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To investigate puncture skills and complications prevention in ultrasound-guided percutaneous needle biopsy for peripheral lung lesions.
Ninety-two peripheral lung lesions in 92 patients, detected via computed tomography (CT) and also visible on ultrasound, were retrospectively analyzed. All patients underwent percutaneous peripheral lung lesion needle biopsy under traditional ultrasound or contrast enhanced ultrasound (CEUS) guidance paying attention to avoiding necrotic areas and large blood vessels. All the specimens were examined histopathologically. Preprocedure all 92 lesions were performed by traditional ultrasonography to evaluate the size, the echogenecity, liquefaction areas and blood flow on color Doppler imaging, some of which were performed by CEUS for evaluating non-enhanced necrosis areas, contrast agent arrival time (AT) and characteristics of blood perfusion.
The histopathologic results of all 92 lesions were as follows 67 malignant tumors (including 28 adenocarcinomas, 19 squamous celld pneumothorax and 4 cases (4.3%) had hemoptysis.
In ultrasound-guided needle biopsy for peripheral lung lesions, using a combination of linear and non-linear puncture techniques and keeping away from necrotic areas and large blood vessels, may help to increase the success rate and reduce the incidence of complications further.
In ultrasound-guided needle biopsy for peripheral lung lesions, using a combination of linear and non-linear puncture techniques and keeping away from necrotic areas and large blood vessels, may help to increase the success rate and reduce the incidence of complications further.
Reported data on the disease spectrum of interstitial lung diseases (ILDs) of China are sparse and varied. We aimed to investigate the spectrum of ILDs and the distribution of diagnostic methods under a uniform diagnosis.
This retrospective study enrolled ILDs cases from Guangzhou Institute of Respiratory Health (GIRH). All cases were classified into specific subgroups of ILDs according to updated guidelines.
A total of 1,945 subjects were enrolled from January 2012 to December 2017. The mean age was 57.9 years, and 1,080 (55.5%) patients were male. The most common subtype of ILDs was idiopathic pulmonary fibrosis (IPF, 20.3%), followed by interstitial pneumonia with autoimmune features (IPAF, 17.9%), connective tissue disease associated ILD (CTD-ILD, 18.3%) and unclassifiable idiopathic interstitial pneumonia (UIIP, 14.7%). A total of 818 (42.1%) patients underwent lung biopsy in order to obtain a histological diagnose. TBLB was performed in 565 (29.0%) patients, eleven of whom underwent SLB because TBl information may help to establish diagnostic algorithm in ILD.
The annual seasonal influenza epidemics in the winter season lead to many hospital admissions, increasing risks of nosocomial infections. Infectious diseases caused by contagious respiratory pathogens also pose a great risk to hospitals as has been seen in the current epidemic by a novel coronavirus infection. Such risk occurs in high density patient settings with few or no partitions, since the pathogens are transmitted by aerosols discharged from the patients. Possible interventions against the transmission are needed.
We developed a compact, lightweight, and portable hood designed to cover just the top half of a patient sitting or lying in bed, to limit the dissemination of infectious aerosols, constructed out of lightweight pipes, transparent plastic curtains, and a fan-filter-unit (FFU). The containment efficacy of the product was tested using an aerosolized cultured influenza virus tracer and an optimal airflow rate was determined according to the test results. It was tested for use in hospital warda seasons. PHA-767491 in vitro It may be suited to hospitals with not enough/no negative pressure facilities, or without enough number of individual patient isolation rooms, and could contribute to decrease the risk of nosocomial infections.
To investigate whether asymptomatic close-contact family members of patients diagnosed with coronavirus disease (COVID-19) should immediately undergo CT screening in addition to the viral nucleic acid test.
We retrospectively analyzed the data of a family cluster of 8 individuals, of whom 1 family member (Patient 3) had an epidemiologic history of having visited Guangzhou from Hubei Province on January 20, 2020. Her father (Patient 1) developed a fever and respiratory system symptoms and was confirmed COVID-19-positive on February 4-5, 2020 at Zengcheng People's Hospital, Guangzhou, China. Seven close-contact family members of the patients were then screened for COVID-19 on February 5-6 at the hospital. The CT imaging manifestation and laboratory tests of this family cluster were investigated and reported.
Five (62.5%) of the 8 family members were confirmed COVID-19-positive. Except for Patient 1, who had fever, cough, fatigue, and dizziness, the remaining four (4/5, 80%) COVID-19-positive family members (Patients 2-5) had no clinical symptoms. Among the 5 patients, 2 had leukopenia (2/5, 40%), 1 had low absolute neutrophil counts (1/5, 20%), and 2 had increased high-sensitivity C-reactive protein (2/5, 40%). Ground-glass opacity (GGO) was found on chest CT imaging in all 5 patients (5/5, 100%), with interlobular septal thickening. Thickened blood vessel shadows were seen in 3 patients (3/5, 60%). The 3 COVID-19-negative family members (Family Members 1-3) did not have CT abnormalities, and they showed negative reverse transcription-polymerase chain reaction (RT-PCR) results twice.
CT screening is necessary in close-contact family members of a confirmed COVID-19 pneumonia case, regardless of the presence of clinical symptoms.
CT screening is necessary in close-contact family members of a confirmed COVID-19 pneumonia case, regardless of the presence of clinical symptoms.
The Friedman staging is a classic system to predict outcomes of obstructive sleep apnea (OSA) surgery. Increasing stage indicates more severe upper airway (UA) obstruction and worse surgical successful rate. In previous studies, the UA obstruction between stages were usually assessed based on awake examination. Drug-induced sleep endoscopy (DISE) is a new method that can evaluate airway collapse characteristics during sleep. Therefore, we planned to compare Friedman staging and DISE findings and fulfill the knowledge gap on the correlation between awake and sedated UA examination.
Retrospective case series study that assessed patients with OSA who underwent DISE. Subjects were classified to stage II and stage III groups based on Friedman staging system. UA collapse characteristics based on velum, oropharynx, tongue base, epiglottis (VOTE) classification, including single/multiple obstruction sites, single/combined upper and lower obstruction levels, collapse degree and patterns in different sites, and surllapse in both, Friedman stage II and III patients. Patients with OSA and Friedman stage III had more than 2 sites of obstruction than stage II patients.
Lymph node dissection is an important part of lung cancer surgery. Preoperational evaluation of lymph node metastases decides which dissection pattern should be chosen. The present study aimed to develop a nomogram to predict lymph node metastases on the basis of clinicopathological features of non-small cell lung cancer (NSCLC) patients.
A total of 35,138 patients diagnosed with NSCLC from 2010-2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly divided into training cohort and validation cohort. Possible risk factors were included and analyzed by logistic regression models. A nomogram was then constructed and validated.
21.83% of all patients were confirmed with positive lymph node metastasis. Age at diagnosis, sex, stage, T status, tumor size, grade and laterality were identified as predicting factors for lymph node involvement. These variables were included to build the nomogram. The AUC of the model was 0.696 (95% CI, 0.617 to 0.775). The model was further validated in the validation set with AUC 0.693 (95% CI, 0.628 to 0.758). The model presented with good prediction accuracy in both training cohort and validation cohort.
We developed a convenient clinical prediction model for regional lymph node metastases in NSCLC patients. The nomogram will help physicians to determine which patients will receive the most benefit from lymph node dissection.
We developed a convenient clinical prediction model for regional lymph node metastases in NSCLC patients. The nomogram will help physicians to determine which patients will receive the most benefit from lymph node dissection.
Patients with tracheobronchial stenosis due to tuberculosis (TSTB) have a variable clinical course and response to treatment including airway intervention. There are no clear guidelines on the best approach to manage such patients. This study examines long-term outcomes of patients with TSTB and factors associated with recurrent symptoms or need for repeat airway intervention following initial bronchoscopic intervention.
This is a retrospective analysis of patients with TSTB over an 18-year period. Symptoms, radiological, bronchoscopic findings, airway interventions and complications were obtained. Multivariate logistic regression analysis was performed to identify factors predictive of recurrence of symptoms or need for repeat airway intervention.
A total of 131 patients with mean age 50±18 years and median follow-up 5 (interquartile range, 2-10) years were included. Nineteen (29.7%) patients underwent balloon dilatation alone, 22 (34.4%) had additional resection or stenting, and 19 (29.7%) underwent athe recurrence of symptoms despite airway intervention. Patients who are diagnosed with TSTB early in the course of active TB may be conservatively managed.
Patients with pectus excavatum which is unsuitable for minimally invasive repair are usually treated by modified Ravitch procedure. For fixation of the sternal osteotomy, mesh and wires are mostly used. To decrease non-union risk, we introduced a technique with double locking plate fixation of the osteotomy and compared this to fixation using mesh and wires.
Patients undergoing a modified Ravitch procedure for pectus excavatum between 2006 and 2016 were included. From 2006 to 2012, the sternum was fixated with mesh and wires. From 2012 to 2016, locking compression plates (LCP) were used. Baseline parameters, symptomatic non-union and total number of complications were retrospectively compared. Statistical analysis was performed using Mann-Whitney or Fisher's exact test. Data are presented as means +/- SD.
Forty-four patients were included. In 18 patients, the sternum was fixed with mesh and wires, in 26 patients with LCP. Mean follow-up was 35 months in the mesh and 30 months in the LCP group, P=0.71. Haller index was similar in both groups (mesh 3.8±1.3
LCP 3.9±1.1, P=0.81). Symptomatic non-union occurred in 17% (n=3) in the mesh group and did not occur after LCP, P=0.062. Total number of complications was 33% (n=6) in the mesh group and 15% (n=4) after LCP, P=0.27.
After modified Ravitch procedure, union of the sternal osteotomy is challenging. In this retrospective cohort study, a lower incidence of symptomatic non-union was observed after fixation of the sternum with LCPs, with a trend towards statistical significance.
After modified Ravitch procedure, union of the sternal osteotomy is challenging. In this retrospective cohort study, a lower incidence of symptomatic non-union was observed after fixation of the sternum with LCPs, with a trend towards statistical significance.