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At least 271 records · Page 15Linked to original sources
PubMed2001

Early detection for lung cancer. New tools for casefinding.

OBJECTIVE: To review data from published population trials and clinical practice guidelines on screening for lung cancer to provide a recommendation for early detection of lung cancer. QUALITY OF EVIDENCE: Literature was searched via MEDLINE using the MeSH headings "lung neoplasm," "mass screening," "thoracic radiography," and "sputum." Only prospective randomized controlled trials with large numbers of subjects were selected. MAIN MESSAGE: Risk of lung cancer among long-term heavy smokers continues even years after stopping smoking. Risk is highest in smokers with chronic obstructive pulmonary disease. Canadian clinical practice guidelines currently recommend that sputum cytology examination and chest radiography (CXR) not be used for lung cancer screening. This guideline was deducted from four randomized population trials in the 1970s that have serious limitations and applies to asymptomatic adults only. A CXR and sputum cytology examination are indicated in symptomatic current and former smokers older than 45 years with a smoking history of 30 pack-years or more and airflow obstruction defined as a forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) of 70% or less and a FEV1 lower than 70%. Curative treatment is available for early lung cancer. Substantial advances in innovative technologies for early detection using low-dose spiral CT and newer sputum tests have been made in the last three decades. Additional studies are under way to evaluate these new technologies. CONCLUSION: Primary care physicians have an important role in identifying people at risk of developing lung cancer and in supporting research to evaluate new screening technology.

Age Factors↗
PubMed2002

Persistent truncus arteriosus in a rhesus monkey (Macaca mulatta).

A 47-day-old female rhesus macaque (Macaca mulatta) was examined because of a severe holosystolic heart murmur (grade 5/6) and signs of congestive heart failure. Results of physical examination, thoracic radiography, and cardiac ultrasonography confirmed an advanced stage of congestive heart failure. Due to the animal's age and clinical signs of disease, a congenital heart defect was suspected. Necropsy revealed a rare congenital heart defect known as persistent (common) truncus arteriosus.

Animals↗
PubMed2002

[Trauma of the brachiocephalic trunk].

UNLABELLED: DIAGNOSTIC CIRCUMSTANCES: Non-iatrogenic traumas of the brachiocephalic arterial trunk (BCAT) are rare. Open traumas predominate and involve the distal half of the artery. Closed traumas are secondary to violent injury with severe deceleration and involve the proximal part of the artery. This diagnosis must be systematically evoked in patients with violent traumas or exhibiting wounds of the thorax and/or base of the neck. Emergency thoracic radiography usually reveals a widening of the mediastinum and a subsequent arteriography is essential for the surgeon. Concomitant lesions are frequent; which complicate diagnosis, prognosis and therapeutic management. SURGICAL TREATMENT: The approach of choice is cervico-sternotomy. For lesions secondary to an open trauma, direct repair is the usual approach. Treatment of disinsertions, secondary to a closed trauma, requires by-pass between the ascending aorta and the distal part of the BCAT and lateral suture of the aortic cross. POOR PROGNOSIS: However, mortality has decreased over the past 30 years due to the advances in medical imaging and improved medical-surgical management in specialized emergency centres. FISTULAS BETWEEN THE TRACHEA AND THE BCAT: Dramatically complicate tracheotomy. Their diagnosis is usually easy and relies on rigid bronchoscopy in the absence of severe hemorrhage. Treatment is above all preventive. Curative treatment is always urgent and consists in binding the BCAT. Prognosis is poor and often worsened by the underlying pathology.

Brachiocephalic Trunk↗
PubMed1989

Classification of primary lung tumors in dogs: 210 cases (1975-1985).

Two hundred ten dogs that had primary lung tumors diagnosed between 1975 and 1985 were evaluated. The majority of the tumors were classified as adenocarcinoma (74.8%) and alveolar carcinoma (20%). The most common clinical signs of disease were cough (52%), dyspnea (23.8%), lethargy (18.1%), weight loss (12.4%), and tachypnea (4.8%). The clinical methods that were most successful in directly or indirectly leading to a diagnosis of primary lung tumor were thoracic radiography (77.1%) and cytologic examination of fine-needle aspirate specimens (24.8%).

Adenocarcinoma↗
PubMed1986

Diphacinone-induced coagulopathy in the dog.

Five cases of coagulopathy caused by consumption of indanedione (diphacinone)-based rodenticides are reported. In each case, acute onset of lethargy and respiratory distress were the predominant initial clinical signs. Thoracic radiography revealed pulmonary edema, pleural effusion, and/or pericardial effusion as consistent findings. Laboratory evaluations confirmed coagulopathies that responded to vitamin K1 therapy.

Animals↗
PubMed1984

[Radiological evaluation of the state of hydration in uremic patients under periodic dialysis].

Seventy-four uremic patients in chronic hemodialysis were studied by X-ray of the thorax before and after the same dialysis. Radiological signs and variables (originally proposed by Milne) related to hemodynamics of pulmonary and systemic circulation were evaluated in relation to fluid subtraction. The study demonstrated the high sensitivity and the clinical value of thoracic radiography in the follow-up of these patients and particularly in the evaluation of fluid overload.

Adolescent↗
PubMed1996

Clinical and clinicopathologic findings in dogs with acute respiratory distress syndrome: 19 cases (1985-1993).

OBJECTIVE: To describe clinical and clinicopathologic findings from dogs with histologic pulmonary lesions consistent with human adult respiratory distress syndrome and to identify potential factors. DESIGN: Retrospective study. ANIMALS: 19 dogs with acute respiratory distress. PROCEDURE: Medical records of dogs were reviewed. Signalment, physical examination and clinicopathologic findings at admission, and thoracic radiographic and necropsy findings were recorded. RESULTS: The most common clinical sign was dyspnea. Respiratory rate ranged from 36 to 140 breaths/min and abnormal breathing patterns were detected. Crackles were auscultated in 7 dogs. Severe diffuse interstitial and alveolar infiltrates were observed on thoracic radiography in 9 dogs shortly after arrival and developed later in 4 dogs. Four dogs were leukopenic and neutropenic. Disseminated intravascular coagulation was diagnosed in 2 dogs, and hypoalbuminemia was found in 8 dogs. Respiratory status deteriorated rapidly in all dogs, and 10 dogs were mechanically ventilated. Death was attributed solely to respiratory failure in 8 dogs. In the other 11 dogs, severe lesions in nonpulmonary organs, sepsis, or both may have contributed to death. The most common associated conditions that may have contributed to acute respiratory failure were microbial pneumonia, sepsis, aspiration pneumonia, and shock, with more than 1 factor found in 11 of 19 dogs. CLINICAL IMPLICATIONS: The index of suspicion for acute respiratory distress syndrome should be high in dogs with bilateral pulmonary infiltrates and acute respiratory distress that rapidly progresses to failure.

Animals↗
PubMed1997

Effects of naturally acquired decompensated mitral valve regurgitation on the renin-angiotensin-aldosterone system and atrial natriuretic peptide concentration in dogs.

OBJECTIVE: To investigate activity of the renin-angiotensin-aldosterone system and N-terminal pro-atrial natriuretic peptide (NT-proANP) during development of clinical signs of decompensated mitral valve regurgitation (MR). ANIMALS: 11 Cavalier King Charles Spaniels with advanced MR attributable to chronic valvular disease. PROCEDURE: Dogs were subjected to repeated examinations at 6-month intervals until signs of decompensation had developed (end point). Data acquired at end point were compared with data obtained from examinations 1 year and 1 to 6 months before decompensation. Each examination included physical examination, collection of venous blood, thoracic radiography, and echocardiography. RESULTS: Echocardiographic measurements of left atrial-to-aortic root ratio and left ventricular end diastolic diameter increased considerably during the study, whereas left ventricular end systolic diameter remained unchanged. The increase in cardiac size was associated with increased plasma concentration of NT-proANP. In contrast, plasma concentrations of aldosterone and angiotensin II were reduced at decompensation (aldosterone compared with the 2 earlier examinations and angiotensin II compared with values obtained 1 to 6 months before), despite decreased plasma protein concentration and hematocrit, suggesting fluid retention. The urine-to-plasma creatinine ratio was reduced at end point. CONCLUSION AND CLINICAL IMPLICATIONS: Early decompensated MR in dogs was not associated with increased circulating renin-angiotensin-aldosterone system activity, which may be caused by increased activity of ANP, and may be important for future therapeutic strategies of MR.

Aldosterone↗
PubMed1997

Pericardiectomy in dogs: 22 cases (1978-1994).

OBJECTIVE: To determine long-term outcome of dogs with neoplastic and nonneoplastic pericardial disease that undergo pericardiectomy. DESIGN: Retrospective study. ANIMALS: 22 dogs. PROCEDURE: Dogs that underwent pericardiectomy and in which the diagnosis had been confirmed histologically were included. Data collected from each record included signalment, history, clinical signs, results of diagnostic evaluations, operative management, postoperative complications, histologic diagnosis, and outcome. Dogs were grouped on the basis of underlying cause of pericardial disease (neoplastic vs nonneoplastic), and survival times were determined by means of Kaplan-Meier analyses. RESULTS: 9 dogs had neoplastic pericardial disease (chemodectoma, 4; hemangiosarcoma, 2; malignant mesothelioma, 2; lymphoblastic lymphoma, 1). Thirteen dogs had nonneoplastic pericardial disease (benign idiopathic pericarditis, 10; lymphocytic plasmacytic pericarditis, 2; osseous metaplasia of unknown cause, 1). Thoracic radiography and echocardiography were the most specific methods for diagnosis of pericardial effusion. Pleural effusion was the most common postoperative complication (8/22 dogs). Prevalence of postoperative complications was not associated with underlying cause of pericardial disease, surgical approach, or surgical procedure (subtotal vs total pericardiectomy). Median survival time of dogs with neoplastic disease (52 days) was significantly shorter than median survival time of dogs with nonneoplastic disease (792 days). Dogs that developed pleural effusion > 30 days after pericardiectomy had a poor prognosis for survival. CLINICAL IMPLICATIONS: Radiography and echocardiography are useful for diagnosis of pericardial effusion in dogs. Dogs with neoplastic pericardial disease have a significantly shorter survival time than do dogs with nonneoplastic pericardial disease.

Animals↗
PubMed1997

Primary lung tumors in cats: 86 cases (1979-1994).

OBJECTIVE: To classify histologic type and morphology of primary lung tumors in cats, to describe clinical findings in these cats, and to determine whether clinical findings were associated with histologic type or morphology. DESIGN: Retrospective study. ANIMALS: 86 cats with histologically confirmed primary lung tumors. PROCEDURE: Medical records for cats treated between 1979 and 1994 at any of 14 participating veterinary referral hospitals were reviewed. RESULTS: Weight loss, lethargy, and dyspnea were the most common clinical signs. Solitary or multiple pulmonary masses were seen on radiographs from 53 of 79 cats; effusion was seen on radiographs from the other 26. In 45 cats, tumors involved a single lung lobe. Caudal lung lobes were more commonly affected than were cranial lung lobes. Sixty-five cats had metastases. Tumors were classified as bronchial (n = 65), bronchiolar-alveolar (9), or other (12) and as poorly differentiated (59), moderately differentiated (20), or well differentiated (7). Breed, age, sex, weight, clinical signs, duration of clinical signs, and radiographic findings were not associated with histologic type or morphology. CLINICAL IMPLICATIONS: To identify possible occult primary lung tumors, thoracic radiography should be performed on cats with clinical signs of long duration, including weight loss, lethargy, and dyspnea.

Adenocarcinoma↗
PubMed1998

Cardiovascular evaluation of lowland gorillas.

OBJECTIVE: To design a diagnostic protocol that uses appropriate techniques, including ultrasonography, to assess cardiovascular health and detect primary cardiac diseases in gorillas and to establish a database of reference values for cardiac measurements in clinically normal gorillas. DESIGN: Prospective study. ANIMALS: 5 adult male lowland gorillas from 11 to 18 years old. PROCEDURE: A complete cardiac evaluation was performed on anesthetized gorillas, including physical examination, thoracic radiography, electrocardiography, echocardiography, blood pressure determination, CBC, serum biochemical analyses, and serologic assay for viral diseases. Standard cardiac measurements were made from images collected during ultrasonography. RESULTS: Cardiac measurements derived from ultrasonographic images were consistent with those considered normal in human beings. Results of other diagnostic tests were also considered normal. CLINICAL IMPLICATIONS: Cardiac disease is the primary cause of mortality in old captive gorillas. The technique used here provided excellent evaluation of cardiac function. Use of these techniques will allow early detection of cardiac disease, making treatment or medical management possible.

Animals↗
PubMed1997

[Can digital selenium-based radiography in thoracic diagnosis replace the analog x-ray imaging technic?].

PURPOSE: To find out the diagnostic value of digital selenium radiography, we compared the image quality of chest x-ray images from 50 patients who had been examined via conventional chest x-ray and digital selenium radiography of the chest. METHOD: 50 patients with a malignant melanoma underwent chest x-ray within 3 months in conventional technique and with digital selenium radiography (Thoravision: Philips Medical Systems, Hamburg, Germany). In this period none of the patients showed a difference in respect of clinical status or radiological diagnosis. Simultaneous examinations on the same day were not performed to avoid unnecessary exposure to x-rays. The digital and conventional images were compared by 4 radiologists with regard to image quality by the detection of defined anatomic structures. RESULTS: Image quality of digital selenium radiography was considered superior to that of conventional chest x-rays in the mediastinum, the retrocardiac and retrodiaphragmatic areas, the superior and inferior lobes of the lung especially near the parietal pleura, and the chest wall. CONCLUSIONS: Compared to analogous techniques there is no loss of image information when employing digital selenium radiography in chest x-rays. On the contrary, new assessment criteria may be gained. We conclude that digital selenium radiography offers diagnostic advantages in chest x-ray examination.

Adult↗
PubMedDate not supplied

Intracranial lesions in dogs with hemangiosarcoma.

A retrospective analysis of 85 dogs with hemangiosarcoma (HSA) that underwent complete necropsy, including gross examination of the brain, was conducted. Grossly identifiable intracranial lesions were present in 17 dogs. Twelve of 85 dogs (14.2%) had brain metastases. Four of 85 dogs (4.7%) had hemorrhagic lesions and/or ischemic necrosis without identifiable tumor. One dog had a primary central nervous system tumor. Signs of intracranial disease were present in six of 85 dogs (7.1%) with HSA; four had brain metastases and two had nonneoplastic lesions. Metastases had a propensity for cerebrum and gray matter. Dogs with brain metastases had more widely disseminated disease than dogs without brain metastases (P less than 0.001). Dogs with pulmonary metastases were at greater risk for developing brain metastases than dogs without pulmonary metastases (odds ratio = 8.31). Although thoracic radiography accurately identified ten of 12 dogs (83%) with pulmonary metastases, too few cases were available to assess the applicability/accuracy of thoracic radiography in predicting the presence or absence of brain metastases in dogs with malignancy and signs of intracranial disease.

Animals↗
PubMedDate not supplied

Comparison of thoracic radiographs and single breath-hold helical CT for detection of pulmonary nodules in dogs with metastatic neoplasia.

Imaging studies in people indicate that x-ray computed tomography (CT) is a more sensitive technique than thoracic radiography for the detection of pulmonary metastasic neoplasia. Systematic studies comparing CT and thoracic radiographic techniques in veterinary patients have not been performed. The present retrospective study was designed to directly compare the efficacy of these 2 techniques in detecting pulmonary nodules in dogs. Eighteen dogs with histologically confirmed pulmonary metastatic neoplasia had contemporaneous thoracic radiographs and pulmonary CT scans compared. Quantitative analyses included estimation of pulmonary nodule size, number, and lobar distribution on thoracic radiographs and CT images. Only 9% of CT-detected pulmonary nodules were identified on thoracic radiographs (P < .003). The lower size threshold was approximately 1 mm to detect pulmonary nodules on CT images and 7-9 mm to reliably detect nodules on radiographs (P < .0001). Additionally, pulmonary nodules were detected in a significantly greater number of lung lobes using CT as compared with thoracic radiographs (P < .0001). These data indicate that CT is significantly more sensitive than thoracic radiography for detecting soft-tissue nodules in dogs. As such, thoracic CT should be considered in any patient with neoplasia that has potential for pulmonary metastasis to more reliably stage the disease, particularly when accurate characterization of the extent and distribution of pulmonary metastatic disease affects therapeutic planning.

Animals↗
PubMed1987

[Clinical results of dual-energy radiography in thoracic studies].

Dual energy methods permit the reconstruction of either soft tissue or calcium density structures. The value of the technique is demonstrated in 220 patients. Demonstration of the thoracic organs without superimposition of the skeleton improves the recognition of pulmonary lesions. Opacities related to ribs no longer simulate pulmonary lesions. The mediastinal borders are demonstrated more clearly by double spectrum radiography than by any other radiographic method. Soft tissue calcification can be shown with a high degree of sensitivity. Skeletal changes which may be obscured by overlapping soft tissue shadows on conventional radiography can also be diagnosed by this technique.

Humans↗