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2.
BMJ Case Rep ; 14(1)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472801

RESUMO

We report a case of a 42-year-old man who presented with acute epigastric and retrosternal chest pain and exertional dyspnoea, and was subsequently diagnosed with polyserositis secondary to post-Streptococcal mitis infection. A CT scan showed a large pericardial effusion requiring pericardiocentesis, small bilateral pleural effusions and small amount of ascites. Several serological tests were done, which were all found to be normal. Pericardial and pleural fluid aspirates revealed an exudate. Culture of the pleural fluid yielded growth of S.  mitis and this was deemed the cause of the polyserositis, which is rare. The patient made a spontaneous recovery. He was started on colchicine by the cardiologists to help prevent pericardial fluid recurrence and this was continued for 3 months. A dental review confirmed the presence of dental caries, the possible source of infection. On follow-up, the patient remained well with no further relapses.


Assuntos
Ascite/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Serosite/diagnóstico por imagem , Infecções Estreptocócicas/diagnóstico , Adulto , Anti-Inflamatórios/uso terapêutico , Ascite/etiologia , Colchicina/uso terapêutico , Humanos , Masculino , Derrame Pericárdico/etiologia , Derrame Pericárdico/terapia , Pericardiocentese , Derrame Pleural/etiologia , Derrame Pleural/microbiologia , Serosite/etiologia , Infecções Estreptocócicas/complicações , Streptococcus mitis , Tomografia Computadorizada por Raios X
3.
Br J Radiol ; 94(1118): 20200716, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33471553

RESUMO

OBJECTIVES: Ground-glass opacity and consolidation are recognized typical features of Coronavirus disease-19 (COVID-19) pneumonia on Chest CT, yet ancillary findings have not been fully described. We aimed to describe ancillary findings of COVID-19 pneumonia on CT, to define their prevalence, and investigate their association with clinical data. METHODS: We retrospectively reviewed our CT chest cases with coupled reverse transcriptase polymerase chain reaction (rt-PCR). Patients with negative rt-PCR or without admission chest CT were excluded. Ancillary findings included: vessel enlargement, subpleural curvilinear lines, dependent subpleural atelectasis, centrilobular solid nodules, pleural and/or pericardial effusions, enlarged mediastinal lymph nodes. Continuous data were expressed as median and 95% confidence interval (95% CI) and tested by Mann-Whitney U test. RESULTS: Ancillary findings were represented by 106/252 (42.1%, 36.1 to 48.2) vessel enlargement, 50/252 (19.8%, 15.4 to 25.2) subpleural curvilinear lines, 26/252 (10.1%, 7.1 to 14.7) dependent subpleural atelectasis, 15/252 (5.9%, 3.6 to 9.6) pleural effusion, 15/252 (5.9%, 3.6 to 9.6) mediastinal lymph nodes enlargement, 13/252 (5.2%, 3 to 8.6) centrilobular solid nodules, and 6/252 (2.4%, 1.1 to 5.1) pericardial effusion. Air space disease was more extensive in patients with vessel enlargement or centrilobular solid nodules (p < 0.001). Vessel enlargement was associated with longer history of fever (p = 0.035) and lower admission oxygen saturation (p = 0.014); dependent subpleural atelectasis with lower oxygen saturation (p < 0.001) and higher respiratory rate (p < 0.001); mediastinal lymph nodes with shorter history of cough (p = 0.046); centrilobular solid nodules with lower prevalence of cough (p = 0.023), lower oxygen saturation (p < 0.001), and higher respiratory rate (p = 0.032), and pericardial effusion with shorter history of cough (p = 0.015). Ancillary findings associated with longer hospital stay were subpleural curvilinear lines (p = 0.02), whereas centrilobular solid nodules were associated with higher rate of intensive care unit admission (p = 0.01). CONCLUSION: Typical high-resolution CT findings of COVID-19 pneumonia are frequently associated with ancillary findings that variably associate with disease extent, clinical parameters, and disease severity. ADVANCES IN KNOWLEDGE: Ancillary findings might reflect the broad range of heterogeneous mechanisms in severe acute respiratory syndrome from viral pneumonia, and potentially help disease phenotyping.


Assuntos
/diagnóstico por imagem , Achados Incidentais , Pulmão/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Dilatação Patológica/diagnóstico por imagem , Feminino , Humanos , Pulmão/irrigação sanguínea , Linfonodos/diagnóstico por imagem , Linfadenopatia/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores/métodos , Variações Dependentes do Observador , Derrame Pleural/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Estudos Retrospectivos
4.
BMJ Case Rep ; 14(1)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509855

RESUMO

Infection by human T-lymphotropic virus 1 (HTLV-1) is often seen as the cause of chronic infection or lymphoproliferative disorders, but many clinicians do not recognise its association with severe immunosuppression. We report the case of a woman in her 70s from the Caribbean who sought care at the emergency department for weakness, fatigue and weight loss. Further work-up showed atypical lymphocytosis with floral lymphocytes and smudge cells in the peripheral blood smear and hypercalcaemia. Chest CT demonstrated a moderate right pleural effusion. Results of HIV testing were negative, and screening and confirmatory tests for HTLV-1 were positive. Empiric antibiotic therapy was administered, and the patient was discharged home. Five days later, she was readmitted with shortness of breath and severe abdominal pain. A disseminated infection with Cryptococcus neoformans was diagnosed. Despite aggressive intravenous antifungal therapy, the patient died on day 7 of hospitalisation.


Assuntos
Criptococose/diagnóstico , Infecções por HTLV-I/diagnóstico , Infecções Fúngicas Invasivas/diagnóstico , Leucemia-Linfoma de Células T do Adulto/diagnóstico , Idoso , Antifúngicos/uso terapêutico , Ascite/diagnóstico por imagem , Criptococose/complicações , Criptococose/tratamento farmacológico , Emigrantes e Imigrantes , Evolução Fatal , Feminino , Infecções por HTLV-I/complicações , Haiti/etnologia , Vírus Linfotrópico T Tipo 1 Humano , Humanos , Infecções Fúngicas Invasivas/complicações , Infecções Fúngicas Invasivas/tratamento farmacológico , Leucemia-Linfoma de Células T do Adulto/complicações , Linfadenopatia/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem
5.
Medicina (Kaunas) ; 57(1)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33430107

RESUMO

Foreign body (FB) aspiration occurs less frequently in adults than in children. Among the complications related to FB aspiration, pneumothorax is rarely reported in adults. Although the majority of FB aspiration cases can be diagnosed easily and accurately by using radiographs and bronchoscopy, some patients are misdiagnosed with endobronchial tumors. We describe a case of airway FB that mimicked an endobronchial tumor presenting with pneumothorax in an adult. A 77-year-old man was referred to our hospital due to pneumothorax and atelectasis of the right upper lobe caused by an endobronchial nodule. A chest tube was immediately inserted to decompress the pneumothorax. Chest computed tomography with contrast revealed an endobronchial nodule that was seen as contrast-enhanced. Flexible bronchoscopy was performed to biopsy the nodule. The bronchoscopy showed a yellow spherical nodule in the right upper lobar bronchus. Rat tooth forceps were used, because the lesion was too slippery to grasp with ellipsoid cup biopsy forceps. The whole nodule was extracted and was confirmed to be a FB, which was determined to be a green pea vegetable. After the procedure, the chest tube was removed, and the patient was discharged without any complications. This case highlights the importance of suspecting a FB as a cause of pneumothorax and presents the possibility of misdiagnosing an aspirated FB as an endobronchial tumor and selecting the appropriate instrument for removing an endobronchial FB.


Assuntos
Brônquios , Neoplasias Brônquicas/diagnóstico , Diagnóstico Diferencial , Corpos Estranhos/diagnóstico por imagem , Ervilhas , Derrame Pleural/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Idoso , Broncoscopia , Corpos Estranhos/complicações , Corpos Estranhos/cirurgia , Humanos , Masculino , Derrame Pleural/etiologia , Derrame Pleural/terapia , Pneumotórax/etiologia , Pneumotórax/terapia , Aspiração Respiratória
6.
Am J Forensic Med Pathol ; 42(1): 1-8, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33416234

RESUMO

ABSTRACT: The 2019 novel coronavirus disease (COVID-19) has spread worldwide, infiltrating, infecting, and devastating communities in all locations of varying demographics. An overwhelming majority of published literature on the pathologic findings associated with COVID-19 is either from living clinical cohorts or from autopsy findings of those who died in a medical care setting, which can confound pure disease pathology. A relatively low initial infection rate paired with a high biosafety level enabled the New Mexico Office of the Medical Investigator to conduct full autopsy examinations on suspected COVID-19-related deaths. Full autopsy examination on the first 20 severe acute respiratory syndrome coronavirus 2-positive decedents revealed that some extent of diffuse alveolar damage in every death due to COVID-19 played some role. The average decedent was middle-aged, male, American Indian, and overweight with comorbidities that included diabetes, ethanolism, and atherosclerotic and/or hypertensive cardiovascular disease. Macroscopic thrombotic events were seen in 35% of cases consisting of pulmonary thromboemboli and coronary artery thrombi. In 2 cases, severe bacterial coinfections were seen in the lungs. Those determined to die with but not of severe acute respiratory syndrome coronavirus 2 infection had unremarkable lung findings.


Assuntos
/mortalidade , Pulmão/patologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Autopsia , Índice de Massa Corporal , Edema Encefálico/patologia , Cardiomegalia/patologia , Comorbidade , Trombose Coronária/patologia , Bases de Dados Factuais , Fígado Gorduroso/patologia , Feminino , Patologia Legal , Glomerulosclerose Segmentar e Focal/patologia , Hepatomegalia/patologia , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Nefroesclerose/patologia , New Mexico/epidemiologia , Sobrepeso/epidemiologia , Pandemias , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/patologia , Edema Pulmonar/diagnóstico por imagem , Edema Pulmonar/patologia , Distribuição por Sexo , Streptococcus pneumoniae/isolamento & purificação , Tomografia Computadorizada por Raios X , Corpo Vítreo/química , Imagem Corporal Total
7.
Nutr. hosp ; 37(6): 1281-1284, nov.-dic. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198318

RESUMO

INTRODUCCIÓN: la nutrición parenteral (NP) es una modalidad de soporte nutricional con posibles complicaciones, en parte asociadas al catéter venoso central (CVC). El quilotórax consiste en el derrame de líquido linfático de origen intestinal en el espacio pleural. CASO CLÍNICO: varón de 57 años ingresado para colecistectomía. Presenta un postoperatorio complicado que requiere reposo digestivo y NP. Posteriormente presenta disnea y dolor torácico con derrame pleural bilateral y pericárdico. Inicialmente se interpretó como un quilotórax, por su aspecto lechoso y su contenido en triglicéridos. La TC confirmó la malposición del CVC con salida de NP a nivel del tronco venoso innominado. Fue intervenido quirúrgicamente, realizándose un lavado del mediastino anterior y la reparación de la perforación. La evolución posterior fue favorable. DISCUSIÓN: la extravasación de la NP al espacio pleural es una complicación infrecuente pero posible de la administración de NP por vía central. Por tanto, debe tenerse en cuenta en el diagnóstico diferencial


INTRODUCTION: parenteral nutrition (PN) is commonly used as a nutritional support option. It may cause complications, partly due to a central venous access. Chylothorax is an accumulation of lymphatic fluid in the pleural space. CASE REPORT: a 57-year-old man was admitted for cholecystectomy. A complicated postoperative period required PN. Cardiorespiratory symptoms started while receiving PN, and a bilateral pleural and pericardial effusion was identified. It was initially interpreted as chylothorax due to its milky appearance and high triglyceride content. A CT scan confirmed a malposition of the CVC with PN leakage at the level of the innominate venous trunk. It was surgically repaired. DISCUSSION: parenteral nutrition leakage is an unusual complication of PN. It should be included in the differential diagnosis of pleural effusion


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral Total/efeitos adversos , Quilotórax/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Esternotomia/métodos , Quilotórax/complicações , Complicações Pós-Operatórias , Dispneia/complicações , Dor no Peito/etiologia , Hematemese/complicações , Diagnóstico Diferencial , Radiografia Torácica
9.
Acta Med Indones ; 52(4): 375-382, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33377883

RESUMO

Coronavirus disease 2019 (COVID-19) is an acute respiratory disease which rapidly disseminated due to Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) virus. Clinical presentations of COVID-19 are fever, non-productive cough, and dyspnea. Although the diagnosis establishment is done by detecting the viral ribonucleic acid (RNA) through reverse transcription-polymerase chain reaction (RT-PCR) method, CT scan has an important role in detection and treatment of COVID-19 especially in high prevalence regions. Chest CT scan has high sensitivity yet low specificity because there are a lot of other pathological spectrums that also present features of COVID-19 such as ground glass opacities (GGO) and consolidation, one of them is CMV infection. The objective of this case report is to raise vigilance towards other diseases that have radiological image similarities with COVID-19, especially in the immunocompromised patients who are susceptible to viral infections like CMV infection so that the delay in the disease treatment can be prevented.


Assuntos
Infecções por Citomegalovirus/diagnóstico , Erros de Diagnóstico , Pulmão/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Tomografia Computadorizada por Raios X
10.
Biomedica ; 40(Supl. 2): 27-33, 2020 10 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33152185

RESUMO

COVID-19 is the viral infection caused by SARS-CoV-2 declared by the World Health Organization (WHO) as a pandemic. Patients with cancer have a higher risk to acquire the infection and worse prognosis as they have to attend more medical visits in healthcare institutions, receive medical and surgical treatments, and be subjected to diagnostic studies such as PET/CT in nuclear medicine services where the infection may be an incidental finding. We present here F18-FDG PET/CT (Positron Emission Tomography and Computed Tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose), images with findings of COVID-19 from patients with different oncological conditions but no respiratory symptoms.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico por imagem , Achados Incidentais , Neoplasias/complicações , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adulto , Idoso , Doenças Assintomáticas , Carcinoma de Células em Anel de Sinete/complicações , Carcinoma de Células em Anel de Sinete/diagnóstico por imagem , Carcinoma de Células em Anel de Sinete/secundário , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Feminino , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Humanos , Metástase Linfática/diagnóstico por imagem , Linfoma não Hodgkin/complicações , Linfoma não Hodgkin/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Pandemias , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Pneumonia Viral/complicações , Compostos Radiofarmacêuticos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Seminoma/complicações , Seminoma/diagnóstico por imagem , Seminoma/secundário , Neoplasias Gástricas
11.
Rev. esp. anestesiol. reanim ; 67(9): 521-526, nov. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-198672

RESUMO

El derrame pleural es una patología frecuente en las unidades de cuidados intensivos. El diagnóstico ha mejorado tras la introducción de la ecografía pulmonar, método accesible a pie de cama, que permite no sólo el diagnóstico sino también el tratamiento de esta entidad. El objetivo de nuestro estudio es determinar la precisión de las fórmulas matemáticas publicadas para calcular el volumen de derrame pleural a partir de mediciones ecográficas. Tras realizar una revisión sistemática, se seleccionaron siete artículos que proponen cada uno de ellos una ecuación matemática. En todos ellos los resultados fueron estadísticamente significativos. No obstante, no existe una fórmula ideal entre las estudiadas


Pleural effusion is a frequent pathology in intensive care units. The diagnosis has improved after the introduction of pulmonary ultrasound, an accessible method at the bedside, which allows not only the diagnosis but also the treatment of this entity. The aim of our study is to determine the accuracy of published mathematical equations to calculate the volume of pleural effusion from ultrasound measurements. After doing a systematic review, seven articles were selected that each proposed a mathematical equation. In all of them the results were statistically significant. However, there is no ideal formula among those studied


Assuntos
Humanos , Unidades de Terapia Intensiva , Derrame Pleural/diagnóstico por imagem , Ultrassonografia , Modelos Teóricos
12.
Turk Kardiyol Dern Ars ; 48(7): 698-702, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33034577

RESUMO

Acute heart failure (HF) is one of the most common cardiac emergencies. Pulmonary edema caused by HF may mimic an exudative disease on chest computed tomography scans. Coronavirus disease 2019 (COVID-19) emerged in China in December 2019 and quickly spread around the world. During this pandemic period, the need to exclude the possibility of COVID-19 pneumonia in patients with acute dyspnea may cause a delay in the diagnosis and treatment of patients with acutely decompensated HF who have similar symptoms. This case report describes a diabetic patient admitted with dyspnea one week after she suffered an acute myocardial infarction. The objective of this report is to draw attention to the differential diagnosis of HF and COVID-19 pneumonia.


Assuntos
Insuficiência Cardíaca/diagnóstico , Tomografia Computadorizada por Raios X , Adulto , Infecções por Coronavirus , Diagnóstico Diferencial , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/fisiopatologia , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pandemias , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Derrame Pleural/patologia , Pneumonia Viral
14.
J Postgrad Med ; 66(4): 206-208, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33109782

RESUMO

Pancreatic-pleural fistula (PPF) is a rare sequela of pancreatitis. High degree of clinical suspicion is required to diagnose a PPF. Confirmation is done by high amylase content in pleural fluid analysis. Here, we present two cases with varied presentation of PPF. A 43-year-old man presented with acute on chronic pancreatitis with bilateral (predominantly right) pleural effusion. Another 57-year-old man, previously diagnosed with chronic calcific pancreatitis, presented with left pleural effusion. Both cases were effectively managed with endoscopic pancreatic duct stenting.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/métodos , Ductos Pancreáticos/cirurgia , Fístula Pancreática/cirurgia , Pancreatite Crônica/complicações , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/cirurgia , Stents , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos/diagnóstico por imagem , Ductos Pancreáticos/patologia , Fístula Pancreática/complicações , Fístula Pancreática/diagnóstico por imagem , Pancreatite Crônica/diagnóstico por imagem , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/terapia , Derrame Pleural/etiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
Pan Afr Med J ; 36: 257, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33014253

RESUMO

Since asymptomatic infections as "covert transmitter", and some patients can progress rapidly in the short term, it is essential to pay attention to the diagnosis and surveillance of asymptomatic patients with SARS-COV2 infection. CT scan has great value in screening and detecting patients with COVID-19 pneumonia, especially in the highly suspected or probable asymptomatic cases with negative RT-PCR for SARS-COV2. This study aimed to detect incidentally COVID-19 pneumonia on medical imaging for patients consulting for other reasons.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pandemias , Pneumonia Viral/diagnóstico por imagem , Dor Abdominal/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Lesões Encefálicas/complicações , Dor no Peito/complicações , Criança , Pré-Escolar , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Achados Incidentais , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/etiologia , Masculino , Pessoa de Meia-Idade , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Pneumonia Viral/complicações , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodos , Tunísia/epidemiologia , Adulto Jovem
17.
J Vasc Interv Radiol ; 31(10): 1636-1644.e1, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32943296

RESUMO

PURPOSE: To retrospectively investigate incidence, clinical outcome, and risk factors of iatrogenic pleural effusion in patients with hepatic tumors undergoing radiofrequency (RF) ablation using artificial ascites (AA). MATERIALS AND METHODS: Patients (N = 163) who underwent RF ablation using AA were classified into pleural effusion and non-pleural effusion groups according to the presence of pleural effusion on immediate follow-up CT and chest radiograph after RF ablation. The pleural effusion group included asymptomatic and symptomatic subgroups. The incidence and subsequent clinical outcomes of patients developing pleural effusion after RF ablation were evaluated. RESULTS: Overall, 96 patients (58.9%) developed pleural effusion, which resolved in 4.4 d ± 3.1. Hospital length of stay in the pleural effusion group was longer than the non-pleural effusion group (6.5 d ± 2.6 vs 5.7 d ± 2.8, P < .01). The pleural effusion group had longer AA infusion time (P = .01), larger infused AA volume (P < .01), and longer ablation time (P < .01) than the non-pleural effusion group. Eighteen patients (18.8%) developed symptomatic pleural effusion and had a larger infused AA volume than asymptomatic patients with pleural effusion (P < .01). Pleural effusion duration and hospital length stay were also longer in the symptomatic pleural effusion subgroup than in the asymptomatic subgroup (P < .01). Infused AA volume was the only independent prognostic factor of pleural effusion duration in multivariate analysis (P = .038). CONCLUSIONS: Pleural effusion frequently occurs after RF ablation using AA. Although generally considered negligible, pleural effusion could be a clinical problem and prolong hospitalization. Therefore, operators should be careful not to infuse too much AA when performing RF ablation.


Assuntos
Ascite , Doença Iatrogênica/epidemiologia , Neoplasias Hepáticas/cirurgia , Derrame Pleural/epidemiologia , Ablação por Radiofrequência/efeitos adversos , Idoso , Feminino , Humanos , Incidência , Infusões Parenterais , Tempo de Internação , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Derrame Pleural/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
18.
Clin Nucl Med ; 45(11): 925-926, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32969899

RESUMO

Pleural and pericardiac effusion could have radioiodine accumulation and be potential pitfall on posttherapeutic I whole-body scintigraphy. However, the volume of the effusion was relatively massive in the previous publications. We report a case of pleural effusion with a very small volume also had radioiodine uptake in a 37-year-old man.


Assuntos
Artefatos , Radioisótopos do Iodo , Derrame Pleural/diagnóstico por imagem , Adulto , Humanos , Masculino , Cintilografia , Imagem Corporal Total
19.
J Korean Med Sci ; 35(34): e316, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32864912

RESUMO

BACKGROUND: The predictors of poor prognosis in patients with coronavirus disease 2019 (COVID-19) using computed tomography (CT) have not been investigated in a large cohort. Therefore, the purpose of this study was to investigate the adverse initial CT features to predict poor prognosis in COVID-19. METHODS: From February to April 2020, 281 COVID-19 patients who underwent CT at the time of admission were included. We divided the patients into the severe and non-severe disease groups. The severe group included patients with severe pneumonia or critical events. Intensive care unit admission or death were the critical events in this study. We compared the clinical and CT findings between the severe and non-severe groups and investigated the prognostic factors and critical events of the severe group using the regression analysis. RESULTS: Among the 281 patients, 36 (12.8%) patients were in the severe group and 245 (87.2%) patients were in the non-severe group. Critical events occurred in 10 patients (3.6%). In the severe group, patients showed significantly more pneumonia with consolidation, crazy-paving appearance, pleural effusion, and higher CT scores than those in the non-severe group (all, P < 0.05). In the multivariate regression, pleural effusion (odds ratio [OR], 8.96; 95% confidence interval [CI], 1.81-44.42; P = 0.007), CT score > 5 (OR, 3.70; 95% CI, 1.44-9.53; P = 0.007), old age (> 77 years, OR, 9.96; 95% CI, 3.78-26.28; P < 0.001), and elevated C-reactive protein (OR, 4.15; 95% CI, 1.62-10.6; P = 0.003) were significant prognostic factors of severe disease. CT score > 5 (OR, 7.29; 95% CI, 1.37-38.68; P = 0.020), pleural effusion (OR, 5.67; 95% CI, 1.04-30.8; P = 0.045) and old age (OR, 8.6; 95% CI, 1.80-41.0; P = 0.007) were also significant predictors of critical events. CONCLUSION: Pleural effusion and the extent of pneumonia on initial CT scans are associated with poor prognosis in patients with COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Pulmão/diagnóstico por imagem , Pulmão/patologia , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/patologia , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Betacoronavirus , Proteína C-Reativa/análise , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
20.
Rev. patol. respir ; 23(3): 111-113, jul.-sept. 2020.
Artigo em Espanhol | IBECS | ID: ibc-198474

RESUMO

La amebiasis es una enfermedad infecciosa causada por el protozoo E. hystolitica con múltiples manifestaciones clínicas. La afectación torácica es la segunda localización extraintestinal más frecuente tras la hepática. Presentamos un caso de derrame pleural secundario a un absceso hepático amebiano y realizamos una revisión de esta entidad poco frecuente


Amebiasis is an infectious disease caused by the protozoan E. hystolitica with multiple clinical manifestations. Chest involvement is the second most frequent extraintestinal location after the liver. We present a case of pleural effusion secondary to an amebic liver abscess and we review this rare entity


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Abscesso Hepático Amebiano/complicações , Abscesso Hepático Amebiano/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , Ultrassonografia , Derrame Pleural/tratamento farmacológico , Abscesso Hepático Amebiano/tratamento farmacológico , Metronidazol/uso terapêutico , Antiprotozoários/uso terapêutico
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