Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide and results in substantial social and economic burdens. COPD is a heterogeneous disease with both extrapulmonary and pulmonary components. The pulmonary component is characterized by an airflow limitation that is not fully reversible. In the authors' opinion, none of the currently available classifications combining airflow limitation measurements with clinical parameters is sufficient to determine the prognosis and treatment of a particular patient with COPD. With regard to the causes of airflow limitation, CT can be used to quantify the two main contributions to COPD: emphysema, and small airways disease (a narrowing of the airways). CT quantification--with subsequent COPD phenotyping--can contribute to improved patient care, assessment of COPD progression, and identification of severe COPD with increasing risk of mortality. Small airways disease can be quantified through measurements reflecting morphology, quantification of obstruction, and changes in airways walls. This article details these three approaches and concludes with perspectives and directions for further research.
The clinical classification of nephrotic syndrome (NS) is based on age at presentation. However, this classification is arbitrary because the majority of early onset NS has a genetic origin and has a widespread age of onset (from fetal life to several years). The aims of this review are to illustrate the knowledge accumulated on congenital nephrotic syndrome (CNS) in terms of genetics, classification, findings at histology and US-based on a review of the literature.
Only lymphadenopathy and bronchial wall thickening are CT features associated with severe COPD exacerbation, respectively in 25% and 50% of patients. Our findings do not advocate a role for CT in the routine work-up of patients with severe COPD exacerbation.
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