ABSTRACT
OBJECTIVE: The number patients surviving COVID-19 hospitalization is steadily increasing. Follow-up management for these patients relies on an understanding of the long-term effects of COVID-19. Specifically, there are insufficient data about the lasting effects of COVID-19 on bone health. We aim in this study to evaluate whether COVID-19 illness and treatment adversely affect the bone health of surviving patients. PATIENTS AND METHODS: We assessed the bone mineral density (BMD) of hospitalized COVID-19 patients at diagnosis and at follow-up visits. Using the chest computed tomography (CT) scans of patients that were obtained for clinical management at diagnosis and follow-up visits, BMD was retrospectively measured by quantitative CT. The effect of COVID-19 severity markers and treatment-related factors on BMD were also assessed. RESULTS: BMD decreased by a mean of 8.6% (± 10.5%) from diagnosis to follow-up. The follow-up visits occurred at a mean of 81 (± 48) days after hospital discharge. The BMD decrease was significantly greater than expected for age-related annual BMD loss. The osteoporosis ratio increased two-fold after hospitalization for COVID-19 because of this substantial bone loss. On multivariable linear regression, only severity of COVID-19 pneumonia on initial chest CT and total steroid dose were predictive of change in BMD after COVID-19 hospitalization. CONCLUSIONS: Secondary osteoporosis may occur as a post-acute sequela of COVID-19. Therefore, the bone health status of patients surviving COVID-19 hospitalization should be monitored closely at follow-up visits, to facilitate the prevention and early treatment of osteoporosis complications.
Subject(s)
Bone Diseases, Metabolic , COVID-19 , Osteoporosis , Bone Density , Humans , Osteoporosis/etiology , Retrospective StudiesABSTRACT
Hydatid disease is a zoonotic infectious disease for which there are known treatment procedures and effective antibiotics; however, there are resistant cases that do not respond to medication or surgery. We report a case diagnosed as hydatid disease of the chest wall and treated with radiation therapy (RT) after medical and surgical therapy had failed. In conclusion, RT represents an alternative treatment modality in resistant cases.
Subject(s)
Bone Diseases/radiotherapy , Echinococcosis/radiotherapy , Sternum , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Bone Diseases/diagnostic imaging , Drug Resistance , Echinococcosis/diagnostic imaging , Follow-Up Studies , Humans , Male , Middle Aged , Radiotherapy Dosage , Radiotherapy, Conformal , Sternum/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To compare the spiral computed tomographic dacryocystography (CT-DCG) findings of failed and successful dacryocystorhinostomies (DCR) and to detect the possible causes of failure before reoperation. METHODS: Eighteen patients with failed and 15 patients with functional DCR were examined by spiral CT-DCG, a combination of contrast dacryocystography and spiral computed tomography. Radiologists, who were blinded to the clinical status of the patients, measured the diameter of the osteotomy window, evaluated its position relative to the lacrimal sac, and documented any abnormal findings around the osteotomy, which may contribute to the failure of DCR. RESULTS: Location of the osteotomy window was inappropriate in 83% (15/18) of unsuccessful cases and in 7% (1/15) of successful cases and the difference was statistically significant (p < 0.01). Presence of the ethmoid air cells medial to the ostium was detected to have a significantly higher frequency in the unsuccessful DCR group (78%, 14/18) than in the successful group (20%, 3/15) (p < 0.01). The antero-posterior diameter of bony ostium was less than 15 mm in 94% (17/18) of failed DCR cases, but in only 60% (9/15) of successful DCR cases, and the difference was statistically significant (p < 0.05). Some additional findings that may contribute to the failure were noted in failed cases. There were ethmoid sinusitis in three, concha bullosa in two, nasal polyposis in two, mass in medial canthus in one, and extensive granulation tissue around the rhinostomy in one of the failed cases. CONCLUSIONS: CT-DCG is a valuable imaging tool to evaluate DCR failures before reoperation. In this series, CT-DCG showed that small size and inappropriate position of osteotomy, and also extension of ethmoid air cells medial to the lacrimal sac, were frequently seen causative factors of DCR failure.
Subject(s)
Dacryocystorhinostomy/methods , Lacrimal Duct Obstruction/diagnostic imaging , Nasolacrimal Duct/diagnostic imaging , Adolescent , Adult , Aged , Child , Child, Preschool , Contrast Media , Female , Humans , Iohexol/analogs & derivatives , Male , Middle Aged , Nasolacrimal Duct/surgery , Osteotomy , Tomography, X-Ray Computed , Treatment FailureABSTRACT
PURPOSE: To compare the spiral computed tomographic dacryocystography (CT-DCG) findings of failed and successful dacryocystorhinostomies (DCR) and to detect the possible causes of failure before reoperation. METHODS: Eighteen patients with failed and 15 patients with functional DCR were examined by spiral CT-DCG, a combination of contrast dacryocystography and spiral computed tomography. Radiologists, who were blinded to the clinical status of the patients, measured the diameter of the osteotomy window, evaluated its position relative to the lacrimal sac, and documented any abnormal findings around the osteotomy, which may contribute to the failure of DCR. RESULTS: Location of the osteotomy window was inappropriate in 83% (15/18) of unsuccessful cases and in 7% (1/15) of successful cases and the difference was statistically significant (p<0.01). Presence of the ethmoid air cells medial to the ostium was detected to have a significantly higher frequency in the unsuccessful DCR group (78%, 14/18) than in the successful group (20%, 3/15) (p<0.01). The antero-posterior diameter of bony ostium was less than 15 mm in 94% (17/18) of failed DCR cases, but in only 60% (9/15) of successful DCR cases, and the difference was statistically significant (p<0.05). Some additional findings that may contribute to the failure were noted in failed cases. There were ethmoid sinusitis in three, concha bullosa in two, nasal polyposis in two, mass in medial canthus in one, and extensive granulation tissue around the rhinostomy in one of the failed cases. CONSLUSIONS. CT-DCG is a valuable imaging tool to evaluate DCR failures before reoperation. In this series, CT-DCG showed that small size and inappropriate position of osteotomy, and also extension of ethmoid air cells medial to the lacrimal sac, were frequently seen causative factors of DCR failure. (Eur J Ophthalmol 2005; 15: 523-9).
ABSTRACT
Orbital hydatid cyst is rare. We present a case with CT and MRI, emphasizing the superiority of the latter.
Subject(s)
Echinococcosis/diagnosis , Magnetic Resonance Imaging , Orbital Diseases/diagnosis , Tomography, X-Ray Computed , Diagnosis, Differential , Echinococcosis/pathology , Echinococcosis/surgery , Female , Humans , Middle Aged , Nerve Compression Syndromes/diagnosis , Nerve Compression Syndromes/pathology , Nerve Compression Syndromes/surgery , Optic Nerve Diseases/diagnosis , Optic Nerve Diseases/pathology , Optic Nerve Diseases/surgery , Orbit/pathology , Orbital Diseases/pathology , Orbital Diseases/surgeryABSTRACT
The cavum septi pellucidi (CSP) and cavum Vergae (CV) are frequently seen in premature and term infants. These cavities rarely enlarge and become symptomatic we describe a giant CSP and CV cyst in an 18-month-old boy, extending to the posterior cranial fossa and causing hydrocephalus. The literature is reviewed, and the MRI and CT findings of the case are reported.
