Computed Tomographic Diagnosis of Myocardial Fat Deposits in Sarcoidosis.

OBJECTIVE: Fat deposits in the left ventricle (LV) myocardium are uncommon and usually indicate scar due to chronic myocardial infarction. The purpose of this study was to determine the incidence of fatty lesions in the LV of patients with sarcoidosis. MATERIALS AND METHODS: Review of noncontrast computed tomographic images (2-mm thickness) in 133 patients with documented extracardiac sarcoidosis (age, 35-82 years, 55 ± 10 years, 67% female) with no history of significant coronary artery disease (clinical and coronary calcium) was performed. A control group included noncontrast computed tomographies with no coronary calcium in 133 patients with age/sex (59 ± 6 years, 73% female) similar to the sarcoid target group. Locations and morphology (linear vs bulky) of fat deposits (-30 to -180 Hounsfield units) and relevant intrathoracic findings were recorded. RESULTS: We found 35 fat deposits in 19 (14.3%) of sarcoid patients (target group: age, 59 ± 7 years, 78% female). Lesions were mainly at the LV apical level (n = 14). In the control group, 15 lesions in 13 (9.7%) patients were found. Numbers of fatty lesions in sarcoid targets were significantly higher than those in the control group (P = 0.015). The number of bulky lesions was significantly higher in sarcoid (n = 9) than in control (n = 1; P < 0.05). No significant difference was found for the rate of linear lesions. Interstitial lung disease was seen in 9 and enlarged lymph nodes in 9 of the sarcoid target group. There was no significant correlation between the severity of interstitial lung disease and the number of fatty lesions. CONCLUSIONS: Sarcoid patients demonstrate a higher chance of having LV fat deposits with a characteristic bulky morphology.

Reactive arthritis after Gam-COVID-Vac vaccination: A case report.

Although the safety and efficacy of vaccinations have been evaluated through clinical trials, medical experts and authorities are very interested in the reporting and investigation of adverse events following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunisation in the general public. This article reports about a 41-year-old man without a history of underlying diseases, complaining of continuous morning stiffness and acute discomfort in his left elbow joint, 20 days after taking the first dosage of Sputnik V. The case was extensively studied, and a possible diagnosis of reactive arthritis was made.

Investigation of the effect of Low-Level Laser Therapy on arm lymphedema in breast cancer patients: A noninvasive treatment for an intractable morbidity.

Purpose: This article aims to study the effect of Low-Level Laser Therapy (LLLT) on arm lymphedema in patients who have breast cancer. Methods and Materials: Twenty-three patients were selected in a nonrandomized phase-2 clinical trial. After measuring the circumference of the affected and unaffected limbs at 6-points, the volume of the limbs, the degree of mental symptoms on visual analog scale by the patient upon entering the study, and performing an ultrasound on the patient's axilla to locate the fibrotic areas, a low-level laser device at a therapeutic dose of 2 J/cm2 was used to treat the patients three times a week for 4 weeks, and after an 8-week gap, for another similar period. Measurement of circumference and volume of affected and unaffected limbs and mental symptoms were carried out at the end of the 4th week, the beginning of the 12th week, and the end of the 16th week, and the obtained results were compared with those before the treatment. Results: We noted that the average reductions in the circumference and volume of the affected limb, as compared with the unaffected limb, were about 16% and 21.7%, respectively, and improvement in the patient's mental symptoms was about 32%. Another notable observation was the great enthusiasm of most patients to continue their treatment, particularly from the second cycle onward. Conclusions: LLLT can, at least in association with current standard methods, be used for arm lymphedema to introduce further reductions in pain and volume.

Preferred view and transducer in lumbar ultrasound in overweight and obese patients.

BACKGROUND: Ultrasound can be used to facilitate lumbar puncture, especially in obese patients. METHODS: In this study, midline and paramedian approaches with curved and linear transducers were compared in patients with Body Mass Index (BMI) above 25 kg/m2 for the identification of spinal landmarks. In each view, six major landmarks, including spinous process, ligamentum flavum, laminae, epidural space, subarachnoid space and posterior longitudinal ligament, were detected by emergency medicine residents and were then reviewed by radiologists. RESULTS: Sixty patients with a mean BMI of 29.18 enrolled in the study. This study showed that a curved transducer detected major landmarks more accurately compared to a linear transducer. There was also a poor kappa correlation between these transducers in the midline and paramedian approaches. CONCLUSION: This study showed that ultrasound can detect lumbar landmarks in overweight and obese patients, with the paramedian approach and a curved transducer being superior to the midline approach and a linear transducer in detecting these landmarks.