COVID-19 versus H1N1: challenges in radiological diagnosis—comparative study on 130 patients using chest HRCT

Abstract Background During the current second wave of COVID-19, the radiologists are expected to face great challenges in differentiation between COVID-19 and other virulent influenza viruses, mainly H1N1. Accordingly, this study was performed in order to find any differentiating CT criteria that would help during the expected clinical overlap during the current Influenza season. Results This study was retrospectively conducted during the period from June till November 2020, on acute symptomatic 130 patients with no history of previous pulmonary diseases; 65 patients had positive PCR for COVID-19 including 50 mild patients and 15 critical or severe patients; meanwhile, the other 65 patients had positive PCR for H1N1 including 50 mild patients and 15 critical or severe patients. They included 74 males and 56 females (56.9%:43.1%). Their age ranged 14–90 years (mean age 38.9 ± 20.3 SD). HRCT findings were analyzed by four expert consultant radiologists in consensus. All patients with COVID-19 showed parenchymal or alveolar HRCT findings; only one of them had associated airway involvement. Among the 65 patients with H1N1; 56 patients (86.2%) had parenchymal or alveolar HRCT findings while six patients (9.2%) presented only by HRCT signs of airway involvement and three patients (4.6%) had mixed parenchymal and airway involvement. Regarding HRCT findings of airway involvement (namely tree in bud nodules, air trapping, bronchial wall thickening, traction bronchiectasis, and mucous plugging), all showed significant p value (ranging from 0.008 to 0.04). On the other hand, HRCT findings of parenchymal or alveolar involvement (mainly ground glass opacities) showed no significant relation. Conclusion HRCT can help in differentiation between non-severe COVID-19 and H1N1 based on signs of airway involvement.

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Computed tomography findings in patients with H1N1 influenza A infection

Radiologia Brasileira ◽

10.1590/s0100-39842013000500006 ◽

2013 ◽

Vol 46 (5) ◽

pp. 299-306 ◽

Cited By ~ 6

Author(s):

Viviane Brandão Amorim ◽

Rosana Souza Rodrigues ◽

Miriam Menna Barreto ◽

Gláucia Zanetti ◽

Edson Marchiori

Keyword(s):

Computed Tomography ◽

Influenza A ◽

H1n1 Virus ◽

Severe Disease ◽

H1n1 Influenza ◽

Wall Thickening ◽

High Resolution Computed Tomography ◽

Air Trapping ◽

Bronchial Wall

The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their nonspecificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease.

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Write Your Mother

Writing Pregnancy in Low-Fertility Japan ◽

10.21313/hawaii/9780824859886.003.0001 ◽

2016 ◽

Author(s):

Amanda C. Seaman

Keyword(s):

Literary History ◽

Japanese Women ◽

The Self ◽

The Other ◽

Pregnancy And Childbirth ◽

Second Wave Feminism ◽

Meiji Era ◽

History Of ◽

The 1960S ◽

Second Wave

This chapter traces the literary history of Japanese women writing about pregnancy and childbirth, focusing on two key figures in this development. The first is Meiji-era poet Yosano Akiko whose works explored her experiences as an expectant mother and highlighted the unsettling aspects of pregnancy. While Yosano’s works permitted the literary treatment of formerly taboo issues, later writers rejected her lead, instead treating pregnancy as the prelude to motherhood, as a quasi-sacred moment. This persisted until the 1960s and 70s, when writers influenced by second-wave feminism challenged patriarchal society, rejecting the roles of wife and mother. The second was Tsushima Yuko, whose novels and stories explored alternative, mother-centered family models. Since then, writing about pregnancy rests on these two authors: on one side, treatments of pregnancy that emphasize the alien and the disquieting, and on the other, more ironic works, focusing upon the self-assertive and individualistic nature of childbearing.

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Complication of post-infectious bronchiolitis obliterans (Swyer-James syndrome)

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.61.05.404 ◽

2015 ◽

Vol 61 (5) ◽

pp. 404-406 ◽

Cited By ~ 2

Author(s):

Gabriel de Deus Vieira ◽

Alessandra Yukari Yamagishi ◽

Natália Nogueira Vieira ◽

Rebeka Mayara Miranda Dias Fogaça ◽

Thaianne da Cunha Alves ◽

...

Keyword(s):

Bronchiolitis Obliterans ◽

Signs And Symptoms ◽

Wall Thickening ◽

Radiological Findings ◽

Air Trapping ◽

Bronchial Wall ◽

Pulmonary Lesions ◽

Post Infectious ◽

Radiological Examinations

Summary Swyer-James syndrome is a complication of post-infectious bronchiolitis obliterans that causes inflammation and fibrosis of the bronchial walls. There are two types: asymptomatic, with most cases diagnosed in adults during routine radiological examinations; and symptomatic, most commonly found in children. Here, we report the case of a 6-year-old child with recurrent dyspnea since the age of 3, who showed signs and symptoms of bronchiolitis obliterans and radiological signs of bronchial wall thickening and air trapping. The clinical and radiological findings led to the diagnosis of Swyer-James syndrome. Treatment of this syndrome is intended to reduce the pulmonary lesions and improve the patient's quality of life.

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Comparison of the HA genes of type B influenza viruses in herald waves and later epidemic seasons

Epidemiology and Infection ◽

10.1017/s0950268800050548 ◽

1992 ◽

Vol 109 (3) ◽

pp. 559-568 ◽

Cited By ~ 9

Author(s):

S. Nakajima ◽

F. Nishikawa ◽

K. Nakamura ◽

K. Nakajima

Keyword(s):

Influenza Season ◽

Winter Season ◽

Influenza Viruses ◽

The Other ◽

Influenza B Virus ◽

Influenza B ◽

Type B ◽

Ha Gene ◽

B Virus ◽

Evolutionary Lineages

SUMMARYFrom January 1985 to May 1991, herald strains of influenza B virus were isolated in 1987 and 1989 in Japan. In both cases, influenza epidemics caused by the same type followed in the next winter season. The HA gene sequences of the influenza B viruses isolated in Japan from 1987–91, which covers two herald waves of influenza B viruses, were analysed and located on the phylogenetic tree for influenza B viruses after the B/Singapore/64 strain. Co-circulation of at least two evolutionary lineages of the HA genes existed for influenza B viruses in Japan during the period of this study. The herald viruses in one wave (1987) were genetically close to the winter isolates and were considered to be the parental viruses for the following influenza season, while in the other wave (1989) winter isolates belonged to another lineage on which one of the herald viruses was located, but they were genetically and antigenically different from the herald viruses.

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Abnormalities on Chest Computed Tomography and Lung Function Following an Intense Dust Exposure: A 17-Year Longitudinal Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091655 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1655 ◽

Cited By ~ 2

Author(s):

Charles Liu ◽

Barbara Putman ◽

Ankura Singh ◽

Rachel Zeig-Owens ◽

Charles B. Hall ◽

...

Keyword(s):

Computed Tomography ◽

High Intensity ◽

Respiratory Symptoms ◽

Airflow Obstruction ◽

Dust Exposure ◽

Wall Thickening ◽

Air Trapping ◽

Bronchial Wall ◽

Chest Computed Tomography ◽

Fev1 Decline

Fire Department of the City of New York (FDNY) firefighters experienced intense dust exposure working at the World Trade Center (WTC) site on and after 11/9/2001 (9/11). We hypothesized that high-intensity WTC exposure caused abnormalities found on chest computed tomography (CT). Between 11/9/2001–10/9/2018, 4277 firefighters underwent a clinically-indicated chest CT. Spirometric measurements and symptoms were recorded during routine medical examinations. High-intensity exposure, defined as initial arrival at the WTC on the morning of 9/11, increased the risk of bronchial wall thickening, emphysema, and air trapping. Early post-9/11 symptoms of wheeze and shortness of breath were associated with bronchial wall thickening, emphysema, and air trapping. The risk of accelerated forced expiratory volume at one second (FEV1) decline (>64 mL/year decline) increased with bronchial wall thickening and emphysema, but decreased with air trapping. The risk of airflow obstruction also increased with bronchial wall thickening and emphysema but decreased with air trapping. In a previously healthy occupational cohort, high-intensity WTC exposure increased the risk for CT abnormalities. Bronchial wall thickening and emphysema were associated with respiratory symptoms, accelerated FEV1 decline, and airflow obstruction. Air trapping was associated with respiratory symptoms, although lung function was preserved. Physiologic differences between CT abnormalities suggest that distinct types of airway injury may result from a common exposure.

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Eosinophilic bronchiolitis successfully treated with benralizumab

BMJ Case Reports ◽

10.1136/bcr-2021-246058 ◽

2021 ◽

Vol 14 (10) ◽

pp. e246058

Author(s):

Keishi Sugino ◽

Hirotaka Ono ◽

Akira Hebisawa ◽

Eiyasu Tsuboi

Keyword(s):

Plasma Cells ◽

Final Diagnosis ◽

Japanese Woman ◽

Wall Thickening ◽

High Dose ◽

Immunoglobulin G4 ◽

Bronchial Wall ◽

History Of ◽

Frequent Exacerbation ◽

Wet Cough

A 53-year-old non-smoking Japanese woman was admitted to our hospital with a 20-year history of wet cough and dyspnoea on exertion. Bronchial asthma (BA) had been diagnosed 20 years earlier. Although she has been treated with high-dose inhaled corticosteroid, she had experienced frequent exacerbation of BA, and short-term oral corticosteroid bursts were occasionally administered. High-resolution CT of the chest revealed diffuse centrilobular nodules with bronchial wall thickening and patchy ground-glass opacities in both lungs. Lung biopsy specimens showed widespread cellular bronchiolitis with follicle formations in the membranous and respiratory bronchioles, accompanied by marked infiltration of plasma cells and eosinophils. In addition, immunohistochemical immunoglobulin G4 (IgG4) staining revealed many IgG4-positive plasma cells, and the ratio of IgG4-positive cells to IgG-positive cells exceeded 40%. The final diagnosis was eosinophilic bronchiolitis with marked IgG4-positive plasma cell infiltration in association with BA. With benralizumab therapy, her clinical condition dramatically improved.

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CT features of normal lung change in asymptomatic elderly patients

Asian Biomedicine ◽

10.5372/1905-7415.0905.431 ◽

2017 ◽

Vol 9 (5) ◽

pp. 613-623 ◽

Cited By ~ 1

Author(s):

Nattinee Leelakanok ◽

Nitra Piyavisetpat

Keyword(s):

Elderly Patients ◽

Smoking History ◽

Normal Lung ◽

Wall Thickening ◽

Study Cohort ◽

Air Trapping ◽

Bronchial Wall ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Background Not all morphological lung changes in the elderly contribute to respiratory disease and may be a consequence of normal aging. Objectives To describe the changes in asymptomatic elderly patients compared with those in younger patients in a Thai population. Methods The study cohort comprised 60 participants without respiratory symptoms in three groups of 20 by age: 20-40 years, 41-60 years, and >60 years. Participants were prospectively selected from patients referred for computed tomography (CT) of the abdomen, or head and neck, and underwent sequential CT during deep breathing at four lung levels. Two observers scored images by consensus. We compared groups using Pearson chi-square and Fisher exact tests, and used receiver operating characteristic curves to categorize bronchiectasis and bronchial wall thickening by age. Results Air trapping was related to age (5/20 group 1, 7/20 group 2, and 18/20 group 3 (P <0.01)) and was most prevalent in lower lobes (78%, P < 0.01). Reticulation was found in only one middle aged patient (P = 0.36). Bronchiectasis was more common in patients <56 years (7/23) than <56 years (3/37), P = 0.035. Bronchial wall thickening (7/23 in patients >56 years and 2/37 in patients <56 years, P = 0.02) and extensive air trapping were related to age (0/6 group 1, 1/6 group 2, and 5/6 group 3, P = 0.02). Findings were independent of smoking history. Conclusions Asymptomatic older patients had higher prevalence of bronchiectasis, bronchial wall thickening, and air trapping, independent of smoking history.

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Pulmonary changes on HRCT scans in nonsmoking females with COPD due to wood smoke exposure

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000200006 ◽

2013 ◽

Vol 39 (2) ◽

pp. 155-163 ◽

Cited By ~ 16

Author(s):

Maria Auxiliadora Carmo Moreira ◽

Maria Alves Barbosa ◽

Maria Conceição de Castro Antonelli Monteiro de Queiroz ◽

Kim Ir Sen Santos Teixeira ◽

Pedro Paulo Teixeira e Silva Torres ◽

...

Keyword(s):

Demographic Data ◽

Positive Association ◽

Smoke Exposure ◽

Wood Smoke ◽

Control Group ◽

Wall Thickening ◽

Bronchial Wall ◽

History Of ◽

Pulmonary Changes ◽

And Control

OBJECTIVE: To identify and characterize alterations seen on HRCT scans in nonsmoking females with COPD due to wood smoke exposure. METHODS: We evaluated 42 nonsmoking females diagnosed with wood smoke-related COPD and 31 nonsmoking controls with no history of wood smoke exposure or pulmonary disease. The participants completed a questionnaire regarding demographic data, symptoms, and environmental exposure. All of the participants underwent spirometry and HRCT of the chest. The COPD and control groups were adjusted for age (23 patients each). RESULTS: Most of the patients in the study group were diagnosed with mild to moderate COPD (83.3%). The most common findings on HRCT scans in the COPD group were bronchial wall thickening, bronchiectasis, mosaic perfusion pattern, parenchymal bands, tree-in-bud pattern, and laminar atelectasis (p < 0.001 vs. the control group for all). The alterations were generally mild and not extensive. There was a positive association between bronchial wall thickening and hour-years of wood smoke exposure. Centrilobular emphysema was uncommon, and its occurrence did not differ between the groups (p = 0.232). CONCLUSIONS: Wood smoke exposure causes predominantly bronchial changes, which can be detected by HRCT, even in patients with mild COPD.

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Influenza A (H1N1) pneumonia: HRCT findings

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000300009 ◽

2013 ◽

Vol 39 (3) ◽

pp. 323-329 ◽

Cited By ~ 15

Author(s):

Viviane Brandao Amorim ◽

Rosana Souza Rodrigues ◽

Miriam Menna Barreto ◽

Glaucia Zanetti ◽

Bruno Hochhegger ◽

...

Keyword(s):

Influenza A ◽

H1n1 Virus ◽

Ground Glass ◽

Wall Thickening ◽

H1n1 Infection ◽

Air Trapping ◽

Bronchial Wall ◽

Influenza A H1n1 ◽

H1n1 Pneumonia ◽

Interlobular Septal Thickening

OBJECTIVE: To describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus. METHODS: We retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. RESULTS: The most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. CONCLUSIONS: The most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or craniocaudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms.

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