Biomedical subjects

G W Grode

Publications and source records attributed to G W Grode.

7 recordsLinked to original sources

PubMed1995

[Percutaneous transthoracic needle aspiration biopsy. Diagnostic yield after negative fiberoptic bronchoscopy in patients with peripheral pulmonary infiltrations].

The diagnostic potential of secondary transthoracic needle biopsy (TNB) following negative fiberoptic bronchoscopy in patients with peripheral circumscribed pulmonary lesions was evaluated in a retrospective study. The records from 224 patients who had TNB performed over a five-year period were reviewed. Of these, 103 patients met the criteria for inclusion in this series. The overall diagnostic yield of TNB in malignancy was 73.8% (54 of 73 patients). TNB allowed cytological classification of the tumour type in 72.2% (39 of 54 patients). Five of the 54 patients (9.3%) presented with small cell anaplastic bronchogenic carcinoma, diagnosed by TNB, and were treated with chemotherapy. Of the 49 patients with a negative TNB, 27 went on to diagnostic surgical procedures; 19 had malignancy, three benign tumour, two infection, and three sequelae after pulmonary infarction. The remaining 22 patients with undiagnosed lesions were followed long term, five showed progression of the pulmonary lesion suggesting malignancy. TNB appeared unsuitable in the diagnosis of benign lesions. Unspecific inflammation was not considered evidence of benignity, and therefore a definitive benign diagnosis was not made by TNB in this series. There were no serious complications to TNB. In 18.1% of the procedures a pneumothorax developed, indicating a chest tube in 8.6% of the procedures. TNB is a suitable diagnostic procedure with a high diagnostic yield in patients with peripheral, malignant pulmonary lesions.

Adult↗

PubMed1994

[Should the presence of Mycobacterium tuberculosis be demonstrated before the treatment of patients with suspected pulmonary tuberculosis?].

In Denmark, treatment of tuberculosis is generally only recommended if the diagnosis is confirmed bacteriologically, which may cause a delay in treatment. We investigated the duration of the treatment delay, and if the delay would cause any serious health problems for the individual or risk of contact infections by a retrospective examination of 324 cases of pulmonary tuberculosis. The mean treatment delay was longer in older age groups. Regarding death due to delay, we found no risk for the patients who are not weakened by old age or another disease. Only 11 (3.6%) above the age of ten years were treated without bacteriological confirmation (1% for Danes). The infection risk from the smear negative, but culture positive patients was minimal, as only one subject was definitely infected from a smear negative subject. In conclusion, we find the epidemiologic and individual risk sufficiently low to continue our rather restrictive treatment policy.

Adult↗

PubMed1994

[Primary lung cancer in patients under 40 years of age].

There seems to be a resistance of patients and physicians towards aggressive diagnostic evaluation of the symptoms of lung cancer in young people. We here review nine series of young patients with primary lung cancer. Patients below 40 years of age represent between 1.2 and 5% of the total lung cancer population. The distribution of sex and histopathologic findings is different, there being more women, fewer cases of squamous cell and more cases of small anaplastic and adenocarcinoma in the young group. Between 87 and 96% are smokers. There is a delay from the debut of symptoms to the first contact with a general physician of 2.4 to 10.8 months. There is a wide variation concerning tendency to operate with a frequency of curative resection of between 15 and 57%. Based on the survival of young patients who are treated by curative surgical resection, the outcome of surgical treatment for young patients does not differ from the general experience concerning resection in patients of all ages. Young patients who are found inoperable have worse survival than the older patients. Seventy to 90%, more than in the group of patients of all ages, have stadium II or III at the time of diagnosis. In conclusion, physicians should be aggressive with respect to the diagnostic evaluation even of young patients with symptoms suggestive of lung cancer.

Adult↗

PubMed1994

[Disseminated primary bronchogenic carcinoma in 3 young patients].

Primary lung cancer in young patients is rare, patients under 40 years of age constituting between 1.2 and five percent of all cases. Three cases of primary lung cancer in young patients are presented, and the typical manifestations of primary lung cancer in young patients are discussed.

Adult↗

PubMed1993

[Pulmonary coccidioidomycosis].

Coccidioidomycosis is an acute, generally mild, respiratory disease that rarely becomes chronic or disseminated and fatal. The aetiologic agent is Coccidioides immitis, a dimorphic fungus growing in soil. The fungus is endemic in hot semi-arid areas in the USA and South America. Human beings and animals become infected by inhaling dust with arthroconidia. The fungus gives rise to either a purulent or a granulomatous inflammation or both. Clinically and radiologically, it can be confused with neoplasms and tuberculosis. The disease may be fatal in immuno-deprived persons who are also at risk of reactivation of a latent infection. Coccidioidomycosis can be detected serologically. The standard treatment of severe illness is Amphotericin B. The authors present the first histologically and serologically verified case of pulmonary coccidioidomycosis in Denmark. An increased number of coccidioidomycosis can be expected with increased travelling and an increased number of immuno-deprived persons.

Coccidioidomycosis↗

PubMed1993

[Idiopathic bilateral paralysis of the diaphragm].

The case of a 38-year old Caucasian man with acute irreversible idiopathic bilateral paralysis of the diaphragm is presented. The relevant diagnostic procedures are discussed. Paralysis of diaphragm during fluoroscopy in the supine position, observation of paradoxical movement of the anterior abdominal wall and upright position during sleep are the major characteristics of this condition. Elevation of both hemidiaphragms on thoracic X-ray during maximal inspiration, lack of phrenic nerve conduction, gradually increasing dyspnoea without ongoing infection or simultaneous vaccination and decreased functional status may further confirm the diagnosis.

Adult↗

PubMed1991

[Thoracic Ewing's sarcoma].

The case history of a girl aged 16 years with Ewing's sarcoma of a rib is presented. The symptomatology was typical and consisted mostly of moderate and intermittent pain in the thorax. The time elapsing between the first symptoms and the diagnosis was about 18 months and the consequent therapeutic delay was obvious. The importance of early diagnosis in cases of this type is emphasized.

Adolescent↗