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1.
BMC Pulm Med ; 23(1): 231, 2023 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-37370050

RESUMO

BACKGROUND: Few studies have evaluated the long-term impact on health-related quality of life (HRQoL) in patients who have been hospitalized for COVID-19 pneumonia. Specific follow-up should be carried out to detect and treat possible pulmonary abnormalities, and the worsening of HRQoL should be estimated to target necessary resources for care of these patients after acute phase. The objective was to know the impact on HRQoL of patients who have been admitted for COVID-19 pneumonia, and to evaluate the clinical-radiological and functional changes of patients who have overcome COVID-19 pneumonia at 3 and 10 months of follow-up. METHODS: Prospective observational study of patients who required hospitalization for COVID-19 pneumonia between April and December 2020. All patients filled out the EuroQol five-dimension (EQ-5D) questionnaire with the EuroQol Visual Analogue Scale (E-VAS) for self-assessment of health status. Respiratory function tests and chest X-ray were carried out at 3 and 10 months of follow-up. RESULTS: 61 patients were included in the study. The need for ventilatory support was associated with anxiety/depression on the EQ-5D scale, as well as patients admitted to the intensive care unit (ICU). The mean EQ-5D and E-VAS index scores decreased with hospitalization time, the number of days spent in intermediate respiratory care unit (IRCU) and the level of dyspnoea at the beginning of the hospitalization period. Pulmonary sequelae were observed in 25 patients (41%) at 3 months and 17 (27.9%) at 10 months. Patients improve their forced vital capacity (FVC) by 196 ml (p = 0.001) at 10 months as well as 9% in diffusing capacity of lung for carbon monoxide (DLCO) (p = 0.001) at 10 months. DLCO was found to be correlated to lymphopenia and time spent in IRCU. Low FVC values were detected 10 months after discharge for subjects exhibiting high levels of dyspnoea at 3 months after discharge. CONCLUSIONS: Hospitalization for COVID-19 pneumonia affects the HRQoL of patients, with greater anxiety/depression in those who were more serious affected and are younger. A significant percentage of patients present fibrotic abnormalities and lung function impairment at the first and second follow-up after discharge.


Assuntos
COVID-19 , Qualidade de Vida , Humanos , Alta do Paciente , Pulmão/diagnóstico por imagem , Dispneia/etiologia
2.
Medicina (Kaunas) ; 59(6)2023 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-37374259

RESUMO

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.


Assuntos
Esclerose Múltipla , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/diagnóstico , Lituânia/epidemiologia , Bandas Oligoclonais , Nervo Óptico , Recidiva
3.
Hum Brain Mapp ; 43(5): 1766-1782, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34957633

RESUMO

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.


Assuntos
Encéfalo , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagem , Humanos , Neuroimagem/métodos , Fenótipo , Reprodutibilidade dos Testes
4.
Neuroradiology ; 63(8): 1215-1225, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33459822

RESUMO

PURPOSE: Meningiomas are the most common extra-axial intracranial neoplasms with typical radiological findings. In approximately 2% of cases, histopathological reports reveal different neoplasms or non-neoplastic lesions that can closely mimic meningiomas. We describe radiological features of meningioma mimics highlighting imaging red flags to consider a differential diagnosis. METHODS: A total of 348 lesions with radiological diagnosis of meningiomas which underwent to surgical treatment or biopsy between December of 2000 and September of 2014 were analyzed. We determined imaging features that are not a typical finding of meningiomas, suggesting other lesions. The following imaging characteristics were evaluated on CT and MRI: (a) bone erosion; (b) hyperintensity on T2WI; (c) hypointensity on T2WI; (d) bone destruction; (e) dural tail; (f) leptomeningeal involvement; (g) pattern of contrast enhancement; (h) dural displacement sign. RESULTS: We have a relatively high prevalence of meningioma mimics (7.2%). Dural-based lesions with homogeneous contrast enhancement (52%) are easily misdiagnosed as meningiomas. Most lesions mimic convexity (37.5%) or parafalcine (21.9%) meningiomas. We have determined five imaging red flags that can alert radiologists to consider meningioma mimics: (1) bone erosion (22.2%); (2) dural displacement sign (36%); (3) marked T2 hypointensity (32%); (4) marked T2 hyperintensity (12%); (5) absence of dural tail (48%). The most common mimic lesion in our series was hemangiopericytomas, followed by lymphomas and schwannomas. CONCLUSION: The prevalence of meningioma mimics is not negligible. It is important to have awareness on main radiological findings suggestive of differential diagnosis due to a wide range of differentials which lead to different prognosis and treatment strategies.


Assuntos
Hemangiopericitoma , Neoplasias Meníngeas , Meningioma , Neurilemoma , Humanos , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem
5.
Orbit ; 40(2): 98-109, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32212885

RESUMO

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.


Assuntos
Doenças Orbitárias , Fraturas Orbitárias , Seios Paranasais , Humanos , Órbita , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Tomografia Computadorizada por Raios X
6.
Niger J Clin Pract ; 24(9): 1259-1267, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34531335

RESUMO

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.


Assuntos
COVID-19 , Radiologia , Criança , Pré-Escolar , Humanos , Lactente , Laboratórios , Pandemias , SARS-CoV-2
7.
J Cell Physiol ; 235(12): 9211-9229, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32452050

RESUMO

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.


Assuntos
Betacoronavirus/patogenicidade , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , COVID-19 , Teste para COVID-19 , China/epidemiologia , Coronavirus/efeitos dos fármacos , Coronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , SARS-CoV-2
8.
AJR Am J Roentgenol ; 214(3): 687-693, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31642696

RESUMO

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.


Assuntos
Embolização Terapêutica/métodos , Hepatomegalia/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Veia Porta , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos
9.
Neurosurg Rev ; 43(2): 719-727, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31098788

RESUMO

Primary pilocytic astrocytoma (PA) of the spine is extremely rare and most published case series only include only a few patients. We attempted to explore the clinical features, radiological findings, and treatment outcomes of patients with spinal PA. Sixteen spinal PA patients who were surgically treated in our hospital between April 2008 and June 2018 were included in this retrospective study. An integrative analysis was performed regarding spinal PA patients by extracting from published studies on PubMed. The 16 patients with spinal PA included eight male and eight female patients with a mean age of 29.1 years. Ten cases (62.5%) had masses located in the cervical segments, five (31.3%) had masses in the thoracic segments, and one (6.2%) had masses in the sacral canal. All the patients were treated surgically with 13 gross total resections (GTRs, 81.3%) and three subtotal resections (STRs). The mean follow-up period was 40.4 months. These tumors accounted for a recurrence rate of 37.5% (6 of 16 patients) and no death during the follow-up periods. The influencing factors of recurrence were mainly STR, gene mutation (NF-1 and H2-K27M), and the number of segments involved. The mean recurrence-free survival duration was 19 months. The imaging features of spinal PA are heterogeneous, and the definitive diagnosis requires pathological support. GTR is the standard therapy for spinal PAs, although patients with GTR are still likely to relapse. The regular spinal magnetic resonance imaging follow-ups are required regardless of the resection status. Reoperation is feasible for patients with recurrence.


Assuntos
Astrocitoma/cirurgia , Recidiva Local de Neoplasia/epidemiologia , Neoplasias da Medula Espinal/cirurgia , Adolescente , Adulto , Astrocitoma/diagnóstico por imagem , Astrocitoma/patologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Reoperação , Estudos Retrospectivos , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/patologia , Resultado do Tratamento , Adulto Jovem
10.
BMC Musculoskelet Disord ; 21(1): 685, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066766

RESUMO

BACKGROUND: Goldenhar syndrome sometimes displays progressive scoliosis and other spinal deformities that require treatment. However, few reports exist on scoliosis correction in Goldenhar syndrome. We described the rare radiological outcomes of a patient with Goldenhar syndrome who received brace treatment for scoliosis. CASE PRESENTATION: A 4-year-old boy was diagnosed as having Goldenhar syndrome and referred to our hospital for scoliosis treatment. The deformity deteriorated gradually, and left convex scoliotic angle was 26 degrees (T3-L2) at 11 years of age. Unexpectedly during treatment with an orthopedic brace, the curve had reversed to 21 degrees (T5-L2) at 7 months of therapy. After another adjustment of the brace, his right convex scoliotic angle improved to 13 degrees (T4-L2) at 15 months of treatment. CONCLUSIONS: Curve reversal may occur during brace treatment for scoliosis in Goldenhar syndrome. Clinicians may opt to periodically check curve correction despite the risk of increased radiation exposure.


Assuntos
Síndrome de Goldenhar , Procedimentos Ortopédicos , Escoliose , Braquetes , Pré-Escolar , Síndrome de Goldenhar/complicações , Síndrome de Goldenhar/diagnóstico por imagem , Síndrome de Goldenhar/terapia , Humanos , Masculino , Radiografia , Escoliose/diagnóstico por imagem , Escoliose/etiologia , Escoliose/terapia , Resultado do Tratamento
11.
Pol J Radiol ; 85: e316-e322, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32685067

RESUMO

PURPOSE: Diagnosis of osteoid osteoma may be delayed if secondary radiological findings such as muscle atrophy, oedema in peripheric soft tissue and bone marrow, joint effusion, or synovitis are more severe than the lesion itself. In this article, the purpose was to demonstrate secondary radiological findings of osteoid osteoma in both paediatric and adult patients. This study is one of the very few with such a large case series. MATERIAL AND METHODS: Radiological images of 152 patients were reviewed retrospectively. Peri-nidus sclerosis, periosteal reactive bone formation, bone marrow and soft tissue oedema, presence of synovial effusion, muscular atrophy in the affected extremity, osteopaenia, and posture deterioration were noted. RESULTS: Most of the lesions (87.5%) were localised in lower extremity bones. Among all the patients, 56% had extra-articular (65% in paediatric patients) and 44% had intraarticular (69% in paediatric patients) osteoid-osteoma. In 44% of the patients, synovial effusion was presented. In 89.4% of these, osteoid osteoma was localised in the joint. Of the 97 patients who had osteoid osteoma in lower extremities or pelvic bones, 73% had muscular atrophy. In 6% of them muscular atrophy was severe, and they had posture-gait disorder with accompanying osteopaenia. In 48% of the patients, there was reactive periosteal bone formation around the nidus. CONCLUSIONS: Secondary radiological findings, such as muscular atrophy, synovitis, posture-gait deterioration, and reactive bone formation in a patient with continuous pain that is relieved by anti-inflammatory drugs may point to an osteoid osteoma.

12.
J Inherit Metab Dis ; 42(2): 295-302, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30693535

RESUMO

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 ß-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 ß-galactosidase activity of more than 8.6% (leukocytes) survived significantly longer than patients with lower enzyme activities.


Assuntos
Doenças por Armazenamento dos Lisossomos/diagnóstico , Doenças por Armazenamento dos Lisossomos/epidemiologia , Adolescente , Adulto , Biomarcadores , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Diagnóstico Tardio , Desenvolvimento de Medicamentos , Feminino , Humanos , Lactente , Recém-Nascido , Doenças por Armazenamento dos Lisossomos/mortalidade , Masculino , Pessoa de Meia-Idade , Mutação , Fenótipo , Radiografia , Literatura de Revisão como Assunto , Análise de Sobrevida , Adulto Jovem
13.
Acta Neurol Scand ; 136(6): 721-726, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28653396

RESUMO

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.


Assuntos
Hidrocefalia/diagnóstico por imagem , Transtornos da Motilidade Ocular/diagnóstico por imagem , Pinealoma/diagnóstico por imagem , Adulto , Tronco Encefálico/diagnóstico por imagem , Feminino , Quarto Ventrículo/diagnóstico por imagem , Humanos , Hidrocefalia/complicações , Hidrocefalia/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos da Motilidade Ocular/complicações , Transtornos da Motilidade Ocular/patologia , Pinealoma/complicações , Pinealoma/patologia
14.
Neurol Sci ; 38(10): 1823-1828, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28733757

RESUMO

Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, seizure, contralateral hemiplegia/hemiparesis, and mental retardation. In this study, clinical and radiological investigations of seven patients who were diagnosed with DDMS as adult age were evaluated and discussed. Seven patients (four male, three female) were included. The mean age ± SD of the patients was 46 ± 21 years. Clinical presentation of six patients was epileptic seizure. One patient was presented with head trauma due to a fall. Two patients had complex partial seizures, three patients had generalized tonic-clonic seizures (GTC), and one had GTC and myoclonic seizure. Mental retardation was in five patients. A congenital cause was detected in one patient in the etiologic investigation and acquired causes in two patients. In four patients, the etiology was not identified. We observed left-hemisphere involvement in four patients and right-hemisphere involvement in three patients. Brain imaging was performed by CT only in four patients and by MRI only in three patients. All patients were diagnosed with DDMS at adulthood. Atrophy in basal ganglia was detected in five patients, and atrophy in brain stem in four patients. Calvarial thickening was observed in four patients. Three patients had hyperpneumatization in mastoid cells. Sinus hyperpneumatization, including the paranasal and frontal sinuses, was seen in six patients. DDMS can also be diagnosed in adulthood symptomatically (mild-severe) or asymptomatically in adulthood. As a result, DDMS is a syndrome with wide clinical and radiological spectra that can be variably symptomatic at different stages of life.


Assuntos
Encéfalo/diagnóstico por imagem , Epilepsia/diagnóstico por imagem , Epilepsia/fisiopatologia , Adulto , Idoso de 80 Anos ou mais , Diagnóstico Tardio , Face/anormalidades , Feminino , Humanos , Deficiência Intelectual/diagnóstico por imagem , Deficiência Intelectual/fisiopatologia , Masculino , Pessoa de Meia-Idade , Síndrome
15.
Ren Fail ; 39(1): 100-103, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27819162

RESUMO

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.


Assuntos
Cicatriz/prevenção & controle , Hidronefrose/diagnóstico por imagem , Rim/diagnóstico por imagem , Infecções Urinárias/diagnóstico por imagem , Refluxo Vesicoureteral/diagnóstico por imagem , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Recidiva , Estudos Retrospectivos , Sensibilidade e Especificidade , Turquia , Ultrassonografia
16.
Orbit ; 36(6): 452-455, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28812938

RESUMO

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.


Assuntos
Inflamação/complicações , Neurite Óptica/etiologia , Doenças Orbitárias/complicações , Dor Ocular/diagnóstico , Dor Ocular/tratamento farmacológico , Dor Ocular/etiologia , Glucocorticoides/administração & dosagem , Humanos , Inflamação/diagnóstico por imagem , Inflamação/tratamento farmacológico , Infusões Intravenosas , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Neurite Óptica/diagnóstico , Neurite Óptica/tratamento farmacológico , Doenças Orbitárias/diagnóstico por imagem , Doenças Orbitárias/tratamento farmacológico , Tomografia Computadorizada por Raios X , Transtornos da Visão/diagnóstico , Transtornos da Visão/tratamento farmacológico , Transtornos da Visão/etiologia
17.
Pediatr Blood Cancer ; 63(7): 1222-6, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26970326

RESUMO

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.


Assuntos
Colo do Fêmur/diagnóstico por imagem , Mutação , Osteopetrose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Osteopetrose/genética , Receptor Ativador de Fator Nuclear kappa-B/genética , Estudos Retrospectivos , Índice de Gravidade de Doença , Nexinas de Classificação/genética , ATPases Vacuolares Próton-Translocadoras/genética
18.
Mycoses ; 59(6): 357-64, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26865204

RESUMO

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.


Assuntos
Leucemia Mieloide Aguda/complicações , Pneumopatias Fúngicas/diagnóstico por imagem , Adulto , Idoso , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/microbiologia , Aspergillus/isolamento & purificação , Contagem de Colônia Microbiana , Feminino , Fungos/isolamento & purificação , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Pneumopatias Fúngicas/diagnóstico , Pneumopatias Fúngicas/microbiologia , Masculino , Pessoa de Meia-Idade , Radiografia , Tomografia Computadorizada por Raios X , Adulto Jovem
19.
J Ayub Med Coll Abbottabad ; 28(2): 229-236, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28718556

RESUMO

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.


Assuntos
Infecções Respiratórias/diagnóstico por imagem , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Contagem de Células Sanguíneas , Pré-Escolar , Estudos Transversais , Hospitalização , Hospitais Pediátricos , Humanos , Lactente , Radiografia Torácica , Infecções Respiratórias/sangue
20.
Braz J Infect Dis ; 28(3): 103768, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38851212

RESUMO

We report an autochthonous case of mild unifocal chronic pulmonary paracoccidioidomycosis in a 48-year-old previously healthy woman with no history of possible environmental exposures in endemic rural areas, supposedly resulting from reactivation of a latent pulmonary focus secondary to the use of methotrexate for the control of Chikungunya arthropathy. Laboratory investigation ruled out other immunosuppression. Her only symptoms were a dry cough and chest pain. Diagnosis confirmed by needle lung biopsy. There were no abnormalities on physical examination nor evidence of central nervous system involvement. MRI of the total abdomen showed no involvement of other organs. Computed chest tomography showed a favorable evolution under the use of itraconazole (200 mg/day). Different tomographic presentations findings are highlighted when performed before and after treatment. CONCLUSIONS: PCM should be considered even in a woman without a history of consistent environmental exposure and in a non-endemic geographic area.


Assuntos
Pneumopatias Fúngicas , Metotrexato , Paracoccidioidomicose , Humanos , Feminino , Paracoccidioidomicose/tratamento farmacológico , Pessoa de Meia-Idade , Metotrexato/uso terapêutico , Metotrexato/efeitos adversos , Pneumopatias Fúngicas/tratamento farmacológico , Doença Crônica , Itraconazol/uso terapêutico , Tomografia Computadorizada por Raios X , Antifúngicos/uso terapêutico , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico
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