thoracic

胸廓
  • 文章类型: Journal Article
    本研究旨在评估TUSG在术后阶段的作用以及手术治疗后早期并发症的检测。肺切除术,或对感染性和炎症性胸部疾病进行剥皮术,与标准方法(胸部X线照相术-CXR)进行比较。
    前瞻性非随机自我对照研究。21名16岁以上的患者接受了炎症性和感染性肺部疾病的手术治疗。对这些患者进行CXR和TUSG随访(在术后第1天和第3天和/或胸管拔除后进行)。
    两项检查都显示出相似的结果,即它们能够安全地预测胸部引流管移除的适当时机。TUSG允许在30%的病例中去除胸腔引流,在34%的病例中去除CXR。统计分析表明,两种检查在检测胸膜腔的术后变化方面具有相似的能力。然而,作者报告TUSG在检测皮下气肿方面比CXR更准确(p=0.037,Kappa[κ=0.3068]).其他参数剖析显示无统计学差别。
    作者得出结论,经过训练的TUSG在寻找感染性和炎症性胸部疾病的手术治疗的术后并发症方面相当于CXR,可以作为一种补充,而不是替代品,到CXR,当CCT不可行时,或者需要更紧急的诊断。
    This study aims to evaluate the role of TUSG in the postoperative period and the detection of early complications after surgical treatment, pulmonary resection, or decortication for infectious and inflammatory thoracic diseases, comparing with the standard method (Chest Radiography ‒ CXR).
    Prospective non-randomized self-controlled study. Twenty-one patients over 16 years of age have undergone surgical treatment of inflammatory and infectious lung diseases. These patients were followed up with CXR and TUSG (performed on the 1st and 3rd postoperative days and/or after the chest tube removal).
    Both exams demonstrated similar results regarding their ability to safely predict the adequate moment for chest drain removal. TUSG allowed chest drain removal in 30% of cases and CXR in 34%. Statistical analysis demonstrates that both exams have similar capabilities in detecting postoperative changes in the pleural space. However, the authors report that TUSG is statistically more accurate in detecting subcutaneous emphysema than CXR (p = 0.037, Kappa [κ = 0.3068]). The analysis of other parameters showed no statistical difference.
    The authors conclude that TUSG in trained hands is equivalent to CXR in searching for postoperative complications regarding the surgical treatment of infectious and inflammatory thoracic diseases and can be used as a complement, and not a substitute, to CXR, when CCT is not feasible, or a more urgent diagnosis is needed.
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  • 文章类型: Case Reports
    全位倒位的特征是胸部和腹部内脏完全移位。个人可以在这种情况下渐近地生活;然而,它可能与所涉及器官的某些异常有关。
    方法:这里,我们介绍了一例全肌位倒位女性,表现为胆总管结石症。术中修改后对患者进行选择性腹腔镜胆囊切除术。患者在健康状况下出院。
    一些病例报告记录了胆石症的典型表现,其特征是左上腹和上腹部疼痛。我们的患者表现出类似的症状,并被诊断为胆总管结石。
    结论:SIT个体的发病率的诊断和治疗管理可以通过推荐的修改来进行,这些修改可以导致有利的结果。
    UNASSIGNED: Situs inversus totalis is characterized by the complete transposition of thoracic and abdominal viscera. Individuals can live asymptomatically with this condition; however, it may be associated with certain abnormalities of the organs involved.
    METHODS: Herein, we present a case of a situs inversus totalis woman presented with choledocholithiasis. Elective laparoscopic cholecystectomy was performed on the patient with intraoperative modifications. The patient was discharged in a healthy condition.
    UNASSIGNED: Several case reports have documented the typical presentation of cholelithiasis, which is characterized by pain in the left upper quadrant and epigastric region. Our patient exhibited similar symptoms and was diagnosed with choledocholithiasis.
    CONCLUSIONS: Diagnostic and therapeutic management of morbidities in SIT individuals can be performed with recommended modifications that can lead to favorable outcomes.
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  • 文章类型: Case Reports
    我们介绍了一例患有DiGeorge综合征和先天性心脏异常的42岁男子,其中包括B型主动脉弓中断,该患者先前曾在童年时期在升主动脉和降主动脉之间进行过两次旁路。发现他的降主动脉有7.4厘米的假性动脉瘤,左锁骨下动脉由动脉瘤引起。患者接受了单阶段混合修复治疗,包括左颈总动脉至锁骨下旁路术,然后进行胸血管内主动脉瘤修复。
    We present a case of a 42-year-old man with DiGeorge syndrome and congenital cardiac anomalies including a type B interrupted aortic arch who had previously undergone two bypasses between the ascending and descending thoracic aorta in childhood. He was found to have a 7.4-cm pseudoaneurysm of the descending thoracic aorta with the left subclavian artery arising from the aneurysm. The patient was treated with a single stage hybrid repair including left common carotid to subclavian bypass followed by thoracic endovascular aortic aneurysm repair.
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  • 文章类型: Journal Article
    目的:评估患病率,type,在神经系统正常的短脑\'螺钉尾\'犬品种中,胸椎先天性椎骨畸形(CVM)的部位和品种倾向。
    方法:回顾性病例系列。
    方法:神经系统正常的法国斗牛犬(n=63),英国斗牛犬(n=42),BostonTerriers(n=4)和Pugs(n=86)用于治疗短脑阻塞性气道综合征。
    方法:对每只狗的胸部进行普通计算机断层扫描或胸椎柱的外侧和背腹侧数字X射线照片进行评估,以确定是否存在任何椎骨畸形,并根据Guiterrez等人提出的改良McMaster椎骨异常分类方案进行分类。结果:在法国斗牛犬中,一个或多个椎骨异常的狗的患病率为96.82%,90.47%的英国斗牛犬,哈巴狗的比例为76.74%。哈巴狗的CVM发生率明显低于法国斗牛犬。四只波士顿猎犬都有脊椎畸形,但由于样本量小,结果被认为没有统计学意义.在法国斗牛犬和英国斗牛犬中,腹侧发育不全(3型)的发生率高于所有其他类型,其次是腹侧和正中发育不全(7型)和对称发育不全(8型)。在哈巴狗,对称发育不全(8型)是最常见的,然后是腹侧发育不全(3型)。受影响最大的椎骨是哈巴狗的T6-T9和法国斗牛犬和英国斗牛犬的T5-T10。
    结论:本文评估的大多数神经系统正常的短头型“螺钉尾”犬具有一种或多种先天性胸椎畸形。发现患有椎骨畸形的狗更有可能患有一个以上的受影响椎骨。性别对CVM的患病率没有影响。
    结论:相当数量的神经系统正常的短头“螺旋尾”犬患有先天性椎骨畸形。因此,需要选择性育种计划来消除这种遗传性疾病是至关重要的。
    OBJECTIVE: To evaluate the prevalence, type, site and breed predisposition of thoracic congenital vertebral malformations (CVM) in neurologically normal brachycephalic \'screw-tail\' dog breeds.
    METHODS: Retrospective case series.
    METHODS: Neurologically normal French Bulldogs (n = 63), British Bulldogs (n = 42), Boston Terriers (n = 4) and Pugs (n = 86) presenting for brachycephalic obstructive airway syndrome treatment.
    METHODS: Either a plain computer tomography scan of the thorax or lateral and dorso-ventral digital radiographs of the thoracic vertebral column of each dog were assessed for any vertebral malformations and classed according to the Modified McMaster vertebral abnormality classification scheme proposed by Guiterrez et al. RESULTS: The prevalence of dogs with one or more abnormal vertebrae was 96.82% in French Bulldogs, 90.47% in British Bulldogs, and 76.74% in Pugs. Pugs had significantly lower instances of CVMs than French Bulldogs. The four Boston Terriers all had vertebral malformations, but the results were not considered to be statistically significant due to their small sample size. In French Bulldogs and British Bulldogs, ventral hypoplasia (Type 3) occurred at greater rates than all other types, followed by ventral and median hypoplasia (Types 7) and symmetrical hypoplasia (Type 8). In Pugs, symmetrical hypoplasia (Type 8) was the most common and then ventral hypoplasia (Type 3). The most affected vertebrae were T6-T9 in Pugs and T5-T10 in French Bulldogs and British Bulldogs.
    CONCLUSIONS: The majority of neurologically normal brachycephalic \'screw-tail\' dogs assessed in this paper possessed one or more congenital thoracic vertebral malformations. Dogs with vertebral malformations were found to be more likely to have more than one affected vertebra. Sex had no effect on the prevalence of CVM.
    CONCLUSIONS: A substantial number of neurologically normal brachycephalic \'screw-tail\' dogs suffer from congenital vertebral malformations. Thus, the need for selective breeding programmes to eliminate this hereditary condition is crucial.
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  • 文章类型: Journal Article
    目的:报告犬胸腔镜颅纵隔肿块切除术的并发症和预后。
    方法:49只接受胸腔镜颅骨纵隔肿块切除术的受助犬。
    方法:这是一项回顾性队列研究(2014年1月1日至2023年7月31日),并回顾了49只接受胸腔镜颅骨纵隔肿块切除术的患者的医疗记录.标志,历史,临床病理特征,围手术期并发症,并记录长期结果。
    结果:在49只狗中的17只(35%)和49只狗中的11只(22%)中发现了术前重症肌无力(MG)和巨食管(ME)。分别。CT图像上的中位最大肿瘤直径为4.7cm(范围,2.7至8.5厘米)。49只狗中有4只(8%)需要非紧急转换为开放程序,与未转换的狗相比,转换为开放程序的狗的中位最大CT肿瘤直径明显更大(P=0.03)。最常见的肿瘤类型是胸腺瘤(37/49[76%])。患有胸腺瘤的狗的总体中位生存时间为1,102天(95%CI,482至上限未达到)。患有胸腺瘤和并发术前MG的狗的中位生存时间为182天(95%CI,14至上限未达到)。术前诊断为MG(P=0.44)或ME(P=0.69)与生存时间无关。
    结论:胸腔镜下切除颅骨纵隔肿块的转化率和并发症发生率较低。长期生存是可能的,选择病例应考虑胸腔镜切除。
    OBJECTIVE: To report the complications and outcomes associated with thoracoscopic cranial mediastinal mass resection in dogs.
    METHODS: 49 client-owned dogs that underwent thoracoscopic cranial mediastinal mass removal.
    METHODS: This was a retrospective cohort study (January 1, 2014, to July 31, 2023), and the medical records of 49 client-owned dogs that underwent thoracoscopic cranial mediastinal mass removal were reviewed. The signalment, history, clinicopathologic features, perioperative complications, and long-term outcome were recorded.
    RESULTS: Preoperative myasthenia gravis (MG) and megaesophagus (ME) were identified in 17 of 49 (35%) dogs and 11 of 49 (22%) dogs, respectively. The median maximal tumor diameter on CT images was 4.7 cm (range, 2.7 to 8.5 cm). Nonemergent conversion to an open procedure was necessary in 4 of 49 (8%) dogs, and dogs with conversion to an open procedure had a significantly larger median maximal CT tumor diameter than dogs without conversion (P = .03). The most common tumor type was thymoma (37/49 [76%]). The overall median survival time for dogs with thymoma was 1,102 days (95% CI, 482 to upper bound not reached). The median survival time for dogs with thymoma and concurrent presurgical MG was 182 days (95% CI, 14 to upper bound not reached). Presurgical diagnosis of MG (P = .44) or ME (P = .69) was not associated with survival time.
    CONCLUSIONS: Thoracoscopic removal of cranial mediastinal masses was associated with low conversion and complication rates. Long-term survival is possible, and thoracoscopic removal should be considered for select cases.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    背景:家庭内的胸椎骨折由于其相关的发病率和大量的医疗保健支出而成为关键的公共卫生问题。这项研究旨在剖析这些伤害的复杂流行病学,整合超越传统人口统计和位置分析的综合风险因素。
    方法:利用国家电子伤害监测系统(NEISS)的十年数据(2013-2022),这项研究调查了家庭中不同年龄和性别的胸椎骨折.纳入标准针对特定的胸椎相关术语,按位置分析裂缝(例如,厨房,楼梯)和相关产品。数据处理采用R编程,以描述性统计和多变量逻辑回归为重点的统计分析,以确定骨折模式,并通过调整赔率比(AORs)评估骨折风险的性别差异。
    结果:对46,371例胸椎骨折的分析将楼梯确定为主要部位(26.81%),随后的频繁地点是卧室(18.52%),客厅(17.88%),和厨房(16.29%)。性别特异性风险分析显示,女性在楼梯上(AOR=1.24,95%CI:1.16-1.37,p<.001)和卧室中(AOR=1.13,95%CI:1.09-1.54,p<.001)骨折的可能性更高。受影响最大的年龄组是51-60岁,显示了危险因素的多面性,而不仅仅是地理位置。
    结论:这项研究通过详细说明各种因素的影响,超越了先前的见解,包括社会经济地位和生活方式,骨折风险。它强调了家庭分裂的复杂性,强调性别和年龄是关键但不是唯一的风险决定因素。
    结论:通过提供包含多种风险因素的综合分析,这项研究提高了人们对居住环境中胸椎骨折的认识。它强调有必要采取有针对性的预防措施,认识到这些伤害的多因素性质,为改进安全干预措施和公共卫生政策铺平道路。
    BACKGROUND: Thoracic vertebral fractures within homes are pivotal public health concerns due to their associated morbidity and significant healthcare expenditures. This study aims to dissect the intricate epidemiology of these injuries, integrating comprehensive risk factors beyond conventional demographics and location analyses.
    METHODS: Utilizing a decade of data (2013-2022) from the National Electronic Injury Surveillance System, this study examines thoracic vertebral fractures across age and gender in household settings. Inclusion criteria targeted specific thoracic spine-related terms, analyzing fractures by location (e.g., kitchen, stairs) and associated products. Data processing employed R programming, with statistical analysis focusing on descriptive statistics and multivariate logistic regression, to identify fracture patterns and assess gender differences in fracture risks through Adjusted Odds Ratios (AORs).
    RESULTS: Analysis of 46,371 thoracic vertebral fractures identified stairs as the primary site (26.81%), with subsequent frequent locations being bedrooms (18.52%), living rooms (17.88%), and kitchens (16.29%). Gender-specific risk analysis revealed females had a higher likelihood of fractures on stairs (AOR = 1.24, 95% CI: 1.16-1.37, P < 0.001) and in bedrooms (AOR = 1.13, 95% CI: 1.09-1.54, P < 0.001). The most affected age group was 51-60, showcasing the multifaceted nature of risk factors beyond mere location.
    CONCLUSIONS: This study transcends prior insights by detailing the influence of various factors, including socioeconomic status and lifestyle, on fracture risk. It emphasizes the complexity of household fractures, highlighting gender and age as pivotal but not exclusive risk determinants.
    CONCLUSIONS: By offering a comprehensive analysis that incorporates a wide array of risk factors, this study advances the understanding of thoracic vertebral fractures in residential environments. It underscores the necessity for targeted preventive measures that are cognizant of the multifactorial nature of these injuries, paving the way for improved safety interventions and public health policies.
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  • 文章类型: Journal Article
    Although kidney transplantation is the best therapeutic option for patients with chronic kidney disease, the immunosuppression required greatly increases susceptibility to infections that are responsible for high post-transplant mortality. Pulmonary tuberculosis (TB) represents a major cause of such infections, and its early diagnosis is therefore quite important. In view of that, we researched the manifestations of active pulmonary TB in kidney transplant recipients, through chest X-ray and computed tomography (CT), as well as determining the number of cases of active pulmonary TB occurring over a 3.5-year period at our institution. We identified four cases of active pulmonary TB in kidney transplant recipients. The CT scans provided information complementary to the chest X-ray findings in all four of those cases. We compared our CT findings with those reported in the literature. We analyzed our experience in conjunction with an extensive review of the literature that was nevertheless limited because few studies have been carried out in lowand middle-income countries, where the incidence of TB is higher.
    Apesar de o transplante renal ser a melhor opção terapêutica para pacientes com doença renal crônica, a imunodepressão decorrente desse tratamento eleva muito a suscetibilidade desses pacientes a infecções, responsáveis por altas taxas de mortalidade pós-operatórias. A tuberculose (TB) pulmonar é uma significativa causa dessas infecções, sendo muito importante o seu diagnóstico precoce. Assim, nós pesquisamos as manifestações da TB pulmonar ativa nessa população de transplantados renais por meio de radiografias simples e tomografia computadorizada (TC) do tórax, também para estabelecer o número de casos de TB pulmonar ativa em nossa instituição após levantamento de 3,5 anos. Encontramos quatro casos de TB pulmonar ativa em pacientes transplantados renais. A TC forneceu informações adicionais em relação às radiografias de tórax em 100% dos casos analisados. Comparamos os nossos achados de TC com os relatados na literatura. Somamos a experiência obtida com extensa revisão da literatura, ainda limitada nessa questão, com poucos estudos realizados em países em desenvolvimento onde a incidência de TB é maior.
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  • 文章类型: Case Reports
    Musculoskeletal aetiologies account for most patients presenting with chest pain. Intercostal neuralgia is a lesser-known cause of musculoskeletal chest pain, which can present a diagnostic challenge with nonspecific imaging findings. We report a case of a 31-year-old male who presented with severe lower thoracic and chest wall pain following a suspected viral infection, where Magnetic Resonance Imaging (MRI) revealed characteristic features of denervation oedema within the affected intercostal muscles. This pattern of imaging findings in intercostal neuralgia is sparely described in the current literature. MRI along with history and examination was crucial in diagnosing the condition and excluding other potential causes of musculoskeletal chest wall pain on this occasion. The patient\'s symptoms were subsequently managed conservatively. The case highlights the importance of considering intercostal neuralgia as a potential cause of chest wall pain, particularly in the setting of post viral infection and absence of preceding mechanical musculoskeletal injury and explores an uncommon yet characteristic imaging finding which may be important in diagnosing the condition.
    Nustatyti raumenų ir skeleto skausmų priežastį yra aktualu daugumai pacientų, besikreipiančių dėl skausmo krūtinės plote. Tarpšonkaulinė neuralgija yra nedažna raumenų ir skeleto krūtinės srities skausmų priežastis. Ją nustatyti iš gaunamos vaizdinės informacijos gali būti sunku, nes joje nėra jokių išskirtinių požymių.
    UNASSIGNED: 31 metų vyras kreipėsi dėl intensyvaus skausmo apatinėje krūtinės ląstos dalyje bei krūtinės sienoje. Skausmas atsirado po, kaip spėjama, virusinės infekcijos. Magnetinio rezonanso tyrimas (MRI) atskleidė įprastinius denervacijos edemos požymius pažeistuose tarpšonkauliniuose raumenyse. Tokios tendencijos vaizdinėje medžiagoje tarpšonkaulinės neuralgijos atveju net ir naujausioje literatūroje yra menkai aprašytos. MRI, ligos istorija ir paciento apžiūra buvo itin svarbios nustatant skausmo priežastį ir atmetant kitas galimas raumenų ir skeleto krūtinės sienos skausmą sukeliančias priežastis šiuo konkrečiu atveju. Anksčiau paciento simptomai buvo išgydyti konservatyviais metodais. Šis atvejis atskleidžia, kaip svarbu atsižvelgti į tarpšonkaulinės neuralgijos galimybę kaip į galimą krūtinės sienos skausmo priežastį, ypač jei buvo persirgta virusine liga ir nėra žinoma buvus jokių ankstesnių mechaninių raumenų ar skeleto traumų. Šiuo atveju ištyrėme nedažną, tačiau vis dėlto standartinę diagnozę, gautą iš vaizdinės medžiagos, kuri gali būti svarbi nustatant šią sveikatos problemą.
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  • 文章类型: Journal Article
    脊柱外科越来越多地采用新兴技术,以提高精度并改善预后。机器人援助是一个非常感兴趣的领域,建议的好处包括提高准确性,并发症发生率降低,减少辐射暴露。这篇综述的目的是概述当前可用的机器人辅助系统及其相关结果和局限性。
    使用关键术语“机器人”对国家数据库进行了审查,\"脊柱\",和“手术”为2014年至2023年的文献。旨在描述内窥镜手术的效用的研究,相关结果,局限性,和未来的方向都包括在内。非英语的研究被排除在外。
    这篇综述简要概述了机器人脊柱手术的历史及其临床结果,局限性,和未来的方向。
    机器人辅助脊柱手术越来越多地用于尝试提高精度和改善预后,并且与椎弓根螺钉置入的准确性提高和并发症发生率降低相关。采用它的障碍包括重要的学习曲线,可能更长的手术病例,和重大的相关成本。随着机器人辅助在脊柱手术中越来越受欢迎,对于外科医生来说,在考虑将哪种系统纳入其实践时,了解可用技术和相关结果以做出明智的决定是至关重要的.
    UNASSIGNED: Emerging technologies have increasingly been adopted in spine surgery in the attempt to increase precision and improve outcomes. Robotic assistance is an area of significant interest, with proposed benefits including increased accuracy, decreased complication rates, and decreased radiation exposure. The purpose of this review is to provide an overview of the currently available robotic assistance systems and their associated outcomes and limitations.
    UNASSIGNED: A review of national databases was performed using key terms \"robotic\", \"spine\", and \"surgery\" for literature from 2014 to 2023. Studies that aimed to describe the utilities of endoscopic surgeries, associated outcomes, limitations, and future directions were included. Studies that were not in English were excluded.
    UNASSIGNED: This review includes a brief overview of the history of robotic spine surgery as well as its clinical outcomes, limitations, and future directions.
    UNASSIGNED: Robotic-assisted spine surgery has seen increasing use in the attempt to increase precision and improve outcomes and has been associated with increased accuracy in pedicle screw placement and decreased complication rates. Barriers to its adoption include a significant learning curve, possibly longer operative cases, and significant associated costs. As robotic assistance continues to become increasingly popular in spine surgery, it is critical for surgeons to understand the technology available and the associated outcomes to make informed decisions when considering which system to incorporate into their practice.
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