Efficiency of Lung Ultrasonography in the Diagnosis and Follow-up of Viral Pneumonia in Newborn

2021 ◽  
Author(s):  
Ahmet Öktem ◽  
Ayşegül Zenciroğlu ◽  
Çiğdem Üner ◽  
Seda Aydoğan ◽  
Dilek Dilli ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Outpatient Clinic ◽  
Lung Diseases ◽  
Neonatal Period ◽  
Control Group ◽  
Lung Ultrasonography ◽  
Lung Consolidation ◽  
Pleural Line ◽  
Lung Sliding

Objective Lung ultrasonography (LUS) is a useful method for diagnosis of lung diseases such as respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax in the neonatal period. LUS has become an important tool in the diagnosis and follow-up of lung diseases. LUS is easy to apply at the bedside and is a practical and low-cost method for diagnosing pneumonia. Study Design This study was conducted in neonatal intensive care unit of Dr. Sami Ulus Obstetrics, Children's Health and Diseases Training and Research Hospital. From September 2019 to April 2020, 50 patients who were diagnosed with viral pneumonia were included in the study. Also, 24 patients with sepsis-related respiratory failure were included in the study as a control group. LUS was performed at the bedside three times, by a single expert, once each before treatment for diagnosis, on discharge, and after discharge in outpatient clinic control. Results Before treatment, LUS findings were lung consolidation with air bronchograms (50/50), pleural line abnormalities (35/50), B-pattern (25/50), disappearance of lung sliding (21/50), lung pulse (5/50), and pleural effusion (9/50). During discharge, we found significant changes: lung consolidation with air bronchograms (6/50), pleural line abnormalities (7/50), B-pattern (12/50), and pleural effusion (1/50) (p < 0.05). Outpatient clinic control LUS findings were lung consolidation with air bronchograms (0/50), pleural line abnormalities (0/50), B-pattern (0/50), disappearance of lung sliding (0/50), and pleural effusion (0/50) (p < 0.05). Also, B-pattern image, disappearance of lung sliding, and pleural line abnormalities were higher in control group (p < 0.05). Conclusion Ultrasound gives no hazard, and the application of bedside ultrasonography is comfortable for the patients. Pneumonia is a serious infection in the neonatal period. Repeated chest radiography may be required depending on the clinical condition of the patient with pneumonia. This study focuses on adequacy of LUS in neonatal pneumonia. Key Points

scholarly journals Complications and residual pleural thickening after intrapleural instillation of streptokinase with pigtail catheter drainage of tuberculous pleural effusion

2019 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Sandeepa H. S. ◽  
Narendra U. ◽  
Gajanan S. Gaude ◽  
Supriya Sandeepa
Keyword(s):  
Pleural Effusion ◽  
Total Duration ◽  
Control Group ◽  
Study Group ◽  
Pigtail Catheter ◽  
Catheter Drainage ◽  
Female Ratio ◽  
Tuberculous Pleural Effusion ◽  
Pleural Thickening

Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in India. Residual pleural thickening (RPT) is observed in about 50 percent of patients even after proper treatment with ATT. Pleural fluid drainage either with simple aspiration or with intercostal drainage and addition of corticosteroids along with antitubercular drugs have not shown to influence the incidence of RPT. The present study was undertaken to study the complications and residual effects of tubercular pleural effusion on the patients during the follow up period following intrapleural streptokinase instillation.Methods: Clinical profile, hospital course and outcome of tuberculous pleural effusion patients at the end of six months of anti-tubercular treatment of 50 patients from January 2009 to June 2010 were analyzed. These patients were randomly divided into two groups. One group (n=25) received intrapleural streptokinase via pigtail catheter and the other group (n=25) received intercostal drainage without intrapleural streptokinase instillation. All the patients received standard daily anti TB regimen of 2HERZ/4HR for a total duration of six months. All the patients were followed up for a total duration of 1 year for evidence of any residual pleural thickening.Results: Majority of the patients were above 40 years of age (60%). The male to female ratio was 2.3:1. The major symptoms of the patients were, fever in 44 patients (88%), cough in 42 patients (84%), breathlessness in 33 patients (66%), loss of appetite in 25 patients (50%) and chest pain in 25 patients (50%). Most of the patients had ADA levels between 40-70IU/L (48%) and only 6% had ADA levels below 40IU/L. The incidence of residual pleural thickening in the study group was less as compared to the control group (2.36±0.49mm vs 9.28±1.50mm) (p <0.0001).Conclusion: Intrapleural streptokinase instillation with pigtail catheter drainage less number of complications associated with study group and is successful with the decreased incidence of residual pleural thickening during the follow up period.

The Box: Cost-utility of an eHealth intervention in the outpatient clinic follow-up of acute myocardial infarction patients. (Preprint)

2021 ◽  
Author(s):  
Roderick Willem Treskes ◽  
M. Elske van den Akker ◽  
Loes A.M. van Winden ◽  
Nicole van Keulen ◽  
Enno T. van der Velde ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Outpatient Clinic ◽  
Remote Monitoring ◽  
Cost Utility ◽  
Cost Of Care ◽  
Control Group ◽  
Life Years ◽  
Ehealth Intervention

BACKGROUND Smartphone compatible wearables have been released on the consumers market, enabling remote monitoring. Remote monitoring is often named as a tool to reduce cost of care. OBJECTIVE The primary purpose of this paper is to describe a cost-utility analysis of an eHealth intervention compared to regular follow-up in patients with acute myocardial infarction (AMI). METHODS In this trial, patients with an AMI were randomized in a 1:1 fashion between an eHealth intervention and regular follow-up. The remote monitoring intervention consisted of a blood pressure monitor, weight scale, electrocardiogram (ECG) device and step counter. Furthermore, two in-office outpatient clinic visits were replaced by e-visits. The control group received regular care. The differences in mean costs and quality of life per patient between both groups during one year follow-up were calculated RESULTS Mean costs per patient were €2412 for the intervention, and €2888 for the control group. This yielded cost reduction of €475 per patient. This difference was not statistically significant (95% CI -€271;€1221; P=.212). The average quality adjusted life years (QALY) in the first year of follow was 0.74 for the intervention group and 0.69 for the control (difference -0.05, 95% CI -0.09;-0.01; P=.028). CONCLUSIONS eHealth in the outpatient clinic setting in patients who suffered from acute myocardial infarction is very likely to be cost-effective compared to regular follow-up. Further research should be done to corroborate these findings in other patient populations and different care settings. CLINICALTRIAL NCT02976376 INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.8038

scholarly journals Lung ultrasound findings in patients with novel SARS-CoV2

2020 ◽  
Author(s):  
Mark Evert Haaksma ◽  
Micah L.A. Heldeweg ◽  
Jorge E. Lopez Matta ◽  
Jasper Martijn Smit ◽  
Jessica D. van Trigt ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Lung Ultrasound ◽  
Dynamic Compliance ◽  
Clinical Parameters ◽  
Duration Of Symptoms ◽  
Pleural Line ◽  
Long Duration ◽  
Academic Hospitals ◽  
Ultrasound Findings ◽  
Lung Sliding

Background: Over 2 million people worldwide have been infected with Severe Acute Respiratory Distress Syndrome Corona Virus 2 (SARS CoV2). Lung ultrasound has been proposed to diagnose and it. However, little is known about ultrasound findings in these patients. Our aim is to present an overview of lung ultrasound characteristics in critically ill patients with SARS CoV2 pneumonia overall and in relation to the duration of symptoms and clinical parameters. Methods: On the Intensive Care Unit of two academic hospitals, adult patients who tested positive for SARS-CoV2 were included. Images were analyzed for pleural line characteristics, number and appearance of B-lines, BLUE-profiles (Bedside Lung Ultrasound in Emergency), pathology in the PLAPS (Postero Lateral Alveolar and Pleural Syndrome) point and a LUS-score (lung ultrasound). The primary outcomes were frequencies, percentages and differences in lung ultrasound findings overall and between short (≤14 days) and long (>14 days) duration of symptoms and their correlation with clinical parameters. Results: In this pilot observational study, 61 patients were included with 75 examinations for analysis. The most prevalent ultrasound findings were decreased lung sliding (36%), thickening of the pleural line (42%) and a C-profile per view (37%). Patients with ″long″ duration of symptoms presented more frequently with a thickened and irregular pleural line (21% (32) vs 9% (11), p=.01), C-profile per patient (47% (18) vs. 25% (8),p=.01) and pleural effusion (19% (14) vs 5% (3),p=.02) compared to patients with short duration of symptoms. Lung ultrasound findings did not correlate with P/F ratio, fluid balance or dynamic compliance, with the exception of the LUS-score and dynamic compliance (R2=0.27, p=.02). Conclusion: SARS CoV2 results in significant ultrasound changes, with decreased lung sliding, thickening of the pleural line and a C-profile being the most observed. With time, a thickened and irregular pleural line, C-profile and pleural effusion become more common findings.

scholarly journals Ten-year experience of an outpatient clinic for CKD-5 patients with multidisciplinary team and educational support

2021 ◽  
Author(s):  
Vincenzo Terlizzi ◽  
Massimo Sandrini ◽  
Valerio Vizzardi ◽  
Mattia Tonoli ◽  
Annalisa Facchini ◽  
...  
Keyword(s):  
Renal Function ◽  
Outpatient Clinic ◽  
Multidisciplinary Team ◽  
Control Group ◽  
Dialysis Access ◽  
Educational Support ◽  
Delayed Initiation ◽  
Group 2 ◽  
Lost To Follow Up

Abstract Purpose To analyze the results of an outpatient clinic with a multidisciplinary team and educational support for patients with late-stage CKD (lsCKD), to check its possible effect on their outcomes. Methods Longitudinal cohort study on patients followed up in the MaReA (Malattia Renale Avanzata = CKD5) outpatient clinic at ASST Spedali Civili of Brescia from 2005 to 2015 for at least six months. Trajectory of renal function over time has been evaluated only in those patients with at least four estimations of eGFR before referring to MaReA. Results Seven hundred and six patients were enrolled, their mean age was 72 ± 14 years, 59% were males. At the end of the study, 147 (21%) were still on MaReA, 240 (34%) on dialysis, 92 (13%) on very low-protein diet (VLPDs), 13 (2%) on pre-hemodialysis clinic, 23 (3%) improved renal function, 10 (1%) transplanted, 62 (9%) transferred/lost to follow-up, and 119 (17%) died. Optimal dialysis start (defined as start with definitive dialysis access, as an out-patient and without lsCKD complications) occurred in 180/240 (75%) patients. The results showed a slower eGFR decrease during MaReA follow-up compared to previous renal follow-up: − 2.0 vs. − 4.0 mL/min/1.73 m2 BSA/year (p < 0.05), corresponding to a median delay of 17.7 months in dialysis start in reference to our policy in starting dialysis. The patient cumulative survival was 75% after 24 months and 25% after 70. Limitations: (1) lack of a control group, (2) one-center-study, (3) about all patients were Caucasians. Conclusion The follow-up of lsCKD patients on MaReA is associated with an optimal and delayed initiation of dialysis.

Audio Stories as Incidental Language Teachers

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Ute Ritterfeld ◽  
Timo Lüke
Keyword(s):  
Language Learning ◽  
Low Socioeconomic Status ◽  
Language Teachers ◽  
Control Group ◽  
Low Socioeconomic ◽  
Migrant Families ◽  
Populations At Risk ◽  
Grammatical Skills ◽  
Entertainment Value

Abstract. Audio stories offer a unique blend of narrative entertainment with language learning opportunities as a user’s enjoyment is dependent on their processing of the linguistic content. A total of 138 third- and fourth-graders from low socioeconomic status and migrant families recruited from a metropolitan area in Germany participated in a randomized pre–post follow-up intervention study with a control group. Children listened to a tailored crime story of approximately 90 min over a period of 3 days within the classroom setting. Entertainment value for the age group was established in a pilot study. Outcome variables included semantic and grammatical skills in German and were administered before (pretest), shortly after intervention (posttest), and 2 weeks later (follow-up). We used nonverbal intelligence, reading, comprehension skills, age and sex as control variables. Results indicate a strong positive effect of media reception on language skills. The effectiveness of the intervention is discussed with reference to different linguistic domains, entertainment value, and compensatory effects in populations at risk of language learning deficits.

The effectiveness of positive training on happiness, aggression and hope in adolescents with leukemia in Ahvaz

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Marzieh . Shamkhani ◽  
Ali . Khalafi
Keyword(s):  
Sampling Method ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Positive Attitudes ◽  
Measurement Tools ◽  
Post Test ◽  
Aggression Questionnaire ◽  
Experimental Group ◽  
Period Measurement

The purpose of this study was to determine the effectiveness of positive learning on happiness, Aggression and hope for adolescents with leukemia in Ahvaz. The sample consisted of 30 people who were selected by available sampling method. 15 subjects in the experimental group and 15 in the control group were randomly assigned. The experimental design was a pre-test-post-test type with control group and follow-up period. Measurement tools included Oxford Happiness Inventory (Argyle, 1989); Ahwaz's Aggression Questionnaire (Zahedifar, Najarian, and Shokrkon, 2000); Hope Scale (Schneider, 1991). To run, at first, the pre-test was taken from both groups. Then, the experimental group was trained in 14 sessions of 90 minutes, and after each group, they were subjected to post-test. And one month later, the follow-up process was completed. Data analysis was performed using multivariate covariance analysis (MANCOVA) and one-way analysis of covariance (ANCOVA). The results showed that positive attitudes toward happiness, aggressiveness and hopefulness of adolescents with leukemia in Ahvaz were effective.

RELATED FACTORS TO RELAPSE IN DEPRESSED PATIENTS AFTER COGNITIVE BEHAVIOURAL THERAPY DURING ONE YEAR PROSPECTIVE FOLLOW-UP

2011 ◽  
pp. 13-19
Author(s):  
Nhu Minh Hang Tran ◽  
Huu Cat Nguyen ◽  
Dang Doanh Nguyen ◽  
Van Luong Ngo ◽  
Vu Hoang Nguyen ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Relapse Rate ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Related Factors ◽  
Depressed Patients ◽  
One Year

Objectives: To determine factors impact on the relapse in depressed patients treated with Cognitive Behavioral Therapy (CBT) during one year follow-up. Materials and Methods: 80 depressed patients divided into two groups, group 1: included 40 patients treated with CBT; group 2: 40 patients on amitriptyline. Non-randomized controlled clinical trial, opened, longiditual and prospective research. Results and Conclusions: relapse rate after CBT during 1 year follow-up is 10% (compared to 25% in control group), related factors to relapse rate in depression after CBT are age and education. Shared predictors between 2 groups are severity and recurrence of depression. Key words: Depression, relapse, Cognitive Behavioral Therapy (CBT)

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