Thromboembolic complications of COVID-19: the combined effect of a pro-coagulant pattern and an endothelial thrombo-inflammatory syndrome.

Coronavirus disease 2019 (COVID-19) is a newly emerging human infectious disease that has quickly become a worldwide threat to health, mainly causing severe acute respiratory syndrome. In addition to the widely described respiratory syndrome, COVID-19 may cause life-treating complications directly or indirectly related to this infection. Among these, thrombotic complications have emerged as an important issue in patients with COVID-19 infection, particularly in patients in intensive care units. Thrombotic complications due to COVID-19 are likely to occur due to a pro-coagulant pattern encountered in some of these patients or to a progressive endothelial thrombo-inflammatory syndrome causing microvascular disease. In the present authors' experience, from five different hospitals in Italy and the UK, imaging has proved its utility in identifying these COVID-19-related thrombotic complications, with translational clinical relevance. The aim of this review is to illustrate thromboembolic complications directly or indirectly related to COVID-19 disease. Specifically, this review will show complications related to thromboembolism due to a pro-coagulant pattern from those likely related to an endothelial thrombo-inflammatory syndrome.

Ultrasound evaluation of hepatic lymph nodes in patients with anti-hepatitis C virus antibody reactivity.

BACKGROUND: Portal lymphadenopathy is frequently found in inflammatory liver diseases. However, the mechanisms underlying portal lymphadenopathy are unknown. AIMS: To evaluate the prevalence of portal lymphadenopathy in patients with serum anti-hepatitis C Virus antibody reactivity and its relationship to clinical parameters. PATIENTS AND METHODS: The presence of portal lymphadenopathy was evaluated by upper abdominal Ultrasound by the same examiner in 114 patients with anti-hepatitis C Virus reactivity: 56 patients with normal liver enzyme activity and 58 randomly selected patients with increased liver enzyme activity undergoing liver biopsy. Laboratory tests were then performed in all patients the following day. RESULTS: Portal lymph nodes were found in a significantly higher percentage of patients with increased liver enzymes (74%) than in patients with persistently normal liver enzymes (29%: p < 0.01). Aminotransferases, gamma glutamyl transpeptidase levels and the percentage of patients with HCVRNA in serum and histological scores for piecemeal and lobular necrosis were significantly higher in patients showing hepatic lymph nodes. Multivariate analysis showed that only alanine aminotransferase and lobular necrosis were independently related to the presence of hepatic lymph nodes. A significant correlation was found between lymph node size, aminotransferase activity and lobular necrosis. CONCLUSION: Ultrasound-proven portal lymph node enlargement is an indirect sign of hepatocellular damage in patients with positive serum anti-hepatitis C Virus antibodies.

CT appearance of the larynx after conservative and radical surgery for carcinomas.

The purpose of this study was to evaluate the normal CT appearance of the larynx after conservative and radical surgery. Postoperative (conservative surgery n = 52, radical surgery n = 21) CT examinations of 73 patients suspected of local/regional recurrence (n = 53) or asymptomatic (n = 20) were retrospectively analysed. The CT findings of 45 patients negative at biopsy were utilised to assess the normal appearance after surgery. Changes in the laryngeal framework represented constant landmarks, whereas the variety of soft tissues resection often resulted in a more unpredictable appearance of the neolarynx. Considerable thickening of the mucosa covering the arytenoid cartilage(s) has been detected after horizontal supraglottic laryngectomy (40 %) or supracricoid laryngectomies (SL; 100 %). A "pseudocord" due to scar tissue appeared to be a constant finding following vertical haemilaryngectomy, frequently after SL. Dilation of a lateral recess of the hypopharynx was observed after SL. This "pharyngeal pouch" had considerable size and air or liquid content. The most frequent CT findings among 28 tumours recurrent after conservative or total surgery were a mass larger than 10 mm spreading beyond the larynx (63.1 %), thickening of anterior commissure (57.9 %), erosion of residual cartilages (16.9 %). Although CT detected one subclinical recurrence, its employment is justified only to assess the submucosal extent of the lesion. This requires a thorough knowledge of normal postoperative findings.