Acute Pulmonary Thromboembolism Masquerading as Pneumocystis Ji-roveci Pneumonia in a Newly Detected HIV Positive Patient

HS, Natraj Setty; Tr, Raghu; Kharge, Jayashree

doi:10.4172/2324-8602.1000291

Cited by 1 publication

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“…It is supplied not only by the vertebral arteries but also by the deep cervical artery for the cervical spinal cord, the artery of Von Haller at the thoracic level and the AKA at the lower thoracic/lumbar level. 15–17 Outcome variables were obtained from the interpretation of the CTA images. All patients received a non-ionic contrast with volumes varying from 26 to 160 mL, the volume being proportional to each patient’s body weight.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Adamkiewicz artery and anterior spinal artery detection through computerized tomographic angiography

2017

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Background:The detection of the Adamkiewicz artery and the anterior spinal artery has been associated with the ability to prevent adverse spinal cord outcomes after aortic surgical procedures. Yet, to our knowledge, no previous studies have attempted to use modern predictive models to identify the most important variables in determining artery detectability.Aims:To develop a model to predict the odds of visualizing the Adamkiewicz artery or anterior spinal artery in patients undergoing computerized tomographic angiography.Methods:We conducted a prospective, cross-sectional study. Outcomes of interest were the non-detection of the Adamkiewicz artery and anterior spinal artery, and their corresponding level of origin. Axial images were inspected in high definition in search of two dense spots characterizing the Adamkiewicz artery and anterior spinal artery. A multiplanar three-dimensional reconstruction was then performed using the OsiriX® software.Results:A total of 110 participants were part of this analysis. When evaluating risks for the Adamkiewicz artery being undetectable, significant factors could be classified into three broad categories: risk factors for arterial disease, established arterial disease, and obesity. Factors in the former category included metabolic syndrome, hypertension, and smoking status, while factors in the arterial disease included descending aortic aneurysm, mural thrombi, aortic aneurysm without a dissection, and aortic disease in general. In relation to anterior spinal artery not being detectable, significant risk factors included hypertension, smoking status, and metabolic syndrome, while those associated with arterial disease involved aortic disease and arterial thrombi. When evaluating the importance of individual clinical factors, the presence of higher body mass index was the single most important risk factor.Conclusion:Arterial disease, established arterial disease, and increased body mass index are risk factors in the detection of Adamkiewicz artery and anterior spinal artery. Specific diagnostic protocols should be in place for patients with these underlying conditions, thus enhancing the likelihood of detection when the Adamkiewicz artery is indeed present.

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Section: Methodsmentioning

confidence: 99%