Non-invasive diagnosis in a case of bronchopulmonary sequestration and proposal of diagnostic algorhythm

The case of a 43-year-old woman with intralobar pulmonary sequestration, Pryce type one, is presented. The medical history was characterised by recurrent bronchopneumonia, productive cough with purulent sputum and hemoptysis in the last three years. Diagnosis was made by CT angiography: multiplanar, maximum intensity projection and volume rendering reconstructions were visualised. A volume reduction of middle and lower lobe with multiple cyst-like bronchiectasis was detected and no evident relationship with tracheobronchial tree was pointed out. Reconstructions aimed at evaluating bronchial structures demonstrated no patency of middle and lower lobar bronchi. The study carried out after contrast medium infusion in arterial phase showed a vascular disorder characterised by an accessory arterial branch arising from the upper portion of thoracic aorta which, after moving caudally to pulmonary hilus with a tortuous course, supplied the atelectatic parenchyma. No anomalous venous drainage was detected. The patient underwent surgery with resection of two pulmonary lobes. CT compares favourably with other alternative imaging technique for pulmonary sequestration as multiplanar reconstructions allow not only the detection of supplying vessel, but also the accurate description of heterogeneous characteristics of the mass and adjacent structures. Finally an imaging-based diagnostic algorhythm is proposed

Incidence of anogenital warts in Germany: a population-based cohort study

<p>Abstract</p> <p>Background</p> <p>Human papilloma virus (HPV) types 6 and 11 account for 90 percent of anogenital warts (AGW). Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc.) who made the initial diagnosis of AGW was assessed.</p> <p>Methods</p> <p>Retrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state.</p> <p>Results</p> <p>The estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%), whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8%) or urologist (25.1%).</p> <p>Conclusions</p> <p>Incidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.</p

Melanomas on the scalp: Are we diagnosing them late? Experience of two Australian dermatology clinics specialised in melanoma

Univ Fed Sao Paulo, Dermatol, Sao Paulo, BrazilRoyal Prince Alfred Hosp, Sydney Melanoma Diagnost Ctr, Camperdown, NSW, AustraliaUniv Sydney, Sydney, NSW, AustraliaMelanoma Inst Australia, Sydney, NSW, AustraliaUniv Fed Sao Paulo, Dermatol, Sao Paulo, BrazilWeb of Scienc

The influence of lean mass in trabecular and cortical bone in juvenile onset systemic lupus erythematosus

The aim of this study was to evaluate risk factors for low bone mineral density (BMD) and vertebral fractures, in juvenile systemic lupus (JSLE). Thirty-one consecutive patients with JSLE were compared with 31 gender- and age-matched healthy controls. BNID and body composition from all participants were measured using dual-energy X-ray absorptiometry. Vertebral fractures were defined as a reduction of >= 20% of the vertebral height for all patients. Lumbar spine and total femur BMD was significantly decreased in patients compared with controls (P = 0.021 and P = 0.023, respectively). A high frequency of vertebral fractures (22.58%) was found in patients with JSLE. Analysis of body composition revealed lower lean mass (P = 0.033) and higher fat mass percentage (P = 0.003) in patients than in controls. Interestingly, multiple linear regression using BMD as a dependent variable showed a significant association with lean mass in lumbar spine (R(2) = 0.262; P = 0.004) and total femur (R(2) = 0.419, P = 0.0001), whereas no association was observed with menarche age, SLE Disease Activity Index, Systemic Lupus International Collaborating Clinics/American College of Rheumatology, and glucocorticoid. This study indicates that low BMD and vertebral fractures are common in JSLE, and the former is associated with low lean mass, suggesting that muscle rehabilitation may be an additional target for bone therapeutic approach

Assessment of Multipath Interference IN Bend-Insensitive Fibers and Patch Cables for NGANs

Multipath interference in bend-insensitive optical fibres is experimentally evaluated in the 1300 nm wavelength range. The main issues concerning the setups for its measurement are discussed. The characterization of some bend-insensitive fibres is presented; the measured fibres exhibit a negligible MPI for lengths ≥10m, whereas jumpers with length ≤2m can produce multipath interference at detrimental levels above -30dB. The phenomenon is even more evidenced in the cascade of field-installable connectors equipped with short bend-insensitive fibres; preliminary results show a rise of the MPI for patchcords equipped with these connector

Multipath interference characterization of bend-insensitive fibers for short-reach optical communications

Multipath interference in bend-insensitive optical fibers is experimentally evaluated in the 1300 nm wavelength range, describing how this phenomenon originates and how it can be measured by a setup based on a tunable laser. The characterization of bend-insensitive fibers from different manufacturers is presented; all the considered fibers exhibit a negligible effect in patchcords longer than 10m, whereas jumpers with length ≤ 2m can produce multipath interference at detrimental levels above -30dB. The phenomenon is even more evident in the cascade of offset-spliced short jumpers made of bend-insensitive fiber; preliminary results showed a large rise of the MPI when two or more jumpers are shortly spaced