Category Archives: Pulmonary Function : Part 4

CT-Guided Fine Needle Aspiration Biopsy in the Diagnosis of Mediastinal Tuberculosis: Discussion

In one study, the CT-guided FNAB of mediastinal masses was successful in establishing the diagnosis in 22 of 23 malignant lesions and 6 of 7 benign lesions; however, no separate information regarding the nature of benign mediastinal lesions was given. In another review article, the reported range for the diagnosis of all benign pulmonary and mediastinal lesions varies between 12 and 57%. In our cases, FNAB was successful in obtaining cellular material in 11 of 12 patients and the diagnosis of MTB was made in eight (66%) patients.
Continue reading

CT-Guided Fine Needle Aspiration Biopsy in the Diagnosis of Mediastinal Tuberculosis: Discussion

CT-Guided Fine Needle Aspiration Biopsy in the Diagnosis of Mediastinal Tuberculosis: DiscussionThe FNAB of mediastinal lymph nodes was diagnostic in 8 of 12 (66%) patients, including 1 with normal results of FOB. There was no cellular yield in one patient, while in three patients the results were negative. The rate of false-negative was 34%. Only one patient developed nonsignificant pneumothorax (Table 1).
Endobronchial disease was noted in only two of the ten (20%) patients who received bronchoscopic examinations.
Continue reading

CT-Guided Fine Needle Aspiration Biopsy in the Diagnosis of Mediastinal Tuberculosis: Results

Air dried smears were stained (Diff Quick, Harkcos, Gibbstown, NJ). The remaining material was sent for mycobacterial culture. Ten patients had FOB examination with brushing and/or biopsies. Transbronchial needle aspiration biopsy (TBNA) was not performed in any patient. Mediastinoscopy (n=8) or thoracotomy (n=6) was performed in patients where either FNAB (n=4) or FOB (n=8) was not diagnostic, or where lymphoma (n=2) was suspected clinically. All the material was submitted for cytologic, histologic, and microbial examinations.
Continue reading

CT-Guided Fine Needle Aspiration Biopsy in the Diagnosis of Mediastinal Tuberculosis: Materials and Methods

CT-Guided Fine Needle Aspiration Biopsy in the Diagnosis of Mediastinal Tuberculosis: Materials and MethodsMediastinal tuberculosis (MTB) has been found to occur more commonly in Asians and black adults. Recently, there has been a reemergence of the disease among patients infected with the human immunodeficiency virus (HIV). A nonspecific clinical presentation, absence of characteristic parenchymal lesions on chest radiographs, and a low diagnostic yield of sputum examination add to the diagnostic challenge. Fibroptic bronchoscopy (FOB) may provide a diagnosis in some patients; however, most patients require invasive procedures such as mediastinoscopy, anterior mediastinotomy, or thoracotomy to establish a definite diagnosis. canadianfamilypharmacy

Fine needle aspiration biopsy (FNAB) is known to be an excellent diagnostic procedure in the investigation of patients with mediastinal lesions. In the present study, we review our experience of computed tomographic (CT) guided FNAB in the diagnosis of MTB and assess its value as compared with other diagnostic procedures.
Continue reading

Cavitary Lung Lesions in an Immunosuppressed Child: Diagnosis

Cavitary Lung Lesions in an Immunosuppressed Child: DiagnosisMycetomas are usually due to saprophytic overgrowth of Aspergillus species in a preexisting cavity from remote tuberculosis or sarcoidosis. Rarely mycetomas due to Nocardia, Candida, Strep-tomyces, Phycomycetes, Coccidioides, Pseudallescheria or hydatid have been described. Pseudallescheria boydii, formerly known as Pet-riellidium boydii, is a ubiquitous fungus found in soil, gaining entry to the body either by inhalation of as-cospores or by traumatic inoculation into the skin. Invasive pneumonia usually occurs in immunocompromised hosts and dissemination is common to lungs, brain, kidneys, heart, skin, and eyes. Survival is rare in disseminated disease. buy ventolin inhaler

Continue reading

Cavitary Lung Lesions in an Immunosuppressed Child: Diagnosis

Disseminated Pseudallescheria boydii involving lung, kidney, and skin. The organism was isolated from the skin biopsy.
The chest radiograph and CT scan obtained during the period of neutropenia demonstrate multiple bilateral ill-defined nodular opacities (Figs 1 and 3). The large right opacity has a peripheral rim of ground glass opacification, known as the “halo sign” (Fig 3). This halo is believed to represent the peripheral rim of hemorrhagic infarction, described in the angioinvasive fungal diseases, aspergillosis, mucormycosis, and Pseudallescheria boydii infection.
Continue reading

Cavitary Lung Lesions in an Immunosuppressed Child

Cavitary Lung Lesions in an Immunosuppressed ChildAn 11-year-old boy, diagnosed 3 years earlier with acute lymphoblastic leukemia, presented in May 1993 with a hematologic relapse. One week after starting high dose multiagent chemotherapy, he developed diffuse pulmonary opacification with respiratory failure requiring mechanical ventilation. Lung biopsy performed after two nondiagnostic bronchoscopies revealed diffuse alveolar hemorrhage and necrotizing bronchiolitis. The patient recovered spontaneously; mechanical ventilation was discontinued, and the chest radiograph returned to normal. In June, he developed a temperature up to 40°C and was neutropenic (absolute neutrophil count <500) as a result of chemotherapy. On physical examination, he was a chronically ill, emaciated child fully contraceptive pills. The lungs were clear to auscultation. The following day, multiple small nodular erythematous skin lesions appeared, which were thought to be embolic.

Continue reading

Preoperative Respiratory Muscle Training: Comment

However, since the report by Black and Hyatt, most of the authors used the instruments with a small air leak in order to prevent the closure of the glottis. But, there has not been any report which compares the measurements with or without an air leak. From our experience, it is generally impossible to sustain the mouth pressure for a few seconds when glottis closure occurs. Our method of measurement of MIP and МЕР without an air leak was to read the maximal mouth pressures which were sustained for 2 to 3 s, which should produce a pressure without the glottis closure. They also showed stability between the two times of measurement in the control group and were similar to the other data reported previously.
Continue reading

Preoperative Respiratory Muscle Training: Conclusion

Preoperative Respiratory Muscle Training: ConclusionIn the present study, eight patients experienced postoperative pulmonary complications. With these patients, none of whom was obese (the highest BMI was 24.6), both MIP and МЕР were low before training and did not increase much even after training. On the other hand, six patients with low values for both MIP and МЕР before training showed significant increases in both after training and did not suffer from postoperative pulmonary complications. Although operative procedures were heterogenous between these complicated and noncomplicated groups, there should be no significant differences in operation damage.

Continue reading

Preoperative Respiratory Muscle Training: Discussion

Several authors have reported that specific inspiratory muscle training increased inspiratory muscle strength and reduced dyspnea in patients with COPD who had inspiratory muscle weakness. Leith and Bradley reported that respiratory muscle training in normal subjects increased both inspiratory and expiratory muscle strength. From our results, it can be stated that preoperative respiratory muscle training with vigorous diaphragmatic breathing increased the strength of inspiratory muscles, and that training with the IDSEP breather and coughing exercises increased the strength of expiratory muscles in patients undergoing thoracic surgery.
Continue reading

Pages: Prev 1 2 3 4 5 6 7 8 9 10 ... 21 22 23 Next