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PubMedDate not supplied

[Prognostic value of chest roentgenograms in children with idiopathic dilated cardiomyopathy].

OBJECTIVE: To analyze the prognostic value of cardiomegaly, pulmonary congestion and cardiothoracic ratio as indicators of death and survival in children with idiopathic dilated cardiomyopathy. METHODS: We carried out a retrospective review of 152 patients with idiopathic dilated cardiomyopathy diagnosed between September 1979 and March 2003. In the first 72 months, 722 exams were performed (100 in the first 15 days). STATISTICAL ANALYSIS: chi-square, Student's t test, ANOVA and Kaplan-Meier curves. Alpha = 0.05; beta = 0.80. RESULTS: The mean age at presentation was 2.2+/-3.2 years. Idiopathic dilated cardiomyopathy incidence was higher in children younger than 2 years (76.3% - 95% CI = 68.7% to 82.8%) (p < 0.0001). Sex (p = 0.07) and color (p = 0.11) were not significant and mortality was not influenced by age (p = 0.73), sex (p = 0.78) or color (p = 0.20). Most patients were severely ill (84.2% - 95% CI = 77.4% to 89.6%; functional class III and IV; p < 0.0001). All 43 deaths occurred in this group (p = 0.0008). Cardiomegaly at presentation was observed in 94.1% (95% CI = 89.1% to 97.2%) (p < 0.0001), and pulmonary congestion in 75.6% (95% CI = 68.0% to 82.2%) (p < 0.0001). Pulmonary congestion and cardiomegaly were more frequent in functional class III/IV patients (RC = 8.03 - 95% CI = 2.85% to 23.1%) (p < 0.0001). Pulmonary congestion was a marker of death (RC = 3.16 - 95% CI = 1.06% to 10.07) (p = 0.0222), but not cardiomegaly (p = 0.1185). Survival was influenced by both cardiomegaly (p = 0.0189) and pulmonary congestion (p = 0.0050). Mean and maximum cardiothoracic ratio were higher in the death group (0.749+/-0.053 vs. 0.662+/-0.080) (p < 0.0001) and (0.716+/-0.059 vs. 0.620+/-0.085) (p < 0.0001). ANOVA revealed a progressive decrease in cardiothoracic ratio in the survival group (p < 0.0001). CONCLUSIONS: In children with idiopathic dilated cardiomyopathy, the presence of pulmonary congestion at presentation and increased cardiothoracic ratio are associated with poor survival.

Adolescent↗
PubMedDate not supplied

Fiberoptic bronchoscopy in patients with haemoptysis and normal chest roentgenograms.

Over the last 10 years, 53 patients with hemoptysis, but with a normal chest radiograph underwent diagnostic fiberoptic bronchoscopy. Forty-three patients did not show any abnormal findings, the site of bleeding could be localised in five and non-specific mucosal changes were seen in the remaining five patients. Thirty-two patients were followed up clinically for a 3-18 months period. One patient on follow-up developed tubercular pleural effusion. Bronchogenic carcinoma was not detected in any of these patients during the procedure or at follow up. A review of literature revealed a 3 per cent incidence of bronchogenic carcinoma and the risk factors associated with higher incidence were age above 40 years, cigarette smoking and a longer duration of hemoptysis. We conclude that fiberoptic bronchoscopy has little role in this relatively benign condition (hemoptysis) especially when the risk factors are absent.

Adult↗
PubMedDate not supplied

Indexes of bone mineral content on second metacarpal bone roentgenogram analyzed by digital image processing: a comparison with other bone mass quantifying methods.

A new photodensitometric technique (digital image processing, DIP) was performed to assess the bone mineral content of the metacarpal bone as a screening test for bone loss in 340 healthy or osteoporotic women as well as 35 steroid-dosed patients and 46 patients with chronic renal failure on hemodialysis. This procedure was compared with single photon absorptiometry and dual photon absorptiometry in terms of clinical value. Two bone mineral indexes, metacarpal index and sigma GS/D (the integrated bone mineral density of cortical and trabecular bone on a cross section in the middle of the second metacarpal bone), were equal to other methods in the quantification of decreases in bone mineral content due to aging in healthy or osteoporotic women. In addition, sigma GS/D was sensitive enough to detect decreases in bone mineral content in patients with vertebral fractures, on steroid therapy, and with chronic renal failure. Thus, sigma GS/D measured by DIP was shown to have clinical value as a tool in screening for decreased bone mineral content.

Absorptiometry, Photon↗
PubMed1990

Fiberoptic bronchoendoscopic examination in patients with haemoptysis and normal chest roentgenogram.

The role of flexible fiberoptic bronchoendoscopic (FOB) examination was evaluated in a retrospective analysis in 155 patients with unexplained haemoptysis and normal chest skiagrams. The procedure was helpful in reaching a specific diagnosis in 11 (7.1%) patients, 4 of whom revealed mycobacteria in bronchial secretions and 7 had neoplastic lesions. In another 68 (43.9%) cases only non-specific findings like inflammation were found, but the site of abnormality could be localized. We recommend the use of FOB in the routine assessment of haemoptysis.

Adolescent↗
PubMed1977

Planimetric evaluation and comparison of roentgenograms of osteogenic sarcomas induced by 226Ra and 224Ra in mice.

Osteosarcomas were induced in mice by three activities of 226Ra (8.8 micronCi, 24.6 micronC and 70.5 micron Ci/kg) and by three activity levels of 224Ra administered in fractionated doses during a period of 75 weeks (total activity per mouse: 0.65 micron Ci, 1.88 micron Ci). In the 226Ra series 74 cases and in the 224Ra series 89 cases of osteosarcomas were evaluated by means of planimetric measurements of roentgenographic images, including the calcified structures. Even though it is not possible to differentiate the series precisely, still some differences between tumors under study could be found. In comparison with 226Ra series, the sarcomas induced by 224Ra are in average rather larger, calcified stuctures appear not to be fully developed and differentiated, he anatomical distribution is different from that characteristic to the 226Ra induced tumors, the mean life span is shorter. It is quite likely that not only the incidence but also some of the features of osteosarcomas are dependent on the time and tissue distribution of the dose delivered.

Animals↗