RESUMEN
Coronavirus disease 2019 (COVID-19) is associated with coagulation activation and high incidence of venous thromboembolism (VTE) in severe patients despite routine thromboprophylaxis. Conflicting results exist regarding the epidemiology of VTE for unselected anticoagulated COVID-19 patients hospitalized in general wards. The aim of this study was to evaluate the prevalence of asymptomatic deep venous thrombosis (DVT) in unselected patients with COVID-19 recently hospitalized in general wards. We performed a systematic complete doppler ultrasound (CDU) at a median 4 days after admission in 42 consecutive COVID-19 patients hospitalized in general wards of our university hospital, irrespective of D-Dimer level, and retrospectively collected clinical, biological and outcome data from electronic charts. Thromboprophylaxis was systematically applied following a French national proposal. In our population, the prevalence of asymptomatic DVT was 19% (8/42 patients), with distal thrombosis in 7/8 cases and bilateral DVT in 4/8 cases. Symptomatic pulmonary embolism was detected in 4 (9.5%) patients, associated to DVT in one case. Compared to patients without DVT, patients with DVT were older and experienced poorer outcomes. In conclusion, prevalence of asymptomatic DVT is high in the first days of hospitalization of unselected COVID-19 patients in general wards and may be related to poor prognosis. Individualized assessment of thromboprophylaxis and early systematic screening for DVT is warranted in this context.
Asunto(s)
COVID-19/complicaciones , Tromboembolia Venosa/virología , Adulto , Anciano , Anciano de 80 o más Años , Anticoagulantes/administración & dosificación , Enfermedades Asintomáticas/epidemiología , COVID-19/diagnóstico por imagen , COVID-19/epidemiología , Femenino , Francia/epidemiología , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Ultrasonografía Doppler , Tromboembolia Venosa/diagnóstico por imagen , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/prevención & controlRESUMEN
Acute abdominal pain is a frequent consultation cause with large causal diversity and possible severity that may lead to emergency surgery. Radiology development and availability have changed their management with possibility of rapid diagnostic. Computed tomography has become the gold standard in this setting, reducing AAS to very few indications. Ultrasound remains the first exploration for children and pregnant woman. Magnetic resonance imaging may be more attractive in the future, thanks to its lack of radiation.
Asunto(s)
Dolor Abdominal/diagnóstico , Diagnóstico por Imagen , Dolor Abdominal/etiología , Enfermedad Aguda , Árboles de Decisión , HumanosRESUMEN
Follicular dendritic cell sarcomas of the tonsil are very rare tumors. Only 10 cases have been published in the English-language medical literature. We present an additional case that occurred in a 27-year-old woman. She presented with a tumor of the right tonsil. Histological sections of tonsillar biopsies and tonsillectomy suggested that this tumor was a nerve sheath tumor or a malignant melanoma. Histological examination and immunohistochemical study were reviewed. The final diagnosis was follicular dendritic cell sarcoma. She underwent a transoral resection of the right oropharynx with ipsilateral selective neck dissection and postoperative irradiation. We emphasize the difficulties in diagnosing this type of tumor. The use of monoclonal specific markers is required to avoid misdiagnosis. We discuss therapeutic methods for this rare tumor for which optimal treatment has not yet been defined.
Asunto(s)
Células Dendríticas Foliculares/patología , Sarcoma/patología , Neoplasias Tonsilares/patología , Adulto , Terapia Combinada , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , Sarcoma/radioterapia , Sarcoma/cirugía , Neoplasias Tonsilares/radioterapia , Neoplasias Tonsilares/cirugíaRESUMEN
The magnetic resonance imaging (MRI) findings in idiopathic adhesive capsulitis (AC) were compared with those of contralateral healthy shoulders and the reliability of measures assessed. Twenty-six consecutive patients (26 AC and 14 healthy shoulders) were prospectively assessed. The main measurements were thickness of the joint capsule and synovial membrane in the axillary recess and rotator interval in T1-weighted spin-echo sequence enhanced with intravenous (IV) gadolinium chelate (Gd-chelate). Reliability was studied by use of the intraclass correlation coefficient (ICC). The mean thickness of the axillary recess on the coronal plane was 9.0+/-2.2 mm in AC shoulders and 0.4+/-0.7 mm in healthy shoulders. The mean thickness of the rotator interval on the sagittal plane was 8.4+/-2.8 in AC shoulders and 0.6+/-0.8 mm in healthy shoulders. Interobserver reliability was good for the axillary recess, with ICC values of 0.84 for the coronal plane, and good for the rotator interval, with ICC values of 0.80 for the sagittal plane. MRI with IV Gd-chelate injection can show, with acceptable reliability, signal and thickness abnormalities of the shoulder joint capsule and synovial membrane in AC.
Asunto(s)
Bursitis/patología , Compuestos Heterocíclicos , Aumento de la Imagen/métodos , Imagen por Resonancia Magnética/métodos , Compuestos Organometálicos , Articulación del Hombro/patología , Adulto , Anciano , Medios de Contraste , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Reproducibilidad de los Resultados , Medición de Riesgo/métodos , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
The authors describe the radiological pattern of meningitis neurological complications. These complications are vascular lesions, arteritis and thrombophlebitis, brain swelling, hydro-cephalus, extra-cerebral collections, neuritis and labyrinthitis. When meningitis complication is suspected, MRI must be the first neuroradiological investigation.