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Identifying Possible Scenarios Where a Deep Learning Auto-Segmentation Model Could Fail
Published in Jinzhong Yang, Gregory C. Sharp, Mark J. Gooding, Auto-Segmentation for Radiation Oncology, 2021
Atelectasis and pleural effusions are not uncommon in cancer patients, with some studies reporting 7–22% of lung cancer patients presenting with these conditions prior to the start of treatment [visual inspection of challenge training data showed that 5/36 (14%) of cases showed signs of atelectasis (LCTSC-S1-008, LCTSC-S1-011, LCTSC-S3-005, LCTSC-S3-008, and LCTSC-S3-012)]. Atelectasis is a condition in which the airways and air sacs in the lung collapse or do not expand properly. This condition can happen in the presence of a tumor or because of a pleural effusion which is a condition that affects the tissue that covers the outside of the lungs and lines the inside of the chest cavity. These occur when an infection, medical condition, or chest injury causes fluid, pus, blood, air, or other gases to build up in the pleural space. Both atelectasis and pleural effusions can greatly alter the anatomy within the thorax; therefore, the auto-segmented organs at risk in cases presenting with these conditions were qualitatively evaluated.
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
My primary diagnosis for this patient suffering from shortness of breath and pyrexia shortly after an operative intervention is atelectasis. I would also consider other related abnormalities including ventilator-associated pneumonia, aspiration pneumonia and pulmonary embolism. I would also check other access sites that may have become infected such as catheters, the central venous line and cannulas.
Diagnostic Imaging in Inhalation Lung Injury
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Caroline Chiles, Laurence W. Hedlund, Charles E. Putman
Focal opacities or diffuse patchy opacities may be seen. If the acute phase is not complicated by adult respiratory distress syndrome, these opacities typically clear within 3 days (Kangarloo et al., 1977) (Fig. 1). The temporal relationship between the inhalation episode and the development and clearing of these opacities suggests that they are most likely due to atelectasis (Fig. 2). Possible causes of atelectasis include decreased mucociliary clearance with inspissation of secretions within bronchi and bronchioles, reflex bronchoconstriction, and surfactant inactivation (Trunkey, 1978). Animal models of smoke inhalation have been used to observe atelectasis in vivo, and to measure surface tension in lung samples as an indicator of surfactant activity (Nieman et al., 1980). Gross atelectasis was seen within seconds of the onset of smoke exposure, and was invariably present at the end of a 5 min period of smoke inhalation. Cinephotomi croscopy suggested that the alveolar walls became unstable, and minimum surface tension measurements increased from 6.8 to 22 dynes/cm. This suggests either a decrease in available surfactant or inactivation of the surfactant present.
Use of dornase alfa in pediatric patients without cystic fibrosis
Published in Hospital Practice, 2023
Krishna C. Daiya, Caroline M. Sierra
Respiratory insufficiency often presents as airway obstruction or inflammation and can lead to hypoxia requiring respiratory support. Atelectasis is often a complication of asthma, pneumonia, acute respiratory distress syndrome, or chronic lung disease [9]. Treatment includes chest physiotherapy, often considered first line, or bronchoscopy, positive airway pressure and use of surfactant [9,10]. Although there are no pharmacologic agents approved by the Food and Drug Administration for atelectasis, several mucolytic agents are used to promote airway clearance, including n-acetylcysteine, DNase, and hypertonic or normal saline [9,11]. However, there is limited high-quality evidence for the efficacy of these agents. The American Association for Respiratory Care recommends against the routine use of DNase in adult and pediatric patients without CF given the inconclusive evidence for its efficacy [12]. Additionally, given the high cost of therapy and unclear clinical benefits, the place in therapy of DNase for other respiratory conditions needs to be further explored.
Features of post-obstructive pneumonia in advanced lung cancer patients, a large retrospective cohort
Published in Infectious Diseases, 2023
Marco Moretti, Shauni Wellekens, Silke Dirkx, Karolien Vekens, Johan Van Laethem, Bart Ilsen, Eef Vanderhelst
Four hundred and eight patients were treated at the University Hospital UZ Brussel from January 2016 up to January 2021. The median age was 69 (IQR: 62-77) years and 62% were male (n = 255). Most of the patients (72%, n = 296) were affected by stage-IV lung neoplasm and in particular adenocarcinoma (59%, n = 218). The median CCI was 9 (7–10) and 36% were actively smoking (n = 141). After initial selection, 55 patients were selected as possibly affected by POP. After retrospective multidisciplinary revision, the diagnosis of POP was rejected in nine patients. The main reason for rejection was the absence of clinical and radiological features of infection. These patients were classified as having post-obstructive atelectasis without signs of infection. Furthermore, antibiotic therapy was not prescribed to these patients and their evolution was favourable. Therefore, after multidisciplinary review, 46 of the 55 patients initially selected as possibly affected by POP were retrospectively confirmed. The study flowchart is depicted in Figure 1.
CT imaging features of paranasal sinuses in children with primary ciliary dyskinesia
Published in Acta Oto-Laryngologica, 2022
Huiying Lyu, Zhuoyao Guo, Chao Chen, Bo Duan, Zhengmin Xu, Wenxia Chen
Rhinosinusitis was present in all 17 (100%) patients on the paranasal sinus CT scans (Figure 1). We observed otitis media with effusion on CT scans in 14 (82.4%) patients, grade 2 adenoidal hypertrophy based on adenoid/nasopharyngeal ratio on sagittal reconstructed image of CT scans [12] in 3 (17.6%) patients in our cohort (Table 3). Five patients got nasal endoscopy, but no nasal polyps were observed. Situs inversus totalis was observed in 8 (47.1%) patients on the chest CT scans. Nine (52.9%) patients had localized consolidation. Eleven (64.7%) patients had atelectasis of lung. Six (35.3%) patients had different degrees of bronchiectasis. Sixteen patients were born at term, one patient was born prematurely, and eight (47.1%) patients had a history of neonatal respiratory distress. Echocardiogram found that one (5.9%) patient had atrial and ventricular septal defects.