Thoracic diseases

Alternative approaches to the standard posterolateral incision for thoracotomy have been developed to minimize its postoperative pain and wound related side effects. Muscle-sparing (MS) thoracotomy has been a well-known substitution to the standard posterolateral thoracotomy for this purpose; however it has not been studied in the pediatric age group in detail. We studied retrospectively the patients with thoracotomy for non-cardiac, thoracic surgical procedures. group 1 included the patients with standard posterolateral thoracotomy for the surgery. The patients with MS thoracotomy composed group 2. The related data were collected retrospectively. The early postoperative morbidities (time requiring for regaining shoulder girdle movement, extubation, intensive care unit stay, and hospital stay) and late musculoskeletal anomalies (scoliosis, elevation of the shoulder, winged scapula, asymmetry of the nipples) were compared between groups. A total of 90 patients were included in the study. Group 1 constituted 50 patients with an average age of 4.24 ± 2.91 years. Group 2 included 40 patients with an average age of 4.20 ± 2.92 years. Comparison of the demographics and the baseline characteristics of the patients were not different between groups. In comparison of operative characteristics, there was lesser morbidity in group 2 as re-exploration for bleeding, wound infection, wound healing and fewer intensive care unit and hospital stay days. Late follow-up revealed a significant increase in musculoskeletal deformities in group 1. We conclude that muscle-sparing incision should be preferred to the standard posterolateral thoracotomy in pediatric age.

This article presents specific uses of the portable chest film. The specific utility, borderline utility, and pitfalls in interpretation of films that are often taken to investigate a number of diagnostic problems common to the practice of emergency medicine are discussed.

General anaesthesia (GA) carries high risks of ventilator dependency with increased morbidity and mortality in patients with severe respiratory disease. It also presents an ethical dilemma if surgery remains the only treatment option for patients with advanced terminal chronic respiratory disease. Thoracic epidural anaesthesia for awake thoracic surgery (TEATS) in high-risk patients with dyspnoea at rest could avoid ventilator dependency and speed up recovery even in patients with severe dyspnoea. This retrospective observational study analysed indications, management and outcome of patients contraindicated to GA undergoing awake thoracic surgery with thoracic epidural anaesthesia. From 716 patients requiring thoracic surgery, nine were contraindicated to GA. Eight patients [American Society of Anesthesiologists (ASA) 4] had a maximum grade four of the modified Medical Research Council dyspnea scale (MMRC). Two patients (ASA 3, grade 1 MMRC and ASA 4, grade 4 MMRC) refused GA. Patie...

Proper assessment of COVID-19 patients has become critical to mitigating and halting the disease's rapid expansion during the present COVID-19 epidemic across the nations. Due to the presence of chronic lung/pulmonary diseases, the intensity and demise rates of COVID-19 patients were increased. This study will analyze radiography utilizing chest X-ray images (CXI), one of the most successful testing methods for COVID-19 case identification. Given that deep learning (DL) is a useful method and technique for image processing, there have been several research on COVID-19 case identification using CXI to train DL models. While few of the study claims outstanding predictive outcomes, their suggested models may struggle with overfitting, excessive variance, and generalization mistakes due to noise, a limited number of datasets and could not be deployed to IoT devices due to heavy network size. Considering deep Convolutional Neural Network (CNN) can conquer the weaknesses by getting predictions with several diseases using a single model deployed on a real-time IoT device. We propose a lightweight Deep Learning model (LDC-Net) that has spearheaded an open-sourced COVID-19 case identification technique using CNN-generated CXI by utilizing a suggested strategy aware of distinct features learning of different classes. Experimental results on Raspberry Pi show that LDC-Net provides encouraging outputs for detecting COVID-19 cases with an overall 96.86% precision, 96.78% recall, 96.77% F1-score, and 99.28% accuracy, better than other state-of-the-art models. By empowering the Internet of Things-IoT and IoMT devices, this suggested framework can identify COVID-19 from CXI and other seven lung diseases with healthy labels.

Περίληψη: Σκοπός της παρούσας μελέτης είναι η ιατροδημογραφική σκιαγράφηση των πρώτων ασθενών που νοσηλεύθηκαν στο πνευμονολογικό τμήμα του Σανατορίου Αθηνών «η Σωτηρία» κατά τη διάρκεια της δεκαετίας του 1950. Η μελέτη βασίστηκε στα Μητρώα και στα Ευρετήρια ασθενών της «Σωτηρίας» για την περίοδο των ετών 1951-1959. Από τη μελέτη του αρχειακού υλικού του Σανατορίου
αντλήθηκαν στοιχεία για το δημογραφικό προφίλ των ασθενών, όπως το φύλο, η ηλικία, η επαγγελματική απασχόληση και η οικογενειακή κατάσταση. Τα διαθέσιμα δεδομένα μας παρείχαν επίσης πληροφορίες για την κίνηση των ασθενών ανά έτος, τον τόπο διαμονής τους σε συνδυασμό με τον τόπο νοσήσεώς τους, καθώς και τις τελικές τους εκβάσεις. Με την ίδια επεξεργασία των δεδομένων επιτεύχθηκε και ο συνδυασμός των ημερών νοσηλείας ανά έτος και ανά κατηγορία έκβασης.

Cardiothoracic surgical pathologies are available in all geographical regions of the world. Human and material resources are necessary for prompt diagnosis and proper treatment of these cases. Retrospective analysis of cardiothoracic surgical cases in the first five years of our new cardiothoracic surgery unit was done. A total of 714 cases were seen during the study period with age range one month to 76 years with mean age of 37.12 +/- 11.24 and male female ratio of 2:1. The yearly admissions from 2007 to 2011 were 14%, 17%, 21%, 21% and 26% respectively. Cardiovascular diseases occurred in 22.30%, with 6% of children suffering from congenital heart defect and 6% of men suffering from acquired vascular disease. Surgical complications of pleuropulmonary tuberculosis occurred in 21.4% while thoracic trauma occurred in upto 21% of the patients. Aerodigestive tract foreign bodies were encountered in 10.1% of cases and Pyogenic diseases occurred in 8.68%. Oesophageal lesions were diagno...

In blunt thoracic aortic injury, thoracic endovascular aortic repair (TEVAR) offers a less invasive alternative to open chest surgery. New reliable and accurate stent grafts have widened the endovascular treatment options. We report our experience with the Relay stent graft Bolton Medical, Sunrise, FL; Barcelona, Spain) for treatment of this injury. Relay Endovascular Registry for Thoracic Disease (RESTORE) is a multicenter, prospective European registry, which enrolled patients treated with the Relay stent graft for thoracic aortic diseases from April 2005 to January 2009. Regular follow-up examinations were conducted for up to 24 months. This paper analyzes the cohort of patients treated for traumatic aortic injury. Forty adult trauma patients from 12 European centers underwent TEVAR. Mean age was 40 years and 34 patients were male. The proximal landing zone involved aortic arch zones 1 to 2 in 40% and zone 3 in 55% of procedures. Technical success was achieved in all cases. One (...

Background and Objectives. The association between polythelia (supernumerary nipple) and kidney and urinary tract malformations (KUTM) is controversial. Some authors reported this association in newborns and infants. Case-control studies dealing with adult subjects are not found in the literature. The purpose of this study is to determine the frequency of the association between accessory mammary tissue (AMT) and congenital and hereditary nephrourinary defects in an adult population compared to a control group.Methods. The study was performed in 146 white patients (123 men, 23 women) with AMT out of 2645 subjects consecutively referred to us for physical examination. The following investigations were undertaken: ultrasonographic examination of the abdomen and the kidneys, ECG, echocardiogram, roentgenogram of the vertebral column, urinalysis, and other laboratory tests. A sex- and age-matched control group without any evidence of AMT or lateral displacement of the nipples underwent the same examinations.Results. Kidney and urinary tract malformations were detected in 11 patients with AMT (nine men, two women) and in one control. These data indicate a significantly higher frequency of KUTM in the AMT-affected patients compared to controls (7.53% vs. 0.68%, P < 0.001). A broad spectrum of KUTM was discovered in association with AMT: adult dominant polycystic kidney disease, unilateral renal agenesis, cystic renal dysplasia, familial renal cysts, and congenital stenosis of the pyeloureteral joint.Conclusion. Accessory mammary tissue offers an important clue for congenital and hereditary anomalies of the kidneys and urinary collecting systems. Patients with AMT should, therefore, be extensively examined for the presence of occult nephrouropathies.