scholarly journals Risk Factors For COVID-19 Positivity in Hospitalized Patients in A Low Prevalence Setting

2020 ◽  
Author(s):  
Iris Zohar ◽  
Orna Schwartz ◽  
Debby Ben David ◽  
Margarita Mashavi ◽  
Mohamad Aboulil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neutrophil Count ◽  
Respiratory Illness ◽  
Hospitalized Patients ◽  
Multivariate Regression Model ◽  
Normal Range ◽  
X Ray ◽  
Chest X Ray ◽  
Low Probability ◽  
Low Prevalence

Abstract Background: Identifying hospitalized patients with Coronavirus disease 2019 (COVID-19) in a low prevalence setting is challenging. We aimed to identify differences between COVID-19 positive and negative patients. Methods: Hospitalized patients with respiratory illness, or fever, were isolated in the emergency room and tested for COVID-19. Patients with a negative PCR and low probability for COVID-19 were taken out of isolation. Patients with a higher probability for COVID-19 remained in isolation during hospitalization and were retested after 48 hours. Risk factors for COVID-19 were assessed using logistic regression. Results: 254 patients were included, 37 COVID-19-positive (14.6%) and 217 COVID-19-negative (85.4%). Median age was 76 years, 52% were males. In a multivariate regression model, variables significantly associated with COVID-19 positivity were exposure to a confirmed COVID-19 case, length of symptoms before testing, bilateral and peripheral infiltrates in chest X-ray, neutrophil count within the normal range, and elevated LDH. In an analysis including only patients with pneumonia (N=78, 18 positive for COVID-19), only bilateral and peripheral infiltrates, normal neutrophil count and elevated LDH were associated with COVID-19 positivity. Conclusions: The clinical presentation of COVID-19 positive and negative patients is similar, but radiographic and laboratory features may help to identify COVID-19 positive patients and to initiate quick decisions regarding isolation.

Chilaiditi Syndrome and Recurrent Colonic Volvulus: A Case Report

2001 ◽  
Vol 87 (2) ◽  
pp. 111-112
Author(s):  
Jon Matthews ◽  
Giles W Beck ◽  
Douglas M G Bowley ◽  
Andrew N Kingsnorth
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Case Report ◽  
Optimal Treatment ◽  
X Ray ◽  
Colonic Volvulus ◽  
Chilaiditi’S Syndrome ◽  
Chest X Ray ◽  
Chilaiditi’S Sign ◽  
Chilaiditi's Syndrome

AbstractThe case of a 31 year old male presenting as an emergency with a recurrent colonic volvulus is described. A chest X-ray on admission to hospital showed the presence of hepato-diaphragmatic interposition of the colon, Chilaiditi’s Sign, which is known to be a risk factor for colonic volvulus. This is only the fourth reported case of colonic volvulus in association with Chilaiditi’s Syndrome and the first with recurrent colonic volvulus. The optimal treatment for recurrent volvulus in patients with risk factors such as Chilaiditi’s Syndrome or megacolon is also discussed.

Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography

2018 ◽  
Vol 35 (10) ◽  
pp. 1032-1038 ◽  
Author(s):  
Aaron S. Weinberg ◽  
William Chang ◽  
Grace Ih ◽  
Alan Waxman ◽  
Victor F. Tapson
Keyword(s):  
Pulmonary Embolism ◽  
Chest Radiograph ◽  
High Probability ◽  
Hemodynamic Instability ◽  
X Rays ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Low Probability ◽  
Clinically Significant

Objective: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. In this retrospective study, we demonstrate that portable V/Q scans can be helpful in ruling in or out clinically significant pulmonary embolism (PE) despite an abnormal chest x-ray in the ICU. Design: Two physicians conducted chart reviews and original V/Q reports. A staff radiologist, with 40 years of experience, rated chest x-ray abnormalities using predetermined criteria. Setting: The study was conducted in the ICU. Patients: The first 100 consecutive patients with suspected PE who underwent a portable V/Q scan. Interventions: Those with a portable V/Q scan. Results: A normal baseline chest radiograph was found in only 6% of patients. Fifty-three percent had moderate, 24% had severe, and 10% had very-severe radiographic abnormalities. Despite the abnormal x-rays, 88% of the V/Q scans were low probability for a PE despite an average abnormal radiograph rating of moderate. A high-probability V/Q for PE was diagnosed in 3% of the population despite chest x-ray ratings of moderate to severe. Six patients had their empiric anticoagulation discontinued after obtaining the results of the V/Q scan, and no anticoagulation was started for PE after a low-probability V/Q scan. Conclusion: Despite the large percentage of moderate-to-severe x-ray abnormalities, PE can still be diagnosed (high-probability scan) in the ICU with a portable V/Q scan. Although low-probability scans do not rule out acute PE, it appeared less likely that any patient with a low-probability V/Q scan had severe hypoxemia or hemodynamic instability due to a significant PE, which was useful to clinicians and allowed them to either stop or not start anticoagulation.

scholarly journals Recurrent spontaneous pneumothorax in pregnancy-a case report

2021 ◽  
Vol 8 (11) ◽  
pp. 3449
Author(s):  
Muhammad S. Shafique ◽  
Fatima Rauf ◽  
Hamza W. Bhatti ◽  
Noman A. Chaudhary ◽  
Muhammad Hanif
Keyword(s):  
Case Report ◽  
Spontaneous Pneumothorax ◽  
Respiratory Illness ◽  
Tube Thoracostomy ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
X Ray ◽  
Chest X Ray ◽  
In Pregnancy

Spontaneous pneumothorax during pregnancy is a rare but a serious condition. The typical symptoms of spontaneous pneumothorax include pleuritic chest pain and shortness of breath. Diagnosis is usually made on chest X-ray with abdominal shielding. Management differs according to severity and no specific guidelines are described for management of spontaneous pneumothorax in pregnancy. We report a case of a 27-year-old multigravida, with insignificant past medical history for any respiratory illness, presenting with recurrent, left sided spontaneous pneumothorax during a single pregnancy. It was managed by chest tube thoracostomy each time and patient was discharged with tube till the delivery of the fetus.

scholarly journals Design of a Convolution Neural Network Model to Predict COVID-19

2021 ◽  
pp. 99-105
Author(s):  
Haritha Akkineni ◽  
Lakshmi Narayana Ukoti ◽  
Venkat Sai Babu Palagani ◽  
Shaik Ijaz Ahammad ◽  
Bindu Meghana Popuri
Keyword(s):  
Neural Network ◽  
Severe Pneumonia ◽  
Respiratory Illness ◽  
High Accuracy ◽  
Blood Oxygen ◽  
Fluid Accumulation ◽  
X Ray ◽  
Life Saving ◽  
Chest X Ray ◽  
Fast Transmission

Coronavirus is a type of viral infection. There are many different kinds, and some cause disease. A newly identified coronavirus, has caused a worldwide pandemic of respiratory illness, called COVID-19. When the virus reaches the lungs, and it causes inflammation, resulting in fluid accumulation and difficulty of breathing. When fluid enters the air in the lungs where gas exchange occurs, it leads to low blood oxygen levels. This condition is termed pneumonia. There are about four to five tests which are used to identify the presence of coronavirus in humans but among them, there are only two tests which are recommended by WHO as they take less time and a low risk to identify the virus During recent times there is a fast transmission of Covid-19, And in some countries that are unable to purchase laboratory kits for testing. We aimed to present the use of Machine learning for the high-accuracy detection of Covid-19 using chest X-ray and these images are publicly available. A convolutional neural network with minimized layers is capable of detecting Covid-19 in a limited number of chest X-ray images. This model can also detect SARS, MERS and severe pneumonia using chest X-ray images has life-saving importance for both patients and doctors.

scholarly journals Optimizing Chest X-ray Indication in Blunt Trauma Patients using Clinical Criteria

2017 ◽  
Vol 6 (1) ◽  
pp. 30-34
Author(s):  
Luca GA Pivetta ◽  
Cristiano Below ◽  
Giovanna Z Rondini ◽  
Jacqueline AG Perlingero ◽  
José C Assef ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Thoracic Injury ◽  
Trauma Patients ◽  
X Rays ◽  
Chest Drainage ◽  
X Ray ◽  
Clinical Criteria ◽  
Chest X Ray ◽  
Low Probability ◽  
Excessive Number

ABSTRACT Background There is an excessive number of unnecessary chest X-rays (CXRs) in minor blunt trauma patients. Objective To identify, using routine clinical criteria, a subgroup of blunt trauma patients that do not require CXR for assessment. Materials and methods This was a retrospective analysis of trauma registry data collected over a 24-month period. Adult blunt trauma patients undergoing CXR on admission were analyzed. The following clinical criteria were assessed: Normal neurologic examination on admission (NNEx), hemodynamic stability (HS), normal physical examination of the chest on admission (NCEx), age ≤ 60 years, and absence of distracting injuries (Abbreviated Injury Scale >2 in head, abdomen, and extremities). These clinical criteria were progressively merged to select a group with lowest risk of exhibiting abnormal CXR on admission. Results Out of 4,647 patients submitted to CXR on admission, 268 (5.7%) had abnormal findings on scans. Of 2,897 patients admitted with NNEx, 116 (4.0%) had abnormal CXR. Of 2,426 patients with NNEx and HS, 74 (3.0%) had abnormal CXR. Of 1,698 patients with NNEx, HS, and NCEx, 24 (1.4%) had abnormal CXR. Of 1,347 patients with NNEx, HS, NCEx, and age < 60 years, 12 had thoracic injury (0.9% of total individuals receiving CXR). A total of 4 patients underwent chest drainage. Among 1,140 cases with all clinical criteria, 8 had confirmed thoracic injuries and 2 underwent chest drainage. Conclusion A subgroup of blunt trauma patients with low probability of exhibiting abnormalities on CXR at admission was identified. The need for CXR in this subgroup should be reviewed. How to cite this article Pivetta LGA, Parreira JG, Below C, Rondini GZ, Perlingero JAG, Assef JC. Optimizing Chest X-ray Indication in Blunt Trauma Patients using Clinical Criteria. Panam J Trauma Crit Care Emerg Surg 2017;6(1):30-34.

scholarly journals Carcinoembryonic antigen (CEA) as a candidate prognostic marker of nonmucinous pneumonic adenocarcinoma (P-ADC) of the lung.

2019 ◽  
Vol 5 (suppl) ◽  
pp. 28-28
Author(s):  
Satoru Nakamura ◽  
Minoru Fukuda
Keyword(s):  
Serum Level ◽  
Prognostic Marker ◽  
First Generation ◽  
Initial Diagnosis ◽  
Smoking History ◽  
Normal Range ◽  
X Ray ◽  
Chest X Ray ◽  
Serum Cea ◽  
Egfr Tki

28 Background: Serum level of CEA as a prognostic marker in NSCLC is well known. In patients with non-mucinous P-ADC, there were some paradoxical cases with high CEA, in spite of improved symptom and chest X-ray after chemotherapy including first-generation EGFR-TKI. Methods: We retrospectively comfirmed serum level of CEA of five patients, including four patients with non-mucinous P-ADC and one patient with mucinous P-ADC, between 2001-2007, all Japanese female without smoking history, 66-78 years old (mean 73.6 y.o.). All of them revealed abnormal pneumonic shadow on chest X-ray, and were diagnosed by TBLB or cytology. These cases were all stage IIIB or IV, and were applied to chemotherapy including first-generation EGFR-TKI. We had measured serum CEA as possible from initial diagnosis and pre or post chemotherapy including first-generation EGFR-TKI to death. OS were between 25~66 months with four patients of non-mucinous P-ADC, and 9 month with one patient of mucinous P-ADC. Other tumor marker such as CYFRA and Pro GRP were all almost normal range. Results: CEA of three patients with non-mucinous P-ADC was elevated according to worsened symptom and X-ray, and were all highly maintained or increased in spite of improved symptom and X-ray after chemotherapy including first-generation EGFR-TKI. CEA of one patient with non-mucinous P-ADC was normal range in initial diagnosis, and no more measured. She has got symptom free and improved chest X-ray after chemotherapy. In one patient with mucinous P-ADC, serum CEA was normal range, so no longer measured. This patient was no effective for chemotherapy, and was dead 9 month after the initial diagnosis. Number of cases was quite few, so further examination is favorable. Furthermore, All cases were exaggerated finally, they might be resistant to first-generation EGFR-TKI. Conclusions: In three patients with non-mucinous P-ADC of the lung, serum CEA was paradoxically highly maintained or elevated in spite of improved symptom and chest X-ray after chemotherapy including first-generation EGFR-TKI. Therefore, serum CEA is a candidate for useful prognostic marker of non-mucimous P-ADC of the lung.

scholarly journals The Role of Imaging In The Diagnosis of Pulmonary Embolism

2019 ◽  
Vol 2 (1) ◽  
pp. 57
Author(s):  
Alfian Nur Rosyid ◽  
M. Yamin ◽  
Arina Dery Puspitasari
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Gold Standard ◽  
Common Condition ◽  
X Ray ◽  
Life Threatening ◽  
Chest X Ray ◽  
Proper Diagnosis ◽  
D Dimer

Pulmonary embolism is a common condition and sometimes can be life-threatening. A proper diagnosis can reduce mortality. Some examinations are needed to diagnose pulmonary embolism, including assessing the risk factors, clinical examination, D-dimer tests, and imaging. Imaging is necessary when the previous assessment requires further investigation. There are more imaging that can be used to diagnose and assess the severity of pulmonary embolism. However, it is still controversial regarding imaging modalities for optimizing pulmonary embolism diagnose. Chest X-Ray cannot exclude pulmonary embolism, but it is needed to guide the next examinations and to find alternative diagnoses. Pulmonary Multi-Detector CT Angiography is the gold standard to diagnose pulmonary embolism.

scholarly journals Risk Factors for Progression to Patients with Severe Stage of COVID-19

2020 ◽  
Author(s):  
Min Cheol Chang ◽  
Yoo-Kyung Park ◽  
Bong-Ok Kim ◽  
Donghwi Park
Keyword(s):  
Risk Factors ◽  
Body Temperature ◽  
Severe Disease ◽  
Initial Symptom ◽  
X Ray ◽  
Disease States ◽  
Logistic Analysis ◽  
Severe Stage ◽  
Chest X Ray ◽  
Multivariate Logistic Analysis

Abstract Background: Coronavirus disease (COVID-19) is rapidly spreading worldwide. Although 10%–20% of patients with COVID-19 have severe symptoms, little is known about the risk factors related to the aggravation of COVID-19 symptoms from asymptomatic or mild to severe disease states. Methods: This retrospective study included 211 patients who were asymptomatic or with mild presentations of COVID-19. We evaluated the differences in in demographic and clinical data between the cured (discharged to home) and transferred (aggravated to severe-stage COVID-19) groups. Results: A multivariate logistic analysis showed that body temperature, chills, initial chest X-ray findings, and the presence of diabetes were significantly associated with predicting the progression to severe stage of COVID-19 (p < 0.05). The odds ratio of transfer in patients with COVID-19 increased by 12.7-fold for abnormal findings such as haziness or consolidation in initial chest X-ray, 6.32-fold for initial symptom of chills, and 64.1-fold for diabetes.Conclusions: Even if patients are asymptomatic or have mild symptoms, clinicians should closely observe patients with COVID-19 presenting with chills, body temperature >37.5°C, findings of pneumonia in chest X-ray, or diabetes.

scholarly journals Transient Global Amnesia as a Possible First Manifestation of COVID-19

2020 ◽  
Vol 11 (1) ◽  
pp. 84-86
Author(s):  
Haitham M. Hussein
Keyword(s):  
Nervous System ◽  
Respiratory Failure ◽  
Brain Mri ◽  
Transient Global Amnesia ◽  
Respiratory Illness ◽  
X Ray ◽  
Unexplained Fever ◽  
Chest X Ray ◽  
Hypoxic Respiratory Failure ◽  
Global Amnesia

Evidence of involvement of the nervous system in COVID-19 disease is accumulating. We describe a case of a 53-year-old man presented with classic syndrome of transient global amnesia with symptoms lasting less than 24 hours and mild transient unexplained fever. Workup including brain MRI, electroencephalogram, and chest X ray was negative and the patient was discharged. The day after discharge, the patient started to experience the classic respiratory and systemic COVID-19 illness and was eventually readmitted with hypoxic respiratory failure and positive COVID-19 test a week after the first hospital discharge. The case highlights the importance of neurological syndromes as presenting prodrome to the respiratory illness of COVID-19.

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