We report a case of an anomalous pulmonary vein on chest X-ray resembling a scimitar sign in an 80-year-old female undergoing investigation of syncope.Multislice computed tomography(CT) with multiplanar reformatting a...We report a case of an anomalous pulmonary vein on chest X-ray resembling a scimitar sign in an 80-year-old female undergoing investigation of syncope.Multislice computed tomography(CT) with multiplanar reformatting and maximum intensity projections demonstrated an aberrant right inferior pulmonary vein coursing inferomedially towards the diaphragm before turning superiorly and draining normally into the left atrium.The diagnosis of an incidental meandering right pulmonary vein was established.The case is used to review the literature on this rare pulmonary anomaly,including pathogenesis,its relationship with scimitar syndrome and scimitar variant,and diagnosis,with an emphasis on the role modern CT techniques can play in noninvasive diagnosis.A revision to the nomenclature of pulmonary vascular anomalies is proposed to help reduce confusion in the literature.展开更多
Clients on Opioid Substitution Therapy (OST) may be at risk of TB. We screened for tuberculosis in asymptomatic OST clients using Chest-X-ray (CXR) and sputum from those with CXR suggestive of TB were tested using Xpe...Clients on Opioid Substitution Therapy (OST) may be at risk of TB. We screened for tuberculosis in asymptomatic OST clients using Chest-X-ray (CXR) and sputum from those with CXR suggestive of TB were tested using Xpert MTB/Rif. Among 472 who underwent CXR, 0.1% had CXR suggestive of TB. The number needed to screen was 118 clients for one CXR suggestive of TB. All four clients with CXR suggestive of TB underwent MTB/Rif assay and one was diagnosed with TB. The TB patient was asymptomatic and could have been missed through the passive approach. We recommend further studies to explore ACF among OST clients.展开更多
Background:Since 2005,the Myanmar National Tuberculosis Programme(NTP)has been implementing active case finding(ACF)activities involving mobile teams in hard-to-reach areas.This study revealed the contribution of mobi...Background:Since 2005,the Myanmar National Tuberculosis Programme(NTP)has been implementing active case finding(ACF)activities involving mobile teams in hard-to-reach areas.This study revealed the contribution of mobile team activities to total tuberculosis(TB)case detection,characteristics of TB patients detected by mobile teams and their treatment outcomes.Methods:This was a descriptive study using routine programme data between October 2014 and December 2014.Mobile team activities were a one-stop service and included portable digital chest radiography(CXR)and microscopy of two sputum samples.The algorithm of the case detection included screening patients by symptoms,then by CXR followed by sputum microscopy for confirmation.Diagnosed patients were started on treatment and followed until a final outcome was ascertained.Results:A total of 9349 people with symptoms suggestive of TB were screened by CXR,with an uptake of 96.6%.Of those who were meant to undergo sputum smear microscopy,51.4%had sputum examinations.Finally,504 TB patients were identified by the mobile teams and the overall contribution to total TB case detection in the respective townships was 25.3%.Among total cases examined by microscopy,6.4%were sputum smear positive TB.Treatment success rate was high as 91.8%in study townships compared to national rate 85%(2014 cohort).Conclusions:This study confirmed the feasibility and acceptability of ACF by mobile teams in hard-to-reach contexts,especially when equipped with portable,digital CXR machines that provided immediate results.However,the follow-up process of sputum examination created a significant barrier to confirmation of the diagnosis.In order to optimize the ACF through mobile team activity,future ACF activities were needed to be strengthened one stop service including molecular diagnostics or provision of sputum cups to all presumptive TB cases prior to CXR and testing if CXR suggestive of TB.展开更多
文摘We report a case of an anomalous pulmonary vein on chest X-ray resembling a scimitar sign in an 80-year-old female undergoing investigation of syncope.Multislice computed tomography(CT) with multiplanar reformatting and maximum intensity projections demonstrated an aberrant right inferior pulmonary vein coursing inferomedially towards the diaphragm before turning superiorly and draining normally into the left atrium.The diagnosis of an incidental meandering right pulmonary vein was established.The case is used to review the literature on this rare pulmonary anomaly,including pathogenesis,its relationship with scimitar syndrome and scimitar variant,and diagnosis,with an emphasis on the role modern CT techniques can play in noninvasive diagnosis.A revision to the nomenclature of pulmonary vascular anomalies is proposed to help reduce confusion in the literature.
文摘Clients on Opioid Substitution Therapy (OST) may be at risk of TB. We screened for tuberculosis in asymptomatic OST clients using Chest-X-ray (CXR) and sputum from those with CXR suggestive of TB were tested using Xpert MTB/Rif. Among 472 who underwent CXR, 0.1% had CXR suggestive of TB. The number needed to screen was 118 clients for one CXR suggestive of TB. All four clients with CXR suggestive of TB underwent MTB/Rif assay and one was diagnosed with TB. The TB patient was asymptomatic and could have been missed through the passive approach. We recommend further studies to explore ACF among OST clients.
基金The program was funded by WHO/TDR Impact grant to two TDR alumni from DMRThe funders had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript。
文摘Background:Since 2005,the Myanmar National Tuberculosis Programme(NTP)has been implementing active case finding(ACF)activities involving mobile teams in hard-to-reach areas.This study revealed the contribution of mobile team activities to total tuberculosis(TB)case detection,characteristics of TB patients detected by mobile teams and their treatment outcomes.Methods:This was a descriptive study using routine programme data between October 2014 and December 2014.Mobile team activities were a one-stop service and included portable digital chest radiography(CXR)and microscopy of two sputum samples.The algorithm of the case detection included screening patients by symptoms,then by CXR followed by sputum microscopy for confirmation.Diagnosed patients were started on treatment and followed until a final outcome was ascertained.Results:A total of 9349 people with symptoms suggestive of TB were screened by CXR,with an uptake of 96.6%.Of those who were meant to undergo sputum smear microscopy,51.4%had sputum examinations.Finally,504 TB patients were identified by the mobile teams and the overall contribution to total TB case detection in the respective townships was 25.3%.Among total cases examined by microscopy,6.4%were sputum smear positive TB.Treatment success rate was high as 91.8%in study townships compared to national rate 85%(2014 cohort).Conclusions:This study confirmed the feasibility and acceptability of ACF by mobile teams in hard-to-reach contexts,especially when equipped with portable,digital CXR machines that provided immediate results.However,the follow-up process of sputum examination created a significant barrier to confirmation of the diagnosis.In order to optimize the ACF through mobile team activity,future ACF activities were needed to be strengthened one stop service including molecular diagnostics or provision of sputum cups to all presumptive TB cases prior to CXR and testing if CXR suggestive of TB.
