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Suheil Albert Atallah-Yunes, Jackson Clark, Shazia Samanani, Myat Soe
BACKGROUND Pituitary gland metastasis is rarely the initial presentation of metastatic cancer. Most cases of pituitary gland metastasis are asymptomatic with diabetes insipidus being the most common symptomatic presentation. It can rarely present with symptoms of hormone underproduction such as secondary adrenal insufficiency. Although pituitary gland metastasis is rare, it is underestimated, as it is commonly misdiagnosed with pituitary gland adenoma due to the lack of clear radiological criteria differentiating between both...
February 17, 2019: American Journal of Case Reports
Yasuyuki Kobayashi, Koji Nakanishi, Mikizo Nakai
A 32-year-old man leaping down from the 3rd floor of his house got injured and was transferred to our center. Pseudoaneurysm at the aortic isthmus as well as pelvic and lower limb fractures were observed by computed tomography (CT) scan. Thoracic endovascular aortic repair(TEVAR)of the thoracic aorta was performed from zone 2, followed by external skeletal fixation. Postoperative chest X-ray revealed right hemothorax, and CT scan showed active bleeding from the right subclavian artery in addition to splenic artery pseudoaneurysm...
February 2019: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Jason M Gauthier, Andrew J Bierhals, Jingxia Liu, Keki R Balsara, Christine Frederiksen, Emily Gremminger, Ramsey R Hachem, Chad A Witt, Elbert P Trulock, Derek E Byers, Roger D Yusen, Patrick R Aguilar, Gary Marklin, Ruben G Nava, Benjamin D Kozower, Michael K Pasque, Bryan F Meyers, G Alexander Patterson, Daniel Kreisel, Varun Puri
OBJECTIVE: Chest computed tomography (CT) imaging is being increasingly used for potential lung donor assessment. However, the efficacy of CT imaging in this setting remains unknown. We hypothesize that chest CT imaging independently affects the decision-making process in donor lung utilization. METHODS: We conducted a retrospective cohort study of all adult donation after brain death donors managed through our local organ procurement organization from June 2011 to November 2016...
November 24, 2018: Journal of Thoracic and Cardiovascular Surgery
A Garner-Purkis, P Hine, A Gamage, S Perera, M C Gulliford
OBJECTIVE: To compare predeparture tuberculosis (TB) screening policies, including screening criteria and screening tests, and visa requirements for prospective migrants to high-income countries that have low to intermediate TB incidence and high immigration. STUDY DESIGN: Systematic review of policy documents. METHODS: We systematically identified high-income, high net-migration countries with an estimated TB incidence of <30 per 100,000...
February 13, 2019: Public Health
Espinoza Bertha, Martínez Ignacio, Schabib-Hany Muslim
BACKGROUND: Chagas disease is an important health problem in Latin America. Relatives of T. cruzi seropositive donors could also test positive in serological assays. Therefore, the study of Chagas diseases in family clusters has become important to accurately evaluate the problem that this infectious disease represents. OBJECTIVE: to investigate family cluster from blood donors, their serological, clinical and epidemiological status. METHODS: 53 family clusters consisting of index case and a variable number of relatives were studied...
February 13, 2019: Acta Tropica
Masatake Kobayashi, Masataka Watanabe, Stefano Coiro, Matthieu Bercker, Yuki Paku, Yoichi Iwasaki, Taishiro Chikamori, Akira Yamashina, Kevin Duarte, João Pedro Ferreira, Patrick Rossignol, Faiez Zannad, Nicolas Girerd
AIMS: Pulmonary congestion is associated with poor prognosis following hospitalization for worsening heart failure (HF), although its quantification and optimal timing during HF hospitalization remains challenging. The aim of this study was to assess the prognostic value of radiographic pulmonary congestion at admission and discharge in patients with worsening HF. METHODS AND RESULTS: Clinical, echocardiographic, laboratory and chest X-ray data of 292 acute decompensated HF patients were retrospectively studied (follow-up 1 year)...
February 8, 2019: International Journal of Cardiology
Wolf Armbruster, Rüdiger Eichholz, Thomas Notheisen
Lung ultrasound is an underrated tool in preclinical emergency situations, intensive care units, ORs and emergency rooms. For certain clinical questions, there is a drastically higher sensitivity in comparison to chest X-ray examinations (sensitivity in pneumothorax diagnostics 86 vs. 28%, specificity 97 vs. 100%. A standardized examination improves the quality of the ultrasound examination and thus the diagnostic value. The article provides basic information on pulmonary ultrasound and aims to highlight the superiority of ultrasound over x-ray procedures for anesthesia, intensive care and emergency medicine in accordance to the international evidence-based recommendations for point of care ultrasound...
February 2019: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Abdulrahman Hakami, Evita Zwartkruis, Teodora Radonic, Johannes M A Daniels
BACKGROUND: Pulmonary carcinoids are included in the group of neuroendocrine tumors (NET) and derive from pulmonary neuroendocrine cells. The incidence of these tumors is increasing, but disease awareness remains low among clinicians. The synchronous presentation of lung cancer and mycobacterial infection is well known but the combination of pulmonary carcinoid and mycobacterial infection is rare. CASE PRESENTATION: We treated a 45-year-old female who presented with recurrent pneumonia...
February 15, 2019: BMC Pulmonary Medicine
Takeshi Saraya, Masaki Tamura, Keisuke Kasuga, Masachika Fujiwara, Hajime Takizawa
A 58-year-old man presented with a two-month history of facial erythema and dry cough. Physical examination revealed typical cutaneous manifestations of dermatomyositis (DM), including heliotrope rash and shawl sign. A chest X-ray revealed a 4-cm mass in the right middle lung. After bronchoscopy and investigation of auto-antibodies, he was diagnosed with co-occurring transcriptional intermediary factor 1-gamma (TIF1-γ) positive DM and lung adenocarcinoma. He was administered oral prednisolone for subsequent muscle weakness, but developed TIF1-γ positive DM-associated oropharyngeal dysphagia complicated by spontaneous oesophageal rupture and died from progression of chemoresistant lung cancer...
April 2019: Respirology Case Reports
Anoopkishore Chidambaram, Sirisha Donekal
Spontaneous subcutaneous emphysema and pneumomediastinum in children without any predisposing factors is a rare entity. We present a case of an adolescent boy with spontaneous pneumomediastinum. He is a 14-year-old boy brought to the hospital with an odd feeling in the neck and chest. Initial chest X-ray revealed subcutaneous emphysema and pneumomediastinum. He was further evaluated with CT thorax and abdomen with contrast which revealed extensive pneumomediastinum with associated surgical emphysema in the chest wall and neck...
February 13, 2019: BMJ Case Reports
John Refait, Julie Macey, Stephanie Bui, Michaël Fayon, Patrick Berger, Laurence Delhaes, François Laurent, Gaël Dournes
BACKGROUND: Mucus plugging (MP), central bronchiectasis (CB), and consolidation/atelectasia (CA) are conventional CT signs to diagnose allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF). Hyperattenuating mucus (HAM) has recently been described and may improve diagnostic accuracy. The goal of our study was to compare HAM versus conventional CT signs to diagnose ABPA in CF. Secondary objectives were to determine the optimal threshold of HAM quantitatively and to assess the diagnostic value of HAM using chest radiograph (CXR)...
February 12, 2019: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
D Herrmann, J Volmerig, R Wolf, G Neuhaus, M Schwamborn, S Ewig, E Hecker
A young man presented with haemoptysis, eight years after foreign body aspiration. The initial evaluation took place in the emergency department of a general hospital. However, neither chest x-ray nor bronchoscopy were performed. Bronchoscopy performed in our hospital revealed a foreign body in right lower lobe bronchus. Extraction failed because it was embedded in granulation tissue. The chronic atelectasis of right lower lobe and recurrent bronchopulmonary infections during the last years were the indication for lobectomy...
February 14, 2019: Pneumologie
Barbara Carl, Miriam Bopp, Benjamin Voellger, Benjamin Saß, Christopher Nimsky
OBJECTIVE: To investigate how augmented reality (AR) can be applied to support transsphenoidal surgery. METHODS: AR was established using the head-up displays integrated into operating microscopes. Navigation registration was performed either fiducial-based or by automatic registration applying intraoperative computed tomography (iCT). Correct microscope calibration was ensured by checking the geometric overlap between the AR representation of the reference array and 3-D reality while focusing on the reference array...
February 11, 2019: World Neurosurgery
Amelia Y Merrill, Mary M Garland, Marissa Howard-McNatt, Mena Isnassuos, Kathleen C Perry, Edward A Levine
National Comprehensive Cancer Network guidelines suggest a selective workup of early-stage breast cancer with complete blood count (CBC) and liver function tests (LFTs) and no longer recommend chest X-ray (CXR) to screen for occult metastasis. We evaluated the utility of routine preoperative screening tests in patients with clinically node-negative (cN0) breast cancer. We identified 1611 patients with cN0 breast cancer treated at our institution between October 1998 and December 2015; 94.4 per cent of the patients underwent at least one preoperative screening test: 90...
January 1, 2019: American Surgeon
M F Sazzad, M A Uddin, M A Imran, A M Ansary, S A Musa, H Saha, M M Rahman, M R Hoque, M N Islam, S Sarkar, G Tanchangya, A K Pal, I Alam, M S Ershad, M Kamruzzaman, S Sultana
We examined the hypothesis that the cross mattress for chest drain insertion site security is better than that of polypropylene horizontal mattress in chest trauma patient required tube thoracostomy at the Department of Casualty Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to June 2016. Accordingly we prospectively studied 50 consecutive patients who needed chest tube insertion. In 25 consecutive cases chest drain insertion site was secured with polypropylene horizontal mattress technique (Control- Group A) and another 25 consecutive patients had a cross-mattress with non-absorbable suture materials (Experimental- Group B)...
January 2019: Mymensingh Medical Journal: MMJ
Clara Angeles, Gary Lombardo, Karthik Prabhakaran, Jorge Con
No abstract text is available yet for this article.
November 1, 2018: American Surgeon
Xiu-Long Feng, Xue-Bin Lei, Wen-Ting Dong, Lin-Feng Yan, Yong-Kang Xin, Gang-Feng Li, Yong Jing, Shi-Jun Duan, Jie Zhang, Yu-Chuan Hu, Bo Li, Sha-Sha Zhao, Qian Sun, Jin Zhang, Tao Zhang, Dong-Liang Cheng, Guang-Bin Cui, Wen Wang
Background: Thymic epithelial tumors (TETs) are the most common primary thymus tumors, but neither the possible ethnical/regional differences in the incidence of TETs nor the inter-relationships among the clinical variables has been revealed in northwest China. Methods: A retrospective chart review was performed among pathologically confirmed TET patients from January 2004 to December 2015 in a tertiary general hospital of northwest China and the incidence, clinical features and the inter-relationships among clinical variables were analyzed...
December 2018: Journal of Thoracic Disease
Helena Huerga, Gabriella Ferlazzo, Stephen Wanjala, Mathieu Bastard, Paolo Bevilacqua, Elisa Ardizzoni, Joseph Sitienei, Maryline Bonnet
BACKGROUND: Empirical treatment of tuberculosis (TB) may be necessary in patients with negative or no Xpert MTB/RIF results. In a context with access to Xpert, we assessed mortality in the 6 months after the initial TB consultation among HIV-positive and HIV-negative patients who received empirical TB treatment or TB treatment based on bacteriological confirmation and we compared it with the mortality among those who did not receive TB treatment. METHODS: This prospective cohort study included consecutively adult patients with signs and symptoms of TB attending an outpatient TB clinic in Western Kenya...
February 11, 2019: BMC Infectious Diseases
Peijin Esther Monica Fan, Siok Bee Tan, Gillan Irani Farah, Poh Gek Cheok, Wan Ting Chock, Wasudevan Sutha, Donghui Xu, Weiyan Chua, Xiu Ling Kwan, Chi Ling Li, Wei Qin Teo, Shin Yuh Ang
BACKGROUND: Distance from the tip of the nose to earlobe to xiphisternum is commonly used to determine the length of nasogastric tube to be inserted. However, it is not evidence-based and frequently leads to improper positioning. OBJECTIVES: This study evaluated four formulae and the distance from the tip of the nose to earlobe to xiphisternum in estimating the internal length of nasogastric tube required for optimal positioning. DESIGN: Observational Study...
January 14, 2019: International Journal of Nursing Studies
Yohsuke Yanase, Akihito Ohkawa, Ryosuke Numaguchi, Hiroshi Sato, Naomi Yasuda, Yosuke Kuroda, Ryo Harada, Toshiro Ito, Hirosato Doi, Nobuyoshi Kawaharada
A 74-year-old man had undergone two-vessel coronary artery bypass grafting (CABG), 19 years ago, with the left internal mammary artery (LITA) to the left anterior descending artery and the saphenous vein graft (SVG) to the posterior descending artery. In outpatient care, a thoracic aortic aneurysm was suspected by the chest X-ray. In the computed tomography, appeared the distal arch aortic aneurysm, abdominal aortic aneurysm (AAA), and giant right coronary artery aneurysm (rCAA). The diameter of rCAA was 70 mm and it oppressed the right atrium and ventricle of the heart...
February 11, 2019: Journal of Cardiac Surgery
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