scholarly journals Association between clinical characteristics and short-term outcomes in adult male COVID-19 patients with mild clinical symptoms: a single-center observational study

2020 ◽  
Author(s):  
Bailing Yan ◽  
Lei Song ◽  
Jia Guo ◽  
Yangyang Wang ◽  
Liping Peng ◽  
...  
Keyword(s):  
Observational Study ◽  
Adult Male ◽  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Blood Oxygen ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Short Term ◽  
Blood Oxygen Saturation ◽  
Abnormal Chest

Abstract Background: Majority of patients with 2019 novel coronavirus infection (COVID-19) exhibit mild symptoms. Identification of COVID-19 patients with mild symptoms who might develop into severe or critical illness is essential to save lives.Materials and Methods: We conducted an observational study in a dedicated make-shift hospital for adult male COVID-19 patients with mild symptoms between February and March 2020. Baseline characteristics, medical history, and clinical presentation were recorded. Laboratory tests and chest computed tomography were performed. Patients were observed until they were either transferred to a hospital for advanced care owing to disease exacerbation or were discharged after improvement. Patients were grouped based on their chest imaging findings or short-term outcomes.Results: A total of 125 COVID-19 patients with mild symptoms were enrolled. Of these, 7 patients were transferred for advanced care while 118 patients were discharged after improvement and showed no disease recurrence during an additional 28-day follow-up period. Eighty-five patients (68.0%) had abnormal chest imaging findings. Patients with abnormal chest imaging findings were more likely to have disease deterioration and require advanced care as compared to those with normal chest imaging findings. Patients with deteriorated outcomes were more likely to have low peripheral blood oxygen saturation and moderately-elevated body temperature. There were no significant differences between patients with deteriorated or improved outcomes with respect to age, clinical presentation, or comorbidities.Conclusions: Abnormal chest imaging findings, low peripheral blood oxygen saturation, and elevated temperature were associated with disease deterioration in adult male COVID-19 patients with mild clinical symptoms. Trial registration: ClinicalTrials.gov ID: NCT04346602. Registered 12 April 2020- Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009RA3&selectaction=Edit&uid=U0003F4L&ts=2&cx=-ajpsbw

scholarly journals Association Between Clinical Characteristics and Short-Term Outcomes in Adult Male COVID-19 Patients With Mild Clinical Symptoms: A Single-Center Observational Study

2021 ◽  
Vol 7 ◽  
Author(s):  
Bailing Yan ◽  
Lei Song ◽  
Jia Guo ◽  
Yangyang Wang ◽  
Liping Peng ◽  
...  
Keyword(s):  
Observational Study ◽  
Adult Male ◽  
Peripheral Blood ◽  
Clinical Symptoms ◽  
Blood Oxygen ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Short Term ◽  
Blood Oxygen Saturation ◽  
Abnormal Chest

Majority of patients with 2019 novel coronavirus infection (COVID-19) exhibit mild symptoms. Identification of COVID-19 patients with mild symptoms who might develop into severe or critical illness is essential to save lives. We conducted an observational study in a dedicated make-shift hospital for adult male COVID-19 patients with mild symptoms between February and March 2020. Baseline characteristics, medical history, and clinical presentation were recorded. Laboratory tests and chest computed tomography were performed. Patients were observed until they were either transferred to a hospital for advanced care owing to disease exacerbation or were discharged after improvement. Patients were grouped based on their chest imaging findings or short-term outcomes. A total of 125 COVID-19 patients with mild symptoms were enrolled. Of these, 7 patients were transferred for advanced care while 118 patients were discharged after improvement and showed no disease recurrence during an additional 28-day follow-up period. Eighty-five patients (68.0%) had abnormal chest imaging findings. Patients with abnormal chest imaging findings were more likely to have disease deterioration and require advanced care as compared to those with normal chest imaging findings. Patients with deteriorated outcomes were more likely to have low peripheral blood oxygen saturation and moderately-elevated body temperature. There were no significant differences between patients with deteriorated or improved outcomes with respect to age, comorbidities, or other clinical symptoms (including nasal congestion, sore throat, cough, hemoptysis, sputum production, shortness of breath, fatigue, headache, nausea or vomiting, diarrhea). Abnormal chest imaging findings, low peripheral blood oxygen saturation, and elevated temperature were associated with disease deterioration in adult male COVID-19 patients with mild clinical symptoms.Clinical Trial Registration: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009RA3&selectaction=Edit&uid=U0003F4L&ts=2&cx=-ajpsbw, identifier NCT04346602.

Left atrio-oesophageal fistula after atrial fibrillation ablation

2020 ◽  
Vol 13 (12) ◽  
pp. e232508
Author(s):  
Vishesh Paul ◽  
Rajamurugan Meenakshisundaram ◽  
Abdur R Jamal ◽  
Talha Bin Farooq
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Presentation ◽  
Surgical Repair ◽  
Posterior Wall ◽  
Cryoballoon Ablation ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Ablation Procedure ◽  
Atypical Chest Pain ◽  
Air Embolus

We report a case of a 68-year-old woman who presented with atypical chest pain and fluctuating neurological symptoms 4 weeks after cryoballoon ablation procedure for atrial fibrillation. Brain imaging showed multiple embolic infarcts, while the chest imaging revealed an abnormal connection between the posterior wall of the left atrium and the oesophagus. Based on her clinical presentation and the imaging findings, a diagnosis of left atrio-oesophageal fistula (AOF) was established. AOF carries a high mortality rate unless an urgent surgical repair is performed. Oesophageal instrumentation for an echocardiogram or endoscopy should be avoided as it can result in massive air embolus, causing stroke or death.

DETERMINISTIC STRUCTURE IN MULTICHANNEL PHYSIOLOGICAL DATA

2000 ◽  
Vol 10 (12) ◽  
pp. 2767-2780 ◽  
Author(s):  
LIANGYUE CAO ◽  
ALISTAIR MEES
Keyword(s):  
Time Series ◽  
Multivariate Time Series ◽  
Good Time ◽  
Physiological Data ◽  
Blood Oxygen ◽  
Santa Fe ◽  
Short Term ◽  
Blood Oxygen Saturation ◽  
Data Set ◽  
Linear Approximation Method

We have found numerical evidence of deterministic properties in a multichannel physiological time series, a segment of the Santa Fe data set B which was recorded from a patient with sleep apnea. We used recently developed methods for finding good time-delay embeddings for multichannel data, together with nonlinear deterministic prediction. We show that determining good embeddings for this multivariate time series gives good short-term predictions, and convincing free-run (simulation) behavior, using only a simple local-linear approximation method. We also discovered relations between the different channels, which are heart-rate, respiration and blood-oxygen saturation.

Concurrent Validity of Arterial Blood Oxygen Saturation Measurements: A Preliminary Analysis of an iPad Pulse Oximeter and Traditional Pulse Oximeter Using Bluetooth

2014 ◽  
Vol 19 (3) ◽  
pp. 37-42
Author(s):  
Scott Cheatham ◽  
Morey J. Kolber ◽  
Michael P. Ernst
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Pulse Rate ◽  
Pulse Oximeter ◽  
Concurrent Validity ◽  
Outcome Measure ◽  
Blood Oxygen ◽  
Short Term ◽  
Blood Oxygen Saturation ◽  
Main Outcome Measure

Context:Pulse oximetry has become mobile with the use of smartphone and Bluetooth wireless technology. This technology offers many benefits but has not been extensively studied. There is a need to further validate its clinimetric properties for health professionals to provide proper guidance to patients.Objective:This investigation assessed the concurrent validity of the iSpO2pulse oximeter against a traditional pulse oximeter in measuring short-term resting blood oxygen saturation (SpO2) and pulse rate.Design:Observational study of reliability.Setting:University kinesiology laboratory.Participants:Thirty healthy, recre-ationally active adults (18 men, 12 women; mean age = 25.7 ± 5.46 years, mean height = 170.3cm ± 9.51, mean body mass = 76.4 kg ± 19.33).Intervention:Resting measurement of SpO2and pulse rate using the iSpO2pulse oximeter with the iPad Mini and a traditional pulse oximeter with Bluetooth.Main Outcome Measure:Resting SpO2and pulse rate were concurrently measured over 5 min.Results:The concurrent validity between the iSpO2and traditional pulse oximeter was moderate for measuring SpO2, intraclass correlation coeffcient (ICC)(3, 1) = .73,SEM= 0.70%, and good for pulse rate, ICC(3, 1) = .97,SEM= 1.74 beats per minute (bpm). The minimal detectable change at the 95% confidence interval for both instruments suggests that there may be 1.94% disagreement for SpO2and 4.82 bpm disagreement between pulse oximetry methods. The 95% limits of agreement (LoA) for measuring SpO2suggests that the iSpO2and traditional pulse oximeters may vary -0.28 ± 1.98%, or approximately 2%. The 95% LoA for measuring pulse rate suggests that the iSpO2and traditional pulse oximeter may vary 1.74 ± 4.98 bpm, potentially upward of 6 bpm. On the basis of the results of the LoA, it appears that there may be a slight systematic bias between the two devices, with the traditional pulse oximeter producing higher pulse rates than the iSpO2.Conclusion:The findings suggest that both instruments may be beneficial for indirect short-term measurements of resting SpO2and pulse rate.

scholarly journals Misdiagnosis of Systemic Metastatic Melanoma for fungal infection: A case report

2021 ◽  
Author(s):  
Juan Sun ◽  
Yun-Zhu Zhu ◽  
Pan-Pan Shao ◽  
Jing Ke ◽  
Wei Wang ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Lung Biopsy ◽  
Clinical Symptoms ◽  
Fungal Infections ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Imaging Diagnosis ◽  
Puncture Wound ◽  
Chest Computed Tomography ◽  
Multiple Nodules

Abstract BackgroundMost of malignant melanomas originate from skin and often metastasize to the lungs, rarely metastasizes to the liver and bone. However, imageology characters of lung metastasis tumor are commonly similar to those of fungal infections. Case presentationA patient was admitted with unhealed plantar puncture wound for 3 years, and cough and expectoration for 2 years. The chest computed tomography (CT) revealed multiple nodules with cavities, and the patient was diagnosed of pulmonary fungal infection in another hospital and received antifungal therapy for more than 8 months, but the clinical symptoms and chest imaging findings continue to progress. After admission, the pathological results of both lung biopsy and biopsy of the plantar wound 3 years ago indicated malignant melanoma. ConclusionsThe diagnosis of lung lesions cannot rely solely on imaging diagnosis, lung biopsy should be performed if necessary.

scholarly journals Electrophysiological correlates of hyperoxia during resting-state EEG in awake human subjects

2018 ◽  
Author(s):  
Sayeed A.D. Kizuk ◽  
Wesley Vuong ◽  
Joanna E. MacLean ◽  
Clayton T. Dickson ◽  
Kyle E. Mathewson
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Human Subjects ◽  
Brain Activity ◽  
Brain State ◽  
Blood Oxygen ◽  
Short Term ◽  
Blood Oxygen Saturation ◽  
Attentional Processing ◽  
Eyes Closed

AbstractRecreational use of concentrated oxygen has increased. Claims have been made that hyperoxic breathing can help reduce fatigue, increase alertness, and improve attentional capacities; however, few systematic studies of these potential benefits exist. Here we examined the effects of short-term (15 minute) hyperoxia on resting-states in awake human subjects by measuring spontaneous EEG activity between normoxic and hyperoxic situations, using a within-subjects design for both eyes-opened and eyes-closed conditions. We also measured respiration rate, heart rate, and blood oxygen saturation levels to correlate basic physiological changes due to the hyperoxic challenge with any brain activity changes. Our results show that breathing short term 100% oxygen led to increased blood-oxygen saturation levels, decreased heart rate, and a slight, but non-significant, decrease in breathing rate. Changes of brain activity were apparent, including decreases in low-alpha (7-10 Hz), high-alpha (10-14 Hz), beta (14-30 Hz), and gamma (30-50 Hz) frequency ranges during eyes-opened hyperoxic conditions. During eyes-closed hyperoxia, increases in the delta (0.5-3.5 Hz) and theta (3.5-7 Hz) frequency range were apparent together with decreases in the beta range. Hyperoxia appeared to accentuate the decrease of low alpha and gamma ranges across the eyes-opened and closed conditions suggesting that it modulated brain state itself. As decreased alpha during eyes-opened conditions has been associated with increased attentional processing and selective attention, and increased delta and theta during eyes-closed condition are typically associated with the initiation of sleep, our results suggest a state-specific and perhaps opposing influence of short-term hyperoxia.

Correlation between Arterial Blood Oxygen Saturation, Underlying Diseases and Clinical Signs of COVID-19 Patients with Their Final Outcome

2021 ◽  
Author(s):  
Ebrahim Nasiri ◽  
Masoumeh Zakeri Azizi ◽  
Kazem Aghajanipoor
Keyword(s):  
Oxygen Saturation ◽  
Clinical Symptoms ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Oxygen Saturation Level ◽  
Positive Correlation ◽  
Risk Of Death ◽  
Arterial Blood ◽  
Arterial Blood Oxygen ◽  
Underlying Diseases

Introduction: COVID-19 can rapidly cause lung damage and severe respiratory distress and subsequently reduce oxygen saturation (SPO2), especially in generally ill patients, which may be exacerbated if severe clinical symptoms or underlying diseases are added. This may lead to deterioration of blood oxygenation or even increase the risk of death when severe clinical symptoms or underlying diseases are present. Therefore, the aim of this study was to Evaluation of the relationship between arterial blood oxygen saturation level and outcome in COVID-19 patients.Material and Methods: A cross-sectional study of 250 patients referred to Imam Sari Hospital with symptoms of respiratory infection, gastrointestinal, and general symptoms in January 2020 to September 2020. Data were analyzed using SPSS version 26.Results: 27 out of 250 patients died. There is a positive correlation between systemic patient, SPO2 and less than 90% with death results (P<0/02). Patients with heart disease (44.4%), cancer (30.1%), diabetes (11.1%), cerebrovascular accident (18.5%) died (P<0/05). There was no positive correlation between weakness, fever, dyspnea, nausea, and diarrhea and appetite loss with death.Conclusion: Based on the present study, it was found that patients whose clinical symptoms were associated with underlying disease and SPO2 to a severe and critical degree had a higher risk of adverse outcome such as death. People with underlying conditions such as DM, CVD, HTN, and a history of angiography and cancer are also more likely to die due to COVID-19. Most deaths in the present study had low SPO2 at before admission, indicating a strong association between patient mortality and severity of lung involvement and low SPO2.

scholarly journals Comparison of medical and surgical treatment for acute cervical compressive hydrated nucleus pulposus extrusion in dogs

2017 ◽  
Vol 181 (23) ◽  
pp. 625-625 ◽  
Author(s):  
Tana Borlace ◽  
Rodrigo Gutierrez-Quintana ◽  
Frances Ellen Taylor-Brown ◽  
Steven De Decker
Keyword(s):  
Surgical Treatment ◽  
Nucleus Pulposus ◽  
Medical Management ◽  
Clinical Presentation ◽  
Imaging Findings ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Successful Outcomes

Although successful outcomes have been reported after medical and surgical treatment for dogs with cervical hydrated nucleus pulposus extrusion (HNPE), it is unknown which treatment option is preferred. Thirty-four dogs treated medically (n=18) or surgically (n=16) for cervical HNPE were retrospectively identified. Signalment, clinical presentation and imaging findings were compared between medically and surgically treated dogs. Medical management consisted of restricted exercise in combination with physiotherapy. Surgical treatment consisted of a ventral slot procedure. Short-term follow-up information was retrieved from re-examination visits. Long-term outcome was obtained via telephone interviews. More dogs in the surgical group demonstrated cervical hyperaesthesia on initial clinical presentation (P=0.045), otherwise there was no significant difference in signalment, clinical presentation or imaging findings between both groups. Two dogs in the medically managed group underwent surgical decompression due to an unsatisfactory response to medical management. All cases for which long-term information was available (n=30) were neurologically normal at the time of data collection. There were no significant differences for any of the short-term or long-term outcome variables between both treatment groups. This study demonstrated successful outcomes after medical or surgical treatment and suggests that both treatment modalities can be considered for dogs with cervical HNPE.

Melatonin as adjuvant treatment for coronavirus disease 2019 pneumonia patients requiring hospitalization (MAC-19 PRO): a case series

2020 ◽  
Vol 3 (3) ◽  
pp. 297-310 ◽  
Author(s):  
Rafael Ricafranca Castillo ◽  
Gino Rei A. Quizon ◽  
Mario Joselito M. Juco ◽  
Arthur Dessi E. Roman ◽  
Donnah G De Leon ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Hospital Stay ◽  
Clinical Improvement ◽  
Case Series ◽  
High Dose ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Rt Pcr ◽  
Average Hospital ◽  
Sleeping Problems

 Treatment for coronavirus disease 2019 (COVID19) pneumonia remains empirical and the search for therapies that can improve outcomes continues. Melatonin has been shown to have anti-inflammatory, antioxidant, and immune-modulating effects that may address key pathophysiologic mechanisms in the development and progression of acute respiratory distress syndrome (ARDS), which has been implicated as the likely cause of death in COVID19. We aimed to describe the observable clinical outcomes and tolerability of high-dose melatonin (hdM) given as adjuvant therapy in patients admitted with COVID19 pneumonia. We conducted a retrospective descriptive case series of patients who: 1) were admitted to the Manila Doctors Hospital in Manila, Philippines, between March 5, 2020 and April 4, 2020; 2) presented with history of typical symptoms (fever, cough, sore throat, loss of smell and/or taste, myalgia, fatigue); 3) had admitting impression of atypical pneumonia; 4) had history and chest imaging findings highly suggestive of COVID19 pneumonia, and, 5) were given hdM as adjuvant therapy, in addition to standard and/or empirical therapy. One patient admitted to another hospital, who one of the authors helped co-manage, was included. He was the lone patient given hdM in that hospital during the treatment period. Main outcomes described were: time to clinical improvement, duration of hospital stay from hdM initiation, need for mechanical ventilation (MV) prior to cardiopulmonary resuscitation, and final outcome (death or recovery/discharge). Of 10 patients given hdM at doses of 36-72mg/day per os (p.o.) in 4 divided doses as adjuvant therapy, 7 were confirmed COVID19 positive (+) by reverse transcription polymerase chain reaction (RT-PCR) and 3 tested negative  (-), which was deemed to be false (-) considering the patients’ typical history, symptomatology, chest imaging findings and elevated bio-inflammatory parameters.  In all 10 patients given hdM, clinical stabilization and/or improvement was noted within 4-5 days after initiation of hdM. All hdM patients, including 3 with moderately severe ARDS and 1 with mild ARDS, survived; none required MV. The 7 COVID19(+) patients were discharged at an average of 8.6 days after initiation of hdM. The 3 highly probable COVID19 patients on hdM were discharged at an average of 7.3 days after hdM initiation. Average hospital stay of those not given hdM (non-hdM) COVID19(+) patients who were admitted during the same period and recovered was 13 days. To provide perspective, although the groups are not comparable, 12 of the 34 (35.3%) COVID19(+) non-hdM patients admitted during the same period died, 7/34 (20.6%) required MV; while 6 of 15 (40%) non-hdM (-) by RT-PCR but highly probable COVID19 pneumonia patients also died, 4/15  (26.7%) required MV. No significant side-effects were noted with hdM except for sleepiness, which was deemed favorable by all patients, most of whom had anxiety- and symptom-related sleeping problems previously. HdM may have a beneficial role in patients treated for COVID19 pneumonia, in terms of shorter time to clinical improvement, less need for MV, shorter hospital stay, and possibly lower mortality. HdM was well tolerated. This is the first report describing the benefits of hdM in patients being treated for COVID19 pneumonia.  Being a commonly available and inexpensive sleep-aid supplement worldwide, melatonin may play a role as adjuvant therapy in the global war against COVID19. 

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