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Ioannis Vlahos

Publications and source records attributed to Ioannis Vlahos.

4 recordsLinked to original sources

Pneumonitis and eosinophilia after in vitro fertilization treatment.

A 33-year-old woman presented to the emergency department (ED) with tachypnea, tachycardia, and hypoxia, complaining of dyspnea and paroxysms of dry cough for 2 days. The patient had undergone an unsuccessful in vitro fertilization procedure 1 month earlier and had had another embryo implantation 6 days earlier. She had been receiving intramuscular injections of estradiol and progesterone in sesame oil to support implantation. A chest radiograph demonstrated extensive bilateral pulmonary consolidation; a leukocytosis count of 19.7 x 10(9) with 20% eosinophils was noted on a CBC count. A MEDLINE search yielded a case report in infertility literature describing an eosinophilic pneumonitis with similar clinical features after injections of progesterone in sesame oil. Treatment with intravenous corticosteroids was initiated in the ED, resulting in symptom and chest radiograph result improvement within 2 days and sparing the patient further imaging and antibiotic therapy.

Adrenal Cortex Hormones↗

Pictorial essay: multinodular disease: a high-resolution CT scan diagnostic algorithm.

The evaluation of patients presenting with multinodular pulmonary disease provides an important clinical challenge for physicians. The differential diagnosis includes an extensive list of benign and malignant processes making the management of these cases frequently problematic. With the introduction of high-resolution CT (HRCT) scanning, the ability to assess various patterns of diffuse multinodular disease has evolved into an essential part of the diagnostic process. The purpose of this article is to develop an approach to the diagnosis of multinodular parenchymal disease using HRCT scan pattern recognition as a point of departure.

Algorithms↗

Bronchiectasis, exacerbation indices, and inflammation in chronic obstructive pulmonary disease.

Relationships between high-resolution computed tomography (HRCT) findings in chronic obstructive pulmonary disease (COPD) and bacterial colonization, airway inflammation, or exacerbation indices are unknown. Fifty-four patients with COPD (mean [SD]: age, 69 [7] years; FEV(1), 0.96 [0.33] L; FEV(1) [percent predicted], 38.1 [13.9]%; FEV(1)/forced vital capacity [percent predicted], 40.9 [11.8]%; arterial partial pressure of oxygen, 8.77 [1.11] kPa; history of smoking, 50.5 [33.5] smoking pack-years) underwent HRCT scans of the chest to quantify the presence and extent of bronchiectasis or emphysema. Exacerbation indices were determined from diary cards over 2 years. Quantitative sputum bacteriology and cytokine measurements were performed. Twenty-seven of 54 patients (50%) had bronchiectasis on HRCT, most frequently in the lower lobes (18 of 54, 33.3%). Patients with bronchiectasis had higher levels of airway inflammatory cytokines (p = 0.001). Lower lobe bronchiectasis was associated with lower airway bacterial colonization (p = 0.004), higher sputum interleukin-8 levels (p = 0.001), and longer symptom recovery time at exacerbation (p = 0.001). No relationship was seen between exacerbation frequency and HRCT changes. Evidence of moderate lower lobe bronchiectasis on HRCT is common in COPD and is associated with more severe COPD exacerbations, lower airway bacterial colonization, and increased sputum inflammatory markers.

Aged↗