RESUMO
BACKGROUND: It is essential to recognize and treat findings that can simulate or worsen symptoms to improve asthma control and thereby to reduce costs. Guidelines highlight a paranasal (PS) and chest computed tomography (CT) scan as a tool for disease evaluation and, although they suggest its indication in patients whom presentation is atypical, there are not well-defined criteria. OBJECTIVES: To describe the most common findings in the PS and chest CT in severe asthma patients and to analyse the characteristics of asthmatics with the finding of nasal polyps or bronchiectasis. METHODS: We retrospectively reviewed the medical records of 161 adults with confirmed severe asthma who had undergone to PS and/or chest CT. Clinical data from their electronic health record and the findings from a PS and/or chest CT within the last five years were collected. RESULTS: In the PS CT, 70.5% of patients presented mucous thickening and 46.7% presented nasal polyps. Both findings were associated with male gender and level of blood eosinophils. In chest CT, 28% of individuals showed atelectasis, 16.5% air trapping, 17.7% affectation of the small airway, 11.6% pulmonary infiltrates and 10.4% emphysema. Bronchiectasis were identified in 60.4% of subjects, who were older and had poorer lung function. CONCLUSION: Paranasal and thoracic computed tomography are important tools in the treatment of severe asthma because they allow us to detect highly prevalent findings in this disease that can lead to poorer control of it.
Assuntos
Asma/diagnóstico por imagem , Seios Paranasais/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , Adulto , Idoso , Asma/complicações , Bronquiectasia/complicações , Bronquiectasia/diagnóstico por imagem , Bronquiectasia/epidemiologia , Estudos Transversais , Eosinófilos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/complicações , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/epidemiologia , Prevalência , Atelectasia Pulmonar/complicações , Atelectasia Pulmonar/diagnóstico por imagem , Atelectasia Pulmonar/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores SexuaisRESUMO
No disponible
Assuntos
Humanos , Asma/tratamento farmacológico , Antiasmáticos/uso terapêutico , Eosinófilos , Recidiva/prevenção & controleRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso , Equinococose Hepática/complicações , Tórax/parasitologia , Derrame Pleural/complicações , Radiografia Torácica , Echinococcus/patogenicidade , Insuficiência Respiratória/etiologiaRESUMO
The most common anomaly of the aortic arch is the occurrence of a left aortic arch with an aberrant right subclavian artery. Other, less common anomalies have also been described. These include the occurrence of a right aortic arch with an aberrant left subclavian artery that, in addition, has a diverticulum at its site of origin known as Kommerell's diverticulum. All cases described in the literature have occurred in individuals younger than 35 years of age, generally with symptoms related to tracheal or esophageal compression. We present the case of a patient diagnosed by chance with this rare anomaly at 75 years of age.
Assuntos
Anormalidades Múltiplas , Aorta Torácica/anormalidades , Divertículo/complicações , Artéria Subclávia/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Idoso , Doenças da Aorta/complicações , Doenças da Aorta/diagnóstico por imagem , Divertículo/diagnóstico por imagem , Humanos , Masculino , RadiografiaRESUMO
La anomalía del arco aórtico más frecuente es la existencia de un arco aórtico izquierdo acompañado de una arteria subclavia derecha aberrante. Se han descrito otras anomalías más raras, entre las que se encuentra la existencia de un arco aórtico derecho asociado a una arteria subclavia izquierda aberrante que, además, tiene en su origen un divertículo, denominado divertículo de Kommerell. Todos los casos descritos en la bibliografía se han producido en sujetos menores de 35 años, generalmente con síntomas relacionados con compresión traqueal o esofágica. Presentamos el caso de un paciente diagnosticado de esta rara anomalía de forma casual a la edad de 75 años
The most common anomaly of the aortic arch is the occurrence of a left aortic arch with an aberrant right subclavian artery. Other, less common anomalies have also been described. These include the occurrence of a right aortic arch with an aberrant left subclavian artery that, in addition, has a diverticulum at its site of origin known as Kommerells diverticulum. All cases described in the literature have occurred in individuals younger than 35 years of age, generally with symptoms related to tracheal or esophageal compression. We present the case of a patient diagnosed by chance with this rare anomaly at 75 years of age
