scholarly journals Six-month pulmonary impairment after severe COVID-19: a prospective, multicenter follow-up study

2021 ◽  
Author(s):  
Paola Faverio ◽  
Fabrizio Luppi ◽  
Paola Rebora ◽  
Sara Busnelli ◽  
Anna Stainer ◽  
...  
Keyword(s):  
Protective Factor ◽  
Pulmonary Function Tests ◽  
Invasive Mechanical Ventilation ◽  
Ventilatory Support ◽  
X Ray ◽  
Heparin Administration ◽  
Observational Cohort ◽  
Chest X Ray

Background and objective. Long-term pulmonary sequelae following SARS-CoV-2 pneumonia are not yet confirmed, however preliminary observations suggests a possible relevant clinical, functional and radiological impairment. The aim of this study was to identify and characterise pulmonary sequelae caused by SARS-CoV-2 pneumonia at 6-month follow-up. Methods. In this multicenter, prospective, observational cohort study, patients hospitalised for SARS-CoV-2 pneumonia and without prior diagnosis of structural lung diseases were stratified by maximum ventilatory support (oxygen only, continuous positive airway pressure (CPAP) and invasive mechanical ventilation (IMV)) and followed up at 6 months from discharge. Pulmonary function tests and diffusion capacity for carbon monoxide (DLCO), 6 minutes walking test, chest X-ray, physical exam and modified Medical Research Council (mMRC) dyspnoea score were collected. Results. Between March and June 2020, 312 patients were enrolled (83, 27% women; median [IQR] age 61.1 [53.4,69.3] years). The parameters that showed the highest rate of impairment were DLCO and chest-X-ray, in 46% and 25% of patients, respectively. However, only a minority of patients reported dyspnoea (31%), defined as mMRC ≥ 1, or showed a restrictive ventilatory defects (9%). In the logistic regression model, having asthma as comorbidity was associated with DLCO impairment at follow-up, while prophylactic heparin administration during hospitalisation appeared as a protective factor. Need for invasive ventilatory support during hospitalisation was associated with chest imaging abnormalities. Conclusion. DLCO and radiological assessment appear to be the most sensitive tools to monitor patients with COVID-19 during follow-up. Future studies with longer follow-up are warranted to better understand pulmonary sequelae.

scholarly journals Six-Month Pulmonary Impairment after Severe COVID-19: A Prospective, Multicentre Follow-Up Study

Respiration ◽  
2021 ◽  
pp. 1-10
Author(s):  
Paola Faverio ◽  
Fabrizio Luppi ◽  
Paola Rebora ◽  
Sara Busnelli ◽  
Anna Stainer ◽  
...  
Keyword(s):  
Protective Factor ◽  
Pulmonary Function Tests ◽  
Invasive Mechanical Ventilation ◽  
Ventilatory Support ◽  
X Ray ◽  
Heparin Administration ◽  
Observational Cohort ◽  
Chest X Ray

<b><i>Background:</i></b> Long-term pulmonary sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia are not yet confirmed; however, preliminary observations suggest a possible relevant clinical, functional, and radiological impairment. <b><i>Objectives:</i></b> The aim of this study was to identify and characterize pulmonary sequelae caused by SARS-CoV-2 pneumonia at 6-month follow-up. <b><i>Methods:</i></b> In this multicentre, prospective, observational cohort study, patients hospitalized for SARS-CoV-2 pneumonia and without prior diagnosis of structural lung diseases were stratified by maximum ventilatory support (“oxygen only,” “continuous positive airway pressure,” and “invasive mechanical ventilation”) and followed up at 6 months from discharge. Pulmonary function tests and diffusion capacity for carbon monoxide (DLCO), 6-min walking test, chest X-ray, physical examination, and modified Medical Research Council (mMRC) dyspnoea score were collected. <b><i>Results:</i></b> Between March and June 2020, 312 patients were enrolled (83, 27% women; median interquartile range age 61.1 [53.4, 69.3] years). The parameters that showed the highest rate of impairment were DLCO and chest X-ray, in 46% and 25% of patients, respectively. However, only a minority of patients reported dyspnoea (31%), defined as mMRC ≥1, or showed restrictive ventilatory defects (9%). In the logistic regression model, having asthma as a comorbidity was associated with DLCO impairment at follow-up, while prophylactic heparin administration during hospitalization appeared as a protective factor. The need for invasive ventilatory support during hospitalization was associated with chest imaging abnormalities. <b><i>Conclusions:</i></b> DLCO and radiological assessment appear to be the most sensitive tools to monitor patients with the coronavirus disease 2019 (COVID-19) during follow-up. Future studies with longer follow-up are warranted to better understand pulmonary sequelae.

scholarly journals Six-month Pulmonary Impairment After Severe COVID-19: a Prospective, Multicenter Follow-up Study

2021 ◽  
Author(s):  
Paola Faverio ◽  
Fabrizio Luppi ◽  
Paola Rebora ◽  
Sara Busnelli ◽  
Anna Stainer ◽  
...  
Keyword(s):  
Protective Factor ◽  
Pulmonary Function Tests ◽  
Invasive Mechanical Ventilation ◽  
Ventilatory Support ◽  
X Ray ◽  
Heparin Administration ◽  
Observational Cohort ◽  
Chest X Ray

Abstract Background. Long-term pulmonary sequelae following SARS-CoV-2 pneumonia are not yet confirmed, however preliminary observations suggests a possible relevant clinical, functional and radiological impairment. The aim of this study was to identify and characterise pulmonary sequelae caused by SARS-CoV-2 pneumonia at 6-month follow-up. Methods. In this multicenter, prospective, observational cohort study, patients hospitalised for SARS-CoV-2 pneumonia and without prior diagnosis of structural lung diseases were stratified by maximum ventilatory support (“oxygen only”, “continuous positive airway pressure (CPAP)” and “invasive mechanical ventilation (IMV)”) and followed up at 6 months from discharge. Pulmonary function tests and diffusion capacity for carbon monoxide (DLCO), 6 minutes walking test, chest X-ray, physical exam and modified Medical Research Council (mMRC) dyspnoea score were collected.Results. Between March and June 2020, 312 patients were enrolled (83, 27% women; median [IQR] age 61.1 [53.4,69.3] years). The parameters that showed the highest rate of impairment were DLCO and chest-X-ray, in 46% and 25% of patients, respectively. However, only a minority of patients reported dyspnoea (31%), defined as mMRC ≥ 1, or showed a restrictive ventilatory defects (9%). In the logistic regression model, having asthma as comorbidity was associated with DLCO impairment at follow-up, while prophylactic heparin administration during hospitalisation appeared as a protective factor. Need for invasive ventilatory support during hospitalisation was associated with chest imaging abnormalities.Conclusions. DLCO and radiological assessment appear to be the most sensitive tools to monitor patients with COVID-19 during follow-up. Future studies with longer follow-up are warranted to better understand pulmonary sequelae.ClinicalTrials.gov Identifier: NCT04435327

Randomized multicenter study on long-term complications of peripherally inserted central catheters positioned by electrocardiographic technique

2020 ◽  
Vol 35 (8) ◽  
pp. 614-622
Author(s):  
Yu-Xia Yin ◽  
Wei Gao ◽  
Xu-Ying Li ◽  
Wei Lu ◽  
Qian-Hong Deng ◽  
...  
Keyword(s):  
Control Group ◽  
Exit Site ◽  
Peripherally Inserted Central Catheters ◽  
Exit Site Infection ◽  
X Ray ◽  
Length Estimation ◽  
Chest X Ray ◽  
Central Catheters

Background The intracavitary electrocardiogram (IC-ECG) method has been used for the tip location of central venous access devices for the advantage of being safe, accurate and highly cost effective. However, long-term follow-up is rare. This randomized clinical trial aimed to evaluate the long-term complications of peripherally inserted central catheters (PICCs) positioned by the IC-ECG method. Methods We randomized 2250 patients who needed PICC placement to either a landmark length estimation supplemented by IC-ECG positioned group (ECG group) or the traditional landmark length estimation alone group (control group) in a 2:1 allocation. Post-procedural chest X-rays were applied to confirm tip position. Follow-up was performed monthly to six months. Standard statistics analyses were performed with the SAS 9.13 software, and p < 0.05 was considered significant. Results As evaluated by post-procedural chest X-ray, tip location in the ECG group had a first-attempt success (catheter tip located at optimal position) of 91.7% (95% confidence interval (CI): 90.3%–93.1%), significantly higher than 78.9% (95% CI: 76.0%–81.9%) observed in the control group (p < 0.001). At six-month follow-up, in the control group, frequency of total complications was 9.5%, including the exit site infection (4.0%), phlebitis (1.3%), deep venous thrombosis (1.5%), liquid extravasation (2.9%) and mechanical failure (1.9%). The IC-ECG group had significantly lower rates of complications (6.4%, p < 0.001), including the exit site infection (2.7%, p > 0.05), phlebitis (1.1%, p > 0.05), deep venous thrombosis (1.2%, p > 0.05), liquid extravasation (2.4%, p > 0.05) and mechanical failure (1.2%, p > 0.05). In the univariable logistic regression analysis, ECG method, other diseases and upper arms were the independent protective factors, and the number of adjustment procedures (n ≥ 2) were the independent risk factors of the complications. Conclusions The intra-procedural tip location by IC-ECG is more safe and accurate than the traditional method of verifying tip location only post-procedurally, by chest X-ray.

Lateral view of chest x-ray in long-term follow-up of Kawasaki disease as a useful screening method for the cardiac sequela

1983 ◽  
Vol 25 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Toshihiro Ino ◽  
Hiraku Nishimoto ◽  
Masazumi Iwahara ◽  
Masashi Abe ◽  
Hiroshi Nittono
Keyword(s):  
Kawasaki Disease ◽  
Screening Method ◽  
Lateral View ◽  
X Ray ◽  
Long Term Follow Up ◽  
Chest X Ray

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

Childhood Fever: Correlation of Diagnosis With Temperature Response to Acetaminophen

PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 315-318
Author(s):  
M. Douglas Baker ◽  
Patricia D. Fosarelli ◽  
Richard O. Carpenter
Keyword(s):  
Patient Management ◽  
Temperature Response ◽  
Pediatric Emergency ◽  
Bacterial Disease ◽  
X Ray ◽  
Chest X Ray ◽  
Antipyretic Treatment ◽  
Fever Response ◽  
Childhood Fever

Many people believe that temperature response to antipyretics in febrile children varies according to diagnosis. To evaluate the validity of this premise, we prospectively studied the temperature response to acetaminophen of febrile children who came to an urban pediatric emergency and walk-in facility. The study group consisted of 1,559 patients between the ages of 8 weeks and 6 years whose temperatures when seen were greater than 38.4°C and who had not received antipyretic treatment within the previous four hours. Acetaminophen (15 mg/kg) was administered to each child and repeat temperatures were taken one and two hours later. Patient management was unaffected by the study, and physicians were unaware of the repeat temperature measurements. Telephone follow-up was conducted with the parents of each child within five days of the initial visit. Children with cultures positive for bacterial disease or chest x-ray films positive for pneumonia had slightly greater one- and two-hour temperature decreases compared with children with other diagnoses. Although statistically significant, we do not consider these differences in response to be clinically useful. We conclude that fever response to acetaminophen is not a clinically useful indicator by which to differentiate the causes of febrile illnesses in young children.

Classification of Fresh Fractures of the Lunate

1988 ◽  
Vol 13 (4) ◽  
pp. 458-462
Author(s):  
H. TEISEN ◽  
J. HJARBAEK
Keyword(s):  
Vascular Anatomy ◽  
X Rays ◽  
Lunate Bone ◽  
X Ray

The X-rays of 17 patients with fresh fractures of the lunate bone have been reviewed. The fractures were classified according to their radiological appearances and according to the vascular anatomy of the lunate. A long term X-ray follow-up examination was performed.

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