Tuberculosis of the chest

The relationship between tuberculosis and mankind has been known for many centuries, with the disease being one of the major causes of illness and death. During the early 1980s, there was a widespread belief that the disease was being controlled, but by the mid-1980s, the number of cases increased. This change in the epidemiological picture has several causes, of which the AIDS epidemic, the progression of poverty in developing countries, the increase in the number of elderly people with an altered immune status and the emergence of multidrug-resistant tuberculosis are the most important. Mainly due to this epidemiological change, the radiological patterns of the disease are also being altered, with the classical distinction between primary and postprimary disease fading and atypical presentations in groups with an altered immune response being increasingly reported. Therefore, the radiologist must be able not only to recognize the classical features of primary and postprimary tuberculosis but also to be familiar with the atypical patterns found in immuno-compromised and elderly patients, since an early diagnosis is generally associated with a greater therapeutic efficacy. Radiologists are, in this way, presented with a new challenge at the beginning of this millennium

not so rare after all

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Árgon-plasma no tratamento de leiomioma benigno metastizante pulmonar: um caso clínico

AbstractBenign metastasizing leiomyomas of the lung are rare smooth muscle cells tumours. We report the case of a 48 year-old female who was evaluated due to persistent cough, progressive dyspnoea and constitutional symptoms. Chest computed tomography revealed a left endobronchial mass, multiple parenchyma nodules and a pleural effusion. Bronchial biopsy histological features were consistent with benign metastasizing leiomyoma. The patient was successfully treated with argon-plasma and mechanical debulking. There was no disease relapse in the last four years

How do patients receiving prescribed B12 injections for the treatment of PA perceive changes in treatment during the covid-19 pandemic? A UK based survey study

Pernicious Anaemia (PA) is a chronic condition which is usually treated using B12 injections. Due to the pandemic many patients were prescribed an alternative oral B12 treatment. There is limited evidence that this is effective at managing symptoms of PA. The aim of this study was to document treatment changes across the UK and the impact on patient experience. An online survey explored how the treatment of PA has been managed during the early stages of the pandemic; responses were analysed for a sub-sample of participants receiving prescribed B12 injections and where changes in treatment applied (n=329) using content analysis. The most common reported change was suspension of injections, with oral B12 being offered as an alternative treatment. Patients were concerned about the long-term impact that changes would have on their condition management and many stated that they were dissatisfied with the level of care received. Those who were supported by healthcare providers to continue their usual treatment reported experiencing improved health and wellbeing. This study highlights the major impact of treatment changes on patient health outcomes, and the need to further support healthcare professionals with PA management during and beyond the pandemic

Observed development of the vertical structure of the marine boundary layer during the LASIE experiment in the Ligurian Sea

In the marine environment, complete datasets describing the surface layer and the vertical structure of the Marine Atmospheric Boundary Layer (MABL), through its entire depth, are less frequent than over land, due to the high cost of measuring campaigns. During the seven days of the Ligurian Air-Sea Interaction Experiment (LASIE), organized by the NATO Undersea Research Centre (NURC) in the Mediterranean Sea, extensive in situ and remote sensing measurements were collected from instruments placed on a spar buoy and a ship. Standard surface meteorological measurements were collected by meteorological sensors mounted on the buoy ODAS Italia1 located in the centre of the Gulf of Genoa. The evolution of the height (<I>z<sub>i</sub></I>) of the MABL was monitored using radiosondes and a ceilometer on board of the N/O Urania. <br><br> Here, we present the database and an uncommon case study of the evolution of the vertical structure of the MABL, observed by two independent measuring systems: the ceilometer and radiosondes. Following the changes of surface flow conditions, in a sequence of onshore – offshore – onshore wind direction shifting episodes, during the mid part of the campaign, the overall structure of the MABL changed. Warm and dry air from land advected over a colder sea, induced a stably stratified Internal Boundary Layer (IBL) and a consequent change in the structure of the vertical profiles of potential temperature and relative humidity

Imaging the postoperative patient: long-term complications of gastrointestinal surgery

The objectives of this review are (1) to become acquainted with the long-term complications of surgery of the gastrointestinal tract, and (2) to appreciate the appropriate use of imaging in the assessment of long-term complications

Sigmoid colon perforation at CT colonography secondary to a possible obstructive mechanism: report of a case

We report a case of colonic perforation in CT colonography, which was observed in a sigmoid colon segment contained within an inguinal hernia. At surgery, apart from the perforation, a normal large-bowel wall was found. Although rare, perforation may occur in patients with normal bowel wall, possibly resulting from a mechanical strain caused by gaseous overdistention. Radiologists performing the procedure must be aware of this possibilit

Dynamics of bovine intramammary infections due to coagulase-negative staphylococci on four farms

The objectives of this study were to compare the impact of different coagulase-negative species (CNS) on udder health measured in terms of individual quarter milk somatic cell count (SCC) and duration of intramammary infection, and to get some insight into most likely routes of infection for different CNS species. This longitudinal observational study was performed on four farms that were sampled at 4-week intervals for a total of 12 visits each. Quarters infected with CNS were followed through time with milk samples being submitted for bacteriological culture and SCC determination. PCR amplification of the internal transcribed spacer region and sequencing of the sodA and rpoB genes were used for species allocation. Pulsed-field gel electrophoresis (PFGE) was performed to assess strain identity. The percentage of quarters affected per farm varied between 6 and 35%, with the most frequently isolated CNS species being Staphylococcus epidermidis, followed by Staph. simulans, Staph. chromogenes and Staph. haemolyticus. It was possible to follow 111 intramammary infections due to CNS through time. Duration of infection had a mean of 188 d and was not significantly different between CNS species. Geometric mean quarter SCC overall was 132 000 cells/ml and was also not significantly different between CNS species. Despite the possibility of a different epidemiology of infection, the impact in terms of udder health seems to be similar for different CNS species

Usefulness of Perfusion CT to Assess Response to Neoadjuvant Combined Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer

RATIONALE AND OBJECTIVES: To prospectively evaluate perfusion computed tomography (CT) for assessment of changes in tumor vascularity after chemoradiation therapy (CRT) in locally advanced rectal cancer and to analyze the correlation between baseline perfusion parameters and tumor response. MATERIALS AND METHODS: Twenty patients with rectal cancer underwent baseline perfusion CT before CRT, and in 11 an examination after CRT was also performed. For each tumor, blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability-surface area product (PS) were quantified. The Mann-Whitney U test compared baseline perfusion parameters of responders and nonresponders and pre- and post-CRT measurements were compared by the Wilcoxon signed-rank test (P < .05 statistically significant for both tests). RESULTS: Baseline BF was significantly lower (P = .013) and MTT was significantly higher (P = .006) in responders. Both were able to discriminate responders from nonresponders with a sensitivity of 80% and 100% and a specificity of 73.3% and 86.7%, respectively, for BF and MTT. Baseline BV and PS were not significantly different in responders and nonresponders. Perfusion parameters changed significantly in post-CRT scans compared to baseline: BF (P = .003), BV (P = .003), and PS (P = .008) decreased, whereas MTT increased (P = .006). CONCLUSION: Baseline BF and MTT can discriminate patients with a favorable response from those that fail to respond to CRT, potentially selecting high-risk patients with resistant tumors that may benefit from an aggressive preoperative treatment approach

Odontoameloblastoma: a Clinical Case Report

O odontoameloblastoma é um tumor odontogénico misto muito raro. Reportam-se 29 casos bem documentados na literatura inglesa consultada, dos quais apenas 5 têm envolvimento do segmento anterior da mandíbula. Um homem de 51 anos apresentava um tumor da região anterior da mandíbula, com tumefacção dura, difusa e indolor na região parassinfisária direita da mandíbula. Radiograficamente existia extensa lesão radiolucente, bem delimitada, desde o dente 46 ao dente 34, com pequenas estruturas calcificadas no interior. Observava-se expansão óssea com provável perfuração cortical e reabsorções radiculares. Após biópsia realizou-se resseção cirúrgica. O exame anatomopatológico permitiu o diagnóstico de odontoameloblastoma. Não houve recorrência nos 30 meses de seguimento. O odontoameloblastoma é um tumor localmente agressivo com comportamento aparentemente semelhante ao dos ameloblastomas, em termos de crescimento, expansão óssea, rizólise e recorrência, parecendo prudente adotar o mesmo critério terapêutico para ambos