Abstract:
:Sarcoidosis is a granulomatous disease of unknown etiology that involves the lungs or intrathoracic lymph nodes in more than 90% of patients. The clinical spectrum of sarcoidosis is protean, but pulmonary manifestations often dominate. Chest radiographs are abnormal in 90 to 95% of patients with sarcoidosis; the most characteristic feature is bilateral hilar lymphadenopathy (BHL), present in 50 to 80% of patients. Pulmonary parenchymal infiltrates are present in 25 to 50% of patients. In this article, we review the radiographic features of sarcoidosis (both typical and atypical), and the impact of chest radiographic stage on long-term prognosis. Computed tomographic (CT) scans are more sensitive than chest radiographs in delineating parenchymal, mediastinal, and hilar structures, and distinctive CT patterns may be virtually pathognomonic for sarcoidosis in some patients. Routine CT scan is not appropriate to diagnose or manage sarcoidosis, but CT may be invaluable in patients with atypical clinical or chest radiographic findings or specific complications of sarcoidosis (pulmonary or extrapulmonary), or to assess prognosis. High-resolution thin-section CT scans (HRCT) may be helpful in selected patients with stage II or III sarcoidosis to discriminate active inflammation from irreversible fibrosis. This article discusses the salient HRCT features of sarcoidosis, accuracy of CT in the differential diagnosis, and correlations of HRCT with disease extent and activity, pulmonary function, and lesion reversibility.
journal_name
Semin Respir Crit Care Medjournal_title
Seminars in respiratory and critical care medicineauthors
Lynch JP 3rddoi
10.1055/s-2003-42375keywords:
subject
Has Abstractpub_date
2003-08-01 00:00:00pages
393-418issue
4eissn
1069-3424issn
1098-9048journal_volume
24pub_type
杂志文章abstract::Advances have been made in minimally invasive diagnostic procedures in sarcoidosis, including bronchoalveolar lavage (BAL), endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), and positron emission tomography (PET). Several independent groups found almost identical predictive values of t...
journal_title:Seminars in respiratory and critical care medicine
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更新日期:2010-08-01 00:00:00
abstract::Tracheostomy is a commonly performed surgical procedure in intensive care units (ICUs). Over the past three decades, there has been a substantial body of evidence to suggest percutaneous tracheostomy (PT) is at least as safe as surgical tracheostomy (ST) in the hands of trained clinicians. In most institutions, PT is ...
journal_title:Seminars in respiratory and critical care medicine
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journal_title:Seminars in respiratory and critical care medicine
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abstract::Pulmonary veno-occlusive disease (PVOD) is a rare disorder and can be misdiagnosed as idiopathic pulmonary arterial hypertension (iPAH). PVOD and iPAH often share a similar clinical presentation, genetic background, and hemodynamic profile. PVOD accounts for 5 to 10% of cases initially considered as iPAH. When compare...
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abstract::Pneumocystis jiroveci remains an important fungal pathogen in a broad range of immunocompromised hosts. The natural reservoir of infection remains unknown. Pneumocystis jiroveci Pneumonia (PJP) develops via airborne transmission or reactivation of inadequately treated infection. Nosocomial clusters of infection have b...
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abstract::The vasculitides affecting large and medium-sized vessels are heterogeneous. This group includes such disorders as giant cell arteritis, Takayasu's disease, and sarcoidosis. There are several challenges that may arise in the care of patients with these disorders. Diagnosis may be elusive when initially evaluating pati...
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abstract::Achieving hemostasis, preventing and treating thrombosis, and laboratory measurement of the hemostatic pathways constitute the core elements of managing the critically ill patient with liver failure. Uncontrolled bleeding in acutely decompensated cirrhosis and acute-on-chronic liver failure is probably the most famili...
journal_title:Seminars in respiratory and critical care medicine
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abstract::Cryptococcosis is an invasive fungal infection (IFI), caused predominantly by Cryptococcus neoformans or Cryptococcus gattii, that affects both immunocompromised (IC) and non-IC patients. Although the most serious disease manifestation is meningoencephalitis, cryptococcal pneumonia is underdiagnosed and may disseminat...
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abstract::Bleeding from gastroesophageal varices is a frequent complication of cirrhosis. Mortality from a variceal bleeding episode has decreased in the last 2 decades from 40% to 15 to 20% due to the implementation of effective treatments and improvement in the general medical care. Initial treatment should include adequate f...
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pub_type: 杂志文章,评审
doi:10.1055/s-0032-1301734
更新日期:2012-02-01 00:00:00
abstract::The genus Scedosporium comprises a group of filamentous fungi found ubiquitously in the environment. The two major human pathogens within this genus are S. apiospermum-the asexual state of Pseudallescheria boydii-and S. prolificans. Both histologically resemble Aspergillus species, with hyphae that are septated and br...
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pub_type: 杂志文章
doi:10.1055/s-2004-824901
更新日期:2004-04-01 00:00:00
abstract::Over the past 3 decades, antimicrobial resistance among Streptococcus pneumoniae, the most common cause of community-acquired pneumonia (CAP), has escalated dramatically worldwide. In the late 1970s, strains of pneumococci displaying resistance to penicillin were described in South Africa and Spain. By the early 1990s...
journal_title:Seminars in respiratory and critical care medicine
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更新日期:2009-04-01 00:00:00
abstract::Survivors of critical illness often experience long-lasting impairments in mental, cognitive, and physical functioning. Acute stress reactions and delusional memories appear to play an important role in psychological morbidity following critical illness, and few interventions exist to address these symptoms. This revi...
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pub_type: 杂志文章,评审
doi:10.1055/s-0035-1570367
更新日期:2016-02-01 00:00:00
abstract::Among immunocompromised individuals, members of the human Herpesviridae family are frequently encountered pathogens. Cytomegalovirus, herpes simplex virus 1 and 2, varicella zoster virus, Epstein-Barr virus, and human herpesvirus-6, -7, and -8 all establish latency after infection and can reactivate during periods of ...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1584793
更新日期:2016-08-01 00:00:00
abstract::Venous thromboembolism (VTE) is a frequent complication in surgical patients, with the potential for long-term disability or fatal outcome. The rationale behind routine use of thromboprophylaxis can be summarized in three points: (1) VTE is frequent in certain surgical populations, (2) VTE may be fatal, (3) thrombopro...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1047566
更新日期:2008-02-01 00:00:00
abstract::Acinetobacter baumannii is a highly resilient, gram-negative coccobacillus that thrives within the unique and complex ecological setting of an intensive care unit. This evolving pathogen has now surpassed human capacity to create new antimicrobials, and has led physicians into a concerning era for hospital-acquired in...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-996413
更新日期:2007-12-01 00:00:00
abstract::Paracoccidioidomycosis (formerly known as South American blastomycosis) is produced by the thermally dimorphic fungus Paracoccidioides brasiliensis. Most often this mycosis runs a chronic progressive course affecting preferentially the lungs followed by the skin, mucous membranes, adrenals, and reticuloendothelial org...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
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abstract::Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in intensive care. Patients who are critically ill, in medical or surgical ICUs are especially at risk for CANDID...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
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abstract::Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality, and health care costs worldwide. Although there exist some heterogeneity between patients, the course of COPD is characterized by recurrent acute exacerbations, which are among the most common causes of medical adm...
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journal_title:Seminars in respiratory and critical care medicine
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abstract::Lung cancer is the number one cause of death from cancer in the United States. Currently, there is no official recommendation to screen for lung cancer even in high-risk populations. Accordingly, we wait for patients to present with symptoms. Only 15-20% of patients are stage I lung cancer at diagnosis. Past screening...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
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abstract::Aspirin-exacerbated respiratory disease (AERD) is a unique syndrome of airway inflammation that frequently occurs in patients with nasal polyposis, chronic sinusitis, and asthma. These patients tend to have progressive and recalcitrant sinus disease requiring frequent surgical intervention and in many cases systemic c...
journal_title:Seminars in respiratory and critical care medicine
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doi:10.1055/s-0032-1325618
更新日期:2012-12-01 00:00:00
abstract::Mechanical ventilation practices in patients with acute respiratory distress syndrome (ARDS) have progressed with a growing understanding of the disease pathophysiology. Paramount to the care of affected patients is the delivery of lung-protective mechanical ventilation which prioritizes tidal volume and plateau press...
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pub_type: 杂志文章,评审
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更新日期:2019-02-01 00:00:00
abstract::Nonneoplastic pulmonary lymphoid disorders consist of a complex spectrum of diseases for pathologists and pulmonologists alike. Advances in our understanding of these disorders in recent years have led to revisions in the classification scheme. This review summarizes the clinicoradiological and pathological features o...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
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更新日期:2012-10-01 00:00:00
abstract::Patients with cystic fibrosis (CF) exhibit significant variability in the course and severity of the disease, and this variability is best interpreted in the context of an interaction between genetic and nongenetic determinants. While a small number of patients with "mild" mutations in the CF transmembrane conductance...
journal_title:Seminars in respiratory and critical care medicine
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doi:10.1055/s-2004-815660
更新日期:2003-12-01 00:00:00
abstract::Patients admitted to the neuroscience intensive care unit (NICU) may have respiratory compromise from either central or peripheral neurological pathology, and may hence require intubation and mechanical ventilation for very diverse reasons. Liberation from invasive ventilation, that is, extubation, at the earliest pos...
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abstract::Healthcare-associated pneumonia (HCAP) represents one of the largest subsets of patients with pneumonia. Based on epidemiological projections for the aging U.S. population, the number of hospitalizations for HCAP is expected to increase exponentially for the next several decades. The unique risk factors for colonizati...
journal_title:Seminars in respiratory and critical care medicine
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更新日期:2009-02-01 00:00:00
abstract::Lung transplantation is a therapeutic option for patients with end stage lung diseases, but long-term survival remains poor, primarily due to chronic allograft rejection. Bronchiolitis obliterans (BO), a fibrotic process resulting in progressive narrowing of bronchiolar lumens and airflow obstruction, is a manifestati...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-815601
更新日期:2003-10-01 00:00:00
abstract::Pulmonary immunity to fungal pathogens requires both innate and adaptive immune responses. Alveolar macrophages, dendritic cells, and neutrophils are the phagocytic cells of the lung innate system. These cells produce early inflammatory mediators (i.e., reactive oxygen species, cytokines, and chemokines) in response t...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2004-02-01 00:00:00