ABSTRACT
Abstract The analysis of body composition is a fundamental part of a nutritional status assessment, and the use of diagnostic imaging methods has been increasingly required for an adequate characterization of the lean body mass and fat mass. Body composition measurements are useful in evaluating the effectiveness of nutritional interventions and monitoring changes associated with aging and chronic diseases. Whole-body densitometry using dual-energy X-ray absorptiometry (DEXA) is one of the most widely used methods in clinical practice, allowing highly accurate assessment of the bone mineral content, lean body mass, and fat mass. Although a DEXA examination provides a lot of information, there is still no universal standardization of the parameters to be included in radiology reports. The aim of this study was to review the most relevant information for assessing body composition by whole-body densitometry.
Resumo A análise da composição corporal é parte fundamental de uma avaliação nutricional, em que a utilização de métodos diagnósticos por imagem tem sido cada vez mais requisitada para uma adequada caracterização da massa magra e massa gorda corporal. Medidas de composição corporal são úteis em avaliar a eficácia das intervenções nutricionais e monitorar as mudanças associadas ao envelhecimento e condições de doenças crônicas. A densitometria de corpo inteiro utilizando a técnica de absorciometria de dupla energia (DEXA) é um dos métodos mais utilizados na prática clínica, que permite avaliação com elevada acurácia do conteúdo mineral ósseo, da gordura corporal e da massa magra. Este exame fornece grande quantidade de informações, no entanto, ainda não existe uma padronização universal de quais parâmetros devem ser incluídos nos relatórios radiológicos. O objetivo deste trabalho é revisar as informações mais relevantes para avaliação da composição corporal fornecidas pela densitometria de corpo inteiro.
ABSTRACT
ABSTRACT Objectives: The severity of pulmonary Covid-19 infection can be assessed by the pattern and extent of parenchymal involvement observed in computed tomography (CT), and it is important to standardize the analysis through objective, practical, and reproducible systems. We propose a method for stratifying the radiological severity of pulmonary disease, the Radiological Severity Score (RAD-Covid Score), in Covid-19 patients by quantifying infiltrate in chest CT, including assessment of its accuracy in predicting disease severity. Methods: This retrospective, single-center study analyzed patients with a confirmed diagnosis of Covid-19 infection by real-time reverse-transcriptase polymerase chain reaction, who underwent chest CT at hospital admission between March 6 and April 6, 2020. CT scans were classified as positive, negative, or equivocal, and a radiological severity score (RAD-Covid Score) was assigned. Clinical severity was also assessed upon hospital admission. Results: 658 patients were included. Agreement beyond chance (kappa statistic) for the RAD-Covid Score was almost perfect among observers (0.833), with an overall agreement of 89.5%. The RAD-Covid Score was positively correlated with clinical severity and death, i.e., the higher the RAD-Covid Score, the greater the clinical severity and mortality. This association proved independent of age and comorbidities. Accuracy of this score was 66.9%. Conclusions: The RAD-Covid Score showed good accuracy in predicting clinical severity at hospital admission and mortality in patients with confirmed Covid-19 infection and was an independent predictor of severity.
Subject(s)
Humans , SARS-CoV-2 , COVID-19 , Severity of Illness Index , Tomography, X-Ray Computed , Retrospective Studies , LungABSTRACT
Rheumatoid arthritis is a disease which characteristically affects the joints. Because it is an autoimmune disease, immunosuppressive drugs are widely used in its treatment. The present case report illustrates the association of immunosuppressive treatment with the development of opportunistic infections in a 64-year-old patient.
A artrite reumatoide é uma doença que, caracteristicamente, acomete as articulações. Por ser autoimune, drogas imunossupressoras são amplamente utilizadas em seu tratamento. Este caso ilustra a associação do tratamento imunossupressor com o desenvolvimento de infecções oportunistas em uma paciente de 64 anos de idade.