scholarly journals Ultrasound-guided thoracoscopic debridement in children with fibrinothorax

2021 ◽  
Vol 11 (3) ◽  
pp. 367-374
Author(s):  
Anatoly A. Pavlov ◽  
Adelina I. Sergeeva ◽  
Zot I. Zolnikov ◽  
Tatyana I. Dianova ◽  
Olga N. Ivanova ◽  
...  
Keyword(s):  
Pleural Cavity ◽  
Ultrasound Examination ◽  
Lung Parenchyma ◽  
Community Acquired Pneumonia ◽  
X Ray ◽  
Surgical Department ◽  
Ultrasound Monitoring ◽  
Complete Restoration ◽  
Chuvash Republic ◽  
Ideal Method

BACKGROUND: With the spread of endoscopic procedures, thoracoscopy has become an ideal method for the surgical treatment of pleural complications. Ultrasound examination of the pleural cavity made it possible to differentiate the nature of the pleural contents and timely use of thoracoscopic sanitation of the pleural cavity. AIM: This study aimed to conduct ultrasound monitoring of the complete restoration of the pleural cavity after video-assisted thoracoscopic debridement in children with fibrinothorax. MATERIALS AND METHODS: The study was conducted in the childrens surgical department of the Republican Childrens Clinical Hospital of Health Ministry of the Chuvash Republic. From 2011 to 2019, 31 children aged 1 month to 18 years were diagnosed with community-acquired pneumonia complicated by fibrinothorax, and thoracoscopic debridement and drainage of the pleural cavity were performed. During hospitalization, before thoracoscopy, 13 ultrasound examinations of the pleural cavities and lungs were performed in all children, which made it possible to determine methods of management. After thoracoscopic debridement, ultrasound examination of the pleural cavities was performed 37 times during hospitalization and 12 times monthly for 36 months after discharge from the hospital until the pleural cavity was completely restored. RESULTS: Ultrasound monitoring of the pleural cavities and lungs after thoracoscopic debridement at the outpatient stage showed that changes in the pleural cavity and lung parenchyma can last up to 6 months, while childrens health status was satisfactory. CONCLUSIONS: Preoperative and postoperative ultrasound monitoring can adequately assess the overall state of the pleural cavities and lungs. Changes in the pleural cavity after thoracoscopic debridement under ultrasound guidance are observed later than by X-ray. In this regard, after discharge from the hospital, children with complicated purulent and destructive pneumonia who underwent thoracoscopic debridement need ultrasound monitoring of the pleural cavity until it is completely restored.

Difference Fourier Analysis of Glucose Embedded and Frozen Hydrated Purple Membrane

1982 ◽  
Vol 40 ◽  
pp. 74-75
Author(s):  
Jules S. Jaffe ◽  
Robert M. Glaeser
Keyword(s):  
Purple Membrane ◽  
Data Set ◽  
High Resolution Data ◽  
X Ray ◽  
X Ray Crystallography ◽  
Fourier Techniques ◽  
Versus Protein ◽  
The Difference ◽  
Difference Fourier ◽  
Ideal Method

Although difference Fourier techniques are standard in X-ray crystallography it has only been very recently that electron crystallographers have been able to take advantage of this method. We have combined a high resolution data set for frozen glucose embedded Purple Membrane (PM) with a data set collected from PM prepared in the frozen hydrated state in order to visualize any differences in structure due to the different methods of preparation. The increased contrast between protein-ice versus protein-glucose may prove to be an advantage of the frozen hydrated technique for visualizing those parts of bacteriorhodopsin that are embedded in glucose. In addition, surface groups of the protein may be disordered in glucose and ordered in the frozen state. The sensitivity of the difference Fourier technique to small changes in structure provides an ideal method for testing this hypothesis.

X-Ray Analysis of Frozen Hydrated Sections:The Unconventional Approach

1982 ◽  
Vol 40 ◽  
pp. 754-757
Author(s):  
R. Beeuwkes ◽  
A. Saubermann ◽  
P. Echlin ◽  
S. Churchill
Keyword(s):  
Ratio Method ◽  
Frozen Sections ◽  
Technical Problems ◽  
Sample Handling ◽  
X Ray ◽  
Common Group ◽  
Ideal Method ◽  
Classic Paper ◽  
Physical Principles ◽  
The Ideal

Fifteen years ago, Hall described clearly the advantages of the thin section approach to biological x-ray microanalysis, and described clearly the ratio method for quantitive analysis in such preparations. In this now classic paper, he also made it clear that the ideal method of sample preparation would involve only freezing and sectioning at low temperature. Subsequently, Hall and his coworkers, as well as others, have applied themselves to the task of direct x-ray microanalysis of frozen sections. To achieve this goal, different methodological approachs have been developed as different groups sought solutions to a common group of technical problems. This report describes some of these problems and indicates the specific approaches and procedures developed by our group in order to overcome them. We acknowledge that the techniques evolved by our group are quite different from earlier approaches to cryomicrotomy and sample handling, hence the title of our paper. However, such departures from tradition have been based upon our attempt to apply basic physical principles to the processes involved. We feel we have demonstrated that such a break with tradition has valuable consequences.

Clinical Impact of Combined Viral and Bacterial Infection in Pediatric Mycoplasmal Community-Acquired Pneumonia in Western China

2020 ◽  
Vol 12 (11) ◽  
pp. 1315-1322
Author(s):  
Zhuoxin Liang ◽  
Wenqiang Zhang ◽  
Yongjiang Jiang ◽  
Ping Wu ◽  
Senxiong Zhang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Severe Disease ◽  
Lung Parenchyma ◽  
Community Acquired Pneumonia ◽  
Western China ◽  
Care Hospital ◽  
Hospital Data ◽  
Chest X Ray ◽  
Ventilation Rates ◽  
The Impact

Community-acquired pneumonia (CAP) refers to an infection contracted outside the hospital that leads to lung parenchyma inflammation. The clinical characteristics of Mycoplasma pneumoniae (M. pneumoniae) infection in CAP patients were rarely reported. The aim of this study was to describe the clinical characteristic and the impact of co-infections of M. pneumoniae with viral and bacterial pathogens in hospitalized children with CAP in Liuzhou, China. This study retrospects children diagnosed with CAP due to M. pneumoniae infection at a tertiary maternal and child health care hospital. Data related to co-infection pathogens, demographics, clinical characteristics, and hospitalization cost were collected from the electronic medical system in this hospital. A total of 983 children were diagnosed with mycoplasmal CAP in 2017. Among them, 18.2% had a bacterial-M. pneumoniae co-infection and 11.3% had a viral-M. pneumoniae co-infection. The highest infection rate of M. pneumoniae was 19.1% in February and March, while the highest rates of bacterial-M. pneumoniae and viral-M. pneumoniae co-infections were 3.6% in December and 2.3% in January, respectively. The prevalence of coughing and wheezing had significant differences between the bacterial- or viral-M. pneumoniae co-infections and the mono-infection groups. Furthermore, the chest X-ray progression, pleural effusions, respiratory failure, and ventilation rates were higher in the respiratory viral- and bacterial-M. pneumoniae co-infection groups than in the mono-infection group. Children with a bacterial or respiratory viral co-infection had a longer hospitalization and spent more on treatment fees than those with a M. pneumoniae mono-infection (P value <0.001). We conclude that children with mycoplasmal CAP, either with a bacterial or viral co-infection, who show signs of coughing and wheezing and have a radiographic progression, will have a severe disease progression and should be specifically treated and managed.

scholarly journals GP management of community-acquired pneumonia in Italy: the ISOCAP study

2005 ◽  
Vol 63 (1) ◽  
Author(s):  
C.M. Sanguinetti ◽  
F. De Benedetto ◽  
C.F. Donner
Keyword(s):  
Outpatient Treatment ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Microbiological Analysis ◽  
X Ray ◽  
Systemic Arterial Hypertension ◽  
Chest X Ray ◽  
Socioeconomic Burden ◽  
Copd Diagnosis ◽  
Observation Period

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.

scholarly journals Community-acquired pneumonia in children – problems and solutions

2021 ◽  
Vol 66 (1) ◽  
pp. 9-21
Author(s):  
V. K. Tatochenko
Keyword(s):  
Pulmonary Infiltrate ◽  
Community Acquired Pneumonia ◽  
Atypical Pneumonia ◽  
Contributing Factors ◽  
X Ray ◽  
High Doses ◽  
Severity Of The Disease ◽  
Unclear Etiology ◽  
High Level

Pneumonia in children remains one of the most serious diseases. Despite intensive study, the diagnosis and treatment still present a variety of problems. The article is aimed to identify these problems and show the ways of their solution.One of the criteria for the diagnosis of pneumonia is pulmonary infiltrate on the X-ray image. Community-acquired pneumonia is often caused by Pneumococci and mycoplasma; respiratory viruses, influenza usually serve as contributing factors for bacterial infection. The high level of hyperand underdiagnosis of community-acquired pneumonia is associated with its similarity with ARVI; the registration of general violations (signs of the severity of the disease) improves the quality of diagnosis. The clinical and radiological picture helps to distinguish pneumococcal pneumonia from pneumonia caused by mycoplasma. To improve the diagnosis of community-acquired pneumonia, it is necessary to study inflammation markers during the first examination of the patient, which is impossible in the conditions of home care. Due to the growth of resistance of pneumococci to macrolides a community-acquired pneumonia of pneumococcal (and unclear) etiology requires the use of amoxicillin in high doses and macrolides (in case of atypical pneumonia). Gentle therapy of destructive pneumonia, steroids for metapneumonic pleurisy allow avoiding invasive interventions and help to repair lung tissue.

scholarly journals Multimicrobial Pneumonia during the Early Stages of a Global Pandemic

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Jalal H ◽  
◽  
Henriksen G ◽  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Acute Infection ◽  
Standard Of Care ◽  
Antibiotic Use ◽  
Lung Parenchyma ◽  
Community Acquired Pneumonia ◽  
Methicillin Resistant ◽  
Global Pandemic

Community-acquired pneumonia is an acute infection of lung parenchyma which causes local and systemic inflammatory changes via cytokines. Several bacteria and viruses are responsible for this type of pneumonia, and the most common bacterial cause is Streptococcus pneumoniae. The classic symptoms are cough, fever, and pleuritic chest pain. In the Winter of 2020, a new strain of coronavirus known as SARS-CoV-2 spread throughout the world and was responsible for a global pandemic that transformed the way we live our lives. A 93-year old female presented to the hospital with respiratory distress and was found to have not only COVID-19 pneumonia but also superimposed Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa pneumonia. Following the most up-to-date guidelines, she was determined to have community-acquired pneumonia. Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa are uncommon causes of communityacquired pneumonia. She was treated with the standard of care at the time, which included vancomycin, piperacillin-tazobactam, and hydroxychloroquine. This case highlights the rarity of this specific presentation of community acquired pneumonia in regards to microbial etiology. It showcases that patients may develop certain diseases despite not having any risk factors. A major takeaway point is that apt decision making is a critical and time sensitive matter when determining whether a bacterial co-infection is present since it can affect patient outcomes. Since co-infections are relatively infrequent, antibiotic use in COVID-19 positive patients needs to be tailored accordingly. At the same time, it is crucial to keep in mind that co-infections are associated with increased severity of COVID-19 as well as poorer outcomes.

scholarly journals On traumatic pneumothorax with primary gas injection

2021 ◽  
Vol 30 (9) ◽  
pp. 891-894
Author(s):  
V. K. Sokolova
Keyword(s):  
Spontaneous Pneumothorax ◽  
Pleural Cavity ◽  
Gas Injection ◽  
Lung Parenchyma ◽  
Pathological Process ◽  
Tuberculosis Patients ◽  
Gas Accumulation ◽  
The Press ◽  
Artificial Pneumothorax ◽  
Traumatic Pneumothorax

Over the last 10-15 years, treatment of tuberculosis patients with artificial pneumothorax has become widespread and there are many works devoted to collapse therapy in the press; details of the technique, efficiency of treatment, and complications are discussed. Spontaneous pneumothorax (SP) is one of the most dangerous complications of pneumothorax. Under p. p. we understand gas accumulation in pleural cavity in case of lung perforation, as the result of pathological process in the lung, more often of subpleural cavernous cavity breakthrough, caseous focus, or due to lung parenchyma needle trauma while applying pneumothorax.

scholarly journals Radiographic aspects of acute community-acquired bacterial pneumonia and pulmonary tuberculosis in children

2021 ◽  
Author(s):  
Rivo Lova Herilanto Rakotomalala ◽  
Harimino Mireille Rakotondravelo ◽  
Andrianina Harivelo Ranivoson ◽  
Annick Lalaina Robinson
Keyword(s):  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Radiographic Images ◽  
X Ray ◽  
Male Predominance ◽  
Mother And Child ◽  
Chest X Ray ◽  
The Right ◽  
The University ◽  
Tuberculosis In Children

Background: The etiological diagnosis of pneumonia is often difficult because of the impossibility of microbiological confirmation most of the time. Therefore, chest X-ray is still essential for a positive diagnosis and etiological orientation. The main objective of our study was to describe the radiographic aspects of acute community-acquired pneumonia and tubercular pneumonia in children.Methods: This was a descriptive retrospective study conducted at the university hospital mother and child of Tsaralalana from January 1st to July 31st, 2017.Results: Sixty-nine cases of pneumonia were included, including 13 cases of TB pneumonia and 46 cases of acute community-acquired pneumonia. The average age was 36.68 months with a male predominance. Clinically, respiratory functional signs predominated in both cases. Alteration in general condition was mainly observed in tubercular pneumonia (26.08%). Alveolar syndromes were present in 43.47% of TB pneumonias and 36.94% of acute community-acquired pneumonia. With regard to the radiographic images, alveolar involvement was common to both types of pneumonia; the nodular image was present in 8.69% of the tubercular pneumonias and 2.17% of the acute community-acquired pneumonia; the cavity image was present only in the tubercular pneumonia (p=0.04); the right-sided location predominated in both cases.Conclusions: X-ray images were common to both TB pneumonia and acute community-acquired pneumonia; some images were specific to TB pneumonia. However, the etiologic orientation of pneumonia is based on a combination of epidemiologic, clinical, and radiographic evidence.

scholarly journals Recurrent Spontaneous Pneumothorax in a Maltese Dog with Endogenous Lipoid Pneumonia

2021 ◽  
Vol 49 ◽  
Author(s):  
Bruno Alberigi ◽  
Alexandre Bendas ◽  
Denise Do Vale Soares ◽  
Loide Machado ◽  
Ana Carolina Rodrigues ◽  
...  
Keyword(s):  
Alveolar Macrophages ◽  
Clinical Condition ◽  
Spontaneous Pneumothorax ◽  
Breathing Pattern ◽  
Present Report ◽  
Lung Parenchyma ◽  
Lipoid Pneumonia ◽  
Cholesterol Crystals ◽  
X Ray ◽  
Chest X Ray

Background: Pneumothorax is a clinical condition which can cause respiratory distress. It can have as its origin traumatic causes or even classified as spontaneous, mainly related to diseases of the lung parenchyma. Lipoid pneumonia is rarely described in dogs, and it is characterized by globules of lipid in the alveolar spaces. Endogenous lipoid pneumonia (EnLP) occurs when lesions on pulmonary cells release cholesterol and other lipids in the alveoli. There is no clinical approach established for EnLP in veterinary patients. The aim of this report is to describe a case of a young Maltese dog, with recurrent spontaneous pneumothorax in which EnLP was diagnosed Post mortem.Case: A 2-year-old sexually intact male Maltese dog was evaluated for restrictive dyspnea. Clinicopathologic findings included cyanotic, muffled chest auscultation with hypersonic thoracic percussion. Chest x-ray demonstrated an increase in pleuropulmonary radio transparency and a floating-looking heart, indicating pneumothorax. Complete blood counts andbiochemical panel results were normal. Dirofilaria immitis antigen test results were negative. Computed tomography demonstrated slightly hyper-expanded pulmonary fields, with slightly enlarged reticular marking with areas of mild multicentric panlobular emphysema and a fracture on the sixth left rib. The treatment was focused on improving the breathing pattern through sedation, supplementation with oxygen, and thoracentesis. Owing to the reserved prognosis of the case, the unknown etiology of the recurrent pneumothorax, and the clinical worsening of the patient, the owner opted for euthanasia. Necropsy displayed multiple, circular whitish areas in the lungs, distributed over the surface of all lobes. Histopathological examination revealed pulmonary tissue with the subpleural micronodular foci, multifocal to coalescent, with a moderate accumulation of foamy intra-alveolar macrophages, occasionally multinucleate, associated with cholesterol crystals compatible with endogenous lipid pneumonia. Discussion: The patient presented with clinical signs and physical examination characteristics of pneumothorax at the first visit. After the pneumothorax diagnosis, and clinical stabilization of the patient. No predisposing factor for the formation of the pneumothorax was identified as the radiography revealed only bronchitis and blood tests were normal, the patient was thus discharged after 24 h, with the recommendations for observing the breathing pattern. Initially, spontaneous pneumothorax was suspected. The antibiotics were administered since bacterial pneumonia, although not confirmed on chest x-ray, is the main cause of pneumothorax in dogs is lung parenchyma disease. With the worsening of the clinical condition of the patient, CT was performed and did not demonstrate any findings that would justify the presence of pneumothorax. Despite the placement of the chest tube for facilitating the management of thoracentesis, there was no stabilization of the condition, enhancing the frequency of centesis procedures, which led to the decision to euthanize. The microscopic examination of the pulmonary alterations was decisive for the diagnostic conclusion. The visualization of the accumulation of foamy intra-alveolar macrophages, occasionally multinucleate, associated with cholesterol crystals, was responsible for the diagnosis of EnLP. This condition is rarely described in dogs and as in the present report, it is a noninfectious inflammatory condition, characterized by intra- or extracellular globules of lipid in the alveolar spaces. In the present report, although it was not possible to determine the etiology of EnLP, we can conclude that although rare, it can affect dogs and can generate severe clinical repercussions.

PS01.067: SHLYAKHOVSKIY I.A., ERMOLOVA I.V., SELINA I. E., P. O., BURCHULADZE/PERFORATED APPENDICITES IN DIAPHRAGMAL HERNIA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 68-68
Author(s):  
Igor Shlyakhovskiy
Keyword(s):  
Pleural Cavity ◽  
Conflicts Of Interest ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Perforated Appendicitis ◽  
X Ray ◽  
Satisfactory Condition ◽  
Left Pleural Cavity ◽  
Surgical Tactics ◽  
Small And Large Intestine

Abstract Background We present a clinical case of a patient with acute perforated appendicitis complicated by empyema in a false left-sided diaphragmatic hernia. Methods Patient K. 21 L. taken by ambulance to the intensive care unit. X-ray conclusion—the rupture of the left dome of the diaphragm to the infringement of the colon. The patient urgently operated. The defect of the diaphragm size 10,0х6,5cm. There is a lack in the abdominal cavity of small and large intestine, and spleen. The diagnosis—gangrenous perforated appendicitis in the left pleural cavity, empyema. Performed appendectomy, diaphragm was sutured. 5 days after surgery performed videothoracoscopy Results The patient is in satisfactory condition was discharged from hospital 32 days after admission. Conclusion Polypositional x-ray examination of the chest and abdominal cavity and active surgical tactics has allowed to establish the correct diagnosis and resulted in a favorable outcome. Disclosure All authors have declared no conflicts of interest.

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