Intense FDG uptake on PET/CT in the upper and lower respiratory system indicative of Wegener's granulomatosis

Wegener's granulomatosis (WG) is an uncommon systemic vasculitis, which involves the upper and lower respiratory tracts and the kidneys. Because the patients generally present with clinical manifestations that are similar to common diseases, WG may be initially misdiagnosed as infection or malignancy. We report the case of a 55-year-old male presenting with weight loss, cough, hemoptysis, low-grade fever, and pulmonary nodules detected on the thoracic CT scan. Malignancy was initially suspected, so a PET/CT was performed. It demonstrated intense FDG uptake in the upper and lower respiratory system. The diagnosis of WG was based on PET findings, elevated serum levels of inflammatory markers, and the presence of c-ANCA. We consider that the knowledge of FDG-PET/CT findings may help to make an easier and earlier diagnosis of WG. (C) 2013 Elsevier Espana, S.L. and SEMNIM. All rights reserved

Pathological and immunohistochemical findings of lungs, heart, liver, and kidneys, and unexpected findings of fungi and parasites in lungs of deceased COVID-19 patients: A case series

Objective: To define histopathologic and immunohistochemical features of the lungs, heart, liver, and kidneys in patients who died from coronavirus disease 2019 (COVID-19), and to determine the presence of SARS-CoV-2 in all tissues, as well as the presence of fungi and parasites in lung tissues.Methods: This retrospective case study was conducted in the intensive care units of Dokuz Eyl & uuml;l University Hospital, and patients (>= 18 years) who died due to COVID-19 between October 2020 and April 2021 were included. The biopsy samples of the patient's lung, heart, liver, and kidney tissues were studied.Results: In the study, we enrolled 12 patients (mean age: 70 years; 50% male). Alveolar epithelial cell damage and diffuse alveolar damage were predominant in lung tissues. Lobular lymphocyte infiltration, centrilobular sinusoidal dilatation, and microvesicular steatosis in the liver, together with pigmented cast, non-isometric vacuolar degeneration, and capillary plugging in the kidneys, were commonly found among the patients. SARS-CoV-2 nucleocapsid protein antibodies were detected in three lung and two kidney tissues, and so did angiotensin-converting enzyme 2 receptor positivity in one lung and more than half of the kidney tissues. The RT-PCR tests were positive in three lungs and one kidney tissue. After DNA isolation from lung tissues, Pneumocystis jirovecii was detected in nine patients, Aspergillus fumigatus in two, Microsporidia in three, and Cryptosporidium in two.Conclusions: SARS-CoV-2 is a multisystemic disease. Fungi and parasites should be investigated in critically ill COVID-19 patients prescribed corticosteroids

COPD: eine unterdiagnostizierte Erkrankung. Ergebnisse einer Screeningstudie in der Umgebung eines Spitals

Background and Aim Chronic obstructive pulmonary disease (COPD) is a serious disease with morbidity and mortality due to delayed diagnosis until significant symptoms arise. We aimed to assess the utility of spirometry and COPD Assessment Test (CAT) in detecting undiagnosed COPD patients in a localized area

COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission.

OBJECTIVE: As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged