scholarly journals CT findings in sequel of COVID-19 pneumonia and its complications: a pictorial review

BJR|Open ◽  
2021 ◽  
Author(s):  
Mandeep Garg ◽  
Nidhi Prabhakar ◽  
Harsimran Bhatia ◽  
Sahajal Dhooria ◽  
Uma Debi ◽  
...  
Keyword(s):  
Pulmonary Thromboembolism ◽  
Imaging Modality ◽  
Vascular Complications ◽  
Pseudoaneurysm Formation ◽  
Pictorial Review ◽  
Vulnerable Patients ◽  
Number Of Patients ◽  
Initial Recovery ◽  
Changes Over Time ◽  
Traction Bronchiectasis

A significant number of patients after initial recovery from COVID-19 continue to experience lingering symptoms of the disease that may last for weeks or even months. Lungs being the most commonly affected organ by COVID-19, bear the major brunt of the disease and thus it is imperative to be aware of the evolution of the pulmonary parenchymal changes over time. CT chest is the imaging modality of choice to evaluate post-COVID lungs. Persistent ground-glass opacities, septal thickening and parenchymal bands, crazy-paving, traction bronchiectasis and consolidation constitute the commonly encountered imaging patterns seen on CT in post COVID-19 lungs. Few vulnerable patients can develop lung fibrosis and show honeycombing on CT. Additionally, many complications like superadded infections (bacterial and fungal), pulmonary thromboembolism and pseudoaneurysm formation are also being reported. In the present pictorial review, we have tried to show the entire CT spectrum of sequelae of COVID-19 pneumonia and commonly associated infections and vascular complications.

scholarly journals Are telephone consultations here to stay in rheumatology?

2020 ◽  
Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham
Keyword(s):  
Older Patients ◽  
Online Survey ◽  
Vulnerable Groups ◽  
Age Group ◽  
Telephone Consultation ◽  
Survey Tool ◽  
Face To Face ◽  
Vulnerable Patients ◽  
Number Of Patients

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.

scholarly journals Is Call Karma Real? Resident After-Hours On-Call Imaging at the University of Saskatchewan: An Assessment of Call Volumes Including Inter-Resident Variability

2021 ◽  
pp. 084653712110263
Author(s):  
James Huynh ◽  
David Horne ◽  
Rhonda Bryce ◽  
David A Leswick
Keyword(s):  
Mean Shift ◽  
Mean Values ◽  
Body Regions ◽  
Time Period ◽  
Relative Value ◽  
Number Of Patients ◽  
After Hours ◽  
Disproportionate Number ◽  
The University ◽  
Changes Over Time

Purpose: Quantify resident caseload during call and determine if there are consistent differences in call volumes for individuals or resident subgroups. Methods: Accession codes for after-hours computed tomography (CT) cases dictated by residents between July 1, 2012 and January 9, 2017 were reviewed. Case volumes by patient visits and body regions scanned were determined and categorized according to time period, year, and individual resident. Mean shift Relative Value Units (RVUs) were calculated by year. Descriptive statistics, linear mixed modeling, and linear regression determined mean values, differences between residents, associations between independent variables and outcomes, and changes over time. Consistent differences between residents were assessed as a measure of good or bad luck / karma on call. Results: During this time there were 23,032 patients and 30,766 anatomic regions scanned during 1,652 call shifts among 32 residents. Over the whole period, there were on average 10.6 patients and 14.3 body regions scanned on weekday shifts and 22.3 patients and 29.4 body regions scanned during weekend shifts. Annually, the mean number of patients, body regions, and RVUs scanned per shift increased by an average of 0.2 (1%), 0.4 (2%), and 1.2 (5%) (all p < 0.05) respectively in regression models. There was variability in call experiences, but only 1 resident had a disproportionate number of higher volume calls and fewer lower volume shifts than expected. Conclusions: Annual increases in scan volumes were modest. Although residents’ experiences varied, little of this was attributable to consistent personal differences, including luck or call karma.

scholarly journals Additional Value of PET Radiomic Features for the Initial Staging of Prostate Cancer: A Systematic Review from the Literature

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6026
Author(s):  
Priscilla Guglielmo ◽  
Francesca Marturano ◽  
Andrea Bettinelli ◽  
Michele Gregianin ◽  
Marta Paiusco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Imaging Modality ◽  
Small Sample ◽  
High Order ◽  
Lesion Detection ◽  
Qualitative Assessment ◽  
Number Of Patients ◽  
Additional Value ◽  
Initial Staging

We performed a systematic review of the literature to provide an overview of the application of PET radiomics for the prediction of the initial staging of prostate cancer (PCa), and to discuss the additional value of radiomic features over clinical data. The most relevant databases and web sources were interrogated by using the query “prostate AND radiomic* AND PET”. English-language original articles published before July 2021 were considered. A total of 28 studies were screened for eligibility and 6 of them met the inclusion criteria and were, therefore, included for further analysis. All studies were based on human patients. The average number of patients included in the studies was 72 (range 52–101), and the average number of high-order features calculated per study was 167 (range 50–480). The radiotracers used were [68Ga]Ga-PSMA-11 (in four out of six studies), [18F]DCFPyL (one out of six studies), and [11C]Choline (one out of six studies). Considering the imaging modality, three out of six studies used a PET/CT scanner and the other half a PET/MRI tomograph. Heterogeneous results were reported regarding radiomic methods (e.g., segmentation modality) and considered features. The studies reported several predictive markers including first-, second-, and high-order features, such as “kurtosis”, “grey-level uniformity”, and “HLL wavelet mean”, respectively, as well as PET-based metabolic parameters. The strengths and weaknesses of PET radiomics in this setting of disease will be largely discussed and a critical analysis of the available data will be reported. In our review, radiomic analysis proved to add useful information for lesion detection and the prediction of tumor grading of prostatic lesions, even when they were missed at visual qualitative assessment due to their small size; furthermore, PET radiomics could play a synergistic role with the mpMRI radiomic features in lesion evaluation. The most common limitations of the studies were the small sample size, retrospective design, lack of validation on external datasets, and unavailability of univocal cut-off values for the selected radiomic features.

Glycemia under control

2021 ◽  
pp. 54-55
Author(s):  
Nadezhda Kalinina
Keyword(s):  
Mobile Application ◽  
Vascular Complications ◽  
Self Monitoring ◽  
Glucose Levels ◽  
Therapy Goals ◽  
Blood Glucose Levels ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
The Russian Federation ◽  
Do It Yourself

Diabetes mellitus (DM) has become a global and national menace. The number of patients with diabetes in the Russian Federation tallied roughly 5.1 million, according to the incidence of outpatient visits in 2020 [1]. “Do-it-yourself” regular measurements of blood glucose levels (self-monitoring) are one of the most important components in achieving the therapy goals for patients with diabetes and preventing severe vascular complications. Now that the technologies have caught on, new “smart” glucometers appeared, which enable remote control and significantly expand opportunities of DM monitoring due to free mobile application integration.

Intra-aortic Balloon Pump

2020 ◽  
pp. 267-274
Author(s):  
Christopher Choi ◽  
Amirali Masoumi
Keyword(s):  
Vascular Complications ◽  
Limb Ischemia ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Pseudoaneurysm Formation ◽  
Intra Aortic Balloon Pump ◽  
Ventricular Afterload ◽  
Early Systole ◽  
Clinically Significant ◽  
Artery Disease

This chapter describes the intra-aortic balloon pump (IABP), which is the single most widely used mechanical circulatory assist device available today. Counterpulsation refers to balloon inflation in diastole and deflation in early systole: this results in increased coronary blood flow, left ventricular afterload reduction, and increased end-organ perfusion. Other uses of balloon counterpulsation include refractory ventricular arrhythmias, inability to wean from cardiopulmonary bypass, bridge to intervention in severe/critical aortic stenosis, and refractory pulmonary edema from decompensated heart failure. However, the absolute contraindications for IABP placement are aortic dissection, clinically significant aortic aneurysm, severe peripheral artery disease, significant aortic regurgitation, uncontrolled bleeding, and/or sepsis. The chapter then explains the optimal positioning for IABP. It also looks at complications associated with IABPs. These include thrombocytopenia and vascular complications, such as limb ischemia, bleeding, dissection, and hematoma/pseudoaneurysm formation. The presence of blood in the balloon tubing suggests the possibility of balloon rupture and gas embolism, an extremely uncommon but catastrophic event.

scholarly journals CT Urography Findings of Upper Urinary Tract Carcinoma and Its Mimickers: A Pictorial Review

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 705
Author(s):  
Paola Martingano ◽  
Marco F. M. Cavallaro ◽  
Alessandro M. Bozzato ◽  
Elisa Baratella ◽  
Maria A. Cova
Keyword(s):  
Urinary Tract ◽  
Disease Management ◽  
Urothelial Carcinoma ◽  
Imaging Modality ◽  
Upper Urinary Tract ◽  
Ct Urography ◽  
Pictorial Review ◽  
Computed Tomography Urography ◽  
Very High ◽  
Upper Urinary Tract Carcinoma

Urothelial carcinoma (UC) is the fourth most frequent tumor in Western countries and upper tract urothelial carcinoma (UTUC), affecting pyelocaliceal cavities and ureter, accounts for 5–10% of all UCs. Computed tomography urography (CTU) is now considered the imaging modality of choice for diagnosis and staging of UTUC, guiding disease management. Although its specificity is very high, both benign and malignant diseases could mimic UTUCs and therefore have to be well-known to avoid misdiagnosis. We describe CTU findings of upper urinary tract carcinoma, features that influence disease management, and possible differential diagnosis.

scholarly journals P.096 Iatrogenic pseudoaneurysm of the MCA secondary to VP shunt insertion

2018 ◽  
Vol 45 (s2) ◽  
pp. S41-S41
Author(s):  
A Chalil ◽  
MD Staudt ◽  
SP Lownie
Keyword(s):  
Rare Complication ◽  
Insertion Site ◽  
Vascular Complications ◽  
Careful Consideration ◽  
External Carotid ◽  
Ventricular Catheter ◽  
Shunt Insertion ◽  
Vp Shunt ◽  
Pseudoaneurysm Formation ◽  
Dural Opening

Background: Ventriculoperitoneal (VP) shunting is a common treatment for hydrocephalus. Complications of VP shunt include infection, malfunction, and hemorrhage. Vascular complications such as pseudoaneurysm are rare, and usually involve the choroid plexus or branches of the external carotid artery. We present the case of a fusiform pseudoaneurysm of the middle cerebral artery arising due to VP shunt insertion. Methods: A 36-year-old female presented with a hypertensive cerebellar hemorrhage and hydrocephalus. This was treated with VP shunt placement with limited dural opening. Three weeks afterward there developed a diffuse intraventricular hemorrhage associated with hemorrhage at the cortical insertion site of the ventricular catheter. CT and catheter angiography revealed a fusiform pseudoaneurysm of the M4 segment of the MCA immediately adjacent to the ventricular catheter. Results: The VP shunt was removed, and the aneurysmal segment was coagulated and occluded. Delayed repeat VP shunt insertion was performed through the same entry point and trajectory via a larger dural opening. Conclusions: Pseudoaneurysm formation secondary to catheter insertion is a rare complication. To our knowledge, this is the second reported case of a cortical branch pseudoaneurysm in an adult. Careful consideration should be given to vascular anatomy when planning shunt insertions, and cruciate dural opening for local cortex visualization may help avoid this complication.

Differential Diagnosis of Colonic Strictures: Pictorial Review with Illustrations from Computed Tomography Colonography

2015 ◽  
Vol 66 (3) ◽  
pp. 259-271 ◽  
Author(s):  
Daniel Wan ◽  
Silvio G. Bruni ◽  
John A. Dufton ◽  
Paul O'Brien
Keyword(s):  
Computed Tomography ◽  
Gold Standard ◽  
Ct Colonography ◽  
Imaging Modality ◽  
Mount Sinai Hospital ◽  
Imaging Features ◽  
University Of Toronto ◽  
Pictorial Review ◽  
Ct Features

Strictures of the colon can lead to significant morbidity requiring surgical management. The etiology of strictures is broad and generally categorized as benign, malignant, or pseudostrictures. Computed tomography (CT) is a crucial imaging modality in the assessment and characterization of colonic pathologies but colonoscopy remains the diagnostic gold standard. However, in the setting of incomplete colonoscopy due to strictures, the imaging features of CT will be relied on. This review will focus on the CT features of different colon pathologies leading to strictures and will be illustrated with images from 10 years of experience with CT colonography at our institutions from 2002-2012 (Hotel Dieu Hospital, Queen's University and Mount Sinai Hospital, University of Toronto).

scholarly journals Mini-review: diabetic renal complications, a potential stinky remedy

2016 ◽  
Vol 310 (2) ◽  
pp. F119-F122 ◽  
Author(s):  
Utpal Sen ◽  
Sathnur Pushpakumar
Keyword(s):  
Therapeutic Potential ◽  
Vascular Complications ◽  
Vital Role ◽  
Diabetic Patients ◽  
Diabetic Vascular Complications ◽  
Number Of Patients ◽  
Matrix Metabolism ◽  
Artery Disease ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease is associated with vasculitis and is also an independent risk factor for peripheral vascular and coronary artery disease in diabetic patients. Despite optimal management, a significant number of patients progress toward end-stage renal disease (ESRD), a suggestion that the disease mechanism is far from clear. A reduction in hydrogen sulfide (H2S) has been suggested to play a vital role in diabetic vascular complications including diabetic nephropathy (DN). This mini-review highlights the recent findings on the role of H2S in mitigating abnormal extracellular matrix metabolism in DN. A discussion on the development of the newer slow-releasing H2S compounds and its therapeutic potential is also included.

scholarly journals EP.WE.962Pre-emptive arterial stenting with covered vascular stents to prevent mycotic haemorrhage in infected fields following failed kidney and pancreas transplants prior to graft explant

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Harry Spiers ◽  
Kelly Burke ◽  
Ganapathy Anantha-Krishnan ◽  
David Van Dellen ◽  
Zia Moinuddin ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Vascular Complications ◽  
Limb Ischaemia ◽  
Pseudoaneurysm Formation ◽  
Vascular Stents ◽  
Arterial Conduit ◽  
Transplant Pyelonephritis ◽  
Allograft Nephrectomy ◽  
Simultaneous Pancreas Kidney ◽  
Arterial Stenting

Abstract Aims Allograft nephrectomy and pancreatectomy present a significant surgical challenge in contaminated surgical fields, with risks of post-operative pseudoaneurysms and mycotic bleeds. We report on our experience of prophylactic endovascular stenting shortly before or after allograft nephrectoym and pancreatectomy to reduce the risk of subsequent pseudoaneurysm formation from the donor arterial conduit. Methods A retrospective analysis of all patients undergoing arterial stenting by interventional radiology prior to graft explant in our unit was performed. Results Twelve patients were identified, 6 of whom had undergone kidney transplant and 6 simultaneous pancreas kidney transplant (SPK) with an average age of 46. Iliac stenting was prophylactic in 7 patients, for pseudoaneurysm (28%), graft pancreatitis (28%), acute rejection (28%), enteric anastomotic leak (16%) and transplant pyelonephritis (14%). Therapeutic stenting was performed in 5 patients, all of whom had ruptured pseudoaneurysms. Post-operative 30-day mortality occurred in 1 patient resulting from an acute on chronic limb ischaemia and subsequent sepsis and death. Of the remaining patients, none experienced complications from stenting. 9 of the 12 stented patients remain alive, with the 3 mortalities resulting from other pathology not relating to stenting. Conclusion Prophylactic iliac stenting around the time of graft excision in inflamed or infected fields provides a safe and effective technique to completely exclude the donor arterial stump, with no subsequent vascular complications reported within our series. Preventing mycotic aneurysm formation in this way may mitigate the risk of potentially catastrophic post-operative mycotic arterial bleeds.

Sign in / Sign up

Export Citation Format

Share Document