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Biomedical subjects

Carlos S Restrepo

Publications and source records attributed to Carlos S Restrepo.

11 recordsLinked to original sources
PubMed2004

Human immunodeficiency virus-associated rheumatic disorders in the HAART era.

OBJECTIVE: To define the frequency and characteristics of human immunodeficiency virus (HIV)-associated rheumatic manifestations in patients receiving highly active antiretroviral therapy (HAART) referred to a rheumatology clinic. METHODS: A total of 75 patients with HIV infection receiving HAART were prospectively evaluated for the presence of rheumatic complaints. Diagnosis of HIV infection was performed by ELISA and confirmed by Western blot, and all HIV patients were classified according to the US Centers for Disease Control criteria. RESULTS: Seventy-five individuals with HIV infection and musculoskeletal manifestations were evaluated: 65 (86%) men and 10 (14%) women. Mean age was 32 +/- 4.5 years (range 21-58). The group included 40 (53%) heterosexuals, 30 (40%) intravenous drugs users, 9 (12%) homosexuals, 3 (4%) who had received blood transfusion, and 2 (2.6%) with unknown risk factors. Septic manifestations were the most common complications seen in 31 (41%) out of 75, and included septic arthritis, cellulitis, osteomyelitis, diskitis, and pyomyositis. Fibromyalgia was present in 13 (17%), seronegative symmetric polyarthritis in 4, oligoarthritis in 4, psoriatic arthritis in 2, carpal tunnel syndrome in 2, and enthesitis in 2. Mutifocal bone non-Hodgkin's lymphoma was present in 7 (9.3%) and Kaposis's sarcoma of bone in 2 (2.6%) patients. Hypertrophic osteoarthropathy in 3 (4%) and aseptic bone necrosis of multiple bones was seen in 3 (4%) patients. Ten patients exhibited only arthralgias. Most patients had moderately elevated erythrocyte sedimentation rate and C-reactive protein. Mean CD4 cell count was 250 mm3 (range 20-450), and mean HIV viral load was 5210 (range 0-75,300) copies/ml. CONCLUSION: Rheumatic manifestations were highly frequent in HIV patients receiving HAART referred to a rheumatology clinic, although the clinical spectrum differed from the pre-HAART era with septic and malignant complications being the most common manifestations seen.

Adult↗
PubMed2004

HIV-associated musculoskeletal involvement.

Various rheumatic manifestations associated with HIV infection have been recognized, ranging from infectious conditions, such as septic arthritis, to seronegative spondyloarthropathy. Other musculoskeletal manifestations include lupus-like and Sjögren-like diseases and HIV-related malignancy. The introduction of HAART has changed the spectrum of the clinical manifestations of rheumatic disease seen today, with infections and articular involvement being the most frequently observed.

Antiretroviral Therapy, Highly Active↗
PubMedDate not supplied

Imaging findings of expansile lesions of the thymus.

The purpose of this article is to review the imaging findings of the different expansile lesions of the thymus. Almost 50% of all mediastinal masses are located in the anterior mediastinum. The thymus is the most common site of origin of these masses. Several kinds of lesions can arise from this gland because it derives from the three embryonic germ cell layers. Primary neoplasms of the thymus are thymoma, thymolipomas, carcinoma, carcinoid, primary germ cell tumors, and lymphoma. The latter can also involve the organ in a secondary fashion. Other lesions that cause thymic enlargement and that can be confused with neoplasia are thymic cysts and thymic hyperplasia. Even though anterior mediastinal masses are first found on conventional radiographs, computed tomography and magnetic resonance are very useful additional studies for assessing the origin and extension of these masses. The basic concepts regarding embryology, anatomy, and histology relevant for the differential diagnosis of an enlarged thymic gland are also described.

Diagnosis, Differential↗
PubMedDate not supplied

CT and MR imaging findings of benign cardiac tumors.

This imaging review describes the appearance of benign cardiac tumors on CT and MRI. Although rare, benign tumors outnumber their primary malignant counterparts three to one. Since mortality varies directly with invasion, identifying the neoplasm at an early stage helps focus treatment, especially in benign cases, which generally respond well to surgical resection. In adults and children, myxomas and rhabdomyomas, respectively, represent the most common benign tumors, which can be grouped into tissue-specific subtypes, such as rhabdomyomas, fibromas, lipomas, teratomas, etc. Besides their variable prevalence in particular age groups, these tumors also differ with regard to their gender predilection, location, and number. For example, myxomas appear predominantly in women and generally as a solitary mass in the left or right atrium, whereas rhabdomyomas present equally in boys and girls and chiefly as multiple masses in the ventricles. Despite their differences, however, both types share an association with heritable syndromes like the Carney complex for myxomas and tuberous sclerosis for rhabdomyomas. As with all cardiac tumors, echocardiographic findings usually suggest the initial diagnosis but cross-sectional imaging with CT and MRI can help resolve diagnostically challenging cases. For example, with its direct multiplanar capability, excellent contrast resolution, and large field of view, MRI permits a detailed examination of the entire mediastinum, helping to rule out an equivocal mass on echocardiography. Through dynamic techniques, MRI, in addition to morphologic characterization, can depict the pathophysiological effects of these tumors, for instance, with regard to myocardial contraction, valvular function, or blood flow.

Heart Neoplasms↗
PubMedDate not supplied

CT and MR imaging findings of malignant cardiac tumors.

This article reviews CT and MRI features of malignant cardiac and pericardial tumors, most of which originate from the lung, breast, melanoma, leukemia, or lymphoma through lymphatic, hematogenous, transvenous, and direct pathways. Although echocardiography establishes the diagnosis in most cases, CT and MRI provide additional physical, spatial, and functional information that further aids the evaluation of metastases. For instance, CT provides superior resolution for detecting calcification or fat, while MRI with its direct multiplanar ability more completely characterizes the heart, pericardium, mediastinum, and lungs. MRI also helps elucidate the pathophysiological effects of these tumors on cardiac function through gated cine-loop sequences. Beyond tumor characterization, both modalities can help confirm diagnosis through the addition of contrast, which helps distinguish tumor from myocardium, thrombus, and blood flow artifact. Ultimately, MRI best facilitates surgical planning and posttreatment follow-up in large part because of its unparalleled ability to locate and delimit these tumors.

Heart Neoplasms↗
PubMedDate not supplied

Neurofibromatosis type 1: spinal manifestations of a systemic disease.

Neurofibromatosis type 1 (NF1) is an autosomal dominant congenital dysplasia of the neural crest cells that affects the development of tissue and structures arising from the 3 germinal layers. Affected patients may present with spinal deformities or with bone or soft tissue abnormalities. Imaging plays an important role in the evaluation of these patients. In this article, a working diagnosis approach is proposed and the spectrum of spinal imaging findings in the NF1 patient is reviewed.

Diagnosis, Differential↗
PubMedDate not supplied

Cardiovascular complications of human immunodeficiency virus infection.

The heart and great vessels are not the sites most frequently affected by opportunistic infections and neoplastic processes in patients with acquired immune deficiency syndrome (AIDS). However, cardiovascular complications occur in a significant number of such patients and are the immediate cause of death in some. The spectrum of cardiovascular complications of AIDS that may be depicted at imaging includes dilated cardiomyopathy, pericardial effusion, human immunodeficiency virus-associated pulmonary hypertension, endocarditis, thrombosis, embolism, vasculitis, coronary artery disease, aneurysm, and cardiac involvement in AIDS-related tumors. To aid accurate diagnosis and appropriate treatment planning, radiologists should be familiar with the imaging appearance of each of these complications.

Adult↗
PubMedDate not supplied

Imaging manifestations of Kaposi sarcoma.

Kaposi sarcoma (KS) is a low-grade vascular tumor that typically manifests as one of four variants: classic KS, endemic (African) KS, iatrogenic (organ transplant-related) KS, or acquired immunodeficiency syndrome (AIDS)-related KS. Several clinical and epidemiologic differences have been noted among these variants. Classic KS and endemic KS rarely require radiologic evaluation due to their usually chronic course and stability of skin compromise. However, iatrogenic KS and AIDS-related KS, the most common forms of the disease, are frequently disseminated or symptomatic and may thus require imaging studies for both diagnosis and staging. KS is the most common tumor among AIDS patients, affecting a high percentage of these individuals, and is considered to be an AIDS-defining illness. Multiple organs can be involved by AIDS-related KS. KS has been linked with human herpes virus type 8 infection and other cofactors. Although pulmonary, gastrointestinal, and skin involvement by KS has previously been described, this tumor can affect multiple organs, generating a wide spectrum of imaging findings and pathologic correlates. It is important for the radiologist to be familiar with this spectrum of imaging manifestations and corresponding pathologic findings.

Humans↗