Aortic sclerosis: clinical signs and diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 2582-2583
Author(s):  
Yuvrajsinh J. Parmar ◽  
Itzhak Kronzon

Atherosclerotic changes in the aorta result in progressive accumulation of cholesterol and other lipids in the intimal–medial layer with secondary inflammation, fibrous tissue deposition, surface erosions (ulcers), and plaque formation. The plaques and ulcers are associated with clot formation and emboli resulting in a variety of clinical symptoms. Modern imaging technologies such as contrast-enhanced computed tomography, magnetic resonance imaging, and echocardiography are used in the diagnosis; however, transoesophageal echocardiography remains the gold standard for plaque visualization in the thoracic aorta. Treatment strategies revolve around risk factor reduction and management of general atherosclerosis, as there are no other proven therapies to date.

Author(s):  
Kazuma Tsujimura ◽  
Yasukatsu Takushi ◽  
Atsushi Nakachi ◽  
Tsuyoshi Teruya ◽  
Kouji Iha

Tumors of the small intestine are rare. In addition, clinical symptoms are nonspecific and neoplasm-related symptoms occur late. We report a case of neuroendocrine tumor (NET) of the small intestine that was diagnosed early with trans-abdominal ultrasonography (US). The patient was a 61-year-old man. Abdominal contrast-enhanced computed tomography (CT) was performed because the patient complained of abdominal pain. The CT showed a tumor lesion in the mesentery. Trans-abdominal US was undertaken to evaluate this tumor lesion, and a tumor lesion of the small intestine was found nearby. A diagnosis of lymph-node metastasis of a small-intestine tumor was made as a preoperative diagnosis. A laparotomy was performed with partial resection of the ileum, together with the small-intestine mesentery including an enlarged lymph node. Histological examination revealed NET of the ileum and lymph-node metastasis. Trans-abdominal US is useful in the diagnosis of small-intestine NET.


2020 ◽  
Vol 8 (1) ◽  
pp. e001011
Author(s):  
Nausikaa Devriendt ◽  
Norbert van de Velde ◽  
Emmelie Stock ◽  
Evelien de Bakker ◽  
Hilde de Rooster

A 10-month-old female intact Australian shepherd dog was diagnosed with an intrapelvic mass. Blood and urinanalyses were unremarkable. A contrast-enhanced CT scan was performed to define the extent of the mass. A large, expansile, heterogeneous mass, extending from the ventral aspect of the last lumbar vertebra until the second caudate vertebra and invading the vertebral canal at the lumbosacral junction with displacement of all organs in the caudal abdomen, was diagnosed. Two days after the CT scan, the dog was euthanased because of deterioration of clinical signs despite the start of multimodal analgesia. Necropsy and subsequent histology and immunohistochemistry revealed the presence of a plasmacytoma and haemorrhagic cystitis. The haemorrhagic cystitis was most likely caused by the contrast agent used for the CT scan that remained in the bladder for a prolonged time, secondary to subobstruction of the urethra.


2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Lei Ying ◽  
Jeong-Moh John Yahng

Abstract Femoral hernias account for ~4% of all groin hernias but are much more common in females, especially those over the age of 70. Risk of incarceration is overall low but can include structures such as bowel, omentum, bladder, ovary and very rarely, the appendix. The subset of femoral hernias containing the vermiform appendix is known as de Garengeot hernias. We describe a rare case of an 87-year-old female patient who presented with an incarcerated right femoral hernia confirmed on contrast-enhanced computed tomography scan of the abdomen and pelvis, with subsequent open hernia reduction revealing a perforated necrotic appendix with pus contained in the hernia sac. Histopathology revealed acute appendicitis with increased stromal fibrosis suggestive of a chronic process. Pre-operative diagnosis of de Garengeot hernias remains challenging due to their non-specific presentation and attenuated clinical symptoms, and most diagnoses are made intraoperatively.


Author(s):  
Harsha Vardhan Mahalingam ◽  
Rajoo Ramachandran ◽  
Venkatesh Bala Raghu Raji ◽  
Prabhu Radhan Radhakrishnan ◽  
Venkata Sai

Fascioliasis is a re-emerging food-borne parasitic zoonosis which presents with nonspecific clinical symptoms. Definitive diagnosis requires demonstration of parasitic ova in stool which may often be elusive. Imaging plays a crucial role in raising the possibility of this diagnosis early in the disease course. Contrast-Enhanced Computed Tomography (CECT) of the abdomen was performed in a 44-year-old male with fever, right upper quadrant pain and dyspepsia. The patient later underwent an ultrasound-guided biopsy of liver lesions. The stool examination for ova was negative. Biopsy of the liver lesions showed ill-defined granulomas. Imaging plays a crucial role in establishing the early diagnosis of hepatic fascioliasis especially in nonendemic regions where the clinical suspicion for this diagnosis is low. This article places emphasis on the description of typical imaging features of this condition and the usage of additional investigative/testing techniques recommended by the Center for Disease Control and Prevention (CDC).


2021 ◽  
Vol 8 ◽  
Author(s):  
Ye Yang ◽  
Xinxin Zhao ◽  
Ying Huang

Background: Endometriosis mainly affects female pelvic tissues and organs, and the presence of endometriosis in the kidney is extremely rare.Case Presentation: We report a case of a 48-year-old woman who presented with intermittent hematuria. She was found to have a cystic mass on renal ultrasonography, and contrast-enhanced computed tomography (CT) showed slight enhancement of the cystic wall and septa. These findings were indicative of cystic renal tumor. The patient subsequently underwent partial right nephrectomy. Histopathology revealed endometriosis of the right renal parenchyma. The patient recovered well and had no evidence of a recurrent renal mass at the 3 months' follow up.Conclusion: The possibility of renal endometriosis should be considered in a female patient with a cystic renal mass and clinical symptoms related to the menstrual cycle.


2020 ◽  
Vol 7 (10) ◽  
pp. 3445
Author(s):  
Rajdave Singh Sadu Singh ◽  
Muhammad Rahimi Mohamad Hisham ◽  
Ahmad Tarmizi Mohammad ◽  
Shabbar Husain Fazle Abbas ◽  
Yussra Yusoff

Primary peritoneal adenocarcinoma is sporadic with few cases cited in pre-existing literature. This cancer arises from the peritoneal epithelium lining of the abdomen, which is derived from extra ovarian mesothelium. It generally carries a poor prognosis. The treatment strategies are similar to ovarian serous papillary carcinoma. Report an incidental finding of primary peritoneal adenocarcinoma in a 39-year-old female army personnel, currently undergoing her chemotherapy and thriving. Exploratory laparotomy was done given the incidental finding of a mass on the contrast-enhanced computed tomography scan (CT). The mass was attached to the greater omentum, however, did not invade the mucosa of the transverse colon. Given this, part of greater omentum was removed. The findings of the immunohistochemical studies of the tumour are described within this report. The diagnosis of a primary peritoneal adenocarcinoma, stage II was established as no other primary site were found upon further investigation. The patient was treated with chemotherapy (carboplatin/paclitaxel) which was planned for 6 cycles. Otherwise, the patient had an uneventful postoperative course, is underway her chemotherapy regime and is planned for interim CT study to assess chemotherapy response. To conclude, isolated solitary primary peritoneal adenocarcinoma without peritoneal carcinomatosis, gastrointestinal manifestations and ascites are rare. This case, however, demonstrates the importance of its diagnosis, accurate evaluation and management.


2019 ◽  
pp. 61-70
Author(s):  
A. A. Pilipovich

Parkinson’s disease (PD) is the second most common neurodegenerative disease that is characterized by steady progression and results into persistent disability. It has been known that more than 10 years may elapse between the onset of cell death in certain structures of the nervous system and the onset of clinical symptoms of the disease, and most of the dopaminergic neurons are lost during this period. The identification of patients in the period between the expected onset of dopaminergic cell loss and the onset of clinical parkinsonism may be crucial for the development of effective neuroprotective treatment strategies. The scientists around the world are currently paying special attention to the search for reliable clinical, neuroimaging and molecular markers that could help diagnose PD in the early stages, distinguish it from other pathological conditions, track progression, and detect a positive response to therapy. The article provides an overview of the status update on the problem of early diagnosis and search for early clinical signs, preclinical biochemical, genetic and neuroimaging markers of PD, the main modern directions of PD therapy. Symptomatic pharmacotherapy, which compensates for dopaminergic deficiency and is able to alleviate motor and some nonmotor symptoms of parkinsonism, as well as some neuroprotective treatment options, have been analysed. Among other factors, the role of amantidines is described in detail. The foreign and domestic experience of their use as monotherapy and complex treatment of PD is presented. The author provides an analysis of the clinical case of PK-Merz therapy of the initial stage of PD.


2020 ◽  
Vol 8 (C) ◽  
pp. 52-54
Author(s):  
Shaun Wayn Paul ◽  
Khasnur Abd Malek ◽  
Alan Basil Peter ◽  
Sabrilhakim Sidek

BACKGROUND: Melioidosis commonly presents with pneumonia and is associated with a high mortality rate. This case report discussed a case of confirmed disseminated melioidosis. The case focused on the chronological clinical progressions of melioidosis which initially masqueraded as community-acquired pneumonia (CAP) and subsequently developed into septicemia. This case report aims to create awareness among the primary care doctors working in a potentially endemic area for melioidosis to be vigilant of its non-specific presentation. CASE REPORT: We report a case of an 80-year-old man who was treated for CAP and presented with unresolved fever and subsequently sepsis. A contrast-enhanced computed tomography showed disseminated lesions of varying sizes in the lungs, liver, spleen, and blood cultures grew Burkholderia pseudomallei. A pigtail drainage catheter was inserted into the liver abscess. In addition, the patient received a 46-day course of intravenous ceftazidime and a 4-month maintenance regime of oral trimethoprim-sulfamethoxazole and oral doxycycline. CONCLUSION: Completion of antimicrobial treatment resulted in resolution of clinical signs and abscesses on imaging.


VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 126-133 ◽  
Author(s):  
Mathias Kaspar ◽  
Iris Baumgartner ◽  
Daniel Staub ◽  
Heinz Drexel ◽  
Christoph Thalhammer

Abstract. Early detection of vascular damage in atherosclerosis and accurate assessment of cardiovascular risk factors are the basis for appropriate treatment strategies in cardiovascular medicine. The current review focuses on non-invasive ultrasound-based methods for imaging of atherosclerosis. Endothelial dysfunction is an accepted early manifestation of atherosclerosis. The most widely used technique to study endothelial function is non-invasive, flow-mediated dilation of the brachial artery under high-resolution ultrasound imaging. Although an increased intima-media thickness value is associated with future cardiovascular events in several large population studies, systematic use is not recommended in clinical practice for risk assessment of individual persons. Carotid plaque analysis with grey-scale median, 3-D ultrasound or contrast-enhanced ultrasound are promising techniques for further scientific work in prevention and therapy of generalized atherosclerosis.


1998 ◽  
Vol 11 (01) ◽  
pp. 08-18 ◽  
Author(s):  
C. W. McIlwraith ◽  
J. A. Auer ◽  
Brigitte von Rechenberg

SummaryCases of cystic bone lesions in horses and humans were reviewed in the literature. These lesions are radiolucent areas of bone, recognized as subchondral cystic lesions in the horse (SCL), intra-osseous ganglia (IOG), subchondral bone cysts secondary to osteoarthrosis (OAC), and unicameral bone cysts (UCB) in humans. Their morphology is quite similar, consisting of lesions with a distinct cyst wall, and a cavity filled with fibrous tissue and yellowish mucoid fluid. The lesions are surrounded by sclerotic bone and can be easily diagnosed radiographically. SCL, IOG and OAC occur in the subchondral bone close to the adjacent joint, whereas UCB occur in the metaphysis of long bones. Their aetiology and pathogenesis is still unknown, although primary damage to the subchondral bone, cartilage or local blood supply and growth disturbances are discussed. In this review 703 lesions of SCL in horses, 289 lesions of IOG and 1460 lesions of UCB in humans were compared in their anatomical location and clinical signs. SCL and OAC resembled each other with respect to anatomical location. A correlation of affected bones could not be found for all four groups. Clinical presentation concerning age was most similar for SCL and UCB with both lesions mainly occurring in young individuals. Gender predominance of males was present in SCL, IOG and UCB. Clinical diagnosis was either incidental, or connected with intermittent pain in all lesions except for OAC. Additionally, the lesions were also found in conjunction with degenerative joint disease (SCL, OAC) or pathological fractures (UCB). Cystic bone lesions were either treated conservatively, surgically with curettage alone, curettage in combination with grafting procedures, or intra-lesional application of corticosteroids. SCL and UCB were similar in their biological behaviour concerning their slow response to the therapy and relatively high recurrence rate. None of the cystic bone lesions were comparable, and a common aetiology and pathogenesis could not be found.In a literature review cases of cystic bone lesions in horses and humans were compared with the goal to find a common aetiology and pathogenesis. Cystic bone lesions occur in horses as subchondral cystic lesions (SCL), and in humans as either intra-osseous ganglia (IOG), subchondral cystic lesions secondary to osteoarthrosis (OAC) or unicameral bone cysts (UCB). IOG and OAC compare with SCL mainly in the anatomical location. IOG and SCL resemble each other in size, clinical signs and histology, whereas UCB and SCL show a similar biological behaviour regarding their therapeutic response and recurrence rate. None of the cystic bone lesions in humans were comparable to the SCL in horses in all aspects. A common aetiology and pathogenesis could not be established.


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