Abstract Recurrent respiratory papillomatosis (RRP) is a benign disease of the upper aero-digestive tract caused by human papillomavirus (HPV) infection, which affects children and young adults. The ...aim of this review is to describe the main etiological, epidemiological, clinical, diagnostic, and treatment aspects of RRP. Most infections in children occur at birth, during passage through the birth canals of contaminated mothers. In adults, HPV is transmitted sexually. Papillomas usually appear as exophytic nodules, primarily in the larynx, but occasionally involving the nasopharynx, tracheobronchial tree, and pulmonary parenchyma. The disease course is unpredictable, ranging from spontaneous remission to aggressive persistent or recurrent disease. Although it occurs rarely, RRP has the potential for malignant transformation to squamous cell carcinoma. Clinically, RRP usually presents with nonspecific symptoms of airway involvement, including chronic cough, hoarseness, wheezing, voice change, stridor, and chronic dyspnea. Helical computed tomography (CT) is highly accurate for the identification and characterization of focal or diffuse airway narrowing caused by nodular vegetant lesions. The typical CT pattern of lung papillomatosis consists of numerous multilobulated nodular lesions of various sizes, frequently cavitated, scattered throughout the lungs. Bronchoscopy is the most reliable method for the diagnosis of RRP; it enables direct visualization of lesions in the central airways and collection of biopsy samples for histopathological diagnosis, and is also useful for therapeutic planning. The definitive diagnosis of RRP is based on histopathological analysis. Currently, no definitive curative treatment for RRP is available; despite the availability of adjunctive treatments, surgery remains the mainstay of treatment.
To perform a systematic review of the effect of blood glucose levels on 2-Deoxy-2-18Ffluoro-D-glucose (18F-FDG) uptake in normal organs.
We searched the MEDLINE, EMBASE and Cochrane databases through ...22 April 2017 to identify all relevant studies using the keywords "PET/CT" (positron emission tomography/computed tomography), "standardized uptake value" (SUV), "glycemia," and "normal." Analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Maximum and mean SUVs and glycemia were the main parameters analyzed. To objectively measure the magnitude of the association between glycemia and 18F-FDG uptake in different organs, we calculated the effect size (ES) and the coefficient of determination (R2) whenever possible.
The literature search yielded 225 results, and 14 articles met the inclusion criteria; studies included a total of 2714 (range, 51-557) participants. The brain SUV was related significantly and inversely to glycemia (ES = 1.26; R2 0.16-0.58). Although the liver and mediastinal blood pool were significantly affected by glycemia, the magnitudes of these associations were small (ES = 0.24-0.59, R2 = 0.01-0.08) and negligible (R2 = 0.02), respectively. Lung, bone marrow, tumor, spleen, fat, bowel, and stomach 18F-FDG uptakes were not influenced by glycemia. Individual factors other than glycemia can also affect 18F-FDG uptake in different organs, and body mass index appears to be the most important of these factors.
The impact of glycemia on SUVs in most organs is either negligible or too small to be clinically significant. The brain SUV was the only value largely affected by glycemia.
Objectives
To compare the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) to other non-COVID viral pneumonia.
Methods
MEDLINE, EMBASE, and Cochrane databases were ...searched through April 04, 2020, for published English language studies. Studies were eligible if they included immunocompetent patients with up to 14 days of viral pneumonia. Subjects had a respiratory tract sample test positive for COVID-19, adenovirus, influenza A, rhinovirus, parainfluenza, or respiratory syncytial virus. We only included observational studies and case series with more than ten patients. The pooled prevalence of each chest CT pattern or finding was calculated with 95% confidence intervals (95% CI).
Results
From 2263 studies identified, 33 were eligible for inclusion, with a total of 1911 patients (COVID-19,
n
= 934; non-COVID,
n
= 977). Frequent CT features for both COVID-19 and non-COVID viral pneumonia were a mixed pattern of ground-glass opacity (GGO) and consolidation (COVID-19, 0.37; 0.17–0.56; non-COVID, 0.46; 0.35–0.58) or predominantly GGO pattern (COVID-19, 0.42; 0.28–0.55; non-COVID 0.25; 0.17–0.32), bilateral distribution (COVID-19, 0.81; 0.77–0.85; non-COVID, 0.69; 0.54–0.84), and involvement of lower lobes (COVID-19, 0.88; 0.80–0.95; non-COVID, 0.61; 0.50–0.82). COVID-19 pneumonia presented a higher prevalence of peripheral distribution (COVID-19 0.77; 0.67–0.87; non-COVID 0.34; 0.18–0.49), and involvement of upper (COVID-19, 0.77; 0.65–0.88; non-COVID 0.18; 0.10–0.27) and middle lobes (COVID-19, 0.61; 0.47–0.76; non-COVID 0.24; 0.11–0.38).
Conclusion
Except for a higher prevalence of peripheral distribution, involvement of upper and middle lobes, COVID-19, and non-COVID viral pneumonia had overlapping chest CT findings.
Key Points
• Most common CT findings of coronavirus disease 2019 (COVID-19) were a predominant pattern of ground-glass opacity (GGO), followed by a mixed pattern of GGO and consolidation, bilateral disease, peripheral distribution, and lower lobe involvement.
• Most frequent CT findings of non-COVID viral pneumonia were a predominantly mixed pattern of GGO and consolidation, followed by a predominant pattern of GGO, bilateral disease, random or diffuse distribution, and lower lobe involvement.
• COVID-19 pneumonia presented a higher prevalence of peripheral distribution, and involvement of upper and middle lobes compared with non-COVID viral pneumonia
Musculoskeletal inflammatory lesions in chronic Chikungunya virus (CHIKV) infection have not been thoroughly assessed using whole-body magnetic resonance imaging (WBMRI). This study aimed to ...determine the prevalence of these lesions in such patients.
From September 2018 to February 2019, patients with positive Chikungunya-specific serology (Immunoglobulin M/Immunoglobulin G anti-CHIKV), with a history of polyarthralgia for > 6 months prior to MRI with no pre-existing rheumatic disorders, underwent 3T WBMRI and localized MRI. The evaluation focused on musculoskeletal inflammatory lesions correlated with chronic CHIKV infection. Pain levels were assessed using a visual analogue scale on the same day as WBMRI.
The study included 86 patients of whom 26 met the inclusion criteria. All patients reported pain and most (92.3%) categorized it as moderate or severe. The most common finding across joints was effusion, particularly in the tibiotalar joint (57.7%) and bursitis, with the retrocalcaneal bursa most affected (48.0%). Tenosynovitis was prevalent in the flexor compartment of the hands (44.2%), while Kager fat pad and soleus edema were also observed. Bone marrow edema-like signals were frequently seen in the sacroiliac joints (19.2%). Most WBMRI findings were classified as mild.
This study represents the first utilization of 3T WBMRI to assess musculoskeletal inflammatory disorders in chronic CHIKV infection. The aim was to identify the most affected joints and prevalent lesions, providing valuable insights for future research and clinical management of this condition regarding understanding disease pathophysiology, developing targeted treatment strategies, and using advanced imaging techniques in the assessment of musculoskeletal manifestations.
Bullous emphysema in a cannabis user Marchiori, Edson; Hochhegger, Bruno; Zanetti, Gláucia
Jornal brasileiro de pneumologia,
01/2024, Letnik:
50, Številka:
1
Journal Article
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