The value of lateral chest X-rays for the diagnosis of lymphadenopathy in children with pulmonary tuberculosis

A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Medicine in the branch of Diagnostic Radiology Johannesburg 2018.INTRODUCTION: Tuberculosis (TB) is an important public health issue, but diagnosis in children can be challenging. The radiological hallmark of pulmonary TB (PTB) in children is mediastinal lymphadenopathy, however there is inter-observer variability in detecting this. The value of the lateral CXR in addition to the frontal view to detect lymphadenopathy has not been well studied. OBJECTIVES: To investigate the prevalence of lymphadenopathy in children with confirmed PTB detected on frontal compared to frontal-lateral CXRs. METHODS: This was a secondary analysis of a study from Red Cross Children’s Hospital in Cape Town. Children with definite TB and a control group (Lower respiratory tract infection other than TB) who had frontal and lateral CXRs were included in this study. Three radiologists independently read the CXRs in 2 separate sittings (frontal CXR and ‘combination frontallateral’ CXR). A 3 reader consensus reading was used during data analysis. Odds ratios and 95% confidence intervals were calculated to determine the presence of lymphadenopathy. Kappa statistics were calculated to determine inter reader agreement. RESULTS: Of 172 children (88 confirmed TB and 84 control children), with a median age of 29 months, lymphadenopathy was reported in 86 (50%) patients on the frontal CXR alone and in 143 (83%) on the frontal-lateral CXR combination, p= 0.00. Amongst confirmed PTB cases, 52 (60%) had lymphadenopathy on the frontal CXR alone while 72 (82%) had lymphadenopathy on the frontal-lateral CXR combination, p= 0.00. Amongst the control group, 34 (40%) had lymphadenopathy on the frontal CXR alone while 71 (85%) had lymphadenopathy on the frontal-lateral CXR combination, p= 0.00. The consensus reading using a frontal-lateral CXR combination resulted in a 5 fold increase (OR 4,9; 95% CI 2,9-8,4) in diagnosis of lymphadenopathy compared to a frontal CXR only. Overall inter reader agreement for all 3 readers was fair on both the frontal CXR (Kappa= 0,21) and the frontal-lateral CXR (Kappa= 0,23) combination. CONCLUSION: The addition of a lateral view to the frontal CXR increased detection of lymphadenopathy, however, the prevalence of lymphadenopathy was similar in children with PTB and those in the control group, with fair inter reader agreement.LG201

Vaping Associated Lung Injury Requiring Bilateral Lung Transplant in an Adolescent

Purpose: E-cigarette, or vaping, product use associated lung injury (EVALI) is a newly recognized entity that is being reported with increasing frequency in the literature and mainstream press. The aim of this case report is to radiographically illustrate the fairly rapid progression of a severe case of EVALI that ultimately required a successful bilateral lung transplant, and to describe a unique histopathology correlation. Case Report: Our patient is a 16-year-old, previously healthy male with a two year history of vaping who presented to an outside hospital for dyspnea and nonproductive cough. He was initially treated with antibiotics for community acquired pneumonia. Initial contrast-enhanced CT of the chest demonstrated subtle bilateral but right lower lobe predominant centrilobular nodules, ground glass opacities (GGO) and mild septal thickening. Bronchial alveolar lavage, microbiology studies and autoimmune panel were negative for an infectious or autoimmune etiology. Repeat chest CT only five days later following clinical deterioration demonstrated a dramatic worsening of bilateral nodular airspace opacities, septal thickening, GGO and dependent diffuse consolidations. Pneumomediastinum and mild bronchiectasis were also present. Our patient’s condition continued to decline requiring intubation and subsequent ECMO support. He was transferred to our tertiary care center for bilateral lung transplant. Histopathology of the explanted lungs described predominant acute necrotizing and granulomatous bronchopneumonia with areas of organizing pneumonia. Discussion: The Centers for Disease Control and Prevention currently considers EVALI a diagnosis of exclusion with a confirmed case requiring the use of an e-cigarette 90 days before symptom onset, pulmonary infiltrates on chest imaging, absence of pulmonary infection and no other plausible diagnoses. Various imaging patterns of EVALI have been reported including hypersensitivity pneumonitis, diffuse alveolar hemorrhage, acute eosinophilic pneumonia and lipoid pneumonia, among others. This case demonstrates progression of a severe case of EVALI requiring bilateral lung transplant in an adolescent. Acute necrotizing and granulomatous bronchopneumonia were the predominant histologic features in our patient and have not previously been described in association with EVALI. It is important to consider EVALI in adolescents with a history of e-cigarette use who have a negative infectious and autoimmune work up presenting with severe respiratory symptoms and patterns of lung injury on chest imaging. As the popularity of these inhalational products evolves, radiologists must be informed of the emerging radiographic appearances of EVALI.https://scholarlycommons.henryford.com/merf2020caserpt/1101/thumbnail.jp

Imaging Findings in Non-Neoplastic Sinonasal Disease: Review of Imaging Features With Endoscopic Correlates

Non-neoplastic sinonasal disease is common and imaging often plays an important role in establishing the proper diagnosis, guiding clinical management, and evaluating for complications. Both computed tomography and magnetic resonance imaging are commonly employed in the imaging evaluation and it is important to understand the imaging characteristics of the unique types of pathology affecting the sinonasal cavities. This article reviews a variety of infectious, inflammatory, and other non-neoplastic sinonasal pathologies, highlighting imaging features that aid in their differentiation

Pan-European geological data, information, and knowledge for a resilient, sustainable, and collaborative future

ABSTRACT: Many fields of research relevant to climate-change-related policy are grounded in geological sciences – far more than is generally recognised by the public or policy makers. These fields include management of marine environments, urban development, groundwater, landslide risk, understanding the geochemistry of soils and water, and securing raw materials. Through the concerted collaborative efforts, over many years, of EuroGeoSurveys – the Geological Surveys of Europe – national datasets bearing on these and other areas have been harmonised at European scale and delivered through an online digital platform, the European Geological Data Infrastructure. This vast store of baseline data, information, and knowledge is crucial for informed pan-European decision making and is considered the core of a future Geological Service for Europe.info:eu-repo/semantics/publishedVersio

Landslides monitoring techniques review in the Geological Surveys of Europe

ABSTRACT: Landsliding is the downslope movement of surface material under the force of gravity, initiated when gravitational and other types of shear stresses within the slope exceed the shear strength of the material that forms the slope. Often, landslides pose a physical and environmental threat to communities living in landslide-prone areas. While much landslide research focuses on monitoring techniques to define the background of the landslide (extent, volume, velocity, magnitude) one of the main goals of the Geological Surveys (GS) are to support and understand the regional and local geology to identify areas susceptible to landslides.N/

Role of Geological Surveys of Europe in landslide monitoring

ABSTRACT: This work was developed by the Earth Observation and Geohazards Expert Group from EGS and provides an overview of landslide monitoring techniques from 2005 to 2021. Based on the questionnaire, the following objectives were set: (1) to identify the type of monitored landslides, (2) to identify the landslide monitoring techniques, (3) to identify the spatial resolution, temporal resolution, and status of the technique (operational, non-operational), time of using (before the event, during the event, after the event), and applicability of the technique to the early warning system.info:eu-repo/semantics/publishedVersio

Landslide monitoring techniques in the Geological Surveys of Europe

Landslide monitoring is a mandatory step in landslide risk assessment. It requires collecting data on landslide conditions (e.g., areal extent, landslide kinematics, surface topography, hydrogeometeorological parameters, and failure surfaces) from different time periods and at different scales, from site-specific to local, regional, and national, to assess landslide activity. In this analysis, we collected information on landslide monitoring techniques from 17 members of the Earth Observation and Geohazards Expert Group (from EuroGeoSurveys) deployed between 2005 and 2021. We examined the types of the 75 recorded landslides, the landslide techniques, spatial resolution, temporal resolution, status of the technique (operational, non-operational), time of using (before the event, during the event, after the event), and the applicability of the technique in early warning systems. The research does not indicate the accuracy of each technique but, rather, the extent to which Geological Surveys conduct landslide monitoring and the predominant techniques used. Among the types of landslides, earth slides predominate and are mostly monitored by geological and engineering geological mapping. The results showed that Geological Surveys mostly utilized more traditional monitoring techniques since they have a broad mandate to collect geological data. In addition, this paper provides new insights into the role of the Geological Surveys on landslide monitoring in Europe and contributes to landslide risk reduction initiatives and commitments (e.g., the Kyoto Landslide Commitment 2020)

Landslide monitoring techniques in the Geological Surveys of Europe

ABSTRACT: Landslide monitoring is a mandatory step in landslide risk assessment. It requires collecting data on landslide conditions (e.g., areal extent, landslide kinematics, surface topography, hydrogeometeorological parameters, and failure surfaces) from different time periods and at different scales, from site-specific to local, regional, and national, to assess landslide activity. In this analysis, we collected information on landslide monitoring techniques from 17 members of the Earth Observation and Geohazards Expert Group (from EuroGeoSurveys) deployed between 2005 and 2021. We examined the types of the 75 recorded landslides, the landslide techniques, spatial resolution, temporal resolution, status of the technique (operational, non-operational), time of using (before the event, during the event, after the event), and the applicability of the technique in early warning systems. The research does not indicate the accuracy of each technique but, rather, the extent to which Geological Surveys conduct landslide monitoring and the predominant techniques used. Among the types of landslides, earth slides predominate and are mostly monitored by geological and engineering geological mapping. The results showed that Geological Surveys mostly utilized more traditional monitoring techniques since they have a broad mandate to collect geological data. In addition, this paper provides new insights into the role of the Geological Surveys on landslide monitoring in Europe and contributes to landslide risk reduction initiatives and commitments (e.g., the Kyoto Landslide Commitment 2020).info:eu-repo/semantics/publishedVersio