Explore the vast range of titles available.

To perform a systematic review of the effect of blood glucose levels on 2-Deoxy-2-[18F]fluoro-D-glucose (18F-FDG) uptake in normal organs. We searched the MEDLINE, EMBASE and Cochrane databases through 22 April 2017 to identify all relevant studies using the keywords \"PET/CT\" (positron emission tomography/computed tomography), \"standardized uptake value\" (SUV), \"glycemia,\" and \"normal.\" Analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Maximum and mean SUVs and glycemia were the main parameters analyzed. To objectively measure the magnitude of the association between glycemia and 18F-FDG uptake in different organs, we calculated the effect size (ES) and the coefficient of determination (R2) whenever possible. The literature search yielded 225 results, and 14 articles met the inclusion criteria; studies included a total of 2714 (range, 51-557) participants. The brain SUV was related significantly and inversely to glycemia (ES = 1.26; R2 0.16-0.58). Although the liver and mediastinal blood pool were significantly affected by glycemia, the magnitudes of these associations were small (ES = 0.24-0.59, R2 = 0.01-0.08) and negligible (R2 = 0.02), respectively. Lung, bone marrow, tumor, spleen, fat, bowel, and stomach 18F-FDG uptakes were not influenced by glycemia. Individual factors other than glycemia can also affect 18F-FDG uptake in different organs, and body mass index appears to be the most important of these factors. The impact of glycemia on SUVs in most organs is either negligible or too small to be clinically significant. The brain SUV was the only value largely affected by glycemia.

ObjectivesTo compare the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) to other non-COVID viral pneumonia.MethodsMEDLINE, EMBASE, and Cochrane databases were searched through April 04, 2020, for published English language studies. Studies were eligible if they included immunocompetent patients with up to 14 days of viral pneumonia. Subjects had a respiratory tract sample test positive for COVID-19, adenovirus, influenza A, rhinovirus, parainfluenza, or respiratory syncytial virus. We only included observational studies and case series with more than ten patients. The pooled prevalence of each chest CT pattern or finding was calculated with 95% confidence intervals (95% CI).ResultsFrom 2263 studies identified, 33 were eligible for inclusion, with a total of 1911 patients (COVID-19, n = 934; non-COVID, n = 977). Frequent CT features for both COVID-19 and non-COVID viral pneumonia were a mixed pattern of ground-glass opacity (GGO) and consolidation (COVID-19, 0.37; 0.17–0.56; non-COVID, 0.46; 0.35–0.58) or predominantly GGO pattern (COVID-19, 0.42; 0.28–0.55; non-COVID 0.25; 0.17–0.32), bilateral distribution (COVID-19, 0.81; 0.77–0.85; non-COVID, 0.69; 0.54–0.84), and involvement of lower lobes (COVID-19, 0.88; 0.80–0.95; non-COVID, 0.61; 0.50–0.82). COVID-19 pneumonia presented a higher prevalence of peripheral distribution (COVID-19 0.77; 0.67–0.87; non-COVID 0.34; 0.18–0.49), and involvement of upper (COVID-19, 0.77; 0.65–0.88; non-COVID 0.18; 0.10–0.27) and middle lobes (COVID-19, 0.61; 0.47–0.76; non-COVID 0.24; 0.11–0.38).ConclusionExcept for a higher prevalence of peripheral distribution, involvement of upper and middle lobes, COVID-19, and non-COVID viral pneumonia had overlapping chest CT findings.Key Points• Most common CT findings of coronavirus disease 2019 (COVID-19) were a predominant pattern of ground-glass opacity (GGO), followed by a mixed pattern of GGO and consolidation, bilateral disease, peripheral distribution, and lower lobe involvement.• Most frequent CT findings of non-COVID viral pneumonia were a predominantly mixed pattern of GGO and consolidation, followed by a predominant pattern of GGO, bilateral disease, random or diffuse distribution, and lower lobe involvement.• COVID-19 pneumonia presented a higher prevalence of peripheral distribution, and involvement of upper and middle lobes compared with non-COVID viral pneumonia

Our purpose was to evaluate the effect of glycemia on 18 F-FDG uptake in normal organs of interest. The influences of other confounding factors, such as body mass index (BMI), diabetes, age, and sex, on the relationships between glycemia and organ-specific standardized uptake values (SUVs) were also investigated. We retrospectively identified 5623 consecutive patients who had undergone clinical PET/CT for oncological indications. Patients were stratified into groups based on glucose levels, measured immediately before 18 F-FDG injection. Differences in mean SUVmax values among glycemic ranges were clinically significant only when >10% variation was observed. The brain was the only organ that presented a significant inverse relationship between SUVmax and glycemia (p < 0.001), even after controlling for diabetic status. No such difference was observed for the liver or lung. After adjustment for sex, age, and BMI, the association of glycemia with SUVmax was significant for the brain and liver, but not for the lung. In conclusion, the brain was the only organ analyzed showing a clinically significant relationship to glycemia after adjustment for potentially confounding variables. The lung was least affected by the variables in our model, and may serve as an alternative background tissue to the liver.

ObjectivesTo evaluate the diagnostic test accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), whole-body magnetic resonance imaging (WB-MRI), and whole-body diffusion-weighted imaging (WB-DWI) for the detection of metastases in patients with non–small cell lung cancer (NSCLC).MethodsMEDLINE, Embase, and Cochrane Library databases were searched up to June 2019. Studies were selected if they reported data that could be used to construct contingency tables to compare 18F-FDG PET/CT, WB-MRI, and WB-DWI. Two authors independently extracted data on study characteristics and assessed methodological quality using the Quality Assessment of Diagnostic Accuracy Studies. Forest plots were generated for sensitivity and specificity of 18F-FDG PET/CT, WB-MRI, and whole-body diffusion-weighted imaging (WB-DWI). Summary receiver operating characteristic plots were created.ResultsThe 4 studies meeting inclusion criteria had a total of 564 patients and 559 lesions, 233 of which were metastases. In studies of 18F-FDG PET/CT, the pooled estimates of sensitivity and specificity were 0.83 (95% confidence interval [CI], 0.54–0.95) and 0.93 (95% CI, 0.87–0.96), respectively. For WB-MRI, pooled sensitivity was 0.92 (95% CI, 0.18–1.00) and pooled specificity was 0.93 (95% CI, 0.85–0.95). Pooled sensitivity and specificity for WB-DWI were 0.78 (95% CI, 0.46–0.93) and 0.91 (95% CI, 0.79–0.96), respectively. There was no statistical difference between the diagnostic odds ratio of WB-MRI and WB-DWI compared with that of PET/CT (p = 0.186 for WB-DWI; p = 0.638 for WB-MRI).ConclusionWB-MRI and DWI are radiation-free alternatives with comparable diagnostic performance to 18F-FDG PET/CT for M staging of NSCLC.Key Points• Whole-body MRI with or without diffusion-weighted imaging has a high accuracy for the diagnostic evaluation of metastases in patients with non–small cell lung cancer.• Whole-body MRI may be used as a non-invasive and radiation-free alternative to positron emission tomography with CT with similar diagnostic performance.

ObjectiveThe study aimed to comparatively evaluate HRQOL in miners of semi-precious stones with and without silicosis, and determine the associated factors, as well as the performance of two different questionnaires in measuring HRQOL.MethodsIn a cross-sectional study of 348 male miners (129 with silicosis) who underwent an interview and spirometry, HRQOL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and the Saint George's Respiratory Questionnaire (SGRQ).ResultsMiners with silicosis were older, had less schooling, worked more hours daily, and had longer exposure to silica. They also had worse scores of QoL in both questionnaires. Respiratory symptoms and %FEV1 were contributing factors for the models of total health and all the domains of the SGRQ, and 40% of the variability of the general health domain of WHOQOL-BREF was due to dyspnea, wheezing, %FEV1, and pack-years of cigarette smoking. Respiratory symptoms, lung function, pack-years of cigarette smoking, years of education, and average monthly income were contributing factors for the models of the different domains of the WHOQOL-BREF.ConclusionsOur study revealed impaired HRQOL in semi-precious stone miners evaluated using both questionnaire tools of SGRQ and WHOQOL-BREF, of which SGRQ had superior performance. Respiratory symptoms, functional impairment, and pack-years of cigarette smoking were the most important determinants of the workers’ general HRQOL.

Objective To estimate the diagnostic accuracy of signal intensity of the lesion-to-spinal cord ratio (LSR) and apparent diffusion coefficient (ADC) in diffusion-weighted (DW) magnetic resonance imaging of pulmonary nodules suspicious for lung cancer in granulomatous lung disease-endemic regions. Methods Forty-nine patients with indeterminate solitary pulmonary nodules detected by chest computed tomography and histopathologically confirmed diagnoses were included in the study. DW images were analysed semiquantitatively by focusing regions of interest on the lesion and spinal cord at the same level (for LSR calculation). ADCs were estimated from ratios of the two image signal intensities. Ratios of T1 and T2 signal intensity between nodules and muscle were calculated for comparison. Results Mean ADCs ± standard deviations for lung cancer and benign lesions were 0.9 ± 0.2 and 1.3 ± 0.2 × 10 -3 mm 2 /s, respectively. Mean LSRs were 1.4 ± 0.3 for lung cancer and 1 ± 0.1 for benign lesions. ADCs and LSRs differed significantly between malignant and benign lesions ( P  < 0.001). Mean T2 signal intensity ratios also differed significantly between benign and malignant lesions (0.8 ± 0.2 vs. 1.6 ± 0.2; P  < 0.05). Conclusions DWI can help to differentiate malignant from benign lesions according to ADC and the LSR with good accuracy. Key Points • DW imaging can help differentiate malignant from benign pulmonary nodules. • ADC and LSR signal intensities had only small overlap between malignant and benign pulmonary nodules. • Mean T2 signal intensity ratios differed significantly between benign and malignant lesions.

Purpose To evaluate the effects of transcutaneous electrical nerve stimulation (TENS) compared to placebo TENS and a control group on pain, pulmonary function, respiratory muscle strength, and analgesic medications in the postoperative period of thoracotomy in an Intensive care unit (ICU). Methods Patients who had undergone posterolateral thoracotomy were randomly allocated to receive TENS during ICU stay, or placebo TENS, or into the control group. All groups received conventional physiotherapy. We analysed the intensity of pain, pulmonary function, respiratory muscle strength, and use of analgesia medications. Outcomes were evaluated before surgery, immediately after, 24 and 48 h after ICU admission. Results Forty-five patients were included. Regarding pain perception, there was no difference between groups ( p  = 0.172), but there was a significant reduction in pain intensity for patients receiving TENS after first physiotherapy session compared to baseline (4.7 ± 3.2 vs 3.3 ± 2.6; p  < 0.05). All groups had a decrease in forced vital capacity (FVC) after surgery ( p  < 0.001). There was no difference between the groups regarding the use of analgesic medications, but a higher intake of morphine and acetaminophen were observed for the control ( p  = 0.037) and placebo group ( p  = 0.035), respectively. Conclusion The use of TENS provides a little benefit of pain (in the first 12 h) but failed to demonstrate any improvement in the recovery of ICU patients after 48 h of posterolateral thoracotomy. Trial Registration NCT02438241.

To evaluate the quantitative computed tomography (QCT) phenotypes, airflow limitations, and exacerbation-like episodes in heavy smokers in Southern Brazil. We enrolled 172 smokers with a smoking history ≥30 pack-years who underwent pulmonary function tests (PFTs) and CT scan for lung cancer screening. Patients were classified regarding airflow limitation (FEV1/FVC <0.7 forced expiratory volume in 1 second/forced vital capacity) and the presence of emphysema on the QCT. The QCT were analyzed in specialized software and patients were classified in two disease-predominant phenotypes: emphysema-predominant (EP) and non-emphysema-predominant (NEP). EP was determined as ≥6% of percent low-attenuation areas (LAA%) with less than -950 Hounsfield units. NEP was defined as having a total LAA% of less than 6%. Most of our patients were classified in the EP phenotype. The EP group had significantly worse predicted FEV1 (60.6 ±22.9 vs. 89.7 ±15.9, p <0.001), higher rates of airflow limitation (85.7% vs. 15%; p <0.001), and had more exacerbation-like episodes (25.8% vs. 8.3%, p <0.001) compared to the NEP group. Smoking history, ethnicity, and BMI did not differ between the groups. The total LAA% was the QCT parameter with the strongest correlation to FEV1 (r = -0.669) and FEV1/FVC (r = -0.787). Heavy smokers with the EP phenotype on QCT were more likely to have airflow limitation, worse predicted FEV1, and a higher rate of exacerbation-like episodes than those with the NEP phenotype. Approximately 23% of patients with no airflow limitation on PFTs were classified in EP phenotype.

To investigate the factors associated with a higher risk of noncompliance to tuberculosis (TB) treatment in Porto Alegre, Brazil. We identified 478 adult patients for this case-control study undergoing treatment for confirmed pulmonary TB. Cases (noncompliance) were defined as patients who stopped treatment for more than 30 consecutive days (n = 118). Controls were defined as all patients who completed treatment and were cured (n = 360). Factors associated with noncompliance were calculated with unadjusted and adjusted odds ratio (OR). The rate of noncompliance in our study was 25%. The factors of noncompliance after adjustments in the overall population were, in order of magnitude, living in an area of lower income (OR = 4.35, 95%CI: 2.50-7.58), abuse of drugs (OR = 2.73, 95%CI: 1.47-5.09), nonadherence to a previous treatment regimen (OR = 2.1, 95%CI: 1.28-3.45), and history of smoking (OR = 1.72, 95%CI: 1.00-3.00). Age, race, gender, level of education, HIV infection or diabetes status were not associated with a higher risk of noncompliance. In the subgroup of re-treatment cases, poverty (OR = 2.65; 95%CI = 1.06-6.66), smoking history (OR = 2.94; 95%CI = 1.09-7.92), male gender (OR = 3.25; 95%CI = 1.32-8.0), and younger age (OR = 4.3; 95%CI = 1.15-16.07) were also associated with a higher risk of dropout. Predictors of poor compliance to TB treatment were low income, abuse of drugs, re-treatment cases and history of smoking.

Objective To evaluate quantitative chest computed tomography (CT) methods for the detection of air trapping (AT) and to assess its diagnostic performance for the diagnosis of bronchiolitis obliterans syndrome (BOS) in single lung transplant (SLT) patients. Methods Adult patients who had a SLT at a single transplant center and underwent CT scan after transplantation were retrospectively included. CT findings of air trapping were measured by three different methods: expiratory air-trapping index (ATIexp), mean lung density on expiratory acquisition (MLDexp) and expiratory to inspiratory ratio of mean lung density ( E / I -ratio(MLD). Sensitivity, specificity and diagnostic accuracy of the three methods for the detection of BOS status evaluated by serial routine measures of pulmonary function tests (gold standard) were assessed. Results Forty-six SLT patients (52.2% females, mean age 58 ± 6 years) were included in the analysis, 12 (26%) patients with a diagnosis of BOS. Quantitative CT diagnosis of AT ranged from 26 to 35%. Sensitivity, specificity and accuracy of each method for the detection of BOS were 85.7%, 84.7% and 85.0% for ATIexp, 78.5%, 93.4% and 90.0% for MLD and 64.2%, 89.1% and 83.3% E / I -ratio(MLD), respectively. Conclusion Quantitative measures of AT obtained from standard CT are feasible and show high specificity and accuracy for the detection of BOS in SLT patients.