Chest-Mostly-Fixed-1
Total Page：16
File Type：pdf, Size：1020Kb
Load more
Recommended publications
-
Pulmonary Talcosis Caused by Intravenous Methadone Injection Dante Luiz Escuissato1, Rimarcs Gomes Ferreira2, João Adriano De Barros1, Edson Marchiori3
J Bras Pneumol. 2017;43(2):154-155 http://dx.doi.org/10.1590/S1806-37562016000000337 LETTER TO THE EDITOR Pulmonary talcosis caused by intravenous methadone injection Dante Luiz Escuissato1, Rimarcs Gomes Ferreira2, João Adriano de Barros1, Edson Marchiori3 TO THE EDITOR: birefringent foreign material, compatible with talc (Figures 1C and 1D). The centrilobular nodules were determined A 38-year-old woman presented to our pulmonology histopathologically to be tiny foreign body particles lodged clinic with complaints of progressive dyspnea and dry in the centrilobular arterioles and perivascular space. cough for more than three months. She denied fever or weight loss. On physical examination, she presented as Upon further discussion, the patient remembered that hypoxemic, with a room air oxygen saturation of 92% approximately one month before the onset of symptoms, and an RR of 24 breaths/min. Pulmonary function tests she had self-administered an i.v. injection of a crushed showed that spirometric values were within normal methadone pill diluted in water, due to strong pain caused limits, but there was a slight increase in residual volume by trigeminal neuralgia. Based on the clinical history, CT (127% of predicted), as well as a reduction in DLCO findings, and pulmonary biopsy results, the diagnosis of (70% of predicted). Other laboratory test results were pulmonary talcosis secondary to i.v. drug injection was normal. A CT of the chest showed bilateral centrilobular made. Echocardiogram results were normal. No signs nodules, most of them showing tree-in-bud appearance, of pulmonary hypertension were seen. During 3 years scattered diffusely in the lung parenchyma (Figures 1A of follow-up, the patient showed clinical stability with and 1B). -
Identifying COPD by Crackle Characteristics
BMJ Open Resp Res: first published as 10.1136/bmjresp-2020-000852 on 5 March 2021. Downloaded from Respiratory epidemiology Inspiratory crackles—early and late— revisited: identifying COPD by crackle characteristics Hasse Melbye ,1 Juan Carlos Aviles Solis,1 Cristina Jácome,2 Hans Pasterkamp3 To cite: Melbye H, Aviles ABSTRACT Key messages Solis JC, Jácome C, et al. Background The significance of pulmonary crackles, Inspiratory crackles— by their timing during inspiration, was described by Nath early and late—revisited: and Capel in 1974, with early crackles associated with What is the key question? identifying COPD by bronchial obstruction and late crackles with restrictive ► In the diagnosis of chronic obstructive pulmonary crackle characteristics. defects. Crackles are also described as ‘fine’ or disease (COPD), is it more useful to focus on the tim- BMJ Open Resp Res ‘coarse’. We aimed to evaluate the usefulness of crackle ing of crackles than on the crackle type? 2021;8:e000852. doi:10.1136/ bmjresp-2020-000852 characteristics in the diagnosis of chronic obstructive What is the bottom line? pulmonary disease (COPD). ► Pulmonary crackles are divided into two types, ‘fine’ Methods In a population-based study, lung sounds Received 2 December 2020 and ‘coarse’ and coarse inspiratory crackles are re- Revised 2 February 2021 were recorded at six auscultation sites and classified in garded to be typical of COPD. In bronchial obstruc- Accepted 5 February 2021 participants aged 40 years or older. Inspiratory crackles tion crackles tend to appear early in inspiration, and were classified as ‘early’ or ‘late and into the types’ this characteristic of the crackle might be easier for ‘coarse’ and ‘fine’ by two observers. -
Age-Related Pulmonary Crackles (Rales) in Asymptomatic Cardiovascular Patients
Age-Related Pulmonary Crackles (Rales) in Asymptomatic Cardiovascular Patients 1 Hajime Kataoka, MD ABSTRACT 2 Osamu Matsuno, MD PURPOSE The presence of age-related pulmonary crackles (rales) might interfere 1Division of Internal Medicine, with a physician’s clinical management of patients with suspected heart failure. Nishida Hospital, Oita, Japan We examined the characteristics of pulmonary crackles among patients with stage A cardiovascular disease (American College of Cardiology/American Heart 2Division of Respiratory Disease, Oita University Hospital, Oita, Japan Association heart failure staging criteria), stratifi ed by decade, because little is known about these issues in such patients at high risk for congestive heart failure who have no structural heart disease or acute heart failure symptoms. METHODS After exclusion of comorbid pulmonary and other critical diseases, 274 participants, in whom the heart was structurally (based on Doppler echocar- diography) and functionally (B-type natriuretic peptide <80 pg/mL) normal and the lung (X-ray evaluation) was normal, were eligible for the analysis. RESULTS There was a signifi cant difference in the prevalence of crackles among patients in the low (45-64 years; n = 97; 11%; 95% CI, 5%-18%), medium (65-79 years; n = 121; 34%; 95% CI, 27%-40%), and high (80-95 years; n = 56; 70%; 95% CI, 58%-82%) age-groups (P <.001). The risk for audible crackles increased approximately threefold every 10 years after 45 years of age. During a mean fol- low-up of 11 ± 2.3 months (n = 255), the short-term (≤3 months) reproducibility of crackles was 87%. The occurrence of cardiopulmonary disease during follow-up included cardiovascular disease in 5 patients and pulmonary disease in 6. -
Cardiothoracic Fellowship Program
Cardiothoracic Fellowship Program Table of Contents Program Contact ............................................................................................ 3 Other contact numbers .................................................................................. 4 Introduction ........................................................................................................... 5 Goals and Objectives of Fellowship: ..................................................................... 6 Rotation Schedule: ........................................................................................ 7 Core Curriculum .................................................................................................... 8 Fellow’s Responsibilities ..................................................................................... 22 Resources ........................................................................................................... 23 Facilities ....................................................................................................... 23 Educational Program .......................................................................................... 26 Duty Hours .......................................................................................................... 29 Evaluation ........................................................................................................... 30 Table of Appendices .................................................................................... 31 Appendix A -
Screening Chest X-Ray Interpretations and Radiographic Techniques IOM GUIDELINES FIRST EDITION Iii
FIRST EDITION 2015 Screening Chest X-Ray Interpretations and Radiographic Techniques IOM GUIDELINES Global Radiology Coordination and Teleradiology Centre Migration Health Division International Organization for Migration (Manila Administrative Centre) 24th floor Citibank Tower, Paseo De Roxas 8741, Makati city 1226 Metro Manila, Philippines Email: [email protected] • [email protected] Tel: +632 230 1674 The opinions expressed in the report are those of the authors and do not necessarily reflect the views of the International Organization for Migration (IOM). The designations employed and the presentation of material throughout the report do not imply the expression of any opinion whatsoever on the part of IOM concerning the legal status of any country, territory, city or area, or of its authorities, or concerning its frontiers or boundaries. IOM is committed to the principle that humane and orderly migration benefits migrants and society. As an intergovernmental organization, IOM acts with its partners in the international community to: assist in meeting the operational challenges of migration; advance understanding of migration issues; encourage social and economic development through migration; and uphold the human dignity and well-being of migrants. Author Sifrash Meseret GELAW, MD Radiologist, MPH; Global Radiology Coordinator IOM, Manila Administrative Centre, Manila, Philippines Major Contributor Anthony MACDERMOTT, MD former Global HAP Quality Coordinator, IOM, Regional Office for Asia and the Pacific, Bangkok, Thailand Additional -
Oral Health and Respiratory Infection
C LINICAL P RACTICE Oral Health and Respiratory Infection • Philippe Mojon, DMD, PhD • Abstract The oral cavity has long been considered a potential reservoir for respiratory pathogens. The mechanisms of infec- tion could be aspiration into the lung of oral pathogens capable of causing pneumonia, colonization of dental plaque by respiratory pathogens followed by aspiration, or facilitation by periodontal pathogens of colonization of the upper airway by pulmonary pathogens. Several anaerobic bacteria from the periodontal pocket have been isolated from infected lungs. In elderly patients living in chronic care facilities, the colonization of dental plaque by pulmonary pathogens is frequent. Notably, the overreaction of the inflammatory process that leads to destruc- tion of connective tissue is present in both periodontal disease and emphysema. This overreaction may explain the association between periodontal disease and chronic obstructive pulmonary disease, the fourth leading cause of death in the United States. These findings underline the necessity for improving oral hygiene among patients who are at risk and those living in long-term care institutions. MeSH Key Words: aged; periodontal diseases/epidemiology; pneumonia, aspiration/epidemiology; pneumonia, aspiration/ prevention & control © J Can Dent Assoc 2002; 68(6):340-5 This article has been peer reviewed. he anatomical continuity between the lungs and the different for the 2 types. CAP is a frequent illness, with an oral cavity makes the latter a potential reservoir of incidence rate estimated at about 8 cases per 1,000 inhabi- Trespiratory pathogens. Yet an infective agent must tants per year in industrialized countries. The mortality rate defeat sophisticated immunological and mechanical is about 7% in hospitalized patients.1 Streptococcus pneumo- defence mechanisms to reach the lower respiratory tract. -
New Jersey Chapter American College of Physicians
NEW JERSEY CHAPTER AMERICAN COLLEGE OF PHYSICIANS ASSOCIATES ABSTRACT COMPETITION 2015 SUBMISSIONS 2015 Resident/Fellow Abstracts 1 1. ID CATEGORY NAME ADDITIONAL PROGRAM ABSTRACT AUTHORS 2. 295 Clinical Abed, Kareem Viren Vankawala MD Atlanticare Intrapulmonary Arteriovenous Malformation causing Recurrent Cerebral Emboli Vignette FACC; Qi Sun MD Regional Medical Ischemic strokes are mainly due to cardioembolic occlusion of small vessels, as well as large vessel thromboemboli. We describe a Center case of intrapulmonary A-V shunt as the etiology of an acute ischemic event. A 63 year old male with a past history of (Dominik supraventricular tachycardia and recurrent deep vein thrombosis; who has been non-compliant on Rivaroxaban, presents with Zampino) pleuritic chest pain and was found to have a right lower lobe pulmonary embolus. The deep vein thrombosis and pulmonary embolus were not significant enough to warrant ultrasound-enhanced thrombolysis by Ekosonic EndoWave Infusion Catheter System, and the patient was subsequently restarted on Rivaroxaban and discharged. The patient presented five days later with left arm tightness and was found to have multiple areas of punctuate infarction of both cerebellar hemispheres, more confluent within the right frontal lobe. Of note he was compliant at this time with Rivaroxaban. The patient was started on unfractionated heparin drip and subsequently admitted. On admission, his vital signs showed a blood pressure of 138/93, heart rate 65 bpm, and respiratory rate 16. Cardiopulmonary examination revealed regular rate and rhythm, without murmurs, rubs or gallops and his lungs were clear to auscultation. Neurologic examination revealed intact cranial nerves, preserved strength in all extremities, mild dysmetria in the left upper extremity and an NIH score of 1. -
Radiology Fundamentals: Introduction to Imaging & Technology
Radiology Fundamentals Harjit Singh ● Janet A Neutze Editors Jonathan R Enterline ● Joseph S Fotos Associate Editors Jonathan J Douds ● Megan Jenkins Kalambo ● Marsha J Bluto Contributing Editors Radiology Fundamentals Introduction to Imaging & Technology Fourth Edition Editors Harjit Singh, MD, FSIR Janet A Neutze, MD Professor of Radiology, Surgery, Associate Professor of Radiology and Medicine Associate Division Chief, Ultrasound Director of Education, Penn State Heart Co-director, Radiology Medical Student and Vascular Institute Education Program Fellowship Director, Cardiovascular Pennsylvania State College of Medicine and Interventional Radiology Penn State Hershey Medical Center Pennsylvania State College of Medicine Hershey, PA, USA Penn State Hershey Medical Center [email protected] Hershey, PA, USA [email protected] Associate Editors Jonathan R Enterline, MD Joseph S Fotos, MD Resident, Department of Radiology Resident, Department of Radiology Pennsylvania State College of Medicine Pennsylvania State College of Medicine Penn State Hershey Medical Center Penn State Hershey Medical Center Hershey, PA, USA Hershey, PA, USA Contributing Editors Jonathan J Douds, BS Megan Jenkins Kalambo, MD Medical Student Resident, Department of Radiology Pennsylvania State College of Medicine University of Texas Health Science Center Penn State Hershey Medical Center at Houston, Houston, TX, USA Hershey, PA, USA Marsha J Bluto, MD Practicing Physician Physical Medicine and Rehabilitation Mill Valley, CA, USA ISBN 978-1-4614-0943-4 e-ISBN 978-1-4614-0944-1 DOI 10.1007/978-1-4614-0944-1 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011938463 © Springer Science+Business Media, LLC 2012 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. -
Diffuse Alveolar Hemorrhage Syndrome Secondary to Bocavirus
Case report Diffuse alveolar hemorrhage syndrome secondary to bocavirus and rhinovirus infection in a pediatric patient Síndrome de hemorragia alveolar difusa secundaria a coinfección por Rhinovirus y Bocavirus en un paciente pediátrico Carlos Eduardo Reina1 , Sandra Patricia Concha2, Rubén Eduardo Lasso2, Fernando Bermúdez2, María Teresa Agudelo3 Abstract The diffuse alveolar hemorrhage syndrome is characterized by the presence of blood in the pulmonary alveolus from arterioles, venules and pulmonary Date correspondence: capillaries, as a consequence of the lesion of the alveolar wall and without an Received: February 20, 2015. endobronchial alteration. Its presentation includes a classic triad of hemopty- Revised: September 11, 2017. sis, anemia and diffuse alveolar infiltrates. It´s a rare but potentially fatal entity Accepted: October 31, 2017. and there are no clear data on its real incidence in the pediatric population. We present the case of a previously healthy pediatric patient, immunocompetent, How to cite: who presented diffuse alveolar hemorrhage syndrome with secondary venti- Reina CE, Concha SP, Lasso RE, latory failure. After discarding all possible etiologies, coinfection by Rhinovirus Bermudez F, Agudelo MT. Diffuse and human Bocavirus was detected through the polymerase chain reaction, alveolar hemorrhage syndrome determining them as causal factors of the event. Recently, viral infections secondary to Rhinovirus and have been postulated as causing serious lung disease, especially coinfec- Bocavirus coinfection in a tion in immunocompromised patients, in this case Rhinovirus and human pediatric patient. Rev CES Bocavirus; however there are no reports on the syndrome caused by these Medicina. 2018; 32(1): 53-60. viruses. Open access Keywords: Diffuse alveolar hemorrhage; Respiratory failure; Rhinovirus; © Derecho de autor Human Bocavirus. -
Chest Radiology: a Resident's Manual
Chest Radiology: A Resident's Manual Bearbeitet von Johannes Kirchner 1. Auflage 2011. Buch. 300 S. Hardcover ISBN 978 3 13 153871 0 Format (B x L): 23 x 31 cm Weitere Fachgebiete > Medizin > Sonstige Medizinische Fachgebiete > Radiologie, Bildgebende Verfahren Zu Inhaltsverzeichnis schnell und portofrei erhältlich bei Die Online-Fachbuchhandlung beck-shop.de ist spezialisiert auf Fachbücher, insbesondere Recht, Steuern und Wirtschaft. Im Sortiment finden Sie alle Medien (Bücher, Zeitschriften, CDs, eBooks, etc.) aller Verlage. Ergänzt wird das Programm durch Services wie Neuerscheinungsdienst oder Zusammenstellungen von Büchern zu Sonderpreisen. Der Shop führt mehr als 8 Millionen Produkte. 1 Heart Failure Acute left heart failure is most commonly caused by a hyperten- " Compare pulmonary vessels that are equidistant to a central sive crisis. Radiographic signs on the plain chest radiograph ob- point in the respective hilum. tained with the patient standing include: " Compare the diameter of a random easily identifiable superior " Redistribution of pulmonary perfusion lobe artery (often the anterior segmental artery is most easily " Presence of interstitial patterns (Kerley lines, peribronchial identifiable) with the diameter of the corresponding ipsilateral cuffing) bronchus (Fig. 1.62). " Alveolar densities with indistinct vascular structures (ad- vanced stage) As the pulmonary artery and corresponding ipsilateral bronchus " Pleural effusions are normally of precisely equal diameter, a larger arterial diameter is indicative of redistribution of perfusion (Fig. 1.63). The diagnos- All of these signs are essentially attributable to increased fluid tic criteria of caudal-to-cranial redistribution cannot be evaluated content in the abnormally heavy “wet” lung. The fluid accumula- on radiographs obtained in the supine patient. -
Congenitally Corrected Transposition Gonzalo a Wallis1*, Diane Debich-Spicer2,3 and Robert H Anderson4
Wallis et al. Orphanet Journal of Rare Diseases 2011, 6:22 http://www.ojrd.com/content/6/1/22 REVIEW Open Access Congenitally corrected transposition Gonzalo A Wallis1*, Diane Debich-Spicer2,3 and Robert H Anderson4 Abstract Congenitally corrected transposition is a rare cardiac malformation characterized by the combination of discordant atrioventricular and ventriculo-arterial connections, usually accompanied by other cardiovascular malformations. Incidence has been reported to be around 1/33,000 live births, accounting for approximately 0.05% of congenital heart malformations. Associated malformations may include interventricular communications, obstructions of the outlet from the morphologically left ventricle, and anomalies of the tricuspid valve. The clinical picture and age of onset depend on the associated malformations, with bradycardia, a single loud second heart sound and a heart murmur being the most common manifestations. In the rare cases where there are no associated malformations, congenitally corrected transposition can lead to progressive atrioventricular valvar regurgitation and failure of the systemic ventricle. The diagnosis can also be made late in life when the patient presents with complete heart block or cardiac failure. The etiology of congenitally corrected transposition is currently unknown, and with an increase in incidence among families with previous cases of congenitally corrected transposition reported. Diagnosis can be made by fetal echocardiography, but is more commonly made postnatally with a combination of clinical signs and echocardiography. The anatomical delineation can be further assessed by magnetic resonance imaging and catheterization. The differential diagnosis is centred on the assessing if the patient is presenting with isolated malformations, or as part of a spectrum. -
Supermicar Data Entry Instructions, 2007 363 Pp. Pdf Icon[PDF
SUPERMICAR TABLE OF CONTENTS Chapter I - Introduction to SuperMICAR ........................................... 1 A. History and Background .............................................. 1 Chapter II – The Death Certificate ..................................................... 3 Exercise 1 – Reading Death Certificate ........................... 7 Chapter III Basic Data Entry Instructions ....................................... 12 A. Creating a SuperMICAR File ....................................... 14 B. Entering and Saving Certificate Data........................... 18 C. Adding Certificates using SuperMICAR....................... 19 1. Opening a file........................................................ 19 2. Certificate.............................................................. 19 3. Sex........................................................................ 20 4. Date of Death........................................................ 20 5. Age: Number of Units ........................................... 20 6. Age: Unit............................................................... 20 7. Part I, Cause of Death .......................................... 21 8. Duration ................................................................ 22 9. Part II, Cause of Death ......................................... 22 10. Was Autopsy Performed....................................... 23 11. Were Autopsy Findings Available ......................... 23 12. Tobacco................................................................ 24 13. Pregnancy............................................................