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1.
BMC Infect Dis ; 20(1): 527, 2020 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-32698804

RESUMO

BACKGROUND: Conidiobolus spp. (mainly C. coronatus) are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas. Rare cases of invasive conidiobolomycosis due to C. coronatus or other species (C.incongruus, C.lamprauges) have been reported in immunocompromised patients. We report here the first case of invasive pulmonary fungal infection due to Conidiobolus pachyzygosporus in a Swiss patient with onco-haematologic malignancy. CASE PRESENTATION: A 71 year-old female was admitted in a Swiss hospital for induction chemotherapy of acute myeloid leukemia. A chest CT performed during the neutropenic phase identified three well-circumscribed lung lesions consistent with invasive fungal infection, along with a positive 1,3-beta-d-glucan assay in serum. A transbronchial biopsy of the lung lesions revealed large occasionally septate hyphae. A Conidiobolus spp. was detected by direct 18S rDNA in the tissue biopsy and subsequently identified at species level as C. pachyzygosporus by 28S rDNA sequencing. The infection was cured after isavuconazole therapy, recovery of the immune system and surgical resection of lung lesions. CONCLUSIONS: This is the first description of C. pachyzygosporus as human pathogen and second case report of invasive conidiobolomycosis from a European country.


Assuntos
Conidiobolus/genética , Leucemia Mieloide Aguda/complicações , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/diagnóstico , Zigomicose/complicações , Zigomicose/diagnóstico , Idoso , Antifúngicos/uso terapêutico , Biópsia , Conidiobolus/isolamento & purificação , DNA Fúngico/genética , DNA Ribossômico/genética , Feminino , Humanos , Hifas/isolamento & purificação , Hospedeiro Imunocomprometido , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/patologia , Nitrilas/uso terapêutico , Piridinas/uso terapêutico , Suíça , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Triazóis/uso terapêutico , Zigomicose/tratamento farmacológico , Zigomicose/patologia
3.
Clin Microbiol Infect ; 24 Suppl 1: e1-e38, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29544767

RESUMO

The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended. Serum and BAL galactomannan measures are recommended as markers for the diagnosis of IA. PCR should be considered in conjunction with other diagnostic tests. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates; antifungal susceptibility testing should be performed in patients with invasive disease in regions with resistance found in contemporary surveillance programmes. Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary IA, whereas liposomal amphotericin B is moderately supported. Combinations of antifungals as primary treatment options are not recommended. Therapeutic drug monitoring is strongly recommended for patients receiving posaconazole suspension or any form of voriconazole for IA treatment, and in refractory disease, where a personalized approach considering reversal of predisposing factors, switching drug class and surgical intervention is also strongly recommended. Primary prophylaxis with posaconazole is strongly recommended in patients with acute myelogenous leukaemia or myelodysplastic syndrome receiving induction chemotherapy. Secondary prophylaxis is strongly recommended in high-risk patients. We strongly recommend treatment duration based on clinical improvement, degree of immunosuppression and response on imaging.


Assuntos
Antifúngicos/uso terapêutico , Aspergilose/diagnóstico , Aspergilose/tratamento farmacológico , Aspergillus/isolamento & purificação , Gerenciamento Clínico , Anticorpos Antifúngicos/sangue , Antifúngicos/farmacologia , Aspergilose/complicações , Aspergilose/imunologia , Aspergillus/efeitos dos fármacos , Aspergillus/imunologia , Biópsia/métodos , Lavagem Broncoalveolar , Diagnóstico Precoce , Flucitosina/farmacologia , Flucitosina/uso terapêutico , Galactose/análogos & derivados , Humanos , Hospedeiro Imunocomprometido , Testes Imunológicos , Aspergilose Pulmonar Invasiva/diagnóstico , Itraconazol/farmacologia , Itraconazol/uso terapêutico , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Imageamento por Ressonância Magnética , Mananas/análise , Testes de Sensibilidade Microbiana , Síndromes Mielodisplásicas/complicações , Síndromes Mielodisplásicas/terapia , Nitrilas/farmacologia , Nitrilas/uso terapêutico , Piridinas/farmacologia , Piridinas/uso terapêutico , Tomografia Computadorizada por Raios X , Triazóis/farmacologia , Triazóis/uso terapêutico , Voriconazol/farmacologia , Voriconazol/uso terapêutico
4.
Int J Infect Dis ; 67: 70-74, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29225070

RESUMO

Gram-negative bacillary meningitis occurring post-trauma and following neurosurgical procedures has been described widely. However, reports of spontaneous cases are sparse, particularly community-acquired cases. Spontaneous community-acquired Escherichia coli meningitis is a rare (although increasingly seen) and specific entity that is poorly reported in the literature. A review of the literature identified only 43 cases of community-acquired E. coli meningitis reported between 1946 and 2016. This article describes two new cases of spontaneous community-acquired E. coli meningitis encountered in Marseille, France, and presents the results of a literature review on spontaneous community-acquired E. coli meningitis.


Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/isolamento & purificação , Meningite/microbiologia , Adulto , Idoso , Infecções Comunitárias Adquiridas/diagnóstico , Escherichia coli/genética , Escherichia coli/fisiologia , Infecções por Escherichia coli/diagnóstico , Feminino , França , Humanos , Masculino , Meningite/diagnóstico
5.
Diagn Interv Imaging ; 97(10): 973-989, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27687833

RESUMO

Lung cancer, the most frequent cancer worldwide, is the fourth most frequent cancer in France, with an overall 5-year survival rate of about 15%, directly correlated to the stage of disease at the time of diagnosis and its treatment. The objective of this article is to describe the role, contributions and pitfalls of computed tomography (CT) in clinical TNM staging, primarily to identify patients eligible for curative surgery. TNM staging criteria, last updated in 2009, are discussed along with the new proposals for the 8th edition to be published late 2016. The most crucial CT features for pre-therapy assessment are highlighted.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/terapia , Tomografia Computadorizada por Raios X/métodos , Endossonografia/métodos , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Metástase Linfática/patologia , Mediastinoscopia/métodos , Tomografia Computadorizada Multidetectores/métodos , Estadiamento de Neoplasias/classificação , Estadiamento de Neoplasias/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Sensibilidade e Especificidade , Taxa de Sobrevida , Toracoscopia/métodos
6.
New Microbes New Infect ; 11: 45-6, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27257492

RESUMO

Paenibacillus spp. are bacteria present in the environment but are rarely isolated in humans. Here we report the first case of bone infection caused by Paenibacillus turicensis and a second case of human infection caused by this bacterium.

7.
Gut ; 65(3): 415-425, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26045134

RESUMO

BACKGROUND: Crohn's disease (CD)-associated dysbiosis is characterised by a loss of Faecalibacterium prausnitzii, whose culture supernatant exerts an anti-inflammatory effect both in vitro and in vivo. However, the chemical nature of the anti-inflammatory compounds has not yet been determined. METHODS: Peptidomic analysis using mass spectrometry was applied to F. prausnitzii supernatant. Anti-inflammatory effects of identified peptides were tested in vitro directly on intestinal epithelial cell lines and on cell lines transfected with a plasmid construction coding for the candidate protein encompassing these peptides. In vivo, the cDNA of the candidate protein was delivered to the gut by recombinant lactic acid bacteria to prevent dinitrobenzene sulfonic acid (DNBS)-colitis in mice. RESULTS: The seven peptides, identified in the F. prausnitzii culture supernatants, derived from a single microbial anti-inflammatory molecule (MAM), a protein of 15 kDa, and comprising 53% of non-polar residues. This last feature prevented the direct characterisation of the putative anti-inflammatory activity of MAM-derived peptides. Transfection of MAM cDNA in epithelial cells led to a significant decrease in the activation of the nuclear factor (NF)-κB pathway with a dose-dependent effect. Finally, the use of a food-grade bacterium, Lactococcus lactis, delivering a plasmid encoding MAM was able to alleviate DNBS-induced colitis in mice. CONCLUSIONS: A 15 kDa protein with anti-inflammatory properties is produced by F. prausnitzii, a commensal bacterium involved in CD pathogenesis. This protein is able to inhibit the NF-κB pathway in intestinal epithelial cells and to prevent colitis in an animal model.


Assuntos
Proteínas de Bactérias/metabolismo , Clostridiales/metabolismo , Doença de Crohn/microbiologia , Disbiose/microbiologia , Mucosa Intestinal/microbiologia , Sequência de Aminoácidos , Animais , Anti-Inflamatórios/uso terapêutico , Proteínas de Bactérias/química , Proteínas de Bactérias/isolamento & purificação , Proteínas de Bactérias/uso terapêutico , Biomarcadores/metabolismo , Linhagem Celular , Colite/induzido quimicamente , Colite/metabolismo , Colite/prevenção & controle , Doença de Crohn/metabolismo , Doença de Crohn/patologia , Disbiose/metabolismo , Disbiose/patologia , Humanos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Dados de Sequência Molecular , NF-kappa B/metabolismo , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
8.
Br J Radiol ; 88(1049): 20140687, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25735428

RESUMO

OBJECTIVE: This study investigated the effectiveness of stereotactic body radiotherapy with helical TomoTherapy (T-SBRT) for treating medically inoperable primary and second-primary early stage non-small-cell lung neoplasm (SPLN) and evaluated whether the movement of organizing pneumonia (OP) within the irradiation field (IF) can be detected via analysis of radiological changes. METHODS: Patients (n = 16) treated for 1 year (2011-12) at our hospital by T-SBRT at a total dose of 60 Gy in five fractions were examined retrospectively. Outcome and toxicity were recorded and were separately described for SPLN. CT scans were reviewed by a single radiologist. RESULTS: Of the 16 patients, 5 (31.3%) had primary lung malignancies, 10 (62.5%) had SPLN, and 1 case (6.3%) had isolated mediastinal metastasis of lung neoplasm. Pathological evidence was obtained for 72.2% of all lesions. The median radiological follow-up was 11 months (10.5 months for SPLN). For all cases, the 6- and 12-month survival rates were 100% and 77.7% (100% and 71.4%, respectively, for SPLN), and the 6- and 12-month locoregional control rates were 100% in all cases. 2 (12.5%) of 16 patients developed grade 3 late transient radiation pneumonitis following steroid therapy and 1 (6.3%) presented asymptomatic infiltrates comparable to OP opacities. CONCLUSION: T-SBRT seems to be safe and effective. ADVANCES IN KNOWLEDGE: Mild OP is likely associated with radiation-induced anomalies in the IF, identification of migrating opacities can help discern relapse of radiation-induced opacities.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Segunda Neoplasia Primária/diagnóstico por imagem , Segunda Neoplasia Primária/cirurgia , Lesões por Radiação/diagnóstico por imagem , Lesões por Radiação/etiologia , Radiocirurgia/efeitos adversos , Idoso , Carcinoma Pulmonar de Células não Pequenas/patologia , Meios de Contraste , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Estadiamento de Neoplasias , Segunda Neoplasia Primária/patologia , Estudos Retrospectivos , Tomografia Computadorizada Espiral , Resultado do Tratamento
9.
Euro Surveill ; 17(22)2012 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-22687914

RESUMO

In May 2012, a Coxsackievirus A24 haemorrhagic conjunctivitis was diagnosed in Marseille, France, in a traveller returning from the Comoros Islands. This case allowed identification of the cause of an ongoing outbreak of haemorrhagic conjunctivitis in Indian Ocean Islands, illustrating that returning travellers may serve as sentinels for infectious diseases outbreaks in tropical areas where laboratory investigation is limited.


Assuntos
Conjuntivite Hemorrágica Aguda/epidemiologia , Infecções por Coxsackievirus/epidemiologia , Surtos de Doenças , Viagem , Adulto , Comores/epidemiologia , Conjuntivite Hemorrágica Aguda/diagnóstico , Conjuntivite Hemorrágica Aguda/etiologia , Infecções por Coxsackievirus/diagnóstico , Infecções por Coxsackievirus/etiologia , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Enterovirus Humano C/imunologia , Enterovirus Humano C/isolamento & purificação , França , Humanos , Ilhas do Oceano Índico/epidemiologia , Masculino , Dados de Sequência Molecular , RNA Viral/isolamento & purificação , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Sensibilidade e Especificidade , Vigilância de Evento Sentinela , Clima Tropical
10.
Diagn Interv Imaging ; 93(6): 431-40, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22658280

RESUMO

Imaging plays a key role in lung infections. A CT scan must be carried out when there is a strong clinical suspicion of pneumonia that is accompanied by normal, ambiguous, or nonspecific radiography, a scenario that occurs most commonly in immunocompromised patients. CT allows clinicians to detect associated abnormalities or an underlying condition and it can guide bronchoalveolar lavage or a percutaneous or transbronchial lung biopsy. An organism can vary in how it is expressed depending on the extent to which the patient is immunocompromised. This is seen in tuberculosis in patients with AIDS. The infective agents vary with the type of immune deficiency and some infections can quickly become life-threatening. Clinicians should be aware of the complex radiological spectrum of pulmonary aspergillosis, given that this diagnosis must be considered in specific settings.


Assuntos
Comportamento Cooperativo , Tolerância Imunológica/imunologia , Comunicação Interdisciplinar , Infecções Oportunistas/diagnóstico por imagem , Pneumonia/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Biópsia por Agulha , Broncoscopia , Diagnóstico Diferencial , Humanos , Pulmão/diagnóstico por imagem , Infecções Oportunistas/imunologia , Pneumonia/imunologia , Radiografia Intervencionista , Sensibilidade e Especificidade , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/imunologia
11.
Diagn Interv Imaging ; 93(5): 360-4, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22542210

RESUMO

PURPOSE: To describe the characteristics of reversible focal pleural thickenings (PTs) mimicking real plaques, that firstly suggest asbestos exposure or pleural metastasis; to propose an imaging strategy and propose an explanation for their mechanism of formation. PATIENTS AND METHODS: Retrospective review of data from 19 patients with PTs fitting the description of pleural plaques at chest computed tomography (CT) and presenting modifications (clearance or appearance) of at least one PT at an additional chest examination in prone position. RESULTS: A total of 152 PTs were recorded on the first chest CT examinations with a range of two to 19 pleural opacities per patient. All PTs had a posterior distribution in the lower lobes. On the additional acquisitions, 144 PTs disappeared. Seventeen patients presented complete regression of PTs and two patients presented persistence of eight PTs. CONCLUSION: Additional low dose acquisition in prone position should be performed in all patients presenting with focal PT in a dependent and basal location. This may allow to exclude a pleural plaque in case of asbestos exposure but also a pleural metastasis in oncologic patients. These reversible dependent PTs could be related to physiological focal accumulation of lymphatic fluid in subpleural area.


Assuntos
Doenças Pleurais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/patologia , Estudos Retrospectivos
12.
J Radiol ; 90(12): 1843-9, 2009 Dec.
Artigo em Francês | MEDLINE | ID: mdl-20032827

RESUMO

PURPOSE: To determine the performance of a CAD system for lung nodules with ground glass opacity component on multidetector-row CT. Materials and methods. The CT examinations of 17 patients with at least one persistent subsolid nodule were reviewed. A first non-blinded consensus review by two expert radiologists resulted in the detection of 104 subsolid nodules larger than 3 mm (74 nodules of ground glass attenuation and 30 mixed nodules with solid and ground glass components). The results from this review were used as a gold standard to determine the performances of the CAD system and 3 independent clinical radiologists involved with the primary interpretations. RESULTS: The sensitivity of the CAD system for the detection of ground glass opacities and mixed nodules was 53% and 73% respectively. These values were not statistically different from the values for the 3 independent observers (42-66% for ground glass opacities and 63-80% for mixed nodules). The sensitivity of each observer significantly increased when the nodules detected by the CAD system were added to those detected by each observer (p<0.0001). CONCLUSION: A CAD system has a potential impact on the detection rate of subsolid nodules by radiologists.


Assuntos
Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
J Radiol ; 90(11 Pt 2): 1801-18, 2009 Nov.
Artigo em Francês | MEDLINE | ID: mdl-19953073

RESUMO

Multidetector row computed tomography (MDCT) is the imaging modality of reference for the diagnosis of bronchiectasis. MDCT may also detect a focal stenosis, a tumor or multiple morphologic abnormalities of the bronchial tree. It may orient the endoscopist towards the abnormal bronchi, and in all cases assess the extent of the bronchial lesions. The CT findings of bronchial abnormalities include anomalies of bronchial division and origin, bronchial stenosis, bronchial wall thickening, lumen dilatation, and mucoid impaction. The main CT features of bronchiectasis are increased bronchoarterial ratio, lack of bronchial tapering, and visibility of peripheral airways. Other bronchial abnormalities include excessive bronchial collapse at expiration, outpouchings and diverticula, dehiscence, fistulas, and calcifications.


Assuntos
Broncopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/secundário , Bronquiectasia/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Carcinoma Broncogênico/diagnóstico por imagem , Carcinoma de Células Pequenas/diagnóstico por imagem , Carcinoma de Células Pequenas/imunologia , Diagnóstico Diferencial , Proteínas ELAV/imunologia , Hamartoma/diagnóstico por imagem , Humanos , Masculino
14.
J Radiol ; 90(11 Pt 2): 1830-40, 2009 Nov.
Artigo em Francês | MEDLINE | ID: mdl-19953075

RESUMO

Bronchiolitis may be encountered in numerous clinical circumstances. Previous history of smoking, infections, toxic exposure, immunodeficiency, chronic inflammatory disorders or transplantation must be known. CT findings consist in centrilobular micronodules with sharp or ill borders of various density and/or a mosaic attenuation with expiratory air trapping. Tree-in-bud pattern suggest an inflammatory or infectious bronchiolitis. The associated presence of bronchiectasis and bronchiolectasis must be considered. Imaging-pathologic correlations will be presented for inflammatory bronchiolitis (infectious bronchiolitis, hypersensitivity pneumonitis, respiratory bronchiolitis, follicular bronchiolitis, diffuse panbronchiolitis) and fibrosing bronchiolitis (constrictive bronchiolitis, post-infectious bronchiolitis, toxic fume exposure, transplant-related bronchiolitis).


Assuntos
Bronquiolite/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X/métodos , Doença Aguda , Adulto , Transplante de Medula Óssea , Bronquiectasia/complicações , Bronquiectasia/diagnóstico por imagem , Bronquiolite/complicações , Bronquiolite Obliterante/diagnóstico por imagem , Bronquiolite Viral/diagnóstico por imagem , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Infecções por HIV/complicações , Infecções por HIV/diagnóstico por imagem , Humanos , Linfoma Folicular/complicações
15.
J Radiol ; 89(11 Pt 2): 1797-811, 2008 Nov.
Artigo em Francês | MEDLINE | ID: mdl-19106840

RESUMO

Blunt chest trauma typically occurs as part of polytrauma, usually secondary to motor vehicle accidents, sports related injuries or defenestration in Western Europe. Each chest compartment may be responsible for immediate and/or delayed complications, thus requiring a dedicated systematic and comprehensive analysis. The use of image post-processing is mandatory in order to not overlook a potentially severe injury. The purpose of this paper is to review the technical considerations of multidetector CT, and the imaging features and interpretation method for each chest compartment, in order to generate an adapted report.


Assuntos
Traumatismos Torácicos/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Humanos , Masculino
16.
Diabetes Metab ; 34(1): 75-81, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18243027

RESUMO

UNLABELLED: Adipose tissue secretes a variety of cytokines, some of which are increased in the serum of obese patients. The anti-inflammatory interleukin-1 receptor antagonist (IL-1Ra) is the most highly elevated known cytokine in human obesity, and its serum levels are strongly associated with the degree of insulin resistance in non-diabetic patients. AIM: The present study examined serum levels of IL-1Ra in type 2 diabetic patients (T2DM) and their relationships with three other adipokines (leptin, interleukin-6 [IL-6], adiponectin). Their correlation with anthropometric and biochemical variables was examined, as well as their intraindividual fluctuations. METHODS: Fifty T2DM patients, aged 58+/-13 years, were consecutively recruited among those electively hospitalized for a one-week intensive training course with our Diabetes Education Service. Anthropometric measurements and blood samples were taken after an overnight fast on admission (baseline) and after four days. RESULTS: Mean serum levels of IL-1Ra and leptin, but not of IL-6 and adiponectin, were significantly higher in women than in men (P<0.0006), and this difference persisted after correction for body mass index (BMI) (P<0.0004). In addition, IL-1Ra and leptin were strongly correlated with the BMI (P<0.0004). By contrast, no significant correlations were observed between IL-1Ra and glucose-control parameters. Finally, all four adipokines exhibited wide interindividual variability, but with limited intraindividual fluctuations over the short time period. CONCLUSION: IL-1Ra, leptin and adiponectin serum levels exhibit marked interindividual variation with high intraindividual consistency. A gender-based dimorphic pattern for IL-1Ra, independent of the degree of adiposity and glucose control, was also found.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Proteína Antagonista do Receptor de Interleucina 1/sangue , Adiponectina/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Peso Corporal , Feminino , Hemoglobinas Glicadas/análise , Humanos , Leptina/sangue , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Caracteres Sexuais
17.
Rev Mal Respir ; 24(6): 759-81, 2007 Jun.
Artigo em Francês | MEDLINE | ID: mdl-17632435

RESUMO

The demonstration by computed tomography of abnormalities related to asbestos is essential for the recognition of industrial disease, the compensation of which has considerable economic consequences. The use of computed tomography, the most reliable technique for the detection of pleuro-parenchymatous abnormalities related to asbestos exposure, has increased considerably in France since the publication of the results of a consensus conference in Paris in 1999. Since that time, developments in CT technology have noticeably modified the protocols of investigation and increased the sensitivity of the detection of pleural and interstitial parenchymatous abnormalities and of nodules. The technical recommendations and those for the interpretation of pleural and parenchymatous abnormalities need to be well known. They are presented in the form of an atlas that gives detailed criteria for asbestosis, pleural plaques and pleural fibrosis. The diagnosis of pleural plaques depends on the combination of clear limits at the pleural and pulmonary interface, typical topography and multiple, bilateral localization. In the context of asbestos exposure the plaques are characteristic of this exposure, unlike diffuse pleural thickening, crow's feet images, parenchymatous bands and entrapped atalectasis. The writing of the radiological report would be most appropriate on this basis.


Assuntos
Asbestose/diagnóstico por imagem , Ilustração Médica , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Fibrose , Humanos , Pulmão/diagnóstico por imagem , Pleura/diagnóstico por imagem , Doenças Pleurais/diagnóstico por imagem , Atelectasia Pulmonar/diagnóstico por imagem , Fibrose Pulmonar/diagnóstico por imagem , Nódulo Pulmonar Solitário/diagnóstico por imagem
18.
J Radiol ; 88(6): 845-62, 2007 Jun.
Artigo em Francês | MEDLINE | ID: mdl-17652978

RESUMO

The demonstration by computed tomography of abnormalities related to asbestos is essential for the recognition of industrial disease, the compensation of which has considerable economic consequences. The use of compute tomography, the most reliable technique for the detection of pleuro-parenchymatous abnormalities related to asbestos exposure, has increased considerably in France since the publication of the results of a consensus conference in Paris in 1999. Since that time, developments in technology have noticeably modified the protocols of investigation and increased the sensitivity of the detection of pleural and interstitial parenchymatous abnormalities and of nodules. The technical recommendations and those for the interpretation of pleural and parenchymatous abnormalities need to be well known. They are presented in the form of an atlas that gives detailed criteria for asbestosis, pleural plaques and pleural fibrosis. The diagnosis of pleural plaques depends on the combination of clear limits at the pleural and pulmonary interface, typical topography and multiple, bilateral localization. In the context of asbestos exposure the plaques are characteristic of this exposure, unlike diffuse pleural thickening, crow's feet images, parenchymatous bands and entrapped atalectasis. The writing of the radiological report would be most appropriate on this basis.


Assuntos
Asbestose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Humanos
19.
JBR-BTR ; 90(2): 85-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17555065

RESUMO

The last generations of Multi Detector Row CT (MDCT) have revolutionized the management of chest disease. This is especially obvious for airway and lung parenchyma evaluation. MDCT allows volumetric high resolution scanning with isotropic resolution. Thus, contiguous visualization of the lung parenchyma is achieved. The resulting high quality 2D and 3D reconstructions enable a significant improvement in the diagnostic approach. Since the lung parenchyma has a unique natural contrast, low and even ultra-low radiation dose scanning protocols may be used in routine practice. In all cases, a good signal to noise ratio has to be maintained combined with the best possible spatial resolution, allowing all types of reconstructions.


Assuntos
Interpretação de Imagem Radiográfica Assistida por Computador , Radiografia Torácica , Tomografia Computadorizada por Raios X/métodos , Humanos
20.
J Radiol ; 88(4): 573-8, 2007 Apr.
Artigo em Francês | MEDLINE | ID: mdl-17464256

RESUMO

OBJECTIVES: Evaluate the improvement in detecting lung nodules when using multidetector CT (MDCT) computer-assisted diagnosis (CAD). MATERIAL AND METHODS: Three radiologists (R1, R2, R3) with different levels of experience independently interpreted 30 MDCT examinations of the thorax taken for screening purposes, first without and then with CAD. The diagnosis was established by two of the three radiologists interpreting the images together, assisted by the CAD. RESULTS: The consensus reading identified 133 nodules, 61 (46%) of which were 4 mm or larger. The sensitivity values in the detection of nodules before and after using the CAD were 54% and 80% (R1), 38% and 71% (R2), and 70% and 88% (R3), respectively. When considering only the nodules that were 4 mm or larger, the sensitivity values varied before and after using the CAD, from 62% to 95% (R1), from 41% to 84% (R2), and from 74% to 92% (R3). By combining two by two the three radiologists' results obtained without the CAD, the sensitivity values were 65%, 83%, and 77%, respectively, for all the nodules, and 70%, 85%, and 77% for the nodules that were 4 mm or larger. The CAD induced a total of 105 false-positive results, with a mean of 3.5 per examination. CONCLUSION: The lung nodules missed by the radiologist can be detected if the CAD is used as a second reader. The CAD can be at least as beneficial as the use of a second independent reader.


Assuntos
Diagnóstico por Computador , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Radiologia/normas , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Reações Falso-Positivas , Estudos de Viabilidade , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Variações Dependentes do Observador , Projetos Piloto , Estudos Prospectivos , Radiografia Torácica , Sensibilidade e Especificidade , Fumar , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada Espiral
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