This means we see the infiltrates on the right and left sides. Their skin is more sensitive than adult skin and has not yet adapted to the environment outside the, Many people have dry skin. At the time the article was created Jeremy Jones had no recorded disclosures. (2013) ISBN: 9781107679689 -. The normal thymus is a frequent cause of physiological widening of the anterior mediastinum occurring during the early years of life. Bilateral pulmonary hypoplasia is most often the result of compression of the lungs during fetal development. The tachypnea usually resolves within 48 hours. Sometimes newborn skin peeling occurs as a result of conditions that require treatment. 11.1. Opacities may be: Diffuse: This describes when opacities show up in multiple lobes or both lungs. US may be particularly helpful in assessing a catheters position and injection of very small amounts of intravenous water-soluble, low osmolar contrast medium may also be useful in checking the position of the tip. Air leaks are common and small associated pleural effusions may be seen. There are multiple causes of perihilar infiltrates. ( a) "Sail" sign. Peeling skin on a newborn baby is quite common and not usually a cause for concern. Their lungs are structurally and biochemically immature and require prolonged ventilatory support. Anything that causes the normal air filled dark lungs to lose this appearance and be whiter can be referred to as perihilar infiltrates. Please find my observations below. Very premature infants, less than 26 weeks' gestation, may have clear lungs or mild pulmonary haziness initially. These prominent airways in the lungs are seen in both lungs and might be due to some sort of inflammation in the airways or possibly due to changes as a . This results in hyperinflation (due to air trapping as a result of partial bronchial obstruction as a result of peribronchial thickening), segmental and subsegmental atelectasis and small patches of consolidation frequently occurring in a perihilar location (Fig. COVID-19 can damage lung tissue and impact your breathing patterns. Neonatal Pneumonia Other imaging findings and the clinical history can help us . Term infant with meconium aspiration undergoing ECMO. The hila are seen on the right and left sides where the lung meets the mediastinum. The left PA arises from the right PA, and as it courses to the left lung, the left PA passes between the trachea and the esophagus and compresses the trachea posteriorly (, Asymmetric/Unilateral Aeration Abnormalities, Pulmonary aeration abnormalities are frequently asymmetric or unilateral. (2018, January). THE CHEST IN OLDER CHILDREN Newborn babies have just spent 9 months surrounded by amniotic fluid. An understanding of the causes of these various patterns is necessary to provide a useful interpretation of abnormal lung opacities in children. A, Hazy, reticular, or reticulonodular opacities, Congenital lobar hyperinflation or emphysema, Aberrant Left Pulmonary Artery (Pulmonary Sling). Hemihyperplasia, also called hemihypertrophy, refers to overgrowth of one side of the body in comparison with the other. Chest CT has, however, an important role in evaluating immunocompromised patients and both the acute and chronic complications of respiratory tract infection, such as empyema and bronchiectasis.14 A frontal radiograph is usually adequate to confirm or exclude pulmonary infection/pneumonia. When there is less distension, the granularity is replaced by more generalised opacification or complete white-out of the lungs (Fig. Interstitial. A new type of BPD was described by Jobe in 19995 in immature infants with minimal lung disease at birth, and who become symptomatic during the first week of life. There is poor lung inflation and aeration with mild diffuse granular opacification in keeping with IRDS. Pneumonias may have more recent onset with cough, fever, and breathlessness while cancer is a more long standing progressive process. This is the principal contributor at the alveolar airfluid interface which lowers alveolar surface tension and prevents acinar collapse on expiration.1 Without this, there is alveolar collapse and, as a result, poor gas exchange, hypoxia, hypercarbia and acidosis. A, Congenital pulmonary airway malformation (cystic adenomatoid malformation), Large Congenital Pulmonary Airway Malformation, Congenital Pulmonary Airway Malformation. The neonatal chest radiograph in the exam setting may strike fear into the heart of many radiology registrars, but it need not! Treatment may include radiation, chemotherapy, and surgery. The anteroposterior (AP) diameter of the neonatal chest is almost as great as its transverse diameter, giving the chest a cylindrical configuration. Clinically these premature infants are usually symptomatic within minutes of birth with grunting, retractions, cyanosis and tachypnoea. Unilateral (left or right) perihilar infiltrates. Similar lung opacities can be seen with neonatal pneumonia, pulmonary lymphangiectasia, neonatal retained fluid syndrome, and congenital heart abnormalities associated with severe pulmonary venous obstruction. Parekh M, et al. Chest pain, Read More Chest X-ray For Chest PainContinue, Please read the disclaimer CT is often done to diagnose the cause of chest pain. These lipoproteins then combine with surface surfactant proteins (A, B, C, D), which are also produced by the type II pneumocytes to form tubular myelin. 76-9). Sometimes it is temporary and the result of a short-term illness. A 2019 study found that in cases when lung opacity showed cancer, pure ground-glass opacity nodules were more likely to be seen in earlier stages of lung cancer. Pulmonary edema or fluid in the lungs may be seen from multiple causes but is commonly seen in patients with heart failure. Medical imaging advances may reduce radiation risk for vulnerable patients. Subsequent chest radiographs showed streaky perihilar opacities that were thought to be con- One of the most common causes of pulmonary edema in children is acute glomerulonephritis (, Pulmonary lymphangiectasia is a rare condition that consists of dilated lymphatic channels secondary to either abnormal embryonic development of the lymphatic system or obstruction. The most common cause of atelectasis is surgery with anesthesia. There is almost complete white-out of the lungs with air bronchograms. Furthermore, 97.1% of African Americans were RT-PCR (+) compared to 65.8% of Caucasians. Leukemia, lymphoma, and lymphatic metastases to the lungs can also cause a reticular or reticulonodular infiltrative pattern. Bat wing opacities, also known as butterfly opacities, refer to a pattern of bilateral perihilar lung shadowing. Conclusion Become a Gold Supporter and see no third-party ads. These complications have become much less common in infants who have been treated with surfactant and high-frequency ventilation. Disorders of surfactant deficiency due to a genetic abnormality in the surfactant protein B (SpB)9 and C (SpC)10 and the ATP-binding cassette transporter protein A3 (ABCA3) can lead to interstitial lung disease. see full revision history and disclosures, Transient tachypnoea of the newborn (TTN), 1. At the end of this phase primitive alveoli form. Fig. Diffuse: Diffuse opacities show up in multiple lobes of one or both lungs. These are plastic clips used to clamp the umbilicus before it is cut at birth. Water that is too hot can dry out the skin. In children, fluid overload tends to cause peribronchovascular oedema, which then results in overinflation of the lungs due to air trapping, along with perihilar infiltrate and upper lobe venous diversion. 76-2), due to collapsed alveoli interspersed with distended bronchioles and alveolar ducts. The ideal position is at the junction of the IVC and the right atrium (Fig. (2014). The clinical use of artificial surfactant, given as a liquid bolus through the endotracheal (ET) tube, has been a major therapeutic advance. On T2-weighted spin-echo sequences, the normal thymus has an intermediate signal similar to that of the spleen. 1. The vast majority of upper respiratory tract infections in childhood are viral in nature and primarily bronchial in location. Surgical conditions consist primarily of congenital and developmental abnormalities that result in a space-occupying lesion within the chest (diaphragmatic hernia, congenital lobar emphysema, chylothorax, pneumothorax, cystic adenomatoid malformation). Chapter Outline Kutlubay, Z., Tanakol, A., Engn, B., Onel, C., Smsek, E., Serdaroglu, S., Eren, B. Hazy opacities in lungs are sometimes referred to as hazy densities or hazy infiltrates in lungs by radiologists. (2009) ISBN: 9780323031257 -. What causes skin on the fingertips to peel? Some medical, Dry skin is a common health problem, especially as adults age. See additional information. 76-16) and when there is a pneumopericardium the air surrounds the heart (Fig. interstitial edema - predominantly perihilar, mild to moderate cardiomegaly has been described rarely, severe cases may have perihilar alveolar opacities, normal chest radiograph by 48-72 hours postpartum, the double lung point signhas a reported specificity of 94.8%in severe cases 5, can rule out in the presence of consolidated lung with air bronchograms, heart size is usually normal in transient tachypnea of the newborn and there is rapid spontaneous resolution, respiratory distress syndrome:lung volumes are slightly decreased in respiratory distress syndrome but are normal to slightly hyperinflated in transient tachypnea of the newborn, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Streaky opacities scattered in both lung fields means that there might be small straight lung shadows along the air passages on your X-ray on both the sides. Pathological tissue is heterogeneous, and may cause compression or indeed occlusion of adjacent airway or vasculature, something which never occurs with a normal thymus. A patent ductus arteriosus is frequent in the premature infant and contributes to the disease. As newborn chest radiographs are taken in the AP plane, the normal cardiothoracic ratio can be as large as 60%. (2013) ISBN: 9780199985753 -. Learn about the benefits, risks, and accuracy of low dose CT scans for lung cancer detection, as well as who should be screened for lung cancer, and, PET scan is an imaging technique that uses a radioactive tracer to locate tissue differences at a molecular level. Mandell J. radiographic changes may mimic meconium aspiration syndrome or severe transient tachypnoea. Potter syndrome, associated with bilateral renal agenesis, congenital renal cystic disease, or obstructive uropathy, Bilateral overaeration of the lungs is most often caused by airway obstruction that can be central or diffuse and peripheral (, Table 50.6 Possible Causes of Bilateral Lung Hyperinflation, A right-sided aortic arch is the key radiographic clue to the presence of an obstructing vascular ring (, The pulmonary sling anomaly is a rare condition that may also result in tracheal compression and bilateral hyperaeration of the lungs. Differential diagnoses of acute ground-glass opacity in chest computed tomography: Pictorial essay. Pulmonary haemorrhage resulting in airspace opacification may also be a superimposed problem, and is usually due to severe hypoxia and capillary damage (Fig. 76-23). The position of PICC line tips inserted through the upper limbs is usually in the superior vena cava. Prenatal corticosteroid administration during the 2 days prior to delivery significantly reduces the incidence of IRDS in premature infants. Our website services, content, and products are for informational purposes only. The extent of the skin peeling will vary according to the babys gestational age at birth. Opportunistic infections may occur in children with HIV infection and other forms of congenital or acquired immunodeficiency. Round pneumonias occur frequently in young children, usually under 8 years of age, due to the presence of immature collateral ventilation pathways between the small airways (Fig. The normal lung development is well described by Agrons etal.1 During the embryonic phase of gestation (from 26 days to 6 weeks) the lung bud develops from the primitive foregut and divides to form the early tracheobronchial tree. One to two layers of skin will shed in this time, mainly because the protective coating they had in the womb is no longer there. Healthline Media does not provide medical advice, diagnosis, or treatment. The incidence of neonatal pneumonia is about 1 in 200 live births. The features may simulate meconium aspiration syndrome and congenital neonatal pneumonia, particularly when severe. Resolution is usually complete but often after multiple aspirations. However, parents and caregivers should look for additional signs and symptoms. The four classic stages of BPD described by Northway. This is the root of the lung on each side. Normally fluid is cleared from the lungs at, or shortly after, birth by the pulmonary lymphatics and capillaries. Inhalational injury, bleeding into the lungs, and certain cancers can also occasionally have this appearance. Dr. Adam W. DeTora (Pediatrics): A newborn boy was admitted to this hospital be- . Some conditions will result in multiple types of opacities. All rights reserved. Using lukewarm water to clean the baby. While confluent consolidation is not common, it may appear in an exam film. The Neonatal and Paediatric Chest However, other tests may be done to confirm the diagnosis or determine the type or severity of atelectasis. Radiograph obtained immediately following insertion of a veno-venous catheter in the right atrium (arrow). Check for errors and try again. de Matos MJR, et al. A, Viral Lower Respiratory Tract Infection With Atelectasis. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Airway Disease and Chronic Airway Obstruction, Pulmonary Circulation and Pulmonary Thromboembolism, High-Resolution Computed Tomography of Interstitial and Occupational Lung Disease, Respiratory Causes with Contralateral Mediastinal Shift, Respiratory Causes without Mediastinal Shift, Foreign body aspirationmay be normal on inspiratory image, fluoroscopy can help, Mucous pluggingasthmatics and ventilated patients, Post-cardiac surgerye.g. CT is good at diagnosing some of the benign and life threatening conditions that can, Read More CT of the Chest for Chest PainContinue, Please read the disclaimer Lateral view chest X-ray is an X-ray done from the side of the chest. The presence of reduced vascularity in the hyperlucent areas resulting from a primary vascular pathological process, such as thromboembolism or pulmonary hypertension, is rare in children, although various congenital cardiac disorders can result in pulmonary oligaemia. Here are eight air purifiers we recommend for dust and allergies. describe the pneumothorax and explain that the apparent size of the pneumothorax underestimates the volume of free pleural gas because the infant is supine, look at the mediastinum and describe whether there is evidence of tension, in the ventilated patient, gas lucencies extend to the edge of the film (i.e. 76-8). At the time the article was last revised Sonam Vadera had It may also cause a chemical pneumonitis (Fig. The whiteness still allows you to see the blood vessels and bronchi through the opacities. Reuter S, Moser C, Baack M. Respiratory Distress in the Newborn. Because of the many advances in neonatal care, its incidence and severity have reduced significantly in infants born at 28 weeks gestation or older. First of all, have a look to see if the neonate is premature or not - signs of prematurity being reduction in subcutaneous fat and the lack of humeral head ossification (the latter occurs around term). Some infants are delivered by cesarean section; some without labor. It is estimated to affect 1-2% of all neonates with an equal gender predilection. Atelectasis is the main cause of this opacification, but in the very premature infant in particular, oedema, haemorrhage and occasionally superimposed pneumonia contribute. There may be additional helpful findings and clinical history to indicate this diagnosis. Group B streptococcus is the most common organism identified. It may migrate to the distal airways, causing complete or partial obstruction and lead to a ball-valve effect. Pediatr Radiol. Sputum is a mixture of saliva and mucus. This means that lung cancer outlook may be better when a person has pure ground-glass opacity, compared with scans that showed a solid part in the nodules. The thymus may involute during periods of illness, severe stress or whilst on steroids or other chemotherapy. If it is in one small area then it may be a lung nodule. If chest radiographic differentiation between normal thymus and pathology proves difficult on the radiograph, US can help distinguish intrathymic or adjacent masses within the anterior mediastinum from a normal isoechoic homogeneous thymus. The circulation bypasses the lungs, which are minimally inflated, and allows physiologic levels of oxygen saturation. Transient Tachypnoea of the Newborn (TTN) The tachypnea usually resolves within 48 hours. There is some question as to whether these opacities represent true airspace consolidations. The ECMO technique can be used either with the veno-arterial method, where one catheter is placed in the internal jugular vein and one in the carotid artery, or the veno-venous method, where a double lumen catheter is placed in the internal jugular vein, superior vena cava or right atrium (Fig. clavicular fracture or shoulder/humerus injury, if the child is a little older, rib fractures in non-accidental injury, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. These gray areas are referred to as ground-glass opacity. In infants who do not have hydrops, the most common cause of a congenital pleural effusion is chylothorax. A large, hyperlucent hemithorax most often indicates overinflation of an entire lobe or lung. 76-5). It enters the left portal vein, through the ductusvenosus and into the inferior vena cava (IVC). You can learn more about how we ensure our content is accurate and current by reading our. Viral infection usually affects the respiratory mucosa and airways, causing bronchial and bronchiolar oedema. Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-16903. Better . Visscher, M. O., Adam, R., Brink, S., & Odio, M. (2015, MayJune). The imaging features may be similar to those seen in the other disorders of surfactant deficiency. There is almost complete 'white-out' of the lungs with air bronchograms. Tracheal and left main bronchus stents can be seen in this patient with known tracheobronchomalacia. This means that the normally dark air filled lung is replaced with a whiter appearance. This can help to prevent secondary exposure to these chemicals. The outlook and treatment options available will depend on the cause of the opacity. They should take a baby to see the doctor if the skin is: If the baby is running a fever, medical attention will be necessary. Check for errors and try again. Infant with group B streptococcus infection. 4. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. There is a pigtail drainage catheter in situ. Become a Gold Supporter and see no third-party ads. Pleural Effusions Nodular: This. Most people expect newborn babies to have soft, flawless skin, and new parents or caregivers often express concern if their newborns have imperfect skin. (2021). (2020). A larger abnormality can be a pneumonia or lung collapse. The umbilical stump remains in situ for approximately 1-2 weeks and its presence helps to age the baby. The Chest Radiograph This can tell us that process is more extensive and involves both lungs. (A) The childs trachea is buckled and the heart appears enlarged; both phenomena are not shown on a subsequent radiograph (B) taken in good inspiration. Other conditions, like alveolar hemorrhage and lung cancer, require more serious treatments. The chest radiograph may demonstrate sudden cardiac enlargement, left atrial enlargement causing elevation of the left main bronchus and varying degrees of pulmonary oedema (Fig. Before the commencement of treatment, the typical radiographic features include underaeration of the lungs, fine granular opacification, which is diffuse and symmetrical, and air bronchograms (Fig. They can indicate a broad range of conditions, and your doctor may need to do further scans and tests to determine the exact cause of any lung opacities. (2016, September 16). Amniotic fluid is normally expressed from the lungs during vaginal delivery and then absorbed after birth. 76-13). Perihilar infiltrates are found on imaging studies of the chest like X-rays and CT. Cold air is often quite dry and can cause the skin to dry out in turn. White opacities in both lungs in someone known to have heart failure is most likely edema or fluid in the lungs. Left lower lobe consolidation/collapse in an intubated child. Pure nodules do not contain any solid mass, whereas partially solid nodules do have solid components. The appearances in some areas mimic those of PIE. Radiographs shows a rounded or spherical opacity with poorly defined margins, unlike a primary or metastatic chest tumour (which are usually very well circumscribed).17. When gray areas are visible instead, it means that something is partially filling this area inside the lungs. It may not be evenly distributed throughout the lungs, leading to areas of atelectasis interspersed with areas of good aeration, and may produce radiographic findings similar to neonatal pneumonia or pulmonary interstitial emphysema (PIE) (Fig. Neonatal chest radiograph in the exam setting. Reference article, Radiopaedia.org (Accessed on 01 May 2023) https://doi.org/10.53347/rID-2198, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":2198,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/transient-tachypnoea-of-the-newborn/questions/1108?lang=us"}. Retained fetal fluid (transient tachypnea of the newborn) Retained fetal fluid, also known as transient tachypnea of the newborn, is a diffuse lung disorder that occurs because of delayed clearance of fetal lung fluid after birth, typically in full-term neonates born via cesarean delivery. Lung opacity can indicate different conditions that have their own treatment plans. With surfactant therapy and improved oxygenation there is reduced pulmonary resistance and as a result there may be left-to-right shunting. These can usually be seen to extend beyond the lung. What is ground-glass opacity in the lungs? Infants present in respiratory distress, classically with grunting and nasal flaring, within the first six hours of life. Congenital bone dysplasias and syndromes associated with short ribs and a small thoracic cage (asphyxiating thoracic, The most common cause of intrathoracic compression of the fetal lungs is congenital diaphragmatic hernia. The symptoms often depend on the cause. Common things are common, and the commonest causes for respiratory distress in the immediate postnatal period can be split into causes that present in the preterm or term infant. The presence of pleural effusions, pulmonary hyperinflation and mild cardiomegaly may not be helpful in differentiating pneumonia from these other conditions. Oatmeal bath treatments are available in many drug stores, natural food stores, and online. 76-8). Fluid in the lungs will be treated based on the cause. An inspiratory plain chest radiograph is considered adequate when the right hemidiaphragm is at the level of the eighth rib posteriorly. Review of the chest ct differential diagnosis of ground-glass opacities in the COVID era. Very premature infants, less than 26 weeks gestation, may have clear lungs or mild pulmonary haziness initially. There is also an increased incidence in small, hypotonic and sedated infants who have had a precipitous delivery. In TTN the normal physiological clearance is delayed. This can tell us that the process is more localized to one area. How to Tell the Difference Between RSV and a Cold. Neonatal Chest Imaging. Such infections may result in pulmonary opacities that differ significantly from those seen with bacterial pneumonia. (A) CXR shows bilateral interstitial, granular and fluffy opacification. Note triangular extension laterally that looks like a sail. Pediatric Radiology. The umbilical arterial line courses inferiorly in the umbilical artery, into the internal and common iliac arteries and then into the aorta. congenital pulmonary airway malformation (CPAM), mass effect with contralateral mediastinal shift. 2023 Healthline Media UK Ltd, Brighton, UK. Lin YH, et al. 76-15). This results in inadequate gas exchange, leads to prolonged ventilation, hazy lung opacification and occasionally a picture similar to that seen in bronchopulmonary dysplasia (Fig. The chest radiograph is used to assess the degree of lung inflation. There are differences and similarities between RSV vs. a cold. Even though over 80 million people undergo computed tomography (CT) scans each year in the United States, some of the words and phrases related to this imaging test can be complicated and hard to understand. 76-4). This can lead to cracks in the skin and peeling. ( c, d) The prominent thymus mimics a . When moisture is present in the air, it helps to prevent dry, itchy skin. Radiograph shows mild hyperinflation, prominent vasculature, interstitial opacification most marked in the lower lobes and small pleural effusions (arrows) suggestive of TTN. The undulated appearance of the left thymic border is due to rib indentation (arrow). There is a lucency surrounding the heart and the pericardial sac is visible as a white line (arrow), indicating a pneumopericardium. The reticular interstitial pattern refers to a complex network of curvilinear opacities that usually involved the lung diffusely. This section will deal with diffuse pulmonary disease of the newborn. The tip of the umbilical venous catheter is in the IVC (short arrow) and should ideally be placed more distally in the IVC close to the right atrium. Primary tuberculosis should be considered when the infiltrate is accompanied by hilar lymphadenopathy (, Table 50.1 Causes of Focal Alveolar Consolidation, Table 50.2 Sources of Multiple Patchy Lung Opacities. This may help us narrow the diagnostic possibilities. If people avoid washing the vernix off the baby immediately after birth, this natural biofilm may also help the babys skin to adapt to life outside the womb. Inherited mutations in the SpB and ABCA3 are autosomal recessive and may present immediately after birth with respiratory symptoms. However, unlike patients with surfactant deficiency, the lung volumes in these conditions are usually normal to increased (, Primary Tuberculosis With Consolidation and Lymphadenopathy. The unchanged overall incidence is due to the increased survival of the infants of extreme prematurity as they require more prolonged ventilation. In the premature infant there maybe diffuse fine granular opacification, similar to the appearances seen in IRDS.7 Some infants may have both IRDS and group B streptococcus pneumonia. The right thymic margin can often have a sharp sail-like configuration (Fig. ncbi.nlm.nih.gov/pmc/articles/PMC7935089/, sciencedirect.com/science/article/abs/pii/S036301881400005X?via%3Dihub, ncbi.nlm.nih.gov/pmc/articles/PMC6909955/, ncbi.nlm.nih.gov/pmc/articles/PMC7434019/, nhlbi.nih.gov/news/2020/medical-imaging-advances-may-reduce-radiation-risk-vulnerable-patients, ncbi.nlm.nih.gov/pmc/articles/PMC7350036/. Peeling skin is a common occurrence in newborns. These descriptions means the same thing. Transient tachypnea of the newborn, also known as retained fetal fluid or wet lung disease, presents in the neonate as tachypnea for the first few hours of life, lasting up to one day. Most of the time, newborn skin peeling is normal. not be relevant to the changes that were made. (2017, January). Breast milk or formula should be sufficient to hydrate babies up to 6 months in age. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, What You Need to Know About RSV and Pneumonia. Atelectasis (at-uh-LEK-tuh-sis) is a complete or partial collapse of the entire lung or area (lobe) of the lung. Bronchopulmonary dysplasia (BPD) or chronic lung disease is a significant long-term complication of IRDS. Is It Normal to Have Shortness of Breath After COVID-19? In addition to washing a baby with fragrance-free soaps, parents should clean a babys clothing in detergents that do not contain unnecessary fragrances.

Coal City Il Police Report, Keith Wuornos Cause Of Death, Westdale Properties Net Worth, Articles S