scholarly journals Lung ultrasound: a narrative review and proposed protocol for patients admitted to Cardiac Rehabilitation Unit

2021 ◽  
Author(s):  
Dario Tino Bertolone ◽  
Cristina De Colle ◽  
Francesco Rozza ◽  
Ilaria Fucile ◽  
Ciro Santoro ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Lung Ultrasound ◽  
Computerize Tomography ◽  
Low Cost ◽  
Diagnostic Methods ◽  
Lung Ultrasonography ◽  
Rehabilitation Unit ◽  
Severe Condition ◽  
Additional Tool ◽  
Consensus Document

Lung ultrasonography (LUS) has become in the last 10 years a technique that has reduced the need of second level diagnostic methods such as chest X-ray (CXR) and computerize tomography (CT) for the diagnostic imaging of lung and pleural space, throughout its diagnostic accuracy, radiation free, low cost, real time and bedside approach. The common use of LUS has been recently extend to cardiac and pulmonary disease even in context of Cardiac Rehabilitation Unit and it could be an additional tool for physiotherapist for the management of patients during Rehabilitation course. The authors performed a literature review in PubMed and suggested a new standardize protocol for LUS, based on guidelines and expert consensus document, for patients admitted to Cardiac Rehabilitation Unit. In this protocol, LUS should be performed in six scan each hemithorax, covering twelve imagine regions. For each scan will be noted a specific physiologic or pathological patterns. Furthermore, we suggest for each patient, the use of the Lung Ultrasound Score (LUS score) to obtain a global view of lung aeration and to monitor any changes during the hospitalization. An increase in score range indicates a more severe condition. This Lung Ultrasonography Protocol should be performed in all patients at the time of admission to Cardiac Rehabilitation Unit to monitoring the aeration of the lungs and the possible lung and/or pleura complications after a cardiac disease avoiding the use of second level surveys.

scholarly journals Patients in intensive care unit for COVID-19 pneumonia: the lung ultrasound patterns at admission and discharge. An observational pilot study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Persona Paolo ◽  
Valeri Ilaria ◽  
Zarantonello Francesco ◽  
Forin Edoardo ◽  
Sella Nicolò ◽  
...  
Keyword(s):  
Intensive Care ◽  
Lung Ultrasound ◽  
Low Cost ◽  
Low Frequency ◽  
Specific Pattern ◽  
University Hospital ◽  
Left Hemithorax ◽  
Significant Difference ◽  
The Right ◽  
B Lines

Abstract Background During COVID-19 pandemic, optimization of the diagnostic resources is essential. Lung Ultrasound (LUS) is a rapid, easy-to-perform, low cost tool which allows bedside investigation of patients with COVID-19 pneumonia. We aimed to investigate the typical ultrasound patterns of COVID-19 pneumonia and their evolution at different stages of the disease. Methods We performed LUS in twenty-eight consecutive COVID-19 patients at both admission to and discharge from one of the Padua University Hospital Intensive Care Units (ICU). LUS was performed using a low frequency probe on six different areas per each hemithorax. A specific pattern for each area was assigned, depending on the prevalence of A-lines (A), non-coalescent B-lines (B1), coalescent B-lines (B2), consolidations (C). A LUS score (LUSS) was calculated after assigning to each area a defined pattern. Results Out of 28 patients, 18 survived, were stabilized and then referred to other units. The prevalence of C pattern was 58.9% on admission and 61.3% at discharge. Type B2 (19.3%) and B1 (6.5%) patterns were found in 25.8% of the videos recorded on admission and 27.1% (17.3% B2; 9.8% B1) on discharge. The A pattern was prevalent in the anterosuperior regions and was present in 15.2% of videos on admission and 11.6% at discharge. The median LUSS on admission was 27.5 [21–32.25], while on discharge was 31 [17.5–32.75] and 30.5 [27–32.75] in respectively survived and non-survived patients. On admission the median LUSS was equally distributed on the right hemithorax (13; 10.75–16) and the left hemithorax (15; 10.75–17). Conclusions LUS collected in COVID-19 patients with acute respiratory failure at ICU admission and discharge appears to be characterized by predominantly lateral and posterior non-translobar C pattern and B2 pattern. The calculated LUSS remained elevated at discharge without significant difference from admission in both groups of survived and non-survived patients.

scholarly journals Validation of Differentially Expressed Immune Biomarkers in Latent and Active Tuberculosis by Real-Time PCR

2021 ◽  
Vol 11 ◽  
Author(s):  
Prem Perumal ◽  
Mohamed Bilal Abdullatif ◽  
Harriet N. Garlant ◽  
Isobella Honeyborne ◽  
Marc Lipman ◽  
...  
Keyword(s):  
Low Cost ◽  
Peripheral Blood Leukocyte ◽  
Primary Diagnosis ◽  
Diagnostic Methods ◽  
World Health ◽  
Molecular Diagnostic ◽  
Roc Curve Analysis ◽  
Simple Arithmetic ◽  
Immune Biomarkers ◽  
The Uk

Tuberculosis (TB) remains a major global threat and diagnosis of active TB ((ATB) both extra-pulmonary (EPTB), pulmonary (PTB)) and latent TB (LTBI) infection remains challenging, particularly in high-burden countries which still rely heavily on conventional methods. Although molecular diagnostic methods are available, e.g., Cepheid GeneXpert, they are not universally available in all high TB burden countries. There is intense focus on immune biomarkers for use in TB diagnosis, which could provide alternative low-cost, rapid diagnostic solutions. In our previous gene expression studies, we identified peripheral blood leukocyte (PBL) mRNA biomarkers in a non-human primate TB aerosol-challenge model. Here, we describe a study to further validate select mRNA biomarkers from this prior study in new cohorts of patients and controls, as a prerequisite for further development. Whole blood mRNA was purified from ATB patients recruited in the UK and India, LTBI and two groups of controls from the UK (i) a low TB incidence region (CNTRLA) and (ii) individuals variably-domiciled in the UK and Asia ((CNTRLB), the latter TB high incidence regions). Seventy-two mRNA biomarker gene targets were analyzed by qPCR using the Roche Lightcycler 480 qPCR platform and data analyzed using GeneSpring™ 14.9 bioinformatics software. Differential expression of fifty-three biomarkers was confirmed between MTB infected, LTBI groups and controls, seventeen of which were significant using analysis of variance (ANOVA): CALCOCO2, CD52, GBP1, GBP2, GBP5, HLA-B, IFIT3, IFITM3, IRF1, LOC400759 (GBP1P1), NCF1C, PF4V1, SAMD9L, S100A11, TAF10, TAPBP, and TRIM25. These were analyzed using receiver operating characteristic (ROC) curve analysis. Single biomarkers and biomarker combinations were further assessed using simple arithmetic algorithms. Minimal combination biomarker panels were delineated for primary diagnosis of ATB (both PTB and EPTB), LTBI and identifying LTBI individuals at high risk of progression which showed good performance characteristics. These were assessed for suitability for progression against the standards for new TB diagnostic tests delineated in the published World Health Organization (WHO) technology product profiles (TPPs).

scholarly journals Emergency department ultrasound for the detection of B-lines in the early diagnosis of acute decompensated heart failure: a systematic review and meta-analysis

CJEM ◽  
2018 ◽  
Vol 20 (3) ◽  
pp. 343-352 ◽  
Author(s):  
Kyle McGivery ◽  
Paul Atkinson ◽  
David Lewis ◽  
Luke Taylor ◽  
Tim Harris ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Emergency Department ◽  
Lung Ultrasound ◽  
Acute Decompensated Heart Failure ◽  
Meta Analysis ◽  
Decompensated Heart Failure ◽  
Diagnostic Methods ◽  
Cochrane Library ◽  
B Lines

AbstractObjectivesDyspnea is a common presenting problem that creates a diagnostic challenge for physicians in the emergency department (ED). While the differential diagnosis is broad, acute decompensated heart failure (ADHF) is a frequent cause that can be challenging to differentiate from other etiologies. Recent studies have suggested a potential diagnostic role for emergency lung ultrasound (US). The objective of this systematic review was to assess the accuracy of early bedside lung US in patients presenting to the ED with dyspnea.MethodsA systematic search of EMBASE, PubMed, and the Cochrane Library was performed in addition to a grey literature search. We selected prospective studies that reported on the sensitivity and specificity of B-lines from early lung ultrasound in dyspneic patients presenting to the ED. Selected studies underwent quality assessment using the Critical Appraisal and Skills Program (CASP) questionnaire.Data Extraction and SynthesisThe search yielded 3674 articles; seven studies met inclusion criteria and fulfilled CASP requirements for a total of 1861 patients. Summary statistics from the meta-analysis showed that as a diagnostic test for ADHF, bedside lung US had a pooled sensitivity of 82.5% (95% confidence interval [CI]=66.4% to 91.8%) and a pooled specificity of 83.6% (95% CI=72.4% to 90.8%).ConclusionsOur results suggest that in patients presenting to the ED with undifferentiated dyspnea, B-lines from early bedside lung US may be reliably used as an adjunct to current diagnostic methods. The incorporation of lung US may lead to more appropriate and timely diagnosis of patients with undifferentiated ADHF.

Amplification-Free DNA Detection Using a Microtip-Sensor Decorated With LNA Probes for Rapid TB Screening

2011 ◽  
Author(s):  
Shinnosuke Inoue ◽  
Woon-Hong Yeo ◽  
Jong-Hoon Kim ◽  
Jae-Hyun Chung ◽  
Kyong-Hoon Lee ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Staphylococcus Epidermidis ◽  
Genomic Dna ◽  
Bacterial Culture ◽  
Low Cost ◽  
Surrogate Marker ◽  
High Sensitivity ◽  
Diagnostic Methods ◽  
Nucleic Acid Amplification ◽  
Highly Sensitive

Tuberculosis (TB) is an epidemic affecting one-third of the world’s population, mostly in developing and low-resource settings. People having active pulmonary TB are considered highly infectious; therefore, it is critical to identify and treat these patients rapidly before spreading to others. However, the most reliable TB diagnostic methods of bacterial culture or nucleic acid amplification are time-consuming and expensive. The challenge of TB diagnosis lies in highly sensitive and specific screening with low cost. Here, we present an LNA-modified microtip-sensor, which is capable of selectively detecting low-abundance DNA from bacteria. When genomic DNA of Bacillus Calmette-Gue´rin (BCG, a surrogate marker of Mycobacterium bovis), and genomic DNA of Staphylococcus epidermidis (S. epi) are used, the microtip-sensor yields the detection limit of 1,000 copies/mL within 20 minutes. The high sensitivity and specificity approaching nucleic acid amplification methods can potentially overcome the current challenges for rapid TB screening.

scholarly journals P305 The evaluation of left ventricle filling pressure and lung ultrasound B-lines in the diagnosis of cardiogenic dyspnea

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Valova
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Lung Ultrasound ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Filling Pressure ◽  
Diagnostic Methods ◽  
Grey Zone ◽  
X Ray ◽  
B Lines

Abstract Introduction Dyspnea is the most frequent symptom of acute heart failure but it could also be a clinical presentation of some other noncardiogenic conditions. The differentiation of the origin of dyspnea could sometimes be a difficult task. The estimated elevation of left ventricle filling pressure with lung ultrasound proved positive B-lines score > 15 could be reliable as diagnostic methods for acute decompensated heart failure and proof of the cardiogenic origin of dyspnea. Purpose To evaluate the reliability of elevated left ventricle filling pressure and positive lung ultrasound B-lines score in differentiation of the origin of dyspnea. Methods Elevated E/e´>15 as a proof for elevated left ventricle filling pressure and multiple bilateral LUS B-lines (>15) were tested against conventional X-ray and NT-proBNP in 44 patients with cardiogenic dyspnea (23 NYHA III patients and 21 NYHA IV patients) and 42 patients with noncardiogenic dyspnea. Results Elevated left ventricle filling pressure detected with echocardography (E/e´>15) as a proof of acute decompensated heart failure was found in 18 NYHA IV patients and strongly correlated with multiple bilateral LUS B-lines > 15 (all 21 NYHA IV patients), alveolar edema from conventional X-ray (21 NYHA IV patients) and NTproBNP > 1000pg/ml in 17 NYHA IV patients. The results for NYHA III patients differ very much. Elevated filling pressure (E/e´ > 15) from echocardiography was found in 10 patients NYHA III. For the left 13 patients NYHA III E/e´ was in grey zone between 8-14. Multiple bilateral LUS B-lines >15 were found in 18 NYHA III patients. Interstitial pulmonary edema was found in 15 NYHA III patients and NTproBNP > 1000pg/ml was found in 16 NYHA III patients. E/e´ between 8-14 (grey zone) moderately correlated with NT-proBNP and strongly with pulmonary blood flow redistribution and interstitial edema from X-ray. Normal left ventricle filling pressure (E/e´ < 8) was found in 36 noncardiogenic patients. Only 6 patients with noncardiogenic dyspnea were with elevated left ventricle filling pressure (E/e´ > 15) which was explained with their overweight (BMI > 30) and hypervolemia and correlated with negative LUS B-lines. Only 1 patient with noncardiogenic dyspnea was with false positive B-lines score > 15 typical for pneumonia. Conclusions Elevated left ventricle filling pressure detected with Tissue Doppler echocardiography (E/e´>15) and positive LUS B-lines score > 15 are reliable modalities for the diagnosis of cardiogenic dyspnea in patients NYHA IV. In patient NYHA III with cardiogenic dyspnea the two presented modalities proved to be with moderate reliability and need references from conventional X-ray and NT-proBNP.

scholarly journals Creation of the first cardiac rehabilitation unit in Moroccan hospital

2017 ◽  
Vol 9 (1) ◽  
pp. 101-102
Author(s):  
N. Mouine ◽  
N. Loudiyi ◽  
I. Asfalou ◽  
M. Raissouni ◽  
M. Sabry ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Rehabilitation Unit

scholarly journals Practical aspects of use of emergency sonography for differential diagnosis of critical respiratory incidents (Blue-protocol “Bedside Lung Ultrasound in Emergency”)

2018 ◽  
Vol 1 (1) ◽  
pp. 46-59
Author(s):  
O. O. Valenko ◽  
O. O. Volkov ◽  
A. S. Bessarab
Keyword(s):  
Respiratory Failure ◽  
Lung Ultrasound ◽  
Low Cost ◽  
Diagnostic Ultrasound ◽  
Interventional Therapy ◽  
Response To Therapy ◽  
Pathological Changes ◽  
Scientific Publications ◽  
Lung Fluid ◽  
The Right

This article contains rather motivating than teaching information. It is a synthesis of analysis of authoritative global scientific publications and personal experience. The modern approaches to diagnosis of critical respiratory incidents using ultrasound, superficial theoretical review of the core of the method and our own experiences regarding effective protocol of sonographic lung assessment are presented here. Several interesting clinical cases emphasize the advantages of routine use of diagnostic ultrasound in patients with critical uncompensated respiratory disaster as well as in sub-compensated and compensated patients. The main principles of bedside lung ultrasound in emergency that should encourage wider implementation and use of this method by doctors of different specialties are: “Lung ultrasound is very easy to perform using simple equipment”, and “BLUE-protocol is a simple protocol that allows quick (< 3 min) diagnosis of the cause of respiratory failure”. Lung sonographic assessment allows not only to determine quickly the cause of critical respiratory failure and counteract it starting the etiotropic treatment as soon as possible, but also visualize the dynamics of pathological changes in response to therapy, thus allowing us to evaluate its effectiveness properly. The use of ultrasound in diagnosing enables more adequate decision making regarding the need of interventional therapy. It also leads to setting the right diagnosis faster, improving the quality of medical care, shortening the length of stay of patients in ICU, decreasing the total cost of the treatment. Identification and analysis of the amount of sonographic signs “B-lines – lung rockets” provides an opportunity to measure the volume/amount of interstitial lung fluid properly and track this marker/indicator in dynamics in response to the treatment. The unified method of protocolized assessment should be used within one medical facility in order to boost effectiveness and make evaluation and dynamic evaluation of pathological changes more objective by the same one or different medical specialists. Diagnostic ultrasound has a very low cost and there is no radiation exposure to patients which allows performing as many examinations as needed, without limitations.

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