scholarly journals EFFECT OF WEIGHT LOSS SURGERY ON PERICARDIAL FAT VOLUME ASSESSED BY CHEST COMPUTED TOMOGRAPHY

2021 ◽  
Vol 77 (18) ◽  
pp. 1364
Author(s):  
Anees Daud ◽  
Elizabeth Dranow ◽  
Majd Ibrahim
2018 ◽  
Vol 3 (2) ◽  
pp. 69-76
Author(s):  
Nóra Raț ◽  
Diana Opincariu ◽  
Emese Márton ◽  
Ramona Zavate ◽  
Mirela Pintican ◽  
...  

Abstract Background: The role of periplaque fat (PPF), as a fragment of the total epicardial adipose tissue, measured in the vicinity of a target coronary lesion, more specifically within the close proximity of a vulnerable plaque, has yet to be evaluated. The study aimed to evaluate the interrelation between PPF and coronary plaque vulnerability in patients with stable coronary artery disease (CAD). Secondary objective: evaluation of the relationship between the total pericardial fat and markers for plaque vulnerability. Materials and methods: We prospectively enrolled 77 patients with stable CAD, who underwent 128-multislice computed tomography coronary angiography (CTCA), and who presented minimum one lesion with >50% stenosis. CTCA analysis included measurements of: total pericardial fat and PPF volumes, coronary plaque characteristics, markers for plaque vulnerability – positive remodeling (PR), low attenuation plaque (LAP), spotty calcifications (SC,) napkin ring sign (NRS). Study subjects were divided into two categories: Group 1 – 1 marker of plaque vulnerability (n = 36, 46.75%) and Group 2 – ≥1 marker of vulnerability (n = 41, 53.25%). Results: The mean age of the population was 61.77 ± 11.28 years, and 41 (53.24%) were males. The analysis of plaque characteristics showed that Group 2 presented significantly longer plaques (16.26 ± 4.605 mm vs. 19.09 ± 5.227 mm, p = 0.02), remodeling index (0.96 ± 0.20 vs. 1.18 ± 0.33, p = 0.0009), and vessel volume (p = 0.027), and more voluminous plaques (147.5 ± 71.74 mm3 vs. 207.7 ± 108.9 mm3, p = 0.006) compared to Group 1. Group 2 presented larger volumes of PPF (512.2 ± 289.9 mm3 vs. 710.9 ± 361.9 mm3, p = 0.01) and of thoracic fat volume (1,616 ± 614.8 mm3 vs. 2,000 ± 850.9 mm3, p = 0.02), compared to Group 1, but no differences were found regarding the total pericardial fat (p = 0.49). Patients with 3 or 4 vulnerability markers (VM) presented significantly larges PPF volumes compared to those with 1 or 2 VM, respectively (p = 0.008). There was a significant positive correlation between PPF volume and the non-calcified (r = 0.474, 95% CI 0.2797–0.6311, p <0.0001), lipid-rich (r = 0.316, 95% CI 0.099–0.504, p = 0.005), and fibro-fatty (r = 0.452, 95% CI 0.2541–0.6142, p <0.0001) volumes. The total pericardial fat was significantly correlated only with the volume of lipid-rich plaques (p = 0.02). Conclusions: Periplaque fat volume was associated with a higher degree of coronary plaque vulnerability. PPF was correlated with lipid-rich, fibro-fatty, and non-calcified plaque-related volumes, as markers for enhanced plaque vulnerability. PPF volume, assessed with native cardiac computed tomography, could become a novel marker for coronary plaque vulnerability.


2019 ◽  
Author(s):  
Jennifer James ◽  
Victoria Sprung ◽  
Wendy Hardeman ◽  
Mark Goodall ◽  
Helen Eborall ◽  
...  

2019 ◽  
Vol 7 (1A) ◽  
Author(s):  
Wadia Aburjaile ◽  
Mauricio Gomez ◽  
Arnaldo Prata Mourão

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Binghua Zhu ◽  
Jing Tang ◽  
Rong Fang ◽  
Xuejie Fei ◽  
Qing Wang ◽  
...  

Abstract Background We diagnosed a clinical case of pulmonary infection involving Mycobacterium tuberculosis and Tropheryma whipplei in a patient with acute respiratory distress syndrome. The diagnosis was assisted by metagenomic next-generation sequencing of bronchoalveolar lavage fluid. Case presentation A 44-year-old Han Chinese inmate was transferred to the emergency department because of dry cough, chest tightness, and shortness of breath. The patient’s body temperature rose to 39.3 °C following empirical cephalosporin treatment for 1 week. The blood CD4+/CD8+ ratio was 0.7, suggesting immunodeficiency. Routine microbiological tests were performed, and tuberculosis interferon gamma release assays were positive. Mycobacterium tuberculosis polymerase chain reaction was also positive. Chest computed tomography scan revealed miliary nodules and ground-glass opacifications, which were in accordance with tuberculosis. To fully examine the etiology, we performed routine laboratory tests and metagenomic sequencing, the results of which indicated the presence of Mycobacterium tuberculosis and Tropheryma whipplei. We administered anti-tuberculosis regimen in combination with trimethoprim/sulfamethoxazole. The patient recovered, with chest computed tomography scan showing absorption of lesions. Conclusions Compared with traditional diagnostic methods such as culture and serology, metagenomic next-generation sequencing has the advantage of detecting a wide array of microorganisms in a single test and therefore can be used for clinical diagnosis of rare pathogens and microbial coinfections. It is particularly useful for immunocompromised patients as they are more prone to infection by opportunistic microorganisms.


2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Muhammad Adel ◽  
Ahmed Magdy

Abstract Background Coronavirus disease (COVID-19) presents in children usually with less severe manifestations than in adults. Although fever and cough were reported as the most common symptoms, children can have non-specific symptoms. We describe an infant with aplastic anemia as the main manifestation. Case presentation We describe a case of SARS-CoV-2 infection in an infant without any respiratory symptoms or signs while manifesting principally with pallor and purpura. Pancytopenia with reticulocytopenia was the predominant feature in the initial laboratory investigations, pointing to aplastic anemia. Chest computed tomography surprisingly showed typical findings suggestive of SARS-CoV-2 infection. Infection was later confirmed by positive real-time reverse transcription polymerase chain reaction assay (RT-PCR) for SARS-CoV-2. Conclusions Infants with COVID-19 can have non-specific manifestations and a high index of suspicion should be kept in mind especially in regions with a high incidence of the disease. Chest computed tomography (CT) and testing for SARS-CoV-2 infection by RT-PCR may be considered even in the absence of respiratory manifestations.


2021 ◽  
Vol 14 (3) ◽  
pp. e240202
Author(s):  
Benjamin McDonald

An 80-year-old woman presented to a regional emergency department with postprandial pain, weight loss and diarrhoea for 2 months and a Computed Tomography (CT) report suggestive of descending colon malignancy. Subsequent investigations revealed the patient to have chronic mesenteric ischaemia (CMI) with associated bowel changes. She developed an acute-on-chronic ischaemia that required emergency transfer, damage control surgery and revascularisation. While the patient survived, this case highlights the importance of considering CMI in elderly patients with vague abdominal symptoms and early intervention to avoid potentially catastrophic outcomes.


Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 50
Author(s):  
Jun-Ho Ha ◽  
Byeong-Ho Jeong

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.


Author(s):  
Shimaa Farghaly ◽  
Marwa Makboul

Abstract Background Coronavirus disease 2019 (COVID-19) is the most recent global health emergency; early diagnosis of COVID-19 is very important for rapid clinical interventions and patient isolation; chest computed tomography (CT) plays an important role in screening, diagnosis, and evaluating the progress of the disease. According to the results of different studies, due to high severity of the disease, clinicians should be aware of the different potential risk factors associated with the fatal outcome, so chest CT severity scoring system was designed for semi-quantitative assessment of the severity of lung disease in COVID-19 patients, ranking the pulmonary involvement on 25 points severity scale according to extent of lung abnormalities; this study aims to evaluate retrospectively the relationship between age and severity of COVID-19 in both sexes based on chest CT severity scoring system. Results Age group C (40–49 year) was the commonest age group that was affected by COVID-19 by 21.3%, while the least affected group was group F (≥ 70 years) by only 6.4%. As regards COVID-RADS classification, COVID-RADS-3 was the most commonly presented at both sexes in all different age groups. Total CT severity lung score had a positive strong significant correlation with the age of the patient (r = 0.64, P < 0.001). Also, a positive strong significant correlation was observed between CT severity lung score and age in both males and females (r = 0.59, P < 0.001) and (r = 0.69, P < 0.001) respectively. Conclusion We concluded that age can be considered as a significant risk factor for the severity of COVID-19 in both sexes. Also, CT can be used as a significant diagnostic tool for the diagnosis of COVID-19 and evaluation of the progression and severity of the disease.


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