Introduction: Total body computerized tomography (TBCT) is frequently used as a diagnostic tool for fever of unknown origin (FUO) workup instead of a recommended fluorodeoxyglucose positron emission tomography FDG-PET/CT. We have assessed the TBCT diagnostic yield on a large, unselected cohort of patients with FUO.
Methods: We performed a single-center retrospective cohort study, examining all patients hospitalized in internal medicine between 2012 and 2019 with a documented fever and three negative blood cultures who subsequently had a total-body CT performed. After manually reviewing, we included 408 who met the criteria of FUO. We defined a positive study as a scan that led to the documented final diagnosis.
Results: A total of 164 patients (40.2 %) had a positive TBCT result. The majority of positive CT findings were of infectious etiologies (58.5 %), followed by neoplasms (22.8 %) and inflammatory disorders (14.0 %), with the chest (43.9 %) and abdomen (29.8 %) most affected. Using a logistic regression model, a positive scan results were associated with an elevated CRP (p<0.001). Decision tree analysis showed that 55 % of scans of patients with an elevated CRP (>6 mg/dL), low hemoglobin and high leucocyte count (>18000/ml) were positive. Patients without an elevated CRP had a positive scan in only 26 % of tests, and those with also an elevated albumin (>4 gr/dL) and low CRP had positive scan in only 11 % of cases.
Conclusions: TBCT has a clinically significant yield under specific clinical scenarios in medical patients with FUO- reaching 55 % in patients with an elevated CRP and leukocyte count and low hemoglobin. It is reasonable to proceed to TTBCT when FDG-PET/CT is unavailable and in well-defined clinical situations.
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http://dx.doi.org/10.1016/j.ejim.2024.01.027 | DOI Listing |
Middle East J Dig Dis
October 2024
Department of Colorectal Surgery, Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Background: Low anterior resection (LAR) is the gold standard for curative cancer treatment in the middle and upper rectum. In radically operated patients, the local recurrence rates with total mesorectal excision (TME) after 5 and 10 years was<10%, with 80% in 5 years survival. Anastomotic leakage (AL) affects 4%-20% of patients who underwent LAR.
View Article and Find Full Text PDFNeurology
February 2025
Department of Neurology, John Hunter Hospital, Newcastle, Australia.
Anal Methods
January 2025
Istanbul University, Faculty of Pharmacy, Department of Analytical Chemistry, 34116, Istanbul, Turkey.
In this study, a new reversed phase high performance liquid chromatography method using two detectors was developed for the analysis of degradation and process impurities of ivabradine in pharmaceutical preparations. A PDA detector set to 285 nm wavelength and a QDa detector set to positive scan mode were used in the method. In the developed method, the separation process was carried out in a Zorbax phenyl column with a gradient application of a 0.
View Article and Find Full Text PDFJ Neuroimaging
January 2025
Neurobiology Research Unit, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Background And Purpose: This study aims to investigate the longitudinal changes in translocator protein (TSPO) following stroke in different brain regions and potential associations with chronic brain infarction.
Methods: Twelve patients underwent SPECT using the TSPO tracer 6-Chloro-2-(4'-123I-Iodophenyl)-3-(N,N-Diethyl)-Imidazo[1,2-a]Pyridine-3-Acetamide, as well as structural MRI, at 10, 41, and 128 days (median) after ischemic infarction in the middle cerebral artery. TSPO expression was measured in lesional (MRI lesion and SPECT lesion), connected (pons and ipsilesional thalamus), and nonconnected (ipsilesional cerebellum and contralesional occipital cortex) regions.
Acta Dermatovenerol Croat
November 2024
Constantin A. Dasanu MD, PhD, Lucy Curci Cancer Center, Eisenhower Health, 39000 Bob Hope Dr, Rancho Mirage, CA 92270 , USA;
Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is currently used in the therapy of several solid malignancies. This agent has been associated with several dermatological side-effects, the most common being papulo-pustular acneiform rash. Herein we describe a unique skin effect in a patient treated with erlotinib for non-small cell lung cancer.
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