scholarly journals 203. Correlating Cardiac PET Results with Intra-Operative Findings in Infectious Endocarditis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S120-S120
Author(s):  
Sami El-Dalati ◽  
Richard Weinberg ◽  
Venkatesh Murthy ◽  
Anna Owczarczyk ◽  
Jamie Riddell ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Infectious Endocarditis ◽  
Cardiac Pet ◽  
Cardiac Positron Emission Tomography ◽  
Prosthetic Valves ◽  
Duke Criteria ◽  
Positron Emission ◽  
Low Sensitivity ◽  
Operative Findings

Abstract Background Care for patients with infectious endocarditis is complicated by delays in diagnosis and relatively low sensitivity of existing diagnostic algorithms, particularly the Duke Criteria. In recent years, cardiac positron emission tomography (PET) has been identified as a useful tool in detecting occult endocardial infections. Multiple prospective studies have demonstrated that when incorporated with conventional imaging modalities cardiac PET can improve the sensitivity of the Duke Criteria by 27–38 percent. These studies used as their gold standard for diagnosis the consensus opinion of an endocarditis team and were characterized by a relatively low percentage of patients who underwent surgery. We reviewed 4 years of surgically managed IE cases at a tertiary care center where cardiac PET was used to aid diagnosis. Methods Between July 1, 2014 and December 31, 2018 we retrospectively reviewed 68 surgically managed cases of endocarditis. Cases were identified using ICD-9 and ICD-10 codes of patients who underwent surgical valve replacement for endocarditis as well as all patients who had cardiac PET scans to rule out endocarditis. Variables including PET results, operative findings, valve culture, pathology and PCR testing were recorded. Results 14 patients were identified who underwent cardiac PET prior to their surgical intervention. 9 cases were classified as possible endocarditis by Duke Criteria and 10 involved prosthetic valves. 12/14 scans were interpreted as suggestive of or consistent with endocarditis. Twelve positive PETs were associated with either operative findings of infection and/or positive PCR testing on the excised valve (positive predictive value: 100%). The 2 patients with negative scans were found to have noninfectious vegetations intra-operatively, negative valve cultures and negative pathology. Conclusion Cardiac PET correlates closely with intra-operative findings in patients with endocarditis. In patients with suspected endocarditis it may help guide surgical decision making. Cardiac PET should be considered for addition to the Modified Duke’s Criteria similar to the European Society of Cardiology guidelines. Disclosures All authors: No reported disclosures.

Cardiac positron emission tomography (PET)

2017 ◽  
Author(s):  
Nikant Sabharwal ◽  
Parthiban Arumugam ◽  
Andrew Kelion
Keyword(s):  
Positron Emission Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Tomography ◽  
Emission Computed Tomography ◽  
Cardiac Pet ◽  
Clinical Tool ◽  
Cardiac Positron Emission Tomography ◽  
Positron Emission ◽  
Recent Developments

As in single photon emission computed tomography (SPECT), positron emission tomography (PET) involves the injection of a radiopharmaceutical, the physiological properties of which determine its distribution within the patient. The labelling radionuclide then allows this distribution to be imaged. The value of cardiac PET as a routine clinical tool, particularly for perfusion imaging, was previously limited by the expense and scarcity of cameras and the short half-lives of the radionuclides with complex radiochemistry. The need for an on-site cyclotron to produce these radiopharmaceuticals made a clinical service non-viable. A number of recent developments, however, have led to renewed interest in cardiac PET. This chapter covers PET instrumentation, detail on the radiopharmaceuticals used in cardiac PET, and a number of sections on F-fluorodeoxyglucose (F-FDG) PET covering infection and inflammation imaging.

scholarly journals Quantitative Cardiac Positron Emission Tomography: The Time Is Coming!

Scientifica ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-16 ◽  
Author(s):  
Roberto Sciagrà
Keyword(s):  
Positron Emission Tomography ◽  
Heart Disease ◽  
Hypertensive Heart Disease ◽  
Microvascular Dysfunction ◽  
Emission Tomography ◽  
Cardiac Pet ◽  
Cardiac Positron Emission Tomography ◽  
Quantitative Pet ◽  
Flow Reserve ◽  
Positron Emission

In the last 20 years, the use of positron emission tomography (PET) has grown dramatically because of its oncological applications, and PET facilities are now easily accessible. At the same time, various groups have explored the specific advantages of PET in heart disease and demonstrated the major diagnostic and prognostic role of quantitation in cardiac PET. Nowadays, different approaches for the measurement of myocardial blood flow (MBF) have been developed and implemented in user-friendly programs. There is large evidence that MBF at rest and under stress together with the calculation of coronary flow reserve are able to improve the detection and prognostication of coronary artery disease. Moreover, quantitative PET makes possible to assess the presence of microvascular dysfunction, which is involved in various cardiac diseases, including the early stages of coronary atherosclerosis, hypertrophic and dilated cardiomyopathy, and hypertensive heart disease. Therefore, it is probably time to consider the routine use of quantitative cardiac PET and to work for defining its place in the clinical scenario of modern cardiology.

scholarly journals SPECTRUM OF PERFORATION PERITONITIS IN WESTERN NEPAL

2018 ◽  
Vol 6 (1) ◽  
pp. 11-13
Author(s):  
Rajesh Poudel ◽  
Santosh Shah ◽  
Kailash Chandra ◽  
Saroj Pradhan ◽  
Pravin Joshi
Keyword(s):  
Indian Subcontinent ◽  
Care Center ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
Medical Sciences ◽  
Peptic Disease ◽  
Perforation Peritonitis ◽  
One Year ◽  
Operative Findings ◽  
Perforated Peritonitis

Introduction: Despite advances in surgical technique, antimicrobial therapy and perioperative care morbidity and mortality in perforated peritonitis is still high.   Aim of this study was to highlight the clinical presentation, intra operative findings and postoperative complications and mortality among patient who has undergone emergency surgery for perforated peritonitis in tertiary care center in western Nepal.Materials and Methods: This was a retrospective descriptive study carried out in Universal College of Medical Sciences, Bhairawha, Nepal. All patients who underwent emergency exploratory laparotomy for perforated peritonitis in one year period (from April 2014 to March 2015) were included in the study.Results: Total 90 cases met inclusion criteria and were analyzed. Most common presenting symptom was pain abdomen. Pneumoperitoneum was seen in 86 (95.6%) patients. Most common site of perforation was prepyloric perforation followed by duodenum. Most common cause of perforation was Acid peptic disease. Most common surgical procedure performed was Omentopexy. There were total of 11 (12.2%)mortality.Conclusion: The spectrum of perforation peritonitis in our study differs from western countries whereas it is similar to that of other research from Indian subcontinent. Majority of perforations are noticed in the duodenum and stomach due to acid-peptic disease and small bowel typhoid followed by trauma. Overall mortality was seen in 12.2%.Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 11-13

Cardiac positron emission tomography (PET)

2011 ◽  
Author(s):  
Nikant Sabharwal ◽  
Chee Yee Loong ◽  
Andrew Kelion
Keyword(s):  
Positron Emission Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
High Energy ◽  
Emission Tomography ◽  
Emission Computed Tomography ◽  
Cardiac Pet ◽  
Cardiac Positron Emission Tomography ◽  
Positron Emission ◽  
Pet Instrumentation

Introduction to cardiac positron emission tomography (PET) 212PET instrumentation (1) 214PET instrumentation (2) 216Radiopharmaceuticals for cardiac PET (1) 218Radiopharmaceuticals for cardiac PET (2) 220Interpretation and clinical significance of cardiac PET studies 222As in single photon emission computed tomography (SPECT), positron emission tomography (PET) involves the injection of a radiopharmaceutical, the physiological properties of which determine its distribution within the patient. The labelling radionuclide then allows this distribution to be imaged. In contrast to SPECT, the positron-emitting radionuclides used in PET produce pairs of high energy 511keV ...

How Does the “Cookie-Bite” Audiogram Shape Perform in Discriminating Genetic Hearing Loss in Adults?

2021 ◽  
pp. 019459982110151
Author(s):  
Shadi Ahmadmehrabi ◽  
Binglan Li ◽  
Douglas J. Epstein ◽  
Michael J. Ruckenstein ◽  
Jason A. Brant
Keyword(s):  
Hearing Loss ◽  
Genetic Variant ◽  
Care Center ◽  
Tertiary Care ◽  
Carrier Status ◽  
Loss Of Function ◽  
Wild Type ◽  
Sequencing Data ◽  
Genetic Hearing Loss ◽  
Low Sensitivity

“Cookie-bite” or U-shaped audiograms—specifically, those showing midfrequency sensorineural hearing loss (HL)—are traditionally taught to be associated with genetic HL; however, their utility as a screening tool has not been reported. We aim to determine the performance of a cookie-bite audiogram shape in stratifying patients carrying putative loss-of-function variants in known HL genes from wild-type controls. We merged audiometric and exome sequencing data from adults enrolled in a large biobank at a tertiary care center. Of 321 patients, 50 carried a putative loss-of-function variant in an HL gene. The cookie-bite shape was present in 9 of those patients, resulting in low sensitivity (18%) and positive predictive value (15%) in stratifying genetic carrier status; 84% of patients with a cookie-bite audiogram did not carry a genetic variant. A cookie-bite audiogram should not be used to screen adults for possible genetic testing.

scholarly journals The increasing incidence of paranasal organizing hematoma: a 20-year experience of 23 cases at a single center

2016 ◽  
Vol 54 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Jong Seung Kim ◽  
Jong Seok Oh ◽  
Sam Hyun Kwon
Keyword(s):  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Care Center ◽  
Relevant Literature ◽  
Tertiary Care ◽  
Age Distribution ◽  
Inferior Turbinate ◽  
Sinus Surgery ◽  
Operative Findings

Background and objectives: Sinonasal organized hematoma is a rare, benign disease that can be locally aggressive and may be mistaken for malignancy. Because of its rarity, the clinical characteristics are not well known. The aim of this study is to investigate the distinguishing features of organized hematoma with an emphasis on incidence change. Materials and methods: In this retrospective study, we reviewed the records of 23 patients with organized hematoma confirmed histopathologically among 5,378 patients who underwent endoscopic sinus surgery performed by a single surgeon from January 1995 to December 2014 at a tertiary care center. Clinical symptoms, endoscopic photography, computed tomography, and operative findings were reviewed. We also reviewed the relevant literature. Age, sex, site, origin subsite and histopathology were investigated. A statistical review was performed using R 3.1.2 to examine incidence change. Results: The most common complaint was frequent epistaxis and nasal obstruction (52.1%). Of the 23 patients, eight were women and 15 were men with an age range of 18 to 75 years. (mean 38.9 years). Nine of these hematomas occurred on the right side and 14 on the left side. The predominant occurrence site was the antrum (65%), followed by the septum (17.3%), inferior turbinate (8%), and ethmoid sinus (8%). The incidence steadily increased over 20 years. Conclusion: Investigation of the clinical characteristics and incidence change of organized hematoma can provide useful information. Through analysis of the 23 cases in our study, the age distribution was found to be bimodal and the incidence of organizing hematoma was observed to steadily increase. Clinicians should be aware of these characteristics to avoid misdiagnoses of malignant tumors.

scholarly journals Evolving trends in infective endocarditis over three decades in a developing country

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Maaroufi ◽  
H Zahidi ◽  
M Abdulhakeem ◽  
S Arous ◽  
E G Benouna ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Infectious Endocarditis ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Male Predominance ◽  
Duke Criteria ◽  
Group A ◽  
Group B

Abstract Introduction Infective endocarditis (IE) is a rare serious disease for which diagnosis and treatment and prophylaxis continue to develop. Purpose The aim of our work were to analyze evolution in its epidemiologic, clinical, and microbiologic characteristics, as well as the outcomes. Methods This study compare data from a retrospective study conducted by Bennis and Al based on 157 cases of infectious endocarditis admitted in tertiary care Hospital between January 1983 and December 1994, theses cases are referred as Group A; and 103 cases of infective endocarditis according to Duke criteria admitted to the same center three decades afterwards from december 2013 to January 2020, which are referred as Group B. Results The mean age of the patients has became older over decades, with a mean of 27.5 years (11–65 years) in the group A versus 39.2 years [13–84] in the group B, with preservation of the male predominance (62.8% in group A vs 62.1% in group B). Infectious endocarditis secondary to rheumatic valvular heart disease has significantly decreased from 63.% of patients in group A to 27.5% in group B. Mitral or mitro-aortic valve involvement stayed predominant in both groups with a increase of mechanical prosthetic valve involvement with 9.7% in group B. A portal of entry of the infection was identified in 63% of patients in group A versus 41% in group B, we noted a significant decrease of dental-related cases from 64% in group A to 29% in group B, and a predominance of invasive procedure/devices cases in group B with 36% of identified cases. In group A Blood cultures were positive in 42% of cases with a predominance of Staphylocci (30%) and coagulase-negative Staphylococci (25.7% of cases) whilst in group B blood cultures were positive in 30% of cases with a predominance of Staphylococci (36.6%) and Streptococci (20% of cases). Echocardiography as a useful diagnostic tool demonstrated specific lesions of infectious endocarditis (abcess or vegetations) in 73.2% of cases in group A and 82% in group B. The clinical course in group A was complicated by congetive heart failure CHF (47.8%) or neurological lesions (11.5%) while in group B CHF was noted in 35% of cases and 8% of neurological lesions and The global mortality went from 28.7% in group A to 15% in group B related mostly to cardiogenic shock. Conclusion Our work demonstrated changes in the epidemiologic characteristics of IE that parallel changes in demographic and risk factors. The progress of diagnosis and treatement options in developing countries explains the better prognosis for this condition today. FUNDunding Acknowledgement Type of funding sources: None.

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