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Dey M, Mishra B, Mohapatra PR, Mohakud S, Behera B. Microbiological profile of long COVID and associated clinical and radiological findings: a prospective cross-sectional study. Lab Med 2024:lmae010. [PMID: 38520687 DOI: 10.1093/labmed/lmae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE To study the frequency of microbiological etiology of respiratory infections in patients with long COVID and their associated clinical and radiological findings. METHODS Nasopharyngeal swabs and sputum specimens were collected from 97 patients with respiratory illness stemming from long COVID. The specimens were assessed for their microbiological profile (bacteria and virus) and their association with the overall clinical and radiological picture. RESULTS In total, 23 (24%) patients with long COVID had viral infection (n = 12), bacterial infection (n = 9), or coinfection (n = 2). Microorganisms were detected at significantly higher rates in hospitalized patients, patients with moderate COVID-19, and patients with asthma (P < .05). Tachycardia (65%) was the most common symptom at presentation. A statistically significant number of patients with long COVID who had viral infection presented with cough and myalgia; and a statistically significant number of patients with long COVID who had bacterial infection presented with productive coughing (P < .05). Post-COVID fibrotic changes were found in 61% of cohort patients (31/51). CONCLUSION A decreasing trend of respiratory pathogens (enveloped viruses and bacteria) was found in long COVID. An analysis including a larger group of viral- or bacterial-infected patients with long COVID is needed to obtain high-level evidence on the presenting symptoms (cough, myalgia) and their association with the underlying comorbidities and severity.
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Affiliation(s)
- Monalisa Dey
- Departments of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Baijayantimala Mishra
- Departments of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Prasanta Raghab Mohapatra
- Departments of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sudipta Mohakud
- Departments of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Bijayini Behera
- Departments of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
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Behaeddin BC, Ramos MM, Jarrett OG, Torres EV. Surgical Proposition of a Slow-Growing Calvarial Exostosis in a Female Patient With a Congenital Iris Cyst of the Anterior Chamber and Mandibular Tori. Cureus 2024; 16:e56642. [PMID: 38646370 PMCID: PMC11032145 DOI: 10.7759/cureus.56642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
We present an unusual case of a woman in her early 50s with a slow-growing calvarial exostosis. Exostoses are bony spurs or osteomas extending outward beyond a bone's surface and may be benign or malignant. Calvarial exostoses are a less common bone tumor that can occur in the population. We present a case of a rare, slow-growing calvarial exostosis with a combination of mandibular tori and a congenital iris cyst. We discuss differentials of this exostosis and different syndromes that may cause it such as hereditary multiple exostoses and Gardner syndrome. The current article aims to spread awareness of this atypical presentation of exostoses and present our institution's surgical proposition for removing a calvarial exostosis to obtain a further histological analysis of its composition. As these masses may commonly be benign, a definitive diagnosis cannot be made through imaging alone to rule out more threatening conditions. We have addressed radiological findings and diagnostic and treatment options offered to the patient. The patient decided not to move forward with removing the mass and would continue to monitor and return should she notice any unusual or acute changes.
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Affiliation(s)
- Bita C Behaeddin
- School of Medicine, St. George's University School of Medicine, New York, USA
- General Surgery, Sanitas Medical Center, Miami, USA
| | - Monica M Ramos
- School of Medicine, Ross University School of Medicine, Miami, USA
- General Surgery, Sanitas Medical Center, Miami, USA
| | - Omar G Jarrett
- School of Medicine, St. George's University School of Medicine, New York, USA
- General Surgery, Sanitas Medical Center, Miami, USA
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Miraj F, Karda IWAM, Abdullah A, Dionysios E. Lessons learned from "the great mimicker disease": A retrospective study of 18 patients with scurvy. J Child Orthop 2023; 17:618-625. [PMID: 38050589 PMCID: PMC10693847 DOI: 10.1177/18632521231213150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
Purpose Scurvy is an uncommon medical condition that affects children and is caused by an inadequate intake of vitamin C. This study presents the characteristics of patients with scurvy to raise awareness of the diagnostic process in developing countries where laboratory testing for vitamin C levels is often not available. Methods A retrospective study was performed from period of 2018 to 2023. Data extraction includes patient age, sex, body mass index, constitutional symptoms, musculoskeletal, mucosal, cutaneous symptoms, other accompanying disorders, anemia, erythrocyte sedimentation rate, C-reactive protein, radiographic examination, vitamin C dose, and duration of treatment. Descriptive statistical analysis was performed in this study. Results Eighteen cases (17 males, 1 female) of scurvy were referred to our institution. Thirteen of 18 patients were misdiagnosed before referral. The median age at presentation was 4.5 (range, 2-11) years. The average body mass index was 13.93 ± 0.63 kg/m2. Half of patients had healthy weight. All patients presented with lower limb pain and 17 of 18 with refusal to walk. The median onset of diagnosis was 11 (range 4-48) weeks. White line of Frankel was described in all patients. Seven had anemia and 6 of 18 had increase in erythrocyte sedimentation rate and/or C-reactive protein levels. Only one patient had ascorbic acid levels evaluation before treatment since it was not readily available in our country. Treatment length varied from 2 weeks to 6 months. Conclusion The diagnosis of scurvy is frequently delayed due to its extreme rarity in modern society and its ability to mimic numerous other conditions. In children presenting with limb pain and/or reluctance to walk and pathognomonic radiological findings, physicians must prioritize scurvy as a differential diagnosis. In scurvy, vitamin C supplementation is curative.
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Affiliation(s)
- Faisal Miraj
- Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - I Wayan Arya Mahendra Karda
- Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ali Abdullah
- Division of Orthopaedic and Traumatology, Department of Surgery, Persahabatan General Hospital, Jakarta, Indonesia
| | - Eugene Dionysios
- Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Barac A, Vujovic A, Drazic A, Stevanovic G, Paglietti B, Lukic K, Stojanovic M, Stjepanovic M. Diagnosis of Chronic Pulmonary Aspergillosis: Clinical, Radiological or Laboratory? J Fungi (Basel) 2023; 9:1084. [PMID: 37998889 PMCID: PMC10672318 DOI: 10.3390/jof9111084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Chronic pulmonary aspergillosis (CPA) is a chronic progressive lung disease associated with a poor prognosis and a 5-year mortality rate of approximately 40-50%. The disease is characterized by slowly progressive destruction of the lung parenchyma, in the form of multiple cavities, nodules, infiltrates or fibrosis. CPA can be challenging to diagnose due to its non-specific symptoms and similarities with other respiratory conditions combined with the poor awareness of the medical community about the disease. This can result in delayed treatment even for years and worsening of the patient's condition. Serological tests certainly play a significant role in diagnosing CPA but cannot be interpreted without radiological confirmation of CPA. Although many data are published on this hot topic, there is yet no single definitive test for diagnosing CPA, and a multidisciplinary approach which involves a combination of clinical picture, radiological findings, microbiological results and exclusion of other mimicking diseases, is essential for the accurate diagnosis of CPA.
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Affiliation(s)
- Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.V.); (G.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.D.); (M.S.); (M.S.)
| | - Ankica Vujovic
- Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.V.); (G.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.D.); (M.S.); (M.S.)
| | - Ana Drazic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.D.); (M.S.); (M.S.)
| | - Goran Stevanovic
- Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.V.); (G.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.D.); (M.S.); (M.S.)
| | - Bianca Paglietti
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Katarina Lukic
- Center for Radiology and MRI, University Clinical Center of Serbia, 11000 Belgrade, Serbia;
| | - Maja Stojanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.D.); (M.S.); (M.S.)
- Clinic of Allergy and Immunology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Mihailo Stjepanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (A.D.); (M.S.); (M.S.)
- Clinic for Pulmonology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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Nakagawa Y, Mukai S, Miyata M, Minami K, Hattori Y, Yamagishi H. Radiological Findings of the Lumbar Spine in High School and Collegiate Sumo Wrestlers. Orthop J Sports Med 2023; 11:23259671231206712. [PMID: 37941889 PMCID: PMC10629334 DOI: 10.1177/23259671231206712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/19/2023] [Indexed: 11/10/2023] Open
Abstract
Background Sumo wrestling is a traditional sport in Japan and becoming popular worldwide. Risk factors for lower back injuries in sumo wrestlers are heavier weight and larger body mass index (BMI). The mawashi (loincloth belt) worn by sumo wrestlers has been shown to restrict motion of the lumbar spine. Purpose To study the effects of sumo wrestling on the lumbar spine of high school and freshmen collegiate wrestlers, investigating the relationship between radiological findings, wearing of the mawashi during training, and lower back symptoms. Study Design Case series; Level of evidence, 4. Methods From 2001 to 2017, a total of 197 members of the Japanese Sumo Federation (55 high school and 142 college freshman students) underwent routine radiographic examination of their lumbar spines and answered a questionnaire regarding lumbar symptoms. Wrestlers were classified as symptomatic and asymptomatic based on responses to a custom questionnaire. We used the unpaired t test to evaluate patient demographics and the chi square test to analyze radiographic lumbar spine abnormalities between symptomatic and asymptomatic wrestlers. Results The wrestlers' mean height, weight, BMI, and duration in the sport were 174.0 ± 6.7 cm, 107.1 ± 22.4 kg, 35.2 ± 6.4, and 8.0 ± 3.2 years, respectively. There were 91 participants in the symptomatic group (46.2%) and 106 (53.8%) in the asymptomatic group. Ten wrestlers (5.1%) had osteophyte formations in the lumbar body; 8 of the 11 osteophytes (72.7%) appeared in the upper lumbar spine. Of the total, 48 wrestlers (24.4%) had deformities (Schmorl nodules) in the lumbar body, and 23 of 50 (46.0%) and 10 of 16 (62.5%) deformities were found in the upper lumbar spine of collegiate and high school wrestlers, respectively. Five wrestlers of the total 197 athletes (2.5%) had disc space narrowing in the lumbar body, with 3 of the 5 cases of disc space narrowing (60.0%) found in the upper lumbar spine. Spondylolysis in the lumbar body was found in 25 wrestlers (12.7%); 19 of the 91 symptomatic wrestlers (20.9%) had spondylolysis, compared with 6 of the 106 (5.7%) asymptomatic wrestlers (P = .0028). Conclusion Almost one-third of sumo wrestlers had ≥1 abnormal radiological finding in the lumbar spine. There was a significant relationship between symptomatic wrestlers and spondylolysis.
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Affiliation(s)
- Yasuaki Nakagawa
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
- Department of Orthopaedic Surgery, Japan Baptist Medical Foundation, Kyoto, Japan
| | - Shogo Mukai
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Masahiko Miyata
- Department of Orthopaedic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kazufumi Minami
- Department of Orthopedic Surgery, International University of Health and Welfare, Tokyo, Japan
| | | | - Hiroya Yamagishi
- Department of Chest Surgery, Japanese Red Cross Fukui Hospital Fukui, Japan
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Akkoyunlu M, Bulgurcu E, Delilbası C, Sabir N. Radiological features of rare non-odontogenic lesions of the jaws. Curr Med Imaging 2023; 20:CMIR-EPUB-134204. [PMID: 37654125 DOI: 10.2174/1573405620666230901102904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/28/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND The jaws can be affected by several lesions that manifest in the oral cavity, but little is known about non-odontogenic benign and malignant lesions and their radiological findings. INTRODUCTION Our aim was to discuss the imaging findings of non-odontogenic jaw lesions to help the surgeon in the diagnosis and formulating a differential diagnosis for this vast spectrum of jaw lesions with overlapping clinical and imaging appearances. METHODS CT and MR images of the mandible, maxillofacial region, and neck were retrieved from the archive of the Radiology Department of Pamukkale University for the duration between 2012-2023 and assessed. RESULTS A total of 8125 CT and MR images were retrospectively analyzed. The mean age of the patients was 39.5 years in females and 43.2 in males, with a range varying from 15 to 72 years. Histopathologically approved benign and malignant non-odontogenic lesions were detected in only 19 patients out of 8125 images (0.23%). Osteomyelitis and abscess were the most common (n=3; 0.03%), followed by two cases (n=2; 0.02%) of each fibrous dysplasia, hemangioma, osteosarcoma, squamous cell carcinoma, and multiple myeloma, and one case (n=1; 0.01%) of each ossifying fibroma, osteoma, lymphoma, metastasis, and solitary bone cyst. CONCLUSION Although non-odontogenic benign and malignant lesions of the jaw are rare, awareness of the radiological features of these lesions plays an important role in their diagnosis and management.
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Affiliation(s)
- Murat Akkoyunlu
- Department of Oral and Maxillofacial Surgery, Istanbul Medipol University Faculty of Dentistry, Istanbul, Turkey
| | - Emre Bulgurcu
- Department of Radiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Cagri Delilbası
- Department of Oral and Maxillofacial Surgery, Istanbul Medipol University Faculty of Dentistry, Istanbul, Turkey
| | - Nuran Sabir
- Department of Radiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Gaskin D, Springer D, Latha K, Gaskin PS, Reid A. Cystic neutrophilic granulomatous mastitis: A case report and review of the literature. Med Int (Lond) 2023; 3:50. [PMID: 37745152 PMCID: PMC10514567 DOI: 10.3892/mi.2023.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
The present study describes a case of cystic neutrophilic granulomatous mastitis. The clinical and radiological findings of the patient were consistent with idiopathic granulomatous mastitis. Cystic neutrophilic granulomatous mastitis is a rare subtype of mastitis with a distinct histological pattern that is associated with the Corynebacterium species. The diagnosis and treatment of cystic neutrophilic granulomatous mastitis remains a significant challenge due to the scarcity of available data. The present study describes a classic case of cystic neutrophilic granulomatous mastitis that includes clinical, radiological and histopathological findings. To the best of our knowledge, this is the first case documenting radiological findings before and after treatment. This report encourages the consideration of this entity in the differential diagnoses of mastitis.
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Affiliation(s)
- David Gaskin
- Department of Pathology, Queen Elizabeth Hospital, Bridgetown, St. Michael BB11155, Barbados
| | - Dale Springer
- Faculty of Medical Sciences, University of The West Indies Cave Hill Campus, Bridgetown, St. Michael BB11000, Barbados
| | - Kandamaran Latha
- Breast Screening Program, Barbados Cancer Society, Bridgetown, St. Michael BB11155, Barbados
| | - Pamela S. Gaskin
- Faculty of Medical Sciences, University of The West Indies Cave Hill Campus, Bridgetown, St. Michael BB11000, Barbados
| | - Alain Reid
- Faculty of Medical Sciences, University of The West Indies Cave Hill Campus, Bridgetown, St. Michael BB11000, Barbados
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Hegazi T. Hydroxyapatite Deposition Disease: A Comprehensive Review of Pathogenesis, Radiological Findings, and Treatment Strategies. Diagnostics (Basel) 2023; 13:2678. [PMID: 37627938 PMCID: PMC10453434 DOI: 10.3390/diagnostics13162678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/12/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
Hydroxyapatite deposition disease (HADD) represents a multifaceted condition characterized by the accumulation of hydroxyapatite crystals in soft tissues, leading to subsequent inflammation and discomfort. The intricate etiology of HADD is the subject of this comprehensive review, which encompasses an in-depth analysis of the four proposed pathogenic mechanisms and a deliberation on the predisposing factors that instigate the development of this disease. In order to provide a thorough understanding of the disease's progression, this manuscript delineates the stages of HADD-those preceding calcification, occurring during calcification, and following calcification-in meticulous detail. This chronology forms the basis of a complete portrayal of the evolution of HADD. Moreover, this review encompasses an examination of the radiological findings associated with HADD, furnishing an extensive discourse on imaging characteristics. The potential of HADD to mimic other diseases, thereby posing diagnostic challenges, is also articulated. The discourse continues with an investigation of HADD's differential diagnosis. This section furnishes a robust framework for distinguishing HADD from other conditions based on imaging results. To enrich the understanding of this diagnostic process, case studies illustrating real-world applications are provided. An overview of treatment modalities for HADD, including both conservative and interventional approaches, forms the concluding discussion. The pivotal role of imaging specialists in the diagnosis and management of HADD is emphasized, highlighting their vital contribution to image-guided procedures and disease monitoring.
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Affiliation(s)
- Tarek Hegazi
- Department of Radiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
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Przybylski G, Bukowski J, Kowalska W, Pilaczyńska-Cemel M, Krawiecka D. Trends from the Last Decade with Nontuberculous Mycobacteria Lung Disease (NTM-LD): Clinicians' Perspectives in Regional Center of Pulmonology in Bydgoszcz, Poland. Pathogens 2023; 12:988. [PMID: 37623948 PMCID: PMC10459785 DOI: 10.3390/pathogens12080988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Nontuberculous mycobacteria (NTM) are the cause of chronic lung disease called NTM lung disease (NTM-LD). There are about 180 known species of NTM. Nowadays the number of NTM-LD is increasing. OBJECTIVE To evaluate the clinical significance of NTM isolated from specimens and assess the frequency and clinical relevance of isolation of NTM in the Regional Center of Pulmonology in Bydgoszcz, hospital of Northern Poland. DESIGN Clinical, radiological, and microbiological data were collected from all patients from whom NTM was isolated between 2013 and 2022. Data were reviewed retrospectively. Diagnostic criteria for NTM-LD published by the American Thoracic Society (ATS) were used to determine clinical relevance. MATERIAL AND METHODS The study comprised 81,985 clinical specimens submitted for mycobacterial culture in the Department of Microbiology at the Regional Center of Pulmonology in Bydgoszcz between 2013 and 2022. Clinical specimens were processed according to the standard procedure in mycobacteria laboratories in Poland. NTM strains were identified using analysis of mycolic acids by chromatography as well as GenoType NTM-DR, GenoType Mycobacterium AS, and GenoType Mycobacterium CM. RESULTS There were 395 patients with NTM strains between 2013 and 2022. Out of them, 149 cases met the diagnostic criteria of NTM-LD and were classified as definite cases. M. kansasii (n = 77) was the most common species in the group (51.68%), followed by M. avium complex (n = 46). Patients with NTM-LD were 22-88 years old (median age was 60 years). There were 81 men and 68 women. The most common symptoms were cough, hemoptysis, and fever. Radiological X-ray images were dominated by infiltrative lesions in the upper and middle lobe of the right lung with cavities; the changes were in the upper lobe of the left lung and on both sides of the chest. They were smokers in 61%. The most common concomitant diseases were chronic obstructive pulmonary disease (COPD), diabetes mellitus, pulmonary carcinoma, and human immunodeficiency virus (HIV) infection, and other immunodeficiencies. The most common treatment was isoniazid, ethambutol, rifampicin, and ofloxacin for 18 months with a minimum of 12 months of culture negativity. CONCLUSIONS NTM-LD infections are present with other pulmonary illnesses and extrapulmonary diseases and may be connected to primary immunologic deficiencies. These diseases concern patients of all ages and have various clinical manifestations. M. kansasii and MAC are the most prevalent NTM isolates among respiratory samples in Northern Poland. In addition, an increase in MAC and a decrease in M. kansasii both in cultivation and the cause of NTM-LD were reported.
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Affiliation(s)
- Grzegorz Przybylski
- Department of Respiratory Medicine and Lung Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus in Torun, 87-100 Toruń, Poland; (W.K.); (M.P.-C.)
- Regional Center of Pulmonology in Bydgoszcz, 85-326 Bydgoszcz, Poland; (J.B.); (D.K.)
| | - Jakub Bukowski
- Regional Center of Pulmonology in Bydgoszcz, 85-326 Bydgoszcz, Poland; (J.B.); (D.K.)
| | - Weronika Kowalska
- Department of Respiratory Medicine and Lung Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus in Torun, 87-100 Toruń, Poland; (W.K.); (M.P.-C.)
| | - Marta Pilaczyńska-Cemel
- Department of Respiratory Medicine and Lung Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus in Torun, 87-100 Toruń, Poland; (W.K.); (M.P.-C.)
| | - Dorota Krawiecka
- Regional Center of Pulmonology in Bydgoszcz, 85-326 Bydgoszcz, Poland; (J.B.); (D.K.)
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Casal-Mouriño A, Álvarez-Dobaño JM, Domínguez MJ, Gude F, Toubes ME, Lado-Baleato Ó, Martínez de Alegría A, Taboada M, Riveiro V, Rodríguez-Núñez N, Lama A, Ferreiro L, Otero B, Suárez-Antelo J, Pose A, Valdés L. Development of prognostic models to estimate the probability of lung injury one year after COVID-19-related hospitalization-a prospective study. J Thorac Dis 2023; 15:2971-2983. [PMID: 37426134 PMCID: PMC10323564 DOI: 10.21037/jtd-22-1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/24/2023] [Indexed: 07/11/2023]
Abstract
Background Long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection still under study. The objectives of this study were to identify persistent pulmonary lesions 1 year after coronavirus disease 2019 (COVID-19) hospitalization and assess whether it is possible to estimate the probability that a patient develops these complications in the future. Methods A prospective study of ≥18 years old patients hospitalized for SARS-COV-2 infection who develop persistent respiratory symptoms, lung function abnormalities or have radiological findings 6-8 weeks after hospital discharge. Logistic regression models were used to identify prognostic factors associated with a higher risk of developing respiratory problems. Models performance was assessed in terms of calibration and discrimination. Results A total of 233 patients [median age 66 years [interquartile range (IQR): 56, 74]; 138 (59.2%) male] were categorized into two groups based on whether they stayed in the critical care unit (79 cases) or not (154). At the end of follow-up, 179 patients (76.8%) developed persistent respiratory symptoms, and 22 patients (9.4%) showed radiological fibrotic lesions with pulmonary function abnormalities (post-COVID-19 fibrotic pulmonary lesions). Our prognostic models created to predict persistent respiratory symptoms [post-COVID-19 functional status at initial visit (the higher the score, the higher the risk), and history of bronchial asthma] and post-COVID-19 fibrotic pulmonary lesions [female; FVC% (the higher the FVC%, the lower the probability); and critical care unit stay] one year after infection showed good (AUC 0.857; 95% CI: 0.799-0.915) and excellent performance (AUC 0.901; 95% CI: 0.837-0.964), respectively. Conclusions Constructed models show good performance in identifying patients at risk of developing lung injury one year after COVID-19-related hospitalization.
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Affiliation(s)
- Ana Casal-Mouriño
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | | | - María Jesús Domínguez
- Internal Medicine Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Francisco Gude
- Clinical Epidemiology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - María E. Toubes
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Óscar Lado-Baleato
- Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | | | - Manuel Taboada
- Anesthesia and Resuscitation Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Vanessa Riveiro
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Adriana Lama
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Lucía Ferreiro
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Borja Otero
- Esteve Teijin Company, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Juan Suárez-Antelo
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Antonio Pose
- Internal Medicine Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
- Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Esteve Teijin Company, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
| | - Luis Valdés
- Pulmonology Department, Clinical University Hospital of Santiago, Santiago de Compostela, Spain
- Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Medicine Department, University of Santiago, Santiago de Compostela, Spain
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Afanasjeva B, Afanasjevas D, Endzinienė M, Balnytė R. Characteristics of the Manifestation of Multiple Sclerosis in Children in Lithuania. Medicina (Kaunas) 2023; 59:1055. [PMID: 37374259 DOI: 10.3390/medicina59061055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Multiple sclerosis (MS) starts quite rarely in childhood, comprising just 3-10% of all diagnosed cases of MS population. The age of onset of the disease may be related to the initial phenotype and the prognosis of MS. The aim of the study is to assess the characteristics of the manifestation of MS in children. Materials and Methods: Two groups of patients were analyzed: those diagnosed with MS in childhood (0 < 18 years of age) and who developed MS in 2005-2021, and those diagnosed in adulthood (≥18 years old). The data were collected from the database of the Lithuanian University of Health Sciences Kauno Klinikos. Results: For the analysis, 105 patients were selected: 35 children (group A) and 70 adults (group B). At the onset of the disease, 62.9% of children and 70.0% of adults experienced visual disturbances (p > 0.05). Isolated symptoms were more common in children (65.7%) as compared to adults (28.6%), p < 0.001. Sensory disorders were more common in adults than in children (p < 0.001). Optic nerve and cerebral hemispheres were the most affected in group A (p < 0.05). During the first year after diagnosis, the median number of relapses in group A was higher (3, range 1-5) as compared to group B (1, range 1-2) (p < 0.001). Recovery time after a relapse was shorter in children as compared to adults (p < 0.001). Oligoclonal bands were found in 85.7% of children and in 98.6% of adults. Oligoclonal bands were less common in the childhood-onset than in the adult-onset group (p = 0.007). Conclusions: The initial symptoms of multiple sclerosis in pediatric patients usually appeared around the age of 16, with a similar frequency in boys and girls, and in most of the childhood cases the initial symptoms were limited to the dysfunction of a single part of the nervous system children usually started with visual disorders, while sensory, coordination and motor disorders were less common. The course of the disease in juvenile patients with MS was more aggressive in the first year as there were more relapses, but the functional impairment recovered faster as compared to adults.
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Affiliation(s)
- Brigita Afanasjeva
- Department of Neurology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania
- Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
| | - Dominykas Afanasjevas
- Department of Maxillofacial Surgery, Faculty of Medicine, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
| | - Milda Endzinienė
- Department of Neurology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania
- Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
| | - Renata Balnytė
- Department of Neurology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania
- Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
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12
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Padar M, Rieseberg A, Hendahewa R. Spontaneous periduodenal hematoma: a rare surgical and radiological conundrum. J Surg Case Rep 2023; 2023:rjad133. [PMID: 36926625 PMCID: PMC10014146 DOI: 10.1093/jscr/rjad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
This is a case of a 68-year-old female with spontaneous and rare periduodenal hematoma of unknown origin without any signs or symptoms of duodenal stenosis. All causes of known precipitating factors, such as trauma, intervention, anticoagulation, pancreatitis or malignant processes, were ruled out. She was managed conservatively, with a series of radiological investigations performed throughout her 7-day admission to further define stability and investigate the possible cause for the periduodenal hemorrhage. A repeat magnetic resonance imaging 4 weeks later showed near resolution of the hematoma. The underlying cause in this case remains unclear.
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Affiliation(s)
- Maria Padar
- Surgical Department, Caboolture Hospital, Caboolture, QLD Australia
| | - Amie Rieseberg
- Radiology Department, Caboolture Hospital, Caboolture, QLD, Australia
| | - Rasika Hendahewa
- Surgical Department, Caboolture Hospital, Caboolture, QLD Australia
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13
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Zhang S, Luo Y, Zhao Y, Zhu F, Jiang X, Wang X, Mo T, Zeng H. Prognostic analysis in children with focal cortical dysplasia II undergoing epilepsy surgery: Clinical and radiological factors. Front Neurol 2023; 14:1123429. [PMID: 36949857 PMCID: PMC10025379 DOI: 10.3389/fneur.2023.1123429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the value of clinical profiles and radiological findings in assessing postsurgical outcomes in children with focal cortical dysplasia (FCD) II while exploring prognostic predictors of this disease. METHODS We retrospectively reviewed 50 patients with postoperative pathologically confirmed FCD II from January 2016 to June 2021. The clinical profiles and preoperative radiological findings were measured and analyzed. The patients were classified into four classes based on the Engel Class Outcome System at the last follow-up. For the analysis, the patients were divided into two categories based on Engel I and Engel II-IV, namely, seizure-free and non-seizure-free groups. Qualitative and quantitative factors were subsequently compared by groups using comparative statistics. Receiver operating characteristic (ROC) curves were used to identify the predictors of prognosis in children with FCD II. RESULTS Thirty-seven patients (74%) had Engel class I outcomes. The minimum postsurgical follow-up was 1 year. At the epilepsy onset, patients who attained seizure freedom were older and less likely to have no apparent lesions on the preoperative MRI ("MRI-negative"). The non-seizure-free group exhibited a higher gray matter signal intensity ratio (GR) on 3D T1-MPRAGE images (p = 0.006), with a lower GR on T2WI images (p = 0.003) and FLAIR images (p = 0.032). The ROC curve indicated that the model that combined the GR value of all MRI sequences (AUC, 0.87; 95% CI, 0.77-0.97; p < 0.001; 86% sensitivity, 85% specificity) was able to predict prognosis accurately. CONCLUSION A lower age at the onset or the MRI-negative finding of FCD lesions suggests a poor prognosis for children with FCD II. The model consisting of GR values from three MRI sequences facilitates the prognostic assessment of FCD II patients with subtle MRI abnormalities to prevent worse outcomes.
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Affiliation(s)
- Siqi Zhang
- Shantou University Medical College, Shantou University, Shantou, China
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Yi Luo
- Shantou University Medical College, Shantou University, Shantou, China
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Yilin Zhao
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Fengjun Zhu
- Department of Epilepsy Surgical Department, Shenzhen Children's Hospital, Shenzhen, China
| | - Xianping Jiang
- Department of Pathology, Shenzhen Children's Hospital, Shenzhen, China
| | - Xiaoyu Wang
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Tong Mo
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
| | - Hongwu Zeng
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
- *Correspondence: Hongwu Zeng
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14
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Abstract
Branchial cleft cysts (BCCs) are congenital anomalies that can be found in children and young adults. The exact incidence of these anomalies is unknown as the diagnosis may be missed. Branchial cleft cysts can present in a variety of locations depending on the cleft they are derived from. Regardless of location, branchial cleft cysts are rather benign. However, a variety of complications can arise due to infection, and infections are often recurrent. Diagnosis may occur incidentally on imaging studies as such studies are often performed to rule out a variety of complications from infections alone. Treatment includes first treating any infection and any such complications that exist, followed by surgical excision. Surgical excision is performed to prevent the recurrence of infection. A case of a 14-year-old female with a painful swollen throat, trismus, and difficulty swallowing is reported.
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15
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Abstract
Mycotic thoracic aortic aneurysm (MTAA) is an aneurysm of the aorta caused by infection of the vessel tissue through microbial inoculation of the diseased aortic endothelium. It is most commonly caused by bacteria. Rarely, it can be caused by fungi. However, viral aortic aneurysm has never been reported. Depending on the area and time period investigated, the infections organism discovered may vary significantly. Little is known about the natural history of MTAA due to its rarity. It is not known if they follow the same pattern as other TAAs. However, it is unclear whether MTAA follows a similar clinical course. The combination of clinical presentation, laboratory results, and radiographic results are used to make the diagnosis of MTAA. Treatment of MTAA is complex since patients frequently present at a late stage, frequently with fulminant sepsis, as well as concomitant complications such as aneurysm rupture. While medical treatment, including antibiotics, is recommended, surgery is still the mainstay of management. Surgery to treat MTAA is complicated and carries a high risk of morbidity and mortality and includes both open repairs and endovascular ones. In this review, we explore the etiology, pathogenesis, clinical presentations, diagnostic modalities as well as treatment management available for MTAA.
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16
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Muacevic A, Adler JR, Abubakar A, Dhinsa BS. Computed Tomography Scan Architectural Measurements in Adult Foot and Ankle Surgery: A Narrative Review for Orthopaedic Trainees. Cureus 2022; 14:e32039. [PMID: 36600866 PMCID: PMC9801486 DOI: 10.7759/cureus.32039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
CT scan plays an important role in adult foot and ankle surgery. Plain radiographs are usually the first-line imaging modality for assessing foot and ankle bone and joint architectural abnormalities. However, despite the fact that a CT scan is more expensive and associated with higher radiation exposure, it offers better imaging quality for the assessment of bony lesions in orthopaedics and trauma. Evidence has shown that more accurate measurements can be obtained from a CT scan compared to plain radiographs. Weight-bearing multi-detection CT scanning goes the extra mile by providing a more detailed assessment, especially for intra-articular fractures, and mirrors the real-life foot and ankle dynamics compared to conventional non-weight-bearing CT scans. It also has a relatively lower radiation dose compared to conventional CT scans. CT scan is the best modality for assessing bony lesions whereas MRI is better for soft tissue pathology. An understanding of the role of CT scan in the anatomical assessment of the foot and ankle will help improve communication between orthopaedic surgeons, radiologists, and radiographers. A thorough understanding of when to use a CT scan compared to the other imaging modalities will also lead to better surgical outcomes, reduced cost, and reduced risk from radiation exposure. This review article analyzes the role of CT in assessing relevant radiographic architectural measurements for diagnosis and surgical planning in adult foot and ankle surgery.
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17
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de Moura LV, Mattjie C, Dartora CM, Barros RC, Marques da Silva AM. Explainable Machine Learning for COVID-19 Pneumonia Classification With Texture-Based Features Extraction in Chest Radiography. Front Digit Health 2022; 3:662343. [PMID: 35112097 PMCID: PMC8801500 DOI: 10.3389/fdgth.2021.662343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 11/29/2021] [Indexed: 12/18/2022] Open
Abstract
Both reverse transcription-PCR (RT-PCR) and chest X-rays are used for the diagnosis of the coronavirus disease-2019 (COVID-19). However, COVID-19 pneumonia does not have a defined set of radiological findings. Our work aims to investigate radiomic features and classification models to differentiate chest X-ray images of COVID-19-based pneumonia and other types of lung patterns. The goal is to provide grounds for understanding the distinctive COVID-19 radiographic texture features using supervised ensemble machine learning methods based on trees through the interpretable Shapley Additive Explanations (SHAP) approach. We use 2,611 COVID-19 chest X-ray images and 2,611 non-COVID-19 chest X-rays. After segmenting the lung in three zones and laterally, a histogram normalization is applied, and radiomic features are extracted. SHAP recursive feature elimination with cross-validation is used to select features. Hyperparameter optimization of XGBoost and Random Forest ensemble tree models is applied using random search. The best classification model was XGBoost, with an accuracy of 0.82 and a sensitivity of 0.82. The explainable model showed the importance of the middle left and superior right lung zones in classifying COVID-19 pneumonia from other lung patterns.
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Affiliation(s)
- Luís Vinícius de Moura
- Medical Image Computing Laboratory, School of Technology, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Christian Mattjie
- Medical Image Computing Laboratory, School of Technology, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Caroline Machado Dartora
- Medical Image Computing Laboratory, School of Technology, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Rodrigo C. Barros
- Machine Learning Theory and Applications Lab, School of Technology, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Ana Maria Marques da Silva
- Medical Image Computing Laboratory, School of Technology, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
- Graduate Program in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
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18
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Sun H, Deng M, Chen W, Liu M, Dai H, Wang C. Graft dysfunction and rejection of lung transplant, a review on diagnosis and management. Clin Respir J 2022; 16:5-12. [PMID: 35080130 PMCID: PMC9060084 DOI: 10.1111/crj.13471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/22/2021] [Indexed: 01/01/2023]
Abstract
Introduction Lung transplantation has proven to be an effective treatment option for end‐stage lung disease. However, early and late complications following transplantation remain significant causes of high mortality. Objectives In this review, we focus on the time of onset in primary graft dysfunction and rejection complications, as well as emphasize the role of imaging manifestations and pathological features in early diagnosis, thus assisting clinicians in the early detection and treatment of posttransplant complications and improving patient quality of life and survival. Data source We searched electronic databases such as PubMed, Web of Science, and EMBASE. We used the following search terms: lung transplantation complications, primary graft dysfunction, acute rejection, chronic lung allograft dysfunction, radiological findings, and diagnosis and treatment. Conclusion Primary graft dysfunction, surgical complications, immune rejection, infections, and neoplasms represent major posttransplant complications. As the main posttransplant survival limitation, chronic lung allograft dysfunction has a characteristic imaging presentation; nevertheless, the clinical and imaging manifestations are often complex and overlap, so it is essential to understand the temporal evolution of these complications to narrow the differential diagnosis for early treatment to improve prognosis. Early and late complications after lung transplantation remain essential causes of high mortality. In this review, we focus on the timing of the onset of primary graft dysfunction and rejection complications and highlight the role of imaging manifestations and clinicopathologic features in early diagnosis, thus assisting clinicians in the early detection and treatment of posttransplant complications and improving patient quality of life and survival.
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Affiliation(s)
- Haishuang Sun
- Department of Respiratory Medicine, The First Hospital of Jilin University, Jilin University, Changchun, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing, China.,Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China
| | - Mei Deng
- Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China.,Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Wenhui Chen
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing, China.,Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Huaping Dai
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing, China.,Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China
| | - Chen Wang
- Department of Respiratory Medicine, The First Hospital of Jilin University, Jilin University, Changchun, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; National Center for Respiratory Medicine; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing, China.,Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China
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19
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Ma Z, Reich DS, Dembling S, Duyn JH, Koretsky AP. Outlier detection in multimodal MRI identifies rare individual phenotypes among more than 15,000 brains. Hum Brain Mapp 2021; 43:1766-1782. [PMID: 34957633 PMCID: PMC8886649 DOI: 10.1002/hbm.25756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/25/2021] [Accepted: 12/04/2021] [Indexed: 01/11/2023] Open
Abstract
Outliers in neuroimaging represent spurious data or the data of unusual phenotypes that deserve special attention such as clinical follow‐up. Outliers have usually been detected in a supervised or semi‐supervised manner for labeled neuroimaging cohorts. There has been much less work using unsupervised outlier detection on large unlabeled cohorts like the UK Biobank brain imaging dataset. Given its large sample size, rare imaging phenotypes within this unique cohort are of interest, as they are often clinically relevant and could be informative for discovering new processes. Here, we developed a two‐level outlier detection and screening methodology to characterize individual outliers from the multimodal MRI dataset of more than 15,000 UK Biobank subjects. In primary screening, using brain ventricles, white matter, cortical thickness, and functional connectivity‐based imaging phenotypes, every subject was parameterized with an outlier score per imaging phenotype. Outlier scores of these imaging phenotypes had good‐to‐excellent test–retest reliability, with the exception of resting‐state functional connectivity (RSFC). Due to the low reliability of RSFC outlier scores, RSFC outliers were excluded from further individual‐level outlier screening. In secondary screening, the extreme outliers (1,026 subjects) were examined individually, and those arising from data collection/processing errors were eliminated. A representative subgroup of 120 subjects from the remaining non‐artifactual outliers were radiologically reviewed, and radiological findings were identified in 97.5% of them. This study establishes an unsupervised framework for investigating rare individual imaging phenotypes within a large neuroimaging cohort.
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Affiliation(s)
- Zhiwei Ma
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Daniel S Reich
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Sarah Dembling
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeff H Duyn
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Alan P Koretsky
- Laboratory of Functional and Molecular Imaging, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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20
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Abstract
Coronavirus disease 2019 (COVID-19) caused by the new [novel] coronavirus, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a pandemic with exceeding 72 million cases and 1.2 million deaths by the end of November 2020. We aimed to evaluate clinical, laboratory, and radiology findings of COVID-19 in children as reported worldwide and thereby to increase the clinical knowledge about the disease. Bibliographic searches were conducted in December 2020 using PubMed and Google Scholar. The search was limited to children [below 18 years of age]. The search strategy yielded a total of 336 potential articles but finally a total of 25 valid studies covering a total of 2446 (China: 1109, Europe: 663, North America: 674) pediatric patients. In the studies covered by this review, it was observed that the median age was calculated at various values between the ages of 1 and 7 years. In the studies, overall rate of the asymptomatic patients was 24.8% (ranging between 10.7 and 56.6). Acute upper respiratory tract infection (URTI) [mild disease] was observed in 40.7 (ranging between 22 and 50.6%), mild pneumonia in 27% (ranging between 9.5 and 40.6%), and severe pneumonia in 5.3% (ranging between 1.9 and 10.6%). A total of 3% (ranging between 0.7 and 5.1%) of the patients had critical severity. Among the most common clinical symptoms and findings; 61.7% (ranging between 57.4 and 64.3%) of the patients had fever, 53.2% (ranging between 30.6 and 75.1%) had cough, 16.8% (ranging between 4.6 and 27.2%) had diarrhea or nausea, and 15% had lymphopenia. Abnormal radiological findings were detected in 47.2 of the children with COVID-19 and ground glass opacity was in 22.2%. COVID-19 manifests milder and the clinical signs and symptoms vary widely in children. Laboratory and radiological findings of COVID-19 in pediatric patients are not mostly disease-specific, except lymphopenia may have a limited value, and ground glass opacity may have a significant diagnostic value.
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Affiliation(s)
- S Simsek Uzunoglu
- Department of Pediatrics, Istanbul Tuzla State Hospital, Istanbul, Turkey
| | - H Akca
- Health Directorate, Public Health Directorate, Siirt, Turkey
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21
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Bhatia A, Vidad AR, Mehra D, Shah H, Ogunjemilusi O. Multifocal Post-Traumatic Myositis Ossificans Circumscripta in a Young Male Following a Motor Vehicle Accident: A Review of Imaging and Clinical Presentation. Cureus 2021; 13:e14328. [PMID: 33968536 PMCID: PMC8102051 DOI: 10.7759/cureus.14328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Traumatic myositis ossificans (MO) circumscripta is an uncommon nonhereditary pathophysiological result of muscular trauma that is detected by radiographic imaging three to four weeks following initial trauma. It is responsible for great global morbidity, with symptoms of prolonged pain, diminished flexibility, and stiffness. There is frequently a delay in diagnosis due to the generalized symptoms and varying radiographic presentation. The goal of therapy is to rule out serious complications (such as soft tissue sarcoma) and to restore strength and range of motion (ROM) as soon as possible. Here we detail the case of a 32-year-old male with a delayed diagnosis of MO who presented to the hospital with left lower extremity pain and swelling following a motor vehicle accident (MVA) that occurred one month prior.
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Affiliation(s)
- Ahjay Bhatia
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Plantation, USA
| | - Ashley Ryan Vidad
- Family Medicine, Internal Medicine, Surgery, Pathology, Gynecology, Infectious Disease, Neurology, Orthopedics, Gastroenterology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Divy Mehra
- Ophthalmology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Himadri Shah
- College of Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA
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22
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Valencia MR, Miyazaki H, Ito M, Nishimura K, Kakizaki H, Takahashi Y. Radiological findings of orbital blowout fractures: a review. Orbit 2021; 40:98-109. [PMID: 32212885 DOI: 10.1080/01676830.2020.1744670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/11/2020] [Indexed: 06/10/2023]
Abstract
Purpose: To summarize the radiological findings in patients with orbital blowout fractures. Methods: We reviewed the published literature on radiological findings of orbital blowout fractures that were searched on PubMed and included our own radiologic findings on patients with orbital blowout fractures that were seen at our hospital. Results: Radiologic examination reveals a variety of findings in each case. However, common radiological findings of orbital blowout fractures include comminuted/unhinged, hinged, and linear fractures. These fractures are usually located in the orbital floor medial to the infraorbital nerve and in the medial orbital wall. Orbital fat is frequently herniated in the paranasal sinus or incarcerated at the fracture site. Orbital emphysema and haematoma sometimes occur as complications. Conclusions: This review will provide surgeons with a better understanding of various radiological findings, which could be helpful in the management of patients with orbital blowout fracture.
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Affiliation(s)
- Ma ReginaPaula Valencia
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital , Aichi, Japan
- Section of Orbital Surgery and Section of Oculoplastic and Lacrimal Surgery, The Medical City Eye and Vision Institute , Metro Manila, Philippines
| | - Hidetaka Miyazaki
- Department of Oral and Maxillofacial Surgery, Graduate School Tokyo Medical and Dental University , Tokyo, Japan
| | - Makoto Ito
- Departments of Radiology, Aichi Medical University , Aichi, Japan
| | | | - Hirohiko Kakizaki
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital , Aichi, Japan
| | - Yasuhiro Takahashi
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital , Aichi, Japan
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23
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Spinato G, Gaudioso P, Falcioni M, Mosto MCD, Cocuzza S, Maniaci A, Fabbris C, Politi D, Volo T, Ferri E, Cristalli G, Mannelli L, Salvatore M, Rizzo PB, Frezza D. Giant Epidermoid Cyst of Posterior Fossa-Our Experience and Literature Review. Dose Response 2021; 19:15593258211002061. [PMID: 33815017 PMCID: PMC7995313 DOI: 10.1177/15593258211002061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction. Intracranial epidermoid cysts are the most frequent congenital intracranial lesion. They rare and benign tumors that can present in different clinical situations depending on location and extension of the disease. Diagnosis is obtained with radiological imaging with RM and non-enhanced TC as elective investigating methods. Elective treatment is surgery, based on total/subtotal excision sparring healthy neurovascular structures, considering the benign nature of this lesion. Case Report. In this study we present the case of a 79-year-old woman affected by recidivist epidermal cyst of the posterior fossa. Clinical presentation was characterized by positional subjective vertigo, intense headache localized in the right part of the head increased by Valsalva maneuver and retroarticular subcutaneous swelling. Radiological investigation found a giant epidemoid cyst of the posterior fossa (8,4 x 4,8 x 5,8 cm), treated with surgery. In the postoperative, the patient was fine and no neurological deficit has been encounterd. REVIEW. In this study, we present a review of the literature regarding giant epidermoid cysts of posterior fossa. Only 11 cases were reported before ours, which actually is one of the largest ever described.
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Affiliation(s)
- Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy.,Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padova, Padova, Italy
| | - Piergiorgio Gaudioso
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Maurizio Falcioni
- Department of Head and Neck, University Hospital of Parma, Parma, Italy
| | - Maria Cristina Da Mosto
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section; University of Catania, Catania, Sicily, Italy
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section; University of Catania, Catania, Sicily, Italy
| | - Cristoforo Fabbris
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Doriano Politi
- Functional Department of Head and Neck, ENT Unit, ULSS3, Venice-Mestre Hospital, Venice, Italy
| | - Tiziana Volo
- Functional Department of Head and Neck, ENT Unit, ULSS3, Venice-Mestre Hospital, Venice, Italy
| | | | | | | | | | - Paolo Boscolo Rizzo
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Daniele Frezza
- Otosurgery Unit, ULSS2, Treviso Hospital, Treviso, Italy
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Ferlito S, Maniaci A, Di Luca M, Grillo C, Mannelli L, Salvatore M, La Mantia I, Spinato G, Cocuzza S. From Uncommon Infection to Multi-Cranial Palsy: Malignant External Otitis Insights. Dose Response 2020; 18:1559325820963910. [PMID: 33414694 PMCID: PMC7750775 DOI: 10.1177/1559325820963910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: The progression of the otitic infectious process toward diseases of
particular severity is often unpredictable, just as it is challenging to
manage the patient over time, even after the apparent resolution of the
disease. We aim to define a radiological reading key that allows us to
correctly and promptly treat the disease, avoiding the possible severe
complications. Methods: We conducted a retrospective study of 13 cases of basal cranial osteomyelitis
(SBO) due to malignant external otitis, by the ENT Department of the
University of Catania. Through a standardized approach and following the
latest guidelines, we have evaluated all patients performing a standardized
and personalized radiological protocol according to the stage of the
patient’s pathology and modulating the treatment consequently. Results: Clinical signs have been observed such as otorrhea (100%), otalgia in 13/13
patients (100%), granulations in external auditory canal (100%),
preauricular cellulitis in 9/13 patients (69%) headache 6/13 cases (46%),
dysphonia 4/13 cases (31%). HRCT of the temporal bone proved useful in
identifying even minimal bone lesions in 13/13 (100%) while improving MRI in
vascular and nervous involvement, although in 1/13 patient with nerve palsy
clinical symptomatology preceded radiological evidence. The 99mTc 3-phase
planar bone scintigraphy was positive for SBO in 9/13 cases (69%) during the
initial phase and, in 100% of the cases in images delayed to 2-3 hours.
Subsequent checks up to 1 year, using the Ga 67 scintigraphy, excluded the
presence of recurrences in 100% of patients. Conclusion: The osteomyelitis of the base of the skull is a severe complication of
malignant external otitis, often not always easily diagnosed. Recurrence can
occur up to 1 year after stopping therapy. Imaging techniques such as Tc and
MRI are relevant for the initial diagnostic approach and the staging of the
pathology and its complications. Nuclear medicine imaging plays a
fundamental role in the evaluation of related osteoblastic activity,
especially in the remission phase of the disease.
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Affiliation(s)
- Salvatore Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - Milena Di Luca
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - Calogero Grillo
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | | | | | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy.,Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padova, Padova, Italy
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
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25
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Ocak Serin S, Isiklar A, Cakit H, Basat SU. A case of tuberculosis presented by obstructive jaundice tuberculosis-related mechanical icterus. J Infect Dev Ctries 2020; 14:1221-1224. [PMID: 33175721 DOI: 10.3855/jidc.12187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/24/2020] [Indexed: 10/31/2022] Open
Abstract
Obstructive jaundice caused by tuberculosis lymphadenitis is a rare condition. It can mimic clinical and radiological findings of hepatobiliary malignancies. The authors report a 24-year-old male patient who presented with abdominal pain, fever and jaundice for the last two weeks. It was found that cholestasis enzymes were increased by 2-3 fold and direct bilirubin was 6.13 mg/dL. Imaging studies revealed conglomerated lymph nodes with some cavitary lesions and dilated intrahepatic biliary canal secondary to compression by the lymph nodes. Tuberculosis was found to be positive in the polymerase chain reaction analysis of the aspirate that was obtained in the guidance of imaging studies. M. tuberculosis complex was isolated from mycobacterial culture. Anti-tuberculosis treatment was initiated. Clinical, laboratory and radiological findings completely resolved by medical therapy alone. Tuberculosis lymphadenitis should be kept in mind in cases presenting with obstructive jaundice in endemic areas and interventional diagnostic techniques should be preferred in eligible patients.
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Affiliation(s)
- Sibel Ocak Serin
- Department of Internal Medicine, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul,Turkey.
| | - Aysun Isiklar
- Department of Internal Medicine, Martyr Prof. İlhan Varank Sancaktepe Training and Research Hospital, Istanbul,Turkey.
| | - Hakan Cakit
- Department of General Surgery, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul,Turkey.
| | - Sema Ucak Basat
- Department of Internal Medicine, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul,Turkey.
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26
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Tekin L, Dinç Elibol F. Is There any Relationship Between Granulomatous Mastitis and Seasons? An Analysis of Seasonal Frequency, Clinical, and Radiologic Findings. Eur J Breast Health 2020; 16:235-243. [PMID: 33062962 DOI: 10.5152/ejbh.2020.5897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/18/2020] [Indexed: 11/22/2022]
Abstract
Objective Idiopathic granulomatous mastitis (IGM) is a rare, resistant, and recurrent benign disease of the breast. IGM can be clinically and radiologically confused with breast carcinoma, and core needle biopsy is needed to diagnose. The etiology and pathogenesis of IGM have not been fully explained. This premenopausal disease may be associated with pregnancy, breastfeeding, autoimmune processes, inflammation, and oral contraceptives. However, there is no study on whether there is a seasonal relationship. Materials and Methods From January 2015 to January 2020, the seasonal relationship of IGM was evaluated in 37 females aged between 25-49. Results Although all cases were distributed between September and May, there was no statistically significant result in the relationship with the season. US is the main modality in the diagnosis of this condition which only provides an accurate pre-diagnosis approach with the typical USG appearance features. Some MRI features may help us to distinguish IGM from breast malignities. Conclusion IGM is a rare chronic non-specific inflammatory lesion of the breast, which can be confused with benign and malignant breast diseases in both clinical and radiologic aspects. To understand the etiology of this condition better, the seasonal connection needs to be evaluated in larger patient groups.
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Affiliation(s)
- Leyla Tekin
- Department of Pathology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Funda Dinç Elibol
- Department of Radiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
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27
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dos Anjos LRB, Parreira PL, Torres PPTS, Kipnis A, Junqueira-Kipnis AP, Rabahi MF. Non-tuberculous mycobacterial lung disease: a brief review focusing on radiological findings. Rev Soc Bras Med Trop 2020; 53:e20200241. [PMID: 32935786 PMCID: PMC7491562 DOI: 10.1590/0037-8682-0241-2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022] Open
Abstract
The incidence and prevalence of lung disease caused by non-tuberculous mycobacteria (NTM-LD) has increased worldwide and its diagnosis represents a complex challenge. This article aims to review the tomographic findings of NTM-LD in order to facilitate their definitive diagnosis. The search for publications on the subject was performed in PMC and Scielo using the keywords 'non-tuberculous mycobacteria', 'lung disease and computed tomography (CT)' and 'radiological findings'. The radiological findings described by 18 articles on mycobacteriosis were reviewed. In addition, CT images of patients diagnosed with NTM-LD were considered to represent radiological findings. Eighteen publications were used whose main findings were pulmonary cavitation (88.9%), bronchiectasis (77.8%), and pulmonary nodules (55.6%). Despite the overlaps in imaging-related analysis of myocobacterioses with other pulmonary infections, such as tuberculosis, the predominant involvement of the middle lobe and lingula should raise suspicion for NTM-LD.
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Affiliation(s)
- Laura Raniere Borges dos Anjos
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Goiânia, GO, Brasil
| | - Poliana Lopes Parreira
- Universidade Federal de Goiás, Faculdade de Medicina, Departamento de Clínica Médica, Goiânia, GO, Brasil
| | | | - André Kipnis
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Goiânia, GO, Brasil
| | - Ana Paula Junqueira-Kipnis
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Goiânia, GO, Brasil
| | - Marcelo Fouad Rabahi
- Universidade Federal de Goiás, Faculdade de Medicina, Departamento de Clínica Médica, Goiânia, GO, Brasil
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28
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Tahmasebi S, Khosh E, Esmaeilzadeh A. The outlook for diagnostic purposes of the 2019-novel coronavirus disease. J Cell Physiol 2020; 235:9211-9229. [PMID: 32452050 PMCID: PMC7283732 DOI: 10.1002/jcp.29804] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 01/08/2023]
Abstract
At the end of December 2019, a novel acute respiratory syndrome coronavirus 2 (SARS‐CoV2) appeared as the third unheard of outbreak of human coronavirus infection in the 21st century. First, in Wuhan, China, the novel SARS‐CoV2 was named by the World Health Organization (WHO), as 2019‐nCOV (COVID‐19), and spread extremely all over the world. SARS‐CoV2 is transmitted to individuals by human‐to‐human transmission leading to severe viral pneumonia and respiratory system injury. SARS‐CoV2 elicits infections from the common cold to severe conditions accompanied by lung injury, acute respiratory distress syndrome, and other organ destruction. There is a possibility of virus transmission from asymptomatic cases as active carriers, in addition to symptomatic ones, which is a crucial crisis of COVID‐19 that should be considered. Hence, paying more attention to the accurate and immediate diagnosis of suspected and infected cases can be a great help in preventing the rapid spread of the virus, improving the disease prognosis, and controlling the pandemic. In this review, we provide a comprehensive and up‐to‐date overview of the different types of Clinical and Para‐clinical diagnostic methods and their practical features, which can help understand better the applications and capacities of various diagnostic approaches for COVID‐19 infected cases.
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Affiliation(s)
- Safa Tahmasebi
- Department of Immunology, Health Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Khosh
- Department of Immunology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Abdolreza Esmaeilzadeh
- Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran.,Cancer Gene Therapy Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
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29
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Onishi T, Yasuda M, Koida A, Inui TA, Okamoto S, Hirano S. A Case of Primary Systemic Amyloidosis Involving the Sinonasal Tract. Ear Nose Throat J 2020; 100:NP397-NP401. [PMID: 32364447 DOI: 10.1177/0145561320922719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We present a case of primary systemic amyloidosis diagnosed by endoscopic sinus surgery. A 75-year-old woman had blurred vision in her left eye; computed tomography and magnetic resonance imaging showed shadows of the bilateral paranasal sinuses. Endoscopic sinus surgery was performed, and amyloidosis was diagnosed by histopathology. She had previously been diagnosed with amyloidosis of the stomach, and therefore, she was diagnosed with primary systemic amyloidosis. A systemic workup for additional amyloid deposits revealed no evidence of other diseases. The patient remained under follow-up without further treatment, as no further amyloid deposition or progression of the lesions was seen. Amyloidosis is a rare condition characterized by the deposition of abnormal protein filaments in the extracellular tissue. Generally, systemic amyloidosis does not involve the head and neck region, and the presence of amyloid in the nasal and paranasal sinus mucosa is more likely to be indicative of a localized process. However, in our patient, the lesions were located in both the sinonasal tract and the stomach, indicating systemic amyloidosis. To our knowledge, there have been no previous reports of systemic amyloidosis involving the sinonasal tract, and therefore, we consider this case to be extremely rare.
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Affiliation(s)
- Toshinori Onishi
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Makoto Yasuda
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsuhide Koida
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Taka-Aki Inui
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shota Okamoto
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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30
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Abstract
After its origin in Wuhan, China, coronavirus related respiratory illness spread across the globe, being declared as a pandemic by WHO on March 13, 2020. Because it is acquired via respiratory droplets, community spread is responsible for the recent global crisis. The current diagnostic options include real-time polymerase chain reaction (RT-PCR) and a few serology tests, including but not limited to the recently approved five minutes serology tests. The disease presents as a lower respiratory tract illness. Anecdotal experiences have shown that imaging characteristics are crucial to diagnosis as radiological evidence of disease appears prior to clinical manifestations and tends to evolve over time, which can be useful in predicting the stage of the disease. CT scan is more sensitive than a chest X-ray in highlighting these changes.
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Affiliation(s)
- Sahar Fatima
- Critical Care, Houston Methodist Hospital, Houston, USA
| | - Iqbal Ratnani
- Critical Care Medicine, Debakey Heart and Vascular Center, Houston, USA
| | - Maha Husain
- Internal Medicine, Dow International Medical College, Karachi, PAK
| | - Salim Surani
- Internal Medicine, Texas A&M Health Science Center, Bryan, USA.,Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA.,Internal Medicine, University of North Texas, Dallas, USA
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31
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Kohno S, Isoda H, Ono A, Furuta A, Taura K, Shibata T, Togashi K. Portal Vein Embolization: Radiological Findings Predicting Future Liver Remnant Hypertrophy. AJR Am J Roentgenol 2020; 214:687-93. [PMID: 31642696 DOI: 10.2214/AJR.19.21440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE. The purpose of this article is to evaluate the radiologic findings predicting the future liver remnant hypertrophy ratio after portal vein embolization of the right branch. MATERIALS AND METHODS. The associations between the radiologic findings and the future liver remnant hypertrophy ratio for 79 patients who underwent portal vein embolization of the right branch between July 2007 and April 2017 were retrospectively analyzed. Multiple linear regression was performed to adjust for potential confounders, and the volume ratio of the right lobe anterior segment, number of proximal small branches from the right anterior and posterior portal veins, transient hepatic parenchymal enhancement, portal vein invasion, and variants of main portal vein anatomy were evaluated. The potential confounders were age, ratio of future liver remnant hypertrophy to total liver volume, indocyanine green clearance rate, maximum serum total bilirubin before portal vein embolization, and history of chemotherapy. RESULTS. Statistically significant associations were found between the future liver remnant hypertrophy ratio and the number of proximal small branches from the right anterior and posterior portal veins (p < 0.001), transient hepatic parenchymal enhancement (p < 0.001), portal vein invasion (p = 0.017), and variants of main portal vein anatomy (p = 0.048). The mean future liver remnant hypertrophy rate was 51.0% (n = 16) in patients without the radiologic findings showing statistically significant differences, and 25.8% (n = 63) in patients with at least one significant finding. CONCLUSION. When added to previously reported factors, the radiologic findings identified can help determine the indications for portal vein embolization and novel strategies for major hepatectomy.
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32
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Durhan G, Önder Ö, Azizova A, Karakaya J, Kösemehmetoğlu K, Akpınar MG, Demirkazık F. Can Radiologist and Pathologist Reach The Truth Together in The Diagnosis of Benign Fibroepithelial Lesions? Eur J Breast Health 2019; 15:176-182. [PMID: 31312794 DOI: 10.5152/ejbh.2019.4656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/16/2019] [Indexed: 11/22/2022]
Abstract
Objective Benign fibroepithelial lesions (BFL) lesions of the breast are various and predominantly benign, although a few can be locally aggressive. Definitive diagnosis of some BFL can be challenging from core needle biopsy (CNB). Radiological findings can help guide the management of the lesions. The aim of this study was to investigate the accuracy rate of CNB results and evaluate the radiological findings of the most common BFL according to the final excision pathology results. The secondary aim was to assess the contribution of the imaging findings to CNB results. Materials and Methods A retrospective review was made of 266 patients diagnosed with suspicious BFL, conventional fibroadenoma, complex fibroadenoma, cellular fibroadenoma and benign phyllodes tumor (PT). The study included 132 patients who underwent surgical excision. The radiological and histopathological findings were evaluated. Results While 66 patients were diagnosed with more descriptive results on CNB, the other 66 patients were diagnosed with suspicious BFL. Agreement between CNB and excisional pathology was good, when CNB provided a definite diagnosis. While conventional and complex fibroadenoma were observed to have hypo or normal vascularity, cellular fibroadenoma and PT showed hypervascularity. Oval shaped and homogeneous internal echo pattern were significantly associated with conventional fibroadenoma. A heterogeneous internal echo pattern was seen in complex fibroadenomas and PT. Conclusion CNB often reaches the correct diagnosis alone when it gives a definite diagnosis. The radiological findings which help in the differentiation of BFL are hypervascularity, oval shape and internal heterogeneity. More accurate results can be obtained when histopathological and radiological findings are evaluated together.
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Affiliation(s)
- Gamze Durhan
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ömer Önder
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aynur Azizova
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Kemal Kösemehmetoğlu
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | - Figen Demirkazık
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
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33
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Durhan G, Azizova A, Önder Ö, Kösemehmetoğlu K, Karakaya J, Akpınar MG, Demirkazık F, Üner A. Imaging Findings and Clinicopathological Correlation of Breast Cancer in Women under 40 Years Old. Eur J Breast Health 2019; 15:147-152. [PMID: 31312789 DOI: 10.5152/ejbh.2019.4606] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/06/2019] [Indexed: 12/13/2022]
Abstract
Objective The aim of this study was to evaluate the clinical, imaging and histopathological features of breast cancer in patients aged under 40 years of age. The relationship between radiological characteristics and histopathological features was also investigated. Materials and Methods The study included 131 patients aged under 40 years, diagnosed pathologically with breast cancer. A retrospective evaluation was made of the imaging and clinicopathological findings and the relationship between pathological and imaging findings was investigated. Results Most of the cancers were detected from clinical symptoms, especially a palpable mass (76.3%). The most common histological type of tumor was invasive ductal carcinoma and 64.8% of the tumors were high grade tumors. The predominant features were irregular borders (92.4%), microlobulated-angulated contours (43.5%), hypo-homogeneous internal echogenicity (80.9%) on ultrasonography, and the presence of a mass (41.2%) and suspicious microcalcifications (40.2%) on mammography. Magnetic resonance imaging commonly showed mass enhancement (66.7%) with type 2 or 3 dynamic curve (92.6%). High-grade tumors were associated with posterior acoustic enhancement (p: 0.03) while low-grade tumors presented with spiculated margins more than high grade tumors (p: 0.04). Conclusion Breast cancer in women aged under 40 years usually presents with a self-detected palpable mass and can show different imaging findings according to the histological grade. Ultrasonography is the main modality for the diagnosis of breast cancer in young women, but mammography and magnetic resonance imaging can help in both diagnosis and evaluation of the extent of disease.
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Affiliation(s)
- Gamze Durhan
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aynur Azizova
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ömer Önder
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Kemal Kösemehmetoğlu
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | | | - Figen Demirkazık
- Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ayşegül Üner
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
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34
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Bruguier C, Genet P, Zerlauth JB, Dédouit F, Grimm J, Meuli R, Fracasso T, Grabherr S. Neck-MRI experience for investigation of survived strangulation victims. Forensic Sci Res 2019; 5:113-118. [PMID: 32939427 PMCID: PMC7476612 DOI: 10.1080/20961790.2019.1592314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 11/23/2022] Open
Abstract
For the medicolegal evaluation of victims of survived strangulation, a neck-magnetic resonance imaging (MRI) can be performed for assessing lesions in the inner soft tissues (fat, muscles or lymph nodes, for example). In our institute, such MRI examinations have been performed for a test period of 4 years with the aim of evaluating the use of this tool by forensic pathologists and identifying medicolegal indicators for the performance of neck-MRI in surviving victims of strangulation. We retrospectively reviewed medicolegal reports from all victims examined during the test period. We extracted objective lesions (e.g. petechiae, bruising and abrasions) and reported clinical symptoms (e.g. vision disorder, dysphasia) from the reports. These findings were compared to those reported from the neck-MRI. In total, 112 victims were clinically examined after suspected strangulation. Eleven of these victims underwent an MRI examination of the neck. Eighty-four of the victims presented objective lesions during the clinical examination, with eight showing signs of both petechiae and bruising. Neck-MRI was performed in four of these eight victims and three of them showed lesions visible in MRI. Of 76 victims with bruising as the only objective finding, 66 victims described clinical symptoms. Of those 66 victims, seven were examined by MRI and two demonstrated lesions in MRI. When MRI was performed, relevant findings were detected in 45% of the cases. This leads to the suspicion that many more findings could have been detected in the other victims, if an MRI had been performed in those cases. Our results lead us to the conclusion that an MRI examination of victims of suspected strangulation is useful, and strict indications for its application should be established.
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Affiliation(s)
- Christine Bruguier
- University Center of Legal Medicine Lausanne - Geneva, University Hospital Lausanne, Lausanne, Switzerland.,Department of Diagnostic and Interventional Radiology, University Hospital Lausanne, Lausanne, Switzerland
| | - Pia Genet
- University Center of Legal Medicine Lausanne - Geneva, University Hospital Lausanne, Lausanne, Switzerland
| | - Jean-Baptiste Zerlauth
- Department of Diagnostic and Interventional Radiology, University Hospital Lausanne, Lausanne, Switzerland.,Clinique Cécile, Lausanne, Switzerland
| | - Fabrice Dédouit
- University Center of Legal Medicine Lausanne - Geneva, University Hospital Lausanne, Lausanne, Switzerland
| | - Jochen Grimm
- University Center of Legal Medicine Lausanne - Geneva, University Hospital Lausanne, Lausanne, Switzerland.,Department of Diagnostic and Interventional Radiology, University Hospital Lausanne, Lausanne, Switzerland
| | - Reto Meuli
- Department of Diagnostic and Interventional Radiology, University Hospital Lausanne, Lausanne, Switzerland
| | - Tony Fracasso
- University Center of Legal Medicine Lausanne - Geneva, University Hospital Lausanne, Lausanne, Switzerland
| | - Silke Grabherr
- University Center of Legal Medicine Lausanne - Geneva, University Hospital Lausanne, Lausanne, Switzerland
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35
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Sláma T, Garbade SF, Kölker S, Hoffmann GF, Ries M. Quantitative natural history characterization in a cohort of 142 published cases of patients with galactosialidosis-A cross-sectional study. J Inherit Metab Dis 2019; 42:295-302. [PMID: 30693535 DOI: 10.1002/jimd.12010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/01/2018] [Accepted: 09/18/2018] [Indexed: 11/10/2022]
Abstract
Galactosialidosis (GS; OMIM #256540) is a rare multisystemic inborn glycoprotein storage disease caused by biallelic mutations in the cathepsin A gene resulting in combined deficiency of the lysosomal enzymes β-galactosidase and α-neuraminidase. The precise understanding of the natural course of the disease is limited. Development of enzyme replacement therapy is at the preclinical stage. The purpose of this research project was to quantitatively characterize the natural history of the condition. Quantitative analysis of all published cases in the literature with sufficient data (N = 142 patients) was carried out. Main outcome variables were survival, diagnostic delay, description of symptoms, biomarker-phenotype associations, and radiological findings. STROBE criteria were respected. Median survival age of the cohort was 48 years. Median age of onset was 4.25 years with interquartile range (IQR) 1 to 16 years. Median age at diagnosis was 19 (IQR: 8.92-29) years, with median diagnostic delay of 8 (IQR: 4-12) years. Patients with residual β-galactosidase activity of more than 8.6% (leukocytes) survived significantly longer than patients with lower enzyme activities.
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Affiliation(s)
- Tomáš Sláma
- Department of Pediatrics, University Children's Hospital Bern, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sven F Garbade
- Division of Pediatric Neurology and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kölker
- Division of Pediatric Neurology and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Georg F Hoffmann
- Division of Pediatric Neurology and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus Ries
- Division of Pediatric Neurology and Metabolic Medicine, Center for Pediatric and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
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Uehara M, Takahashi J, Kuraishi S, Ikegami S, Futatsugi T, Oba H, Takizawa T, Munakata R, Koseki M, Kato H. Two-stage posterior spinal fusion for early-onset scoliosis: Two case reports. Medicine (Baltimore) 2019; 98:e14728. [PMID: 30817622 PMCID: PMC6831329 DOI: 10.1097/md.0000000000014728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Fusionless techniques for early-onset scoliosis (EOS) have evolved to allow near-normal growth while maintaining the correction achieved during the initial surgery. However, such procedures require repeated surgeries and have increased complication rates. We have developed a 2-stage fusion technique using pedicle screws for EOS to reduce patient burden and complication risk. This series describes the clinical and radiological features of 2 patients with EOS who received 2-stage posterior spinal fusion. This surgical method for EOS represents the first of its kind. PATIENT CONCERNS Case 1 was a 10-year-old girl who was diagnosed as having scoliosis with Prader Willi syndrome at the age of 2 years. Her preoperative major curve Cobb angle was 100 degrees at age 10 years. Case 2 was an 11-year-old boy who was found to have scoliosis with 22q11.2 deletion syndrome at the age of 4 years. His preoperative major curve Cobb angle was 77 degrees at age 11 years. DIAGNOSIS Whole-spine radiographs were performed to diagnose scoliosis. INTERVENTIONS Both patients received 2-stage posterior spinal fusion. OUTCOMES Postoperative Cobb angle of the major curve improved to 46 and 48 degrees, respectively. Thoracic height respectively improved from 160 and 148 mm before surgery to 206 and 211 mm at final follow-up. Surgical outcome as evaluated by Scoliosis Research Society-22 patient questionnaires revealed acceptable results without any severe complications. LESSONS Based on the present case report, 2-stage posterior spinal fusion for EOS achieves good radiological and clinical outcomes without severe complications.
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Pollak L, Zehavi-Dorin T, Eyal A, Milo R, Huna-Baron R. Parinaud syndrome: Any clinicoradiological correlation? Acta Neurol Scand 2017; 136:721-726. [PMID: 28653396 DOI: 10.1111/ane.12795] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The significance of MRI findings of patients with Parinaud syndrome (PS) with respect to clinical characteristics is poorly defined. Over the past decades, all patients with PS undergo magnetic resonance imaging which allows a better identification of the lesion localization. We compared the neuro-ophthalmological findings of patients with PS caused by intrinsic (intra-axial) vs extrinsic (pineal gland tumor) brainstem lesions. METHODS Medical records of patients with PS evaluated between 2000 and 2016 were retrospectively reviewed. RESULTS Twenty-six patients with PS were included. Eight patients had pineal gland tumors and hydrocephalus. Two patients had hydrocephalus due to aqueduct stenosis and fourth ventricle tumor. Sixteen patients suffered from an intrinsic brainstem lesion and seven associated with hydrocephalus. The neuro-ophthalmological findings did not differ between patients with extrinsic and intrinsic brainstem lesions. No correlation was found between the grade of hydrocephalus and number of clinical findings except for more findings in low-grade hydrocephalus in intrinsic (40%) vs extrinsic (0%) lesions (P=.003). Patients with moderate brainstem lesions and hydrocephalus had more clinical findings (65%) than patients with the same grade of brainstem involvement without hydrocephalus (29%) (P=.03). The resolution rate of ophthalmological findings was comparable in all groups of patients. CONCLUSIONS Our results did not show differences in neuro-ophthalmological findings between intra- and extra-axial lesions causing PS. However, the presence of hydrocephalus was an important factor influencing clinical findings. The prognosis of PS was less favorable than generally reported.
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Affiliation(s)
- L. Pollak
- Department of Neurology; Barzilai Medical Center; Ashkelon Israel
- Ben Gurion University of the Negev; Beer Sheva Israel
| | - T. Zehavi-Dorin
- Goldschleger Eye Institute; Sheba Medical Center; Ramat Gan Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - A. Eyal
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Radiology Department; Sheba Medical Center; Ramat Gan Israel
| | - R. Milo
- Department of Neurology; Barzilai Medical Center; Ashkelon Israel
- Ben Gurion University of the Negev; Beer Sheva Israel
| | - R. Huna-Baron
- Goldschleger Eye Institute; Sheba Medical Center; Ramat Gan Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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Ozen C, Ertan P, Aras F, Gumuser G, Ozkol M, Horasan Dinc G. Evaluation of abnormal radiological findings in children aged 2 to 36 months followed by recurrent urinary tract infection: a retrospective study. Ren Fail 2017; 39:100-103. [PMID: 27819162 PMCID: PMC6014493 DOI: 10.1080/0886022x.2016.1251460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/06/2016] [Accepted: 09/16/2016] [Indexed: 10/30/2022] Open
Abstract
Our aim is to determine the rational usage of imaging techniques in order to prevent or minimize permanent renal damage in recurrent urinary tract infections (UTIs). This study was enrolled children aged between 2 and 36 months, following-up with the diagnosis of recurrent UTI. All children had ultrasonography (USG) and dimercaptosuccinic acid scanning, 39 of them had underwent on voiding cystourethrography. There were 133 children (87 girls, 46 boys) with the mean age of 32.82 ± 38.10 months included into the study. Forty-three kidney units were normal in ultrasonogram of which seven units had reflux whereas among 35 units with hydronephrosis 22 units had reflux. Sensitivity and specificity presence of hydronephrosis in ultrasonogram for prediction of reflux was 75.9% and 73.5%, respectively. There were 19 dilated ureters in ultrasonogram, and among them 14 had reflux. Sensitivity and specificity of presence with ureteral dilatation in ultrasonogram for prediction of reflux was found as 48.3% and 89.8%, respectively. The sensitivity of parenchymal thinning seen in ultrasonogram for the evaluation of renal parenchyma was 15.9%, whereas specificity was 98.2% .Sensitivity and specificity of dimercaptosuccinic acid for prediction of reflux was 51.6% and 72.3%, respectively. The normal ultrasonogram findings cannot rule out neither possibility of reflux presence nor development of renal scarring. Therefore, DMSA scanning has major role both in determination of parenchymal damage and prevention of scarring. Also we get an important result as ureteral dilatation seen in USG, related to presence of reflux.
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Affiliation(s)
- Cinar Ozen
- Department of Pediatric Nephrology, Celal Bayar University, Manisa, Turkey
| | - Pelin Ertan
- Department of Pediatric Nephrology, Celal Bayar University, Manisa, Turkey
| | - Feray Aras
- Department of Nuclear Medicine, Celal Bayar University, Manisa, Turkey
| | - Gul Gumuser
- Department of Nuclear Medicine, Celal Bayar University, Manisa, Turkey
| | - Mine Ozkol
- Department of Radiology, Celal Bayar University, Manisa, Turkey
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Abstract
Nonspecific orbital inflammation is an idiopathic chronic tumor-like inflammation process that usually affects the orbital tissues of both eyes. Isolated optic nerve involvement by an idiopathic inflammatory process is a rare finding. Here, we report a patient with unilateral sudden onset severe orbital pain and headache with visual loss to no light perception that could only be attributed to perineuritis. Radiological findings enabled making the correct diagnosis. Various relevant diagnoses are also discussed.
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Affiliation(s)
- Pinar Nalcacioglu
- a Yildirim Beyazit University Faculty of Medicine , Department of Ophthalmology , Ankara , Turkey
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Simanovsky N, Rozovsky K, Hiller N, Weintraub M, Stepensky P. Extending the Spectrum of Radiological Findings in Patients With Severe Osteopetrosis and Different Genetic Backgrounds. Pediatr Blood Cancer 2016; 63:1222-6. [PMID: 26970326 DOI: 10.1002/pbc.25952] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 01/12/2016] [Accepted: 01/25/2016] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate radiological findings in a cohort of 22 patients with infantile malignant osteopetrosis in order to establish the correlation between radiological findings and different genetic backgrounds. MATERIALS AND METHODS Clinical files, genetic analysis results, and radiological examinations of children treated for osteopetrosis with bone marrow transplantation in a referral center in the last 5 years were retrospectively evaluated. The study received institutional review board (IRB) approval. RESULTS Twenty-two patients were included in the study: 18 males, four females, ages 1 month-9 years 10 months, and the median age was 11 months (mean 23 months). There were 12 patients with different mutations in the TCIRG1 gene, five with mutations in the SNX10 gene, four children harbored RANK mutations, and one patient had a CLCN7 mutation. We noted more severe radiological findings in patients with TCIRG1 and RANK mutations, including fractures, osteopetrorickets, hydrocephalus, and hepatomegaly. Varus deformity of the femoral neck was seen exclusively in patients with a TCIRG1 mutation. CONCLUSIONS The variable genetic spectrum of osteopetrosis is associated with a variable radiological presentation. These correlations may be helpful for priorities in genetic analysis.
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Affiliation(s)
- Natalia Simanovsky
- Department of Medical Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Katya Rozovsky
- Department of Medical Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Nurith Hiller
- Department of Medical Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Michael Weintraub
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Polina Stepensky
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hadassah Hebrew University Medical Center, Jerusalem, Israel
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Kishaba T. Community-Acquired Pneumonia Caused by Mycoplasma pneumoniae: How Physical and Radiological Examination Contribute to Successful Diagnosis. Front Med (Lausanne) 2016; 3:28. [PMID: 27379238 PMCID: PMC4904022 DOI: 10.3389/fmed.2016.00028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/30/2016] [Indexed: 11/29/2022] Open
Abstract
Mycoplasma pneumoniae is one of the most common causes of community-acquired pneumonia (CAP), particularly in young adults. Vital signs are usually normal except for temperature. On physical examination, general appearance is normal compared with that of typical pneumonia such as pneumococcal pneumonia patients. Mycoplasma sometimes causes ear infections such as otitis media. It is important to distinguish between typical pneumonia and atypical pneumonia such as mycoplasma pneumonia because having the right diagnosis allows for the use of the correct antibiotic to treat CAP while preventing development of drug-resistant bacteria and also decreasing medical cost. The symptoms and diagnosis of mycoplasma pneumonia is multi-fold. Auscultation of patients can demonstrate trace late inspiratory crackles or normal alveolar sounds; however, bilateral polyphonic wheezes can sometimes be heard because of bronchiolitis. With regard to radiological findings, a chest radiogragh often shows bilateral reticulonodular or patchy consolidation in both lower lobes. Pleural effusion is rarely observed in adult cases. Immunocompetent patients tend to reveal more extensive shadowing compared with immunocompromised patients. As serological diagnostic methods are not able to offer 100% reliable diagnosis, integration of physical and radiological examination is crucial to accurately diagnose mycoplasma pneumonia. Herein, I review the typical findings from physical examination and imaging patterns of patients with mycoplasma pneumonia.
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Affiliation(s)
- Tomoo Kishaba
- Department of Respiratory Medicine, Okinawa Chubu Hospital , Uruma City, Okinawa , Japan
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Waris R, Nisar YB, Bhatti N. Association of haematological and radiological Findings with clinical outcome in hospitalized Children 2-36 months old with severe lower Respiratory tract infection. J Ayub Med Coll Abbottabad 2016; 28:229-236. [PMID: 28718556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Despite reduction in child mortality during last decade, lower respiratory tract infection (LRTI) remained number one killer of under-five. The current study aimed to assess the association of haematological and radiological findings with clinical outcome in hospitalized children 2-36 months old with severe LRTI. METHODS In the current cross sectional study, 581 children 2-36 months old with severe LRTI were enrolled and followed at the Children Hospital, Islamabad, between 2011 and 2014. At the time of enrolment, complete history of present illness, anthropometric measurements, blood sample and chest radiograph were obtained. The primary outcome was either early clinical response (within 72 hours) or delayed clinical response (>72 hours). Multivariable logistic regression was performed to examine the association between haematological and radiological findings with clinical outcome, adjusted for potential confounding factors. RESULTS Of 581 enrolled children, 292 (50.3%) children had early, and 289 (49.7%) had delayed clinical response. The multivariable logistic regression showed that leucocytosis (OR 1.79, 95% CI 1.15-2.79), neutrophilia (OR 1.91, 95% CI 1.29-2.84), radiological interstitial pneumonia (OR 2.49, 95%CI 1.70-3.64), and lobar consolidation (OR 6.00, 95%CI 2.41-14.96) were significantly associated with delayed clinical response, after adjusted for potential confounding factors. CONCLUSIONS Delayed clinical response was significantly associated with abnormal haematological and radiological findings at the time of admission in children 2-36 months old with severe LRTI. Haematological and radiological findings at the time of presentation are useful for predicting delayed clinical response in children 2-36 months old with severe LRTI.
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Affiliation(s)
- Rehmana Waris
- Paediatric Medicine, The Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Yasir Bin Nisar
- Sydney School of Public Health, The University of Sydney, NSW, Australia
| | - Naseera Bhatti
- Paediatric Medicine, The Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
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Maccioni F, Vetere S, De Felice C, Al Ansari N, Micozzi A, Gentile G, Foà R, Girmenia C. Pulmonary fungal infections in patients with acute myeloid leukaemia: is it the time to revise the radiological diagnostic criteria? Mycoses 2016; 59:357-64. [PMID: 26865204 DOI: 10.1111/myc.12480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 12/19/2015] [Accepted: 01/17/2016] [Indexed: 11/27/2022]
Abstract
The definition of pulmonary fungal infections (PFI) according to the EORTC-MSG criteria may lack diagnostic sensitivity due to the possible presentation of PFI with different radiological pictures. We evaluated the hypothesis to apply less restrictive radiological criteria to define PFI in patients with acute myeloid leukaemia (AML) submitted to chemotherapy. Overall, 73 consecutive episodes of pulmonary infiltrates associated to positive serum galactomannan test or fungal isolation or galactomannan detection from respiratory specimens were considered. CT scans acquired at the onset of symptoms (time-0) and within 4 weeks (time-1) were analysed to identify specific (group A) or aspecific radiological signs (group B). Pulmonary infiltrates fulfilled the EORTC-MSG criteria in 49 patients (group A), whereas in 24 patients (group B) they did not reach the criteria due to aspecific CT findings at time-0. Eleven of 21 (52.4%) patients of the group B evaluable for the evolution of the radiological findings fulfilled EORTC-MSG criteria at time-1. All the analysed clinical and mycological characteristics, response to antifungal therapy and survival were comparable in the two groups. Our study seems to confirm the possibility to extend the radiological suspicion of PFI to less restrictive chest CT findings when supported by microbiological criteria in high-risk haematological patients.
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Affiliation(s)
- Francesca Maccioni
- Dipartimento di Scienze Radiologiche, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
| | - Simone Vetere
- Dipartimento di Scienze Radiologiche, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
| | - Carlo De Felice
- Dipartimento di Scienze Radiologiche, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
| | - Najwa Al Ansari
- Dipartimento di Scienze Radiologiche, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
| | - Alessandra Micozzi
- Dipartimento di Ematologia, Oncologia, Anatomia Patologica e Medicina Rigenerativa, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
| | - Giuseppe Gentile
- Dipartimento di Ematologia, Oncologia, Anatomia Patologica e Medicina Rigenerativa, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
| | - Robin Foà
- Dipartimento di Ematologia, Oncologia, Anatomia Patologica e Medicina Rigenerativa, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
| | - Corrado Girmenia
- Dipartimento di Ematologia, Oncologia, Anatomia Patologica e Medicina Rigenerativa, Azienda Policlinico Umberto I 'Sapienza' University of Rome, Rome, Italy
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Reinhold M, Knop C, Beisse R, Audigé L, Kandziora F, Pizanis A, Pranzl R, Gercek E, Schultheiss M, Weckbach A, Bühren V, Blauth M. Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, Internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery. Eur Spine J 2010; 19:1657-76. [PMID: 20499114 PMCID: PMC2989217 DOI: 10.1007/s00586-010-1451-5] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 03/07/2010] [Accepted: 05/09/2010] [Indexed: 10/19/2022]
Abstract
The second, internet-based multicenter study (MCSII) of the Spine Study Group of the German Association of Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie) is a representative patient collection of acute traumatic thoracolumbar (T1-L5) injuries. The MCSII results are an update of those obtained with the first multicenter study (MCSI) more than a decade ago. The aim of the study was to assess and bring into focus: the (1) epidemiologic data, (2) surgical and radiological outcome, and (3) 2-year follow-up (FU) results of these injuries. According to the Magerl/AO classification, there were 424 (57.8%) compression fractures (A type), 178 (24.3%) distractions injuries (B type), and 131 (17.9%) rotational injuries (C type). B and C type injuries carried a higher risk for neurological deficits, concomitant injuries, and multiple vertebral fractures. The level of injury was located at the thoracolumbar junction (T11-L2) in 67.0% of the case. 380 (51.8%) patients were operated on by posterior stabilization and instrumentation alone (POSTERIOR), 34 (4.6%) had an anterior procedure (ANTERIOR), and 319 (43.5%) patients were treated with combined posteroanterior surgery (COMBINED). 65% of patients with thoracic (T1-T10) and 57% with lumbar spinal (L3-L5) injuries were treated with a single posterior approach (POSTERIOR). 47% of the patients with thoracolumbar junction (T11-L2) injuries were either operated from posterior or with a combined posterior-anterior surgery (COMBINED) each. Short angular stable implant systems have replaced conventional non-angular stable instrumentation systems to a large extent. The posttraumatic deformity was restored best with COMBINED surgery. T-spine injuries were accompanied by a higher number and more severe neurologic deficits than TL junction or L-spine injuries. At the same time T-spine injuries showed less potential for neurologic recovery especially in paraplegic (Frankel/AISA A) patients. 5% of all patients required revision surgery for perioperative complications. Follow-up data of 558 (76.1%) patients were available and collected during a 30-month period from 1 January 2004 until 31 May 2006. On average, a posterior implant removal was carried out in a total of 382 COMBINED and POSTERIOR patients 12 months after the initial surgery. On average, the rehabilitation process required 3-4 weeks of inpatient treatment, followed by another 4 months of outpatient therapy and was significantly shorter when compared with MCSI in the mid-1990s. From the time of injury until FU, 80 (60.6%) of 132 patients with initial neurological deficits improved at least one grade on the Frankel/ASIA Scale; 8 (1.3%) patients deteriorated. A higher recovery rate was observed for incomplete neurological injuries (73%) than complete neurological injuries (44%). Different surgical approaches did not have a significant influence on the neurologic recovery until FU. Nevertheless, neurological deficits are the most important factors for the functional outcome and prognosis of TL spinal injuries. POSTERIOR patients had a better functional and subjective outcome at FU than COMBINED patients. However, the posttraumatic radiological deformity was best corrected in COMBINED patients and showed significantly less residual kyphotic deformity (biseg GDW -3.8° COMBINED vs. -6.1° POSTERIOR) at FU (p = 0.005). The sagittal spinal alignment was better maintained when using vertebral body replacement implants (cages) in comparison to iliac strut grafts. Additional anterior plate systems did not have a significant influence on the radiological FU results. In conclusion, comprehensive data of a large patient population with acute thoracolumbar spinal injuries has been obtained and analyzed with this prospective internet-based multicenter study. Thus, updated results and the clinical outcome of the current operative treatment strategies in participating German and Austrian trauma centers have been presented. Nevertheless, it was not possible to answer all remaining questions to contradictory findings of the subjective, clinical outcome and corresponding radiological findings between different surgical subgroups. Randomized-controlled long-term investigations seem mandatory and the next step in future clinical research of Spine Study Group of the German Trauma Society.
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Affiliation(s)
- M Reinhold
- Department of Trauma Surgery, Medical University Innsbruck, Innsbruck, Austria.
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Borgwardt SJ, Radue EW, Götz K, Aston J, Drewe M, Gschwandtner U, Haller S, Pflüger M, Stieglitz RD, McGuire PK, Riecher-Rössler A. Radiological findings in individuals at high risk of psychosis. J Neurol Neurosurg Psychiatry 2006; 77:229-33. [PMID: 16421128 PMCID: PMC2077602 DOI: 10.1136/jnnp.2005.069690] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the prevalence of radiological magnetic resonance imaging (MRI) findings in individuals at high risk of schizophrenia. METHODS MRI scans from individuals at high risk of schizophrenia (HR; n = 37) were assessed by a radiologist blind to group status and compared with scans from patients with first episode psychosis (FE; n = 30), depressive controls (DC; n = 17), and healthy controls (HC; n = 26). RESULTS There was a significantly higher proportion of radiological findings in individuals at high risk of schizophrenia (35%) and patients with first-episode psychosis (40%) than in patients with depression (18%) or healthy controls (12%). These differences were specific to findings regarded as potentially clinically significant as opposed to normal variants; however, there was no indication for medical treatment. CONCLUSIONS The results suggest that a large proportion of those at high risk of psychosis have radiological findings on MRI scanning, and that the prevalence of radiological findings in this group is similar to that in patients with first episode psychosis.
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Affiliation(s)
- S J Borgwardt
- Psychiatric Outpatient Department, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland
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