A 21-year-old woman with dyspnea and an abnormal chest radiograph.
Female; Humans; Young Adult; Follow-Up Studies; Risk Assessment; Radiography; Tomography; Angiography/methods; Bronchi/*abnormalities; Dyspnea/diagnosis/etiology; Lung/abnormalities/diagnostic imaging; Pulmonary Artery/diagnostic imaging; Respiratory System Abnormalities/complications/*diagnosis; X-Ray Computed; Thoracic
Barreiro Timothy J; Gemmel David J
Chest
2009
2009-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1378/chest.08-1214" target="_blank" rel="noreferrer noopener">10.1378/chest.08-1214</a>
Malignant mesothelioma: a case presentation and review.
Humans; Male; Aged; Biopsy; Radiography; Fatal Outcome; Tomography; Adenocarcinoma/diagnosis/secondary; Mesothelioma/diagnostic imaging/*pathology; Pleural Neoplasms/diagnostic imaging/*pathology; Diagnosis; Differential; X-Ray Computed; Thoracic
Diffuse malignant mesothelioma is the most common primary tumor involving the pleura. Unfortunately, it also poses the most difficulty for physicians to diagnose and treat. Latency from the time of initial asbestos exposure, clinical features of chest pain and dyspnea, and radiographic findings of pleural effusion or pleural thickening are the characteristic features. Pathologic verification remains challenging. The primary distinctions to be made are between reactive and neoplastic mesothelial processes and between malignant mesothelioma and metastatic adenocarcinoma. Adequate tissue sampling is important to help diagnose malignant mesothelioma. This article describes a rare subtype of mesothelioma and illustrates the difficulty in establishing the diagnosis. Also included is a discussion of the clinical features, diagnostic dilemmas, and unsatisfactory outcome associated with this disease.
Barreiro Timothy J; Katzman Philip J
The Journal of the American Osteopathic Association
2006
2006-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Sarcoidosis: an enigmatic disease calls for a measured workup.
Biopsy; Radiography; Physical Examination; Tomography; X-Ray Computed; Thoracic; Disease Remission; Heart-Lung Transplantation; Sarcoidosis – Complications; Adrenal Cortex Hormones – Therapeutic Use; Sarcoidosis – Therapy; Adrenal Cortex Hormones – Adverse Effects; Sarcoidosis – Diagnosis; Sarcoidosis – Pathology; Sarcoidosis – Radiography; Sarcoidosis – Surgery
Treatment options for sarcoidosis range from observation to complex immunosuppressive agents and organ transplant. A careful examination will help you assess the likelihood of spontaneous remission and determine when to initiate appropriate treatment to forestall organ damage.
Barreiro TJ; DeMarco R; Gemmel D J; Schaub C R
Patient Care for the Nurse Practitioner
2005
2005-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Adherence to Endotracheal Tube Depth Guidelines and Incidence of Malposition in Infants and Children.
Female; Humans; pediatrics; Male; Ohio; Random Allocation; Incidence; Chi-Square Distribution; Child; Guideline Adherence/*statistics & numerical data; Infant; intubation; Medical Errors/*statistics & numerical data; NRP; PALS; Radiography/*statistics & numerical data; Trachea/diagnostic imaging; tracheal tube malposition; United States; Odds Ratio; Intensive Care Units; Hospitals; Guideline Adherence; Radiography; Intubation; ROC Curve; Confidence Intervals; Inpatients; Human; Chi Square Test; Descriptive Statistics; P-Value; Data Analysis Software; Practice Guidelines; Retrospective Design; Preschool; Thoracic; Intratracheal/adverse effects/standards/*statistics & numerical data; Intratracheal – Standards – United States; Pediatric – Ohio
BACKGROUND: Adherence to guidelines for endotracheal tube (ETT) insertion depth may not be sufficient to prevent malposition or harm to the patient. To obtain an estimate of ETT malpositioning, we evaluated initial postintubation chest radiographs and hypothesized that many ETTs in multiple intubation settings would be malpositioned despite adherence to Pediatric Advanced Life Support and Neonatal Resuscitation Program guidelines. METHODS: In a random subset (randomization table) of 2,000 initial chest radiographs obtained from January 1, 2009, to May 5, 2012, we recorded height, weight, age, sex, ETT inner diameter, and cm marking at the lip from the electronic health record. Chest radiographs of poor quality and with spinal or skeletal deformities were excluded. We defined adherence to Pediatric Advanced Life Support or Neonatal Resuscitation Program guidelines as the difference between predicted and actual ETT markings at the lip as +/- 0.25, +/- 0.50, or +/- 1.0 cm for ETTs of 2.5-4, 4.5-6.0, or \textgreater6.5 mm inner diameter, respectively. We defined the proper position as the ETT tip being below the thoracic inlet (superior border of the clavicular heads) and \textgreater/=1 cm above the carina. Descriptive statistics reported demographics, guideline adherence, and malposition incidence. The chi-square test was used to assess relationships among intubation setting, malposition, and depth guideline adherence (P \textless .05, significant). RESULTS: We reviewed 507 records, 477 of which met inclusion criteria and had sufficient data for analysis. Fifty-six percent of the subjects were male, with median (interquartile range) age 15.2 (3.4-59.4) months, and 330 ETTs (69%) were malpositioned: 39 above the thoracic inlet, and 291 \textless 1 cm above the carina. Of 79 ETTS (17%) that adhered to depth guidelines, 56 (74%) were malpositioned. Three-hundred seventy-three ETTs (83%) did not meet guidelines. Two-hundred sixty-four (68%) were malpositioned. The intubation setting did not influence malposition or guideline adherence (P = .54). CONCLUSIONS: In infants and children, a high proportion of ETTs were malpositioned on the first postintubation chest radiograph, with little influence of guideline adherence.
Volsko Teresa A; McNinch Neil L; Prough Donald S; Bigham Michael T
Respiratory Care
2018
2018-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.4187/respcare.06024" target="_blank" rel="noreferrer noopener">10.4187/respcare.06024</a>
Mediastinal mass in a 25-year-old man.
Adult; Humans; Male; Biopsy; Flow Cytometry; Radiography; Carcinoid Tumor/*complications/diagnosis/secondary; Chest Pain/diagnosis/*etiology; Mediastinal Neoplasms/*complications/diagnosis/secondary; Thymus Neoplasms/*complications/diagnostic imaging/pathology; Tomography; Diagnosis; Differential; X-Ray Computed; Thoracic
A 25-year-old black man presented with left-sided chest pain and cough for 3 days. His pain was pressure-like and nonradiating and was aggravated with movement and relieved when the patient lay at a 45 degrees angle. The patient denied fevers, chills, night sweats, and swelling but reported gaining 4 to 6 kg (10 to 15 lbs) in the past few months. His cough had started 2 weeks prior with yellow mucus production but he denied facial swelling or tenderness. He had no chronic medical conditions and was not taking medications. He had no known exposure to chemicals, fumes, or dust and no history of tobacco or alcohol abuse.
Waghray Abhijeet; Sherpa Lakpa; Carpio Gandhari; Barreiro Timothy J
Chest
2014
2014-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1378/chest.13-1444" target="_blank" rel="noreferrer noopener">10.1378/chest.13-1444</a>