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A cascade and heterogeneous neural network for CT pulmonary nodule detection and its evaluation on both phantom and patient data.

Comput Med Imaging Graph 2021 Mar 4;90:101889. Epub 2021 Mar 4.

Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address:

Screening of pulmonary nodules in computed tomography (CT) is crucial for early diagnosis and treatment of lung cancer. Although computer-aided diagnosis (CAD) systems have been designed to assist radiologists to detect nodules, fully automated detection is still challenging due to variations in nodule size, shape, and density. In this paper, we first propose a fully automated nodule detection method using a cascade and heterogeneous neural network trained on chest CT images of 12155 patients, then evaluate the performance by using phantom (828 CT images) and clinical datasets (2640 CT images) scanned with different imaging parameters. Read More

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United States Chronic Thromboembolic Pulmonary Hypertension Registry: Protocol Design.

JMIR Res Protoc 2021 Apr 13. Epub 2021 Apr 13.

Temple University Hospital, Philadelphia, US.

Background: Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare sequela of acute pulmonary embolism that is treatable when recognized. Awareness of this disease has increased with recent advancements in therapeutic options, but delays in diagnosis remain common and diagnostic and treatment guidelines are often not followed. Data gathered from international registries has improved our understanding of CTEPH, but this data may not be applicable to the U. Read More

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Presentation, Management and Outcomes of Pediatric Pulmonary Embolus: A Retrospective Review.

Pediatr Emerg Care 2021 Apr 9. Epub 2021 Apr 9.

From the *Department of Pediatrics, Massachusetts General Hospital for Children †Department of Medicine, Massachusetts General Hospital, Boston MA.

Objectives: To review the presentation, management, and outcomes of pediatric pulmonary embolism (PE) patients treated at a single institution over 10 years to determine whether laboratory findings and clinical presentation predict disease severity.

Methods: We performed a retrospective chart review of patients treated for PE in a 14-bed pediatric intensive care unit from January 1, 2008, to December 31, 2018. Associations between clot burden and disease severity, clinical risk factors (body mass index, recent hospitalization, estrogen use), clinical presentation (heart rate, oxygen saturation), and laboratory values (white blood cell count, D-Dimer, troponin, proBNP) were performed using Student t test, χ tests, and 1-way analysis of variance. Read More

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Clinical guidelines for the treatment of congenital diaphragmatic hernia.

Pediatr Int 2021 Apr 13. Epub 2021 Apr 13.

Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.

Congenital diaphragmatic hernia (CDH) is a birth defect of the diaphragm in which abdominal organs herniate through the defect into the thoracic cavity. The main pathophysiology is respiratory distress and persistent pulmonary hypertension because of pulmonary hypoplasia caused by compression of the elevated organs. Recent progress in prenatal diagnosis and postnatal care has led to an increase in the survival rate of patients with CDH. Read More

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Diagnostic utility of rapid on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration samples: A study in a region of high tuberculosis burden.

Cytopathology 2021 Apr 13. Epub 2021 Apr 13.

Department of Pathology, Dr. Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India.

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool for precise diagnosis of thoracic lesions. However, the procedure sometimes has a poor yield. Rapid on-site evaluation (ROSE) in EBUS-TBNA has been shown to be helpful to improve its diagnostic yield and minimise the need for repeat procedures. Read More

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Metastatic Esophageal Carcinoma: Prognostic Factors and Survival.

J Gastrointest Cancer 2021 Apr 13. Epub 2021 Apr 13.

Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

Background: Worldwide, esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer-related death. At initial diagnosis, about 50% of esophageal cancer patients present with metastasis. The prognosis of metastatic esophageal cancer is poor with 5-year survival rate of less than 5%. Read More

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Human-recognizable CT image features of subsolid lung nodules associated with diagnosis and classification by convolutional neural networks.

Eur Radiol 2021 Apr 13. Epub 2021 Apr 13.

Radiology Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Haining Rd.100, Shanghai, 200080, China.

Objectives: The interpretability of convolutional neural networks (CNNs) for classifying subsolid nodules (SSNs) is insufficient for clinicians. Our purpose was to develop CNN models to classify SSNs on CT images and to investigate image features associated with the CNN classification.

Methods: CT images containing SSNs with a diameter of ≤ 3 cm were retrospectively collected. Read More

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Volume-related structures predict UIP pathology in those with a non-IPF pattern on CT.

Eur Radiol 2021 Apr 13. Epub 2021 Apr 13.

Section of Pulmonary/Critical Care, Department of Medicine, The University of Chicago Medical Center, 5841 South Maryland Ave., Chicago, IL, 60637, USA.

Objectives: To determine if a quantitative imaging variable (volume-related structures [VRS]) could identify subjects with a non-IPF diagnosis CT pattern who were highly likely to have UIP histologically.

Methods: Subjects with a multidisciplinary diagnosis of interstitial lung disease including surgical lung biopsy and chest CT within 1 year of each other were included in the study. Non-contrast CT scans were analyzed using the Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) program, which quantifies the amount of various abnormal CT patterns on chest CT. Read More

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Atypical pulmonary metastases in children: the spectrum of radiologic findings.

Pediatr Radiol 2021 Apr 13. Epub 2021 Apr 13.

Pediatric Radiology Unit, Ruth Rappaport Children's Hospital, 8 HaAliya HaShniya Street, 3109601, Haifa, Israel.

Pulmonary nodules present a diagnostic challenge when they appear as atypical metastases in pediatric oncology patients. Chest computed tomography (CT) is the primary imaging modality for assessing lung nodules. In pediatric populations, Wilms tumor and osteosarcoma are the cancers most likely to produce pulmonary metastasis, both typical and atypical. Read More

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Prednisone reduction for metastatic castration-resistant prostate cancer with recurrent pulmonary tuberculosis: Case report.

Medicine (Baltimore) 2021 Apr;100(15):e25584

Department of Radiation Oncology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.

Introduction: Prednisone (10 mg/d) is often used in combination with docetaxel or abiraterone in the treatment of advanced prostate cancer. LATITUDE studies have confirmed that the combination of abiraterone and prednisone (5 mg/d) can be used for the treatment of newly diagnosed high-risk metastatic castration-sensitive prostate cancer, and have achieved satisfactory results. However, it has not been reported that abiraterone combined with prednisone (5 mg/d) in the treatment of metastatic castration-resistant prostate cancer (mCRPC). Read More

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Squamous cell carcinoma of the tongue with cardiac metastasis on 18F-FDG PET/CT: A case report and literature review.

Medicine (Baltimore) 2021 Apr;100(15):e25529

Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat.

Introduction: The most common malignancies metastasizing to the heart are cancers of the lung, breast, mesothelioma, melanoma, leukemia, and lymphoma. Cardiac metastasis from a tongue cancer is a rare finding and only a few cases have been reported previously in the literature. In this case report and literature review, we discuss the main clinical features of patients with cardiac metastases secondary to a tongue cancer and imaging modalities performed, especially the 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). Read More

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Thymic adenocarcinoma accompanied by type A thymoma and pulmonary minimally invasive adenocarcinoma and harboring distinct gene alterations: A case report.

Medicine (Baltimore) 2021 Apr;100(15):e25254

Department of Pathology, the First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang.

Rationale: Thymic adenocarcinoma is an extremely rare thymic carcinoma. The exact genetic alteration associated with thymic adenocarcinoma is unclear. Here, we report a case of thymic adenocarcinoma accompanied by type A thymoma and pulmonary minimally invasive adenocarcinoma (MIA). Read More

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Acral Dedifferentiated Chondrosarcoma: Report of a Case Arising in the Proximal Phalanx of the Fourth Finger.

Int J Surg Pathol 2021 Apr 13:10668969211010221. Epub 2021 Apr 13.

9310Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.

Dedifferentiated chondrosarcoma is a well-recognized entity, but its occurrence in the distal extremities is exceedingly rare. We present the case of a 49-year-old woman who experienced local recurrence of an "enchondroma" of the proximal phalanx of the fourth finger of the left hand, which had been initially treated with intralesional curettage at another hospital 4 years before, and 1 year before for a local recurrence. The imaging findings indicated an aggressive behavior, and an incisional biopsy showed a highly cellular proliferation of spindle and pleomorphic elements without evidence of matrix production intermixed with few fragments of a well-differentiated cartilaginous neoplasm with bland cellular atypia, focal nuclear hyperchromatism, and binucleation. Read More

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Pericarditis as the Main Clinical Manifestation of COVID-19 in Adolescents.

Pediatr Infect Dis J 2021 May;40(5):e197-e199

From the Second Department of Paediatrics, National and Kapodistrian University of Athens, School of Medicine, P. and A. Kyriakou Children's Hospital, Athens, Greece.

Children and adolescents with severe acute respiratory syndrome coronavirus 2 infection usually have a milder illness, lower mortality rates and may manifest different clinical entities compared with adults. Acute effusive pericarditis is a rare clinical manifestation in patients with COVID-19, especially among those without concurrent pulmonary disease or myocardial injury. We present 2 cases of acute pericarditis, in the absence of initial respiratory or other symptoms, in adolescents with COVID-19. Read More

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Hypersensitivity reactions to paclitaxel: The Mexican experience of rapid desensitization.

J Oncol Pharm Pract 2021 Apr 13:10781552211008503. Epub 2021 Apr 13.

Regional Center of Allergy and Clinical Immunology, University Hospital "Dr, José Eleuterio González", Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico.

Background: Taxanes adjuvant therapy is recommended in certain high risk or metastatic tumors, particularly in lung and breast cancer, but also in other types of cancer like ovarian. The incidence of severe adverse drug reactions to paclitaxel is of approximately 10%.

Objectives: Analyze type I hypersensitivity reactions to paclitaxel and their management in the Mexican population. Read More

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Intercostal Hernia due to Forceful Coughing With Protrusion of the Lung.

Am Surg 2021 Apr 13:31348211011087. Epub 2021 Apr 13.

378743University of California Riverside School of Medicine, Riverside, CA, USA.

Intercostal herniation is an abnormal protrusion of lung tissue through the boundaries of the thoracic cavity. It is commonly seen after chest trauma or thoracic surgery but rarely occurs spontaneously. We report a male patient who presented with an intercostal herniation after vigorous coughing for over 2 weeks. Read More

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The Effectiveness of Qigong in Managing a Cluster of Symptoms (Breathlessness-Fatigue-Anxiety) in Patients with Lung Cancer: A Randomized Controlled Trial.

Integr Cancer Ther 2021 Jan-Dec;20:15347354211008253

The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hksar, China.

Background And Purpose: Qigong is used by cancer patients, but its effect is not adequately evaluated to date. The aim of this study was to investigate the effects of Qigong for the management of a symptom cluster comprising fatigue, dyspnea, and anxiety in patients with lung cancer.

Methodology: A total of 156 lung cancer patients participated in this trial, and they were randomized to a Qigong group (6 weeks of intervention) or a waitlist control group receiving usual care. Read More

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The interplay of SARS-CoV-2 and infection.

Future Microbiol 2021 Apr 13. Epub 2021 Apr 13.

Department of Pathology & Laboratory Medicine, Emory University, Atlanta, GA 30322, USA.

The COVID-19 pandemic has changed the way we practice medicine and lead our lives. In addition to pulmonary symptoms; COVID-19 as a syndrome has multisystemic involvement including frequent gastrointestinal symptoms such as diarrhea. Due to microbiome alterations with COVID-19 and frequent antibiotic exposure, COVID-19 can be complicated by infection. Read More

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RPLS-Net: pulmonary lobe segmentation based on 3D fully convolutional networks and multi-task learning.

Int J Comput Assist Radiol Surg 2021 Apr 12. Epub 2021 Apr 12.

College of Computer Science, Sichuan University, Chengdu, 610065, Sichuan Province, People's Republic of China.

Purpose: The robust and automatic segmentation of the pulmonary lobe is vital to surgical planning and regional image analysis of pulmonary related diseases in real-time Computer Aided Diagnosis systems. While a number of studies have examined this issue, the segmentation of unclear borders of the five lobes of the lung remains challenging because of incomplete fissures, the diversity of anatomical pulmonary information, and obstructive lesions caused by pulmonary diseases. This study proposes a model called Regularized Pulmonary Lobe Segmentation Network to accurately predict the lobes as well as the borders. Read More

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Athletes with valvular heart disease and competitive sports: a position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology.

Eur J Prev Cardiol 2021 Apr 13. Epub 2021 Apr 13.

Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.

This article provides an overview of the recommendations from the Sports Cardiology section of the European Association of Preventive Cardiology on sports participation in individuals with valvular heart disease (VHD). The aim of these recommendations is to encourage regular physical activity including sports participation, with reasonable precaution to ensure a high level of safety for all affected individuals. Valvular heart disease is usually an age-related degenerative process, predominantly affecting individuals in their fifth decade and onwards. Read More

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The controversial therapeutic journey of chloroquine and hydroxychloroquine in the battle against SARS-CoV-2: A comprehensive review.

Med Drug Discov 2021 Jun 10;10:100085. Epub 2021 Mar 10.

Department of Pharmaceutical Chemistry, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.

Recently, the pandemic outbreak of a novel coronavirus, officially termed as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), indicated by a pulmonary infection in humans, has become one of the most significant challenges for public health. In the current fight against coronavirus disease-2019, the medical and health authorities across the world focused on quick diagnosis and isolation of patients; meanwhile, researchers worldwide are exploring the possibility of developing vaccines and novel therapeutic options to combat this deadly disease. Recently, based on various small clinical observations, uncontrolled case studies and previously reported antiviral activity against SARS-CoV-1 chloroquine (CQ) and hydroxychloroquine (HCQ) have attracted exceptional consideration as possible therapeutic agents against SARS-CoV-2. Read More

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[When a Cold Becomes Life-threatening].

Authors:
Karin Schöls

Rheuma Plus 2021 Apr 8:1-3. Epub 2021 Apr 8.

Klinische Abteilung für Innere Medizin II, Rheumatologie, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100 Sankt Pölten, Österreich.

A 30-year-old woman presented with remitting upper airway infections. Over time she developed mastoiditis resistant to antibiotics, arthritis of her ankle as well as multilocular arthralgias and a livid discoloration of her fingertips. A computed tomography (CT) scan of her chest revealed a cavernous process and c‑ANCA (Anti Neutrophilen Cytoplasmatic Antibody) positivity led to the diagnosis granulomatosis with polyangiitis (formerly called Wegener's). Read More

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Lung-selective 25-hydroxycholesterol nanotherapeutics as a suppressor of COVID-19-associated cytokine storm.

Nano Today 2021 Apr 8:101149. Epub 2021 Apr 8.

Aging Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141 Republic of Korea.

In response to the coronavirus disease-19 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global efforts are focused on the development of new therapeutic interventions. For the treatment of COVID-19, selective lung-localizing strategies hold tremendous potential, as SARS-CoV-2 invades the lung ACE2 receptors and causes severe pneumonia. Similarly, recent reports have shown the association of COVID-19 with decreased 25-hydroxycholesterol (25-HC) and increased cytokine levels. Read More

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Risk factors and outcomes of diffuse alveolar haemorrhage after allogeneic haematopoietic stem cell transplantation.

Bone Marrow Transplant 2021 Apr 12. Epub 2021 Apr 12.

Peking University People's Hospital, Peking University Institute of Haematology, Beijing, China.

Diffuse alveolar haemorrhage (DAH) is a life-threatening pulmonary complication occurring after allogeneic haematopoietic stem cell transplantation (allo-HSCT) without an explicit aetiology or a standard treatment. This study aimed to explore the occurrence and prognosis of DAH after allo-HSCT, in addition to comparing discrepancies in the incidence, clinical characteristics and outcomes of DAH between patients undergoing haploidentical HSCT (HID-HSCT) and matched related donor HSCT (MRD-HSCT). We retrospectively evaluated 92 consecutive patients among 3987 patients with a confirmed diagnosis of DAH following allo-HSCT (HID: 71 patients, MRD: 21 patients). Read More

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Aerosol components associated with hospital mortality in systemic sclerosis: an analysis from a nationwide Thailand healthcare database.

Sci Rep 2021 Apr 12;11(1):7983. Epub 2021 Apr 12.

Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.

Occupational and environmental associations with systemic sclerosis (SSc) have been confirmed; however, the association between aerosol components and mortality is uncertain. The study aimed to define the association between aerosol components and hospital mortality among Thai SSc patients. A study was conducted using a national database of patients covered by the National Health Security Office, hospitalised between 2014 and 2018. Read More

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Favourable outcome after a delayed complication secondary to COVID-19.

BMJ Case Rep 2021 Apr 12;14(4). Epub 2021 Apr 12.

Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK

A 41-year-old man was admitted to hospital with 7-day history of fever, cough and having had a positive SARS-CoV-2 PCR test. The chest radiograph (CXR) showed bilateral peripheral parenchymal infiltrates. He required 4 L/min oxygen via nasal cannula for 72 hours and was discharged after 7 days with appropriate advice. Read More

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Benign metastasising leiomyoma with endometrial carcinoma, with a differential diagnosis of metastatic lung cancer.

BMJ Case Rep 2021 Apr 12;14(4). Epub 2021 Apr 12.

Department of Obstetrics and Gynecology, St Luke's International University, Chuo-ku, Tokyo, Japan.

Benign metastasising leiomyoma (BML) is a rare disease in which histologically benign uterine fibroids spread throughout the body. It is thought to originate from the hematogenous metastasis of myoma cells following myomectomy. To date, BML has been noted in patients with respiratory symptoms, even during regular checkups. Read More

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Pulmonary mucormycosis in immunocompetent hosts diagnosed by bronchioalveolar lavage.

BMJ Case Rep 2021 Apr 12;14(4). Epub 2021 Apr 12.

Pathology, KS Hegde Medical Academy, Mangalore, India

Mucormycosis is a rare infection caused by Mucorales fungi belonging to Zygomycetes class. It can present with spectrum of symptoms and signs based of organ involvement. Common forms of mucormycosis includes rhinocerebral, cutaneous, gastrointestinal, pulmonary, disseminated and miscellaneous forms involving bones, breast, kidney and central nervous system. Read More

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Tracheobronchopathia osteochondroplastica: a cause of chronic cough and haemoptysis.

BMJ Case Rep 2021 Apr 12;14(4). Epub 2021 Apr 12.

Pathology and Microbiology, Aga Khan University, Karachi, Pakistan.

Tracheobronchopathia osteochondroplastica (TPO) is a rare disorder of the tracheopulmonary tree characterised by osseous and cartilaginous submucosal nodules projecting into the tracheal lumen, sparing the posterior tracheal membranous wall. Symptoms are non-specific and may include dry cough, hoarseness, dyspnoea, recurrent pneumonia and occasionally haemoptysis. A fibreoptic bronchoscopy showing multiple tracheal nodules followed by pathological biopsy is required to reach the final diagnosis. Read More

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Acute lung injury after exchange transfusion in two newborns with Glucose-6-phosphate dehydrogenase deficiency.

Transfus Apher Sci 2021 Apr 6:103133. Epub 2021 Apr 6.

Department of Pediatrics, Division of Neonatology, Marmara University Faculty of Medicine, İstanbul, Turkey. Electronic address:

Transfusion-related lung injury (TRALI) is a condition that develops suddenly within the first six hours after a blood transfusion and it is one of the most important causes of blood transfusion-related mortality. There are few data in the literature about TRALI in the neonatal period. We present two newborn patients who developed TRALI after exchange transfusion due to high bilirubin levels. Read More

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