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Clinical Radiology Sep 2022To determine whether the injection of haemocoagulase into the biopsy tract can reduce pneumothorax and pulmonary haemorrhage after computed tomography (CT)-guided...
AIM
To determine whether the injection of haemocoagulase into the biopsy tract can reduce pneumothorax and pulmonary haemorrhage after computed tomography (CT)-guided percutaneous transthoracic lung biopsy (PTLB).
MATERIALS AND METHODS
A retrospective study was performed involving patients with undiagnosed pulmonary lesions scheduled for PTLB between January 2020 and March 2021. Patients were assigned to the haemocoagulase group or the non-haemocoagulase group. After CT-guided biopsies were performed with a 17 G coaxial system, patients in the haemocoagulase group received a haemocoagulase injection (0.2-0.5 units) in the biopsy tract as the sheath was withdrawn. Postoperative image studies were performed to evaluate complications, including pneumothorax and pulmonary haemorrhage. Factors, including the patient's position, lesion location, and pathological results, were evaluated to determine their associations with the complications.
RESULTS
A total of 100 patients were included, with 44 men and a mean age of 53 years old. The overall incidences of pneumothorax and pulmonary haemorrhage were 15% and 13%, respectively. The incidences of pneumothorax and pulmonary haemorrhage were statistically significantly lower in the haemocoagulase group (8% and 6%, respectively) than in the non-haemocoagulase group (22% and 20%, respectively; p=0.04 and 0.03, respectively). There was no statistically significant difference in haemoptysis between the haemocoagulase (6%) and non-haemocoagulase (2%) groups (p=0.23). There were also no statistically significant associations of pneumothorax or pulmonary haemorrhage with the patients' positions, lesion location, or pathological results.
CONCLUSION
Biopsy tract haemocoagulase injection reduced the incidences of postoperative pneumothorax and pulmonary haemorrhage after PTLB.
Topics: Batroxobin; Female; Hemorrhage; Humans; Image-Guided Biopsy; Lung; Lung Diseases; Male; Middle Aged; Pneumothorax; Radiography, Interventional; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed
PubMed: 35788268
DOI: 10.1016/j.crad.2022.05.019 -
Hematology/oncology and Stem Cell... 2010Hematopoietic stem cell transplantation (HSCT) is an established treatment for a variety of malignant and nonmalignant conditions. Pulmonary complications, infectious... (Review)
Review
Hematopoietic stem cell transplantation (HSCT) is an established treatment for a variety of malignant and nonmalignant conditions. Pulmonary complications, infectious and noninfectious, are a major cause of morbidity and mortality in these patients. The recent advances in prophylaxis and treatment of infectious complications increased the significance of noninfectious pulmonary conditions. Acute lung injury due to diffuse alveolar hemorrhage or idiopathic pneumonia syndrome are the main acute complications, while bronchiolitis obliterans remains the most challenging pulmonary complications facing clinicians who are taking care of HSCT recipients. There are other noninfectious pulmonary complications following HSCT that are less frequent. This report provides a clinical update of the incidence, risk factors, pathogenesis, clinical characteristics and management of the main noninfectious pulmonary complications following HSCT.
Topics: Hematopoietic Stem Cell Transplantation; Hemorrhage; Humans; Lung; Lung Diseases; Postoperative Complications; Risk Factors
PubMed: 20890072
DOI: 10.1016/s1658-3876(10)50025-6 -
Tidsskrift For Den Norske Laegeforening... May 2022
Topics: Hemorrhage; Humans; Lung
PubMed: 35635406
DOI: 10.4045/tidsskr.22.0008 -
American Family Physician Apr 2012Knowledge of the anatomy and function of the nail apparatus is essential when performing the physical examination. Inspection may reveal localized nail abnormalities... (Review)
Review
Knowledge of the anatomy and function of the nail apparatus is essential when performing the physical examination. Inspection may reveal localized nail abnormalities that should be treated, or may provide clues to an underlying systemic disease that requires further workup. Excessive keratinaceous material under the nail bed in a distal and lateral distribution should prompt an evaluation for onychomycosis. Onychomycosis may be diagnosed through potassium hydroxide examination of scrapings. If potassium hydroxide testing is negative for the condition, a nail culture or nail plate biopsy should be performed. A proliferating, erythematous, disruptive mass in the nail bed should be carefully evaluated for underlying squamous cell carcinoma. Longitudinal melanonychia (vertical nail bands) must be differentiated from subungual melanomas, which account for 50 percent of melanomas in persons with dark skin. Dystrophic longitudinal ridges and subungual hematomas are local conditions caused by trauma. Edema and erythema of the proximal and lateral nail folds are hallmark features of acute and chronic paronychia. Clubbing may suggest an underlying disease such as cirrhosis, chronic obstructive pulmonary disease, or celiac sprue. Koilonychia (spoon nail) is commonly associated with iron deficiency anemia. Splinter hemorrhages may herald endocarditis, although other causes should be considered. Beau lines can mark the onset of a severe underlying illness, whereas Muehrcke lines are associated with hypoalbuminemia. A pincer nail deformity is inherited or acquired and can be associated with beta-blocker use, psoriasis, onychomycosis, tumors of the nail apparatus, systemic lupus erythematosus, Kawasaki disease, and malignancy.
Topics: Carcinoma, Squamous Cell; Hematoma; Hemorrhage; Humans; Nail Diseases; Nails; Nails, Malformed; Skin Neoplasms
PubMed: 22534387
DOI: No ID Found -
American Journal of Respiratory Cell... Feb 2009Platelets are the chief effector cells in hemostasis and have additional major functions in inflammation, vascular integrity, and tissue repair. Platelets and the lungs... (Review)
Review
Platelets are the chief effector cells in hemostasis and have additional major functions in inflammation, vascular integrity, and tissue repair. Platelets and the lungs have interrelated activities. Previous studies provide evidence that platelets contribute to pulmonary vascular barrier function and are required for defense against pulmonary hemorrhage, and that the lungs can influence platelet number and distribution. There is also evidence that platelets contribute to pathologic syndromes of pulmonary inflammation and thrombosis. Thus, platelets have an "amicus or adversary" relationship with the lung. Recent observations and discoveries have established new paradigms relevant to influences of platelets on lung cell and molecular biology. These new findings are in a variety of areas including thrombopoieis, nontraditional activities of platelets, new synthetic capabilities and mechanisms of post-translational gene expression, interactions of platelets with endothelial cells and contributions to alveolar capillary barrier permeability, interactions of platelets with myeloid leukocytes, and platelet involvement in stem cell signaling and vascular repair. These issues are considered in a translational approach, with an emphasis on acute lung injury and the acute respiratory distress syndrome.
Topics: Acute Lung Injury; Animals; Blood Platelets; Blood-Air Barrier; Cell Communication; Endothelial Cells; Gene Expression Regulation; Hemorrhage; Hemostasis; Humans; Inflammation; Pneumonia; Respiratory Distress Syndrome; Thrombopoiesis
PubMed: 18723438
DOI: 10.1165/rcmb.2008-0241TR -
Clinical and Translational Medicine Dec 2021scRNA-seq is on track for use as a routine measurement of clinical biochemistry and to assist in clinical decision-making and guide the performance of molecular...
scRNA-seq is on track for use as a routine measurement of clinical biochemistry and to assist in clinical decision-making and guide the performance of molecular medicine, but there are still a large number of challenges to be overcome. In conclusion, scRNA-seq-based clusters and differentiation of circulating blood cells have been examined and informative in patients with various diseases, although the information generated from scRNA-seq varies between different conditions, technologies, and diseases. Most of the clinical studies published have focused on the landscape of circulating immune cells, disease-specific patterns of new clusters, understanding of potential mechanisms, and potential correlation between cell clusters, differentiations, cell interactions, and circulating and migrated cells. It is clear that the information from scRNA-seq advances the understanding of the disease, identifies disease-specific target panels, and suggests new therapeutic strategies. The adaptation of scRNA-seq as a routine clinical measurement will require standardization and normalization of scRNA-seq-based comprehensive information and validation in a large population of healthy and diseased patients. The integration of public databases on human circulating cell clusters and differentiations with an application of artificial intelligence and computational science will accelerate the application of scRNA-seq for clinical practice. Thus, we call special attention from scientists and clinicians to the clinical and translational discovery, validation, and medicine opportunities of scRNA-seq development.
Topics: Artificial Intelligence; Chemistry, Clinical; Hematology; Humans; Single-Cell Analysis
PubMed: 34898038
DOI: 10.1002/ctm2.671 -
Ultrasound in Medicine & Biology Nov 2022This study investigated induction of pulmonary capillary hemorrhage (PCH) in neonatal pigs (piglets) using three different machines: a GE Venue R1 point-of-care system...
This study investigated induction of pulmonary capillary hemorrhage (PCH) in neonatal pigs (piglets) using three different machines: a GE Venue R1 point-of-care system with C1-5 and L4-12t probes, a GE Vivid 7 Dimension with a 7L probe and a SuperSonic Imagine machine with an SL15-4 probe and shear wave elastography (SWE). Female piglets were anesthetized, and each was mounted vertically in a warm bath for scanning at two or three intercostal spaces. After aiming at an innocuous output, the power was raised for a test exposure. Hydrophone measurements were used to calculate in situ values of mechanical index (MI). Inflated lungs were removed and scored for PCH area. For the C1-5 probe at 50% and 100% acoustical output (AO), a PCH threshold of 0.53 MI was obtained by linear regression (r = 0.42). The L4-12t probe did not induce PCH, but the 7L probe induced zones of PCH in the scan planes. The Venue R1 automated B-line tool applied with the C1-5 probe did not detect PCH induced by the C1-5 probe as B-line counts. However, when PCH induced by C1-5 and 7L exposures were subsequently scanned with the L4-12t probe using the automated tool, B-lines were counted in association with the PCH. The SWE induced PCH at push-pulse positions for 3, 30 and 300 s of SWE with PCH accumulating at 0.33 mm/s and an exponential rise to a maximum of 18.4 mm (r = 0.61). This study demonstrated the induction of PCH by LUS of piglets, and supports the safety recommendation for use of MIs <0.4 in neonatal LUS.
Topics: Animals; Disease Models, Animal; Elasticity Imaging Techniques; Female; Hemorrhage; Lung; Lung Diseases; Rats; Rats, Sprague-Dawley; Swine
PubMed: 36030131
DOI: 10.1016/j.ultrasmedbio.2022.06.020 -
Advances in Respiratory Medicine 2020
Topics: Aged; Amiodarone; Anti-Arrhythmia Agents; Cough; Dyspnea; Female; Hemorrhage; Humans; Lung Diseases; Male; Middle Aged; Pulmonary Alveoli
PubMed: 32383473
DOI: 10.5603/ARM.2020.0095 -
Canadian Medical Association Journal Apr 1975In a patient receiving warfarin and heparin in the treatment of pulmonary embolism, a hematoma developed in the iliacus muscle, compressing the overlying femoral nerve....
In a patient receiving warfarin and heparin in the treatment of pulmonary embolism, a hematoma developed in the iliacus muscle, compressing the overlying femoral nerve. Femoral nerve paralysis ensued, causing inability to walk, pain and loss of sensation in the sensory distribution of the nerve. Surgical intervention and removal of the hematoma relieved the nerve compression and the condition gradually improved.
Topics: Adult; Female; Femoral Nerve; Hematoma; Heparin; Humans; Muscles; Nerve Compression Syndromes; Pulmonary Embolism; Thigh; Warfarin
PubMed: 1122461
DOI: No ID Found -
The Journal of Surgical Research Jan 2020Phosphatidylserine (PS) is a key cell membrane phospholipid normally maintained on the inner cell surface but externalizes to the outer surface in response to cellular...
BACKGROUND
Phosphatidylserine (PS) is a key cell membrane phospholipid normally maintained on the inner cell surface but externalizes to the outer surface in response to cellular stress. We hypothesized that PS exposure mediates organ dysfunction in hemorrhagic shock. Our aims were to evaluate PS blockade on (1) pulmonary, (2) renal, and (3) gut function, as well as (4) serum lysophosphatidic acid (LPA), an inflammatory mediator generated by PS externalization, as a possible mechanism mediating organ dysfunction.
MATERIALS AND METHODS
Rats were either (1) monitored for 130 min (controls, n = 3), (2) hemorrhaged then resuscitated (hemorrhage only group, n = 3), or (3) treated with Diannexin (DA), a PS blocking agent, followed by hemorrhage and resuscitation (DA + hemorrhage group, n = 4). Pulmonary dysfunction was assessed by arterial partial pressure of oxygen, renal dysfunction by serum creatinine, and gut dysfunction by mesenteric endothelial permeability (L). LPA levels were measured in all groups.
RESULTS
Pulmonary: there was no difference in arterial partial pressure of oxygen between groups. Renal: after resuscitation, creatinine levels were lower after PS blockade with DA versus hemorrhage only group (P = 0.01). Gut: L was decreased after PS blockade with DA versus hemorrhage only group (P < 0.01). Finally, LPA levels were also lower after PS blockade with DA versus the hemorrhage only group but higher than the control group (P < 0.01).
CONCLUSIONS
PS blockade with DA decreased renal and gut dysfunction associated with hemorrhagic shock and attenuated the magnitude of LPA generation. Our findings suggest potential for therapeutic targets in the future that could prevent organ dysfunction associated with hemorrhagic shock.
Topics: Animals; Annexin A5; Disease Models, Animal; Female; Humans; Infusions, Intravenous; Intestinal Mucosa; Kidney; Lung; Lysophospholipids; Organ Dysfunction Scores; Phosphatidylserines; Rats; Resuscitation; Shock, Hemorrhagic; Treatment Outcome
PubMed: 31499368
DOI: 10.1016/j.jss.2019.07.050