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Sickle Cell Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
New pulmonary infiltrate of at least one complete lung segment with alveolar consolidation and excluding atelectasis; and presence of chest pain, temp T >38.5°C, tachypnea, wheezing, or cough. Hypoxia, decreasing hemoglobin levels, and progressive pneumonia are frequent. Mostly associated with pulmonary fat embolism and pulmonary infection, with 3–10% chance of death, related to pulmonary embolism and pneumonia.
Democratic gestures
Published in Alan Bleakley, Medical Education, Politics and Social Justice, 2020
The thinking has now strayed far from “patient-centredness” (that is a de-territorializing tactic affording power to the patient) to reintroduce the boundary that denotes “medical territory: do not enter”. Thus: Tachycardia is a condition that makes your heart beat more than 100 times per minute: “your heart is racing”.A pulmonary infiltrate, observed on the chest X-ray, is a substance denser than air, such as pus, blood or protein, which lingers within the lungs: “your lungs are clogged, stopping you from breathing easily”.Ground-glass opacity is a metaphor or resemblance used to shortcut to an instant diagnosis (technically referring to an area of increased attenuation in the lung with preserved bronchial and vascular markings). While it is a non-specific sign with a wide aetiology including infection, chronic interstitial disease and acute alveolar disease, here it is linked with a COVID-19 infection. The patient could readily identify with this resemblance (“ground glass” as opaque) giving him (in the example above) a strong image for relating to his illness. Resemblances, often used as rapid diagnosis in medicine (“strawberry tongue” – possibly scarlet fever) can readily be related to by a layperson.
Acute Pulmonary Embolism
Published in Hau C. Kwaan, Meyer M. Samama, Clinical Thrombosis, 2019
Arthur A. Sasahara, Giuseppe Cella, Antonio Palla, G. V. R. K. Sharma
The plain film of the chest continues to be a standard tool by which all disorders of the lung are evaluated. It is readily obtained and aside from the radiation exposure which is small, it is a harmless, noninvasive procedure. Although a number of findings have been described over the years, a useful combination was described by the radiologists in the NIH-sponsored UPET: the combination of a pulmonary infiltrate and an elevated hemidiaphragm on the same side, found in 41% of the patients in the UPET study (Table 3). The pulmonary infiltrate initially was thought to represent pneumonia. The elevated hemidiaphragm on the involved side represents the decreased lung volume which results from the frequent atelectasis occurring in PE. The combination, therefore, of a pulmonary infiltrate and an elevated hemidiaphragm on the same side should suggest PE/infarction rather than pneumonia.
Radiological findings among children with community-acquired pneumonia with exclusively viral or bacterial infection: a prospective investigation
Published in Infectious Diseases, 2019
Débora Souto, César Araújo-Neto, Cristiana M. Nascimento-Carvalho
For the purpose of this study, all CXR were read by an experienced and independent paediatric radiologist, blinded to patient’s clinical data and aetiological diagnosis. Radiological findings were recorded, based on the standardized interpretation previously published [4]. The radiological findings included pulmonary infiltrate, pleural effusion, atelectasis, hyperinflation, abscess, peri-bronchial thickening, pneumatocele, and pneumothorax. The pulmonary infiltrate was characterized as alveolar, interstitial or alveolar-interstitial. Alveolar infiltrate was characterized as a dense or fluffy opacity that occupies a portion or whole of a lobe or of the entire lung, which may or may not contain air-bronchogram and interstitial infiltrate was defined as linear and patchy densities in a lacy pattern [4]. Cases had radiologically-confirmed pneumonia when pulmonary infiltrate or pleural effusion was found. Results on the association between aetiological subgroups and radiologically-confirmed pneumonia or normal CXR have been previously published [3]. Therein, no result on distinct radiological findings and aetiology was presented.
Rare nocardiosis in danish patient with diabetes
Published in European Clinical Respiratory Journal, 2021
Cecilie Norup Thomsen, Søren Sperling, Joan Fledelius, Pia Holland Gjørup
The initial diagnostic CT-imaging showed a pulmonary infiltrate. The patient responded clinically and biochemically on antibiotic treatment, however, a 6 week control scan showed progression of the infiltrate. Hence, the patient underwent additional diagnosing with PET-CT, bronchoscopy, and core needle biopsy (CNB). PET-CT showed multiple muscular abscesses (Figure 1). AN was found in fluid from bronchoalveolar lavage and CNB from the lung did not confirm malignity. Only CNB from the abdominal musculature was positive for bacterial growth, namely NP. The patient was HIV negative and had normal levels of immunoglobulins.
Comparison of mechanical cardiopulmonary support strategies during lung transplantation
Published in Expert Review of Medical Devices, 2020
Noah Weingarten, Dean Schraufnagel, Gilman Plitt, Anthony Zaki, Kamal S. Ayyat, Haytham Elgharably
Of the four studies that compared measures of hypoxemia – PaO2/FiO2, arterial/alveolar oxygen tension ratio (PaO2/PAO2), and alveolar-arterial (A-a) gradient – within 72 hours after LT between CPB and off pump patients, one showed more severe hypoxemia in the CPB patients [67], while the other three found no difference between groups [52,53,56]. One study specifically commenting on pulmonary infiltrate severity in CPB compared to off pump found no difference [52].