scholarly journals Comparison of direct vision and video imaging during bronchoscopy for pediatric airway foreign bodies

2003 ◽  
Vol 82 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Cheng-Chien Yang ◽  
Kuo-Sheng Lee
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Direct Vision ◽  
Pediatric Airway ◽  
Video Imaging ◽  
Significant Difference ◽  
Positive Rate ◽  
The Difference ◽  
Videotape Recording ◽  
Second Procedure

Rigid ventilation bronchoscopy is a most useful means of detecting and removing foreign bodies in the airway. We performed a retrospective study of 114 children who had undergone such a procedure during a 12-year period. During bronchoscopy, 48 of these patients had been examined under direct vision and 66 by videotape recording. We found that the positive rate on first-look direct vision was 93.8% and the positive rate on first-look video imaging was 89.4%. The lower positive rate during the first-look examination by video imaging might be attributable to the facts that it is safer and that it provides a better visual field, which can encourage operators to choose video ventilation bronchoscopy, either as a diagnostic or therapeutic tool. In addition, three foreign-body-negative patients in the direct-vision group underwent a second procedure, and a foreign body was found in all three. Only one of the video-imaging patients underwent a second procedure, and no foreign body was found. The difference in the positive rates after the second procedure was statistically significant (p<0.05). This might be attributable to the higher success rate with video imaging following the first procedure, which significantly reduced the need for a second look and the possibility of overlooked or residual foreign bodies. The condition of the mucosa postprocedurally was described in every case after video imaging but after only 41.7% of the direct-vision cases—a statistically significant difference (p<0.001). Video imaging provides the physician with a clear, magnified view of the area under examination. It allows for later review of the videotape when necessary, and it reduces the risk that residual foreign-body material will remain in the airway.

Utility of Conventional Radiography in the Diagnosis and Management of Pediatric Airway Foreign Bodies

1998 ◽  
Vol 107 (10) ◽  
pp. 834-838 ◽  
Author(s):  
Andrew B. Silva ◽  
Harlan R. Muntz ◽  
Randall Clary
Keyword(s):  
Foreign Body ◽  
Physical Examination ◽  
Foreign Bodies ◽  
Surgical Intervention ◽  
Operative Intervention ◽  
Radiographic Imaging ◽  
Pediatric Airway ◽  
Diagnosis And Management ◽  
Breath Sounds ◽  
Airway Foreign Body

Pediatric airway foreign bodies are potentially life-threatening situations. The otolaryngologist is often consulted to aid in the diagnosis and management of these difficult cases. Although radiographic studies are often obtained, the decision for surgical intervention is usually based on a suspicious history and physical examination. Our hypothesis is that radiographic imaging should not alter the decision for surgical intervention. We retrospectively reviewed the cases of pediatric airway foreign bodies managed by the otolaryngology department at St Louis Children's Hospital between December 1990 and June 1996 with both radiographic imaging and operative intervention. Ninety-three cases of potential aspiration were identified, with a median patient age of 20 months. The most common presenting signs and symptoms were aspiration event (n = 82), wheezing (n = 76), decreased breath sounds (n = 47), cough (n = 39), respiratory distress (n = 17), fever (n = 16), pneumonia (n = 14), and stridor (n = 7). At the time of endoscopy, 73 patients were found to have an airway foreign body. The sensitivity and specificity of the imaging studies in identifying the presence of an airway foreign body in the 93 patients were 73% and 45%, respectively. Our decision for operative intervention was based on the history and physical examination, and was not changed in the presence of a negative radiographic study. The routine use of radiography should not alter the management of airway foreign bodies, providing that there is a well-equipped endoscopic team familiar with airway foreign bodies.

scholarly journals Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of flexible bronchoscopy and urology stone retrieval basket in emergency setting

2021 ◽  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Pediatric Population ◽  
Operation Time ◽  
Operative Management ◽  
Flexible Bronchoscopy ◽  
Emergency Setting ◽  
Flexible Bronchoscope ◽  
Pediatric Airway

Objective: Tracheobronchial aspiration of foreign body in children is an emergency that can lead to major complications. In the last years flexible bronchoscopy has gained popularity for foreign bodies retrieval in the pediatric population, yet the small size of the pediatric airway and of the flexible bronchoscope channel limit the availability of instruments during the procedure. Aim of this paper is to describe our experience in treating foreign bodies tracheobronchial aspiration in children aged 2 years or less by means of flexible bronchoscope and an urology stone retrieval basket. Methods: A review of endoscopic foreign bodies removal by means of flexible bronchoscopy and urology stone retrieval basket has been carried out in children ≤ 2 years that presented at the Emergency Room of our hospital from 2005 to 2019. In the paper, we analyze characteristics of patients, timing of bronchoscopy, instruments and operative management. Results: There were 25 patients with a mean age of 20 ± 3.8 months. Organic material was the most frequent observed foreign body. Association of main bronchus and distal bronchi was the preferred site of the foreign body in 19 patients and the right side of the bronchial tree was involved in 17 cases. Complications occurred in one case. Mean operation time was 37 ± 20 minutes. Conclusions: The use of flexible bronchoscope can be helpful in handling endoscopic removal of tracheobronchial foreign bodies in toddlers. The use of the urology stone retrieval basket resulted very effective in all shapes of foreign bodies and/or when the object was located in the distal bronchi.

scholarly journals Application of aqueous humor polymerase chain reaction for virus in Posner-Schlossman syndrome

2020 ◽  
Author(s):  
Shuya Tao ◽  
Qin Jiang ◽  
Li Tang ◽  
Xiyan Ding ◽  
Xiumiao Li ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Aqueous Humor ◽  
Antiviral Treatment ◽  
Control Group ◽  
Case Group ◽  
Viral Detection ◽  
Detection Technology ◽  
Significant Difference ◽  
Positive Rate ◽  
The Difference

Abstract Background To study the effectiveness and safety of aqueous humor PCR viral detection in the diagnosis of PSS. Methods 20 patients (case group) with PSS who suffered from recurrences and poor intraocular pressure (IOP) control by use of drugs underwent anterior chamber puncture. The concentration of different viruses in aqueous humor were detected by PCR. 20 patients (control group) with POAG were given the same treatment and we compared the difference of positive rate of the viruses between two groups. Finally, the effectiveness and safety of aqueous humor PCR viral detection in the diagnosis of PSS were observed. Besides, the advantage of PCR viral detection technology in treatment was evaluated. Results No complications and long-term sequelae related to anterior chamber puncture were found. The total positive rate of aqueous humor viral detection was 30% (6/20) in case group ,and was found none in control group (0/20) (P = 0.027). Then, we divided the case group into two groups. Six virus positive patients were given local and systemic antiviral treatment for 3 months and then interrupted the treatment. Fourteen patients left were given no antiviral treatment. All PSS patients were observed for 9 months from the first time of treatment. There is significant difference between two groups in recurrence rate (P = 0.013). Conclusions Viral infection is a risk factor of PSS. The detection of virus in aqueous humor by PCR is effective and safe for diagnosis of PSS, and helpful for targeted treatment on virus-positive patients.

scholarly journals ROLE OF HRCT THORAX IN TRACHEOBRONCHIAL FOREIGN BODY DETECTION

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Manphool Singh Maharia ◽  
Sandeep Kumar ◽  
Deep Chand ◽  
Gaurav Gupta
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Multidetector Ct ◽  
Clinical History ◽  
High Resolution Computed Tomography ◽  
X Ray ◽  
Medical College ◽  
Tracheobronchial Foreign Body ◽  
The Difference

Background: Aspirated foreign bodies in the airway continue to present challenges to the otorhinolaryngologist and interventional pulmonologists. To established the role of HRCT in diagnosis of foreign bodies in suspected cases. Methods-30 patients with suspected FB inhalation on the basis of clinical history and symptoms like respiratory distress, stridor, and history of chocking were recruited for study in department of Otorhinolaryngology in Sardar Patel Medical College and Hospital, Bikaner Rajasthan. Results: 29 patients (96.67%) with foreign bodies were identified on chest CT. For the patients with tracheobronchial foreign bodies, the occurrence of unilateral hyperlucent lung and post-obstructive lobar or segmental infiltrates on plain chest X-ray was 43.33%. 17 patients (56.67%) had no abnormalities on plain X-ray. The difference between multidetector CT and plain X-ray results was statistically significant. Conclusion: Foreign bodies are missed byclinical and X-ray examination in many cases and that is only picked up by HRCT. Thus it is the ideal modality in diagnosis of foreign bodies to avoid the morbidity and mortality associated with missing foreign body. Keywords: foreign bodies, high resolution computed tomography, X-ray

STUDY ON LEVEL OF ANTI GAD AND ICA AUTOANTIBODIES IN PATIENTSWITH DIABETES MELLITUS

2016 ◽  
pp. 78-85
Author(s):  
Thi Minh Phuong Phan ◽  
Dinh Thanh Truong
Keyword(s):  
Diabetes Mellitus ◽  
Statistical Significance ◽  
Enzyme Linked Immunosorbent Assay ◽  
Acid Decarboxylase ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Positive Rate ◽  
The Difference ◽  
The One

Background: Autoantibodies anti GAD and ICA associated to the autoimmune process of patients with diabetes. Detection of these antibodies in progessive diabeticpatients is very necessary because the presence of anti GAD and ICA can predict the progression of the disease to insulin-dependent diabetes in the future. This study was carried out with aims: (1) to define the positive rate, anti GAD and ICA level in patients with diabetes. (2) to evaluate the correlation between anti GAD and ICA with several clinical and paraclinical features of diabetic patients. Materials and method: 88 patients diagnosed of diabetes by the criteria of ADA 2014, withfasting glucose ≥ 126 mg/dL or≥ 7,0 mmol/L) and HbA1C> 6.5%. Indirect enzyme linked immunosorbent assay (ELISA) was used to measure those autoantibodies of anti GAD and ICA, kits were supplied by DRG company, Germany. Results: the anti GAD positive rate was 10.2%; mean of level of anti GAD was 1.44±0.25 U/mL. ICA positive ratewas 9.1%; mean of level of ICA was 1.44±0.12 U/mL. Positive rate with anti GAD and/or ICA was 19.3%. About the correlation between level of anti GAD, ICA with some of clinical features, we found only the statistically significant difference with p<0.05 between blur vision in the group of ICA level > 1.25U/mL with group of ICA level< 1.25U/mL. About the paraclinical features, the difference with statistical significance (p<0.05) of HbA1C>6.5% was found between the group with anti GAD> 1.05U/mLand the one with anti GAD< 1.00U/mLand also betweenthe group of ICA > 1.25 U/mL and ICA < 1.25 U/mL. Key words: autoantibody anti glutamic acid decarboxylase, islet cell autoantibodies, diabetes mellitus.

Elbow Valgus Stress Radiography in an Uninjured Population

1998 ◽  
Vol 26 (3) ◽  
pp. 425-427 ◽  
Author(s):  
Guy A. Lee ◽  
Stephen D. Katz ◽  
Mark D. Lazarus
Keyword(s):  
False Positive ◽  
False Positive Rate ◽  
Stress Radiography ◽  
Valgus Stress ◽  
Stress Radiographs ◽  
Significant Difference ◽  
Positive Rate ◽  
Positive Assessment ◽  
Valgus Instability ◽  
The Difference

Valgus instability of the elbow joint is a clinical diagnosis. However, many authors describe valgus stress radiographs as an aid in making this diagnosis. We studied valgus stress radiographs of 20 men (40 elbows) and 20 women (40 elbows), none with a history of elbow trauma or instability. The medial ulnohumeral distance was measured with no stress, valgus stress by gravity, and an applied valgus stress of 25 N (approximately 5 pounds). Measurements were made with the elbow positioned in extension and in 30° of flexion. The increase in medial ulnohumeral gapping with either gravity or 5 pounds of stress was statistically significant at both extension and 30° of flexion compared with the unstressed condition. The difference in ulnohumeral gapping between gravity stress and 5 pounds of valgus stress in extension and in 30° of flexion was also significant. We found no differences with regard to hand dominance or sex. We conclude that uninjured elbows have significant medial ulnohumeral gapping on valgus stress radiography. Although this is an important tool in diagnosing valgus instability of the elbow, it may yield a false-positive assessment of valgus instability. Valgus stress radiographs comparing contralateral elbows may reduce the false-positive rate since there appears to be no significant difference in medial ulnohumeral gapping between the two elbows.

scholarly journals Delayed Diagnosis of a Pediatric Airway Foreign Body: Case Report and Review of the Literature

2002 ◽  
Vol 81 (9) ◽  
pp. 655-656 ◽  
Author(s):  
Christine B. Franzese ◽  
John M. Schweinfurth
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Delayed Diagnosis ◽  
Foreign Body Aspiration ◽  
Review Of The Literature ◽  
Pediatric Airway ◽  
Unexplained Symptoms ◽  
Airway Foreign Body ◽  
Body Case

Foreign body aspiration is a common pediatric problem that affects children of all ages, including those who are well into their adolescence. We describe the case of a 9-year old boy with an airway foreign body that had gone unrecognized for 3 months. We also review the literature on pediatric airway foreign bodies, with a focus on delayed diagnosis. A diagnosis of foreign body aspiration should be considered whenever a previously healthy child suddenly exhibits unexplained symptoms that are refractory to medical treatment and are consistent with airway obstruction.

Grassheads in the Tracheobronchial Tree: Two Different Outcomes

1981 ◽  
Vol 90 (4) ◽  
pp. 406-408 ◽  
Author(s):  
Mary J. Spencer ◽  
Victoria E. Millet ◽  
James P. Dudley ◽  
Jessie L. Sherrod ◽  
Yvonne J. Bryson
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Clinical Course ◽  
Lower Lobe ◽  
Tracheobronchial Tree ◽  
Pulmonary Complications ◽  
Essential Factor ◽  
Chemical Irritation ◽  
The Difference ◽  
The Right

Many vegetable foreign bodies can produce serious pulmonary complications because of chemical irritation to the airway. Barley grass, a type of grasshead, does not induce such a reaction because of its resistance to organic decay. Complications which may occur are illustrated by the clinical course of two patients with aspiration of this foreign body. In the first patient the grasshead entered the trachea with the flowering unit first and the stem following. In the second patient the stem entered the trachea first. Recurrent pneumonias were noted in the first patient. Despite its presence in the right stem bronchus for three years, no further episodes of pneumonia followed its removal. In the second patient the grassheads could not be removed endoscopically. They migrated into the right lower lobe producing pneumonia and ultimately resulting in a brain abscess. The difference of entry of the same foreign body into the trachea, stem first versus flowering unit first, is an essential factor in altering the clinical outcome.

A Large Bullet in the Bladder

Swiss Surgery ◽  
2001 ◽  
Vol 7 (3) ◽  
pp. 139-140 ◽  
Author(s):  
Halkic ◽  
Wisard ◽  
Abdelmoumene ◽  
Vuilleumier
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Gross Hematuria ◽  
Suprapubic Cystostomy ◽  
Laparoscopic Port ◽  
Urethral Trauma ◽  
Bullet Injury

All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimise bladder and urethral trauma. We report a case of a bullet injury to the bladder, which finally presented as a gross hematuria after remaining asymptomatic for four years. We present here an alternative to suprapubic cystostomy with a large bladder foreign body treated via a combined transurethral unroofing followed by removal using a grasper passed through a suprapubic laparoscopic port.

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