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1.
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.436-441, tab, ilus.
Monography in Portuguese | LILACS | ID: biblio-1352663
2.
Int. j. med. surg. sci. (Print) ; 8(3): 1-7, sept. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1292574

ABSTRACT

La tuberculosis es una enfermedad granulomatosa, con espectro clínico variable. El objetivo es presentar un caso con tuberculosis miliar, una de las formas clínicas menos frecuente de la enfermedad y la utilización del método clínico proporcionó el diagnóstico certero. Se presenta un paciente masculino de 54 años, no fumador, alcohólico atendido en el Hospital Clínico Quirúrgico Hermanos Ameijeiras por referir historia de tos poco productiva, cefalea, fiebre, pérdida de apetito y de peso de dos meses de evolución. En la radiografía y tomografía de tórax se evidencia un patrón miliar y la baciloscopía directa confirma la presencia del Mycobacterium tuberculosis. La TB miliar es muy poco frecuente, pero se puede sospechar ante un patrón radiológico miliar y confirmar mediante análisis microbiológico.


Tuberculosis is a granulomatous disease with a variable clinical spectrum. The objective is to present a case with miliar tuberculosis, one of the least frequent clinical forms of the disease, and the use of the clinical method provided an accurate diagnosis. We present a 54-year-old male, non-smoker, alcoholic who attended in the Ameijeiras Brothers Surgical Clinical Hospital for referring to a history of unproductive cough, headache, fever, loss of appetite, and weight two months of evolution. Chest X-ray and CT showed a miliar pattern and direct bacilloscopy confirmed the presence of Mycobacterium tuberculosis. Miliar TB is very rare but can be suspected by a miliar radiological pattern and confirmed by microbiological analysis.


Subject(s)
Humans , Male , Middle Aged , Tuberculosis, Miliary/diagnostic imaging , Radiography, Thoracic/methods , Tomography, X-Ray Computed/methods
3.
Rev. cuba. med. mil ; 50(3): e1381, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1357313

ABSTRACT

Introducción: Desde el surgimiento de los primeros casos en la pandemia de la COVID-19, se ha desarrollado una carrera vertiginosa en crear un espacio de investigación para el diagnóstico, tratamiento y control de la enfermedad. Objetivo: Describir las características clínicas y radiológicas de los pacientes con la COVID-19. Métodos: Se realizó un estudio descriptivo, en el período comprendido de marzo a octubre del año 2020, se estudiaron 404 pacientes de todas las edades, ingresados, con diagnóstico confirmado con PCR en tiempo real. Las variables utilizadas fueron: edad, sexo, síntomas y radiografía del tórax. Resultados: El 54,5 por ciento de los pacientes fueron del sexo femenino y entre ellos asintomáticos el 55,9 por ciento; el 36,9 por ciento tenía entre 40 a 59 años de edad, en los menores de 20 años, el 64,9 por ciento no presentó síntomas de la enfermedad al ingreso. Estuvieron asintomáticos el 53,5 por ciento; el 76,6 por ciento de las radiografías positivas correspondieron a los sintomáticos, la tos fue el síntoma más frecuente. La mayor positividad en la radiografía del tórax se encontró en los pacientes mayores de 60 años, se observó como patrón más frecuente, la opacidad en velo, de distribución periférica. Conclusiones: Predominan los pacientes asintomáticos, la positividad de las radiografías es mayor en los ancianos(AU)


Introduction: Since the emergence of the first cases of COVID-19 pandemic, a dizzying race has developed in creating a research space for the diagnosis, treatment and control of the disease. Objective: To describe the clinical and radiological characteristics of patients with COVID-19. Methods: A descriptive study was carried out, in the period from March to October 2020, 404 patients of all ages, admitted, with confirmed diagnosis with real-time PCR, were studied. The variables used were: age, sex, symptoms and chest X-ray. Results: 54.5 percent of the patients were female and 55,9 percent of them were asymptomatic, 36,9 percent were between 40 and 59 years old, in those under 20 years 64,9 percent were not. They presented symptoms of the disease upon admission 53,5 percent were asymptomatic, 76,6 percent of the positive radiographs corresponded to the symptomatic ones, coughing was the most frequent symptom. The greatest positivity in the chest X-ray was found in patients older than 60 years, the most frequent pattern was the opacity in the peripheral distribution veil. Conclusions: Asymptomatic patients predominate, the positivity of radiographs is higher in the elderly(AU)


Subject(s)
Humans , Polymerase Chain Reaction , Continental Population Groups , Real-Time Polymerase Chain Reaction , COVID-19 , Radiography, Thoracic/methods , Epidemiology, Descriptive
4.
Rev. urug. cardiol ; 36(2): e402, ago. 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1289998

ABSTRACT

El tromboembolismo pulmonar tiene una presentación clínica variada. Es fundamental tener un alto índice de sospecha para arribar al diagnóstico oportuno. El síncope se asocia a casos graves y tiene importancia pronóstica. El tratamiento trombolítico es la piedra angular en el subgrupo de pacientes de alto riesgo. Se presentan tres casos clínicos de tromboembolia pulmonar de alto riesgo con el fin de discutir el escenario clínico de presentación y el tratamiento instaurado.


Pulmonary thromboembolism has a varied clinical presentation. It is essential to have a high index of suspicion to arrive at a timely diagnosis. Syncope is associated with severe cases and is of prognostic significance. Thrombolytic treatment is the cornerstone in the subgroup of high-risk patients. Three clinical cases of high-risk pulmonary thromboembolism are presented in order to discuss the clinical presentation scenario and the established treatment.


O tromboembolismo pulmonar tem a presentação clínica variada. É essencial ter um alto índice de suspeita para chegar a um diagnóstico oportuno. A síncope está associada a casos graves e tem significado prognóstico. O tratamento trombolítico é a pedra angular no subgrupo de pacientes de alto risco. São apresentados três casos clínicos de tromboembolismo pulmonar de alto risco para discutir o quadro clínico e o tratamento instituído.


Subject(s)
Humans , Male , Female , Aged , Pulmonary Embolism/diagnosis , Syncope/complications , Heart Arrest/complications , Pulmonary Embolism/etiology , Pulmonary Embolism/drug therapy , Radiography, Thoracic , Catastrophic Illness , Electrocardiography
5.
Arq. bras. med. vet. zootec. (Online) ; 73(4): 812-820, Jul.-Aug. 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1285272

ABSTRACT

The objective of this study was to describe the prevalence, survival time, and risk factors of myxomatous mitral valve disease (MMVD) in dogs by a retrospective observational cohort study design of a Brazilian veterinary center, admitted from 2012 to 2018 (2.585 days). Considering the 105 dog files confirmed as MMVD, the prevalence of the disease was higher in small-breed dogs with ages from 10 to 19 years (30.3%). The survival time of the dogs at B1 stage (1.854 ± 145 days) was higher than the B2 (1.508+209) and C/D (930 ± 209). Higher risks of death (hazard ratio) were detected in the presence of syncope (2.5), pulmonary crackling (2.0), dyspnea (1.9), and higher values of vertebral heart scale (1.7), radiographic left atrium dimension (1.8), the ACVIM staging (1.7), and the duration of QRS complex (1.05). The results achieved demonstrated higher prevalence of MMVD in old small-breed dogs, associated with longer survival time in the B1 stage of the disease, and higher risk of death related to the presence of clinical signs, such as dyspnea, syncope, and pulmonary crackling, beyond some radiographic, echocardiographic, and electrocardiographic variables of heart or atrial enlargement.(AU)


O objetivo deste estudo foi descrever a prevalência, o tempo de sobrevivência e os fatores de risco da doença mixomatosa valvar mitral (DMVM) em cães, por meio de estudo de coorte observacional retrospectivo, os quais foram atendidos em um centro veterinário de 2012 a 2018 (2.585 dias). Considerando os 105 arquivos de cães com confirmação da DMVM, maior prevalência foi observada em raças pequenas com idades entre 10 e 19 anos (30,3%). O tempo de sobrevivência de cães em estágio B1 (1.854+145 dias) foi superior ao B2 (1.508+209) e ao C/D (930+209). Maior risco de morte (hazard ratio) foi observado na presença de síncope (2,5), crepitação pulmonar (2,0), dispneia (1,9), bem como de valores superiores de VHS (1,7), dimensão radiográfica do átrio esquerdo (1,8), estadiamento ACVIM (1,7) e duração do complexo QRS (1,05). Os resultados obtidos demonstraram maior prevalência de DMVM em cães idosos de raças pequenas, associada a maior tempo de sobrevida no estágio B1 da doença e a maior risco de morte relacionado à presença de sinais clínicos como dispneia, síncope e crepitação pulmonar, além de algumas variáveis radiográficas, ecocardiográficas e eletrocardiográficas de cardiomegalia ou aumento atrial esquerdo.(AU)


Subject(s)
Animals , Dogs , Fibrosis/veterinary , Endocardium/pathology , Heart Disease Risk Factors , Heart Valve Diseases/veterinary , Prognosis , Echocardiography/veterinary , Radiography, Thoracic/veterinary , Electrocardiography/veterinary
7.
Neumol. pediátr. (En línea) ; 16(4): 172-176, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1362265

ABSTRACT

El sarcoma sinovial primario de pulmón (SSPP) localizado en bronquio, es una entidad no reportada en la edad pediátrica. Se presenta el caso de un niño de siete años con antecedente de aparentes neumonías recurrentes derechas de siete meses de evolución; en la evaluación por neumología pediátrica se destaca en las radiografías de tórax, la presencia de atelectasias recurrentes en lóbulo medio e inferior derecho, por lo que se realiza broncoscopia, donde se observa una masa obstruyendo el 100% de la luz del bronquio fuente derecho y se sospecha tumor carcinoide. Se realiza extirpación de masa endobronquial con fines diagnósticos y terapéuticos, incluyendo resección segmentaria bronquial y anastomosis término-terminal. El respectivo análisis inmunohistoquímico muestra hallazgos sugestivos de sarcoma sinovial monofásico. Se descarta compromiso tumoral extrapulmonar, por lo que se diagnostica como tumor primario de bronquio. Se administraron 7 ciclos de quimioterapia y 31 sesiones de radioterapia. Actualmente en control, sin evidencia de metástasis, tumores residuales o recidivas.


Primary Synovial Sarcoma of Lung (PSSL) located in the bronchus is an unreported entity in pediatric age. We present the case of a 7-year-old child with a history of apparent recurrent right pneumonia of 7 months of evolution; in the evaluation by pediatric pulmonology, the presence of recurrent atelectasis in the middle and lower right lobe is highlighted on chest X-rays, so bronchoscopy is performed, where a mass is observed obstructing 100% of the right bronchus lumen and carcinoid tumor is suspected. Endobronchial mass resection is performed for diagnostic and therapeutic purposes, including bronchial segmental resection and termino-terminal anastomosis. The respective immunohistochemical analysis shows suggestive findings of monophasic synovial sarcoma. Extrapulmonary tumor involvement is ruled out, so it is diagnosed as a primary bronchial tumor. 7 cycles of chemotherapy and 31 sessions of radiation therapy are given. Currently in control, with no evidence of metastasis, residual tumors, or recurrence.


Subject(s)
Humans , Male , Child , Sarcoma, Synovial/surgery , Sarcoma, Synovial/diagnosis , Lung Neoplasms/surgery , Lung Neoplasms/diagnosis , Bronchoscopy , Radiography, Thoracic , Sarcoma, Synovial/pathology , Lung Neoplasms/pathology
9.
Neumol. pediátr. (En línea) ; 16(2): 69-74, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1293287

ABSTRACT

La bronquiolitis aguda es una condición respiratoria frecuente en los niños menores de 2 años. Representa la principal causa de hospitalización infantil y se caracteriza por la presencia de sibilancias asociada a signos de una infección respiratoria alta. El agente etiológico más común es el virus respiratorio sincicial. Existe una falta de consenso con respecto a su definición clínica; y por ello, su tratamiento varía en todo el mundo. El diagnóstico es clínico, sin necesidad de emplear laboratorio o imágenes en forma rutinaria. Diversas revisiones han demostrado que los broncodilatadores, adrenalina, corticoides y antibióticos, entre otros, carecen de eficacia por lo que no se sugiere su empleo. El tratamiento sigue siendo de soporte, mediante la administración de oxígeno y manteniendo una adecuada hidratación. Cuando no se logra disminuir el trabajo respiratorio o corregir la hipoxemia se puede utilizar la presión positiva en la vía aérea para prevenir y controlar la insuficiencia respiratoria. Este artículo desarrolla una breve revisión de las principales características clínicas, epidemiológicas, radiológicas, así como algunos de los diferentes tratamientos publicados en las últimas dos décadas.


Acute bronchiolitis is a common respiratory condition in children under 2 years old. It represents the main cause of childhood hospitalization characterized by the presence of wheezing associated with signs of an upper respiratory infection. The most common etiologic agent is respiratory syncytial virus. There is a lack of consensus regarding its clinical definition; and therefore, its treatment varies around the world. Diagnosis is clinical, without the need for routine laboratory or imaging. Various reviews have shown that bronchodilators, epinephrine, corticosteroids, and antibiotics, among others, lack efficacy, so their use is not suggested. Treatment continues to be supportive, by administering oxygen and maintaining adequate hydration. When it is not possible to reduce the work of breathing or correct the hypoxemia, positive airway pressure can be used to prevent and control respiratory failure. This article develops a brief review of the main clinical, epidemiological, and radiological characteristics, as well as some of the different treatments published in the last two decades.


Subject(s)
Humans , Bronchiolitis/diagnosis , Bronchiolitis/therapy , Oxygen Inhalation Therapy , Bronchiolitis/etiology , Bronchiolitis/physiopathology , Bronchiolitis/drug therapy , Radiography, Thoracic , Physical Therapy Modalities , Diagnosis, Differential , Noninvasive Ventilation
12.
Journal de la société de Biologie Clinique ; (38): 45-48, 2021. figures, tables
Article in French | AIM, AIM | ID: biblio-1362992

ABSTRACT

Objectif : Evaluer l'apport de l'échographie thoracique (ET) dans le diagnostic des pleuropneumopathies de l'adulte au Centre Hospitalier Universitaire Départemental du Borgou et de l'Alibori (CHUD-B/A). Patients et Méthodes : Il s'est agi d'une étude transversale descriptive analytique réalisée sur la période allant du 15 Mars au 15 Aout 2019. Un examen pleuropulmonaire (EPP), une radiographie thoracique (RT) et une ET ont été réalisés aux patients adultes reçus dans le service d'imagerie médicale et présentant des symptômes fonctionnels respiratoires. Les indicateurs de performance diagnostique de l'ET ont été calculés en prenant la RT comme examen de référence. Résultats : Sur les 83 patients inclus, l'EPP, la RT et l'ET étaient pathologiques chez respectivement 52 (62,65%), 67 (80,72%) et 72 (86,75%) patients. L'ET était pathologique chez 10 (62,50%) des 16 patients ayant eu une RT normale. La RT était pathologique chez 5 (45,45%) des 11 patients qui avaient une ET normale. En prenant la RT comme référence, l'ET avait globalement une sensibilité de 92,54%, une spécificité de 37,50%, une valeur prédictive positive de 86,11% et une valeur prédictive négative de 54,55%. Conclusion : L'ET est performante dans le diagnostic des pleuropneumopathies de l'adulte. Elle peut être utilisée comme examen de première intention, en alternative à la RT ou complétée la RT dans l'exploration des pathologies pleuropulmonaires à Parakou


Objective: To evaluate the contribution of chest ultrasonography in the diagnosis of pneumonia in adults at the teaching hospital of Borgou and Alibori (CHUD-B/A). Method: This was a descriptive and analytical cross-sectional study carried out from 15 March to 15 August 2019. Clinical examination of lungs, chest X-ray and chest ultrasonography were performed on adult patients received in the medical imaging department and presenting with functional respiratory symptoms. Diagnostic performance indicators for chest ultrasonography were calculated by using chest X-ray as the reference test. Results: Of the 83 patients included, clinical examination of lungs, chest X-ray and chest ultrasonography were pathological in 52 (62.65%), 67 (80.72%) and 72 (86.75%) patients respectively. Chest ultrasonography was pathological in 10 (62.50%) of the 16 patients with normal chest X-ray. Chest X-ray was pathological in 5 (45.45%) of the 11 patients with normal chest ultrasonography. With chest X-ray as a reference, the overall sensitivity of chest ultrasonography was 92.54%, specificity 37.50%, positive predictive value 86.11% and negative predictive value 54.55%. Conclusion: Chest ultrasonography is an effective tool in the diagnosis of pneumonia in adults. It can be used as a first-line examination, as an alternative to chest X-ray or as a complement to chest X-ray in the exploration of pneumonia in Parakou


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Pneumonia , Radiography, Thoracic , Tomography, X-Ray Computed , Diagnosis
16.
Neumol. pediátr. (En línea) ; 16(1): 41-47, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1284223

ABSTRACT

Congenital pulmonary airway malformations (CPAM) are rare and occur due to a failure in lung embryological development. They are classified according to their pathological characteristics and their anatomical origin. They can occur from the antenatal period to adulthood, can be associated with hydrops fetalis, respiratory distress, recurrent infections, or in an otherwise asymptomatic patient. In this article we carry out a scope review of the literature to answer frequent questions of the clinical teams in charge of patients with CPAM, such as the antenatal approach, the different types of surgeries and the management of asymptomatic patients. Although the indication for surgery is clear in symptomatic patients, little is known about its natural history of this condition, including the possibility of spontaneous resolution and the development of complications or neoplasm. So, the treatment of asymptomatic patients continues to be controversial. Therapeutic decisions must be made by multidisciplinary teams with the informed participation of parents and patients. In our opinion, considering the excellent results of minimally invasive surgery, its low incidence of complications, and practically zero mortality when performed by experienced groups, it seems reasonable to consider elective resection of a MCVAP in asymptomatic patients.


Las malformaciones congénitas de la vía aérea pulmonar (MCVAP) son infrecuentes y ocurren debido a una falla en el desarrollo embriológico pulmonar. Se clasifican de acuerdo con sus características patológicas y a su origen anatómico. Se pueden presentar desde el periodo antenatal hasta la adultez, asociarse a cuadros de hidrops fetal, distrés respiratorio, infecciones recurrentes, o como un hallazgo en pacientes asintomáticos. En este artículo realizamos una revisión bibliográfica exploratoria para responder dudas frecuentes de los equipos clínicos a cargo de pacientes con MCVAP, como el enfrentamiento antenatal, los distintos tipos de cirugía y su abordaje, y el manejo de pacientes asintomáticos. Si bien la indicación de cirugía es clara en pacientes sintomáticos, poco se conoce acerca de su historia natural, incluyendo la posibilidad de resolverse de forma espontánea, de complicarse o de evolucionar hacia el desarrollo de una neoplasia, por lo que el tratamiento de pacientes asintomáticos continúa siendo controversial. Las decisiones terapéuticas deben ser tomadas por equipos multidisciplinarios con la participación informada de los padres y de los pacientes. En nuestra opinión, considerando los excelentes resultados de la cirugía mínimamente invasiva, su baja incidencia de complicaciones y prácticamente nula mortalidad, al ser realizada por grupos con experiencia, nos parece razonable plantear la resección electiva de una MCVAP en un paciente asintomático.


Subject(s)
Humans , Child , Respiratory System Abnormalities/surgery , Pneumonectomy , Prenatal Care , Magnetic Resonance Imaging , Thoracotomy , Radiography, Thoracic , Cystic Adenomatoid Malformation of Lung, Congenital/surgery , Respiratory System Abnormalities/classification , Respiratory System Abnormalities/embryology , Respiratory System Abnormalities/diagnostic imaging , Risk , Lung/abnormalities
17.
Neumol. pediátr. (En línea) ; 16(1): 48-52, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1284224

ABSTRACT

Unilateral agenesis of the pulmonary artery is a rare malformation, sometimes asymptomatic and underdiagnosed. Right agenesis is usually isolated, while the left agenesis is more frequently associated with cardiovascular malformations. Some patients have recurrent respiratory infections, exercise limitation, hemoptysis, and/or pulmonary hypertension. The diagnosis is suspected by chest radiograph showing a hypoplastic lung ipsilateral to the agenesis. It is confirmed with contrast-enhanced chest computed tomography. In asymptomatic patients, management should be conservative, however, the search for collateral vessels should be started from adolescence, because they can bleed. In symptomatic patients or those with serious complications, the treatment must be interventional. The objective of this article is to present two patients with right and left pulmonary artery agenesis respectively and review the literature.


La agenesia unilateral de la arteria pulmonar es una malformación poco frecuente, en ocasiones asintomática y subdiagnosticada. La agenesia derecha suele ser aislada, en cambio la izquierda se asocia más frecuentemente a malformaciones cardiovasculares. Algunos pacientes presentan infecciones respiratorias recurrentes, limitación al ejercicio, hemoptisis y/o hipertensión pulmonar. El diagnóstico se sospecha al solicitar una radiografía de tórax que muestra un pulmón hipoplásico ipsilateral a la agenesia. Se confirma con tomografía computada de tórax con contraste. En pacientes asintomáticos el manejo debe ser conservador, sin embargo, se debe iniciar la búsqueda de vasos colaterales especialmente durante la adolescencia, los que pueden sangrar. En cambio, en los pacientes sintomáticos o que presentan complicaciones graves, el tratamiento debe ser intervencional. El objetivo de este trabajo es presentar a dos pacientes con agenesia de la arteria pulmonar derecha e izquierda respectivamente y hacer una revisión de la literatura.


Subject(s)
Humans , Male , Adolescent , Pulmonary Artery/abnormalities , Pulmonary Artery/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Hemoptysis/etiology
18.
Neumol. pediátr. (En línea) ; 16(3): 126-129, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1344717

ABSTRACT

El soporte ventilatorio no invasivo es una herramienta que ha demostrado mejorar la sobrevida de pacientes con falla muscular de la bomba respiratoria y el manejo de enfermedades pulmonares crónicas, incluso la ventilación no invasiva nocturna ha servido de puente hacia el trasplante pulmonar. Se presenta el caso de una adolescente de 14 años con enfermedad pulmonar crónica hipoxémica severa y falla ventilatoria secundaria, que requirió ventilación prolongada y traqueostomía en espera de trasplante pulmonar. Luego de reevaluar indemnidad de la vía aérea fue decanulada a soporte ventilatorio no invasivo, con uso alternado de mascarilla nasal nocturna y pieza bucal diurna, permitiendo descanso muscular respiratorio eficiente, y mejoría de flujo de tos con técnicas de apilamiento de aire. Este plan permitió una decanulación segura y realizar soporte continuo ventilatorio no invasivo con un programa de rehabilitación cardiorrespiratorio. Generalmente, el soporte ventilatorio no invasivo se utiliza en trastornos primarios de la bomba respiratoria. En este caso, se indicó para enfermedad pulmonar crónica hipoxémica, mostrando claros beneficios con oxigenación adecuada, buen rendimiento cardiovascular con mejor tolerancia al ejercicio y entrenamiento en el escenario de preparación al trasplante pulmonar.


Noninvasive Ventilatory Support has demonstrated to improve survival of patients with ventilatory pump muscle failure and nocturnal noninvasive ventilation is useful in chronic lung disease, even bridging to lung transplant. We present a 14 years old girl with severe hypoxemic chronic lung disease and secondary ventilatory failure, who required continuous long-term ventilation and underwent a tracheostomy waiting for lung transplant. After reevaluated the airway patency the patient was decannulated to Noninvasive Ventilation Support, alternating nocturnal nasal mask with diurnal mouth piece in order to provide efficient respiratory muscle rest, made air stacking and improved cough flow. This plan allows safe decannulation to continuous Noninvasive Ventilatory Support tailoring a rehabilitation cardiorespiratory program. Usually, Noninvasive Ventilation Support is prescribed for primary respiratory pump muscles failure, but in this case, it was applied for a hypoxemic chronic lung disease. Clear benefits were observed leading to appropriate oxygenation, good cardiovascular performance with better tolerance to exercise for training in the preparatory scenario of a lung transplant.


Subject(s)
Humans , Female , Adolescent , Respiratory Insufficiency/therapy , Lung Transplantation , Device Removal/methods , Noninvasive Ventilation/methods , Respiratory Insufficiency/diagnostic imaging , Preoperative Care/methods , Tracheostomy , Radiography, Thoracic , Ventilator Weaning , Tomography, X-Ray Computed , Chronic Disease , Hypoxia
19.
Article in English | WPRIM | ID: wpr-878330

ABSTRACT

Objective@#Prior pulmonary tuberculosis (PTB) on chest X-ray (CXR) was commonly found in infertile patients receiving examinations before @*Method@#We conducted a retrospective cohort study of 14,254 infertile patients who had received IVF-ET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth, clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.@*Results@#The untreated PTB group had significantly lower clinical pregnancy (31.7% @*Conclusions@#Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.


Subject(s)
Abortion, Spontaneous/epidemiology , Adult , China/epidemiology , Embryo Transfer/statistics & numerical data , Female , Fertilization in Vitro/statistics & numerical data , Humans , Infertility, Female/etiology , Live Birth/epidemiology , Middle Aged , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome/epidemiology , Radiography, Thoracic , Retrospective Studies , Tuberculosis, Pulmonary/epidemiology , Young Adult
20.
Singapore medical journal ; : 458-465, 2021.
Article in English | WPRIM | ID: wpr-920941

ABSTRACT

INTRODUCTION@#Chest radiographs (CXRs) are widely used for the screening and management of COVID-19. This article describes the radiographic features of COVID-19 based on an initial national cohort of patients.@*METHODS@#This is a retrospective review of swab-positive patients with COVID-19 who were admitted to four different hospitals in Singapore between 22 January and 9 March 2020. Initial and follow-up CXRs were reviewed by three experienced radiologists to identify the predominant pattern and distribution of lung parenchymal abnormalities.@*RESULTS@#In total, 347 CXRs of 96 patients were reviewed. Initial CXRs were abnormal in 41 (42.7%) out of 96 patients. The mean time from onset of symptoms to CXR abnormality was 5.3 ± 4.7 days. The predominant pattern of lung abnormality was ground-glass opacity on initial CXRs (51.2%) and consolidation on follow-up CXRs (51.0%). Multifocal bilateral abnormalities in mixed central and peripheral distribution were observed in 63.4% and 59.2% of abnormal initial and follow-up CXRs, respectively. The lower zones were involved in 90.2% of initial CXRs and 93.9% of follow-up CXRs.@*CONCLUSION@#In a cohort of swab-positive patients, including those identified from contact tracing, we found a lower incidence of CXR abnormalities than was previously reported. The most common pattern was ground-glass opacity or consolidation, but mixed central and peripheral involvement was more common than peripheral involvement alone.


Subject(s)
COVID-19 , Humans , Lung/diagnostic imaging , Radiography, Thoracic , Retrospective Studies , SARS-CoV-2 , Singapore
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