RESUMEN
OBJECTIVE: Interstitial lung disease is the most frequent lung symptom of rheumatoid arthritis and is a significant contributor to morbid- ity. As a result, the target of this research was to measure the frequency of radiological and functional abnormalities in rheumatoid arthritis patients who did not have any respiratory symptoms. MATERIAL AND METHODS: This study consists of 30 patients diagnosed with rheumatoid arthritis. All involved cases were exposed to entire history taking and clinical examination. All patients were examined by high-resolution computed tomography and pulmonary function tests. RESULTS: According to the computed tomography visual score, 73.3% showed interstitial lung disease. The most common abnormalities were reticular patterns (46.7%) followed by nodular patterns (40%) and septal lines (23.3%). However, 36% of the patients had a normal pulmonary function, while 32% had a small airway affection, 20% had restrictive lung disease, and 12% had obstructive lung disease. A significant association was found between supine expiratory volume and computed tomography visual score. Results showed no associa- tion between interstitial lung disease and all lung function test parameters. CONCLUSION: Subclinical interstitial lung disease is frequent among rheumatoid arthritis patents. A combination of pulmonary func- tion tests with computed tomography is essential to enhance the recognition of subclinical interstitial lung disease as normal pulmonary function alone cannot exclude its presence.
RESUMEN
OBJECTIVE: To evaluate the add value of combined analysis of high resolution computed tomography (HRCT) temporal bone parameters in accurate prediction of round window (RW) visibility through posterior tympanotomy. PATIENTS AND METHODS: a retrospective observational study was held in a tertiary center, conducted on 45 cochlear implant pediatric candidates between January 2017 and September 2019. Candidates were referred for CT temporal bone. They were classified into fully visible RW cases and partially or non-visible RW cases. Radiological measurements were compared between the two groups for prediction of RW visibility separate and in combination. RESULTS: 45 patients were included in the study (26 males (57.8%) and 19 females (42.2%)). Their median age was 4 years (2-12 years). There were 38 (84.4%) fully visible and 7 (15.6%) partially or non-visible RW cases. Kashio posterior line (n:32/3), fascial recess width (FRW) (mean: 4.9 (3.5-7.5)/4.2 (4-4.7) mm) and round window location (RWL) (3 (1-4)/2.8 (1-3)mm) measurements significantly differentiated between the two groups; (P value 0.034, 0.012 & 0.025 respectively). Posterior kashio line and cut off values of ≥4.75 mm of FRW & 2.95 mm of RWL were showed sensitivity 84.2%, 63.2% & 65.8%, and accuracy 80%, 68.9% &68.9% in prediction of RW visibility respectively. Combination of Kashio prediction line with cut off value ≥ 7.45 mm (sum of FRW & RWL) showed P value 0.003 with further improve in the sensitivity and overall accuracy in prediction of RW visibility from 84.2% to 80% up to 91.4% and 88.6% respectively. CONCLUSION: combined parameters using Kashio line with FRW and RWL increases sensitivity and overall accuracy in prediction of RW visibility rather than single parameter.
