Role of Chest X-Ray in Coronavirus Disease and Correlation of Radiological Features with Clinical Outcomes in Indian Patients

Recent literature has reported that radiological features of coronavirus disease (COVID-19) patients are influenced by computed tomography. This study aimed to assess the characteristic chest X-ray features of COVID-19 and correlate them with clinical outcomes of patients. This retrospective study included 120 COVID-19 patients. Baseline chest X-rays and serial chest X-rays were reviewed. A severity index in the form of maximum radiological assessment of lung edema (RALE) score was calculated for each lung, and scores of both the lungs were summed to obtain a final score. The mean ± standard deviation (SD) and frequency (%) were determined, and an unpaired t test, Spearman’s rank correlation coefficient, and logistic regression analyses were performed for statistical analyses. Among 120 COVID-19 patients, 74 (61.67%) and 46 (38.33%) were males and females, respectively; 64 patients (53.33%) had ground-glass opacities (GGO), 55 (45.83%) had consolidation, and 38 (31.67%) had reticular-nodular opacities, with lower zone distribution (50%) and peripheral distribution (41.67%). Baseline chest X-ray showed a sensitivity of 63.3% in diagnosing typical findings of SARS-CoV-2 pneumonia. The maximum RALE score was 2.13 ± 1.9 in hospitalized patients and 0.57 ± 0.77 in discharged patients ( p value <0.0001). Spearman’s rank correlation coefficient between maximum RALE score and clinical outcome parameters was as follows: age, 0.721 ( p value <0.00001); >10 days of hospital stay, 0.5478 ( p value <0.05); ≤10 days of hospital stay, 0.5384 ( p value <0.0001); discharged patients, 0.5433 ( p value <0.0001); and death, 0.6182 ( p value = 0.0568). The logistic regression analysis revealed that maximum RALE scores (0.0932 [0.024–0.367]), (10.730 [2.727–42.206]), (1.258 [0.990–1.598]), and (0.794 [0.625–1.009]) predicted discharge, death, >10 days of hospital stay, and ≤10 days of hospital stay, respectively. The study findings suggested that the RALE score can quantify the extent of COVID-19 and can predict the prognosis of patients.

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The Proportion and Radiological Features of Pneumoconiosis in Workers Exposed to Dust in The Workplace

Jurnal Respirologi Indonesia ◽

10.36497/jri.v39i4.89 ◽

2019 ◽

Vol 39 (4) ◽

pp. 266-271

Author(s):

Mukhtar Ikhsan

Keyword(s):

Pulmonary Tuberculosis ◽

X Rays ◽

International Labor Organization ◽

Cross Sectional ◽

X Ray ◽

Radiological Features ◽

International Labor ◽

Chest X Ray ◽

Sinus Obliteration ◽

Parenchymal Abnormalities

Background: One of the most common occupational diseases found in workplace is pneumoconiosis. The most disease is silicosis, which is lung disease caused by inhalation of dust containing free crystalline silica which afflicts tens of millions of workers in hazardous work and kill thousands of people worldwide. This study aimed to determine proportion and radiologic appearance of pneumoconiosis in workers exposed to dust in various industrial and mining processes. Method: This research used cross-sectional desaign, was conducted 2017 until September 2019 for various industrial and mining workers exposed to dust. Chest X-ray with digital radiography was read in International Classification of Pneumoconiosis Radiography from ILO version 2011, by a lung specialist who certified by The International Labor Organization (ILO) and The Asian Intensive Reader of Pneumoconiosis Project (AIR Pneumo). Results: ILO chest X-ray readings were carried out on 810 chest photos. Various radiological features of pneumoconiosis were obtained in 132 chest X-rays (16.2%), mostly abnormalities in parenchyma 87.1%. Parenchymal abnormalities are mostly of small round (p/p) with a profusion of 0/1 (89.6%). The most zones were lower right (58.1%). Pleural disorders (2%) mostly of costophrenic sinus obliteration 64.8%. Other disorders were 61/810 (7.24%), mostly of diaphragm abnormalities 15/61 (27.9%). Relevant appearance with pulmonary tuberculosis (infiltrates) was 8/810 (0.9%). Conclusion: The proportion of pneumoconiosis was 16.2%, mostly of parenchymal abnormalities (87.1%). Parenchymal abnormalities that occured still in the early phase, most zones were lower right (58.1%), pleural disorders 2%, other abnormalities were 7.24% and those that relevant to pulmonary tuberculosis 0.9%. (J Respir Indo. 2019; 39(4): 266-71)

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STUDY OF INFLAMMATORY MARKERS IN RELATION TO RADIOLOGICAL FINDINGS IN COVID 19

10.36106/ijsr/9604567 ◽

2021 ◽

pp. 48-50

Author(s):

Kalyanisri. Koneru ◽

V M Kiran Ogirala ◽

Kommavarapu. Kalyani Madhuri ◽

Bokam. Bhanu Rekha

Keyword(s):

Hospital Stay ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

X Rays ◽

X Ray ◽

Duration Of Hospital Stay ◽

Number Of Patients ◽

Chest X Ray ◽

Severity Of The Disease

BACKGROUND Currently, the Coronavirus disease 2019 (COVID-19) has become pandemic globally. Elevated inammatory markers are observed and are a common pathophysiological response to acute illness. Chest X-ray changes are also commonly seen in COVID -19 patients. The present study was undertaken to determine the relationship between inammatory markers to chest X-ray ndings in COVID-19 patients. METHODS This is a prospective observational study of COVID-19 patients admitted to tertiary care hospital from may 2020-November 2020. Comorbidities, inammatory markers, and Chest X ray were collected and analyzed. Correlations between radiological and inammatory markers were studied. AIMS & OBJECTIVES: Ÿ Correlation of inammatory markers to radiographic ndings and their outcome in COVID 19 patients Ÿ The outcome was studied in terms of: Ÿ Patients requiring oxygen/ NIVsupport Ÿ duration of hospital stay Ÿ Number of patients Recovered/death RESULTS: Ÿ Out of 500 patients studied, the mean age was 49.41 years, and (295)59% of patients were male,(205)41% were females. (455)91% patients discharged and (43)8.6% died. We found a positive correlation between inammatory markers and Chest X-ray ndings at the time of admission with a signicant statistical P-value. The inammatory markers CRP, ESR, D-Dimer & Sr.ferritin compared with the mode of ventilation(O2 & NIV, duration of hospital stay and outcome also showed signicant statistical P-value. CONCLUSIONS We conclude that in patients with raised inammatory markers there were increased abnormalities on Chest X-rays which required an increase in oxygen or NIVsupport. This can be a useful predictor of the severity of the disease and assessment of outcome.

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Heterotopic Ossification Following Decompression and Interspinous Dynamic Stabilization for Treating Lumbar Degenerative Disease Based on Minimum Follow-Up of Five Years and X-ray Imaging

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.3223 ◽

2020 ◽

Vol 10 (12) ◽

pp. 2952-2958

Author(s):

Haibo Lu ◽

Yong Hai ◽

Yangpu Zhang ◽

Li Guan ◽

Yuzeng Liu ◽

...

Keyword(s):

Confidence Interval ◽

Clinical Outcomes ◽

Rank Correlation ◽

Clinical Results ◽

Lumbar Degenerative Disease ◽

X Ray ◽

Spearman’S Rank Correlation ◽

Spearman’S Rank Correlation Coefficient ◽

X Ray Imaging ◽

Post Operation

Objective: Hetertopic ossiofication (HO) was considered one of the main adverse events following lumbar decompression and could negatively affect these patients' daily activity. However, there is still a lack of evidence to assess the association between the incidence of HO at surgical segment and clinical outcomes following the implantation of a Coflex™ device. The objective of this study is determine the association between the incidence of HO and clinical outcomes following implantation of a Coflex™ device based on X-ray imaging. Methodology: One hundred sixty-nine consecutive patients who underwent decompression and implantation of a Coflex™ device from December 2007 to January 2014 were studied. A logistic regression analysis was used to analyze complications and development of HO. Spearman's rank correlation coefficient was used to analyze the correlation between clinical results and the incidence of HO based on X-ray imaging. Results: All patients showed improvement from baseline in clinical outcomes at all time points up to 5 years post-operation (all p = 0.000). Preoperative range of motion (ROM) of operated segment had a positive relationship with the incidence of HO (r = 0.194, p = 0.012). No correlation exists between the incidence of HO and clinical outcomes. The odds ratio (OR) for development of complications in patients with Pfirrmann disc degeneration classification grades III and IV compared to those with grades 0, I and II was 3.003 (p = 0.005, 95% confidence interval, 1.621–34.195). In addition, the OR for the incidence of HO in the large ROM of the surgical segment compared to that in the normal/small ROM segment was 21.670 (p = 0.001, 95% confidence interval, 21.137–22.280). Conclusions: Our findings provide evidence that high Pfirrmann disc degenerative classification grades and a large ROM of the surgical segment were the main risk factors for complications and development of HO, respectively.

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Diagnostic chest X-rays and breast cancer risk among women with a hereditary predisposition to breast cancer unexplained by a BRCA1 or BRCA2 mutation

Breast Cancer Research ◽

10.1186/s13058-021-01456-1 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Maximiliano Ribeiro Guerra ◽

Juliette Coignard ◽

Séverine Eon-Marchais ◽

Marie-Gabrielle Dondon ◽

Dorothée Le Gal ◽

...

Keyword(s):

Breast Cancer ◽

Dna Repair ◽

Logistic Regression ◽

Dna Repair Genes ◽

X Rays ◽

Repair Gene ◽

X Ray ◽

Dna Repair Gene ◽

Chest X Ray ◽

Repair Genes

Abstract Background Diagnostic ionizing radiation is a risk factor for breast cancer (BC). BC risk increases with increased dose to the chest and decreases with increased age at exposure, with possible effect modification related to familial or genetic predisposition. While chest X-rays increase the BC risk of BRCA1/2 mutation carriers compared to non-carriers, little is known for women with a hereditary predisposition to BC but who tested negative for a BRCA1 or BRCA2 (BRCA1/2) mutation. Methods We evaluated the effect of chest X-rays from diagnostic medical procedures in a dataset composed of 1552 BC cases identified through French family cancer clinics and 1363 unrelated controls. Participants reported their history of X-ray exposures in a detailed questionnaire and were tested for 113 DNA repair genes. Logistic regression and multinomial logistic regression models were used to assess the association with BC. Results Chest X-ray exposure doubled BC risk. A 3% increased BC risk per additional exposure was observed. Being 20 years old or younger at first exposure or being exposed before first full-term pregnancy did not seem to modify this risk. Birth after 1960 or carrying a rare likely deleterious coding variant in a DNA repair gene other than BRCA1/2 modified the effect of chest X-ray exposure. Conclusion Ever/never chest X-ray exposure increases BC risk 2-fold regardless of age at first exposure and, by up to 5-fold when carrying 3 or more rare variants in a DNA repair gene. Further studies are needed to evaluate other DNA repair genes or variants to identify those which could modify radiation sensitivity. Identification of subpopulations that are more or less susceptible to ionizing radiation is important and potentially clinically relevant.

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Spontaneous Pneumomediastinum: Uncommon Cause of Air Leak in Late Preterm Neonate

Journal of Neonatology ◽

10.1177/09732179211023763 ◽

2021 ◽

Vol 35 (2) ◽

pp. 93-94

Author(s):

Jyotsna Bhushan ◽

Shagufta Iqbal ◽

Abhishek Chopra

Keyword(s):

Respiratory Distress ◽

Conservative Management ◽

Preterm Neonate ◽

Late Preterm ◽

Intravenous Fluids ◽

X Rays ◽

Blood Gas ◽

X Ray ◽

Spontaneous Pneumomediastinum ◽

Chest X Ray

A clinical case report of spontaneous pneumomediastinum in a late-preterm neonate, chest x-ray showing classical “spinnaker sail sign,” which was managed conservatively and had excellent prognosis on conservative management. Respiratory distress in a preterm neonate is a common clinical finding. Common causes include respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax. Pneumomediastinum is not very common cause of respiratory distress and more so spontaneous pneumomediastinum. We report here a preterm neonate with spontaneous pneumomediastinum who had excellent clinical recovery with conservative management. A male baby was delivered to G3P1A1 mother at 34 + 6 weeks through caesarean section done due to abruptio placenta. Apgar scores were 8 and 9. Maternal antenatal history was uneventful and there were no risk factors for early onset sepsis. Baby had respiratory distress soon after birth with Silverman score being 2/10. Baby was started on oxygen (O2) by nasal prongs through blender 0.5 l/min, FiO2 25%, and intravenous fluids. Blood gas done was normal. Possibility of transient tachypnea of newborn or mild hyaline membrane disease was kept. Respiratory distress increased at 20 h of life (Silverman score: 5), urgent chest x-ray done revealed “spinnaker sign” suggestive of pneumomediastinum, so baby was shifted to O2 by hood with FiO2 being 70%. Blood gas repeated was normal. Baby was managed conservatively on intravenous fluids and O2 by hood. Baby was gradually weaned off from O2 over next 5 days. As respiratory distress decreased, baby was started on orogastric feed, which baby tolerated well and then was switched to oral feeds. Serial x-rays showed resolution of pneumomediastinum. Baby was discharged on day 7 of life in stable condition on breast feeds and room air.

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Deregulation of lncRNA HIST1H2AG-6 and AIM1-3 in peripheral blood mononuclear cells is associated with newly diagnosed type 2 diabetes

BMC Medical Genomics ◽

10.1186/s12920-021-00994-z ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Hui Jiang ◽

Peian Lou ◽

Xiaoluo Chen ◽

Chenguang Wu ◽

Shihe Shao

Keyword(s):

Roc Curve ◽

Multivariate Logistic Regression Analysis ◽

Rank Correlation ◽

Differentially Expressed ◽

Healthy Controls ◽

Biological Functions ◽

Multivariate Logistic Regression ◽

Spearman’S Rank Correlation ◽

Spearman’S Rank Correlation Coefficient

Abstract Background Type 2 diabetes mellitus (T2DM) is mainly affected by genetic and environmental factors; however, the correlation of long noncoding RNAs (lncRNAs) with T2DM remains largely unknown. Methods Microarray analysis was performed to identify the differentially expressed lncRNAs and messenger RNAs (mRNAs) in patients with T2DM and healthy controls, and the expression of two candidate lncRNAs (lnc-HIST1H2AG-6 and lnc-AIM1-3) were further validated using quantitative real-time polymerase chain reaction (qRT-PCR). Spearman’s rank correlation coefficient was used to measure the degree of association between the two candidate lncRNAs and differentially expressed mRNAs. Furthermore, the KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway and GO (Gene Ontology) enrichment analysis were used to reveal the biological functions of the two candidate lncRNAs. Additionally, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. Results The microarray analysis revealed that there were 55 lncRNAs and 36 mRNAs differentially expressed in patients with T2DM compared with healthy controls. Notably, lnc-HIST1H2AG-6 was significantly upregulated and lnc-AIM1-3 was significantly downregulated in patients with T2DM, which was validated in a large-scale qRT-PCR examination (90 controls and 100 patients with T2DM). Spearman’s rank correlation coefficient revealed that both lncRNAs were correlated with 36 differentially expressed mRNAs. Furthermore, functional enrichment (KEGG and GO) analysis demonstrated that the two lncRNA-related mRNAs might be involved in multiple biological functions, including cell programmed death, negative regulation of insulin receptor signal, and starch and sucrose metabolism. Multivariate logistic regression analysis revealed that lnc-HIST1H2AG-6 and lnc-AIM1-3 were significantly correlated with T2DM (OR = 5.791 and 0.071, respectively, both P = 0.000). Furthermore, the ROC curve showed that the expression of lnc-HIST1H2AG-6 and lnc-AIM1-3 might be used to differentiate patients with T2DM from healthy controls (area under the ROC curve = 0.664 and 0.769, respectively). Conclusion The profiles of lncRNA and mRNA were significantly changed in patients with T2DM. The expression levels of lnc-HIST1H2AG-6 and lnc-AIM1-3 genes were significantly correlated with some features of T2DM, which may be used to distinguish patients with T2DM from healthy controls and may serve as potential novel biomarkers for diagnosis in the future.

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Accessory pathway analysis using a multimodal deep learning model

Scientific Reports ◽

10.1038/s41598-021-87631-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Makoto Nishimori ◽

Kunihiko Kiuchi ◽

Kunihiro Nishimura ◽

Kengo Kusano ◽

Akihiro Yoshida ◽

...

Keyword(s):

Deep Learning ◽

Electrophysiological Study ◽

Accessory Pathway ◽

Learning Model ◽

X Rays ◽

X Ray ◽

Wpw Syndrome ◽

Chest X Ray ◽

Deep Learning Model ◽

Ecg Data

AbstractCardiac accessory pathways (APs) in Wolff–Parkinson–White (WPW) syndrome are conventionally diagnosed with decision tree algorithms; however, there are problems with clinical usage. We assessed the efficacy of the artificial intelligence model using electrocardiography (ECG) and chest X-rays to identify the location of APs. We retrospectively used ECG and chest X-rays to analyse 206 patients with WPW syndrome. Each AP location was defined by an electrophysiological study and divided into four classifications. We developed a deep learning model to classify AP locations and compared the accuracy with that of conventional algorithms. Moreover, 1519 chest X-ray samples from other datasets were used for prior learning, and the combined chest X-ray image and ECG data were put into the previous model to evaluate whether the accuracy improved. The convolutional neural network (CNN) model using ECG data was significantly more accurate than the conventional tree algorithm. In the multimodal model, which implemented input from the combined ECG and chest X-ray data, the accuracy was significantly improved. Deep learning with a combination of ECG and chest X-ray data could effectively identify the AP location, which may be a novel deep learning model for a multimodal model.

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Association between Endoscopic Milk-White Mucosa, Epithelial Intracellular Lipid Droplets, and Histological Grade of Superficial Non-Ampullary Duodenal Epithelial Tumors

Diagnostics ◽

10.3390/diagnostics11050769 ◽

2021 ◽

Vol 11 (5) ◽

pp. 769

Author(s):

Yuko Hara ◽

Kenichi Goda ◽

Shinichi Hirooka ◽

Takehiro Mitsuishi ◽

Masahiro Ikegami ◽

...

Keyword(s):

Lipid Droplets ◽

Histological Grade ◽

Rank Correlation ◽

Intraepithelial Neoplasia ◽

Low Grade ◽

Intracellular Lipid ◽

En Bloc ◽

Spearman’S Rank Correlation ◽

Spearman’S Rank Correlation Coefficient ◽

Positive Rate

We previously reported that superficial non-ampullary duodenal tumors (SNADETs) commonly had a whitish mucosal surface, named milk-white mucosa (MWM). The aim of this study was to evaluate the association of MWM with epithelial intracellular lipid droplets (immunohistochemically stained by adipose differentiation-related protein (ADRP)) and histological tumor grades. We reviewed endoscopic images and the histopathology of SNADETs resected en bloc endoscopically. We analyzed the correlation between the positive rates of endoscopic MWM in preoperative endoscopy and resected specimens, and ADRP-positive rates in the resected specimens. Associations between the MWM-positive rates and tumor grades, high-grade intraepithelial neoplasia (HGIN)/intramucosal carcinoma (IC), and low-grade intraepithelial neoplasia (LGIN) were analyzed. All the 92 SNADETs analyzed were <20 mm and histologically classified into 39 HGIN/IC and 53 LGIN. Spearman’s rank correlation coefficient showed a significant correlation between MWM-positive and ADRP-positive rates (p < 0.001). MWM-positive rates were significantly lower in the HGIN/IC than in the LGIN in preoperative endoscopy (p < 0.001) and resected specimens (p = 0.02). Our results suggest that endoscopic MWM is closely associated with epithelial intracellular lipid droplets and that the MWM-positive rate may be a predictor of histological grade in small SNADETs.

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3D Imaging in Unilateral Primary Pulmonary Hypoplasia in an Adult: A Case Report

Case Reports in Radiology ◽

10.1155/2011/659586 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6

Author(s):

Aristida Georgescu ◽

Crinu Nuta ◽

Simona Bondari

Keyword(s):

3D Imaging ◽

Pulmonary Hypoplasia ◽

Left Lung ◽

Left Lobe ◽

X Rays ◽

X Ray ◽

Female Smoker ◽

Multidetector Computer Tomography ◽

Biological Tests ◽

Chest X Ray

Unilateral primary pulmonary hypoplasia is rare in adulthood (UPHA); it is characterized by a decreased number of bronchial segmentation and decreased/absent alveolar air space. Classical chest X-ray may be confusing, and the biological tests are unspecific. We present a case of UPHA in a 60-year-old female, smoker, with 3 term normal deliveries, who presented with late recurrent pneumonias and bronchiectasis-type symptomathology, arterial hypertension, and obesity. Chest X-rays revealed opacity in the left lower pulmonary zone, an apparent hypoaerated upper left lobe and left deviation of the mediastinum. Preoperatory multidetector computer tomography (MDCT) presented a small retrocardiac left lung with 5-6 bronchial segmentation range and cystic appearance. After pneumonectomy the gross specimen showed a small lung with multiple bronchiectasis and small cysts, lined by hyperplasic epithelium, surrounded by stromal fibrosclerosis. We concluded that this UPHA occurred in the 4–7 embryonic weeks, and the 3D MDCT reconstructions offered the best noninvasive diagnosis.

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Correlation between nasopharyngoscopy and cephalometry in the diagnosis of hyperplasia of the pharyngeal tonsils

International Archives of Otorhinolaryngology ◽

10.7162/s1809-97772012000200009 ◽

2012 ◽

Vol 16 (02) ◽

pp. 209-216 ◽

Cited By ~ 1

Author(s):

Luana Berwig ◽

Ana da Silva ◽

Eliane Corrêa ◽

Eliane Serpa ◽

Rodrigo Ritzel

Keyword(s):

Quantitative Study ◽

Fiber Optic ◽

Rank Correlation ◽

Accurate Diagnosis ◽

Cross Sectional ◽

Significance Level ◽

Spearman’S Rank Correlation ◽

Spearman’S Rank Correlation Coefficient ◽

Tonsil Hyperplasia ◽

Pharyngeal Tonsil

Summary Introduction: Hyperplasia of the pharyngeal tonsil is one of the main causes of mouth breathing, and accurate diagnosis of this alteration is important for proper therapeutic planning. Therefore, studies have been conducted in order to provide information regarding the procedures that can be used for the diagnosis of pharyngeal obstruction. Objective: To verify the correlation between nasopharyngoscopy and cephalometric examinations in the diagnosis of pharyngeal tonsil hyperplasia. Method: This was a cross-sectional, clinical, experimental, and quantitative study. Fifty-five children took part in this study, 30 girls and 25 boys, aged between 7 and 11 years. The children underwent nasofibropharyngoscopic and cephalometric evaluation to determine the grade of nasopharyngeal obstruction. The Spearman's rank correlation coefficient at the 5% significance level was used to verify the correlation between these exams. Results: In the nasopharyngoscopy evaluation, most children showed grade 2 and 3 hyperplasia of the pharyngeal tonsil, which was followed by grade 1. In the cephalometry assessment, most children showed grade 1 hyperplasia of the pharyngeal tonsil, which was followed by grade 2. A statistically significant regular positive correlation was observed between the exams. Conclusion: It was concluded that the evaluation of the pharyngeal tonsil hyperplasia could be carried out by fiber optic nasopharyngoscopy and cephalometry, as these examinations were regularly correlated. However, it was found that cephalometry tended to underestimate the size of the pharyngeal tonsil relative to nasopharyngoscopy.

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