Barcelona Respiratory Network (BRN)’s Post

Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Cirrhosis 🩺 Dive into a comprehensive study on the Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure, an essential intervention for managing complications of portal hypertension in cirrhosis patients. Authored by Sasidharan Rajesh, Thomas George, MD, Cyriac Abby Philips, Rizwan Ahamed, Sandeep Kumbar, Narain Mohan, Meera Mohanan, and Philip Augustine, this critical review examines the latest advancements, challenges, and patient outcomes associated with TIPS. 🔹 Key Highlights: Historical Perspective: Evolution of TIPS as a rescue therapy for variceal bleeding. Technological Advances: Impact of covered stents in reducing shunt dysfunction. Clinical Applications: Expanding roles in managing variceal bleeding, refractory ascites, hepatic hydrothorax, and more. Patient Selection & Care: Importance of meticulous patient selection and post-procedural care. 💡 Earn 1.0 CME Credit by exploring the article: https://lnkd.in/diGjZh9A #PhysicianInsights #MedicalPractice #TIPS #Cirrhosis #CME #MedicalResearch #DoctorsUpdate

Hi everyone Hope all in good health. We performed bone marrow biopsy of a known case of PML-RARA for further evaluation by flowcytometry. But the examination of patient extremities revealed bilateral edema. This raised some suspicion of kidney disorder or fluid retention but all are within normal limits. Suddenly after marrow biopsy patient becomes hypotensive and immediately shifted to ICU. As there is presence of tenderness in abdomen so CT scan was performed and it showed a large mixed attenuation retroperitoneal hematoma involving the left psoas extending into the midline and pelvis. It extended cephalad to the level of his first lumbar vertebra. There was an arterial extravasation in pelvis anterior to inferior sacrum. Using lateral fluoroscopy a 5 French reverse curve angiographic catheter was used to take material from swollen part at artery ostial region. Nerve cytology was done and it revealed MPNST. Its a case of double hit phenomenon where bone marrow biopsy was done for diagnosing and accessing PMA-RARA along with incidental finding of MPNST at sacral nerve. Karyotyping was performed which shows translocation involving chromosome 1;17;15 indicative of the breakpoints on 1q21,15q24 and 17q21. #karyoytyping #bone #marrow #biopsy #followed #by #hypotension #trans #cathether #wire #guided #nerve #cytology

Today, I've prepared a fun way to remember the Balthazar score for acute pancreatitis on CT acquisitions. As a reminder, acute pancreatitis is defined as acute inflammation of the pancreas, with varying degrees of involvement in surrounding tissues and organ systems. Its clinical presentation can range from mild edematous forms to severe cases with necrosis and even organ failure. It's clear that the greater the impact on the patient and other organ systems, the higher the mortality rate. The Balthazar CT Severity Index, developed some time ago, remains a useful tool in modern medical practice. A CT scan with intravenous contrast is considered the standard imaging procedure for describing the pathology. The Balthazar score is a component of the CT Severity Index (CTSI) and is used for grading the severity of acute pancreatitis. More specifically, the CTSI considers both the Balthazar grade (A to E) and the extent of pancreatic necrosis. Today's poster focuses primarily on a fun method for remembering the Balthazar score, but also covers its interpretation and clinical implications. #pancreatitis #educational #medical #pathology #balthazar #CT #radiology #imaging #diagnosis #health #medicine #healthcare #pancreas #classification #mnemonic #risk

AN UNUSUAL CAUSE OF PERIPHERAL LUNG NODULE - NODULAR PULMONARY AMYLOIDOSIS Cone Beam CT guided Biopsy 70-year-old female patient, known case of hypertension and well controlled type 2 diabetes mellitus presented with complaints of cough since 2 months. She had unintentional weight loss of 4kgs over the last year. Her symptoms did not improve with symptomatic treatment and inhalers. HRCT chest performed for further evaluation revealed a 2.1 x 2 cm nodule in right upper lobe, and smaller nodules in the right lower lobe. Under general anesthesia and lung navigation ventilation protocol ‘Cone Beam Computed Tomography’ was performed. The lesion was identified in the right upper lobe posterior segment and marked. Radial EBUS was performed, but no lesion was identified. Using 3 dimensional augmented fluoroscopy a 1.1mm mini cryoprobe was placed abutting the lesion. A repeat CBCT spin showed the cryo probe to be in contact with the lesion. Multiple Cryobiopsies were then performed under augmented fluoroscopy and sent for analysis. Histopathological examination revealed pale, hyalinized, eosinophilic material surrounded by multinucleated giant cells and lymphoplasmacytic cells. This material was found to be congo red positive with apple green birefringence on polarizer. Final diagnosis: ‘Pulmonary Nodular Amyloidosis’ TAKE HOME MESSAGES 1. CBCT can help confirming tool adjacent to lesion even in instances where radial EBUS doesn't show an image (index case) 2. Primary pulmonary amyloidosis presenting as lung nodules is uncommon and needs to be considered as an uncommon differential of lung nodule #PulmonaryAmyloidosis #LungNodule #CBCT #Cryobiopsy #RadialEBUS #Histopathology #RareDiseases #MedicalImaging #LungHealth #drvnagarjunamaturu #pulmonologist #YashodaHospitals #hitechcity

#NephrostomyDevices industry is anticipated to register an 8.3% CAGR between 2023 and 2032 due to the rising prevalence of kidney disorders and increased adoption of minimally invasive surgical procedures.

#NephrostomyDevices industry is anticipated to register an 8.3% CAGR between 2023 and 2032 due to the rising prevalence of kidney disorders and increased adoption of minimally invasive surgical procedures.

#NephrostomyDevices industry is anticipated to register an 8.3% CAGR between 2023 and 2032 due to the rising prevalence of kidney disorders and increased adoption of minimally invasive surgical procedures.

Hi everyone Hope all in good health. A nice was diagnosed this morning sacral artery sarcoma. We performed bone marrow biopsy of a known case of PML-RARA for further evaluation by flowcytometry. But the examination of patient extremities revealed bilateral edema. This raised some suspicion of kidney disorder or fluid retention but all are within normal limits. Suddenly after marrow biopsy patient becomes hypotensive and immediately shifted to ICU. As there is tenderness in abdomen so CT scan was performed and it showed a large mixed attenuation retroperitoneal hematoma involving the left psoas extending into the midline and pelvis. It extended cephalad to the level of his first lumbar vertebra. There was an arterial extravasation in pelvis anterior to inferior sacrum. Using lateral fluoroscopy a 5 French reverse curve angiographic catheter was used to take material from swollen part at artery ostial region. Nerve cytology was done and it revealed MPNST. Its a case of double hit phenomenon where bone marrow biopsy was done for diagnosing and accessing PMA-RARA along with incidental finding of MPNST at sacral nerve. Karyotyping was performed which shows abnormalities in chromosomes 4,8,9,14,18 and 21. #karyoytyping #bone #marrow #biopsy #followed #by #hypotension #trans #cathether #wore #guided #nerve #cytology

#NephrostomyDevices industry is anticipated to register an 8.3% CAGR between 2023 and 2032 due to the rising prevalence of kidney disorders and increased adoption of minimally invasive surgical procedures.