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Biomedical subjects

R P Byrd

Publications and source records attributed to R P Byrd.

At least 19 recordsLinked to original sources
PubMed1999

Delayed chest radiographs and the diagnosis of pneumothorax following CT-guided fine needle aspiration of pulmonary lesions.

We prospectively studied 64 consecutive patients on whom computerized tomography-guided fine needle aspirations (CT-FNA) of pulmonary lesions were performed to determine whether obtaining a delayed chest radiography (CXR) after CT-FNA is helpful in the diagnosis of post-procedure pneumothorax (PTX). Two of the 64 patients developed a delayed PTX. Only one of the patients with a delayed PTX required chest tube drainage. If patients have no evidence of a PTX immediately after a CT-FNA by CT scan then a delayed CXR adds little to care of these patients.

Aged↗
PubMed1999

Comparison of the use and accuracy of methods for determining pleural fluid pH.

BACKGROUND: The blood gas analyzer (BGA) has been considered the "gold standard" for pleural fluid pH determination. METHODS: We report the various methods used to measure pleural fluid pH by 277 acute care institutions who responded to a mailed questionnaire. The techniques used included the BGA (32%), dip stick or pH indicator paper (56%), and a pH meter (12%). We tested 36 consecutive exudative pleural fluid samples using each method. RESULTS: The alternative methods were incomparable to accurately measuring pleural fluid pH by the BGA, with a mean difference of 0.16 pH unit. With a delay in testing, the pH of the pleural fluid was more alkalotic and variable, with a mean difference of 0.039 pH unit. CONCLUSIONS: Clinicians should be encouraged to test selected samples for pleural fluid pH by the BGA when accurate measurements will influence therapy.

Blood Gas Analysis↗
PubMed1999

Demographic changes in tuberculosis: high risk groups.

We conducted a statistical analysis of all verifiable tuberculosis (TB) cases in Tennessee from 1990 through 1996 to determine the demographic changes in TB. We studied variables, including age, sex, race, site of the disease, and possible impact of known risk factors such as human immunodeficiency virus (HIV) infection, homelessness, foreign birth, and residency in extended care facility. The percentage increase in all such categories, except in the nursing home population, had a statistically significant increase. Unlike national epidemiologic findings, foreign-born TB comprised less than 1% of the total cases. Association of HIV as a co-infection increased from 16 (2.7%) in 1990 to 41 (8.1%) in 1996. These findings will have significant impact on TB control measures and the clinical practice of TB cases in Tennessee and other areas of the southeastern US.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Acute lung injury after massive household endotoxin exposure.

Household exposures may result in a variety of respiratory illnesses. Most of these inhalation injuries are benign and self-limited. However, an acute injury that results in exacerbation of asthma or chronic fibrosing processes may be life-threatening. We report the case of a patient who suffered a massive household dust exposure when the bag of his upright vacuum cleaner exploded. Inhalation of the dust resulted in respiratory distress characterized by non-cardiogenic pulmonary edema. We believe this is the first report of acute respiratory distress syndrome (ARDS) as a result of endotoxin exposure from the inhalation of household dust.

Aged↗
PubMed1998

Axillary artery injuries after proximal fracture of the humerus.

Although axillary artery injury occurs frequently with dislocations of the shoulder and fractures of the clavicle, it is rarely associated with fractures of the proximal humerus. If the axillary artery is damaged, prompt recognition and treatment are necessary to salvage the involved extremity.

Accidental Falls↗
PubMed1998

Hypersensitivity reaction to azathioprine.

Adverse drug reactions can vary from a simple rash to anaphylactic shock. While certain medications including the penicillins are well known to cause such reactions, other drugs are not as commonly recognized. Azathioprine hypersensitivity reactions tend to be benign and self-limiting with cessation of drug ingestion. We report a patient who had a hypersensitivity reaction to azathioprine, which manifested as distributive shock that mimicked sepsis. We also reviewed the English language literature for risk factors for a hypersensitivity reaction to azathioprine and its possible mechanism.

Acute Kidney Injury↗
PubMed1998

Symptomatic pulmonary hyalinizing granuloma.

An otherwise healthy 37-year-old man came to the emergency room with left-sided dull chest pain of 4 weeks' duration. Physical examination, laboratory studies, and electrocardiogram were all unremarkable. A chest x-ray film revealed calcified pulmonary nodules. Computed tomography of the chest confirmed bilateral parenchymal cavitary lesions. Via limited thoracotomy, a tan nodule measuring 2.5 to 3.0 cm in diameter was excised from the left upper lobe. Histopathologic examination revealed a well circumscribed lesion and extensive lamellar hyalinization. A few foci of finely granular calcification were present within the hyalinizing areas. After surgery and short-term use of nonnarcotic analgesics, the chest pain resolved. Although pulmonary hyalinizing granuloma (PHG) is known to produce cavitating lesions, calcification at multiple sites is also consistent with this diagnosis. Clinicians should remember to include PHG in the differential diagnosis of multiple pulmonary nodules.

Adult↗
PubMed1998

Chronic cavitary pulmonary sporotrichosis: efficacy of oral itraconazole.

The small number of patients suffering from pulmonary involvement with Sporothrix schenckii has prevented prospective controlled studies that could determine the optimal therapy for this chronic infection. The clinician's ability to determine the best medical treatment for chronic cavitary pulmonary sporotrichosis is also tempered by the limited use of newer azole antifungal agents in this disorder as well as the relative lack of efficacy reported with older therapies. We present a 50-year-old male with primary pulmonary sporotrichosis whose chronic cavitary disease responded to oral itraconazole.

Administration, Oral↗
PubMed1998

Paradoxical embolism and a patent foramen ovale.

Patients who sustain an unexplained stroke or peripheral ischemic event should be examined for paradoxical embolism via right-to-left shunting. The confirmation of a patent foramen ovale by echocardiography is simple and noninvasive, and should suggest the possibility of a right-sided embolic source. Unrecognized right-to-left shunting that allows paradoxical embolism may be more frequent than generally recognized.

Adult↗
PubMed1997

Delayed onset of pseudomembranous colitis after rifampin therapy.

Rifampin therapy is an infrequently reported cause of pseudomembranous colitis. A low index of suspicion may account for this lack of recognition. Awareness of this potentially hazardous complication of rifampin therapy is encouraged, especially since increasing numbers of patients infected with the human immunodeficiency virus, who may have diarrhea from other etiologies, require rifampin therapy.

Antibiotics, Antitubercular↗
PubMed1997

Primary subclavian vein thrombosis and pulmonary embolism.

Thrombotic veno-occlusion of the upper extremity is infrequent in the absence of external trauma or in the presence of an indwelling catheter. Inadvertent injury to the underlying venous circulation can occur when the upper extremity is subjected to an unaccustomed repetitive action. The resultant intimal damage may become a nidus for thrombus development.

Adult↗