Pulmonary complications following allogeneic hematopoietic stem‐cell transplantation (HSCT) are a significant source of morbidity and complications may arise from a myriad of infectious and noninfectious sources. These complications may occur soon or many months post‐transplantation and can have a broad range of outcomes. Surveillance for pulmonary involvement in the pediatric HSCT population can be challenging due to poor compliance with clinical pulmonary function testing, primarily spirometry, and there may be a role for clinical imaging to provide an additional means of monitoring, particularly in the era of clinical low‐dose computed tomography (CT) protocols. In this single‐site, retrospective study, a review of our institution's radiological and HSCT databases was conducted to assess the utility of a quantitative CT algorithm to describe ventilation abnormalities on high‐resolution chest CT scans of pediatric HSCT patients. Thirteen non‐contrast enhanced chest CT examinations acquired both in inspiration and expiration, from 12 deceased HSCT patients (median age at HSCT 10.4 years, median days of CT 162) were selected for the analysis. Also, seven age‐matched healthy controls (median age 15.5) with non‐contrast‐enhanced inspiration–expiration chest CT were selected for comparison. We report that, compared to healthy age‐matched controls, HSCT patients had larger percentages of poorly ventilated (median, 13.5% vs. 2.3%, p < .001) and air trapped (median 12.3% vs. 0%, p < .001) regions of lung tissue, suggesting its utility as a potential screening tool. Furthermore, there was wide variation within individual HSCT patients, supporting the use of multivolume CT and quantitative analysis to describe and phenotype post‐transplantation lung involvement.
Back Ground/Objective Cervical spine injuries are considered to be a major trauma and classified in various types. They are associated with various neurologic deficits and mortality rates. They account for 50 to 75% of all spine injuries. Various studies are associated with outcome of spinal cord injuries. Our aim was to analyze outcome of upper and lower cervical spine injuries.
Study Design It was a retrospective study in all traumatic cervical spine injuries in all age groups at our center during the past 3 years.
Method All cases operated in the past 3 years at our center were taken up for study. Initial hospital records were reviewed. Patients will be divided into two groups on the basis of anatomic level upper (C1 and C2) and lower (C3 or below) cervical spine. Outcomes were analyzed on criteria of demography, mechanism of injury, preoperative neurologic status, involvement of respiratory system, and time of surgery following injury.
Result tatically significant test was applied for analysis of outcome of cervical spine injury based on aforementioned criteria.
Conclusion In this study, survival rates of patients with upper and lower cervical spine injuries were calculated on the basis of mechanism of injury, preoperative neurologic status, respiratory involvement, and time of surgery following injury. Operative treatment of lower cervical injury was better associated with an improved outcome than upper cervical spine injuries. Further prospective study is required for better assessment.
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