Correção endovascular de pseudoaneurisma de tronco tibiofibular secundário a endocardite ­ relato de caso / Endocarditis-related tibioperoneal trunk pseudoaneurysm managed with endovascular treatment ­ case report

Os aneurismas do tronco tibiofibular são raros e consistem principalmente em pseudoaneurismas. Os autores descrevem um caso incomum de pseudoaneurisma do tronco tibiofibular secundário a endocardite bacteriana diagnosticada e tratada vários anos antes. Após a exclusão de um processo infeccioso ativo, o paciente foi tratado com sucesso através do implante percutâneo de um stent recoberto. O tratamento endovascular, neste contexto, apresentou uma alternativa segura e eficaz

ibioperoneal trunk aneurysms are rare and the majority of them are pseudoaneurysms This report describes an unusual case of a pseudoaneurysm secondary to bacterial endocarditis diagnosed and treated several years previously. After ruling out ongoing infection, the patient was successfully treated by percutaneous covered stent implantation. In this scenario, the use of endovascular techniques offered a safe and effective alternative treatment

Optimization condition in labeling of ofloxacin with [99m]Tc and its biological evaluation in Staphylococcus aureus and Escherichia coli for infection imaging

The use of radiopharmaceuticals is a powerful tool in the management of patients with infectious or inflammatory diseases in nuclear medicine. In this study ofloxacin as a second-generation fluoroquinolone is used to design a desired infection imaging agent after labeling with [99m]Tc via direct labeling. Ofloxacin was radiolabeled with [99m]Tc using different concentrations of ligand, stannous chloride, sodium pertechnetate and at different pH. Then labeling yield, stability in saline and serum, lipophilicity, binding with Staphylococcus aureus and Escherichia coli and biodistribution in infected mice for labeled compound were studied. The final complex was characterized by TLC and HPLC and radiochemical purity of >90% was obtained when 1.5 mg ofloxacin in presence of 75 micro g SnCl2 was labeled with 370 MBq sodium pertechnetate. The complex showed specific binding to Staphylococcus aureus and Escherichia coli. Biodistribution results showed that radioligand had high affinity in the infected site in mice. The uptake for Staphylococcus aureus induced infections [T/NT = 2.33 +/- 0.17 at 1 h post injection] was higher than that was for Escherichia coli [T/NT = 1.96 +/- 0.13 at 1 h post injection]. This complex may lead to further development of a radiotracer for imaging of infections induced by grampositive or gram-negative bacteria

PET and PET-CT imaging in infection and inflammation: Its critical role in assessing complications related to therapeutic interventions in patients with cancer.

Over the past decade, there has been an increasing evidence of false-positive FDG uptake in several infectious diseases and aseptic inflammatory processes. With the widespread application of FDG-PET imaging in oncology, the interpreting physicians have come across these conditions frequently leading to false-positive diagnosis. Such conditions can coexist with metastatic lesions in patients with cancer, and hence, early and accurate diagnosis or exclusion of infection and inflammation is of utmost importance for the optimal management of these patients. Also, this powerful imaging modality can play an invaluable role for the appropriate management of these complicated benign conditions. The present communication on this non-oncological application of FDG is intended as an educative primer for practicing oncologists on this very important aspect of PET-CT imaging with an ultimate aim for bettering patient management.

role Gallium- 67 Whole body scintigraphy in secondary infections in HIV-positive patients

Secondary infections in HIV-positive patients are a major cause of morbidity and mortality. Early diagnosis of these secondary infections is the key to successful treatment and survival. The role of [67] Ga citrate scintigraphy is established as a screening method for opportunistic pneumonia. However, few reports have focused on abdominal [67] Ga imaging and there have been none from the Middle East. This study was designed to assess the role of [67] Ga citrate whole body scintigraphy [[67] Ga WBS] for detection of secondary infections in symptomatic and asymptomatic HIV-positive patients. Thirty-one [67] Ga Wbs studies > were performed on 28 HIV-positive patients; of whom 7 were asymptomatic and 21 were symptomatic. [67] Ga WBS studies were normal in the 7 asymptomatic patients. Abnormal [67] Ga WBS studies were obtained in 9 patients with myocobacteria, in 4 with pneumoncystis carinii, and in 6 with other organisms. [67] Ga WBS studies were normal in 3 patients with salmonella infection. In the symptomatic group as a whole, 18 [75%] showed abnormal abdominal uptake whereas only 12 [50%] showed abnormal chest uptake. [67] Ga WBS detects more lesions than [67] Ga thorax scintigraphy only. In this series the sensitivity and specificity of [67] Ga WBS for the detection of abdominal sites of secondary infections were 84% and 83% respectively, the positive predictive value was 88%, the negative predictive value was 70% and the accuracy was 81%. The examination is very useful in localizing the sites of infections in symptomatic patients