Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity.

BACKGROUND: The aim of this study was to evaluate the correlation between clinical and imaging findings with a worse clinical outcome in patients with a confirmed diagnosis of H1N1 influenza A virus. METHODS: Patients with a positive viral test for influenza A H1N1 in 2016 and chest radiography (CR) and/or computed tomography (CT) results had clinical and imaging data reviewed. Hospitalization, admission to the intensive care unit or death were defined as worse clinical outcomes. The association between clinical and imaging features and the worse outcome was calculated in a logistical regression model. RESULTS: Eighty of 160 (50%) patients were men, with a mean age of 43 ± 19 years. The most common symptoms were as follows: flu-like symptoms 141/160 (88%), dyspnea (25/160, 17%), and thoracic pain (7/160, 5%). Abnormalities on CR were detected in 8/110 (7%) patients, and 43/59 (73%) patients had an abnormal CT. The following variables were associated with worse clinical outcomes: the presence of diabetes mellitus (DM), hypertension, dyspnea, thoracic pain, abnormal CR or CT regardless of the type of finding, CT with consolidation or ground glass opacity. CONCLUSIONS: The presence of DM, hypertension, dyspnea, thoracic pain, or an abnormal CR or CT on admission were associated with worse clinical outcomes in patients with H1N1 influenza A virus infection. Thus, the use of readily accessible clinical and imaging features on admission may have a role in the evaluation of patients with H1N1 infection.

Epithelioid pituicytoma: An unusual case report.

BACKGROUND: Pituicytomas are considered World Health Organization Grade I malignancies. Until September 2017, a total of 81 cases of pituicytomas were diagnosed and described in literature. We present such a case in which histopathology shows an epithelioid pattern, a rare variant of pituicytoma. As far as we know, this is only the second such case described in the literature. CASE DESCRIPTION: A 61-year-old male patient presented with complaints of progressive decrease in visual acuity for about 7 months, worse on the left side. Laboratory and endocrinological investigation returned normal values. Magnetic resonance imaging revealed a mixed solid-cystic lesion, measuring about 3.1 × 2.2 × 2.9 cm. The lesion presented with intermediate signal intensity in T1 and T2 sequences and showed avid postcontrast enhancement. The patient underwent resection through a left pterional approach. Pathology revealed a glial neoplasm with an epithelioid pattern and moderate cellularity with rounded-elongated cell nuclei and with a broad eosinophilic cytoplasm. Absence of cellular pleomorphism, any mitotic figures, or areas of necrosis was noted. CONCLUSION: The epithelioid variant of pituicytomas differs from the commonly encountered forms of this tumor which typically present in a fascicular pattern. Microsurgical resection is the treatment of choice. However, in many cases, subtotal resection was performed because of a considerable risk for neurovascular injuries.

Religiosity and Impulsivity in Mental Health: Is There a Relationship?

Our aim is to evaluate the relationship between religiosity and impulsivity in patients with mental illness who had attempted suicide and in healthy individuals. This is a cross-sectional study that included 61 healthy individuals and 93 patients. The instruments used were a sociodemographic data questionnaire, the Mini International Neuropsychiatric Interview, the Barratt Impulsiveness Scale, and the Duke University Religion Index. The healthy individuals presented higher scores in the religiosity domains (organizational, p = 0.028; non-organizational, p = 0.000; intrinsic, p = 0.000). The patients presented higher scores in the impulsivity dimensions (attentional, p = 0.000; motor, p = 0.000; absence of planning, p = 0.000). In the patient group, intrinsic religiosity had a significant inverse relationship with total impulsivity (p = 0.023), attentional (p = 0.010), and absence of planning (p = 0.007), even after controlling for sociodemographic variables. Healthy individuals were more religious and less impulsive than patients. The relationship between religiosity, impulsiveness, and mental illness could be bidirectional; that is, just as mental illness might impair religious involvement, religiosity could diminish the expression of mental illness and impulsive behaviors.