Pulomanry involvement in asymptomatic Systemic Lupus Erythematosus patients with antiphospholipid syndrome multislice CT angiography and pulomnary involvement in asymptomatic SLE patients with APS

To detect the pulmonary involvement in asymptomatic secondary APS patients by pulmonary function tests [PFTs] and chest multislice HRCT angiography. Comparing the pulmonary findings to those of asymptomatic SLE patients without APS was considered. Thirty-four SLE patients with APS and another 34 SLE patients without APS and with a negative ACL test were included as control. All patients were asymptomatic for any pulmonary manifestations. Plain chest X-ray, HRCT angiography and PFTs were performed for all patients in an attempt to assess the pulmonary vasculature and lung parenchyma. Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index [SLEDAI] while assessment of organ damage was made using the Systemic Lupus International Collaborating Clinics/ACR [SLICC/ACR] index. There were abnormal pulmonary CT findings in 11 [32.35%] of the asymptomatic secondary APS patients with an obvious association to lupus anticoagulants. However, plain X-ray showed basal atelectasis and/or elevation of the copulae in four patients. Pulmonary abnormalities included a high frequency of pulmonary artery aneurysms [20.59%] thrombosis, basal atelectasis, embolism, bronchiectasis, pleural effusion and thickening. The SLEDAI and SLICC were significantly higher in APS patients. More SLE patients without APS were receiving hydroxychloroquine which suggests a protective role on the thromboembolic events occurring in APS. Multislice HRCT pulmonary angiography, with its multiplanar capability, vascular reconstruction and high quality, is useful in demonstrating the entire thoracic spectrum in asymptomatic APS patients. Particular concern about the medications used in APS could prevent the risk of developing noticeable thromboembolic events

Clinical probability of pulmonary embolism: comparison of different scoring systems

Pulmonary embolism is one of the greatest diagnostic challenges in emergency medicine and clinical probability assessment is a fundamental step in its diagnosis. To evaluate the role of estimating clinical probability of pulmonary embolism and to compare between different pre-test probability scoring systems as regards their sensitivity and specificity. We used seven scoring systems [original Geneva score, revised Geneva score, simplified Geneva score, Wells score, simplified Wells score, simplified Charlotte rule, Pisa model] to assess the clinical probability of PE in 41 patients with suspected pulmonary embolism for whom the final diagnosis was based on multislice CT pulmonary angiography [CTPA]. Twenty-four patients [58.5%] had pulmonary embolism. The scores with the strongest correlation with the result of CTPA were the Pisa model [P 6

Estudo e classificaçäo das membranas neovasculares subretinianas na degeneraçäo macular relacionada à idade pela angiografia digital com indocianina verde / Study and classification of subretinal neovascularization in age-related macular degeneration by digital angiography with indocyanine green

Objetivo: analisar por meio da angiografia digital com indocianina verde (ICV) casos de membrana neovascular subretiniana (MNSR) oculta ou mal definida, diagnosticada pela angiofluoresceinografia (AF) em degeneraçäo macular relacionada à idade. Material e método: pacientes com MNSR oculta ou mal definida, diagnosticada pela AF foram analisados por meio do ICV, excluindo-se olhos com tratamento prévio com raio laser ou outra doença ocular. Resultados: trinta e quatro olhos foram estudados. Foi encontrada placa com hiperfluorescência difusa em 18 olhos (52,9 por cento) em 11 olhos (32,3 por cento) a existência de um ponto focal hiperfluorescente, sendo que estas alteraçöes näo foram detectadas pela angiofluoresceinografia. Conclusäo: a ICV em alguns casos detecta a presença de membrana neovascular subretiniana presumível näo-evidenciada ao exame

Utilidade da angiografia digital na realizaçäo da angioplastia coronária: análise de 100 casos / Utility of Digital Angiography in the Coronary Angioplasty. Analysis of 100 Cases

Objetivo - Analisar a real contribuição da angiografia digital para a realização da angioplastia coronária e como ela ajudaria na otimização dos resultados da dilatação. Métodos - Cem pacientes uniarteriais, sem angioplastia ou cirurgia de revascularização prévias, submetidos à dilatação de estenoses coronárias entre janeiro e dezembro de 1990. Além do registro cinecoronariográfico convencional foram feitas aquisições digitais antes do procedimento, para medir o diâmetro da artéria, escolhendo-se, dessa forma, o cateter balão mais adequado para cada caso, e também para quantificar a importância da estenose coronária a ser tratada. Novas aquisições eram feitas durante o procedimento para medir o diâmetro no local dilatado e, logo após a retirada do sistema dilatador, um novo registro digital permitia a quantificação da lesão residual e o diâmetro final do segmento tratado. Resultados - A estenose média pré-angioplastia era de 78,2%. O diâmetro de referência médio era de 2,8mm e no local estenosado 0,8mm. A relação balão/artéria era 0,9:1. A lesão residual pós-angioplastia foi de 13,6% e o diâmetro no local dilatado aumentou para 2,6mm. Não houve complicações em qualquer paciente. Conclusão - A angiografia digital é um método útil para os laboratórios que se dedicam a intervenções coronárias pois permite a confirmação da severidade anatômica da estenose, otimizar a escolha do cateter-balão a ser utilizado e monitorar os resultados obtidos, quantificando a lesão residual e medindo o diâmetro final atingido

Purpose - To analyse the actual contribution of digital angiography in the angioplasty setting and to assess its utility to optimize angioplasty results. Methods - One hundred patients with single vessel coronary artery disease, without previous angioplasty or coronary artery bypass graft surgery, who underwent angioplasty from January to December 1990. Views were obtained in standard films and also in digitized angiograms. The latter was acquired before angioplasty in order to precisely quantify the stenosis and also to measure the reference diameter of the artery that was used and to choose the balloon catheterfor each case. New acquisitions were done during and after the end of the procedure to confirm the residual stenosis and to measure the final diameter. Results - The mean stenosis pre angioplasty was 78.2%, the mean reference diameter 2.8 mm and the mean diameter at the stenotic site 0.8mm. The balloon artery relation was 0.9:1. After angioplasty the residual stenosis was 13.6% and the dilated segment had a final diameter of 2. 6mm. There were no complications in any patient. Conclusion - Digital angiography is a useful methodfor laboratories devoted to coronary interventions forit allows confirmation of the severity of the stenosis, optimizes the balloon/artery relation, monitors partial results and measures the residual stenosis as well as the final diameter.