scholarly journals Role of pulmonary circulation assessment in CT imaging in evaluating the severity and tendency of severe and critical COVID-19 pneumonia

2020 ◽  
Author(s):  
Qiongjie Hu ◽  
Yiwen liu ◽  
Yueying Pan ◽  
Ziyan Sun ◽  
Min Xiang ◽  
...  
Keyword(s):  
Pulmonary Circulation ◽  
Demographic Data ◽  
Pulmonary Veins ◽  
Fatal Outcome ◽  
Ct Imaging ◽  
Cardiac Insufficiency ◽  
Imaging Features ◽  
Laboratory Findings ◽  
Pulmonary Manifestations ◽  
Significant Difference

Abstract Objective: To investigate the value of changes of pulmonary circulation in CT imaging in evaluating the severity and tendency of 2019 novel coronavirus disease (COVID-19) pneumonia.Methods: This retrospective study analyzed 99 severe and critical COVID-19 pneumonia patients including the 47 improved cases and 52 dead cases. Demographic data, laboratory findings, comorbidities, and CT imaging features including the diameters of pulmonary vein (PV), pulmonary artery (PA) and ascending aorta were collected and assessed.Results: The PV diameters of the deceased patients were larger than recovered patients in the severe phase. Compared with the severe phase in the improvement group, the diameters of the pulmonary veins during the improved phase were smaller, and the total CT scores were significantly decreased (p < 0.001). Instead, there was no significant difference in the ratio of main PA to aorta diameter between the recovered group and the deceased group, nor did the self control of the recovered group and the deceased group (p > 0.05). Construction of a ROC curve yielded an optimal cut-off value of the PV diameters for prediction of survival (p < 0.05).Conclusion: The changes of the PV diameters might indirectly reflect the activity of pulmonary inflammation and cardiac insufficiency. Pulmonary manifestations of severe and critical COVID-19 pneumonia might be related to myocardial injury and cardiac insufficiency, expecially accompanied by dilated PVs. Evaluation of changes in pulmonary circulation by chest CT images may be considered as a useful tool for determining the severity, fatal outcome and tendency of COVID-19.Key words: COVID-19, pneumonia, pulmonary circulation, Computed Tomography

scholarly journals Quantitative CT imaging features for COVID-19 evaluation: The ability to differentiate COVID-19 from non- COVID-19 (highly suspected) pneumonia patients during the epidemic period

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0256194
Author(s):  
Shengkun Peng ◽  
Lingai Pan ◽  
Yang Guo ◽  
Bo Gong ◽  
Xiaobo Huang ◽  
...  
Keyword(s):  
Volume Ratio ◽  
Ct Imaging ◽  
Lesion Volume ◽  
Component Ratio ◽  
Imaging Features ◽  
Quantitative Ct ◽  
Epidemic Period ◽  
Significant Difference ◽  
Sensitivity Specificity ◽  
Ct Features

Objectives COVID-19 and Non-Covid-19 (NC) Pneumonia encountered high CT imaging overlaps during pandemic. The study aims to evaluate the effectiveness of image-based quantitative CT features in discriminating COVID-19 from NC Pneumonia. Materials and methods 145 patients with highly suspected COVID-19 were retrospectively enrolled from four centers in Sichuan Province during January 23 to March 23, 2020. 88 cases were confirmed as COVID-19, and 57 patients were NC. The dataset was randomly divided by 3:2 into training and testing sets. The quantitative CT radiomics features were extracted and screened sequentially by correlation analysis, Mann-Whitney U test, the least absolute shrinkage and selection operator (LASSO) logistic regression (LR) and backward stepwise LR with minimum AIC methods. The selected features were used to construct the LR model for differentiating COVID-19 from NC. Meanwhile, the differentiation performance of traditional quantitative CT features such as lesion volume ratio, ground glass opacity (GGO) or consolidation volume ratio were also considered and compared with Radiomics-based method. The receiver operating characteristic curve (ROC) analysis were conducted to evaluate the predicting performance. Results Compared with traditional CT quantitative features, radiomics features performed best with the highest Area Under Curve (AUC), sensitivity, specificity and accuracy in the training (0.994, 0.942, 1.0 and 0.965) and testing sets (0.977, 0.944, 0.870, 0.915) (Delong test, P < 0.001). Among CT volume-ratio based models using lesion or GGO component ratio, the model combining CT lesion score and component ratio performed better than others, with the AUC, sensitivity, specificity and accuracy of 0.84, 0.692, 0.853, 0.756 in the training set and 0.779, 0.667, 0.826, 0.729 in the testing set. The significant difference of the most selected wavelet transformed radiomics features between COVID-19 and NC might well reflect the CT signs. Conclusions The differentiation between COVID-19 and NC could be well improved by using radiomics features, compared with traditional CT quantitative values.

scholarly journals Clinical features of 162 fatal cases of COVID-19: a multi-center, retrospective study

2020 ◽  
Author(s):  
Xianlong Zhou ◽  
Guoyong Ding ◽  
Qing Fang ◽  
Jun Guo ◽  
Luyu Yang ◽  
...  
Keyword(s):  
Medical Records ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Demographic Data ◽  
Antiviral Treatment ◽  
Fatal Outcome ◽  
Intervention Programs ◽  
Laboratory Findings ◽  
Co Morbidity ◽  
Moderate Condition

Abstract Understanding the epidemiological and clinical characteristics of fatal cases infected with SARS-CoV-2 is import to develop appropriate preventable intervention programs in hospitals. Demographic data, clinical symptoms, clinical course, co-morbidities, laboratory findings, CT scans, treatments and complications of 162 fatal cases were retrieved from electric medical records in 5 hospitals of Wuhan, China. The median age was 69.5 years old (IQR: 63.0-77.25; range: 29-96). 112 (69.1%) cases were men. Hypertension (45.1%) was the most common co-morbidity, but 59 (36.4%) cases had no co-morbidity. At admission, 131 (81.9%) cases were assessed as severe or critical. However, 39 (18.1%) were assessed as moderate. Moderate cases had a higher prevalence of hypertension and chronic lung disease comparing with severe or critical cases (P<0.05, respectively). 126 (77.8%) and 132 (81.5%) cases received antiviral treatment and glucocorticoids, respectively. 116 (71.6%) cases were admitted to ICU and 137 (85.1%) cases received mechanical ventilation. Respiratory failure or acute respiratory distress syndrome (93.2%) was the most common complication. The young cases of COVID-19, without co-morbidity and in a moderate condition at admission could develop fatal outcome. We need to be more cautious in case management of COVID-19 for preventing the fatal outcomes.

Abstract 14661: High Sensitive Troponin Elevation Pattern in Covid-19 Era

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alessandro Maino ◽  
Enrico Di Stasio ◽  
Maria Chiara Grimaldi ◽  
Luigi Cappannoli ◽  
Erica Rocco ◽  
...  
Keyword(s):  
Disease Severity ◽  
Demographic Data ◽  
Fatal Outcome ◽  
Treatment Strategies ◽  
High Sensitivity ◽  
Laboratory Findings ◽  
Reference Limit ◽  
Care Information ◽  
Upper Reference Limit ◽  
The Impact

Introduction: Coronavirus disease 2019 (COVID-19) is a pandemic disease that has caused a public health emergency due to its high rapid spread, to the high mortality rate, and the high percentage of patients requiring hospitalization and intensive care . Information regarding the impact of cardiovascular complication on fatal outcome is scarce. Purpose: To compare the levels of hs-Tn between patients affected by SARS-CoV-2 admitted to our hospital in the period February 20-April 9, 2020 versus the general population COVID free. Furthermore, we studied the dependence of hs-Tn levels in SARS-CoV-2 patients on disease severity and on other epidemiological, clinical and laboratory parameters. Methods: This retrospective single-center study analyzed all patients in whom hs-TnI was determined at the Policlinico A.Gemelli (Rome, Italy) from 20 February 2020 to 09 April 2020. One hundred-seventy of these patients received SARS-CoV-2 diagnosis. Demographic data, laboratory findings, comorbidities, and treatments were collected and analyzed in patients with COVID 19. Results: In our study, the population affected by SARS-CoV-2 (n=170) showed a significant association between disease severity and troponin levels (median [range] = 4.0 [<2.4-227.0], 13.5 [<2.4-545.0] and 34.0 [<2.4-45345.0], p<0.001, for mild, severe and critical state, respectively). Moreover, 27 subjects out of 170 (16%) showed high sensitivity troponin values higher than the 99 percentile upper reference limit stratified among previously defined severity classes as follows n=2 (2.4%), n=7 (15.9%) and n=18 (45.0%), respectively. Conclusions: The distribution of the troponin values greater than the cut-off in the SARS-CoV-2 population indicates a myocardial suffering independently related to COVID19 infection. This phenomenon may partially explain the high risk of adverse outcome in COVID-19 patients with underlying CVD. Therefore, it may be reasonable to triage patients with COVID-19 according to the presence of underlying CVD and evidence of myocardial injury for prioritized and personalized treatment strategies.

scholarly journals Temporal delays in trauma craniotomies

2016 ◽  
Vol 125 (3) ◽  
pp. 642-647 ◽  
Author(s):  
Judith Marcoux ◽  
David Bracco ◽  
Rajeet S. Saluja
Keyword(s):  
Injury Severity ◽  
Demographic Data ◽  
Ct Scanning ◽  
Skin Incision ◽  
Outcome Data ◽  
Ct Imaging ◽  
Median Delay ◽  
Brain Trauma Foundation ◽  
Significant Difference ◽  
Life Threatening

OBJECTIVE The Brain Trauma Foundation recommendation regarding the timing of surgical evacuation of epidural hematomas and subdural hematomas is to perform the procedure as soon as possible. Indeed, faster evacuation is associated with better outcome. However, to the authors' knowledge, no study has looked at where delays in intrahospital care occurred for patients suffering from traumatic intracranial mass lesions. The goals of this study were as follows: 1) to characterize the performance of a Level 1 trauma center in terms of delays for emergency trauma craniotomies, 2) to review step by step where delays occurred in patient care, and 3) to propose ways to improve performance. METHODS A retrospective review was conducted covering a 5-year period of all emergency trauma craniotomies. Demographic data, injury severity, neurological status, and functional outcome data were collected. The time elapsed between emergency department (ED) arrival and CT imaging, between CT imaging and arrival at the operating room (OR), between ED arrival and OR arrival, between OR arrival and skin incision, and between ED arrival and skin incision were calculated. Patients were also subcategorized as either having immediate life-threatening emergencies (E0) or life-threatening emergencies (E1). The operative technique was also reviewed (standard craniotomy opening vs immediate bur hole decompression followed by craniotomy). RESULTS The study included 166 patients. Of these, 58 (35%) were classified into the E0 group and 108 (64.2%) into the E1 group. The median ED-to-CT delay was 54 minutes with no significant difference between the E0 and the E1 groups. The median CT-to-OR time delay was 57 minutes. The median delay for the E0 group was 39 minutes and that for the E1 group was 70 minutes (p = 0.002). The median delay from ED to OR arrival for patients with a CT scanning done at an outside hospital was 75 minutes. The median delay from ED to OR arrival was 85 minutes for the E0 group and 127 minutes for the E1 group (p < 0.0001). The median delay from OR arrival to skin incision was 35 minutes (E0: median 27 minutes; E1: median 39 minutes; p < 0.0001). The median total time elapsed between ED arrival and skin incision was 150 minutes (E0: median 131 minutes; E1: median 180 minutes). Overall, only 17% of patients underwent immediate bur hole decompression, but the proportion climbed to 41% in the E0 group. A lower Glasgow Coma Scale score was associated with a shorter delay (p = 0.0004). CONCLUSIONS A long delay until surgery still exists for patients requiring urgent mass lesion evacuation. Many factors contribute to this delay, including performing imaging and transfer to and preparation in the OR. Strategies can be implemented to reduce delays and improve the delivery of care.

scholarly journals Immunophenotype Study in Children with Leukemia and Its Relationship with Relapse in Ahvaz Shafa Hospital from 2013 to 2018

2019 ◽  
Vol 9 (1) ◽  
pp. 61
Author(s):  
Arash Alghasi ◽  
Jamshid Safdarian
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
B Cell ◽  
Leukocyte Count ◽  
Lymphoblastic Leukemia ◽  
Demographic Data ◽  
Laboratory Findings ◽  
Khuzestan Province ◽  
Significant Difference ◽  
Male Patients ◽  
The Mean

Introduction: Acute lymphoblastic leukemia (ALL) is one of the most common cancers in children. Since the identification of patients immunophenotypes is effective for disease diagnose and prognosis, and due to very few studies in Iran, especially Khuzestan province, the aim of this study was to investigate the immunophenotype of children with leukemia and its association with recurrence in Ahvaz Shafa Hospital from 2013 to 2019. Methods: This is a retrospective study that was conducted in patients referring to Ahvaz Shafa Hospital during the years 2013 to 2019. Demographic data including age, gender, height, weight, leukocyte count, flow cytometry and other laboratory findings were collected and analyzed by version 22 SPSS statistical software. Results: The mean age of the patients was 7.59 &plusmn; 3.94 years and the sex of 51 (52%) were female. Immunophenotype of 81 patients (82.7%) was Pre B cell, 4 patients (4.1%) was Pro-B Cell, 5 patients (5.1%) was Pro-T Cell, and 8 patients (8.2%) was T Cells. 87 patients (88.8%) recovered and 11 patients (11.2%) had recurrence. Only 11 patients with Pre B cell (13.6%) had recurrence, but in other immunophenotypes, 100% of patients had remission, but this difference was not statistically significant (p = 0.46). There was no statistically significant difference between the prevalence of phenotypes in female and male sexes (p = 0.76). The incidence of recurrence was 9.8% in female patients and 12.8% in male patients, which was not statistically significant (p = 0.64). Conclusion: The results of this study showed that preB cell immunophenotypes with the prevalence of 82.7% had the highest frequency in acute lymphoblastic leukemia, and the incidence of recurrence in patients was 11.2%. Also, patients with other immunophenotypes did not recurrence, so his finding may have been because of insufficent patients to study and compare.

scholarly journals Is Caesarean Myomectomy a Safe Procedure? A Comparative Study

2016 ◽  
Vol 22 (1) ◽  
Author(s):  
Serdar Başaranoğlu ◽  
Elif Ağaçayak ◽  
Ayşegül Deregözü ◽  
İlknur İnegöl Gümüş ◽  
Mustafa Acet ◽  
...  
Keyword(s):  
Postoperative Morbidity ◽  
Demographic Data ◽  
Safe Procedure ◽  
Laboratory Findings ◽  
Significant Difference ◽  
Maternal Morbidity And Mortality ◽  
Gestational Week ◽  
The Mean ◽  
Group 2 ◽  
Group 1

<p><strong>OBJECTIVE:</strong> Uterine myomas are the most common benign pelvic tumours observed during the reproductive period.Increased risks of haemorrhage and postoperative morbidity lead professionals to avoid myomectomy at the time of Cesarean (C-section). The present study retrospectively analysed the data of patients who had undergone C-section only and those that had undergone C-section and simultaneous myomectomy.</p><p><strong>STUDY DESIGN:</strong> The data of 42 patients (Group 1) who had underwent caesarean myomectomy and of 50 patients underwent C-section only (Group 2) out of 92 patients that had been taken into C-section on the basis of obstetric indications were retrospectively analysed in this study. The relevant patient data were recorded with the inclusion of demographic data, gestational week, and preoperative and postoperative laboratory findings. Types, locations and sizes (the largest diameter) of individual myomas were identified and noted.</p><p><strong>RESULTS:</strong> The mean diameter of myomas was 66.3±30.2 mm. Ten patients that had underwent caesarean myomectomy (23.8%) developed a need for intensive care. No statistically significant difference was found in laboratory parameters between Group 1 and Group 2.</p><p><strong>CONCLUSION:</strong> Caesarean myomectomy, when performed by experienced obstetricians, does not lead to a significant increase in maternal morbidity and mortality. Although the short-term effects of this procedure are known, there is a need for the conduct of more comprehensive studies to establish its longterm effects on fertility or how it will affect the next pregnancy processes.</p>

scholarly journals Vitamin D Toxicity in A Pediatric Toxicological Referral Center: A Cross-Sectional Study from Iran

2020 ◽  
Author(s):  
Fariba Farnaghi ◽  
Hossein Hassanian-Moghaddam ◽  
Nasim Zamani ◽  
Narges Gholami ◽  
Latif Gachkar ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Pediatric Population ◽  
Demographic Data ◽  
Essential Element ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Benign Condition ◽  
Significant Difference ◽  
Vitamin D Toxicity

Abstract Background: Vitamin D is an essential element for body health whose supplements are generally administered to prevent vitamin D deficiency. Since these supplements are available at homes, vitamin D toxicity may happen in children.Methods: All children younger than 12 years who presented to the pediatric emergency department of Loghman Hakim Hospital, Tehran, Iran with history of ingestion ofvitamin D supplements more than 1500 IU/day were enrolled. Patients’ demographic data, on-presentation signs and symptoms, laboratory findings, treatments given, and outcome were evaluated.Result: Fifteenpatients presented during the study period. Their mean age was 46.53 ±10.14 months and 12 (80%) were girls. All of them had unintentionally ingested vitamin D. Mean ingested dose was 406700.7±227400.1 IU. In eight patients (53.3%), 25 Hydroxyvitamin D level was more than 100 ng/mL. One patient experienced hypercalcemia while all of them were asymptomatic and discharged without complications. There was no significant difference between patients with and without high levels of 25 OH vitamin D regarding lab tests, toxicity course, and outcome.Conclusion: It seems that acute vitamin D toxicity is a benign condition in our pediatric population which may be due to high prevalence of vitamin D deficiency in Iran.

scholarly journals CT scans in psychiatric patients - an exploratory study at Chris Hani Baragwanath Hospital

2007 ◽  
Vol 13 (1) ◽  
pp. 4
Author(s):  
F Y Jeenah ◽  
M Y H Moosa
Keyword(s):  
Mentally Ill ◽  
Exploratory Study ◽  
Psychiatric Patients ◽  
Demographic Data ◽  
Ct Scanning ◽  
First Episode Psychosis ◽  
First Episode ◽  
Laboratory Findings ◽  
Episode Psychosis ◽  
Significant Difference

<p><strong>Objective.</strong> An exploratory study was undertaken to determine the value of computed tomography (CT) in the assessment of mentally ill patients at Chris Hani Baragwanath Hospital.</p><p><strong>Method.</strong> All mentally ill inpatients aged 18 years and older who presented during the period March - August 2005, were screened for eligibility for CT of the head. The patients’ demographic data, clinical details, special investigations and the results of the CT were recorded. <strong></strong></p><p><strong>Results.</strong> Of approximately 600 admissions, 55 were eligible for CTs during the study period. The mean age of the study population was 38.3 years (standard deviation (SD) 16.3 years). Twenty patients (36.4%) had abnormal CTs; 7 (35%) of these patients were over the age of 60 years. There was a significant correlation between abnormal CTs and advancing age (r = 0.5, p &lt; 0.001). In the group with abnormal CTs the gender distribution was similar, 15 (75%) presented with a first episode of psychosis, 5 (25%) had a concurrent abnormal physical examination, and 7 (35%) had abnormal special investigations. There was no significant difference between this group and the group with normal CTs with regard to gender (χ2 = 0.75, p = 0.385), first-episode psychosis (χ2 = 2.76, p = 0.096), abnormal physical findings (χ2 = 0.51, p = 0.473), or abnormal laboratory findings (χ2 = 0.13, p = 0.714) respectively. <strong></strong></p><p><strong>Conclusion.</strong> In this psychiatric population CT scanning revealed a significant number of abnormalities, especially in patients with first-episode psychosis. The study also suggests that clinical abnormalities (physical and laboratory) may not be reliable predictors of abnormal CTs and therefore the need for further research with bigger sample size.</p>

scholarly journals Pruritus, as a Neglected Symptom, in Opioid Poisoning in Children

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fariba Farnaghi ◽  
Marjaneh Abbasi Ghadi ◽  
Latif Gachkar ◽  
Hossein Hassanian Moghaddam
Keyword(s):  
Complete Blood Count ◽  
Demographic Data ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Patient Specific ◽  
P Value ◽  
Specific Information ◽  
Laboratory Findings ◽  
Clinical Scenarios ◽  
Significant Difference

Background: Opioid poisoning is common and fatal childhood poisoning in Iran with nonspecific, hidden, vague, and misleading clinical manifestations in some cases. Objectives: The aim of this study was to investigate and emphasize pruritus, as a neglected and helpful symptom in this important poisoning. Methods: In this cross-sectional study, one hundred pediatrics patients (< 14 years) with opioid poisoning who were referred to Loghman Hakim Hospital, Tehran-Iran, from April 2018 to April 2019 were enrolled the study. Demographic data including age, sex, type of poisoning, clinical manifestations including pruritus, its onset, location, duration, and therapy, also laboratory findings including complete blood count (CBC) and Eosinophilia recorded in patient-specific information forms. The collected data were analyzed using SPSS 21 software. Results: The patients’ mean age was 43.4 ± 31.4 months. Fifty-seven (57%) of them were male. Fifty-two (52%) of them reported Pruritus that in 84% observed in face. In 31% of children, itching resulted in skin scratches. The most common clinical manifestations were CNS depression (93%), respiratory suppression (68%), vomiting (52%), pruritus (52%), and meiosis (51%). There was no significant relationship between pruritus and gender, age, laboratory findings, family history of addiction, and allergy. Pruritus had a significant difference with Respiratory suppression (apnea, bradypnea, cyanosis), meiosis, vomiting, and redness of the skin (P-value: 0.05, 0.003, 0.009, and 0.002, respectively). Pruritus was controlled by naloxone in all of our patients. Conclusions: According to the results of the present study, pruritus is a common and helpful clinical manifestation in children with opioid poisoning that helps the physician for correct diagnosis, especially in hidden clinical scenarios.

scholarly journals Differences between the Incident and Prevalent Hemodialysis Patients in Egypt

2020 ◽  
pp. 42-54
Author(s):  
Abir Farouk Megahed ◽  
Ghada El-Said ◽  
Mona Mohammed Tawfik Abdelhady ◽  
Nagy Sayed-Ahmed
Keyword(s):  
Demographic Data ◽  
Hemodialysis Patients ◽  
Prospective Multicenter Study ◽  
Laboratory Findings ◽  
Predictors Of Mortality ◽  
Number Of Patients ◽  
Significant Difference ◽  
Definition Of ◽  
Mortality Predictors ◽  
Urea Reduction Ratio

Background and Aim: The number of patients on hemodialysis (HD) increases continuously. The HD population is usually divided into early and late HD patients according to the duration of HD, that are known as incident and prevalent groups. Still, there is a debate about the exact definition of both the incident and prevalent groups. Furthermore, predictors of death of both of these groups are not yet identified, especially in Egyptian HD patients. We aimed to compare between the incident and prevalent HD patients as well as to define predictors of mortality among each of these groups. Study Design and Methodology: This prospective multicenter study was started in June 2016, comprising 2123 HD patients recruited from twenty-five Egyptian HD centers. Patients were classified according to HD duration into two groups: Incident group including patients with HD duration equals to or less than 6 months, and a prevalent group including patients who had been maintained on HD for more than 6 months. All patients were observed for one and half years and their demographic data, laboratory findings and mortality events were recorded. Results: In comparison to the prevalent group, the incident HD patients showed significantly lower hemoglobin, serum albumin, urea reduction ratio, serum phosphorus, and serum ferritin but higher average erythropoiesis stimulating agents (ESA) dose. There was significantly a higher number of patients with hypertension in the incident group, while there was no significant difference in diabetes mellitus or ischemic heart disease in both groups. There were a higher number of patients with positive hepatitis C virus antibodies and hyperparathyroidism in the prevalent group. By the end of the study, the mortality frequency was found to be significantly higher in the incident than the prevalent groups. Older age and corrected serum calcium were significant predictors of mortality in the total studied group as well as the prevalent group. However, no significant predictors of mortality could be detected among the incident group. Conclusion: The incident HD group tends to show higher frequency of hypertension, laboratory findings suggestive of malnutrition as well as higher frequency of mortality with different pattern of mortality predictors compared to the prevalent group.

Sign in / Sign up

Export Citation Format

Share Document