Résumé
SUMMARY OBJECTIVE: In coronary computed tomography angiography, a part of the lung parenchyma also enters the image area which is called the field of view. The aim of this study was to evaluate the rate of pulmonary abnormalities and document their association with demographic features in subjects undergoing multislice coronary computed tomography angiography obtained for the assessment of coronary artery disease. METHODS: This was a retrospective observational study evaluating the coronary computed tomography angiography scans of 1,050 patients (58.5% males and 47.3% smokers) with a mean age of 52.2±11.2 years, obtained between January 2018 and March 2020. Pulmonary abnormalities were reported as nodules, focal consolidations, ground-glass opacities, consolidations, emphysema, cysts, bronchiectasis, atelectasis, and miscellaneous. RESULTS: In total, 274 pulmonary abnormalities were detected in 266 patients (25.3%). The distribution of incidental lung findings was as follows: pulmonary nodules: 36.4%, emphysema: 15.6%, bronchiectasis: 11%, ground-glass opacities: 7.2%, atelectasis 7.2%, focal consolidations: 5%, cysts: 6%, consolidations: 2.5%, and miscellaneous: 9.1%. The patients with pulmonary pathology were older (55.5±11.4 versus 51.0±10.9 years), and the percentage of smokers was higher (60.1 versus 43.2%). The possibility of the presence of any incidental lung findings in field of view of coronary computed tomography angiography increases significantly over the age of 40.5 years (p<0.001, AUC 0.612, 95%CI 0.573-0.651). CONCLUSION: Multislice coronary computed tomography angiography can give important clues regarding pulmonary diseases. It is essential for the reporting radiologist to review the entire scan for pulmonary pathological findings especially in patients with smoking history and over the age of 40.5 years.
Sujets)
Humains , Mâle , Femelle , Adulte , Résultats fortuits , Angiographie par tomodensitométrie , Tomodensitométrie , Études rétrospectives , Coronarographie , Poumon/imagerie diagnostique , Adulte d'âge moyenRésumé
BACKGROUND AND PURPOSE: This randomized controlled study examined the effect of repetitive transcranial magnetic stimulation (rTMS) on spasticity in patients with multiple sclerosis (MS). METHODS: This study included 16 patients with a history of MS and spasticity in the adductor hip muscles according to the Modified Ashworth Scale (MAS). The participants were randomized into the active group (n=10) and control group (n=6), in which active rTMS and sham rTMS were applied in 10 sessions, respectively. A physical therapy and rehabilitation program was applied along with rTMS sessions in both groups. The evaluation parameters were assessed at baseline and then 1 week and 1 month after applying rTMS. RESULTS: Statistical analyses with post-hoc correction revealed statistically significant improvements in the active group compared to the control group in the bilateral MAS score, Penn Spasm Frequency Scale score, patient satisfaction, amount of urine leakage, actual health status, perceived health status, energy and fatigue, role limitations due to physical problems, social function, overall quality of life, cognitive functioning, physical health composite score, mental health composite score, and total score on the Multiple Sclerosis Quality of Life-54 (MSQOL-54) (p<0.05). Statistically significant changes were detected in the MSQOL-54 social function and physical health composite scores of patients in the control group (p<0.05). CONCLUSIONS: Active rTMS combined with a physical therapy program reduced spasticity in MS patients compared to the control group that received only physical therapy. Further comprehensive and more advanced studies are needed to confirm the present findings.
Sujets)
Humains , Fatigue , Hanche , Santé mentale , Sclérose en plaques , Spasticité musculaire , Muscles , Satisfaction des patients , Qualité de vie , Réadaptation , Problèmes sociaux , Spasme , Stimulation magnétique transcrânienneRésumé
The aim of this study is to assess the value of cytology in the diagnosis of pleural effusions. It is a retrospective review of the patients with pleural effusions admitted at our clinic in a 8-year period. We evaluated the cytological and diagnostic results of 470 patients. Male to female ratio was 3:1 with a mean age of 38.6 years (range 18-76 years). Samples were processed and evaluated according to the standard methods. Cytology results were reviewed and the patients were stratified according to the their final diagnosis of the 470 effusions, 40 were transudates. Among 430 exudates, 190 (74.8%) were malignant on pleural fluid analysis alone. Adenocarcinoma was the most common malignancy. Tuberculosis was the second most frequent etiology for the exudative effusions. Cells in benign or malignant effusions were easily recognized without further invasive evaluation, contributing to diagnosis and therapeutic decisions. Diagnostic power of cytology was high and showed a good correlation with the eventual pathologic diagnosis, with an overall 70.6% sensitivity. Cytologic examination of the pleural fluid is a simple minimally invasive procedure as an initial step in the diagnostic work-up of patients with pleural effusions. It does not only provide high diagnostic sensitivity but also leads the clinician in the correct algorithm as the most informative and leading test even when not diagnostic on its own.
Résumé
Aims: There are no current data about the adverse effects of anxiety on patient intolerance during bronchoscopy.The aim of our study was to assess the correlation between anxiety and patient intolerance during bronchoscopy. Study Design: Retrospective research study Place and Duration of Study: Department of Pulmonary Diseases, Cerrahpasa Medical Faculty, between January 2010 and 2013 March. Methodology: Data from 94 patients were analyzed. The mean age of the patients was 59 years. Bronchoscopy was performed for lung cancer in 54, pulmonary nodules in 26 and pulmonary infiltration in 14 patients. Hospital Anxiety Depression scale was used to appraise the anxiety symptoms. Cytologic examination of bronchoalveolar lavage, and sputum samples were performed in each patient when available. Results: The anxiety or fear profile of the patients before bronchoscopy were as follows: dyspnea (78%), malignant disease (74%), nasal, laryngeal or tracheal irritation (70%), bronchoscopic findings (68%), and hemorrhage (42%). Bronchoscopic examination was intolerable in 14 cases while there was great difficulty to perform the procedure in 18 patients. Cytologic analysis revealed severe in 18, moderate in 22, and mild dysplasia in 25 patients while it was normal in 29 subjects. Hospital Anxiety Depression scale was over eight in 33 patients. The scale was over eight in 13 out of 14 patients who were intolerant to bronchoscopy. Cytology revealed severe in one and moderate dysplasia in another patient intolerant to bronchoscopy. Conclusions: Anxiety appears to be the predominant factor for patient intolerance during bronchoscopy. Pulmonary function, atypical or dysplastic cytomorphological changes in sputum or bronchoalveolar lavage cytology did not show correlation with patient performance.