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Invasive mold infection is a serious complication described in patients with severe viral pneumonia (1). Centers in Europe, China, and the United States have reported cases of fungal superinfections among [...]

Finally, an SP 18 sp F-fluorodeoxyglucose positron emission tomography/computed tomography ( SP 18 sp F-FDG PET/CT) showed a hypermetabolic solitary mass with moderate glucose uptake (SUVmax of 5.1) (Panel C-1, black arrows). MRI and PET/CT reports included a paraganglioma as a strong consideration in the differential diagnosis. PET/CT was performed to evaluate lesion metabolism and look for other masses. [Extracted from the article]

Gastrointestinal (GI) bleeding is the most common GI diagnosis leading to hospitalization within the United States. Prompt diagnosis and treatment of GI bleeding is critical to improving patient outcomes and reducing high healthcare utilization and costs. Radiologic techniques including computed tomography angiography, catheter angiography, computed tomography enterography, magnetic resonance enterography, nuclear medicine red blood cell scan, and technetium-99m pertechnetate scintigraphy (Meckel scan) are frequently used to evaluate patients with GI bleeding and are complementary to GI endoscopy. However, multiple management guidelines exist which differ in the recommended utilization of these radiologic examinations. This variability can lead to confusion as to how these tests should be used in the evaluation of GI bleeding. In this document, a panel of experts from the American College of Gastroenterology and Society of Abdominal Radiology provide a review of the radiologic examinations used to evaluate for GI bleeding including nomenclature, technique, performance, advantages, and limitations. A comparison of advantages and limitations relative to endoscopic examinations is also included. Finally, consensus statements and recommendations on technical parameters and utilization of radiologic techniques for GI bleeding are provided., (Copyright © 2024 by The American College of Gastroenterology and the Radiological Society of North America.)

Background: Dissections that involve the ascending aorta are classified as type A, regardless of the site of the primary intimal tear, and all other dissections as type B. Type B dissections can have fatal ischemic and hemorrhagic complications. In the chronic state, dilatation and rupture can be mortal. Endovascular surgery is a therapeutic alternative, considering the high rate of complications of conventional surgery., Aim: To report the results of endovascular treatment of type B aortic dissection., Material and Methods: Report of 36 treated patients (30 males) aged 43 to 87 years, with a type B aortic dissection. Seventy eight percent were hypertensive and 39% smoked. The diagnosis was confirmed by CAT scan. Acute patients were treated for complications and chronic patients, for dilatation. In the operating room, an endoprothesis was placed through the femoral artery, to cover the tear. The tear was located and the lumens were differentiated using angiography and transesophageal echocardiography., Results: All procedures were successful. In 16 acute dissections the indications were malperfusion syndrome or unmanageable hypertension in seven patients and imminent rupture or persistent pain in nine. Twenty chronic patients were operated due to dilatation (mean 6 cm). One patient died due to cardiac failure. One patient had a transient paraparesia and two had pulmonary embolism. No patient died in a follow up period ranging from 2.5 to 74 months. Four patients required a new aortic endovascular procedure due to progressive dilatation or endoleak., Conclusion: Endovascular treatment of type B aortic dissection has good immediate and long term results.

Background: Magnetic resonance cholangiopancreatography MRCP) is a non-invasive diagnostic method for choledocholithiasis., Aim: To evaluate the results of MRCP in the diagnosis of choledocholithiasis., Patients and Methods: Retrospective review of MRCP reports performed between October 2001 and December 2004. We included patients with suspected choledocholithiasis who were studied with MRCP and some other confirmatory test such as endoscopic retrograde cholangiopancreatography ERCP), surgical common bile duct exploration or transcystic colangiography TC)., Results: One hundred and twenty five patients aged 58+/-20 years 70 females) were included. In 54 patients 43%) we compared the results of MRCP with the findings of surgical common bile duct exploration or TC and in 71 57%) we did so with ERCP. MRCP suggested choledocholithiasis in 93 patients and in 32 it was negative. Eighty six 67%) patients had choledocholithiasis according to TC or ERCP, including 3 patients who had a negative MRCP. Therefore the sensibility was 97%, specificity 74% positive predictive value 89%, negative predictive value 90% and accuracy of MRCP was 90% for the diagnosis of choledocholithiasis., Conclusions: MRCP has a high accuracy for the diagnosis of choledocholithiasis.

Background: Endovascular repair of abdominal aortic aneurysms (AAA) avoids laparotomy, shortens hospital stay and reduces morbidity and mortality related to surgical repair, allowing full patient recovery in less time., Aim: To report short and long term results of endovascular repair of AAA in 80 consecutive patients treated at our institution., Patients and Methods: Between September 1997 and February 2005, three women and 77 men with a mean age 73.6+/-7.7 years with AAA 5.8+/-1.0 cm in diameter, were treated. The surgical risk of 38% of patients was grade III according to the American Society of Anesthesiologists classification. Each procedure was performed in the operating room, under local or regional anesthesia, with the aid of digital substraction angiography. The endograft was deployed through the femoral artery (83.7% bifurcated, 16.3% tubular graft). A femoro-femoral bypass was required in 11.3% of cases. Follow-up included a spiral CT scan at 1, 6 and 12 months postoperatively, and then annually., Results: Endovascular repair was successfully completed in 79/80 patients (98.7% technical success). The procedures lasted 147+/-71 min. Length of stay in the observation unit was 20.6+/-13.5 h. Blood transfusion was required in 10%. Sixty two percent of the patients were discharged before 72 h. One patient died 8 days after surgery due to a myocardial infarction (1.3%). During follow-up (3-90 months), 1 patient developed late AAA enlargement due to a type I endoleak, requiring a new endograft. No AAA rupture was observed. Survival at 4 years was 84.2% (SE =9.2). Endovascular re-intervention free survival was 82.7% (SE =9.5)., Conclusion: Endovascular surgery allows effective exclusion of AAA avoiding progressive enlargement and/or rupture and is a good alternative to open repair. Close and frequent postoperative follow up is mandatory.

Rhodococcus equi, is a grampositive intracellular bacillus, that causes infection mainly in immunocompromised hosts. We report the case of a 52 years old woman, with a systemic lupus erythematosus and a progressive 10 months evolution with cough, dyspnea, mucous-purulent sputum, occasionally hemoptysis, intermittent fever, and weight loss of 10%. With partial response to antibiotic treatment, radiological evolution of thoracic scanners evidenced the development of multiple bilateral areas of consolidation, some of them nodular. Percutaneous thoracic biopsy showed characteristic histology and microbiological analysis yielded the identification of Rhodococcus equi in both bronchoalveolar lavage and pulmonary biopsy. She received prolonged bi-associated antibiotic treatment with good clinical and radiological response. This agent must be considered in the study of immunocompromised patients that present with a prolonged evolution of pneumonia.