Look at the lung: can chest ultrasonography be useful in pregnancy?

Background: This study aimed to evaluate the clinical value of chest ultrasound (US) in the detection, diagnosis and follow-up of pathologic processes of both peripheral lung parenchyma and pleural space in pregnant women. Findings: Pregnant women admitted to Obstetric Pathology Hospital Department for respiratory diseases were enrolled. Chest US examination was performed when there was a respiratory disease highly suggestive of pneumonia and/or pleural effusion and chest X-ray (CXR) should have been obtained. Three chest US patterns were identified: lung consolidation (LC), pleural effusion (PE) and focal sonographic interstitial syndromes (SIS). When chest US pathologic signs were reported, one or more subsequent chest US examinations were performed to follow-up the patient until their complete resolution. Sixteen inpatients underwent 54 chest US evaluations. We identified: 9 LCs, 6 PEs and 11 SISs. Total number of CXRs was 7 (10 females avoided X-rays exposure and one underwent 2 CXR evaluations on the advice of Gynecologist). Chest US follow-up, during and after therapy, showed complete resolution of echographic patterns previously described. Conclusions: Chest US evaluation during pregnancy is a useful diagnostic tool to detect and monitor respiratory diseases, avoiding excessive X-rays exposure.

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Awareness of Pregnant Women for COVID-19 Infection

Tropical Health and Medical Research ◽

10.35916/thmr.v0i0.28 ◽

2020 ◽

Author(s):

Erhan Okuyan ◽

Emre Gunakan ◽

Sertaç Esin

Keyword(s):

Pregnant Women ◽

Respiratory Diseases ◽

Prospective Observational Study ◽

Information Source ◽

Home Birth ◽

Patient Characteristics ◽

Emotional Status ◽

Prevention Method ◽

And Behavior

Covid outbreak has been getting worse and spread affected all over the world. Pregnant patients are also vulnerable to respiratory diseases. We aimed to evaluate the awareness, emotional status, and behavior of pregnant during the COVID outbreak. This study's main benefit is to analyze the knowledge and understanding of pregnant women about the pandemic and draw attention to the prevention issues that need improvement. This research is a prospective observational study that 199 patients subjected to a questionnaire including 29 questions about patient characteristics, pregnancy information, knowledge about COVID19-infection, behavioral and emotional changes. 130 (65.3) of the patients stated an above-average knowledge level. Television was the most frequent information source (75.4%, n:150) and was the only information source for 90 (45.1%) of the patients. Sixty-nine patients used more than one information source. More than one prevention method uses by 149 (75%) of the patients. Washing hands (n:183, 92.0%) and cleaning the house (n:122, 61.3%) were the most preferred methods. Only 55 (27.6%) of the patients used a mask for prevention. 88(44.2%) of the patients stated that they preferred a shorter hospital stay, and 75 (37.7%) of the patients indicated that they postponed or avoided the pregnancy follow-up visits due to the COVID-19 issue. Pregnant women seem to be aware and stressed of COVID-19, but knowledge of what to do seems insufficient. Patients informed of risks of COVID infection, unplanned hospital admission, and chances of avoiding necessary visits and home birth demands.

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Role of diagnostic imaging in diagnosis by Covid-19

Journal of Advanced Health Care ◽

10.36017/jahc2012-008 ◽

2020 ◽

Author(s):

Coda Marco ◽

Sica Federica ◽

Finelli Mirko ◽

Ungaro Gaetano ◽

Sica Alfonso Marco

Keyword(s):

Differential Diagnosis ◽

Lung Parenchyma ◽

Chest Ct ◽

Initial Assessment ◽

X Rays ◽

Radiological Imaging ◽

Laboratory Examinations ◽

Clinical Conditions

The diagnosis from Covid-19 provides the set of several examinations such as: clinical examinations, laboratory examinations, radiographic examinations. Using radiological imaging, RX and chest CT, it is possible to evaluate the impairment of lung function and thanks to this aspect it is possible to define the severity and clinical conditions of the patient. In this way, it allows timely therapeutic intervention especially if the patient shows a mild condition in such a way as to avoid the onset of further complications. Chest X-rays allow both an initial assessment of patients and the possibility to perform a differential diagnosis towards other possible causes of lung parenchyma involvement. The CT scan, which highlights the peculiar characteristics of COVID pneumonia, is performed both as diagnostic confirmation and in the patient’s follow-up.

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Retained Foreign Bodies after Emergent Trauma Surgery: Incidence after 2526 Cavitary Explorations

The American Surgeon ◽

10.1177/000313480707301024 ◽

2007 ◽

Vol 73 (10) ◽

pp. 1031-1034 ◽

Cited By ~ 9

Author(s):

Pedro G.R. Teixeira ◽

Kenji Inaba ◽

Ali Salim ◽

Carlos Brown ◽

Peter Rhee ◽

...

Keyword(s):

Foreign Bodies ◽

Damage Control ◽

Trauma Surgery ◽

Radiographic Evaluation ◽

Trauma Patients ◽

X Rays ◽

Chest X Ray ◽

Cavity Closure ◽

Level 1 Trauma Center

Trauma patients are thought to be at high risk for iatrogenic retained foreign bodies (RFBs). The objective of this study was to evaluate this incidence. All cases of RFB after cavitary trauma surgery were identified by review of Morbidity and Mortality reports at a Level 1 trauma center from January 1998 to December 2005 and confirmed by the Octagon Risk Management System. Over 8 years, 10,053 trauma operations were performed (2075 laparotomies, 377 thoracotomies, and 74 sternotomies). Three cases (0.1%) of RFB (all sponges) occurred during one single-stage and two damage control laparotomies. The counts were correct before definitive closure in two of three cases. No postoperative x-rays were obtained in any of the cases. RFB diagnosis occurred between days 3 and 9, one on a routine chest x-ray and the other two on abdominal computed tomography scans during a septic workup. Four-month to 8-year follow up documented one pleural effusion and one abscess resulting from the RFB. Iatrogenic RFBs after emergent cavitary trauma surgery occur at a rate of 0.12 per cent and are associated with significant morbidity. In addition to standard preventive strategies, in emergent cases with risk factors such as requiring damage control, before final cavity closure, even with a correct sponge count, radiographic evaluation is warranted.

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Postural drainage in intubated patients with acute lobar atelectasis - A pilot study

South African Journal of Physiotherapy ◽

10.4102/sajp.v56i3.540 ◽

2000 ◽

Vol 56 (3) ◽

pp. 29-32 ◽

Cited By ~ 4

Author(s):

M. W. Krause ◽

H. Van Aswegen ◽

E. H. De Wet ◽

G. Joubert

Keyword(s):

Intensive Care ◽

X Rays ◽

Average Group ◽

Postural Drainage ◽

Group A ◽

Chest X Ray ◽

Group B ◽

Comparison Of Effectiveness ◽

Clinical Experiment

Objectives: The movement and mobilisation of an intubated patient in the intensive care unit is restricted by the presence of various drains and intravenous lines. Difficulty to position the patient in the correct postural drainage positions, often leads physiotherapists to using modified postural drainage positions to mobilise secretions. A comparison of effectiveness between the correct postural drainage positions and the modified postural drainage positions during the treatment of acute lobar atelectasis in the intubated patient was conducted. Subjects: Intubated men and women between the ages of 13 and 85 years in the intensive care units of Pelonomi and Universitas Hospitals in Bloemfontein diagnosed with acute lobar atelectasis of the lower lobes were considered for inclusion in this pilot study.Intervention: A controlled randomised clinical experiment was conducted. Group A received inhalation therapywhilst placed in a postural drainage position for 15 minutes. Thereafter percussion was done for five minutes followed by a sterile suction procedure. Group B received the same treatment but modified postural drainage positions were used. Both groups received treatment twice daily.Results: On average, group A required three treatments and nil follow-up chest X-rays before the collapse was resolved, as opposed to the average of 4.5 treatments and one follow-up chest X-ray required by group B before the same result was obtained. In group A the oxygenation compared to Group B was improved. The findings were not statistically significant.Conclusion: The use of postural drainage positions in intensive care suggests quicker resolution of acute lobar atelectasis and improves oxygenation.

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Chest X-Ray findings and visual quantitative assessment of COVID-19 pneumonia

10.21203/rs.3.rs-32480/v1 ◽

2020 ◽

Author(s):

Michaela Cellina ◽

Marcello Orsi ◽

Marta Panzeri ◽

Giulia van der Byl ◽

Giancarlo Oliva

Keyword(s):

Severity Score ◽

Quantitative Assessment ◽

X Rays ◽

Imaging Findings ◽

Rt Pcr ◽

Disease Evolution ◽

X Ray ◽

Radiological Score ◽

Chest X Ray

Abstract AimTo assess the most common chest X-Ray findings and distribution in patients with confirmed diagnosis of COVID-19; to verify the repeatability of a radiological severity score, based on visual quantitative assessment; to assess the evolution of chest X-Ray findings at follow-up; to evaluate chest X-Ray sensitivity.MethodsWe analysed chest X-Rays at baseline of 110 consecutive COVID-19 patients (79 males, 31 females; mean age: 64±16 years) with RT-PCR confirmation, who presented to our ED.Two radiologists evaluated the imaging findings and distribution.A severity score, based on the extension of lung abnormalities, was assigned by two other radiologists, independently, to the baseline and follow-up X-Rays, executed in 77/110 cases; interobserver agreement was calculated. Chest X-Ray sensitivity was assessed, with RT-PCR as gold standard.ResultsInterobserver agreement was excellent for baseline and follow-up X-Rays (Cohen's K=0.989, p<0.001, Cohen's K=0.985, p<0.001, respectively). The mean score at baseline was 2.87±1.7 for readers 1 and 2. We observed radiological worsening in 52/77 (67%) patients, with significantly higher scores at follow-up (mean score: 4.27±2.15 for reader 1 and 4.28±2.14 for reader 2, respectively); p<0.001.Ground glass opacities were the most common findings (97/110, 88%). Abnormalities showed bilateral involvement in 67/110 (61%), with prevalent peripheral distribution (48/110, 43.5%).The X-Ray sensitivity for the detection of COVID-19 infection was 91%.ConclusionChest X-Ray highlighted imaging findings in line with those previously reported for chest CT. The use of a radiological score can result in clearer communication with Clinicians and a more precise assessment of disease evolution.

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Deep Learning for Screening COVID-19 using Chest X-Ray Images

10.1101/2020.05.04.20090423 ◽

2020 ◽

Cited By ~ 3

Author(s):

Sanhita Basu ◽

Sushmita Mitra ◽

Nilanjan Saha

Keyword(s):

Deep Learning ◽

Lung Parenchyma ◽

Clinical Findings ◽

Data Sets ◽

X Rays ◽

X Ray ◽

Chest X Ray ◽

Increasing Demand ◽

Novel Coronavirus ◽

Diverse Data

AbstractWith the ever increasing demand for screening millions of prospective “novel coronavirus” or COVID-19 cases, and due to the emergence of high false negatives in the commonly used PCR tests, the necessity for probing an alternative simple screening mechanism of COVID-19 using radiological images (like chest X-Rays) assumes importance. In this scenario, machine learning (ML) and deep learning (DL) offer fast, automated, effective strategies to detect abnormalities and extract key features of the altered lung parenchyma, which may be related to specific signatures of the COVID-19 virus. However, the available COVID-19 datasets are inadequate to train deep neural networks. Therefore, we propose a new concept called domain extension transfer learning (DETL). We employ DETL, with pre-trained deep convolutional neural network, on a related large chest X-Ray dataset that is tuned for classifying between four classes viz. normal, other_disease, pneumonia and Covid — 19. A 5-fold cross validation is performed to estimate the feasibility of using chest X-Rays to diagnose COVID-19. The initial results show promise, with the possibility of replication on bigger and more diverse data sets. The overall accuracy was measured as 95.3% ± 0.02. In order to get an idea about the COVID-19 detection transparency, we employed the concept of Gradient Class Activation Map (Grad-CAM) for detecting the regions where the model paid more attention during the classification. This was found to strongly correlate with clinical findings, as validated by experts.

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Evaluation of Malignant Mesothelioma in Central Anatolia: A Study of 67 Cases

Canadian Respiratory Journal ◽

10.1155/2004/204793 ◽

2004 ◽

Vol 11 (4) ◽

pp. 287-290 ◽

Cited By ~ 11

Author(s):

Inci Gulmez ◽

Levent Kart ◽

Hakan Buyukoglan ◽

Ozlem Er ◽

Suleyman Balkanli ◽

...

Keyword(s):

Pleural Effusion ◽

Malignant Mesothelioma ◽

Environmental Control ◽

Public Health Problem ◽

Central Anatolia ◽

Major Public Health Problem ◽

Pleural Thickening ◽

Chest X Ray ◽

Fibrous Mineral

BACKROUND:Malignant mesothelioma (MM) is a fatal neoplasm which frequently results from exposure to asbestos or erionite.METHOD:Sixty-seven patients with MM were seen between 1990 and 2001. Their clinical and radiological features, as well as the therapy, were retrospectively evaluated.RESULTS:In 51 patients (76.1%), the MM was confined to the pleura, in 14 patients it was exclusively peritoneal and in two patients, it involved both areas. Of the 67 cases, 35 (52.2%) were women. The mean (± SD) age for all cases was 57.6±11.5 years. Dyspnea (67.2%), cough (55.2%) and chest pain (50.7%) were the most frequent symptoms of onset. Pleural effusion (92.4%) was the most common chest x-ray finding, whereas pleural effusion (60.8%), pleural nodules (34.7%) and pleural thickening (34.7%) were the most common computed tomography findings in pleural MM patients. The histological subtypes of MM were determined as epithelial in 60 patients (89.5%), sarcomatous in four patients (5.9%) and mixed in three patients (4.4%). Although 50.7% and 25.4% of the cases were exposed to erionite and asbestos, respectively, 23.9% of the cases recalled no exposure to asbestos or erionite. Exposures were environmental as opposed to occupational. Thirty-five patients (52.2%) were administered chemotherapy, and follow-up data were available for 22 patients. For these patients, the two-year survival rate was 22% and the two-year progression-free interval was 15.7%. There were no differences between patients with asbestos and erionite exposure.CONCLUSION:MM should be considered when exudative pleural effusion is detected in a patient who has been exposed to asbestos or erionite. MM is a major public health problem in parts of Turkey and compulsory environmental control of fibrous mineral should be considered.

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Application of autologous blood patch in patients with non-expanded lungs and persistent air leak

Turkish Journal of Thoracic and Cardiovascular Surgery ◽

10.5606/tgkdc.dergisi.2020.18983 ◽

2020 ◽

Vol 28 (3) ◽

pp. 521-526

Author(s):

Burhan Apilioğulları

Keyword(s):

Autologous Blood ◽

Lung Parenchyma ◽

X Rays ◽

Poor General Condition ◽

Air Leak ◽

Chemical Pleurodesis ◽

Study Results ◽

Blood Patch ◽

Persistent Air Leak

Background: This study aims to evaluate the effectiveness of pleurodesis procedure by ensuring the expansion of the lung and occluding lung parenchyma leaks with an autologous blood patch. Methods: A total of 24 patients (17 males, 7 females; mean age 59.9±12.2 years; range, 30 to 86 years) who underwent autologous blood patch pleurodesis in our clinic between November 2015 and November 2019 were retrospectively analyzed. The patients were not eligible to undergo chemical pleurodesis due to a non-expandable lung or poor general condition. Demographic and clinical characteristics of the patients and postoperative data were evaluated. Results: The air leak stopped within 48 h after autologous blood patch pleurodesis in seven patients. The air leak significantly decreased in 13 patients, while it remained unchanged in four patients. A Heimlich valve was placed in the patients in whom the air leak stopped or significantly decreased. The follow-up chest X-rays showed that the respective lungs of these patients became completely expandable. Conclusion: Our study results suggest that the autologous blood patch procedure is a favorable option for the patients who are unable to benefit much from the conventional chemical pleurodesis methods due to contraindications to surgery or the presence of non-expandable lungs.

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Chest X-Ray Findings and Temporal Lung Changes in Patients with COVID-19 Pneumonia

10.21203/rs.3.rs-45829/v1 ◽

2020 ◽

Author(s):

Liqa A Rousan ◽

Eyhab Elobeid ◽

Musaab Karrar ◽

Yousef Khader

Keyword(s):

Ct Scan ◽

Chest Ct ◽

Common Finding ◽

X Rays ◽

Radiographic Findings ◽

X Ray ◽

Abnormal Chest ◽

Chest X Ray ◽

Chest Ct Scan

Abstract Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.

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Implementing Lung Ultrasound in the Outpatient Management of COVID-19 Pneumonia: A Pilot Study to Update Local Guidelines

Frontiers in Medicine ◽

10.3389/fmed.2021.774035 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chloé Chevallier Lugon ◽

Aileen Kharat ◽

Paola M. Soccal ◽

Idris Guessous ◽

Hervé Spechbach ◽

...

Keyword(s):

Systematic Approach ◽

Lung Ultrasound ◽

High Sensitivity ◽

Descriptive Statistics ◽

X Rays ◽

Single Center ◽

X Ray ◽

Ambulatory Patients ◽

Chest X Ray

Background: Lung ultrasound (LUS) has a good performance with a high sensitivity and specificity for the diagnosis of pneumonia compared with chest X-ray, and it has been extensively used to assess patients during the COVID-19 pandemic. This study aims to evaluate the potential advantages of the regular use of LUS for the assessment of the severity and prognosis of COVID-19 pneumonia and to propose an adapted protocol with its inclusion in current local validated and published guidelines.Methods: This is a single-center prospective study conducted during the first (April–May 2020) and second (October 2020–January 2021) waves of the SARS-CoV2 pandemic in Switzerland. All adult patients presenting to dedicated test centers with a suspicion of mild-to-moderate COVID-19 pneumonia and not requiring hospitalization at the time of diagnosis were included. Patients with confirmed COVID-19 pneumonia were referred to an ambulatory follow-up unit at our institution for reassessment, with the inclusion of the use of LUS in a random selection. Descriptive statistics were calculated for demographics using percentages, means, and standard deviations according to the distribution of variables.Results: Eighty-eight ambulatory patients with a confirmed COVID-19 pneumonia were included (men = 57 [59%]; mean age, 52.1 ± 13.5 years). Among these, 19 (21%) were hospitalized and none died. Twenty-five lung assessments by ultrasound were performed during the follow-up consultation. All were consistent with the clinical examination and confirmed the clinician's opinion.Conclusion: The use of a standardized pleuro-pulmonary ultrasound protocol for ambulatory patients with COVID-19 could help to reduce the use of chest X-rays and improve overall management at the time of referral and eventual follow-up. However, a specific study including LUS in a systematic approach should be performed to evaluate the outcome of patients according to findings.

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