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Edson Marchiori

Publications and source records attributed to Edson Marchiori.

26 records · Page 2Linked to original sources

High-resolution CT findings of respiratory syncytial virus pneumonia after bone marrow transplantation.

OBJECTIVE: The aim of this study was to describe the high-resolution CT findings of respiratory syncytial virus pneumonia in 20 patients who had undergone allogeneic bone marrow transplantation. MATERIALS AND METHODS: The study included 20 consecutive patients who developed respiratory syncytial virus pneumonia after bone marrow transplantation and who had high-resolution CT of the chest performed within 24 hr after the onset of symptoms. The CT scans were reviewed by two chest radiologists who assessed the pattern and distribution of findings. RESULTS: Bone marrow transplantation was performed on 12 male and eight female patients ranging from 3 to 48 years old (mean age, 25 years) for treatment of various forms of leukemia (n = 12), severe aplastic anemia (n = 6), Fanconi's syndrome (n = 1), and paroxysmal nocturnal hemoglobinuria (n = 1). Sixteen patients (80%) had abnormal CT findings. The predominant patterns of abnormality on high-resolution CT scans were small centrilobular nodules (10/20, 50%), air-space consolidation (7/20, 35%), ground-glass opacities (6/20, 30%), and bronchial wall thickening (6/20, 30%). The abnormalities were distributed in the central and peripheral areas of the lungs in nine cases, only in the periphery in five cases, and only in the central regions in two cases. The abnormalities were bilateral and asymmetric in distribution in 13 patients, bilateral and symmetric in two patients, and unilateral in one patient. CONCLUSION: The most common high-resolution CT findings in patients with respiratory syncytial virus pneumonia after bone marrow transplantation consist of small centrilobular nodules and multifocal areas of consolidation and ground-glass opacities in a bilateral asymmetric distribution.

Adolescent↗

Initial results of endovascular repair of abdominal aortic aneurysms with a self-expanding stent-graft.

PURPOSE: This study was performed to evaluate the authors' experience with the endovascular treatment of abdominal aortic aneurysm (AAA) with use of a self-expanding nitinol stent covered with a polyester fabric device and to report the implant's technical features, the immediate results, and the outcome 30 days after device implantation. MATERIALS AND METHODS: From June 1997 to December 2001, we admitted 169 patients diagnosed with AAA. Of these, 134 were suitable to undergo endovascular repair with use of the Talent stent-graft. In one patient, it was technically impossible to proceed with the implantation procedure. Therefore, a total of 133 patients were treated with use of this technique (78.7%). The average age was 70.7 years (range, 52-88 y). There were 119 men and 14 women. Computed tomographic follow-up was done between the 15th and 30th postoperative days. RESULTS: The stent-grafts were successfully implanted in all 133 patients. Complications during the procedure included three type-I endoleaks (2.3%) and four iliac artery ruptures (3.0%), which were effectively treated by means of aortic or iliac extension grafts, respectively. The average surgical time was 2.92 hours (from 1.67 h to 7 h). Of the stent-grafts used, 125 were bifurcated (94.0%), two were straight tube grafts (1.5%), and six were conical aortouniiliac grafts (4.5%). Custom-made grafts were used in 62 patients (46.6%) and standard grafts were used in 71 (53.4%). Suprarenal fixation was performed in 117 patients (88%). One female patient developed a serious pulmonary embolism. Eight patients (6.0%) developed serious systemic inflammatory syndrome; two died of disseminated intravascular coagulopathy. There were two additional deaths, one from refractory shock and one suddenly from an unknown cause (total mortality rate, 3.0%). During the postoperative period, 70.3% of the patients developed mild fever (37.6 degrees C-38.9 degrees C). The average length of stay in the intensive care unit was 1.3 days (ranging from 1 d to 12 d) and the total hospitalization time was 4.2 days. Six type-II endoleaks were observed: two were corrected by video laparoscopy-assisted inferior mesenteric artery interruption and the other four were clinically followed up. CONCLUSIONS: The exclusion of AAA by endovascular techniques with use of the Talent device was possible in the majority of cases with a low incidence of complications. The most common serious postprocedural complication was systemic inflammatory syndrome.

Aged↗

[Influenza B virus pneumonia after bone marrow transplantation: case report with emphasis to the high resolution computed tomography findings].

Nine year-old male patient, who underwent bone marrow transplantation because of acute myelogenous leukemia, presented with fever and dry cough three days after the procedure. The chest radiograph demonstrated bilateral diffuse reticular infiltrate. The high resolution computed tomography showed peribronchovascular interstitial thickening, peripheral small centrilobular nodules and areas of ground-glass attenuation. The bronchoalveolar lavage demonstrated positive direct fluorescence antibody testing against influenza B virus. Treatment with aerolizated ribavirin was instituted during 10 days and the patient showed clinical-radiological improvement.

Bone Marrow Transplantation↗

[High resolution computed tomography findings in parainfluenza virus pneumonia after bone marrow transplantation: case report].

Nineteen year-old female patient, who underwent bone marrow transplantation because of chronic myelogenous leukemia, presented with dry cough and coriza sixty-seven days after the procedure. The chest radiograph was normal. The high resolution computed tomography showed a subsegmental air-space consolidation at the periphery of the left inferior lobe and areas of low attenuation at the superior and middle lung zones. The bronchoalveolar lavage demonstrated positive direct fluorescence antibody testing against parainfluenza virus. Treatment with aerolizated ribavirin was instituted during 10 days and the patient showed clinical-radiological improvement.

Adult↗

[Comparative study of high resolution computer-assisted tomography with chest radiograph in silicosis].

The diagnosis of silicosis is based on the history of exposure to silica dust associated with the radiological alterations compatible with the disease. With the main objective of comparing the alterations found in the chest radiography to those of high resolution computed tomography 49 patients with silicosis were selected. These imaging methods were evaluated separately by three readers and the results summarized through the median of the readings. The following alterations were analysed: nodules, coalescences, large opacities, lynfadenopathy. The patients were male, at an average age of 47.1 years, the majority being sandblasters, with an average exposure time to dust of 15.3 years. When the chest radiography was compared to high resolution computed tomography the following alterations were observed: i) the high resolution computed tomography showed greater profusion of nodules in 19 cases; ii) the high resolution computed tomography detected isolated coalescence and large opacities in 28 cases, seven of them who were classified initially as having simple silicosis were later changed to the complicated form; iii) the high resolution computed tomography was superior in the evaluation of lynfadenopathy in 16 cases. So, from the 49 analysed patients the high resolution computed tomography was more sensitive than the chest radiography in the evaluation of the alterations studied in 38 (77,5%) cases. Other alterations such as cavities, pleural thickening and emphysema were also observed only by this method in 5 cases. In the last 6 (12,2%) cases the high resolution computed tomography did not add any data when compared to chest radiography, four of these showed the initial form of the disease.

Adult↗

Niemann-Pick disease: high-resolution CT findings in two siblings.

Niemann-Pick disease is a rare inherited disorder characterized by deposition of sphingomyelin in various organs. We describe the high-resolution computed tomography findings in 2 adult sisters with Niemann-Pick disease and extensive pulmonary involvement. The main abnormalities consisted of thickening of the interlobular septa and patchy areas of ground-glass attenuation.

Adult↗

[Traumatic chest lesions. Computed tomography findings].

Trauma is nowadays one of the most common causes of death and traumatic thoracic lesions are important agravant to trauma patients. In this work the aspects of computed tomography from 200 cases of thoracic trauma were studied. Lung lesions predominated, found in 192 cases (96%), manifested as contusions in 178 cases (89%), atelectasis in 41 cases (20.5%), lacerations in 15 cases (7.5%) and hematomas in 6 cases (3%). Pleural lesions were showed in 140 cases (70%), among them in 121 cases (60.5%) there were hemothorax and in 84 cases (42%), pneumothorax. Mediastinal lesions were observed in 28 cases (14%), with pneumomediastinum in 18 cases (9%), mediastinal hematoma in 7 cases (3.5%), hemopericardium in 4 cases (2%) and aortic lesions in 3 cases (1.5%). Diaphragmatic rupture was seen in 8 patients (4%). Soft tissue emphysema was demonstrated in 36 cases (18%).

Adolescent↗