scholarly journals Chest Computed Tomography (CT) Findings and Semiquantitative Scoring of 60 Patients with Coronavirus Disease 2019 (COVID-19): A Retrospective Imaging Analysis Combining Anatomy and Pathology

2020 ◽  
Author(s):  
Hao Zhang ◽  
Xu-jing Jiang ◽  
Xiao-hua Liu ◽  
Hong Ma ◽  
Ya-hong Zhang ◽  
...  
Keyword(s):  
Disease Severity ◽  
Healthcare Workers ◽  
Treatment Options ◽  
Chest Ct ◽  
Ct Findings ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Ct Data ◽  
Severity Of The Disease ◽  
Selection Of

Abstract In this study, we ascertained the chest CT data of 60 patients admitted to 3 hospitals in Chongqing with confirmed COVID-19. We conducted anatomical and pathological analyses to elucidate the possible reasons for the distribution, morphology, and characteristics of COVID-19 in chest CT. We also shared a semiquantitative scoring of affected lung segments, which was recommended by our local medical association. This scoring system was applied to quantify the severity of the disease. The most frequent imaging findings of COVID-19 were subpleural ground glass opacities and consolidation; there was a significant difference in semiquantitative scores between the early, progressive, and severe stages of the disease. We conclude that the chest CT findings of COVID-19 showed certain characteristics because of the anatomical features of the human body and pathological changes caused by the virus. Therefore, chest CT is a valuable tool for facilitating the diagnosis of COVID-19 and semiquantitative scoring of affected lung segments may further elucidate diagnosis and assessment of disease severity. This will assist healthcare workers in diagnosing COVID-19 and assessing disease severity, facilitate the selection of appropriate treatment options, which is important for reducing the spread of the virus, saving lives, and controlling the pandemic.

Biochemical parameters and relation to disease severity in COVID-19 patients

2021 ◽  
pp. 93-96
Keyword(s):  
Biochemical Parameters ◽  
Troponin I ◽  
Total Bilirubin ◽  
Early Stage ◽  
Length Of Hospital Stay ◽  
Rt Pcr ◽  
Sodium Potassium ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Severity Of The Disease

Aim: In this study, we aimed to evaluated whether there is an association between the biochemistry parameters obtained from the first blood test after hospitalization of COVID 19 patients and the prognosis and severity of the disease. Thus, we planned to identify patients with a severe course at an early stage and to help physicians determine the appropriate treatment. Material and Method: The study included 106 COVID 19 patients confirmed by RT-PCR. Patients were categorized into two groups: those admitted to the hospital ward and discharged with recovery (mild cases) and those admitted directly or eventually to the intensive care unit (severe cases). Biochemical parameters of the groups were compared with the Mann Whitney-U Test, as none of the compared parameters fit the normal distribution. Results: There was no statistically significant difference between the male-female numbers and ages of the two groups. Statistically significant differences were observed in the length of hospital stay, procalcitonin, hs-troponin I, ferritin, glucose, urea, creatinine, calcium, direct bilirubin, AST, LDH and CRP values (p<0,05). However, no significant difference was found in sodium, potassium, chloride, total bilirubin and ALT tests. Conclusion: The results show that some biochemistry parameters may be used to predict the prognosis of the disease. In particular, procalcitonin, hs troponin I, LDH and CRP values seem to be moderate biomarkers of the prognosis of the disease.

scholarly journals Chest CT Imaging Characteristics of COVID-19 Pneumonia in Surviving and Non-Surviving Hospitalized Patients: A Retrospective Study in a Referral Center in Tehran, Iran

2021 ◽  
Vol 18 (2) ◽  
Author(s):  
Sara Besharat ◽  
Fatemehsadat Rahimi ◽  
Siamak Afaghi ◽  
Farzad Esmaeili Tarki ◽  
Fatemeh Pourmotahari ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Ct Scan ◽  
Chest Ct ◽  
Ct Scans ◽  
Early Management ◽  
Ct Findings ◽  
Imaging Characteristics ◽  
Significant Difference ◽  
Chest Ct Scan ◽  
Lung Lobes

Background: Coronavirus disease 2019 (COVID-19) has several chest computed tomography (CT) characteristics, which are important for the early management of this disease, because viral detection via RT-PCR can be time-consuming, resulting in a delayed pneumonia diagnosis. The Radiological Society of North America (RSNA) proposed a reporting language for CT findings related to COVID-19 and defined four CT categories: typical, indeterminate, atypical, and negative. Objectives: To retrospectively evaluate the chest CT characteristics of patients with COVID-19 pneumonia. Patients and Methods: A total of 115 hospitalized laboratory-verified COVID-19 cases, underdoing chest CT scan, were included in this study from April 30 to May 15, 2020. Of 115 cases, 53 were discharged from the hospital, and 62 expired. The initial clinical features and chest CT scans were assessed for the type, pattern, distribution, and frequency of lesions. Moreover, the findings were compared between ward-hospitalized, ICU-admitted, and non-surviving (expired) patients. Results: Of four CT categories, typical CT findings for COVID-19 were more frequent in the expired group (77.4%), compared to the ward-admitted (44.8%) and ICU-admitted (70.8%) groups (P = 0.017). However, no significant difference was observed in the prevalence of intermediate or atypical CT findings between the groups. Negative CT scans for the diagnosis of COVID-19 were significantly fewer in the expired group (0%) as compared to the ward-admitted (10.3%) and ICU-admitted (8.3%) groups (P = 0.0180). Also, the mean number of involved lung lobes and segments was significantly higher in the expired group compared to the other two groups (P = 0.032 and 0.010, respectively). The right upper lobe involvement, right middle lobe involvement, bilateral involvement, central lesion, air bronchogram, and pleural effusion were among CT scan findings with a significantly higher prevalence in non-surviving cases (P < 0.0001, 0.047, 0.01, 0.036, 0.038, and 0.047, respectively). Conclusion: The increased number of involved lung lobes and segments, bilateral and central distribution patterns, air bronchogram, and severe pleural effusion in the initial chest CT scan can be related to the increased severity and poor prognosis of COVID-19.

scholarly journals Pyogenic brain abscess

2008 ◽  
Vol 24 (6) ◽  
pp. E2 ◽  
Author(s):  
Ersin Erdoğan ◽  
Tufan Cansever
Keyword(s):  
Treatment Options ◽  
Neurological Status ◽  
Diagnostic Techniques ◽  
Diagnosis And Treatment ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Brain Abscesses ◽  
Lower Morbidity

✓ Brain abscesses have been one of the most challenging lesions, both for surgeons and internists. From the beginning of the computed tomography (CT) era, the diagnosis and treatment of these entities have become easier and less invasive. The outcomes have become better with the improvement of diagnostic techniques, neurosurgery, and broad-spectrum antibiotics. Atypical bacterial abscesses are more often due to chemotherapy usage in oncology, long life expectancy in patients with human immunodeficiency virus (HIV) infection, and immunosuppression in conjunction with organ transplantation. Surgical treatment options showed no significant difference with respect to mortality levels, but lower morbidity rates were achieved with stereotactically guided aspiration. Decompression with stereotactically guided aspiration, antibiotic therapy based on results of pus culture, and repeated aspirations if indicated from results of periodic CT follow-up scans seem to be the most appropriate treatment modality for brain abscesses. Immunosuppression and comorbidities, initial neurological status, and intraventricular rupture were significant factors influencing the outcomes of patients. The pitfalls and evolution in the diagnosis and treatment of brain abscesses are discussed in this study.

scholarly journals Proposed Algorithm for Management of Meibomian Gland Dysfunction Based on Noninvasive Meibography

2020 ◽  
Vol 10 (1) ◽  
pp. 65
Author(s):  
Reiko Arita ◽  
Shima Fukuoka ◽  
Motoko Kawashima
Keyword(s):  
International Workshop ◽  
Treatment Options ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Ocular Symptoms ◽  
Appropriate Treatment ◽  
Stage Classification ◽  
Surface Staining ◽  
Selection For ◽  
Selection Of

Although the pathophysiology of meibomian gland dysfunction (MGD) remains incompletely understood, many treatment options have recently become available. According to an international workshop report, treatment selection for MGD should be based on a comprehensive stage classification dependent on ocular symptoms, lid margin abnormalities, meibum grade, and ocular surface staining. However, it is often difficult to evaluate all parameters required for such classification in routine clinical practice. We have now retrospectively evaluated therapeutic efficacy in MGD patients who received five types of treatment in the clinic setting: (1) meibocare (application of a warm compress and practice of lid hygiene), (2) meibum expression plus meibocare, (3) azithromycin eyedrops plus meibocare, (4) thermal pulsation therapy plus meibocare, or (5) intense pulsed light (IPL) therapy plus meibocare. Patients in each treatment group were classified into three subsets according to the meiboscore determined by noncontact meibography at baseline. Eyes in the IPL group showed improvement even if the meiboscore was high (5 or 6), whereas meibocare tended to be effective only if the meiboscore was low (1 or 2). The meiboscore may thus serve to guide selection of the most appropriate treatment in MGD patients. Prospective studies are warranted to confirm these outcomes.

Comparison of Resonance Outcomes after Pharyngeal Flap and Furlow Double-Opposing Z-Plasty for Surgical Management of Velopharyngeal Incompetence

2006 ◽  
Vol 43 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Scott A. Dailey ◽  
Michael P. Karnell ◽  
Lucy Hynds Karnell ◽  
John W. Canady
Keyword(s):  
Retrospective Study ◽  
Cleft Palate ◽  
Surgical Management ◽  
Surgical Procedures ◽  
University Of Iowa ◽  
Velopharyngeal Incompetence ◽  
Appropriate Treatment ◽  
Significant Difference ◽  
Pharyngeal Flap ◽  
Selection Of

Objective The purpose of this study was to test the hypothesis that no significant difference exists in the speech outcomes between patients with severe velopharyngeal incompetence (VPI) who receive a pharyngeal flap and patients with less severe VPI who receive a Z-plasty for management of VPI. Design This retrospective study from 1993 to 2002 included a review of pre- and postoperative perceptual speech and resonance assessments of patients with marginal VPI who received a Furlow double-opposing Z-plasty and patients with VPI who received a pharyngeal flap. Setting All patients had surgical management of VPI at the Cleft Palate– Craniofacial Clinic at University of Iowa Hospitals and Clinics. Results Both groups benefited from surgery with significant reduction in perceived hypernasality (p < .001). Comparison of postoperative assessments indicated no difference between the groups in hypernasality or hyponasality ratings. Neither group had a significant increase in hyponasality. Conclusion Both pharyngeal flap and double-opposing Z-plasty proved equally effective at reducing hypernasality when the selection of the surgical procedures was based on preoperative ratings of perceived hypernasality and evaluation of velopharyngeal physiology. Severity of the VPI is an important factor when considering surgical management of VPI. Thorough preoperative evaluations of patients with VPI are essential in appropriate treatment planning.

scholarly journals Pulmonary Sequelae in Patients After Recovery From Coronavirus Disease 2019: A Follow-Up Study With Chest CT

2022 ◽  
Vol 8 ◽  
Author(s):  
Xuejiao Liao ◽  
Dapeng Li ◽  
Zhi Liu ◽  
Zhenghua Ma ◽  
Lina Zhang ◽  
...  
Keyword(s):  
Disease Severity ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
Trend Test ◽  
Lung Involvement ◽  
Follow Up Study ◽  
Ct Findings ◽  
Over Time

Objective: The pulmonary sequelae of coronavirus disease 2019 (COVID-19) have not been comprehensively evaluated. We performed a follow-up study analyzing chest computed tomography (CT) findings of COVID-19 patients at 3 and 6 months after hospital discharge.Methods: Between February 2020 and May 2020, a total of 273 patients with COVID-19 at the Shenzhen Third People's Hospital were recruited and followed for 6 months after discharge. Chest CT scanning was performed with the patient in the supine position at end-inspiration. A total of 957 chest CT scans was obtained at different timepoints. A semi-quantitative score was used to assess the degree of lung involvement.Results: Most chest CT scans showed bilateral lung involvement with peripheral location at 3 and 6 months follow-up. The most common CT findings were ground-glass opacity and parenchymal band, which were found in 136 (55.3%) and 94 (38.2%) of the 246 patients at 3 months follow-up, and 82 (48.2%) and 76 (44.7%) of 170 patients at 6 months follow-up, respectively. The number of lobes involved and the total CT severity score declined over time. The total CT score gradually increased with the increasement of disease severity at both 3 months follow-up (trend test P &lt; 0.001) and 6 months follow-up (trend test P &lt; 0.001). Patients with different disease severity represented diverse CT patterns over time.Conclusions: The most common CT findings were ground-glass opacity and parenchymal bands at the 3 and 6 months follow-up. Patients with different disease severity represent diverse CT manifestations, indicating the necessary for long-term follow-up monitoring of patients with severe and critical conditions.

scholarly journals Geo-temporal distribution of 1,688 Chinese healthcare workers infected with COVID-19 in severe conditions – a secondary data analysis

2020 ◽  
Author(s):  
Wayne Gao ◽  
Mattia Sanna ◽  
Chi Pang Wen
Keyword(s):  
Disease Severity ◽  
Healthcare Workers ◽  
Case Fatality ◽  
Temporal Distribution ◽  
Secondary Data ◽  
Accurate Estimation ◽  
Fatality Rate ◽  
Quality Healthcare ◽  
Short Period ◽  
Significant Difference

IntroductionThe COVID-19 outbreak is posing an unprecedented challenge to healthcare workers. This study analyzes the geo-temporal effects on disease severity for the 1,688 Chinese healthcare workers infected with COVID-19.MethodUsing the descriptive results recently reported by the Chinese CDC, we compare the percentage of infected healthcare workers in severe conditions over time and across three areas in China, and the fatality rate of infected healthcare workers with all the infected individuals in China aged 22-59 years.ResultsAmong the infected Chinese healthcare workers whose symptoms onset appeared during the same ten-day period, the percentage of those in severe conditions decreased statistical significantly from 19.7% (Jan 11 – 20) to 14.4% (Jan 21 – 31) to 8.7% (Feb 1 – 11). Across the country, there was also a significant difference in the disease severity among patients symptoms onset during the same period, with Wuhan being the most severe (17%), followed by Hubei Province (10.4%), and the rest of China (7.0%). The case fatality rate for the 1,688 infected Chinese healthcare workers was significantly lower than that for the 29,798 infected patients aged 20-59 years—0.3% (5/1,688) vs. 0.65% (193/29,798), respectively.ConclusionThe disease severity improved considerably over a short period of time in China. The more severe conditions in Wuhan compared to the rest of the country may be attributable to the draconian lockdown. The clinical outcomes of infected Chinese healthcare workers may represent a more accurate estimation of the severity of COVID-19 for those who have access to quality healthcare.

scholarly journals Selection of treatment for hepatic epithelioid hemangioendothelioma: a single-center experience

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Linping Cao ◽  
Jiawei Hong ◽  
Lingfeng Zhou ◽  
Yufu Ye ◽  
Yuanxing Liu ◽  
...  
Keyword(s):  
Treatment Options ◽  
Needle Aspiration ◽  
Epithelioid Hemangioendothelioma ◽  
Multiple Strategies ◽  
Single Center Experience ◽  
Appropriate Treatment ◽  
Significant Disease ◽  
Selection Of ◽  
Observation Period

Abstract Background Hepatic epithelioid hemangioendothelioma (HEHE) is a rare angiogenic tumor with no recognized effective treatment. Treatment options used worldwide include liver transplantation (LT), liver resection (LR), radiofrequency ablation (RFA), chemotherapy, and observation. The aim of this study was to describe the efficacy of different treatment options used for HEHE at our center. Methods The medical charts of 12 patients with HEHE (9 women and 3 men) who were diagnosed and treated at the First Affiliated Hospital of Zhejiang University, China, between January 2011 and December 2017 were retrospectively reviewed. Results The patients were diagnosed by postoperative histopathology or fine needle aspiration biopsy. Two patients with diffuse lesions received LT and were alive without recurrence at the last follow-up. Three patients received LR as the initial treatment, and all of them developed recurrence during the follow-up period. One patient received RFA and remained free of disease, while the remaining six patients opted for simple observation rather than treatment. One of the patients who received LR passed away because of tumor recurrence within 32 months after surgery; the other patients showed no significant disease activity after treatments for their recurrent lesions. As of April 2018, the mean follow-up duration was 39.6 ± 20.1 months (15–82 months). Conclusions There are multiple strategies for HEHE. Considering its indolent course, initial observation for assessment of the lesion behavior may aid in the selection of appropriate treatment. Surgery or LT is suitable for patients with disease progression during the observation period. However, our sample size was small, and further studies are required to gather more information that can aid in optimal treatment selection.

Selection of Appropriate Treatment Options for Hand Fractures

Hand Clinics ◽  
2013 ◽  
Vol 29 (4) ◽  
pp. 501-505 ◽  
Author(s):  
Douglas M. Sammer ◽  
Tarik Husain ◽  
Rey Ramirez
Keyword(s):  
Treatment Options ◽  
Appropriate Treatment ◽  
Hand Fractures ◽  
Selection Of
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