scholarly journals Evolution of Cavitary Lesion in a Case of COVID-19 Pneumonia: A Rare Entity

2021 ◽  
Author(s):  
Debasis Behera ◽  
Saswat Subhankar ◽  
Rajesh Venkataram ◽  
Suman Kumar Jagaty ◽  
C. M. Rao ◽  
...  
Keyword(s):  
Ct Scan ◽  
Early Stage ◽  
Morphological Changes ◽  
Diffuse Alveolar Damage ◽  
Complete Recovery ◽  
Late Complications ◽  
Causative Organism ◽  
Radiological Findings ◽  
Cavitary Lesion ◽  
Novel Coronavirus

Abstract Introduction Toward the end of 2019, a novel coronavirus was identified as the causative organism of a cluster of pneumonia cases in Wuhan, China, spreading rapidly resulting in an epidemic throughout China, followed by a global pandemic. The initial radiological findings of coronavirus disease 2019 (COVID-19) pneumonia at the early stage on a computed tomography (CT) scan include multiple small patchy shadows and interstitial inflammation, predominantly distributed in the peripheral one-third of the lungs. Gradually, it develops into multiple ground glass opacities and infiltrates in the lungs. Furthermore, pulmonary consolidation is observed, but pleural effusion is rare. Objective From time of presentation to complete recovery, CT scans show significant morphological changes in the lesions, but very few literatures have reported cavitary lesion in the lungs. We present the case of a 64-year-old patient with COVID-19 pneumonia who had typical manifestations of the disease on a CT scan along with constantly changing small cavity in the lung. Discussion Delayed cavitation is a rarely described radiological manifestation of COVID-19. Atypical presentations of COVID-19 raise possibility of other infections or additional diagnoses. Bacterial and fungal infection should be excluded, as well as cavity-causing organisms. Although the proper mechanism of cavitation in COVID-19 pneumonia is not known, it may be due to intra- alveolar hemorrhage, diffuse alveolar damage, and necrosis of parenchymal cells based on findings of autopsy reports. Early and late complications associated with COVID-19 are yet to be defined. Conclusion Common causes of cavitary lesions must be investigated properly in all patients. Most cases are self-limited hence managed conservatively. The clinical spectrum of disease due to COVID-19 continues to evolve. Physicians must be aware of evolving radiological findings of COVID-19 and must conduct regular follow-up of convalescent patients with COVID-19 to ensure complete recovery.

Connection of discontinuous segments in early functional recovery from thoracic ossification of the posterior longitudinal ligament treated with posterior instrumented surgery

2020 ◽  
Vol 32 (2) ◽  
pp. 200-206
Author(s):  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Masaaki Machino ◽  
Kyotaro Ota ◽  
Satoshi Tanaka ◽  
...  
Keyword(s):  
Early Stage ◽  
Morphological Changes ◽  
Japanese Orthopaedic Association ◽  
Multislice Ct ◽  
Posterior Longitudinal Ligament ◽  
Ct Images ◽  
Rigid Fixation ◽  
Disc Space ◽  
Fusion Surgery ◽  
Estimated Blood Loss

OBJECTIVEThe objective of this study was to investigate the relationship between morphological changes in thoracic ossification of the posterior longitudinal ligament (T-OPLL) and postoperative neurological recovery after thoracic posterior fusion surgery. Changes of OPLL morphology and postoperative recovery in cases with T-OPLL have not been examined.METHODSIn this prospective study, the authors evaluated data from 44 patients (23 male and 21 female) who underwent posterior decompression and fusion surgery with instrumentation for the treatment of T-OPLL at our hospital. The patients’ mean age at surgery was 50.7 years (range 38–68 years). The minimum duration of follow-up was 2 years. The location of thoracic ossification of the ligamentum flavum (T-OLF), T-OLF at the OPLL level, OPLL morphology, fusion range, estimated blood loss, operative time, pre- and postoperative Japanese Orthopaedic Association (JOA) scores, and JOA recovery rate were investigated. Reconstructed sagittal multislice CT images were obtained before and at 3 and 6 months and 1 and 2 years after surgery. The basic fusion area was 3 vertebrae above and below the OPLL lesion. All parameters were compared between patients with and without continuity across the disc space at the OPLL at 3 and 6 months after surgery.RESULTSThe preoperative morphology of OPLL was discontinuous across the disc space between the rostral and caudal ossification regions on sagittal CT images in all but one of the patients. Postoperatively, these segments became continuous in 42 patients (97.7%; occurring by 6.6 months on average) without progression of OPLL thickness. Patients with continuity at 3 months had significantly lower rates of diabetes mellitus (p < 0.05) and motor palsy in the lower extremities (p < 0.01). The group with continuity also had significantly higher mean postoperative JOA scores at 3 (p < 0.01) and 6 (p < 0.05) months and mean JOA recovery rates at 3 and 6 months (both p < 0.01) after surgery.CONCLUSIONSPreoperatively, discontinuity of rostral and caudal ossified lesions was found on CT in all patients but one of this group of 44 patients who needed surgery for T-OPLL. Rigid fixation with instrumentation may have allowed these segments to connect at the OPLL. Such OPLL continuity at an early stage after surgery may accelerate spinal cord recovery.

Novel Coronavirus SARS-CoV-2 (COVID-19) and Pregnancy: A hypothetical view

2020 ◽  
Vol 20 ◽  
Author(s):  
Ahmed RG
Keyword(s):  
Immune System ◽  
Cellular Therapy ◽  
Early Stage ◽  
Control Strategies ◽  
Vital Role ◽  
Healthy Life ◽  
Global Pandemic ◽  
Maternal Immune System ◽  
Perinatal Management ◽  
Novel Coronavirus

Background: The complications of the SARS-CoV-2 infection and its COVID-19 disease on mothers and their offspring are less known. Objective: The aim of this review was to determine the transmission, severity, complications of SARS-CoV-2 infection during the pregnancy. This review showed the influence of COVID-19 disease on the neonatal neurogenesis. Owing to no specific vaccines or medicines that were reported for the treatment of COVID-19 disease, this review suggested some control strategies like treatments (medicinal plants, antiviral therapy, cellular therapy, and immunotherapy), nutrition uptake, prevention, and recommendations. Discussion: This overview showed in severely states that SARS-CoV-2 infection during the early stage of pregnancy might increase the risk of stress, panic, and anxiety. This disorder can disturb the maternal immune system, and thus causing a neurodevelopmental disturbance. This hypothesis may be depending on the severity and intensity of the SARS-CoV-2 infection during pregnancy. However, vertical transmission of SARS-CoV-2 from dams to their fetuses is absent until now. Conclusion: During this global pandemic disease, maintaining safety during pregnancy, vaginal delivery, and breastfeeding may play a vital role in a healthy life for the offspring. Thus, international and national corporations should be continuing for perinatal management, particularly during the next pandemic or disaster time.

scholarly journals Typical and atypical CT chest imaging findings of novel coronavirus 19 (COVID-19) in correlation with clinical data: impact on the need to ICU admission, ventilation and mortality

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doaa M. Emara ◽  
Nagy N. Naguib ◽  
M. A. Moustafa ◽  
Salma M. Ali ◽  
Amr Magdi El Abd
Keyword(s):  
Pleural Effusion ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Mediastinal Lymphadenopathy ◽  
Imaging Features ◽  
Imaging Findings ◽  
Icu Admission ◽  
Mortality Outcome ◽  
Novel Coronavirus ◽  
Contrast Ct

Abstract Background The aim of this study was to highlight the typical and atypical chest CT imaging features at first presentation in 120 patients who were proved to be COVID-19 by PCR and to correlate these findings with the need for ICU admission, ventilation, and mortality. We retrospectively included 120 patients 71 males (59.2%) and 49 females (40.8%) with a mean age of 47.2 ± 14.4 years. Patients subjected to clinical assessment, CBC, PCR for COVID-19, and non-contrast CT chest at first presentation. Typical and atypical imaging findings were reported and correlated with the clinical findings of the patients, the need for ICU admission, ventilation, and mortality. Results Clinically, fever was seen in 112 patients followed by dry cough in 108 patients and malaise in 35 patients. The final outcome was complete recovery in 113 cases and death in 7 cases. Typical CT findings included bilateral peripheral ground-glass opacities (GGO) in 74.7%, multilobar affection in 92.5% while atypical findings such as homogeneous consolidation, pleural effusion, mediastinal lymphadenopathy, and single lobar affection were found in 13.4, 5, 6.7, and 7.5% respectively. A statistically significant association between the presence of white lung, pleural effusion, peripheral GGO, and the need for ICU admission as well as mechanical ventilation was noted. The death was significantly higher among elderly patients; however, no significance was found between the imaging features and mortality. Conclusion CT features at first presentation can predict the need for ICU admission and the need for ventilation but cannot predict the mortality outcome of the patients.

Staphylococcal infection and pathomurfological characteristic of the pituitary-adrenal-thyroid system

2020 ◽  
Vol 03 (04) ◽  
pp. 69-73
Author(s):  
Samira Mammadhasan Yagubova ◽  
◽  
Elchin Chingiz Akbarov ◽  
Tarana Nadir Mirzayeva ◽  
◽  
...  
Keyword(s):  
Structural Changes ◽  
Adrenal Glands ◽  
Early Stage ◽  
Morphological Changes ◽  
Endocrine System ◽  
Staphylococcal Infection ◽  
The Body ◽  
Glandular Cells ◽  
Exogenous Factors ◽  
Specific Symptoms

During the staphylococcal infection, changes in the interaction of glandular cells, dystrophic and disorganizing pathologies in tissues, especially acute structural and hemodynamic changes in the stroma of the glands in the pituitary-adrenal-thyroid system, develop from the first day of the experiment. At the end of the experiment, on the background of a decrease in exudative processes, fibroplastic reactions are significantly activated, resulting in signs of incomplete regeneration – mainly sclerotic processes and cystic-atrophic changes in the parenchyma. Structural changes in tissues in the early stages of staphylococcal infection and the dynamics of development are characterized by specific symptoms in each of the glands. Since the pituitary gland is exposed to endogenous and exogenous factors earlier and more often than the adrenal glands, and the adrenal glands are earlier than the thyroid gland, dystrophic and destructive changes in the pituitary and adrenal glands are more pronounced at the early stage of the experiment. These morphological changes can change the hormonal status of the body and lead to dysfunction of the endocrine system as a whole – a decrease in the functional activity of the glands to some extent, and even inhibition of adenohypophyseal cells. Key words: staphylococcal infection, peritonitis, pituitary, adrenal and thyroid glands

Current perspective of COVID-19 on neurology: A mechanistic insight

2021 ◽  
Vol 24 ◽  
Author(s):  
Rajesh Kumar ◽  
Seetha Harilal ◽  
Sabitha M ◽  
Leena K Pappachan ◽  
P R Roshni ◽  
...  
Keyword(s):  
Cell Types ◽  
Systemic Circulation ◽  
Multiple Organ ◽  
Coagulation Cascade ◽  
Neurological Involvement ◽  
Causative Organism ◽  
Depth Study ◽  
Novel Coronavirus ◽  
Transmembrane Serine Protease ◽  
The Brain

: SARS-CoV-2, the novel coronavirus and the causative organism of Covid-19 pandemic wreaked havoc worldwide producing asymptomatic to symptomatic cases leading to significant morbidity and mortality even after infection. Most of the countries reported a mortality rate of 2-3 % majorly due to cardiorespiratory failures. Recent studies highlighted the neurological involvement playing a key role in cardiorespiratory failures and other symptoms such as headache, anosmia, and ageusia observed in Covid-19 patients. Studies suggests SARS-CoV-2 entry via olfactory epithelium (OE) and the expression of type 2 transmembrane serine protease (TMPRSS2) in addition to angiotensin converting enzyme 2 (ACE2) can facilitate SARS-CoV-2 neurotropism. The virus can either travel via peripheral blood vessel causing endothelial dysfunction, triggering coagulation cascade and multiple organ dysfunction or reach the systemic circulation and take a different route to the blood brain barrier (BBB), disrupting the BBB causing neuroinflammation or neuronal excitotoxicity resulting in the development of encephalitis, encephalopathy, seizures, and strokes. SARS-CoV-2 invasion on brain stem is believed to be responsible for the cardiorespiratory failures observed in Covid-19 patients. Apart from viral invasion via hematogenous route, SARS-CoV-2 neural invasion via PNS nerve terminal, resulting in viral replication and retrograde transportation to soma leading to invasion of the CNS including the brain producing neurological manifestations of the disease either in the initial stages or during the course of the disease and even in a long period post infection in many cases. The ACE2 receptors are expressed in the brain and glial cells and SARS-CoV-2 acts via neuronal as well as non-neuronal pathway. But the exact cell types involved and how they can trigger inflammatory pathways need further in-depth study for the development of targeted therapy.

Morphological Changes to Early Stage Taenia solium Cysticerci Following Oxfendazole Treatment

2003 ◽  
Vol 165 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Liu Yong-Jie ◽  
LI Qing-Zhang ◽  
Hao Yan-Hong
Keyword(s):  
Early Stage ◽  
Morphological Changes ◽  
Taenia Solium

scholarly journals Peroxisomal assembly: membrane proliferation precedes the induction of the abundant matrix proteins in the methylotrophic yeast Candida boidinii

1990 ◽  
Vol 96 (4) ◽  
pp. 583-590
Author(s):  
M. Veenhuis ◽  
J.M. Goodman
Keyword(s):  
Early Stage ◽  
Morphological Changes ◽  
Polyclonal Antibodies ◽  
Alcohol Oxidase ◽  
Methylotrophic Yeast ◽  
Candida Boidinii ◽  
Peroxisomal Membrane ◽  
Cell Induction ◽  
The Matrix ◽  
Dihydroxyacetone Synthase

Peroxisomes are massively induced when methylotrophic yeasts are cultured in medium containing methanol. These organelles contain enzymes that catalyze the initial steps of methanol assimilation. In Candida boidinii, a methylotrophic yeast, the peroxisomal matrix (internal compartment) is composed almost exclusively of two proteins, alcohol oxidase and dihydroxyacetone synthase; catalase is present in much lower abundance. Monoclonal and polyclonal antibodies are available against peroxisomal matrix and membrane proteins. These were utilized to correlate the induction of specific proteins with the morphological changes occurring during peroxisomal proliferation. Cells cultured in glucose-containing medium contain two to five small microbodies, which are identifiable by catalase staining and immunoreactivity with a monoclonal antibody against PMP47, an integral peroxisomal membrane protein. Three stages of proliferation can be distinguished when cells are switched to methanol as the carbon source. (1) There is an early stage (within 1 h) in which several peroxisomes develop from a preexisting organelle. This is accompanied by an increase in catalase activity and an induction of PMP47, but no detectable induction of alcohol oxidase or dihydroxyacetone synthase is observed. (2) From 1 to 2.5 h there is further division of these microbodies until up to 30 small peroxisomes generally are present in each of one or two clusters per cell. Induction of alcohol oxidase, dihydroxyacetone synthase and PMP20, a protein that is distributed in the matrix and membrane, is detectable during this time. Serial sections reveal that some peroxisomes remain uninduced while others undergo proliferation. Such sections also show no obvious connections between peroxisomes within clusters.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals The Impact of Armed Conflict on the Epidemiological Situation of COVID-19 in Libya, Syria and Yemen

2021 ◽  
Vol 9 ◽  
Author(s):  
Mohamed A. Daw
Keyword(s):  
Armed Conflict ◽  
Early Stage ◽  
Armed Conflicts ◽  
Cumulative Number ◽  
The Novel ◽  
Global Pandemic ◽  
Large Numbers ◽  
Public Data ◽  
Novel Coronavirus ◽  
The Impact

Background: Since the Arab uprising in 2011, Libya, Syria and Yemen have gone through major internal armed conflicts. This resulted in large numbers of deaths, injuries, and population displacements, with collapse of the healthcare systems. Furthermore, the situation was complicated by the emergence of COVID-19 as a global pandemic, which made the populations of these countries struggle under unusual conditions to deal with both the pandemic and the ongoing wars. This study aimed to determine the impact of the armed conflicts on the epidemiology of the novel coronavirus (SARS-CoV-2) within these war-torn countries and highlight the strategies needed to combat the spread of the pandemic and its consequences.Methods: Official and public data concerning the dynamics of the armed conflicts and the spread of SARS-COV-2 in Libya, Syria and Yemen were collected from all available sources, starting from the emergence of COVID-19 in each country until the end of December 2020. Datasets were analyzed by a set of statistical techniques and the weekly resolved data were used to probe the link between the intensity levels of the conflict and the prevalence of COVID-19.Results: The data indicated that there was an increase in the intensity of the violence at an early stage from March to August 2020, when it approximately doubled in the three countries, particularly in Libya. During that period, few cases of COVID-19 were reported, ranging from 5 to 53 cases/day. From September to December 2020, a significant decline in the intensity of the armed conflicts was accompanied by steep upsurges in the rate of COVID-19 cases, which reached up to 500 cases/day. The accumulative cases vary from one country to another during the armed conflict. The highest cumulative number of cases were reported in Libya, Syria and Yemen.Conclusions: Our analysis demonstrates that the armed conflict provided an opportunity for SARS-CoV-2 to spread. The early weeks of the pandemic coincided with the most intense period of the armed conflicts, and few cases were officially reported. This indicates undercounting and hidden spread during the early stage of the pandemic. The pandemic then spread dramatically as the armed conflict declined, reaching its greatest spread by December 2020. Full-blown transmission of the COVID-19 pandemic in these countries is expected. Therefore, urgent national and international strategies should be implemented to combat the pandemic and its consequences.

scholarly journals Epidemiological,clinical and radiological findings in medical staff with COVID-19 in Wuhan, China: a single-centered, retrospective cohort study

2020 ◽  
Author(s):  
Jie Liu ◽  
Liu Ouyang ◽  
Pi Guo ◽  
Haisheng Wu ◽  
Peng Fu ◽  
...  
Keyword(s):  
Small Proportion ◽  
Medical Staff ◽  
Cox Regression ◽  
Early Stage ◽  
Wholesale Market ◽  
Regression Methods ◽  
Kaplan Meier ◽  
Union Hospital ◽  
Potential Risk Factors ◽  
Novel Coronavirus

Abstract Backgrounds In December 2019, a pneumonia associated with the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) emerged in Wuhan city, China. As of 20 Feb 2020, a total of 2,055 medical staff infected with SARS-Cov-2 in China had been reported. The predominant cause of the infection and the failure of protection among medical staff remains unclear. We sought to explore the epidemiological, clinical characteristics and prognosis of novel coronavirus-infected medical staff.Methods Medical staff who infected with SARS-Cov-2 and admitted to Union Hospital, Wuhan between 16 Jan, 2020 to 25 Feb, 2020 were included retrospectively. Epidemiological, clinical and radiological data were compared by occupation and analyzed with the Kaplan-Meier and Cox regression methods.Results A total of 101 medical staff (32 males and 69 females; median age: 33 years old) were included in this study and 74% were nurses. None had an exposure to Huanan seafood wholesale market or wildlife. A small proportion of the cohort had contact with specimens (3%) as well as patients infected with SARS-Cov-2 in fever clinics (15%) and isolation wards (3%). 80% of medical staff showed abnormal IL-6 levels and 33% had lymphocytopenia. Chest CT mainly manifested as bilateral (62%), septal/subpleural (77%) and ground­glass opacities (48%). The major differences between doctors and nurses manifested in laboratory indicators. As of the last observed date, no patient was transferred to intensive care unit or died, and 98 (97%) had been discharged. Fever (HR=0.57; 95% CI 0.36-0.90) and IL-6 levels greater than >2.9 pg/ml (HR=0.50; 95% CI 0.30-0.86) on admission were unfavorable factors for discharge.Conclusions Our findings suggested that the infection of medical staff mainly occurred at the early stages of SARS-CoV-2 epidemic in Wuhan, and only a small proportion of infection had an exact mode. Meanwhile, medical staff infected with COVID-19 have relatively milder symptoms and favorable clinical course than other ordinary patients, which may be partly due to their medical expertise, younger age and less underlying diseases. The potential risk factors of presence of fever and IL-6 levels greater than >2.9 pg/ml could help to identify medical staff with poor prognosis at an early stage.

scholarly journals Dynamic Chest CT Evaluation in Three Cases of 2019 Novel Coronavirus Pneumonia

2020 ◽  
Vol 23 (4) ◽  
pp. 277-280 ◽  
Author(s):  
Xing Chen ◽  
Shuying Liu ◽  
Chunyi Zhang ◽  
Guimei Pu ◽  
Jian Sun ◽  
...  
Keyword(s):  
Ct Scan ◽  
Chest Ct ◽  
Ground Glass ◽  
Imaging Findings ◽  
Recent Outbreak ◽  
Multiple Regions ◽  
Ct Evaluation ◽  
Characteristic Features ◽  
Novel Coronavirus ◽  
Pulmonary Ct

A recent outbreak of pneumonia in Wuhan, China, was caused by the 2019 novel coronavirus (2019-nCoV). There have been some reports of imaging findings regarding the disease’s characteristic features. Here, we report three cases of coronavirus disease 2019 (COVID-19) with dynamic pulmonary CT evaluation. The CT scan showed multiple regions of ground-glass opacities and patchy consolidation in COVID-19 patients and the CT scan was useful in tracking the progression or regression of COVID-19.

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