Imaging Findings in Aspergillosis: From Head to Toe.

Aspergillosis is a mycotic infection induced by airborne fungi that are ubiquitous. Inhalation of Aspergillus conidia results in transmission through the respiratory tract. The clinical presentation is dependent on organism and host specifics, with immunodeficiency, allergies, and preexisting pulmonary disease constituting the most important risk factors. In recent decades, the incidence of fungal infections has increased dramatically, due in part to the increased number of transplants and the pervasive use of chemotherapy and immunosuppressive drugs. The spectrum of clinical manifestations can range from an asymptomatic or mild infection to a swiftly progressive, life-threatening illness. Additionally, invasive infections can migrate to extrapulmonary sites, causing infections in distant organs. Recognition and familiarity with the various radiological findings in the appropriate clinical context are essential for patient management and the prompt initiation of life-saving treatment. We discuss the radiological characteristics of chronic and invasive pulmonary aspergillosis, as well as some of the typically unexpected extrapulmonary manifestations of disseminated disease.

Artificial Intelligence for Cardiothoracic Imaging: Overview of Current and Emerging Applications.

Artificial intelligence algorithms can learn by assimilating information from large datasets in order to decipher complex associations, identify previously undiscovered pathophysiological states, and construct prediction models. There has been tremendous interest and increased incorporation of artificial intelligence into various industries, including healthcare. As a result, there has been an exponential rise in the number of research articles and industry participants producing models intended for a variety of applications in medical imaging, which can be challenging to navigate for radiologists. In thoracic imaging, multiple applications are being evaluated for chest radiography and computed tomography and include applications for lung nodule evaluation and cancer imaging, quantifying diffuse lung disorders, and cardiac imaging, to name a few. This review aims to provide an overview of current clinical AI models, focusing on the most common clinical applications of AI in cardiothoracic imaging.

Chest Imaging in Systemic Endemic Mycoses.

Endemic fungal infections are responsible for high rates of morbidity and mortality in certain regions of the world. The diagnosis and management remain a challenge, and the reason could be explained by the lack of disease awareness, variability of symptoms, and insidious and often overlooked clinical presentation. Imaging findings are nonspecific and frequently misinterpreted as other more common infectious or malignant diseases. Patient demographics and clinical and travel history are important clues that may lead to a proper diagnosis. The purpose of this paper is to review the presentation and differential diagnosis of endemic mycoses based on the most common chest imaging findings.

Avaliação do atendimento médico na fase aguda do infarto do miocárdio em centro de referência em cardiologia / Evalution of the medical attendance in the acute phase of myocardial infarction in a cardiology reference center

Introdução: Apesar da evolução em relação às opções terapêuticas no infarto agudo do miocárdio (IAM) e do advento de unidades coronarianas, percebe-se que os índices de mortalidade desse evento permanecem substancialmente elevados e com isso, questiona-se o fato de muitos pacientes com IAM não estarem recebendo de maneira integral o tratamento preconizado. Este trabalho teve como objetivo avaliar, em um centro de referência em cardiologia, se medidas recomendadas no atendimento inicial do IAM estão sendo realizadas. Métodos: Foi realizado um estudo observacional, no período de fevereiro de 2009 a novembro de 2009, no Hospital Regional Hans Dieter Schmidt / Joinville - SC, onde foram incluídos os pacientes com diagnóstico de IAM e indicação de angioplastia primária, observando-se quais medicações foram empregadas na fase aguda, além de exames complementares e o tempo necessário para realizar o diagnóstico de IAM com necessidade de reperfusão coronariana. Resultados: Uma amostra de 83 pacientes foi reunida, sendo que 80,72% fizeram uso de AAS e 54,22% de betabloqueadores. Não houve diferença estatisticamente significativa entre as prescrições nas diferentes faixas etárias. Radiografia do tórax foi solicitada em 43,37% e nenhum paciente realizou ecocardiograma. Do total, 23 pacientes (27,71%) tiveram tempo porta-diagnóstico abaixo de 10 minutos, sem diferença significativa quando comparado por sexos. Conclusões: Quando comparado com dados da literatura, nosso estudo mostrou que medicações que comprovadamente aumentam a sobrevida de pacientes com IAM estão sendo subutilizadas. Além disso, houve demora em realizar a indicação de angioplastia primária como recomendado pelas principais diretrizes.

Introduction: Despite the evolution in therapeutic options in acute myocardial infarction and the advent of Coronary Units, one can notice that the mortality rates of this event remains substantially high, and by that, it is questioned the fact of many patients with AMI are not receiving the full praised treatment. This paper had as goal to asses, in a Cardiology Reference Center, if the recommended treatments in the initial attendance of AMI are being fulfilled. Methods: An observational study was carried through, in the period of February/2009 to November/2009 in Hans Dieter Schmidt regional Hospital/ Joinville-SC, where patients diagnosed with AMI and primary angioplasty indication were included, observing which medications were prescribed, which ancillary tests were requested and time necessary to diagnose a AMI with coronary reperfusion treatment indication Results: A sample of 83 patients was selected, of whom 80,72% received Aspirin and 54,22% received betablockers. There was no meaningful statistic difference in prescriptions between different age groups. Chest radiographs was requested in 43,37% and in none patients a Echocardiogram was performed. In 23 patients (27,71%), less than 10 minutes were necessary between arrival in the Emergency Department to diagnosis, without statistic differences between sex groups. Conclusions : Compared to available data, this study showed that increasing survival proven drugs in AMI are misused. Besides, there were a delay in time of performing primary angioplasty indication as recommended by the main guidelines.