scholarly journals Functional Respiratory Changes in Patients with Chest Wall Deformities Secondary to Autologous Costal Cartilage Harvest for Auricle Reconstruction

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Gutiérrez Gómez C
Keyword(s):  
Chest Wall ◽  
Gold Standard ◽  
Costal Cartilage ◽  
Ct Scanner ◽  
Thoracic Deformity ◽  
Functional Implications ◽  
One Year ◽  
Auricle Reconstruction

Background: The gold standard for auricle reconstruction is currently performed with autologous costal cartilage. This process is done at about nine years of age, but it leads to thoracic deformity, reported in up to 70% of the patients using aComputed Tomography (CT) scanner. Objective: The present study aims to determine if this deformity has functional implications for the patients. Methods: 54 patients were clinically evaluated and subjected to spirometry at least one year after the surgery. Results: Four cases had moderate pulmonary restriction, while seven had mild lung restriction. A total of 20.3% of the patients showed pulmonary restriction. The new results are particularly crucial for patients with preoperative (pre-op) ventilatory disease. Conclusion: In patients with thoracic deformity diagnosed by clinic exploration, spirometric abnormalities occur in up to 20.3%; when stratifying the risk by gender, the risk is only significant for women older than 15 years old.

1150 A Painless Anterior Chest Wall Mass Post Coronary Artery Bypass Grafting Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Reid ◽  
F Alakhras Aljanadi ◽  
R Beattie ◽  
A Graham
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Chest Wall ◽  
Artery Bypass ◽  
Costal Cartilage ◽  
Bypass Graft ◽  
Anterior Chest Wall ◽  
Chronic Obstructive ◽  
Wall Mass ◽  
Chest Wall Mass

Abstract Aim We aim to present here a case of a painless anterior chest wall mass which was first noted during routine follow up post coronary artery bypass graft surgery Case presentation An 80-year-old male developed an asymptomatic slow growing pronounced swelling over the right anterior chest wall post CABG. His other past medical history includes chronic obstructive pulmonary disease, pulmonary fibrosis, ischaemic heart disease, an AICD for complete heart block, hypertension, hyperlipidaemia and osteoarthritis. A CT scan demonstrated a 10 x 12 x 6.5 cm subcutaneous lesion at the mid-line of the lower chest wall adjacent to the xiphisternum and the previous sternotomy site. On clinical examination there was a large non-tender cystic swelling with peripheral calcifications, but overlying skin was normal. Fluid was aspirated from the lesion and cytology showed a paucicellular specimen with features in keeping with seroma. Due to the progressive increase in size patient underwent surgical resection. A gelatinous bloody fluid was aspirated from the lesion and it was then resected enbloc. The tumour base appeared to arise from 6/7th costal cartilage and tumour was shaved away. The mass was confirmed histologically to be chondrosarcoma. Conclusions Given the uncommon prevalence of malignant primary chest wall tumours this case highlights the importance of high clinical suspicion even after developing post CABG.

scholarly journals Primary chest wall neoplasms - an experience of 39 patients

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Muhammad Salim ◽  
Aamir Bilal ◽  
Muhammad Shoaib Nabi
Keyword(s):  
Chest Wall ◽  
Primary Closure ◽  
Medical Institute ◽  
Chest Wall Resection ◽  
Chest Wall Tumor ◽  
Respiratory Compromise ◽  
Term Survival ◽  
Chest Wall Tumors ◽  
One Year ◽  
Painless Mass

Objective: To evaluate treatment approaches, role of surgical resection and reconstruction and outcome of patients with primary chest wall tumor. Study Design A prospective observational study. Place and Duration. The study was conducted at the Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital from March 1996 to April 2000. Patient and Methods A total of 39 patients underwent resection for primary chest wall tumors. Male were 27 and female were 12. Age range was 15 years - 55 years with a mean age of 23±2 years. 75% of patients presented with a painless mass while 25% complained of pain. Twenty three were on right side, twelve were on the left side while 4 extended onto the sternum. Sizes were <3cm (7 patients), 3-5cm (24 patients), 5-10cm (6 patients) and > 10cm (2 patients). Chest radiograph in all and CT thorax was done in 20 cases. Out of 39 cases, 25 had previous biopsies attempted by other surgeons leading to ulceration and fungation in 18 cases. Chest wall resection and primary closure was done in 33 cases. In 4 cases marlex mesh alone was used while in 2 cases it was reinforced with Methyl Methacrylate. Results Mean operative time was 68 (+/-40) minutes. Postoperatively, 19 patients required ventilation. Out of these, 14 patients were extubated the same day, 3 the next day while 02 patients died despite prolonged ventilation. Post-operative flail was observed in 3 cases without respiratory compromise. Histopathology reporting were chondrosarcoma in 24, fibrosarcoma in 6 cases while the rest were not reported. Twenty one patients were followed-up for up to one year with no evidence of disease while the remaining were lost to follow up. Conclusion To conclude primary chest wall tumors can be safely managed by resection and primary closure or chest wall reconstruction and are associated with long term survival.

scholarly journals Current Situation of Surgical Treatment for Rib Fractures in China: Questionnaires from Multi-hospital

2020 ◽  
Author(s):  
Weigang Zhao ◽  
Weiwei He ◽  
Qiang Zhang ◽  
Jinliang Yang ◽  
Weimin Wu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Chest Wall ◽  
Large Scale ◽  
Pure Titanium ◽  
Rib Fractures ◽  
Rib Fracture ◽  
Rib Fixation ◽  
Technical Details ◽  
One Year ◽  
High Level

Abstract Background: Although chest wall stabilization (CWS) has been widely performed for rib fractures in the past decade in China, consensus about operative indication, timing, and technical details for CWS is not formulated yet. The aim of this study is to investigate the existing situation of surgical treatment for rib fractures in China. Methods: Four hundred and fourteen questionnaires were sent out to surgeons in different hospitals in China and collected between January 2018 and April 2018. Data were reviewed and extracted for analysis.Results: Three-hundred and seventy-one valid questionnaires were included in this study. About 14500 cases of CWS for rib fracture were performed in the investigated hospitals in 2016 and about 17600 cases in 2017. There were 38.3% hospitals performed chest wall stabilization for single rib fracture and 44.9% hospitals performed chest wall stabilization for two rib fractures. About 92.1% of CWS cases were performed within two weeks while 42.2% surgeons performed CWS for patients with rib fracture more than two weeks. CWS of was performed in 95.6% of hospitals and 93.2% cases were performed by thoracic surgeons. Nickel-titanium memory alloy and pure titanium rib embracing device are mostly used in rib fixation. Only 33.93% of surgeons chose to remove internal fixator at one year after surgery.Conclusions: Although CWS has been widely performed in China, there are many controversies on the indications, timing, and technical details of CWS. Large-scale clinical trial, high-level literature, uniform standards of surgical indications are critical for the healthy development of CWS.

The effect of costal cartilage resection on the chest wall development: Pathological evaluation

2015 ◽  
Author(s):  
Mustafa Calik ◽  
Saniye Goknil Calik ◽  
Mustafa Cihat Avunduk ◽  
Olgun Kadir Aribas
Keyword(s):  
Chest Wall ◽  
Costal Cartilage ◽  
Pathological Evaluation

scholarly journals Use of the14C Breath Test in the Treatment ofHelicobacter pylori

1995 ◽  
Vol 9 (4) ◽  
pp. 191-194 ◽  
Author(s):  
AJ Rae ◽  
A Belzberg ◽  
IGM Cleator ◽  
M Caglar
Keyword(s):  
Helicobacter Pylori ◽  
Gold Standard ◽  
Breath Test ◽  
Acute Inflammation ◽  
Eradication Therapy ◽  
False Negatives ◽  
Breath Testing ◽  
Amoxicillin Trihydrate ◽  
One Year ◽  
Sensitivity Specificity

Fifty-two patients with gastric disorders referred to the same physician over the course of one year were endoscoped, biopsied and given a14C breath test to identifyHelicobacter pylori. Sensitivity, specificity and accuracy of the14C breath test were found to be 83%, 89% and 87%, respectively, when taking biopsy results as the `gold standard'. These figures rose to 85%, 93% and 89%, respectively, when the first five cases were not included, representing a ‘learning curve’ associated with the development of cut-off levels for the breath test. In five cases, persons were biopsied and given a breath test at least one month later, making 10 comparisons possible. Biopsy and breath test corresponded in nine of 10 comparisons (90%). In two of four false negatives (14C breath test negative but biopsy positive) only scant numbers of helicobacter organisms were found. In one of three false positives (14C breath test positive but biopsy negative) acute inflammation of the duodenal biopsied material was detected. Also, double eradication therapy (omeprazole 20 mg bid and amoxicillin trihydrate 1000 mg bid), administered in all three false positive cases, was followed by14C breath testing six weeks later, which indicated normal scores or absence of the organism.

Chest wall motion during tidal breathing

1997 ◽  
Vol 83 (5) ◽  
pp. 1531-1537 ◽  
Author(s):  
A. De Groote ◽  
M. Wantier ◽  
G. Cheron ◽  
M. Estenne ◽  
M. Paiva
Keyword(s):  
Chest Wall ◽  
Wall Motion ◽  
Costal Cartilage ◽  
Three Dimensional ◽  
Normal Subjects ◽  
Costal Margin ◽  
Tidal Breathing ◽  
Lateral Direction ◽  
Rib Cage ◽  
Chest Wall Motion

De Groote, A., M. Wantier, G. Cheron, M. Estenne, and M. Paiva. Chest wall motion during tidal breathing. J. Appl. Physiol. 83(5): 1531–1537, 1997.—We have used an automatic motion analyzer, the ELITE system, to study changes in chest wall configuration during resting breathing in five normal, seated subjects. Two television cameras were used to record the x-y-z displacements of 36 markers positioned circumferentially at the level of the third (S1) and fifth (S2) costal cartilage, corresponding to the lung-apposed rib cage; midway between the xyphoid process and the costal margin (S3), corresponding to the abdomen-apposed rib cage; and at the level of the umbilicus (S4). Recordings of different subsets of markers were made by submitting the subject to five successive rotations of 45–90°. Each recording lasted 30 s, and three-dimensional displacements of markers were analyzed with the Matlab software. At spontaneous end expiration, sections S1–3 were elliptical but S4 was more circular. Tidal changes in chest wall dimensions were consistent among subjects. For S1–2, changes during inspiration occurred primarily in the cranial and ventral directions and averaged 3–5 mm; displacements in the lateral direction were smaller (1–2 mm). On the other hand, changes at the level of S4 occurred almost exclusively in the ventral direction. In addition, both compartments showed a ventral displacement of their dorsal aspect that was not accounted for by flexion of the spine. We conclude that, in normal subjects breathing at rest in the seated posture, displacements of the rib cage during inspiration are in the cranial, lateral outward, and ventral directions but that expansion of the abdomen is confined to the ventral direction.

The effect of costal cartilage resection on chest wall development

1990 ◽  
Vol 5 (3) ◽  
Author(s):  
Debbie Martinez ◽  
Juan Juame ◽  
Theodore Stein ◽  
Alberto Pe�a
Keyword(s):  
Chest Wall ◽  
Costal Cartilage

scholarly journals Spondyloarthritis and Strength Training: A 4-Year Report

2021 ◽  
Vol 6 (3) ◽  
pp. 58
Author(s):  
Roberto Cannataro ◽  
Lorenzo Di Maio ◽  
Andrea Malorgio ◽  
Matteo Levi Micheli ◽  
Erika Cione
Keyword(s):  
Gold Standard ◽  
Biological Therapy ◽  
Nutritional Intervention ◽  
Peripheral Arthritis ◽  
Biological Drug ◽  
Intervention Plan ◽  
Motor Difficulties ◽  
Peripheral Spondyloarthritis ◽  
One Year

Peripheral spondyloarthritis (SpA) has predominant peripheral (arthritis, enthesitis, or dactylitis) involvement. The severity of the symptoms can have a significant impact on the quality of life. There is no therapeutic gold standard, and physical exercise, with the opposition of resistance, remains controversial. Herein, we report the case of a woman who, at the age of 50, comes to our center with evident motor difficulties. She was previously diagnosed with SpA and was in therapy with a biological drug (adalimumab) for over one year. The training program and the nutritional intervention plan improved her condition, as pointed out by WOMAC, SQS, RAD-36 questionnaire, and BIA analysis, suspending biological therapy for almost two years. During this period, she achieved in sequence: (i) the Italian master deadlift championship, and (ii) the Italian master powerlifting championship, both for two consecutive years.

scholarly journals Optimization and Clinical Evaluation of a Multi-Target Loop-Mediated Isothermal Amplification Assay for the Detection of SARS-CoV-2 in Nasopharyngeal Samples

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 940
Author(s):  
Foteini Roumani ◽  
Sarah Azinheiro ◽  
Hugo Sousa ◽  
Ana Sousa ◽  
Mafalda Timóteo ◽  
...  
Keyword(s):  
Gold Standard ◽  
Isothermal Amplification ◽  
Nasopharyngeal Swab ◽  
Lower Sensitivity ◽  
Infected People ◽  
Loop Mediated Isothermal Amplification ◽  
Specialized Equipment ◽  
Good Concordance ◽  
One Year ◽  
Low Sensitivity

SARS-CoV-2 is the coronavirus responsible for COVID-19, which has spread worldwide, affecting more than 200 countries, infecting over 140 million people in one year. The gold standard to identify infected people is RT-qPCR, which is highly sensitive, but needs specialized equipment and trained personnel. The demand for these reagents has caused shortages in certain countries. Isothermal nucleic acid techniques, such as loop-mediated isothermal amplification (LAMP) have emerged as an alternative or as a complement to RT-qPCR. In this study, we developed and evaluated a multi-target RT-LAMP for the detection of SARS-CoV-2. The method was evaluated against an RT-qPCR in 152 clinical nasopharyngeal swab samples. The results obtained indicated that both assays presented a “good concordance” (Cohen’s k of 0.69), the RT-LAMP was highly specific (99%) but had lower sensitivity compared to the gold standard (63.3%). The calculated low sensitivity was associated with samples with very low viral load (RT-qPCR Cq values higher than 35) which may be associated with non-infectious individuals. If an internal Cq threshold below 35 was set, the sensitivity and Cohen’s k increased to 90.9% and 0.92, respectively. The interpretation of the Cohen’s k for this was “very good concordance”. The RT-LAMP is an attractive approach for frequent individual testing in decentralized setups.

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