Association between lung opacities and visceral fat in COVID-19 patients

Purpose: To assess the relationship between the amount of the epigastric visceral fat area and the severity of pneumonia in the course of COVID-19 using chest computed tomography (CT) examinations. Material and methods: 177 patients (54 female), with COVID-19 infection were included. A routine chest CT was performed to assess the severity of pneumonia. The affected lung tissue as well as semi-quantitative scales such as the Chest CT Score and Total Opacity Score were calculated using SyngoVia VB30A CT Pneumonia Analysis software. The epigastric region area of visceral fat (L1) was also determined. Results: The mean value of the visceral adipose tissue area was 196.23 ± 101.36 cm2. The area of adipose tissue significantly correlated with the percentage of the affected lung tissue (r = 0.1476; p = 0.050), the Chest CT Score (r = 0.2086; p = 0.005), and the Total Opacity Score (r = 0.1744; p = 0.200). The mean area of adipose tissue in the age group ≥ 65 years was 216.13 ± 105.19 cm2, while in the group < 65 years, it was 169.18 ± 89.69 cm2. This difference was statistically significant (p = 0.002). Conclusions: The study showed a relationship between the area of visceral adipose tissue and the degree of lung inflammation in COVID-19 disease in patients under 65 years of age

Tumoral calcinosis of the cervical spine in a dialysis patient. Case report and review of the literature

The authors present a case of tumoral calcinosis (TC) in a patient with chronic renal insufficiency. The clinical course, imaging features and microscopic findings are detailed. A 60-year-old woman with a 4-year history of hemodialysis presented with a painful mass in the right posterior cervical triangle. The neuroimaging revealed polycystic mass bulging from the C3–C5 facet joints and lamina on the right. The majority of cystic mass was excised and microscopic features of the specimen were consistent with TC. Tumoral calcinosis is a rare disease characterized by calcium salt deposits in periarticular soft tissue, which enlarge to form tumor-like cystic masses containing chalky calcareous material. TC is typically seen around large joints but rarely in the spine. Review of past publications provided six cases of TC involving the spine in dialyzed patients

BOLD fMRI signal in stroke patients and its importance for prognosis in the subacute disease period – Preliminary report

Functional magnetic resonance imaging (fMRI) allows for the assessment of neuronal activity through the blood-level-dependent signal. The purpose of study was to evaluate the pattern of brain activity in fMRI in patients with ischemic stroke and to assess the potential relationship between the activity pattern and the neurological/functional status. Methods The fMRI was performed in patients up to 4th day of stroke. All the patients were analyzed according to NIHSS on 1st day and mRankin scale on 14th day of stroke, followed by analyzing of fMRI signal. Results The study enrolled 13 patients at a mean age of 64.3years. Eight (61.5%) showed cerebellar activation and 2 (15.38%)- insular activation. In those who scored 0–2 on mRankin scale, the most frequently observed activity was located in the regions: the M1, SMA and PMC in the stroke hemisphere and the cerebellum. In those cases, the non-stroke hemisphere was more frequently involved in the areas: the M1 and PMC. There was a tendency for a better prognosis in relation to age &lt;65years and activation of the SMA in the stroke hemisphere. Conclusion There are differences observed in the activation areas of the cerebral cortex both in the stroke and non-stroke hemispheres. More than half of the patients with hemispheric stroke but all with good outcome showed cerebellar activation. There is probable positive correlation between the BOLD-signal size, young age, activation of supplementary motor area in stroke hemisphere and good functional status of patients in the subacute period of stroke

Post-tracheostomy complications: respiratory failure caused by authologic foreign body – case report

Tracheostomy is performed frequently as a palliative treatment in patients with end-stage respiratory failure (RF). However, in patients requiring prolonged mechanical ventilation it may be difficult to recognize and can often lead to life-threatening RF. We present two cases of acute-on-chronic respiratory failure (ACRF) occurring in patients who had undergone tracheostomy [one with percutaneous dilatational tracheostomy (PDT) and the second with surgical tracheostomy (ST)]. The first case was admitted due to ACRF several months after previous successful decannulation and the second case after failure of several attempts of weaning from tracheal cannula. In both cases, noninvasive mechanical ventilation assisted flexible bronchoscopy (NIV-FB) was able to identify and solve the tracheal stenosis secondary to stiff bananashaped whitish foreign bodies. Histology sampling and genetic testing confirmed autologous foreign body formation—tracheal cartilage calcification. NIV-FB was found to be safe and effective in both diagnosis and treatment of the tracheal stenosis. Life-threatening RF connected with tracheal stenosis may be caused by rupture of tracheal cartilage ossification in patients with a history of ST and PDT. Bronchofiberoscopy performed with NIV will be a useful procedure to evaluate and treat the respiratory tract in patients with RF with suspected tracheal stenosis

Aortic regurgitation and left ventricle remodeling on cardiac magnetic resonance and transthoracic echocardiography

Background: Transthoracic echocardiography (TTE) is the first imaging modality used to assess aortic regurgitation (AR). However, it is not possible to provide precise quantification in all patients. Aim: Our aim was to compare TTE and cardiovascular magnetic resonance (CMR) measurements in grading AR and left ventricle (LV) remodeling. Methods: A total of 51 consecutive patients with AR in TTE (New York Heart Association I/II, 55%/38%) were enrolled into the study and 49 individuals (age, 57.1 [14]; 61% males) underwent a non-contrast CMR (2 patients excluded) obtained on 1.5 T system (GE Optima MR450w). Results: The comprehensive quantitative grading with AR volume (AR vol) and regurgitant fraction (RF) were measurable in TTE in 24 cases and showed an association with CMR parameters (AR vol: r = 0.75; P &lt;0.001 and RF: r = 0.55; P &lt;0.01). CMR revealed larger LV end-diastolic volumes (EDV) (185.5 [61] vs 158.4 [61] ml; P = 0.03) and a trend towards higher left ventricular ejection fraction (59% [8] vs 56% [8]; P = 0.08). The association of AR vol and LV EDV was stronger in CMR (r = 0.85; P &lt;0.0001) compared to TTE (r = 0.6; P = 0.001). The inter-modality agreement (TTE-CMR) in AR grading was low (κ = 0.15), with highly concordant grading in mild AR (91%). Conclusions: CMR provides a comprehensive assessment of AR severity and LV remodeling with a weak or a moderate agreement with TTE

Analiza porównawcza wczesnych wyników leczenia podnerkowego tętniaka aorty brzusznej u pacjentów wysokiego ryzyka pomiędzy latami 1999–2003 a 2014; co się zmieniło. Badanie jednoośrodkowe

Autorzy pojęli próbę porównania wyników leczenia pacjentów wysokiego ryzyka (ASA III/IV) z podnerkowym tętniakiem aorty brzusznej leczonych w latach 1999–2003 i 2014 w Katedrze i Klinice Chirurgii Ogólnej, Naczyń, Angiologii i Flebologii WLK SUM. Kryteria wyjściowe leczenia uległy zmianie, podczas gdy w latach 1999–2003 do zabiegu kwalifikowano pacjentów z tętniakiem o śr. 50 mm u mężczyzn i 45 mm u kobiet , odpowiednio w roku 2014 śr. u mężczyzn 55 mm u kobiet 50 mm. Podjęto próbę ujednolicenia kryteriów kwalifikacyjnych i dyskwalifikacyjnych do badanych grup chorych. Uzyskane wyniki wykazały znaczne zmniejszenie odsetka zgonów oraz skrócenie czasu pobytu w roku 2014 w stosunku do lat 1999–2003. Odnotowano nie badany uprzednio spadek parametrów morfologii krwi u pacjentów leczonych implantacją stentgraftu w roku 2014