RESUMO
Objective/Background: Most tuberculosis cases in children are primary infection, with difficult and imprecise diagnosis mainly based on the existence of mediastinal lymphadenopathy. Here, we investigated the characteristics of mediastinal lymphadenopathy in lung computed tomography [CT] scans of children with tuberculosis
Methods: This cross-sectional study was performed on 75 children with tuberculosis referred to Masih Danesh-vari Hospital in Tehran, Iran, from 2009 to 2013. Their medical records were investigated, and CT-scan characteristics were extracted by a radiologist
Results: Mean +/- standard deviation age of cases was 11.2 +/- 4.6 years. CT-scan results indicated 94.7% of cases had lymphadenopathy, with lower paratracheal, upper paratracheal, hilar, and subcarinal forms observed in 81.7%, 69.1%, 53.5%, and 47.9% of cases as the most involved stations in lymph nodes, respectively. In 74.6% of patients with mediastinal lymphadenopathy, perilymph node fat inflammation [matting] was observed, with 52.11% exhibiting conglomeration. Bronchial pressure was observed in 4.23% of children with tuberculosis, and bilateral-, right-, and left-parenchymal involvement was observed in 42.7%, 25.3%, and 8% of these cases, respectively. Left- and right-pleural effusion and calcification was reported in 6.7%, 12%, and 5.6% of patients, respectively
Additionally, nearly 80% of patients exhibited mediastinal lymphadenopathy and lung-parenchyma involvement simultaneously. Lung-parenchyma involvement was significantly correlated with subcarinal [p < .001], hilar [p < .001], subaortic [p = .030], lower paratracheal [p = .037], and axillary [p = .006] stations
Conclusion: Situation of mediastinal lymphadenopathy and its synchronicity with lung-parenchyma involvement can help in differential diagnosis of pulmonary tuberculosis from other lung diseases
RESUMO
Chronic Obstructive Pulmonary Disease[COPD] is one of the most common lung diseases in which the chronic duration of disease and disability can cause COPD exacerbation. Since there is insufficient dataavailable for this caseinIran, we have investigatedthepsychopathological featuresof these patients. In a descriptive analytic study, from March to September 2008, amongpatients of respiratoryclinicat Ghaem Hospitalof Mashhad city, in northeastern part of Iran, 43 people who werediagnosedwith COPD were selected via a convenience sampling and a spirometry was performed. A clinicalpsychologistassessedthe mentalstatus ofthe patients with the Symptom Checklist-90-R [SCL-90-R] instrument,and theHamilton andBeck Depression Inventory. Data were analyzed using theSPSS-14software and tests such as t-test, ANOVA and Pearson. Mean score for Global Severity Index [GSI] was 0.56 for men and 0.98 for women, and 51.2% of patients had developedmorbid psychopathologicalstatus. 51.8% of the patients were clinicallydepressed and 46.5% of them had abnormalanxiety. Women are more prone to experiencing symptoms such as depression, anxiety, phobia and physical disorders [P<0.05]. Patients with severe COPD were more depressed in compare to patients with mild and moderate COPD [P=0.01 and P=0.03, respectively]. Patients with COPD had high scores of psychopathological status. Depression is more prevalent among women diagnosed with COPD which is directly proportional to the severity of disease