS verified level 1 trauma center from July 2012 to June 2015 was performed. Data was obtained from the hospital’s trauma registry and chart review, with the following data included: age, sex, injury type, ISS, physical exam findings, all injuries recorded, injuries detected by torso CT, missed injuries, and complications. The statistical tests conducted in the analysis of the collected data were chi-squared, Fischer exact test, and ANOVA analysis. Results There were 2306 patients included in this study, with a mean ISS of 8. For patients with a normal chest exam that had a chest CT, 15% were found to have an occult chest injury. In patients with a negative chest exam and negative chest X-ray, 35% had occult injuries detected on chest CT. For patients with a negative abdominal exam and CT abdomen and pelvis, 16% were found to have an occult injury on CT. Lastly, 25% of patients with normal chest, abdomen, and pelvis exams with chest, abdomen, and pelvis CT scans demonstrated occult injuries. Asymptomatic patients with a negative CT had a length of stay 1 day less than patients without a corresponding CT. No incidents of contrast-induced complications were recorded. Conclusions A negative physical exam combined with a normal chest X-ray does not rule out the presence of occult injuries and the need for torso imaging. In blunt trauma patients with normal sensorium, physical exam and chest X-ray, the practice of obtaining cross-sectional imaging appears beneficial by increasing the accuracy of total injury burden and decreasing the length of stay.

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