Correlations between chest-CT and laboratory parameters in SARS-CoV-2 pneumonia: A single-center study from Italy

To investigate the relationship between damaged lung assessed by chest computed tomography (CT) scan and laboratory biochemical parameters with the aim of finding other diagnostic tools. Patients who underwent chest CT for suspected Corona Virus Disease-2019 (COVID-19) pneumonia at the emergency department admission in the first phase of COVID-19 epidemic in Italy were retrospectively analyzed. Patients with both negative chest CT and absence of the novel coronavirus in nasopharyngeal or oropharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) swabs were excluded from the study. A total of 462 patients with positive CT scans for interstitial pneumonia were included in the study (250 males and 212 females, mean age 57 ± 17 years, range 18–89). Of these, 344 were positive to RT-PCR test, 118 were negative to double RT-PCR tests. CTs were analyzed for quantification of affected lung volume visually and by dedicated software. Statistical analysis to evaluate the relationship between laboratory analyses and CT patterns and amount of damaged lung related with COVID-19 pneumonia was performed in 2 groups of patients: positive RT-PCR COVID-19 group and negative RT-PCR COVID-19 group, but both with positive CT scans for interstitial pneumonia. Lymphocytopenia, C-reactive protein (CRP), lactate dehydrogenase (LDH), d-dimer, and fibrinogen increased levels occurred in most patients without statistically significant differences between the 2 groups with CT scans suggestive for COVID-19. In fact, in both groups the volume of lung damage was strongly associated with altered laboratory test results, even for patients with negative RT-PCR test. The decreased number of lymphocytes, and the increased levels of CRP, LDH, d-dimer, and fibrinogen levels are associated with SARS-CoV 2 related pneumonia. This may be useful as an additional diagnostic tool in patients with double negative RT-PCR assay and with highly suspected clinic and chest CT features for COVID-19 to isolate patients in a pandemic period.publishedVersio

A rare but fatal behçet variant: the hughes–stovin syndrome—successful case report and new evidence from literature review

hughes-stovin syndrome (HSS) is a rare potentially fatal vasculitis supposedly belonging to the spectrum of behçet disease without ocular involvement. HSS tends to play by a temporal pattern, starting with thrombosis and followed by formation of pulmonary aneurysms. wince its mortality can reach 25% of cases, early recognition and appropriate therapy represent the major clinical challenges. we describe a rare case of HSS successfully treated via multidisciplinary management by an endovascular approach and immunosuppressive therapy

CT Perfusion as a Predictor of the Final Infarct Volume in Patients with Tandem Occlusion

Background: CT perfusion (CTP) is used in patients with anterior circulation acute ischemic stroke (AIS) for predicting the final infarct volume (FIV). Tandem occlusion (TO), involving both intracranial large vessels and the ipsilateral cervical internal carotid artery could generate hemodynamic changes altering perfusion parameters. Our aim is to evaluate the accuracy of CTP in the prediction of the FIV in TOs. Methods: consecutive patients with AIS due to middle cerebral artery occlusion, referred to a tertiary stroke center between March 2019 and January 2021, with an automated CTP and successful recanalization (mTICI = 2b - 3) after endovascular treatment were retrospectively included in the tandem group (TG) or in the control group (CG). Patients with parenchymal hematoma type 2, according to ECASS II classification of hemorrhagic transformations, were excluded in a secondary analysis. Demographic, clinical, radiological, time intervals, safety, and outcome measures were collected. Results: among 319 patients analyzed, a comparison between the TG (N = 22) and CG (n = 37) revealed similar cerebral blood flow (CBF) > 30% (29.50 +/- 32.33 vs. 15.76 +/- 20.93 p = 0.18) and FIV (54.67 +/- 65.73 vs. 55.14 +/- 64.64 p = 0.875). Predicted ischemic core (PIC) and FIV correlated in both TG (tau = 0.761, p < 0.001) and CG (tau = 0.315, p = 0.029). The Bland-Altmann plot showed agreement between PIC and FIV for both groups, mainly in the secondary analysis. Conclusion: automated CTP could represent a good predictor of FIV in patients with AIS due to TO

La fistola artero-venosa brachio-basilica come accesso per emodialisi. Tecnica originale e risultati a distanza

Gli Autori riferiscono su 14 pazienti affetti da insufficienza renale cronica terminale (IRCT) e sottoposti ad intervento chirurgico di con - fezionamento di fistola artero-venosa (FAV) con l’utilizzo della vena basilica (VB) superficializzat. I pazienti sono stati trattati nell’Ospedale “G.B. Grassi” di Roma, nel periodo compreso tra il gen - naio 1998 e il gennaio 2001, nell’Unità Operativa Complessa di Chirugia Generale e nell’ Unità Operativa Complessa di Nefrologia. I dati raccolti e analizzati sono stati quelli demografici e anamnestici, quelli inerenti pervietà primaria e secondaria delle FAV e la adegua - tezza dialitica. In tutti i casi compresi nello studio è stato eseguito un follow up completo per un periodo minimo di 12 mesi. Particolare attenzione è stata posta sui risultati funzionali a distanza delle FAV realizzate. Delle quattordici fistole realizzate sette sono risultate pervie, al ter - mine del follow up, senza che fosse necessario metter in opera procedure di salvataggio. Le percentuali di pervietà primaria e secondaria a 24 mesi sono risultate essere del 50% e del 75% rispettivamente. I risultati della ricerca confermano la validità della superficializ - zazione della vena basilica per il confezionamento di una FAV per emodialisi. I bassi costi di tale procedura, associati alla ridotta percen - tuale di complicanze ed insuccessi, sembrano pertanto proporla come “step” nel percorso di prossimalizzazione-protesizzazione dell’accesso vascolare nei pazienti con IRC

Congenital left ventricular diverticulum: Multimodality imaging evaluation and literature review

AbstractCongenital ventricular diverticulum is a rare cardiac malformation. We present the case of a 57-year-old man who underwent cardiac catheterization for suspected unstable angina. No coronary artery disease was diagnosed and a left ventricular diverticulum was incidentally found. Coronary CT and cardiac MRI were performed in order to confirm the diagnosis of a muscular type diverticulum and to exclude a post-ischemic aneurysm

[Treatment of electrolyte disorders by hemodialysis]

Electrolyte disorders may constitute a life-threatening emergency. Sometimes they can be treated with medical therapy but there are cases where emergency dialysis will be necessary. An important role is played by the dialysate (including different concentrations of electrolytes), which removes uremic toxins and balances the electrolyte disorders in patients with end-stage renal disease. The choice of dialysate is also important for control of the patient's vital functions during the dialysis session and in the period between sessions. Sodium is strongly related to weight gain between dialysis sessions and its concentration causes fluid overload or, on the contrary, hypotension. The choice of the buffer takes into account any possible bicarbonate- or acetate-related systemic effects. Potassium is very important for heart contraction and its fast removal could be associated with cardiac arrhythmias. The role of magnesium is still controversial. Calcium is related to hemodynamic stability, mineral bone disease and also cardiac arrhythmias. A correctly balanced dialysate is important to prevent and reduce intradialytic and interdialytic complications. The dialysate should be tailored to the needs of the individual patient

Real time evaluation of monolateral clubfoot with sonoelastography. Preliminary results

Purpose: to assess the real time elastosonography (RTE) as a primary diagnostic tool for the evaluation of mechanical properties of Achilles tendons in patients affected by not surgically treated monolateral clubfoot. Materials and method: six patients were evaluated, four males and two females, mean age 1.2 ± 1.3 months, treated with Ponseti method, and afterward, they underwent RTE examination of the Achilles tendon in clubfoot. A following ROI (region of interest) was positioned on the distal third of the tendon and the obtained data was examined retrospectively. Results: in the examined cohort of patients, the mean value ROI 1/mean value ROI 2 ratio was 2.0 ± 0.18, with an increased red area in the RTE evaluation of the affected tendon, while in the contralateral foot the mean observed value was 2.50 ± 2.1. Conclusion: RTE is a feasible and simple technique, which allows the study of the mechanical properties of Achilles tendons in children with clubfoo

[Treatment of electrolyte disorders by hemodialysis]

Electrolyte disorders may constitute a life-threatening emergency. Sometimes they can be treated with medical therapy but there are cases where emergency dialysis will be necessary. An important role is played by the dialysate (including different concentrations of electrolytes), which removes uremic toxins and balances the electrolyte disorders in patients with end-stage renal disease. The choice of dialysate is also important for control of the patient's vital functions during the dialysis session and in the period between sessions. Sodium is strongly related to weight gain between dialysis sessions and its concentration causes fluid overload or, on the contrary, hypotension. The choice of the buffer takes into account any possible bicarbonate- or acetate-related systemic effects. Potassium is very important for heart contraction and its fast removal could be associated with cardiac arrhythmias. The role of magnesium is still controversial. Calcium is related to hemodynamic stability, mineral bone disease and also cardiac arrhythmias. A correctly balanced dialysate is important to prevent and reduce intradialytic and interdialytic complications. The dialysate should be tailored to the needs of the individual patient