China
Africa
Explore chapters and articles related to this topic
Respiratory Diseases
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Aref T. Senno, Ryan K. Brannon
Typical responses to therapy include defervescence in 2–4 days, with resolution of leukocytosis in the same time period. The chest x-ray may take longer to clear, as may the auscultatory findings. Antibiotic therapy should not be changed within the first 72 hours unless clinical deterioration is overt or organism sensitivities become available. There is no evidence in non-pregnant adults that intravenous and oral therapy differ in efficacy. Patients should be switched from intravenous to oral therapy when hemodynamically stable and improving clinically, able to ingest medications, and have a normally functioning GI tract. If the pathogen and sensitivities are known, the narrowest spectrum agent should be chosen for oral therapy, but in most cases, this will not be possible. When switching to oral agents, choose the same medication or the same class when possible. The ATS/IDSA recommend discharge to home the same day that clinical stability is achieved (afebrile, no tachypnea nor tachycardia, normotensive, normoxemic, normal mental status, and able to tolerate oral intake) and the switch to oral agents is made. Inpatient observation while receiving oral therapy is not necessary. A follow-up inpatient chest x-ray is not recommended [52].
Investigation of COVID-19 Chest X-ray Images using Texture Features – A Comprehensive Approach
Published in S. Prabha, P. Karthikeyan, K. Kamalanand, N. Selvaganesan, Computational Modelling and Imaging for SARS-CoV-2 and COVID-19, 2021
J. Thamil Selvi, K. Subhashini, M. Methini
Chest X-ray images are filtered using LAWS mask. Texture energy is computed from the filtered image by summing the absolute values of pixels and their neighborhood. Three filters with corresponding masks, such as L-averaging filter [1 4 6 4 1], E-Edge detector filter [-1 -2 0 2 1] and S- Spot detector filter [-1 0 2 0 -1] [Rachidi et al., 2008] are used and convolved with each other to create 5 × 5 2D mask kernel LL, EE, LE, ES and LS. These masks are applied over an image to obtain a filtered image. The energy from filtered images is extracted usingwhere , Sr (x, y) is the neighborhood of (x, y) at radius ‘r’.
Diagnosis and Treatment of Inhalation Injury in Burn Patients
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Khan Z. Shirani, Joseph A. Moylan, Basil A. Pruitt
In patients with inhalation injury, the admission blood gases on room air often reveal a mild hypoxemia with PaO2 in the 60-70 torr range (Petroff et al., 1976). The initial chest x-ray is usually normal in these individuals and thus is of little diagnostic value since it does not rule out the presence of inhalation injury (DiVincenti et ah, 1971). Earlier reports in patients with acute carbon monoxide poisoning and inhalation injury have suggested that physical examination of the chest and chest x-rays in these individuals may reveal abnormal findings (Smith and Brandon, 1970; Meigs and Hughes, 1952; Sones et al., 1974) due to the development of interstitial and interalveolar pulmonary edema (Drinker, 1938), but the appearance of these findings (usually focal or diffuse pulmonic infiltrates) is usually delayed for 24-36 hr and they are also nonspecific (Putman et al., 1977). Besides the history, clinical findings, and the results of arterial blood gas determinations, which are essential to the work-up of any injured patient, the accurate diagnosis of inhalation injury often requires use of specialized tests.
A case of visible diffuse peritoneal Bacillus Calmette-Guérin infection at the time of planned radical cystectomy
Published in Scandinavian Journal of Urology, 2021
Marie Ødum Nielsen, Johanna Elversang, Alicia Martin Poulsen, Zahra Persson Theilgaard, Ulla Nordström Joensen
Two years before planned RC, the patient presented with macroscopic hematuria, dysuria, urgency and frequency. A diagnosis of CIS of the bladder was made at transurethral resection (TURBT). Induction treatment with 6 instillations of BCG was prescribed, with some doses cancelled due to local side effects, and re-induction started after three months due to persistent CIS. Biopsies after re-induction treatment showed a small focus of CIS. Cystectomy was discussed, but the patient opted for another trial of BCG. Maintenance treatment was not tolerated. A small focus of Ta high grade was noted during follow-up and resected. For the following year, cystoscopy and cytology every 4 months showed no recurrence. A suspicious erythematous lesion was biopsied one year after the last BCG instillation, after which the patient presented with abdominal pain and fever. A small retroperitoneal perforation of the bladder was noted and resolved with a Foley catheter for two weeks. Biopsies showed chronic inflammation, not indicative of a BCG ulcer [4]. During the following months, the patient had an unintentional weight loss of 20 kg due to loss of appetite, malaise and fatigue and had hospital admissions at other institutions for persistent diarrhea, pneumonia and atrial fibrillation. Plain chest x-ray was inconspicuous.
Specific gut microbiome signature predicts the early-stage lung cancer
Published in Gut Microbes, 2020
Yajuan Zheng, Zhaoyuan Fang, Yun Xue, Jian Zhang, Junjie Zhu, Renyuan Gao, Shun Yao, Yi Ye, Shihui Wang, Changdong Lin, Shiyang Chen, Hsinyi Huang, Liang Hu, Ge-Ning Jiang, Huanlong Qin, Peng Zhang, Jianfeng Chen, Hongbin Ji
All 76 fecal samples from lung cancer patients were collected in Shanghai Pulmonary Hospital, Tongji University School of Medicine. The 105 fecal samples from healthy volunteers were collected in The Tenth People’s Hospital Affiliated to Tongji University upon routine physical examination. Fecal samples were collected according to the approved protocol by the local ethics committees ahead of procedure of enrollment, and written informed consent was obtained from all patients and volunteers. Lung cancer was diagnosed according to the international guidelines by comprehensive consideration of lung biopsy, imaging examination, clinical symptoms, physical signs, laboratory tests, medical history, progress notes and cancer-associated comorbidities. All clinical information was collected according to standard procedures. Patients suffering from gastrointestinal tract disorders were excluded. Individuals who received antibiotics or probiotics within latest 8 weeks were excluded. As for healthy control samples, physical examination including routine examination of blood, urine, and feces, liver function, renal function, electrocardiogram, and chest X-ray results were used to exclude any unhealthy sample. Comprehensive clinical information for the enrolled participants, including age, gender, body mass index (BMI), tumor stage, tumor type, tumor metastasis, and smoking status are summarized in Table 1 and Table S1. The study was conducted in accordance with the Declaration of Helsinki and Rules of Good Clinical Practice.
Fluoroscopy guided percutaneous biopsy in combination with bronchoscopy and endobronchial ultrasound in the diagnosis of suspicious lung lesions – the triple approach
Published in European Clinical Respiratory Journal, 2020
Jatinder Singh Sidhu, Geir Salte, Ida Skovgaard Christiansen, Therese Marie Henriette Naur, Asbjørn Høegholm, Paul Frost Clementsen, Uffe Bodtger
If no lung tumor or no abnormal lymph nodes were demonstrated by bronchoscopy or EBUS, it was considered unlikely that endoscopy would provide a conclusive diagnosis. Rapid onsite evaluation (ROSE) was not accessible. In these cases F-TTNAB was performed immediately (Figure 1). The patient was placed in an appropriate supine position depending of the location of the lung lesion, which was localized in two planes with X ray fluoroscopy and the preferred route of the biopsy needle was chosen. X ray fluoroscopy was performed using a C-arm Ziehm exposcop 8000 (Ziehm GmBH, Nürnberg, Germany). The skin entry site was sterilized with standardized antiseptic solution and the cutaneous and subcutaneous tissue infiltrated with lidocaine up to a maximum dose of 20 ml of a 2% solution. Firstly, during lateral fluoroscopy and suspended patient respiration, a 7.5 mm guiding needle (Super 4 needle, (BD Angiomed GmBH, Karlsruhe, Germany) was placed adjacent to the lesion. Secondly, aspiration biopsies were obtained using a 220 mm Chiba 22G needle (BD Angiomed GmBH, Karlsruhe, Germany) via the guiding needle during shallow patient breathing and lateral fluoroscopy with at least two needle passes [14]. Suction was applied to the Chiba-needle by a 10 mL syringe, and aspirated material was transferred to slides and a designated container for cell block preparation. The biopsy procedure was followed by observation for at least 60 minutes with measurements of respiration frequency, peripheral oxygen saturation, blood pressure, pulse. At 60 minutes, all patients underwent a standing, full inspiration chest X ray.