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Pulmonary Edema and pleural effusion Detection Using Efficient Net-V1-B4 Architecture and AdamW Optimizer from Chest X-Rays Images

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Computers, Materials & Continua 2024年第7期80卷 1055-1073页

作者： Anas AbuKaraki Tawfi Alrawashdeh Sumaya Abusaleh Malek Zakarya Alksasbeh Bilal Alqudah Khalid Alemerien Hamzah Alshamaseen Faculty of Information Technology Al-Hussein Bin Talal UniversityMa’an71111Jordan College of Information and Communications Technology(ICT) Tafila Technical UniversityTafila66110Jordan IOTISTIC Solutions Company Amman11185Jordan

This paper presents a novelmulticlass systemdesigned to detect pleural effusion and pulmonary edema on chest Xray images,addressing the critical need for early detection in healthcare.A new comprehensive dataset was formed by combining 28,309 samples from the ChestX-ray14,PadChest,and CheXpert databases,with 10,287,6022,and 12,000 samples representing pleural effusion,Pulmonary Edema,and Normal cases,***,the preprocessing step involves applying the Contrast Limited Adaptive Histogram Equalization(CLAHE)method to boost the local contrast of the X-ray samples,then resizing the images to 380×380 dimensions,followed by using the data augmentation *** classification task employs a deep learning model based on the EfficientNet-V1-B4 architecture and is trained using the AdamW *** proposed multiclass system achieved an accuracy(ACC)of 98.3%,recall of 98.3%,precision of 98.7%,and F1-score of 98.7%.Moreover,the robustness of the model was revealed by the Receiver Operating Characteristic(ROC)analysis,which demonstrated an Area Under the Curve(AUC)of 1.00 for edema and normal cases and 0.99 for *** experimental results demonstrate the superiority of the proposedmulti-class system,which has the potential to assist clinicians in timely and accurate diagnosis,leading to improved patient ***,ablation-CAM visualization at the last convolutional layer portrayed further enhanced diagnostic capabilities with heat maps on X-ray images,which will aid clinicians in interpreting and localizing abnormalities more effectively.

关键词： Image classification decision support system EfficientNet-V1-B4 AdamW optimizer pulmonary edema pleural effusion chest X-rays

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pleural effusion,ascites,colon ulcers and hematochezia:What we can learn from the diagnostic process of a patient with plasma cell myeloma:A case report

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World Journal of Clinical Cases 2024年第22期12卷 5196-5207页

作者： Ming-Xian Yan Department of Gastroenterology The First Affiliated Hospital of Shandong First Medical UniversityShandong Provincial Qianfoshan HospitalJinan 250014Shandong ProvinceChina

BACKGROUND Plasma cell myeloma(PCM)is characterized by hypercalcemia,renal impairment,anemia,and bone *** pleural effusion,ascites,abdominal pain,and bloody stool are common manifestations of lung disease or gastrointestinal disorders,they are rarely observed in patients with *** SUMMARY A 66-year-old woman presented with complaints of recurrent chest tightness,wheezing,and abdominal bloating accompanied by bloody *** tomography revealed pleural effusion and *** effusion tests showed inflammation,but the T-cell spot test and carcinoembryonic antigen were *** showed colonic mucosal edema with ulcer formation and local intestinal lumen *** revealed enlarged atria and reduced left ventricular systolic *** diagnosis remained *** testing revealed elevated blood light chain lambda and urine immunoglobulin *** immunofixation electrophoresis was positive for immunoglobulin G lambda *** cytology of the bone marrow showed a high proportion of plasma cells,accounting for about 4.5%.Histopathological examination of the bone marrow suggested *** cytometry showed abnormal plasma cells with strong expression of CD38,CD138,cLambda,CD28,CD200,and *** in situ hybridization gene testing of the bone marrow suggested 1q21 gene amplification,but cytogenetic testing showed no clonal *** mucosa and bone marrow biopsy tissues were negative for Highman Congo red *** patient was finally diagnosed with *** A diagnosis of PCM should be considered in older patients with pleural effusion,ascites,and multi-organ injury.

关键词： Plasma cell myeloma pleural effusion Ascites Hematochezia Colon ulcers Bone marrow aspirate Case report

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Comparison of efficacy of lung ultrasound and chest X-ray in diagnosing pulmonary edema and pleural effusion in ICU patients: A single centre, prospective, observational study

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Open Journal of Anesthesiology 2024年第3期14卷 41-50页

作者： Kunal Tewari Sumanth Pelluru Deepak Mishra Nitin Pahuja Akash Ray Mohapatra Jyotsna Sharma Om Bahadur Thapa Manjot Multani Department of Anesthesiology and Critical Care Armed Forces Medical College Pune India Department of Anesthesiology and Critical Care Military Hospital Bhopal India

Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.

关键词： Chest X ray (CXR) Consolidation Pulmonary edema pleural effusion Lung ultrasound (LUS) Pneumothorax

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pleural effusion and ascites in extrarenal lymphangiectasia causedby post-biopsy hematoma: A case report

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World Journal of Clinical Cases 2020年第24期8卷 6330-6336页

作者： Qiong-Zhen Lin Hui-En Wang Dong Wei Yun-Feng Bao Hang Li Tao Wang Department of Nephrology The Third Hospital of Hebei Medical UniversityShijiazhuang 050051Hebei ProvinceChina Department of Thoracic Surgery Hebei Provincial General HospitalShijiazhuang 050051Hebei ProvinceChina Department of Urology Hebei Provincial General HospitalShijiazhuang 050051Hebei ProvinceChina Department of Medical Imaging Hebei General HospitalShijiazhuang 050051Hebei ProvinceChina Department of Nephrology Peking Union Medical College HospitalBeijing 100045China Department of Nephrology The First Hospital of Hebei Medical UniversityShijiazhuang 050000Hebei ProvinceChina

BACKGROUNDThe renal system has a specific pleural effusion associated with it in the form of“urothorax”, a condition where obstructive uropathy or occlusion of thelymphatic ducts leads to extravasated fluids (urine or lymph) crossing thediaphragm via innate perforations or lymphatic channels. As a rare disorder thatmay cause pleural effusion, renal lymphangiectasia is a congenital or acquiredabnormality of the lymphatic system of the kidneys. As vaguely mentioned in areport from the American Journal of Kidney Diseases, this disorder can be causedby extrinsic compression of the kidney secondary to *** SUMMARYA 54-year-old man with biopsy-proven acute tubulointerstitial nephropathyexperienced bleeding 3 d post hoc, which, upon clinical detection, manifested as amassive perirenal hematoma on computed tomography (CT) scan withoutconcurrent pleural effusion. His situation was eventually stabilized byexpeditious management, including selective renal arterial embolization. Despite good hemodialysis adequacy and stringent volume control, a CT scan 1 mo laterfound further enlargement of the perirenal hematoma with heterogeneoushypodense fluid, left side pleural effusion and a small amount of ascites. Thesefluid collections showed a CT density of 3 Hounsfield units, and drained fluid ofthe pleural effusion revealed a dubiously light-colored transudate withlymphocytic predominance (> 80%). Similar results were found 3 mo later, duringwhich time the patient was free of pulmonary infection, cardiac dysfunction andovert hypoalbuminemia. After careful consideration and exclusion of otherpossible causative etiologies, we believed that the pleural effusion was due to theocclusion of renal lymphatic ducts by the compression of kidney parenchymaand, in the absence of typical dilation of the related ducts, considered our case asextrarenal lymphangiectasia in a broad *** such, our case highlighted a morbific passage between the kidney and thoraxunder an extrao

关键词： Urothorax pleural effusion Perirenal hematoma Renal lymphangiectasia Lymphatic drainage Case report

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pleural effusion in critically ill patients and intensive care setting

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World Journal of Clinical Cases 2023年第5期11卷 989-999页

作者： Adel Salah Bediwy Mohammed Al-Biltagi Nermin Kamal Saeed Hosameldin A Bediwy Reem Elbeltagi Department of Chest Diseases Faculty of MedicineTanta UniversityTanta 31527AlgharbiaEgypt Department of Chest Diseases University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Pediatric Faculty of MedicineTanta UniversityTanta 31527AlgharbiaEgypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Medical Microbiology Section Chairperson of the Pathology DepartmentSalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 26671Bahrain Microbiology Section Pathology DepartmentRoyal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain Faculty of Medicine Tanta UniversityTanta 31527AlgharbiaEgypt Department of Medicine Royal College of Surgeons in Ireland-BahrainBusaiteen 15503MuharraqBahrain

pleural effusion usually causes a diagnostic dilemma with a long list of differential *** studies found a high prevalence of pleural effusions in critically ill and mechanically ventilated patients,with a wide range of variable prevalence rates of up to 50%-60%in some *** review emphasizes the importance of pleural effusion diagnosis and management in patients admitted to the intensive care unit(ICU).The original disease that caused pleural effusion can be the exact cause of ICU *** is an impairment in the pleural fluid turnover and cycling in critically ill and mechanically ventilated *** are also many difficulties in diagnosing pleural effusion in the ICU,including clinical,radiological,and even laboratory *** difficulties are due to unusual presentation,inability to undergo some diagnostic procedures,and heterogenous results of some of the performed *** effusion can affect the patient’s outcome and prognosis due to the hemodynamics and lung mechanics changes in these patients,who usually have frequent ***,pleural effusion drainage can modify the ICUadmitted patient’s ***,pleural effusion analysis can change the original diagnosis in some cases and redirect the management toward a different way.

关键词： pleural effusion Intensive care unit Mechanical ventilation Diagnosis Drainage Pigtail catheters

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3D spiral channels combined with flexible micro-sieve for high-throughput rare tumor cell enrichment and assay from clinical pleural effusion samples

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Bio-Design and Manufacturing 2022年第2期5卷 358-370页

作者： Jie Cheng Lina Zhang Yiran Zhang Yifei Ye Wenjie Zhao Lingqian Zhang Yuang Li Yang Liu Wenchang Zhang Hongyan Guo Mingxiao Li Yang Zhao Chengjun Huang Institute of Microelectronics Chinese Academy of SciencesBeijing 100029China School of Future Technology University of Chinese Academy of SciencesBeijing 100049China Department of Cellular and Molecular Biology Beijing Chest HospitalCapital Medical UniversityBeijing Tuberculosis and Thoracic Tumor Research InstituteBeijing 101149China National Engineering Research Center for Beijing Biochip Technology Beijing 102206China

The sieving and enrichment of rare tumor cells from large-volume pleural effusion(PE)samples is a promising technique for cell-based lung tumor diagnosis and drug tests,which features high throughput and recovery,purification,as well as viability rates of rare target cells as the prerequisites for high sensitivity,specificity,and accuracy of tumor cell *** this paper,we propose a three-dimensional(3 D)sieving method for rare tumor cell enrichment,which effectively eliminates the"dead zones"in traditional two-dimensional(2 D)cell filters with a dimension-raising strategy to satisfy the requirements mentioned *** prototype device was combined with a funnel-shaped holder,a flexible micropore membrane in the middle,and a3 D spiral fluid channel covered on the membrane as a three-layer ice-creaming cone composite *** by gravity alone,the device performed as follows:(1)20-fold throughput compared with the 2 D commercial planee hich was up to 20 mL/min for a threefold dilution of whole blood sample;(2)high recovery rates of 84.5%±21%,86%±25%,83%±14%for 100,1000,and 10000 cells/mL,respectively,in 30 mL phosphate buffer saline(PBS)sample,and a 100%positive detection rate in the case of≤5 A549 cells in 1 mL PBS;(3)a typical purification rate of 85.5%±9.1%;and(4)a viability rate of>93%.In the demonstration application,this device effectively enriched rare target cells from large volumes(>25 mL)of clinical pleural *** following results indicated that tumor cells were easy-to-discover in the enriched PE samples,and the proliferation capability of purified cells was(>4.6 times)significantly stronger than that of unprocessed cells in the subsequent 6-day *** above evaluation indicates that the proposed easily reproducible method for the effective execution of rare cell enrichments and assays is expected to become a practical technique for clinical cell-based tumor diagnosis.

关键词： Cell enrichment High throughput pleural effusion Liquid biopsy 3D printing

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Delayed internal pancreatic fistula with pancreatic pleural effusion postsplenectomy

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World Journal of Gastroenterology 2010年第35期16卷 4494-4496页

作者： Shu-Guang Jin Zhe-Yu Chen Lu-Nan Yan Yong Zeng Departmentof Hepato-Bilio-Pancreatic Surgery West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina

The occurrence of pancreatic pleural effusion,secondary to an internal pancreatic fistula,is a rare clinical syndrome and diagnosis is often *** key to the diagnosis is a dramatically elevated pleural fluid *** pancreatic pleural effusion is also called a pancreatic pleural *** is characterized by profuse pleural fluid and has a tendency to *** we report a case of delayed internal pancreatic fistula with pancreatic pleural effusion emerging after *** the treatment of this case,we conclude that the symptoms and signs of a subphrenic effusion are often obscure;abdominal computed tomography may be required to look for occult,intra-abdominal infection;and active conservative treatment should be carried out in the early period of this complication to reduce the need for endoscopy or surgery.

关键词： Pancreatic fistula pleural effusion Splenectomy Subphrenic effusion Postoperative complications

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Database-assisted global metabolomics profiling of pleural effusion induced by tuberculosis and malignancy

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Chinese Chemical Letters 2021年第10期32卷 3207-3210页

作者： Guodong Cao Zhengbo Song Zhiyi Yang Zhongjian Chen Yanjun Hong Zongwei Cai State Key Laboratory of Environmental and Biological Analysis Department of ChemistryHong Kong Baptist UniversityHong KongChina Department of Thoracic Oncology Zhejiang Cancer HospitalHangzhou 310000China Department of Cancer Research Zhejiang Cancer HospitalHangzhou 310000China School of Pharmaceutical Sciences(Shenzhen) Sun Yat-sen UniversityShenzhen 518000China

Database-assisted global metabolomics has received growing attention due to its capability for unbiased identification of metabolites in various biological ***,we established a mass spectrometry(MS)-based database-assisted global metabolomics method and investigated metabolic distance between pleural effusion induced by tuberculosis and malignancy,which are difficult to be distinguished due to their similar clinical *** present method utilized a liquid chromatography(LC) system coupled with high resolution mass spectrometry(MS) working on full scan and data dependent mode for data *** identification of metabolites was performed through mass spectral searching and then confirmed by using authentic *** a result,a total of 194 endogenous metabolites were identified and 33 metabolites were found to be differentiated between tuberculous and malignant pleural *** metabolites involved in tryptophan catabolism,bile acid biosynthesis,and β-oxidation of fatty acids,provided non-invasive biomarkers for differentiation of the pleural effusion samples with high sensitivity and specificity.

关键词： Database-assisted global metabolomics Mass spectrometry Non-invasive biomarker pleural effusion

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Initial 12-h Operative Fluid Volume is an Independent Risk Factor for pleural effusion after Hepatectomy

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第6期36卷 859-864页

作者： Xiang CHENG Jia-wei WU Ping SUN Zi-fang SONG Qi-chang ZHENG Department of Hepatobiliary Surgery Union Hospital Tongji Medical College Huazhong University of Seienee and Technology Wuhan 430022 China

pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital *** studies have addressed the risk factors for postoperative pleural ***,there are no researches concerning the role of the initial 12-h operative fluid *** aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after *** this study,we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December *** prospectively collected and retrospectively analyzed baseline and clinical data,including preoperative,intraoperative,and postoperative *** and multivariate analyses were carried out to identify whether the initial 12-h operative fluid volume was an independent risk factor for pleural effusion after *** multivariate analysis identified 2 independent risk factors for pleural effusion：operative time [odds ratio（OR）=10.2] and initial 12-h operative fluid volume（OR=1.0003）.Threshold effect analyses revealed that the initial 12 h operative fluid volume was positively correlated with the incidence of pleural effusion when the initial 12-h operative fluid volume exceeded 4636 m *** conclude that the initial 12-h operative fluid volume during liver resection and operative time are independent risk factors for pleural effusion after *** intravenous fluids should be restricted properly.

关键词： hepatectomy pleural effusion

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Diagnostic value and safety of medical thoracoscopy for pleural effusion of different causes

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World Journal of Clinical Cases 2022年第10期10卷 3088-3100页

作者： Xiao-Ting Liu Xi-Lin Dong Yu Zhang Ping Fang Hong-Yang Shi Zong-Juan Ming Department of Respiratory Medicine The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina Department of Respiratory The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina

BACKGROUND pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic *** thoracoscopy(MT)can be used for both diagnostic and therapeutic purposes,especially in patients with undiagnosed pleural *** To assess the diagnostic efficacy and safety of MT in patients with pleural effusion of different *** Between January 1,2012 and April 30,2021,patients with pleural effusion underwent MT in the Department of Respiratory Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University(Shaanxi,China).According to the discharge diagnosis,patients were divided into malignant pleural effusion(MPE),tuberculous pleural effusion(TBPE),and inflammatory pleural effusion(IPE)*** information,and tuberculosis-and effusion-related indices of the three groups were *** diagnostic yield,diagnostic accuracy,performance under thoracoscopy,and complications of patients were compared among the three ***,the significant predictive factors for diagnosis between the MPE and TBPE groups were *** Of the 106 patients enrolled in this 10-year study,67 were male and 39 female,with mean age of 57.1±14.184 *** the 74 thoracoscopy-confirmed patients,41(38.7%)had MPE,21 had(19.8%)TBPE,and 32(30.2%)were *** diagnostic yield of MT was 69.8%(MPE:75.9%,TBPE:48.8%,and IPE:75.0%,with diagnostic accuracies of 100%,87.5%,and 75.0%,respectively).Under thoracoscopy,single or multiple pleural nodules were observed in 81.1%and pleural adhesions in 34.0%with pleural *** most common complication was chest pain(41.5%),followed by chest tightness(11.3%)and fever(10.4%).Multivariate logistic regression analyses showed effusion appearance[odds ratio(OR):0.001,95%CI:0.000-0.204;P=0.010]and carcinoembryonic antigen(OR:0.243,95%CI:0.081-0.728;P=0.011)as significant for differentiating MPE and TBPE,with area under the receiver operating cha

关键词： Medical thoracoscopy pleural effusion Diagnostic value Safety Thoracoscopic performance Differential diagnosis

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