scholarly journals Comparison of Relapsing Polychondritis Patients with and Without Respiratory Involvement Based on Chest Computed Tomography: A Retrospective Cohort Study

2022 ◽  
Author(s):  
Dong Wang ◽  
Lujia Guan ◽  
Xin Dong ◽  
Xiaofan Zhu ◽  
Zhaohui Tong
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Pulmonary Infection ◽  
Relapsing Polychondritis ◽  
Eye Disease ◽  
Chest Computed Tomography ◽  
Respiratory Involvement ◽  
Inflammatory Eye Disease ◽  
Auricular Chondritis

Abstract Background Relapsing polychondritis (RP) patients with tracheal cartilage involvement are different from other patients. The objectives of this study were to compare the clinical features and disease patterns between respiratory involvement subgroup and non-respiratory involvement subgroup according to chest computed tomography. Method We performed a retrospective cohort study collected RP patients hospitalized at the Beijing Chao-Yang Hospital between January 2012 - August 2021. Results The incident of costochondritis was more frequent in RP patients with respiratory involvement(p=0.03), the incidence of inflammatory eye disease(p=0.001) and auricular chondritis(p=0.001) was less frequent in RP respiratory involvement patients, compared with those of RP patients without respiratory involvement. Correlation analysis showed that a negative correlation between respiratory involvement and auricular chondritis (r=-0.58, p < 0.01), and between respiratory involvement and inflammatory eye disease (r=-0.45, P < 0.01). Auricular chondritis was positively correlated with inflammatory eye disease (r=0.49, P < 0.01). Compared with non-respiratory involvement subgroup, the incidence of pulmonary infection marginally increased in respiratory involvement subgroup(p=0.06). Inflammatory indexes except for CAR were significantly higher in respiratory involvement subgroup, subgroup analysis found that there was no significant relationship between inflammatory indexes and pulmonary infection. Conclusion RP patients with respiratory involvement was characterized by higher rate of costochondritis and pulmonary infection, fewer inflammatory eye disease and auricular chondritis compared to non-respiratory involvement. Increase inflammatory indexes may suggested that patients with respiratory involvement had a higher disease activity index of RP. The probability of survival was not significant between two subgroups.

scholarly journals Clinical characteristics and disease patterns of patients with relapsing polychondritis: a retrospective cohort

2021 ◽  
Author(s):  
Dong Wang ◽  
Lujia Guan ◽  
xin Dong ◽  
Xiaofan Zhu ◽  
Zhaohui Tong
Keyword(s):  
Retrospective Cohort ◽  
Pulmonary Infection ◽  
Activity Index ◽  
Relapsing Polychondritis ◽  
Disease Activity Index ◽  
Chest Ct ◽  
Ocular Involvement ◽  
Respiratory Involvement ◽  
Disease Patterns

Abstract Background Relapsing polychondritis (RP) is a rare autoimmune disease affected various cartilage, Patients with tracheal cartilage involvement are different from other patients. The objectives of this study were to allocated RP patients into two subgroups by chest computed tomography (CT) and compare the clinical features and disease patterns of each group.Methods A retrospective cohort study collected RP patients hospitalized at the Beijing Chao-Yang Hospital between January 2012 - August 2021. Patients were divided into two groups: respiratory involvement group and non-respiratory involvement group according to chest CT.Results In our study, respiratory involvement found in 59.7% (n=43) patients, which had higher rate of costochondritis, fewer rate of Inflammatory eye disease and auricular chondritis than those in non-respiratory involvement. Compared with non-respiratory involvement subgroup, The incidence of pulmonary infection marginally increased and those inflammatory indexes except for CAR were significantly higher in respiratory involvement subgroup, further subgroup analysis found that there was no significant relationship between inflammatory indexes and pulmonary infection. Finally, 5 patients died during the follow-up in this cohort with a median follow-up time of 6 years (range 3-8 years).Conclusion 59.7% of patients had respiratory involvement according to chest CT findings in our cohort, which had a strong inverse relationship between respiratory and auricular, ocular involvement. Increase inflammatory indexes were not correlated with pulmonary infection, suggesting that patients with respiratory involvement had a higher disease activity index of RP. The probability of survival was not found significant in two subgroups.

scholarly journals Pre-operative Localisation of the Parathyroid Glands in Secondary Hyperparathyroidism: A Retrospective Cohort Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Takahisa Hiramitsu ◽  
Toshihide Tomosugi ◽  
Manabu Okada ◽  
Kenta Futamura ◽  
Makoto Tsujita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Retrospective Cohort ◽  
Parathyroid Glands ◽  
Imaging Modalities ◽  
Intact Parathyroid Hormone ◽  
Intact Pth ◽  
Persistent Hyperparathyroidism

Abstract Complete parathyroidectomy (PTx) is essential during total PTx for secondary hyperparathyroidism (SHPT) to prevent recurrent and persistent hyperparathyroidism. Pre-operative imaging evaluations, including computed tomography (CT), ultrasonography (US), and Tc-99m sestamibi (MIBI) scans, are commonly performed. Between June 2009 and January 2016, 291 patients underwent PTx for SHPT after pre-operative evaluations involving CT, US, and MIBI scans, and the diagnostic accuracies of these imaging modalities for identifying the parathyroid glands were evaluated in 177 patients whose intact parathyroid hormone (PTH) levels were <9 pg/mL after the initial PTx. Additional PTx procedures were performed on 7 of 114 patients whose intact PTH levels were >9 ng/mL after PTx, and the diagnostic validities of the imaging modalities for the remnant parathyroid glands were evaluated. A combination of CT, US, and MIBI scans achieved the highest diagnostic accuracy (75%) for locating bilateral upper and lower parathyroid glands before initial PTx. The accuracies of CT, US, and MIBI scans with respect to locating remnant parathyroid glands before additional PTx were 100%, 28.6%, and 100%, respectively. A combination of CT, US, and MIBI scans is useful for initial PTx for SHPT, and CT and MIBI scans are useful imaging modalities for additional PTx procedures.

scholarly journals Signs of Pulmonary Infection on Admission Chest Computed Tomography Are Associated With Pneumonia or Death in Patients With Acute Stroke

Stroke ◽  
2020 ◽  
Vol 51 (6) ◽  
pp. 1690-1695
Author(s):  
Jeroen C. de Jonge ◽  
Richard A.P. Takx ◽  
Frans Kauw ◽  
Pim A. de Jong ◽  
Jan W. Dankbaar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Pulmonary Infection ◽  
Stroke Onset ◽  
Odds Ratios ◽  
Chest Computed Tomography ◽  
Risk Of Death ◽  
Increased Risk

Background and Purpose— In patients with acute stroke, the occurrence of pneumonia has been associated with poor functional outcomes and an increased risk of death. We assessed the presence and consequences of signs of pulmonary infection on chest computed tomography (CT) before the development of clinically overt pneumonia. Methods— In 200 consecutive patients with acute ischemic stroke who had CT angiography from skull to diaphragm (including CT of the chest) within 24 hours of symptom onset, we assessed the presence of consolidation, ground-glass-opacity and the tree-in-bud sign as CT signs of pulmonary infection and assessed the association with the development of clinically overt pneumonia and death in the first 7 days and functional outcome after 90 days with logistic regression. Results— The median time from stroke onset to CT was 151 minutes (interquartile range, 84–372). Thirty patients (15%) had radiological signs of infection on admission, and 22 (11.0%) had a clinical diagnosis of pneumonia in the first 7 days. Patients with radiological signs of infection had a higher risk of developing clinically overt pneumonia (30% versus 7.6%; adjusted odds ratios, 4.2 [95% CI, 1.5–11.7]; P =0.006) and had a higher risk of death at 7 days (adjusted odds ratios, 3.7 [95% CI, 1.2–11.6]; P =0.02), but not at 90 days. Conclusions— About 1 in 7 patients with acute ischemic stroke had radiological signs of pulmonary infection within hours of stroke onset. These patients had a higher risk of clinically overt pneumonia or death. Early administration of antibiotics in these patients may lead to better outcomes.

scholarly journals Risk factors for myocardial injury and death in patients with COVID-19: insights from a cohort study with chest computed tomography

2020 ◽  
Vol 116 (14) ◽  
pp. 2239-2246 ◽  
Author(s):  
Giuseppe Ferrante ◽  
Fabio Fazzari ◽  
Ottavia Cozzi ◽  
Matteo Maurina ◽  
Renato Bragato ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Cohort Study ◽  
Myocardial Injury ◽  
Troponin I ◽  
Cox Regression ◽  
Chest Ct ◽  
Chest Computed Tomography ◽  
Risk Of Death ◽  
Increased Risk

Abstract Aims Whether pulmonary artery (PA) dimension and coronary artery calcium (CAC) score, as assessed by chest computed tomography (CT), are associated with myocardial injury in patients with coronavirus disease 2019 (COVID-19) is not known. The aim of this study was to explore the risk factors for myocardial injury and death and to investigate whether myocardial injury has an independent association with all-cause mortality in patients with COVID-19. Methods and Results This is a single-centre cohort study including consecutive patients with laboratory-confirmed COVID-19 undergoing chest CT on admission. Myocardial injury was defined as high-sensitivity troponin I &gt;20 ng/L on admission. A total of 332 patients with a median follow-up of 12 days were included. There were 68 (20.5%) deaths; 123 (37%) patients had myocardial injury. PA diameter was higher in patients with myocardial injury compared with patients without myocardial injury [29.0 (25th–75th percentile, 27–32) mm vs. 27.7 (25–30) mm, P &lt; 0.001). PA diameter was independently associated with an increased risk of myocardial injury [adjusted odds ratio 1.10, 95% confidence interval (CI) 1.02–1.19, P = 0.01] and death [adjusted hazard ratio (HR) 1.09, 95% CI 1.02–1.17, P = 0.01]. Compared with patients without myocardial injury, patients with myocardial injury had a lower prevalence of a CAC score of zero (25% vs. 55%, P &lt; 0.001); however, the CAC score did not emerge as a predictor of myocardial injury by multivariable logistic regression. Myocardial injury was independently associated with an increased risk of death by multivariable Cox regression (adjusted HR 2.25, 95% CI 1.27–3.96, P = 0.005). Older age, lower estimated glomerular filtration rate, and lower PaO2/FiO2 ratio on admission were other independent predictors for both myocardial injury and death. Conclusions An increased PA diameter, as assessed by chest CT, is an independent risk factor for myocardial injury and mortality in patients with COVID-19. Myocardial injury is independently associated with an approximately two-fold increased risk of death.

scholarly journals The Role of Imaging in the Preoperative Assessment of Patients with Nasal Obstruction and Septal Deviation—A Retrospective Cohort Study

2020 ◽  
Author(s):  
Narin Nard Carmel-Neiderman ◽  
Ahmad Safadi ◽  
Anat Wengier ◽  
Tomer Ziv-Baran ◽  
Anton Warshavsky ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Nasal Obstruction ◽  
Retrospective Cohort Study ◽  
Nasal Septum ◽  
Retrospective Cohort ◽  
Preoperative Planning ◽  
Preoperative Assessment ◽  
Ct Scans ◽  
Radiological Findings

Abstract Introduction Isolated nasal obstruction (INO) is a common complaint of multiple etiology. The preoperative evaluation of patients presenting with nasal obstruction and deviated nasal septum (DNS) does not typically include imaging. The benefits of performing computed tomography (CT) in the preoperative setting are inconclusive. Objective Assessing the contribution of preoperative CT to the surgical treatment of non-sinusitis patients presenting with INO and DNS. Methods A retrospective cohort study on patients referred to surgery for nasal obstruction due to DNS or turbinate hypertrophy between 2006 and 2015. Data was retrieved from patients' medical charts. The CT scans and clinical data were reassessed by a second surgeon blinded to the patients' clinical course. Results Seventy of the 843 patients (8.06%) who underwent endoscopic sinonasal procedures during the study period had presented with INO and met the inclusion criteria. Thirty-eight (55.88%) of them underwent CT scans during their preoperative assessment. Modification of the initial preoperative planning based on the radiological findings was required in 32 cases (84.2%). When reassessed by a second blinded surgeon, 58% of cases required surgical modification rather than classical submucosal resection of nasal septum and turbinate reduction (P = 0.048). Conclusion Computed tomography was found beneficial in the preoperative planning for patients with INO. The original surgical plan based upon physical examination findings was modified based on radiological findings in 84.2% of the patients.

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