BACKGROUND Tracheobronchial tuberculosis(TBTB)is a common subtype of pulmonary tuberculosis.Concomitant diseases often obscure the diagnosis of senile TBTB.AIM To characterize senile patients with TBTB and to identify...BACKGROUND Tracheobronchial tuberculosis(TBTB)is a common subtype of pulmonary tuberculosis.Concomitant diseases often obscure the diagnosis of senile TBTB.AIM To characterize senile patients with TBTB and to identify the potential causes of misdiagnosis.METHODS One hundred twenty patients with senile TBTB who were admitted to the Anhui Chest hospital between May 2017 and May 2019 were retrospectively analyzed.Patients were classified as diagnosed group(n=58)and misdiagnosed group(n=62).Clinical manifestations,laboratory results,radiographic data,and endoscopic findings were compared between the two groups.RESULTS Patients in the misdiagnosed group were most commonly diagnosed as pulmonary tuberculosis(non-TBTB,29/62,46.8%),general pneumonia(9/62,14.5%),chronic obstructive pulmonary disease(8/62,12.9%),and tracheobronchial carcinoma(7/62,11.3%).The time elapsed between disease onset and confirmation of diagnosis was significantly longer in the misdiagnosed group[median(first quartile,third quartile):6.32(4.94,16.02)mo vs 3.73(2.37,8.52)mo].The misdiagnosed group had lower proportion of patients who underwent bronchoscopy[33.87%(21/62)vs 87.93%(51/58)],chest computed tomography(CT)scan[69.35%(43/62)vs 98.28%(57/58)],and those who showed CT signs of tuberculosis[27.91%(12/62)vs 50%(29/58)]as compared to that in the diagnosed group(P<0.05).There were no significant between-group differences with respect to age,gender,occupation,clinical manifestations,or prevalence of comorbid chronic diseases(P>0.05).CONCLUSION Insufficient or inaccurate radiographic or bronchoscopic assessment was the predominant cause of delayed diagnosis of TBTB.Increased implementation and better interpretation of CT scan and early implementation of bronchoscopy can help reduce misdiagnosis of senile TBTB.展开更多
Ebstein＇s anomaly is a kind of congenital heart disease ＇with part or all leaflets of tricuspid valve notnormally attaching to the tricuspid annulus in the normal position, but spirally shifting downward and abnorma...Ebstein＇s anomaly is a kind of congenital heart disease ＇with part or all leaflets of tricuspid valve notnormally attaching to the tricuspid annulus in the normal position, but spirally shifting downward and abnormally attaching to the right ventricular wall. Ebstein＇s anomaly patients often suffer from arrhythmias, featured by paroxysmal fibrillation and supraventricular tachycardia, atrial atrial flutter, etc.展开更多
目的比较新生儿良性和非良性心律失常的临床特点。方法回顾性分析317例心律失常新生儿的临床资料,根据临床表现、心电图或Holter监测结果将患儿分为良性心律失常组和非良性心律失常组。总结两组心律失常的常见类型,并比较两组的一般资...目的比较新生儿良性和非良性心律失常的临床特点。方法回顾性分析317例心律失常新生儿的临床资料,根据临床表现、心电图或Holter监测结果将患儿分为良性心律失常组和非良性心律失常组。总结两组心律失常的常见类型,并比较两组的一般资料和病史资料、实验室检查结果及预后。结果317例心律失常新生儿中,271例为良性心律失常,46例为非良性心律失常。良性心律失常的最常见类型为房性期前收缩、室性期前收缩合并房性期前收缩、室性期前收缩;非良性心律失常的最常见类型为心房扑动、房室传导阻滞、阵发性室上性心动过速。与良性心律失常组相比,非良性心律失常组早产率更高,阴道分娩率、出生后1 min Apgar评分正常率、产前胎心监测正常率更低,肌酸激酶同工酶水平以及钠离子、氯离子、钾离子、镁离子的异常率均更高,住院天数更长,死亡率更高(均P<0.05)。结论良性和非良性新生儿心律失常在母体因素、生化指标等方面存在差异,这或有助于早期鉴别新生儿心律失常的类型;非良性新生儿心律失常需要积极干预,以提高新生儿的存活率。展开更多
基金China's 13th Five-Year Major Science and Technology Project,No.2018ZX10302-302.
文摘BACKGROUND Tracheobronchial tuberculosis(TBTB)is a common subtype of pulmonary tuberculosis.Concomitant diseases often obscure the diagnosis of senile TBTB.AIM To characterize senile patients with TBTB and to identify the potential causes of misdiagnosis.METHODS One hundred twenty patients with senile TBTB who were admitted to the Anhui Chest hospital between May 2017 and May 2019 were retrospectively analyzed.Patients were classified as diagnosed group(n=58)and misdiagnosed group(n=62).Clinical manifestations,laboratory results,radiographic data,and endoscopic findings were compared between the two groups.RESULTS Patients in the misdiagnosed group were most commonly diagnosed as pulmonary tuberculosis(non-TBTB,29/62,46.8%),general pneumonia(9/62,14.5%),chronic obstructive pulmonary disease(8/62,12.9%),and tracheobronchial carcinoma(7/62,11.3%).The time elapsed between disease onset and confirmation of diagnosis was significantly longer in the misdiagnosed group[median(first quartile,third quartile):6.32(4.94,16.02)mo vs 3.73(2.37,8.52)mo].The misdiagnosed group had lower proportion of patients who underwent bronchoscopy[33.87%(21/62)vs 87.93%(51/58)],chest computed tomography(CT)scan[69.35%(43/62)vs 98.28%(57/58)],and those who showed CT signs of tuberculosis[27.91%(12/62)vs 50%(29/58)]as compared to that in the diagnosed group(P<0.05).There were no significant between-group differences with respect to age,gender,occupation,clinical manifestations,or prevalence of comorbid chronic diseases(P>0.05).CONCLUSION Insufficient or inaccurate radiographic or bronchoscopic assessment was the predominant cause of delayed diagnosis of TBTB.Increased implementation and better interpretation of CT scan and early implementation of bronchoscopy can help reduce misdiagnosis of senile TBTB.
文摘Ebstein＇s anomaly is a kind of congenital heart disease ＇with part or all leaflets of tricuspid valve notnormally attaching to the tricuspid annulus in the normal position, but spirally shifting downward and abnormally attaching to the right ventricular wall. Ebstein＇s anomaly patients often suffer from arrhythmias, featured by paroxysmal fibrillation and supraventricular tachycardia, atrial atrial flutter, etc.
文摘目的比较新生儿良性和非良性心律失常的临床特点。方法回顾性分析317例心律失常新生儿的临床资料,根据临床表现、心电图或Holter监测结果将患儿分为良性心律失常组和非良性心律失常组。总结两组心律失常的常见类型,并比较两组的一般资料和病史资料、实验室检查结果及预后。结果317例心律失常新生儿中,271例为良性心律失常,46例为非良性心律失常。良性心律失常的最常见类型为房性期前收缩、室性期前收缩合并房性期前收缩、室性期前收缩;非良性心律失常的最常见类型为心房扑动、房室传导阻滞、阵发性室上性心动过速。与良性心律失常组相比,非良性心律失常组早产率更高,阴道分娩率、出生后1 min Apgar评分正常率、产前胎心监测正常率更低,肌酸激酶同工酶水平以及钠离子、氯离子、钾离子、镁离子的异常率均更高,住院天数更长,死亡率更高(均P<0.05)。结论良性和非良性新生儿心律失常在母体因素、生化指标等方面存在差异,这或有助于早期鉴别新生儿心律失常的类型;非良性新生儿心律失常需要积极干预,以提高新生儿的存活率。
