GeneXpert® MTB/RIF for rapid detection of Mycobacterium tuberculosis in pulmonary and extra-pulmonary samples.

Int J Tuberc Lung Dis. 2011 Sep;15(9):1274-5

Authors: Hanif SN, Eldeen HS, Ahmad S, Mokaddas E

PMID: 21943862 [PubMed - in process]

Patterns of pulmonary tuberculosis on FDG-PET/CT.

Eur J Radiol. 2011 Sep 24;

Authors: Soussan M, Brillet PY, Mekinian A, Khafagy A, Nicolas P, Vessieres A, Brauner M

Abstract
OBJECTIVE: This study aims to describe patterns of pulmonary tuberculosis (TB) on FDG-PET/CT. METHODS: All patients with a diagnosis of TB and who underwent FDG-PET/CT between January 2009 and June 2010 were included. Clinical, biological and imaging data were reviewed. TB was proven either on bacteriological or histopathological studies (n=13) or on a clinical and imaging basis (n=3). RESULTS: Sixteen patients (11 men; median age 56, range 22-84 years) were included. Two distinct patterns were identified. In the lung pattern (9/16), patients had predominantly pulmonary symptoms (6/9 patients, 67%) with a parenchymal involvement: uptakes on lung consolidation ± cavitation surrounded by micronodules. Mediastino-hilar lymph nodes were slightly enlarged (15mm, 10-27) with moderate uptake (3.9, 2.5-13.4). In the lymphatic pattern (7/16), patients had predominantly systemic symptoms (5/7 cases, 71%) and all had extra-thoracic involvement. Mediastino-hilar lymph nodes were more enlarged (30mm, 18-35, p=0.03) and with higher uptake (6.8, 5.7-16.8, p=0.034) than in the lung pattern. CONCLUSION: We identified two distinct patterns of pulmonary TB on FDG-PET/CT. The lung pattern related to a restricted and slight hypermetabolic infection and the lymphatic pattern related to a systemic and intense infection. Combined interpretation of PET and CT findings improves the specificity of images, especially for the lung pattern.

PMID: 21945403 [PubMed - as supplied by publisher]

Catheter Ablation of Atrial Fibrillation in Patients with Chronic Lung Disease.

Circ Arrhythm Electrophysiol. 2011 Sep 26;

Authors: Roh SY, Choi JI, Lee JY, Kwak JJ, Park JS, Kim JB, Lim HE, Kim YH

Abstract
BACKGROUND: -Chronic lung disease (CLD) is one of the important underlying diseases of atrial fibrillation (AF). The outcomes after radiofrequency catheter ablation (RFCA) of AF in patients with CLD have not yet been reported. We investigated the electroanatomical alterations in pulmonary veins (PVs) in CLD patients with AF and assessed their effect on the outcomes for RFCA of AF. METHODS AND RESULTS: -We assessed 15 patients who had CLD and underwent RFCA of AF. CLD included chronic obstructive pulmonary disease (COPD), a tuberculosis-destroyed lung (TDL), and interstitial lung disease (ILD). For controls, we selected 60 sex-, age- and procedure era- matched non-CLD patients who received RFCA for AF (4 controls for each 1 CLD patient). Eight patients had COPD, 6 had TDL, and 1 had ILD. PV morphology in the affected lung was significantly altered i.e., obliteration, pulling of the PVs towards the destroyed lung, or compensatory bulging of the PV antrum. These alterations were related to arrhythmogenicity in 6 out of 15 (40%) patients with CLD. Non-PV foci were more common in the CLD group (4/15, 26.7%) than in the control group (3/60, 5.0%, p=0.025). All non-PV foci were located in the right atrium (RA). The AF recurrence rate in the CLD group (26.7%, 4/15) was similar to that in the control group (18.3%, 11/60, p=0.45). CONCLUSIONS: -Significant alteration of PV anatomy was related to arrhythmogenicity and non-PV foci from the RA were commonly observed in the CLD group. RFCA can be carried out safely for AF in CLD patients with a comparable success rate to that in patients with normal lungs.

PMID: 21946388 [PubMed - as supplied by publisher]

Conclusions:  These results show that malnutrition is associated with weakness of the expiratory muscles, decreased chest wall expansion and increased incidence of pulmonary complications in patients undergoing elective upper abdominal surgery. (Source: Respirology)