Various radiological findings in Indonesian patients with COVID-19: a case series

Abstract Background: Plain chest X-rays (CXRs) are considered more effective and useful for the initial screening and follow-up of patients with COVID-19. Moreover, radiological evaluation of suspected COVID-19 patients is required for early detection of thoracic involvement, particularly in emergency units, while waiting for definitive diagnosis by real-time reverse transcription polymerase chain reaction (RT-PCR). Here, we report a case series of CXR findings in Indonesian patients with COVID-19 in our institution.Case presentations: We included 7 patients with COVID-19 confirmed by RT-PCR, including 4 females and 3 males, with ages ranging from 36–71 years. All patients showed abnormal findings on CXR when admitted to the hospital, except one, composed of ground glass opacity (GGO) (n=1), consolidation (n=3), and both (n=2). Both and one side of the lung were affected in three and three (left side=2; right side=1) patients, respectively. Pneumonia degrees of mild, moderate and severe were observed in three, one, and two patients, respectively. All patients eventually recovered.Conclusions: CXR showed various abnormality findings in patients with COVID-19, including the type, location, and degree of pneumonia.

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Chest CT Findings after 4 Months from the Onset of COVID-19 Pneumonia: A Case Series

Diagnostics ◽

10.3390/diagnostics10110899 ◽

2020 ◽

Vol 10 (11) ◽

pp. 899

Author(s):

Luigi Urciuoli ◽

Elvira Guerriero

Keyword(s):

Case Series ◽

Chest Ct ◽

Reference Standard ◽

Rt Pcr ◽

Comprehensive Understanding ◽

Chain Reaction ◽

Published Evidence ◽

Lung Abnormalities ◽

Polymerase Chain

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the reference standard for SARS-CoV-2 diagnosis is real-time reverse transcription polymerase chain reaction (RT-PCR), computed tomography (CT) is recommended for both initial evaluation and follow-up. There is a growing body of published evidence about CT evolution during the course of COVID-19 pneumonia. Here, we report six confirmed cases of COVID-19 patients who underwent unenhanced chest CT on admission and after 4 months from the onset of symptoms. Chest-CT at first admission showed the typical CT features of COVID-19. Interestingly, the follow-up CT revealed the persistence of lung abnormalities in five cases even if all the patients were completely asymptomatic. Further studies are needed for a comprehensive understanding of the disease progression and the resulting late imaging modifications.

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Ocular and Systemic Manifestations in Paediatric Multisystem Inflammatory Syndrome Associated with COVID-19

Journal of Clinical Medicine ◽

10.3390/jcm10132953 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2953

Author(s):

Tzu-Chen Lo ◽

Yu-Yen Chen

Keyword(s):

Serum Antibody ◽

Case Series ◽

Pooled Analysis ◽

Rt Pcr ◽

Laboratory Findings ◽

Systemic Manifestations ◽

Polymerase Chain ◽

Exposure History ◽

Systemic Symptoms ◽

Inflammatory Syndrome

This study aimed to achieve a better understanding of the epidemiological and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) following coronavirus disease 2019 (COVID-19). We searched PubMed and Embase between December 2019 and March 2021 and included only peer-reviewed clinical studies or case series. The proportions of patients who had conjunctivitis, systemic symptoms/signs (s/s), Kawasaki disease (KD), and exposure history to suspected/confirmed COVID-19 cases were obtained. Moreover, positive rates of the nasopharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) and serum antibody for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recorded. Overall, 32 studies with 1458 patients were included in the pooled analysis. Around half of the patients had conjunctivitis. The five most common systemic manifestations were fever (96.4%), gastrointestinal s/s (76.7%), shock (61.5%), rash (57.1%), and neurological s/s (36.8%). Almost one-third presented complete KD and about half had exposure history to COVID-19 cases. The positivity of the serology (82.2%) was higher than that of the nasopharyngeal RT-PCR (37.0%). MIS-C associated with COVID-19 leads to several features similar to KD. Epidemiological and laboratory findings suggest that post-infective immune dysregulation may play a predominant role. Further studies are crucial to elucidate the underlying pathogenesis.

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Stepwise progression from ground-glass opacity towards invasive adenocarcinoma: Long-term follow-up of radiological findings

Lung Cancer ◽

10.1016/j.lungcan.2007.09.001 ◽

2008 ◽

Vol 60 (2) ◽

pp. 298-301 ◽

Cited By ~ 21

Author(s):

Hiroshi Soda ◽

Yoichi Nakamura ◽

Katsumi Nakatomi ◽

Nanae Tomonaga ◽

Hiroyuki Yamaguchi ◽

...

Keyword(s):

Ground Glass Opacity ◽

Ground Glass ◽

Radiological Findings ◽

Invasive Adenocarcinoma ◽

Long Term Follow Up

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Loss of Correction After Chevron Osteotomy for Hallux Valgus as a Function of Preoperative Deformity

Foot & Ankle International ◽

10.1177/1071100718807699 ◽

2018 ◽

Vol 40 (3) ◽

pp. 287-296 ◽

Cited By ~ 8

Author(s):

Gerhard Kaufmann ◽

Stefanie Sinz ◽

Johannes M. Giesinger ◽

Matthias Braito ◽

Rainer Biedermann ◽

...

Keyword(s):

Hallux Valgus ◽

Case Series ◽

X Rays ◽

Retrospective Case ◽

Level Of Evidence ◽

Loss Of Correction ◽

Chevron Osteotomy ◽

Significant Correction ◽

Preoperative Deformity

Background: Recurrence is relatively common after surgical correction of hallux valgus. Multiple factors are discussed that could have an influence in the loss of correction. The aim of this study was to determine preoperative radiological factors with an influence on loss of correction after distal chevron osteotomy for hallux valgus. Methods: Five hundred twenty-four patients who underwent the correction of a hallux valgus by means of distal chevron osteotomy at our institution between 2002 and 2012 were included. We assessed weightbearing x-rays at 4 time points: preoperatively, postoperatively, and after 6 weeks and 3 months. We investigated the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), joint congruity, and the position of the sesamoids. Results: At all points of the survey, significant correction of the IMA and HVA was detected. The IMA improved from 12.9 (± 2.8) to 4.5 (± 2.4) degrees and the HVA from 27.5 (± 6.9) to 9.1 (± 5.3) degrees. Loss of correction was found in both HVA and IMA during follow-up with a mean of 4.5 and 1.9 degrees, respectively. Loss of correction showed a linear correlation with preoperative IMA and HVA, and a correlation between preoperative DMAA and sesamoid position. Conclusion: The chevron osteotomy showed significant correction for HVA, IMA, and DMAA. Preoperative deformity, in terms of IMA, HVA, DMAA, and sesamoid position, correlated with the loss of correction and could be assessed preoperatively for HVA and IMA. Loss of correction at 3 months persisted during the follow-up period. Level of Evidence: Level IV, retrospective case series.

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Emergent management of complicated paraesophageal hernia due to distal gastrointestinal obstruction: three-case series

Journal of Gastric Surgery ◽

10.36159/jgs.v2i3.54 ◽

2020 ◽

Vol 2 (3) ◽

Author(s):

Constantinos Avgoustou ◽

Dionisis Theodoropoulos ◽

Dimitrios Fagrezos ◽

Eirini Avgoustou ◽

Dimitrios Giannousis

Keyword(s):

Paraesophageal Hernia ◽

Case Series ◽

Gastric Fundus ◽

Abdominal Hernia ◽

X Rays ◽

Gastrointestinal Obstruction ◽

Acute Complications ◽

Operative Findings ◽

Emergent Surgery

Background: The aim of this study is to describe the diagnostic evaluation and treatment in patients with complicated paraesophageal hernia (PEH) and distal gastrointestinal (GI) obstruction. Methods: Three cases with known PEH in the Department of Surgery of the General Hospital of Nea Ionia ‘’Constantopoulion-Patission’’, I woman 78 yrs, II man 88 and III man 78, underwent emergent open surgery for complicated PEH and GI obstruction. Cardiorespiratory distress in all and sepsis in I, were encountered. Case I had coexistent incarcerated abdominal hernia, II had a prepyloric lesion revealed by gastroscopy and III chronic constipation. X-rays and CT scan helped diagnosis. Operative findings: In case I, we found viable incarcerated bowel, gastric fundus and body strangulated in mediastinum, fundus ruptured, and antrum ischemic; total gastrectomy with esophageal and duodenal stapling were performed. In case II, the stomach with an obstructive prepyloric lesion was volvulized in mediastinum; distal gastrectomy, gastrojejunostomy, cruroraphy and fundopexy were performed. In case III, strangulation of the dolichosigmoid was the prominent feature, moreover, incarceration of gastric fundus and transverse colon in PEH sac were also found; reduction of PEH contents, limited resection of thick congenital bands, extended left colectomy, cruroraphy, fundopexy and caecopexy were performed. Results: Case I and II were transferred intubated to ICU. Case I was never stabilized, died after 50 hours; histology confirmed gastric necrosis. Case II was extubated on day 4, discharged on day 28; histology revealed antral ischemia and prepyloric pT2 adenocarcinoma. Case III had uneventful outcome; histology revealed dolichosigmoid ischemia. Follow-up of cases II and III (32 and 30 months respectively) has been uneventful. Conclusion: Obstructive conditions distal to large PEHs may lead to acute complications in hernia contents and emergent surgery is challenging. Obstructive conditions distal to large PEHs may lead to acute complications in hernia contents and emergent surgery is challenging.

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One-Time Cortical Lamina: A New Technique for Horizontal Ridge Augmentation. A Case Series

Journal of Biomedical Engineering and Medical Imaging ◽

10.14738/jbemi.86.11270 ◽

2021 ◽

Vol 8 (6) ◽

pp. 22-30

Author(s):

Vincenzo Foti ◽

Davide Savio ◽

Roberto Rossi

Keyword(s):

Fibrin Sealant ◽

Case Series ◽

X Rays ◽

Marginal Bone Loss ◽

Ridge Augmentation ◽

Keratinized Tissue ◽

A New Technique ◽

The One ◽

Hard Consistency

The aim of this case series is to introduce the One-Time Cortical Lamina Technique, a simplification of the F.I.R.S.T. (Fibrinogen-Induced Regeneration Sealing Technique) in cases where only horizontal augmentation is needed. The indications for this technique are ASA2 and ASA1 anxious patients. Pre-requisites for this surgical technique are: a good amount of keratinized tissue, sufficient alveolar ridge width for placement of implants, thickness of vestibular bone at CBCT planning less than 1 mm with risk of threads exposure. Five patients with horizontal deficiencies were selected to test the efficacy of this approach. The defects were augmented using a porcine cortical bone lamina in combination with collagenated porcine bone mixed with fibrin sealant. The cortical lamina was placed only buccal to the implants and stabilized with fibrin sealant, without pins or screws. Upon completion of the implant surgery, healing abutments were connected to the implants and the soft tissue sutured around them. The healing was uneventful in all cases. Six months after surgery impressions for final restorations were taken and screwed crowns delivered. The new volume had hard consistency and the follow-up CBCT measured an average of 4.17 mm of horizontal bone augmentation. One to three years of follow up demonstrated the maintenance of vestibular volume, hard consistency and clinical stability. Intraoral X-rays showed no marginal bone loss. An advantage of this technique could be the one stage surgery that creates a stable environment for regeneration from day one.

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Chest CT as a Complement to RT-PCR to Confirm and Follow-up COVID-19 Patients

Medicinus ◽

10.19166/med.v8i1.3122 ◽

2021 ◽

Vol 8 (1) ◽

pp. 31

Author(s):

Aziza Ghanie Icksan ◽

Muhammad Hafiz ◽

Annisa Dian Harlivasari

Keyword(s):

Chest Ct ◽

Rt Pcr ◽

High Resolution Computed Tomography ◽

X Ray ◽

First Case ◽

Chest X Ray ◽

Polymerase Chain

Background : The first case of COVID-19 in Indonesia was recorded in March 2020. Limitation of reverse-transcription polymerase chain reaction (RT-PCR) has put chest CT as an essential complementary tool in the diagnosis and follow up treatment for COVID-19. Literatures strongly suggested that High-Resolution Computed Tomography (HRCT) is essential in diagnosing typical symptoms of COVID-19 at the early phase of disease due to its superior sensitivity (97%) compared to chest x-ray (CXR).The two cases presented in this case study showed the crucial role of chest CT with HRCT to establish the working diagnosis and follow up COVID-19 patients as a complement to RT-PCR, currently deemed a gold standard.

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Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans

Clinical Kidney Journal ◽

10.1093/ckj/sfaa086 ◽

2020 ◽

Vol 13 (3) ◽

pp. 328-333 ◽

Cited By ~ 3

Author(s):

Rui Wang ◽

Hong He ◽

Cong Liao ◽

Hongtao Hu ◽

Chun Hu ◽

...

Keyword(s):

Computed Tomography ◽

Invasive Mechanical Ventilation ◽

Case Series ◽

Ground Glass Opacity ◽

High Sensitivity ◽

Chest Ct ◽

Maintenance Hemodialysis ◽

Rt Pcr ◽

Chest Computed Tomography ◽

Reactive Protein

Abstract Background Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in humans in Wuhan, Hubei Province, China, in December 2019, and has subsequently spread worldwide. Methods We conducted a retrospective, single-center case series of the seven maintenance hemodialysis (HD) patients infected with COVID-19 at Zhongnan Hospital of Wuhan University from 13 January to 7 April 2020 and a proactive search of potential cases by chest computed tomography (CT) scans. Results Of 202 HD patients, 7 (3.5%) were diagnosed with COVID-19. Five were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) because of compatible symptoms, while two were diagnosed by RT-PCR as a result of screening 197 HD patients without respiratory symptoms by chest CT. Thirteen of 197 patients had positive chest CT features and, of these, 2 (15%) were confirmed to have COVID-19. In COVID-19 patients, the most common features at admission were fatigue, fever and diarrhea [5/7 (71%) had all these]. Common laboratory features included lymphocytopenia [6/7 (86%)], elevated lactate dehydrogenase [3/4 (75%)], D-dimer [5/6 (83%)], high-sensitivity C-reactive protein [4/4 (100%)] and procalcitonin [5/5 (100%)]. Chest CT showed bilateral patchy shadows or ground-glass opacity in the lungs of all patients. Four of seven (57%) received oxygen therapy, one (14%) received noninvasive and invasive mechanical ventilation, five (71%) received antiviral and antibacterial drugs, three (43%) recieved glucocorticoid therapy and one (14%) received continuous renal replacement therapy. As the last follow-up, four of the seven patients (57%) had been discharged and three patients were dead. Conclusions Chest CT may identify COVID-19 patients without clear symptoms, but the specificity is low. The mortality of COVID-19 patients on HD was high.

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Autologous Bone Marrow Transplantation for Acute Promyelocytic Leukemia in Second Remission: Prognostic Relevance of Pretransplant Minimal Residual Disease Assessment by Reverse-Transcription Polymerase Chain Reaction of the PML/RARα Fusion Gene

Blood ◽

10.1182/blood.v90.3.1321 ◽

1997 ◽

Vol 90 (3) ◽

pp. 1321-1325 ◽

Cited By ~ 136

Author(s):

Giovanna Meloni ◽

Daniela Diverio ◽

Marco Vignetti ◽

Giuseppe Avvisati ◽

Saveria Capria ◽

...

Keyword(s):

Median Time ◽

Fusion Gene ◽

Autologous Bone Marrow Transplantation ◽

Autologous Bone Marrow ◽

Promyelocytic Leukemia ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Autologous Bone

Abstract Reverse-transcription polymerase chain reaction (RT-PCR) of the PML/RARα fusion gene may predict relapse in acute promyelocytic leukemia (APL) patients in hematologic complete remission (CR). We have prospectively studied by RT-PCR 15 PML/RARα+ APL patients undergoing autologous bone marrow transplantation (ABMT) in second CR. The median time of first CR duration was 12 months (range, 6 to 40). All patients were reinduced with all-trans retinoic acid (ATRA), followed in 12 of 15 cases by mitoxantrone and Ara-C as consolidation. Fourteen patients received the BAVC (BCNU, Ara-C, m-AMSA, and VP-16) schedule as conditioning regimen. Unpurged marrows were collected immediately before conditioning treatment, analyzed by RT-PCR, and reinfused at median of 2 months (range, 2 to 7) from the achievement of second CR. Seven patients were PCR+ and eight PCR− for PML/RARα in their pretransplant marrows. All seven patients of the former group remained PCR+ during the follow-up and relapsed at a median time of 5 months (range, 2 to 9) from ABMT and 9 months (range, 4 to 14) from second CR. Of the eight PCR− patients, all remained PCR− during the follow-up controls. One patient relapsed at 10 months from ABMT, one died of a secondary (PML/RARα−) leukemia, and six are in hematologic and molecular remission at a median time of 28 months (range, 15 to 60) after ABMT and 32 months (range, 17 to 62) from second CR. Our results indicate that, in APL patients in second CR, ABMT with PML/RARα− marrow cells is likely to result in prolonged clinical and molecular remissions. Conversely, patients who test PCR+ after reinduction necessitate the use of alternative aggressive approaches, including unrelated allogeneic transplant.

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