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1.
Rev. colomb. cir ; 37(2): 237-244, 20220316. tab, fig
Article in Spanish | LILACS | ID: biblio-1362955

ABSTRACT

Introducción. La presencia de neumomediastino secundario a un trauma contuso es un hallazgo común, especialmente con el uso rutinario de la tomografía computarizada. Aunque en la mayoría de los casos es secundario a una causa benigna, la posibilidad de una lesión aerodigestiva subyacente ha llevado a que se recomiende el uso rutinario de estudios endoscópicos para descartarla. El propósito de este estudio fue determinar la incidencia de neumomediastino secundario a trauma contuso y de lesiones aerodigestivas asociadas y establecer la utilidad de la tomografía computarizada multidetector en el diagnóstico de las lesiones aerodigestivas. Métodos. Mediante tomografía computarizada multidetector se identificaron los pacientes con diagnóstico de neumomediastino secundario a un trauma contuso en un periodo de 4 años en un Centro de Trauma Nivel I. Resultados. Fueron incluidos en el estudio 41 pacientes con diagnóstico de neumomediastino secundario a un trauma contuso. Se documentaron en total tres lesiones aerodigestivas, dos lesiones traqueales y una esofágica. Dos de estas fueron sospechadas en tomografía computarizada multidetector y confirmadas mediante fibrobroncoscopia y endoscopia digestiva superior, respectivamente, y otra fue diagnosticada en cirugía. Conclusión. El uso rutinario de estudios endoscópicos en los pacientes con neumomediastino secundario a trauma contuso no está indicado cuando los hallazgos clínicos y tomográficos son poco sugestivos de lesión aerodigestiva.


Introduction.The presence of pneumomediastinum secondary to blunt trauma is a common finding, especially with the use of computed tomography. Although in most cases the presence of pneumomediastinum is secondary to a benign etiology, the possibility of an underlying aerodigestive injuries has led to the recommendation of the routine use of endoscopic studies to rule them out. The purpose of this study was to determine the incidence of pneumomediastinum secondary to blunt trauma and associated injuries and to establish the role of multidetector computed tomography in the diagnosis of aerodigestive injuries. Methods.Using multidetector computed tomography, patients with a diagnosis of pneumomediastinum secondary to blunt trauma were identified over a period of 4 years in a Level 1 Trauma Center. Results. Forty-one patients diagnosed with pneumomediastinum secondary to blunt trauma, were included in this study. Two airway ruptures were documented: two tracheal injuries and one esophageal injury. Two of them suspected on multidetector computed tomography and confirmed on bronchoscopy and esophagogastroduodenoscopy, respectively, and another was diagnosed in surgery. Conclusion.The routine use of endoscopic studies in patients with pneumomediastinum secondary to blunt trauma is not indicated when the clinical and tomographic findings are not suggestive of aerodigestive injury.


Subject(s)
Humans , Thorax , Esophageal Perforation , Trachea , Wounds and Injuries , Mediastinum
2.
An. bras. dermatol ; 96(6): 771-773, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355643

ABSTRACT

Abstract Carcinoma of the mammary crease is a very rare variant of breast carcinoma, in which the skin lesions are usually the presenting sign. The authors present the case of an 88-year-old woman with an exophytic plaque in the mammary crease of approximately ten years duration. The histopathological and immunohistochemical studies confirmed the diagnosis of infiltrative breast carcinoma (carcinoma of the mammary crease variant). This case highlights the important role of the dermatologist in the early diagnosis of this rare variant of breast cancer.


Subject(s)
Humans , Female , Aged, 80 and over , Breast Neoplasms/diagnosis , Carcinoma , Thorax , Breast
4.
Fisioter. Bras ; 22(3): 412-424, Jul 15, 2021. tab, graf
Article in English | LILACS | ID: biblio-1284564

ABSTRACT

Objective: To compare in neonates with transitory tachypnea if chest rebalancing thoraco-abdominal method (RTA) increased immediate pain. Methods: This was a randomized controlled clinical trial. Forty-nine neonates with transitory tachypnea and aged < 72 hours were included to receive either conventional physiotherapy (CP) or RTA method. Participants received usual care and one 15- minute session of chest physiotherapy. Neonatal Infant Pain Scale (NIPS), peripheral oxygen saturation, heart rate, respiratory rate, axillary temperature before and after chest physiotherapy were recorded. Kruskal-Wallis ANOVA and Mc Nemar test were used to compare differences between measures. The relative risk (RR) for pain after interventions was calculated using a Poisson regression model (robust estimation). A significance level of 5% (p < 0.05) was adopted for all analyses. Results: RTA was not associated to pain. After chest physiotherapy, NIPS reduced (2 versus 3, p < 0.001) and number of neonates with pain reduced (10.2% versus 28.6%, p = 0.02). RR for pain after chest physiotherapy in comparison to before was 0.3 (95% CI 0.15-0.41; p = 0.02); respiratory frequency decreased after chest physiotherapy (58 versus 70, p < 0.001) and peripheral oxygen saturation increased (98% versus 96%, p < 0.001). Conclusion: In neonates with transitory tachypnea, in the first 72 hours of life, RTA did not influence pain evaluation, chest physiotherapy was safe and reduced immediate pain. (AU)


Objetivo: Comparar em recém-nascidos com taquipneia transitória se o método reequilíbrio tóraco-abdominal (RTA) aumentou a dor imediatamente após. Métodos: Estudo de ensaio clínico randomizado. Quarenta e nove recémnascidos com diagnóstico de taquipneia transitória com menos de 72 horas de vida, foram incluídos para receber fisioterapia respiratória. Os participantes receberam os cuidados usuais e uma sessão de fisioterapia convencional ou do método reequilíbrio tóraco-abdominal. Foram registradas a escala NIPS (Neonatal Infant Pain Scale), a saturação periférica de oxigênio, a frequência cardíaca, a frequência respiratória e a temperatura axilar antes e depois da fisioterapia. Para as comparações entre as medidas, foram utilizados o teste de ANOVA de Kruskal-Wallis e o teste de McNemar. O risco relativo de dor após os procedimentos foi calculado usando o modelo de regressão de Poisson (estimação robusta). Foi considerado o nível de significância de 5% para todas as análises (p < 0,05). Resultados: O método RTA não foi associado a dor. Após a fisioterapia respiratória, a escala NIPS reduziu (2 versus 3, p < 0,001) e a proporção de recém-nascidos com dor também reduziu (10,2% versus 28,6%, p = 0,02). O risco relativo de dor após a fisioterapia respiratória em comparação a antes, foi de 0,3 (IC 95% 0,15-0,41; p = 0,02), a frequência respiratória diminuiu (58 versus 70, p < 0,001) e a saturação periférica de oxigênio aumentou (98% versus 96%, p < 0,001). Conclusão: Em recém-nascidos com taquipneia transitória nas primeiras 72 horas de vida, o método RTA não influenciou a avaliação da dor, a fisioterapia respiratória foi segura e reduziu a dor imediatamente após. (AU)


Subject(s)
Humans , Infant, Newborn , Pain Measurement , Infant, Newborn , Physical Therapy Modalities , Pain , Respiration , Thorax , Analysis of Variance , Respiratory Rate
6.
Medisan ; 25(3)2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1287309

ABSTRACT

La actual pandemia de COVID-19 ha afectado múltiples sectores económicos y sociales a escala mundial, con especial afectación sobre el sector de la salud, ya que constituye un reto adicional para la atención primaria, dada la marcada escasez de recursos. La infección por SARS-CoV-2 ocasiona morbilidad y mortalidad crecientes, por lo que el diagnóstico mediante imágenes es una herramienta imprescindible en la práctica clínica; sin embargo, el acceso limitado a algunos medios como la tomografía axial computarizada en diferentes niveles de atención, justifica el uso de la radiografía de tórax como una opción costo-efectiva y accesible en muchas regiones. En el presente artículo se exponen los hallazgos asociados a procesos infecciosos virales sugestivos de infección por el nuevo coronavirus y una serie de escalas de clasificación que buscan estandarizar la lectura e interpretación radiográfica por parte del personal médico.


The pandemic of COVID-19 has affected multiple economic and social sectors worldwide, with special effects on the health sector, since it constitutes an additional challenge for the primary health care, given the marked lack of resources. The infection due to SARS-CoV-2 causes increasing morbidity and mortality, reason why the diagnosis by means of images is an indispensable tool in the clinical practice; however, the limited access to some means as the computerized axial tomography in different levels of care, justifies the use of the thorax x-ray as a cost-effective and accessible option in many regions. Findings associated with suggestive viral infectious processes of infection due to the new coronavirus and a series of classification scales that seek to standardize reading and radiographic interpretation by the medical staff are exposed in this work.


Subject(s)
Primary Health Care , Thorax/diagnostic imaging , COVID-19 , Radiography , Coronavirus , SARS-CoV-2
7.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 77-82, 20210000.
Article in Spanish | LILACS | ID: biblio-1178631

ABSTRACT

El empiema es una colección de líquido purulento en el espacio pleural. La causa más común es la neumonía. Las opciones de tratamiento incluyen toracocentesis terapéutica, colocación de catéter de drenaje, terapia fibrinolítica, pleurodesis y cirugía, como la decorticación pleural. El drenaje pleural es eficaz en la etapa I y la cirugía está reservada para casos complicados (estadios II y III). En estos casos, es necesaria la decorticación pulmonar. Actualmente, el enfoque más favorecido para la decorticación es mediante una toracotomía abierta. Este es un estudio observacional, descriptivo, de corte transversal, retrospectivo, con un muestreo no probabilístico de casos consecutivos que tuvo como población accesible a pacientes con el diagnostico de empiema en quienes se realizó una decorticación pleural en el Hospital de Clínicas por el Departamento de Cirugía de Tórax durante el periodo de marzo 2016 a febrero 2019. Un total de 24 pacientes con el diagnóstico de empiema fueron sometidos a una decorticación pleural. La etiología de empiema más frecuente (75%) fue el derrame paraneumónico. Las complicaciones post quirúrgicas estuvieron presentes en 9 (37,5%) pacientes, de estos, 4 (17%) presentaron fuga aérea durante los primeros días postoperatorios. Se constató la resolución completa del cuadro en 21 (87,5%) pacientes y 3 (12,5%) pacientes presentaron colección residual pleural. Se constató recurrencia en 1 (4%) paciente, requiriendo un re intervención quirúrgica. En conclusión, la casuística de nuestro departamento de tórax coincide en cuanto a valores internacionales de complicaciones, resolución y mortalidad.


Empyema is a collection of purulent fluid in the pleural space. The most common cause is pneumonia. Treatment options include therapeutic thoracentesis, drainage catheter placement, fibrinolytic therapy, pleurodesis, and surgery, such as pleural decortication. Pleural drainage is effective in stage I and surgery is reserved for complicated cases (stages II and III). In these cases, pulmonary decortication is necessary. Currently, the most favored approach to decortication is by open thoracotomy. This is an observational, descriptive, cross-sectional, retrospective study, with a non-probabilistic sampling of consecutive cases that had as the accessible population, patients with the diagnosis of empyema in whom pleural decortication was performed at the Clinica´s Hospital of San Lorenzo, by the Department of Thoracic Surgery during the period from March 2016 to February 2019. A total of 24 patients with the diagnosis of empyema underwent pleural decortication. The most frequent aetiology of empyema (75%) was parapneumonic effusion. Post-surgical complications were present in 9 (37.5%) patients, of these, 4 (17%) presented air leakage during the first postoperative days. Complete resolution of the condition was verified in 21 (87.5%) patients and 3 (12.5%) patients presented residual pleural collection. Recurrence was found in 1 (4%) patient, requiring reoperation. In conclusion, the casuistry of our thoracic department coincides in terms of international values of complications, resolution and mortality.


Subject(s)
Pneumonia , Thoracic Surgery , Thoracotomy , Drainage , Pleurodesis , Thoracentesis , General Surgery , Thorax , Thrombolytic Therapy , Retrospective Studies , Catheters
8.
Rev. Eugenio Espejo ; 15(1): 54-65, 20210102.
Article in Spanish | LILACS | ID: biblio-1145491

ABSTRACT

El Síndrome de Eisenmenger es un desorden multisistémico caracterizado por hipertensión pulmonar con inversión o bidireccionalidad del flujo a través de una comunicación intracardiaca o aortopulmonar. Se presenta el caso de un paciente masculino de 48 años de edad con antece- dentes de Hipertensión Pulmonar e Insuficiencia Cardíaca en tratamiento, quien acude por cuadro de melenas, decaimiento e inestabilidad hemodinámica. Al examen físico se ausculta soplo sistólico ascendente en foco pulmonar, abdomen distendido con presencia de onda ascíti- ca. En los exámenes complementarios; la radiografía convencional de tórax mostró aumento de la trama vascular pulmonar, además de encontrarse alteraciones electrocardiográficas. El paciente mostró una evolución desfavorable produciéndose falla cardíaca, que dio lugar al posterior fallecimiento debido a un paro cardiorrespiratorio.


Eisenmenger Syndrome is a multisystemic disorder identified by pulmonary hypertension with reversal or bidirectional flow through intracardiac or aortopulmonary communication. The case of a 48-year-old male patient with a history of Pulmonary Hypertension and Heart Failure in treatment is presented, who comes due to mane of mane, decay, and hemodynamic instability. The physical examination auscultated systolic murmur ascending in pulmonary focus, distended abdomen with presence of ascites wave. In the complementary exams, conventional chest x-ray, increased pulmonary vascular weft, in addition to finding electrocardiographic abnormalities. The patient seemed an unfavorable evolution, producing a heart failure, which resulted in subse- quent death due to cardiorespiratory arrest.


Subject(s)
Humans , Male , Middle Aged , Syndrome , Eisenmenger Complex , Hypertension, Pulmonary , Patients , Thorax , Heart
9.
Repert. med. cir ; 30(1): 64-67, 2021. ilus.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1292233

ABSTRACT

La pseudodextrocardia se ha definido como un desplazamiento irregular del corazón y sus estructuras vasculares hacia la derecha por causas extracardiacas. Es un hallazgo ocasional en estudios imagenológicos de tórax o abdomen y varía acorde con las diferentes relaciones causales. Se presenta el caso de un paciente con una neumopatía crónica, quien a su ingreso presenta pseudodextrocardia como hallazgo incidental.


Pseudo-dextrocardia has been defined as an unusual displacement of the heart and its vascular structures to the right secondary to extracardiac causes. It is an occasional finding in thoracic or abdominal imaging studies and varies according to the various causal relationships. We report a case of pseudo-dextrocardia as an incidental finding in a patient admitted with chronic pulmonary disease.


Subject(s)
Humans , Male , Aged, 80 and over , Dextrocardia/diagnostic imaging , Heart/diagnostic imaging , Mediastinum/diagnostic imaging , Thorax , Dextrocardia
11.
Article in English | WPRIM | ID: wpr-880353

ABSTRACT

BACKGROUND@#Body mass-independent parameters might be more appropriate for assessing cardiometabolic abnormalities than weight-dependent indices in Asians who have relatively high visceral adiposity but low body fat. Dual-energy X-ray absorptiometry (DXA)-measured trunk-to-peripheral fat ratio is one such body mass-independent index. However, there are no reports on relationships between DXA-measured regional fat ratio and cardiometabolic risk factors targeting elderly Asian men.@*METHODS@#We analyzed cross-sectional data of 597 elderly men who participated in the baseline survey of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study, a community-based single-center prospective cohort study conducted in Japan. Whole-body fat and regional fat were measured with a DXA scanner. Trunk-to-appendicular fat ratio (TAR) was calculated as trunk fat divided by appendicular fat (sum of arm and leg fat), and trunk-to-leg fat ratio (TLR) as trunk fat divided by leg fat.@*RESULTS@#Both TAR and TLR in the group of men who used ≥ 1 medication for hypertension, dyslipidemia, or diabetes ("user group"; N = 347) were significantly larger than those who did not use such medication ("non-user group"; N = 250) (P < 0.05). After adjusting for potential confounding factors including whole-body fat, both TAR and TLR were significantly associated with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, fasting serum insulin, and the insulin resistance index in the non-user group and non-overweight men in the non-user group (N = 199).@*CONCLUSION@#The trunk-to-peripheral fat ratio was associated with cardiometabolic risk factors independently of whole-body fat mass. Parameters of the fat ratio may be useful for assessing cardiometabolic risk factors, particularly in underweight to normal-weight populations.


Subject(s)
Absorptiometry, Photon , Adiposity/physiology , Aged , Aged, 80 and over , Biomarkers/metabolism , Cardiometabolic Risk Factors , Cross-Sectional Studies , Humans , Intra-Abdominal Fat/diagnostic imaging , Japan , Male , Osteoporosis/etiology , Prospective Studies , Risk Assessment , Risk Factors , Thorax/diagnostic imaging
12.
An. bras. dermatol ; 95(6): 751-753, Nov.-Dec. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1142116

ABSTRACT

Abstract Paget's disease is a rare disorder of the nipple and/or the areola that is characterized by an erythematosquamous lesion and is often associated with in situ or invasive breast carcinoma. The authors present an atypical, exuberant case that had evolved over eight years, emphasizing the importance of early diagnosis.


Subject(s)
Humans , Breast Neoplasms/diagnosis , Paget's Disease, Mammary , Thorax/diagnostic imaging , Ulcer , Nipples
13.
Rev. méd. Maule ; 35(1): 25-46, oct. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1366390

ABSTRACT

In December 2019, an epidemic of cases with unexplained lower respiratory infections detected in Wuhan, China was first reported to the WHO China Office. The respiratory picture presents in various ways, from asymptomatic or paucisymptomatic forms, to clinical conditions characterized by respiratory failure that require mechanical ventilation and support in the ICU, with multi-organ and systemic manifestations in terms of sepsis, septic shock and multiple organ dysfunction syndromes. The etiological agent was identified as a virus belonging to the coronavirus family (CoV) with a high contagion capacity that determined its rapid spread, triggering a pandemic with high morbidity and mortality. This review attempts to address the basics of this disease.


Subject(s)
Humans , Pneumonia, Viral/physiopathology , COVID-19/etiology , COVID-19/transmission , Asthma , Thorax/diagnostic imaging , Tomography, X-Ray Computed , Clinical Diagnosis , Sepsis , Diagnostic Techniques and Procedures , Pulmonary Disease, Chronic Obstructive , Diagnosis, Differential , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/physiopathology , COVID-19/prevention & control , COVID-19/therapy , COVID-19/epidemiology
14.
Int. j. morphol ; 38(5): 1258-1265, oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134434

ABSTRACT

SUMMARY: The aim of this exploratory design science research (DSR) study was to design a computer-based teaching simulation tool (CBTST) for training medical imaging (MI) students in chest pattern recognition. A DSR methodology used in the design of the CBTST entailed the following phases: 1) awareness of the problem (proposal design); 2) suggestion; 3) development; 4) evaluation; and 5) conclusion. The CBTST was designed using Microsoft Visual Studio which operates on the Structured Query Language server. The designed CBTST was evaluated using the System Usability Scale (SUS) and MI educators. The designed CBTST evaluation yielded an average score of 70.1 which exceeded the score of 68 which is generally accepted to indicate that the CBTST has good usability. The CBTST proved to be an authentic tool that is user-friendly and allows communication and feedback between the educator and the students. It is envisaged that the implementation of this tool will enhance the future training of MI students in pattern recognition while contributing immensely to the current development of the use of computer-based simulation.


RESUMEN: El objetivo de este estudio de investigación en ciencias de diseño (DSR) fue desarrollar una herramienta de simulación de enseñanza basada en computadora (CBTST) para capacitar a los estudiantes en el reconocimiento de patrones de tórax a través de la imagenología médica. Una metodología DSR utilizada en el diseño del CBTST implicaba las siguientes fases: 1) conciencia del problema (diseño de la propuesta); 2) sugerencia; 3) desarrollo; 4) evaluación; y 5) conclusión. El CBTST se diseñó con Microsoft Visual Studio, que opera en el servidor de Structured Query Language. El CBTST diseñado se evaluó utilizando la escala de usabilidad del sistema (SUS) y educadores de IM. La evaluación CBTST diseñada arrojó un puntaje promedio de 70,1 que excedió el puntaje de 68 que generalmente se acepta para indicar que el CBTST tiene buena usabilidad. El CBTST demostró ser una herramienta auténtica, fácil de usar y que permite la comunicación y la retroalimentación entre el educador y los estudiantes. Se prevé que la implementación de esta herramienta mejorará la formación futura de los estudiantes de IM en el reconocimiento de patrones y contribuirá de manera importante al desarrollo actual del uso de la simulación basada en computadora.


Subject(s)
Humans , Thorax/diagnostic imaging , Computer Simulation , Pattern Recognition, Automated , Computer-Assisted Instruction/methods , Education, Medical/methods , Aptitude , Software , Education, Medical, Undergraduate , Educational Measurement , Simulation Training/methods , Anatomy/education
15.
Arq. bras. cardiol ; 115(3): 501-502, out. 2020.
Article in English, Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131310

Subject(s)
Tomography , Calcium , Thorax
16.
Arq. bras. cardiol ; 115(3): 493-500, out. 2020. tab, graf
Article in English, Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131308

ABSTRACT

Resumo Fundamento A doença cardiovascular representa a principal causa de mortalidade no mundo. Calcificações parietais nas artérias podem ser visualizadas e quantificadas por tomografia computadorizada (TC) em estágios iniciais e subclínicos, sendo expressa em escore de cálcio (EC). Com esse número, é possível estimar o prognóstico de eventos cardiovasculares futuros. Objetivos Correlacionar a detecção e quantificação do EC pela TC do tórax utilizando como padrão-ouro a TC cardíaca sincronizada ao eletrocardiograma. Métodos Estudo transversal e descritivo que selecionou pacientes (n=73) consecutivos para investigação de doença arterial coronariana estável e que realizaram TC cardíaca no período de junho de 2013 a outubro de 2014. Realizado protocolo com TC do tórax e EC, em aparelho de 64 canais. Os valores de p<0,05 foram considerados estatisticamente significativos. Resultados Na avaliação por paciente, após a transformação logarítmica a média do EC sincronizado foi de 8,7 e na TC de tórax foi de 9,4. Prevalência de doença de 49,3% (n= 36). A sensibilidade foi de 97,2% e a especificidade de 100,0%. Observou-se excelente correlação entre os métodos (r= 0,993 com p<0,001). Na avaliação por segmento, a média do EC sincronizado foi de 3,0. Já a média do EC na TC de tórax foi de 3,2. Prevalência de doença de 29,5% (n= 86), com sensibilidade de 95,3% e especificidade de 97,5%. Observou-se também excelente correlação entre os métodos (r= 0,985 com p<0,001). Conclusão O EC sincronizado e não sincronizado têm boa correlação entre si e não mostram resultados estatisticamente diferentes. (Arq Bras Cardiol. 2020; 115(3):493-500)


Abstract Background Cardiovascular disease is the leading cause of mortality in the world. Parietal calcifications of the arteries may be visualized and quantified at initial and subclinical states by computed tomography (CT), and expressed as calcium score (CS). It is possible to estimate the prognosis of future cardiovascular events using this score. Objectives To correlate the detection and quantification of the CS obtained by chest CT with that obtained by electrocardiography (ECG)-synchronized cardiac computed tomography (the gold-standard). Method Cross-sectional, descriptive study of 73 consecutive patients in investigation for coronary artery disease who underwent cardiac CT between June 2013 and October 2014. Chest computed tomography and CS protocols were performed in a 64-channel TC scanner. P-values <0.05 were considered statistically significant. Results In the per-patient analysis, after logarithmic transformation, mean CS was 8.7 and 9.4 by the ECG-synchronized method and chest CT, respectively. The prevalence of disease was 49.3% (n=36), with a sensitivity of 97.2% and specificity of 100.0%. There was an excellent correlation between the methods (r= 0.993, p<0.001). In the per-segment analysis, after logarithmic transformation, mean CS was 3.0 and 3.2 by the ECG-synchronized method and chest CT, respectively. The prevalence of disease was 29.5% (n=86), with a sensitivity of 95.3% and specificity of 97.5%. There was an excellent correlation between the methods (r= 0.985, p<0.001). Conclusion ECG-synchronized CT is well correlated with the non-ECG-synchronized CT for CS determination, without statistical difference between the methods. (Arq Bras Cardiol. 2020; 115(3):493-500)


Subject(s)
Humans , Coronary Artery Disease/diagnostic imaging , Calcium , Thorax , Tomography, X-Ray Computed , Cross-Sectional Studies , Coronary Angiography
17.
Rev. am. med. respir ; 20(3): 270-272, sept. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1123091

ABSTRACT

Paciente de 88 años que consultó por presentar tos productiva con expectoración mucopurulenta de 15 días de evolución. Equivalentes febriles. No refirió pérdida de peso ni inapetencia. Al examen clínico, cicatriz de toracotomía en el hemitórax izquierdo. A la auscultación, hipoventilación generalizada en ambas playas pulmonares, con rales subcrepitantes húmedos en base derecha. La Rx. de Tórax solicitada reveló en la playa pulmonar derecha, retracción lobular superior y en la playa izquierda, múltiples imágenes circulares y geométricas, que ocupaban campos pulmonares superior y medio. Signo de la columna vertebral desnuda por retracción de la imagen cardiovascular hacia dicho hemitórax en el campo inferior


Subject(s)
Humans , Bronchitis , Physical Examination , Thorax
18.
Prensa méd. argent ; 106(7): 403-412, 20200000. graf, tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1366842

ABSTRACT

Introducción: El compromiso pulmonar es la complicación más frecuente de la infección por SARS-CoV-2 (COVID-19). Objetivos: Describir la utilidad de la tomografía computarizada (TC) de tórax realizada tempranamente para la detección y evaluación del compromiso pulmonar en la enfermedad COVID-19. Materiales y métodos: Se analizaron de manera retrospectiva ochenta (80) pacientes con diagnóstico confirmado (RT-PCR en hisopados nasofaríngeos con detección de SARS-Cov-2) de neumonía por COVID-19 internados en la Unidad 17, División "B", del Hospital de Referencia en Enfermedades Infecciosas F.J.Muñiz, CABA, a los que se les efectuó TC de tórax en las primeras 24 horas de su ingreso hospitalario. Se analizaron de manera retrospectiva y descriptiva los patrones radiológicos de compromiso pulmonar más frecuentes, su localización y distribución. Resultados: se incluyeron en la evaluación, 80 pacientes internados en el Hospital entre los meses de Junio y Agosto de 2020. Todos (100%) fueron varones con una mediana de edad de 45.5 años (rango 21 a 81 años). El patrón radiológico predominante en la TC fueron las opacidades en vidrio esmerilado (33 [41.3%] de los pacientes); con predominio del compromiso bilateral (71 [93.4%] pacientes), multilobar (71 [93.4%] pacientes) y localización subpleural (periférica) (38 [57.6%] casos). Conclusión: Las opacidades en vidrio esmerilado, bilaterales, difusas y de predominio subpleural en su localización fueron los hallazgos más comunes en la TC de tórax efectuada de forma precoz en pacientes con diagnóstico de neumonía por COVID-19. Las imágenes de consolidación y los patrones mixtos también fueron hallazgos frecuentes en la TC de tórax observados en la mayoría de los pacientes, aún en estadios tempranos de la enfermedad por COVID-19.


Introduction: Pulmonary involvement is the most frequent complication of SARS-CoV-2 infection (COVID-19). Objectives: Describe the utility of early computed tomography (CT) scan of thorax in the management and detection of pulmonary parenchyma compromise. Material and methods: Eighty (80) patients with COVID-19 pneumonia (confirmed by RT-PCR detection of SARS-Cov-2 in nasopharyngeal swabs) who were admitted to the Unit 17th,, "B" Division, Infectious Diseases F. J. Muñiz Reference Hospital, CABA, and who underwent early chest CT scans were retrospectively enrolled. Imaging features, predominant radiological lung patterns, and distribution were retrospectively analyzed. Results: 80 patients admitted to the hospital between June 2020 to August 2020, were retrospectively enrolled. The cohort included 80 (100%) men with a mean age of 45.5 years (range 21 to 81 years). The predominant pattern of abnormality observed was ground-glass opacification (33 [41.3%] patients), bilateral compromise (71 [93.4%] patients), multilobar involvement (71 [93.4%] patients) and subpleural lesions (peripheral) (38 [57.6%] cases). Conclusion: Bilateral, diffuse, ground-glass opacities were the predominance findings on early CT thorax scan of confirmed COVID-19 pneumonia. Consolidation and mixed patterns were also frequent. COVID-19 pneumonia presents with chest CT imaging abnormalities in the majority of patient even in early stages of the disease


Subject(s)
Humans , Adult , Middle Aged , Aged , Thorax/pathology , Tomography, X-Ray Computed , Epidemiology, Descriptive , Retrospective Studies , COVID-19 , Lung/pathology
19.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1566-1570, July-Aug. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1131516

ABSTRACT

No Brasil, Mangalarga Marchador é a raça com o maior número de equinos registrados, um total de 600.000 animais. Devido à falta de estudos termográficos, este estudo buscou avaliar alterações superficiais de temperatura corporal de membros torácicos e pélvicos após o esforço de marcha, usando uma câmera termográfica com infravermelho. O estudo avaliou 25 equinos, com peso médio de 414,9±34,5kg e idade média de 6,5±3 anos. As imagens foram obtidas a cinco metros de distância perpendicular à superfície lateral e caudal do corpo, em uma sala apropriada. Os animais foram submetidos ao exercício de marcha na velocidade de 15km.h-1 por 20 minutos. As imagens foram capturadas imediatamente antes e após o esforço, e repetidas após 30 minutos de repouso. As frequências cardíaca e respiratória aumentaram significativamente (P<0,001), comparando-se antes e após o esforço. Embora tenha sido notado também aumento significativo da temperatura retal (P<0,001), as alterações de temperatura superficial dos membros torácicos e pélvicos entre os termogramas obtidos antes e após o exercício não foram significativas (P>0,05). Dessa forma, mais estudos se fazem necessários para avaliar a relação da duração desse esforço e elevação da temperatura corporal.(AU)


Subject(s)
Animals , Pelvis , Physical Conditioning, Animal/physiology , Thorax , Body Temperature , Body Temperature Regulation/physiology , Horses/physiology , Thermography/veterinary
20.
Cuad. Hosp. Clín ; 61(1): [24], jul. 2020. ilus.
Article in Spanish | LILACS, LIBOCS | ID: biblio-1118878

ABSTRACT

PREGUNTA DE INVESTIGACIÓN: ¿Qué identifica a los integrantes del equipo de salud que proporcionan atención humanizada en la unidad de terapia Intermedia del servicio de neumología en el Hospital del Tórax de la ciudad de La Paz? OBJETIVO: conocer las vivencias de las personas que enfrentan una situación de hospitalización en la unidad de terapia intermedia en el servicio de neumología del Hospital del Tórax de la ciudad de La Paz, para distinguir que identifica a los integrantes del equipo de salud que les proporcionan atención humanizada. MATERIAL Y MÉTODOS: diseño cualitativo, análisis hermenéutico. RESULTADOS: el descubrimiento más significativo fue que los integrantes del equipo de salud que proporcionan atención humanizada y demuestran mayor disposición de ayuda al prójimo, son los que en su experiencia de vida tuvieron la necesidad de atravesar por una situación similar al estar en el rol de beneficiarios (al ser atendidos o acompañar en el proceso de recuperación a otra persona) y conocieron de cerca esta situación en la que se espera recibir una atención humanizada que no siempre se encuentra. CONCLUSIONES: la concepción de atención humanizada no solo se reduce a la amabilidad, se debe considerar al ser humano de manera integral y como parte de este trato integral implícitamente también se comprende el proporcionar excelencia técnica para atender al ser humano y no solo a la enfermedad. A veces desde una perspectiva excesivamente biomédica se descuida el aspecto psicosocial del que nadie, sano o enfermo, puede desprenderse.


RESEARCH QUESTION: ¿What identifies the members of the health team that provide humanized care in the intermediate therapy unit of the pneumology service at the Hospital of the Thorax in the city of La Paz? OBJECTIVE: to know the experiences of people facing a hospitalization situation in the intermediate therapy unit in the peumology service of the Hospital del Tórax in the city of La Paz, in order to distinguish that it identifies the members of the health team that provide them with humanized care. MATERIAL AND METHODS: qualitative design, hermeneutical analysis. RESULTS: the most significant discovery was that the members of the health team that provide humanized care and demonstrate greater willingness to help others, are those who in their life experience had the need to go through a similar situation as they were in the role of beneficiaries (when being treated or accompanying someone else in the recovery process) and they got to know this situation closely, in which it is expected to receive humanized attention that is not always found. CONCLUSIONS: the concept of humanized care is not only reduced to kindness, the human being must be considered in an integral way and as part of this integral treatment it is also implicitly understood to provide technical excellence to attend to the human being and not only to the disease. Sometimes from an excessively biomedical perspective, the psychosocial aspect is neglected, from which no one, healthy or ill, can discard.


Subject(s)
Humans , Attention , Pulmonary Medicine , Humanization of Assistance , Patients , Role , Thorax
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