Are Subpleural Consolidations on Lung Ultrasound Early Findings of Acute Chest Syndrome?

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4869-4869
Author(s):  
Stephanie G. Cohen ◽  
Zayir M Malik ◽  
Robert Hagbom ◽  
Samuel H Friedman ◽  
Stephen T Russell ◽  
...  
Keyword(s):  
Statistical Difference ◽  
Lung Ultrasound ◽  
Imaging Modality ◽  
Acute Chest Syndrome ◽  
P Value ◽  
Pediatric Radiologist ◽  
Likelihood Ratios ◽  
Convenience Sample ◽  
Lung Consolidation ◽  
Number Of Patients

Abstract Background: Acute chest syndrome (ACS) is a common complication in patients with sickle cell disease (SCD) and is a leading cause of morbidity and mortality.Chest X-ray (CXR) is recommended for evaluating ACS in patients with SCD because clinical findings alone have a low sensitivity. Children with SCD are repeatedly exposed to diagnostic radiation for the evaluation of ACS. Lung ultrasound (LUS) has been compared to CXR as an alternative imaging modality for evaluating ACS, and a lung consolidation > 1 cm is sensitive and specific for diagnosing patients with ACS. Consolidations < 1 cm, or subpleural consolidations, can detect pneumonia earlier than CXR; however, the significance of these findings for evaluating ACS is unknown. We evaluated LUS with consolidations <1 cm to determine if they could identify patients with ACS. Methods: This is a prospective observational study that took place from November 2014-July 2016 in 2 urban pediatric emergency departments (EDs). The study population consisted of a convenience sample of patients with SCD from birth to 18 years of age at risk for ACS and who received a clinically-indicated CXR for suspected ACS. ACS was defined as a new pulmonary infiltrate on CXR together with the presence of fever, cough, chest pain, or respiratory symptoms. LUS were performed to evaluate for lung consolidation and determine the sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-) of LUS to identify ACS. In a subanalysis, the charts of patients who had a negative CXR interpreted by a pediatric radiologist or consolidation < 1 cm on LUS at the time of enrollment were reviewed for development of ACS within 7 days of the visit. The development of ACS in patients with subpleural findings on LUS was compared to patients with negative ultrasound findings. Fischer's-Exact Test was used to determine significance between the 2 groups with α = 0.05. Results: One hundred sixty-eight patients were enrolled. ACS was diagnosed in 14% of patients, while a CXR was negative in 150 cases. The sensitivity of LUS to predict ACS was 91%, specificity was 91%, LR+ 10.5, LR- 0.1. Thirty-six cases had subpleural consolidation on LUS and 3 patients (8%) developed ACS. Of the 114 patients with negative LUS, 7 (6%) developed ACS. There was no statistical difference between these groups with p-value of 0.7. Conclusions: Patients with subpleural consolidations on LUS were no more likely to develop ACS than those patients with a negative LUS. The small number of patients who developed ACS may have failed to show a statistical difference between these groups. Further studies with serial ultrasound examinations are needed to better define the significance of this finding. Disclosures Morris: MAST: Research Funding; Pfizer: Consultancy; Calithera: Consultancy; Nourish Life: Patents & Royalties: I am the inventor of IP owned by UCSF-Benioff Children's Hospital that is licensed to NL; Endeavor: Consultancy; Nestle: Honoraria.

Impact of COVID-19 Lockdown on Ocular Trauma in Benghazi, Libya

2021 ◽  
pp. 53-57
Author(s):  
Mariam Gebril ◽  
Bahjah Esehiyb ◽  
Suliman Masoud
Keyword(s):  
Statistical Difference ◽  
Surgical Intervention ◽  
Ocular Trauma ◽  
Public Health Problem ◽  
P Value ◽  
Eye Trauma ◽  
Number Of Patients ◽  
The World ◽  
The Impact ◽  
Similar Incidence

Background. COVID-19 is a new pandemic that spread over the world in 2020, for which most countries imposed rigorous lockdown to reduce its upsurge and thus its socioeconomics’ sever effects. Global measures include isolation, social distancing, lockdown any nonemergency facilities, local and international travelling restrictions. But these rules are implacable in case of trauma in general and more with ocular trauma, which represents a serious public health problem and leading cause of visual impairment. The aim of this study was to evaluate the impact of COVID -19 lock down on number of ocular traumas acquiring surgery. Methods. A retrospective study in Aljala trauma hospital in the period from 18 March to 18 April 2020 on patients who underwent surgical intervention for non-war eye trauma. Results. A total number of patients seen in emergency department were 350 patients in 2020 with four patients needed hospital admission and surgical intervention making a 1.14% of total number. While number of patients seen at the same time in 2019 were 965 patients and three patients needed surgical intervention (0.31%). There was no statistical difference in the amount of patient acquiring surgical intervention in the two periods with the P value of >0.05 Conclusion. Although total emergency eye visits decreased during the covid-19 lockdown period, similar incidence of surgery needed ocular trauma persisted.

scholarly journals Effectiveness of Lung Ultrasound in Comparison with Chest X-Ray in Diagnosis of Lung Consolidation

2019 ◽  
Vol 7 (15) ◽  
pp. 2457-2461
Author(s):  
Youssef Ibrahim Haggag ◽  
Karim Mashhour ◽  
Kamal Ahmed ◽  
Nael Samir ◽  
Waheed Radwan
Keyword(s):  
Lung Ultrasound ◽  
Community Acquired Pneumonia ◽  
P Value ◽  
Initial Examination ◽  
X Ray ◽  
Chest Ultrasound ◽  
Lung Consolidation ◽  
Plain Chest ◽  
Chest X Ray

BACKGROUND: Lung ultrasound (US) is an available and inexpensive tool for the diagnosis of community-acquired pneumonia (CAP); it which has no hazards of radiation and can be easily used. AIM: To evaluate the efficacy of lung ultrasound in the diagnosis and follow-up of CAP. PATIENTS AND METHODS: 100 patients aged from 40 to 63 years with a mean age of 52.3 ± 10 years admitted to the Critical Care Department, Cairo University with pictures of CAP. Lung US was performed for all patients initially, then a plain chest X-ray (CXR) was performed. Another lung ultrasound was performed on the 10th day after admission. RESULTS: Initial chest X-ray was correlated with the initial chest ultrasound examination in CAP diagnosis (R-value = 0.629, P < 0.001). Cohen's κ was run to determine if there is an agreement between the findings of the initial chest X-ray findings and those of the initial chest ultrasound in CAP diagnosis. A moderate agreement was found where κ = .567 (95% CI, 0.422 to 0.712) and P < 0.001. Upon initial examination, the CXR diagnosed CAP in 48.0% of patients, while lung US diagnosed the disease in 70% of patients. Moreover, lung US was more sensitive than CXR (P-value < 0.001). Compared to the accuracy of computed tomography (CT) chest (100%) which is the gold standard for CAP diagnosis, the accuracy of lung US was 95.0%, while the accuracy of CXR was 81.0%. CONCLUSION: This study proved the effectiveness of lung ultrasound in CAP diagnosis.

scholarly journals Advances in lung ultrasound

2016 ◽  
Vol 14 (3) ◽  
pp. 443-448 ◽  
Author(s):  
Miguel José Francisco Neto ◽  
Antonio Rahal Junior ◽  
Fabio Augusto Cardillo Vieira ◽  
Paulo Savoia Dias da Silva ◽  
Marcelo Buarque de Gusmão Funari
Keyword(s):  
Lung Ultrasound ◽  
Imaging Modality ◽  
Quantitative Information ◽  
Chest Ultrasonography ◽  
Qualitative And Quantitative ◽  
Lung Consolidation ◽  
Pathological Conditions ◽  
Pleural Line ◽  
Sonographic Patterns ◽  
B Lines

ABSTRACT Ultrasound examination of the chest has advanced in recent decades. This imaging modality is currently used to diagnose several pathological conditions and provides qualitative and quantitative information. Acoustic barriers represented by the aerated lungs and the bony framework of the chest generate well-described sonographic artifacts that can be used as diagnostic aids. The normal pleural line and A, B, C, E and Z lines (also known as false B lines) are artifacts with specific characteristics. Lung consolidation and pneumothorax sonographic patterns are also well established. Some scanning protocols have been used in patient management. The Blue, FALLS and C.A.U.S.E. protocols are examples of algorithms using artifact combinations to achieve accurate diagnoses. Combined chest ultrasonography and radiography are often sufficient to diagnose and manage lung and chest wall conditions. Chest ultrasonography is a highly valuable diagnostic tool for radiologists, emergency and intensive care physicians.

Corticosteroids and Increased Risk of Readmission after Acute Chest Syndrome.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2329-2329
Author(s):  
John J. Strouse ◽  
Clifford M. Takemoto ◽  
Jeffrey R. Keefer ◽  
James F. Casella
Keyword(s):  
Risk Factors ◽  
Severity Of Illness ◽  
Clinical Severity ◽  
Johns Hopkins Hospital ◽  
Acute Chest Syndrome ◽  
P Value ◽  
High Dose ◽  
Pulmonary Infiltrates ◽  
Number Of Patients ◽  
Increased Risk

Abstract Acute chest syndrome (ACS) is a cause of frequent hospitalization and death in patients with sickle cell disease (SCD). Therapies commonly used include antibiotics, inhaled B-agonists, oxygen, high-dose dexamethasone and transfusions. Although corticosteroids appear to speed resolution of ACS, the frequency of rebound vasoocclusive crises has not been adequately assessed. We conducted a retrospective cohort study to characterize risk factors for readmission after ACS. We included patients <22 years of age hospitalized at Johns Hopkins Hospital from January 1998 to April 2004 for ACS. We identified cases using the hospital’s discharge database (ICD-9 codes for ACS, pneumonia, asthma, respiratory symptoms and respiratory failure) and by reviewing dictated summaries. We defined ACS as a new pulmonary infiltrate and ≥2 of the following: chest, rib or upper abdominal pain; fever; dyspnea; tachypnea; grunting; nasal flaring; or retractions. We defined severe ACS as lethargy, marked respiratory distress, an oxygen saturation of <85% with supplemental oxygen or extensive pulmonary infiltrates. We used a respiratory clinical severity score (RCSS) wherein normal respirations=0, tachypnea for age=1 and tachypnea and retractions=2. We recorded baseline characteristics, severity of illness, treatments given, duration of hospitalization and readmissions within 14 days of discharge. We compared variables by ANOVA and calculated odds ratios for readmission using univariate and multivariate logistic regression with adjustment for clustering and robust estimates of errors. We identified 62 patients with 127 episodes of ACS (mean age 12.5 years, range 1.2 to 21.9 years); 114 had definite new pulmonary infiltrates and 13 had probable. Nineteen episodes of ACS were severe; males had more episodes (64%) than females. Patients presented with tachypnea (90%), fever (83%) and pain (78%) and received antibiotics (98%), oxygen (80%) and bronchodilators (71%). Thirty-nine episodes were treated with corticosteroids (dexamethasone in 32 and prednisone in 5) and 42 with transfusions (exchange in 12). Corticosteroids were tapered in 18. Age, clinical severity, duration of ACS and frequency of wheezing and readmission were different among treatment groups. In the multivariate analysis, readmission was associated with use of inhalers at home before presentation (OR 6.2, 95% CI 1.7–22, p<0.01), higher SBP (OR 2.0 per 10 mm Hg increase, 95% CI 1.2–3.4, p<0.01) and RCSS (OR 7.2, 95% CI 2.1–25, p<0.005) at diagnosis and treatment with corticosteroids (OR 10, 95% CI 2.1–51, p<0.005). Transfusion (OR 0.02, 95% CI 0.001–0.3, p<0.01), but not corticosteroid taper, was associated with decreased readmission. Children and young adults with SCD are often readmitted after treatment for ACS. Risk factors for readmission likely include corticosteroids, severity of ACS and asthma. Our results suggest an unacceptable frequency of readmission after corticosteroids. Transfusion, but not a taper of corticosteroids, may reduce this risk. Limitations of this study include the retrospective design and small number of patients that received a taper. Patient Characteristics by Treatment Supportive N=64 Corticosteroids N=20 Transfusion N=23 Corticosteroids and Transfusion N=19 P-value Age 13±6 11±4 13±5 9±3 <0.05 RR 24±6 31±13 34±13 36±10 <0.0001 Involved lobes 1.2±0.4 1.4±0.6 1.7±0.8 1.7±0.8 <0.005 Wheezing (%) 11 15 9 42 <0.01 ACS (days) 3.5±1.5 3.4±1.7 4.7±2.2 5±3.9 <0.0001 Readmission (%) 13 60 9 26 <0.0001

Utility of Lung Ultrasound for Evaluating Acute Chest Syndrome in Pediatric Patients with Sickle Cell Disease

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 980-980
Author(s):  
Stephanie G. Cohen ◽  
Zayir M Malik ◽  
Robert Hagbom ◽  
Adina L Alazraki ◽  
April G. Zmitrovich ◽  
...  
Keyword(s):  
At Risk ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Conflicts Of Interest ◽  
Positive Likelihood Ratio ◽  
Observer Agreement ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Convenience Sample ◽  
Lung Consolidation

Abstract Background: Acute chest syndrome (ACS) is a common complication in patients with sickle cell disease (SCD) and is a leading cause of morbidity and mortality. Physical assessment alone is not sensitive for diagnosing ACS and therefore Chest x-ray (CXR) is recommended because of the difficulty of diagnosing ACS on clinical grounds alone. Children with SCD are repeatedly exposed to diagnostic radiation for the evaluation of ACS. Focused chest ultrasound (US) has been used to evaluate for lung consolidation. If lung US can identify patients with ACS this application could potentially limit radiation exposure in patients with SCD at risk for ACS. We evaluated the utility of physician performed US as compared to CXR to identify patients with SCD who have ACS. Methods: This is a prospective observational study that took place from November 2014-July 2015 in 2 urban pediatric emergency departments (EDs). The study population consisted of a convenience sample of patients with SCD from birth to 18 years of age at risk for ACS and who received a CXR for suspected ACS. Medical students and clinicians with training in lung sonography consented patients and performed a focused study to evaluate for lung consolidation. A blinded expert in point-of-care US reviewed for quality assurance and agreement. Sensitivity, specificity, and likelihood ratios were calculated for test performance characteristics of ultrasound using CXR as a reference standard. Inter-observer agreement (κ) between enrolling sonologists and reviewer was also calculated. Results: 85 patients were enrolled for a total of 98 cases. Median age was 7 years (IQR 2-13 years) and 53% of patients were male. The prevalence of ACS by CXR was 14%. Lung US was able to detect consolidation with a sensitivity of 86% (95% CI, 56-97%), specificity of 95% (95% CI, 87%-98%), positive likelihood ratio (LR) 18 (95% CI, 7-48) and negative LR 0.2 (95% CI, 0.04-0.5). The agreement between enrolling novice sonologists' interpretation and blinded reviewer's interpretation was very good with a Cohen κ of 0.86 (95% CI, 0.7-1). Conclusions: Focused lung US was able to identify ACS with high specificity. There was very good agreement between novice and expert sonologist interpretation. Lung US may decrease the need for CXR in patients at risk for ACS. Further studies are needed to see how this test performs within current clinical practice guidelines. Disclosures No relevant conflicts of interest to declare.

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

Correlation Between Serological Makers and Immunofluorescence Deposits i n Kidney Tissue of Patients with Lupus Nephritis

2019 ◽  
Vol 9 (02) ◽  
Author(s):  
Haider S Al-Hadad ◽  
Aqeel Abbas Matrood ◽  
Maha Abdalrasool Almukhtar ◽  
Haider Jabur Kehiosh ◽  
Riyadh Muhi Al-Saegh
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Pearson Correlation ◽  
Standard Procedure ◽  
Kidney Tissue ◽  
P Value ◽  
American College Of Rheumatology ◽  
Immune Deposits ◽  
Number Of Patients

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease. Few biomarkers for SLE have been validated and widely accepted for the laboratory follow-up of inflammatory activity. In SLE patients, with lupus nephritis (LN), complement activation leads to fluctuation of serum C3 and C4 that are frequently used as clinicalm biomarker of disease activity in SLE. Patients and Methods: In this study the number of patients were 37, seven patients were excluded for incomplete data collection, 28 were females ,2 were males. The duration of the study is two years from 2015 to 2017. Patients were considered to have SLE and LN according to American College of Rheumatology (ACR) criteria, and International Society of Nephrology/ Renal Pathology Society (ISN/RPS). All patients were evaluated withm clinical presentation, laboratory investigations. Our patients underwent kidney biopsy according to standard procedure by Kerstin Amann, and their tissue specimens were studied in the laboratory with light microscope (LM) and immunofluorescence microscope reagents. The relationship between the serological markers and immunofluorescence deposits in kidney biopsy of all patients were studied using the statistical analysis of Pearson correlation and single table student's T test. A P value 0.05 was considered statistically significant. Results: The granular pattern of IF deposits was present in all LN patients, and in more than two third of patients these IF deposits presented in glomerular, tubular, and mesangium sites. While less than one third of patients had IF deposits in the mesangium only. There was no statistically significant correlation between serum ANA, anti-dsDNA, and IF deposits of different types. There was significant correlation between serum C3 and C4 hypocomplementemia and IgG immune deposits in kidney biopsy, and there was significant relationship between serum C3 hypocomplementemia and full house immunofluorescence (FHIF) deposits inm kidney biopsy.Conclusions:Immunofluorescence deposits is mainly granular pattern in LN patients. There was no significant association between serum ANA, anti-dsDNA, and immune deposits in kidney tissue. Immunofluorescence deposits of IgG type correlates significantly with serum C3 and C4 hypocomplemetemia, and these immune deposits in association with low complement levels correlates with LN flare. There was significant correlation between C3 hypocomplementemia and FHIF.

Planning for End of Life

2021 ◽  
pp. 104990912110141
Author(s):  
Natasha Ansari ◽  
Eric Johnson ◽  
Jennifer A. Sinnott ◽  
Sikandar Ansari
Keyword(s):  
End Of Life ◽  
Treatment Options ◽  
Stage Iv ◽  
P Value ◽  
Life Planning ◽  
Number Of Patients ◽  
End Of Life Planning ◽  
The Difference ◽  
Alternative Medications ◽  
Patient’S Perception

Background: Oncology provider discussions of treatment options, outcomes of treatment, and end of life planning are essential to care for patients with advanced malignancies. Studies have shown that despite this, many patients do not have adequate care planning, including end of life planning. It is thought that the accessibility of information outside of clinical encounters and individual factors and/or beliefs may influence the patient’s perception of disease. Aims: The objective of this study was to evaluate if patient understanding of treatment goals matched the provider and if there were areas of discrepancy. If a discrepancy was found, the survey inquired further into more specific aspects. Methods: A questionnaire-based survey was performed at a cancer hospital outpatient clinic. 100 consecutive and consenting patients who had stage IV non-curable lung, gastrointestinal (GI), or other cancer were included in the study. Patients must have had at least 2 visits with their oncologist. Results: 40 patients reported their disease might be curable and 60 reported their disease was not curable. Patients who reported their disease was not curable were more likely to be 65 years or older (P-value: 0.055). They were more likely to report that their doctor discussed the possibility of their cancer getting worse (78.3% VS 55%; P-value 0.024), that their doctor discussed end of life plans (58.3% VS 30%; P- value: 0.01), and that they had appointed a health care decision-maker (86.7% VS 62.5%; P-value: 0.01). 65% of patients who thought their disease might be curable reported that their doctor said it might be curable, compared with only 6.7% of patients who thought their disease was not curable (p < 0.001). Or, equivalently, 35% of patients who thought their disease might be curable reported that their doctor’s opinion was that it was not curable, compared with 93% of patients who thought their disease was not curable (p < 0.001). Patients who had lung cancer were more likely to believe their cancer was not curable than patients with gastrointestinal or other cancer, though the difference was not statistically significant (p = 0.165). Patients who said their disease might be curable selected as possible reasons that a miracle (50%) or alternative medicine (66.7%) would get rid of the cancer, or said their family wanted them to believe the cancer would go away (16.7%) or that another doctor said it would (4.2%). Patients who said their disease might be curable said they did so due to alternative medications, another doctor, or their family. Restricting to the 70 patients who reported their doctors telling them their disease was not curable, 20% of them still said that they personally felt their disease might be curable. Patients below 65 years of age were more likely to disagree with the doctor in this case (P-value: 0.047). Conclusion: This survey of patients diagnosed with stage IV cancer shows that a significant number of patients had misunderstandings of the treatment and curability of their disease. Findings suggest that a notable proportion kept these beliefs even after being told by treating physicians that their disease is not curable.

scholarly journals Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

2021 ◽  
Vol 10 (6) ◽  
pp. 1288
Author(s):  
Riccardo Senter ◽  
Federico Capone ◽  
Stefano Pasqualin ◽  
Lorenzo Cerruti ◽  
Leonardo Molinari ◽  
...  
Keyword(s):  
Lung Ultrasound ◽  
Clinical Laboratory ◽  
Imaging Modality ◽  
Case Series ◽  
Severity Index ◽  
Disease Stage ◽  
Retrospective Case ◽  
North East ◽  
High Flow Oxygen ◽  
B Lines

Background and Aim. Lung ultrasound (LUS) is a convenient imaging modality in the setting of coronavirus disease-19 (COVID-19) because it is easily available, can be performed bedside and repeated over time. We herein examined LUS patterns in relation to disease severity and disease stage among patients with COVID-19 pneumonia. Methods. We performed a retrospective case series analysis of patients with confirmed SARS-CoV-2 infection who were admitted to the hospital because of pneumonia. We recorded history, clinical parameters and medications. LUS was performed and scored in a standardized fashion by experienced operators, with evaluation of up to 12 lung fields, reporting especially on B-lines and consolidations. Results. We included 96 patients, 58.3% men, with a mean age of 65.9 years. Patients with a high-risk quick COVID-19 severity index (qCSI) were older and had worse outcomes, especially for the need for high-flow oxygen. B-lines and consolidations were located mainly in the lower posterior lung fields. LUS patterns for B-lines and consolidations were significantly worse in all lung fields among patients with high versus low qCSI. B-lines and consolidations were worse in the intermediate disease stage, from day 7 to 13 after onset of symptoms. While consolidations correlated more with inflammatory biomarkers, B-lines correlated more with end-organ damage, including extrapulmonary involvement. Conclusions. LUS patterns provide a comprehensive evaluation of patients with COVID-19 pneumonia that correlated with severity and dynamically reflect disease stage. LUS patterns may reflect different pathophysiological processes related to inflammation or tissue damage; consolidations may represent a more specific sign of localized disease, whereas B-lines seem to be also dependent upon generalized illness due to SARS-CoV-2 infection.

Comparison of lung bedside ultrasound and BNP in the diagnosis of acute heart failure in the emergency department

2020 ◽  
Vol 8 (1) ◽  
pp. 50-50
Author(s):  
Seyed Hossein Ojaghi Haghighi ◽  
Neda Hamed ◽  
Shiva Ebrahimi ◽  
Jafar Ghobadi ◽  
Hoorolnesa Ameli
Keyword(s):  
Heart Failure ◽  
Emergency Room ◽  
Pulmonary Edema ◽  
Acute Heart Failure ◽  
Lung Ultrasound ◽  
P Value ◽  
Ultrasound Evaluation ◽  
Ultrasound Findings ◽  
Medical Advances ◽  
B Lines

Introduction: Congestive heart failure is heart muscle failure that causes pulmonary congestion and eventually pulmonary edema, which despite recent medical advances, is still a progressive syndrome with high mortality, the prevalence of which has increased in recent decades. Therefore, in this study we compared lung ultrasound findings in acute heart failure patients with the BNP. Methods: This study was performed in the emergency room of Imam Reza hospital in Tabriz. For patients entering the emergency room after taking a history, both standard gold (BNP) tests and beside ultrasound of the lung were performed. Ultrasound was performed at the same time as obtaining blood sample to ensure that the ultrasound specialist did not know the result of diagnosis. During the ultrasound, if there were multiple B-Lines that were at least 3 mm apart, patient was diagnosed with pulmonary edema due to heart failure. Results: Number of participants in this study was 108 people, 54.6% of whom were men and the rest were women. The correlation coefficient between width and number of kerley lines was 0.79, between NT-pro BNP and width of kerley lines was 0.65 and between NT-pro BNP and number of kerley lines was 0.77, which indicates a significant positive correlation (P value <0.001). Conclusion: The results of present study showed that in patients with acute heart failure, the number and width of kerley lines in pulmonary ultrasound evaluation increase rapidly. There is also a high correlation between number and length of kerley lines with NT-pro BNP serum values.

Sign in / Sign up

Export Citation Format

Share Document