scholarly journals Can point-of-care lung ultrasound (POCUS) be implemented as a substitute for chest CT scan for the assessment of patients with COVID-19 pneumonia?

2021 ◽  
Vol 20 (2) ◽  
pp. 43-55
Author(s):  
Treefa Salih Hasan ◽  
Keyword(s):  
Lung Ultrasound ◽  
Point Of Care ◽  
Pulmonary Involvement ◽  
P Value ◽  
The Novel ◽  
Lung Involvement ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Sensitivity Specificity ◽  
Chest Ct Scan

Background: In the novel COVID outbreak , chest imaging was in the front door for the diagnostic approach to any patient with respiratory symptoms , including chest HRCT & lung ultrasound modalities. Objective: To find the correlation between lung ultrasound and chest high-resolution computed tomography (HRCT) signs in patients suffering from COVID-19 pulmonary involvement. Patients and Methods: This cross-sectional observational study conducted in Arbil / Iraq, from July to November 2020 , enrolled 50 patients who assessed using HRCT and lung ultrasound (LUS),12 areas in the chest examined by ultrasound and corresponding percentage (absent or limited, moderate, extensive, severe & critical grads ) of lung affection on HRCT. Results: Analysis of the obtained data from 50 affected patients done , a highly significant positive relation noted between the findings on ultrasound & the extend of lung involvement by chest HRCT (r factor 0.78, the p-value was <0.001), the sensitivity, specificity, and accuracy of LUS were 90%, 70% ,and 68% respectively. Conclusion: The current study showed that ultrasound and HRCT are parallel in assessing the extent of lung involvement among COVID-19 pneumonia victims, thus making lung ultrasound a relevant substitute for HRCT.

scholarly journals FRI0056 LUNG COMPROMISE SCREENING IN PATIENTS WITH EARLY RA. A MULTICENTRIC CROSS SECTIONAL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 604.1-604
Author(s):  
F. Benavidez ◽  
G. Rodriguez ◽  
A. Riopedre ◽  
D. Mata ◽  
A. Benitez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Examination ◽  
Lung Disease ◽  
Lung Involvement ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Multicentric Study ◽  
Link Type ◽  
Immunological Tests ◽  
Pulmonary Manifestations

Background:Rheumatoid arthritis (RA) affects 0.4-1.3% of general population (1). It can affect lungs in different ways, with interstitial lung disease (ILD) as the most severe. Clinically evident ILD has been reported in 10-42% of patients, with a great impact in prognosis (2).Objectives:Toidentify the prevalence of lung involvement in early rheumatoid arthritis patients (ERA) without previous known lung disease and describe the association between high resolution computed tomography (HRCT), lung functional tests (LFT) and clinical findings.Methods:Cross sectional multicentric study. We included ERA patients (1 year or less since diagnose) consecutively. Patients with previous RA related lung disease or biologic/targeted synthetic Dmard treatment were excluded. HRCT, immunological tests (rheumatoid factor, anti-CCP, ANA), LFT and clinical evaluation were performed.Results:We included 74 patients, 63 (85,1%) woman, mean (SD) of 47 (17,7) years. Thirty-seven patients (50%) were current or former smokers. Abnormal findings in HRCT were found in 62 patients (88,6%): ILD in 6 (8,6%), airway involvement in 40 (70%) and emphysema in 7 (10%). Ten patients (13,5%) had abnormal auscultation (2 sibilances, 2 roncus, and 6 crackles). Six patients (8,1%) had digital clubbing. Regarding immunological tests, 54/61 (88,5%) patients were positive for Anti CCP, and 53/61 (86,9%) were positive for FR. We compared features of patients with findings related to RA in HRCT (interstitial and/or airway) with those without them. We found no differences in the mean (SD) of DAS-28 [4,74 (1,38) vs 4,32 (1,39); p= 0,27]. The prevalence of anti- CCP was not higher in patients with abnormal HRCT [38/44 (86,3%) vs 16/17 (94,1%); p=0,39]. Patients with abnormal HRCT were older [median (IQR) 50,5 years (44,5-59,5) vs 43 years (32-51); p=0,008) and showed higher VSG values [mean (SD) 39,09 (24,03) vs 27,38 (17,6); p= 0,043]. Abnormal physical examination or dyspnea (class 2 mMRC or higher) was significantly associated with HRCT abnormalities [26 (50%) vs 3 (13,6%); p=0.003) and the presence of ILD on HRCT was significantly associated with crackles on the auscultation [4/68(6,25%) vs 2/6 (33,33%); p 0,023].Conclusion:This study shows a high prevalence of lung involvement in ERA patients of less 1 year from diagnosis. Also, we showed a significant association between HRCT and physical examination findings. This data highlights the importance of the clinical examination in Rheumatoid Arthritis patients. More studies with bigger samples and longitudinal follow up are needed to confirm and complete our results.References:[1]Rooney BK, Silman AJ. Epidemiology of the rheumatic diseases. Curr Opin Rheumatol [Internet]. 1999 Mar [cited 2016 Jul 19];11(2):91–7. Available from:http://www.ncbi.nlm.nih.gov/pubmed/10319210.[2]Antin-Ozerkis D, Evans J, Rubinowitz A, Homer RJ, Matthay RA. Pulmonary Manifestations of Rheumatoid Arthritis. Clin Chest Med [Internet]. 2010;31(3):451–78. Available from:http://dx.doi.org/10.1016/j.ccm.2010.04.003.Disclosure of Interests:None declared

scholarly journals Analysis of the Specificity, Sensitivity and Accuracy of Goniometry Method Compared to Tape Method for Measuring Trunk Mobility in Normal Adults

2021 ◽  
pp. 138-145
Author(s):  
Purvi Patel
Keyword(s):  
Range Of Motion ◽  
Standard Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Spine Mobility ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Normal Adults

Measurement of lumbar range of motion (LROM) is a routine method in the examination of patients with low back pain. There is no standard technique which may be used to accurately describe the range of motion in the different plane. So in present study, an attempt has been made to compare goniometric measurement with tape measurement for its sensitivity, specificity and accuracy for measuring spine mobility in normal adults. In this cross sectional study, 137 healthy adults between the ages of 18-26 years of age were included consecutively and assessed using Tape method and goniometry for trunk mobility in all planes (sagittal, frontal and transverse). The association of goniometry with tape method was assessed using chi square test. The study showed that the difference between goniometry and tape method was statistically significant (p value <0.05) for all movements except flexion (p value 0.215). Also the sensitivity, specificity and accuracy of goniometry is not as good as tape method except for flexion compared to tape method. So, from this study we can conclude that Goniometry was not as good as tape method for all movements except forward flexion where both can be equally used.

scholarly journals Lung Involvement Found on Chest CT Scan in a Pre-Symptomatic Person with SARS-CoV-2 Infection: A Case Report

2020 ◽  
Vol 5 (2) ◽  
pp. 56 ◽  
Author(s):  
Ali Asadollahi-Amin ◽  
Mehrdad Hasibi ◽  
Fatemeh Ghadimi ◽  
Hosnieh Rezaei ◽  
SeyedAhmad SeyedAlinaghi
Keyword(s):  
Ct Scan ◽  
Stable Condition ◽  
Lung Field ◽  
The Novel ◽  
Lung Involvement ◽  
Compassionate Use ◽  
Unrelated Condition ◽  
Novel Coronavirus ◽  
Care Worker ◽  
Chest Ct Scan

The novel coronavirus SARS-CoV-2 infection is spreading worldwide, and there are many reports of acute respiratory distress syndrome caused by this infection. However, asymptomatic lung involvement has not been reported. We hereby present the case of a 44-year-old health-care worker, who was found to be infected with the SARS-CoV-2 virus after a CT-scan performed for an unrelated condition revealed a lesion in the lung field compatible with COVID-19 infection. His condition deteriorated initially, but eventually improved with supportive treatment and the compassionate use of antivirals and antimalarials and is now in a stable condition.

scholarly journals Interleukin 21 as a diagnostic marker of rheumatoid arthritis.

2019 ◽  
Vol 26 (08) ◽  
pp. 1229-1232
Author(s):  
Khadija Kiran ◽  
Amtul Huda ◽  
Zuhair Bhatti
Keyword(s):  
Rheumatoid Arthritis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Marker ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Sensitivity Specificity

To investigate the role of IL-21 as diagnostic marker in diagnosis of rheumatoid arthritis. Study Design: Cross sectional study. Setting: Department of Physiology and Orthopedic Gujranwala Medical College, Gujranwala. Period: October 2017 to October 2018 in one year duration. Materials and Methods: A total of 150 patients were included in the study, main variables assessed in this study were positive predictive value negative predictive value, sensitivity, specificity and accuracy of IL-21 in diagnosis of rheumatoid arthritis. SPSS version 23 was used to analyze the data. P value less than or equal to 0.05 was taken as significant. Study was started after permission from hospital ethical committee and patients were informed in detail about disease and procedure to be done. Non probability consecutive sampling was used. Results: The estimated sensitivity was 93.6%. The estimated specificity was 50%. Positive predictive value was 96.3% and negative predictive value was 35.7%. The overall accuracy was 90.6% for diagnosing rheumatoid arthritis. Conclusion: IL-21 induces MMP3 in rheumatoid arthritis patients, identification of IL-21 from synovium of patients indicates the presence of rheumatoid arthritis. We observed 90.6% diagnostic accuracy of IL-21 for rheumatoid patients taking RA factor as gold standard of diagnostic tool.

scholarly journals Lung ultrasound patterns in pediatric pneumonia in Mozambique and Pakistan

2020 ◽  
pp. 00518-2020
Author(s):  
Amy Sarah Ginsburg ◽  
Pio Vitorino ◽  
Zunera Qasim ◽  
Jennifer L. Lenahan ◽  
Jun Hwang ◽  
...  
Keyword(s):  
Interrater Reliability ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Integrated Management ◽  
Secondary Analysis ◽  
World Health ◽  
P Value ◽  
Pediatric Pneumonia ◽  
District Hospitals ◽  
Health Organization

ObjectiveImproved pneumonia diagnostics are needed, particularly in resource-constrained settings. Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing pneumonia. The objective was to explore LUS patterns associated with pediatric pneumonia.MethodsWe conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at two district hospitals in Mozambique and Pakistan. We assessed LUS and chest radiograph (CXR) examinations, and viral and bacterial nasopharyngeal carriage, and performed a secondary analysis of LUS patterns.ResultsLUS demonstrated a range of distinctive patterns that differed between children with and without pneumonia and between children in Mozambique versus Pakistan. The presence of LUS consolidation or interstitial patterns was more common in children with chest-indrawing pneumonia than in those without pneumonia. Consolidations were also more common among those with only bacterial but no viral carriage detected (50.0%) than among those with both (13.0%) and those with only virus detected (8.3%;p-value 0.03). LUS showed high interrater reliability among expert LUS interpreters for overall determination of pneumonia (κ=0.915), consolidation (κ=0.915), and interstitial patterns (κ=0.901), but interrater reliability between LUS and CXR for detecting consolidations was poor (κ=0.159, Pakistan) to fair (κ=0.453, Mozambique).DiscussionPattern recognition was discordant between LUS and CXR imaging modalities. Further research is needed to define and standardise LUS patterns associated with pediatric pneumonia and to evaluate the potential value of LUS as a reference standard.

scholarly journals Perbedaan Hasil Pemeriksaan Hemoglobin Antara Metode Point of Care Testing Dengan Metode Sianmethemoglobin Pada Ibu Hamil

2020 ◽  
Vol 9 (1) ◽  
pp. 24
Author(s):  
Puspitasari Puspitasari ◽  
Andika Aliviameita ◽  
Evi Rinata ◽  
Rizka Afifah Yonika Yasmin ◽  
Sukma Nur Saidah
Keyword(s):  
Point Of Care ◽  
P Value ◽  
Point Of Care Testing ◽  
Cross Sectional

Pemeriksaan kadar hemoglobin pada ibu hamil merupakan faktor yang penting karena sering ditemukan kondisi kurangnya zat besi selama masa kehamilan. Berbagai metode pemeriksaan hemoglobin digunakan pada fasilitas pelayanan kesehatan. Penelitian ini bertujuan untuk mengetahui perbedaan hasil pemeriksaan hemoglobin antara metode Point of Care Testing (POCT) menggunakan darah kapiler dan darah vena dengan metode sianmethemoglobin menggunakan darah vena pada ibu hamil. Penelitian ini merupakan penelitian eksperimental laboratorium dengan desain studi observasi analitik <em>cross sectional</em>. Penelitian dilakukan di Laboratorium Puskesmas Sukodono Kabupaten Sidoarjo pada Maret - April 2020. Sampel yang digunakan yaitu pasien ibu hamil di Puskesmas Sukodono berumur 15-34 tahun sebanyak 30. Hasil analisis menggunakan uji t tes sampel bebas didapatkan nilai t hitung sebesar 1,543 dengan p- value sebesar 0,128. Hasil analisis menggunakan uji t tes berpasangan didapatkan nilai t hitung sebesar 2,736 dengan p-value sebesar 0,011. Dapat disimpulkan bahwa tidak terdapat perbedaan yang signifikan secara statistik antara rata-rata hasil pemeriksaan hemoglobin metode POCT darah kapiler dengan metode sianmethemoglobin darah vena dan terdapat perbedaan yang signifikan secara statistik antara rata-rata hasil pemeriksaan hemoglobin metode POCT darah vena dengan metode sianmethemoglobin darah vena.

scholarly journals THE EVALUATION OF LUNG INVOLVEMENT AND FUNCTIONAL CAPACITIES IN PATİENTS DİAGNOSED WITH PRIMARY SJOGREN’S SYNDROME

2021 ◽  
Author(s):  
Tugce Sahin Ozdemirel ◽  
Ali Erhan Ozdemirel ◽  
Berna Akinci Ozyurek ◽  
Derya Yenibertiz ◽  
Yurdanur Erdogan
Keyword(s):  
Lymphocytic Infiltration ◽  
Pulmonary Involvement ◽  
Lung Involvement ◽  
High Resolution Computed Tomography ◽  
Treatment Regimens ◽  
Ct Findings ◽  
Systemic Inflammatory Disease ◽  
Functional Capacities ◽  
6 Minute Walk Test

ABSTRACT Introduction: Sjögren syndrome is a chronic, systemic, inflammatory disease characterized with lymphocytic infiltration of the exocrine glands, frequently manifested by dryness in the region affected. Although the most common extraglandular involvement in SS is pulmonary involvement. Early diagnosis and treatment is considered to be important. It was aimed to evaluate the frequency of early lung involvement, high resolution computed tomography (HRCT) findings and data of pulmonary function test (PFT) in SS in this study. Material-Method: Thirty five patients diagnosed with SS and referred by the Department of Rheumatology to determine potential lung involvement to the 8th chest diseases outpatient clinic of our hospital between September 2015 and December 2018 were included in this study. Respiratory signs, demographic features, length of disease and treatment regimens, PFT, data of 6-minute walk test (MWT) and findings of HRCT of the patients were retrospectively obtained from hospital information system and patient files. Results: The mean age of the patients was 54.4 ± 9.2. The majority of the patients were women (94.3%). When the HRCT findings were evaluated, 28 (80%) patients had CT findings, while 7 (20%) patients had no CT findings. The most common HRCT findings found in patients were peribronchial thickening (48.6 %), ground glass appearance (28.6%) and prominence in interstitial scars. Conclusion: We think that the evaluation of HRCT and PFTs in patients diagnosed with SS for assessing early pulmonary involvement will be guiding in terms of follow-up and treatment.

scholarly journals Lung ultrasound for the diagnosis of cystic fibrosis pulmonary exacerbation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Hassanzad ◽  
Arda Kiani ◽  
Atefeh Abedini ◽  
Hoseinali Ghaffaripour ◽  
Habib Emami ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Lung Ultrasound ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Pulmonary Exacerbation ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Pleural Thickening

Abstract Background High-resolution computed tomography (HRCT) is the gold standard for the evaluation of cystic fibrosis (CF) lung disease; however, lung ultrasound (LUS) is being increasingly used for the assessment of lung in these patients due to its lower cost, availability, and lack of irradiation. We aimed to determine the diagnostic performance of LUS for the evaluation of CF pulmonary exacerbation. Methods This cross-sectional study included patients with CF pulmonary exacerbation admitted to Masih Daneshvari Hospital, Tehran, Iran, from March 21, 2020 to March 20, 2021. Age, gender, and body mass index (BMI) of the patients were recorded. All patients underwent chest X-ray (CXR), HRCT, and LUS on admission. Pleural thickening, atelectasis, air bronchogram, B-line, and consolidation were noted in LUS and then compared with the corresponding findings in CXR and HRCT. Taking HRCT findings as reference, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (DA) of LUS and CXR for the detection of each pulmonary abnormality were determined. Results Of the 30 patients included in this study, with a mean age of 19.62 ± 5.53 years, 14 (46.7%) were male. Of the 15 patients aged 2–20 years, BMI was below the 5th percentile in 10 (66.7%), within the 5–10 percentiles in 1 (6.7%), 10–25 percentiles in 3 (20%), and 25-50 percentiles in 1 (6.7%). The mean BMI for 15 patients > 20 years was 18.03 ± 2.53 kg/m2. LUS had better diagnostic performance compared to CXR for the detection of air bronchogram, consolidation, and pleural thickening (area under the receiver operating characteristic curve [AUROC]: 0.966 vs. 0.483, 0.900 vs. 0.575, and 0.656 vs. 0.531, respectively). Also, LUS was 100% and 96.7% specific for the diagnosis of pleural effusion and atelectasis, respectively. Conclusions LUS appears to be superior to CXR and comparable with HRCT for the evaluation of CF pulmonary exacerbation, especially in terms of air bronchogram and consolidation detection. LUS can be used to lengthen the HRCT evaluation intervals in this regard or utilized along with HRCT for better evaluation of CF pulmonary exacerbation.

Accuracy of Bilistick (a Point-of-Care Device) to Detect Neonatal Hyperbilirubinemia

2020 ◽  
Vol 66 (6) ◽  
pp. 630-636
Author(s):  
Bhargavi Kamineni ◽  
Anusha Tanniru ◽  
Venkateshwarlu Vardhelli ◽  
Deepak Sharma ◽  
Dinesh Pawale ◽  
...  
Keyword(s):  
Point Of Care ◽  
Low Cost ◽  
Venous Blood ◽  
P Value ◽  
Moderate Degree ◽  
Cross Sectional ◽  
System A ◽  
The Mean ◽  
Sample Transfer ◽  
Severe Hyperbilirubinemia

Abstract Introduction Early diagnosis and appropriate management of neonatal jaundice is crucial in avoiding severe hyperbilirubinemia and brain injury. A low-cost, minimally invasive, point-of-care (PoC) tool for total bilirubin (TB) estimation which can be useful across all ranges of bilirubin values and all settings is the need of the hour. Objective To assess the accuracy of Bilistick system, a PoC device, for measurement of TB in comparison with estimation by spectrophotometry. Design/methods In this cross-sectional clinical study, in infants who required TB estimation, blood samples in 25-µl sample transfer pipettes were collected at the same time from venous blood obtained for laboratory bilirubin estimation. The accuracy of Bilistick in estimating TB within ±2 mg/dl of bilirubin estimation by spectrophotometry was the primary outcome. Results Among the enrolled infants, 198 infants were eligible for study analysis with the mean gestation of 36 ± 2.3 weeks and the mean birth weight of 2368 ± 623 g. The median age at enrollment was 68.5 h (interquartile range: 48–92). Bilistick was accurate only in 54.5% infants in measuring TB within ±2 mg/dl difference of TB measured by spectrophotometry. There was a moderate degree of correlation between the two methods (r = 0.457; 95% CI: 0.339–0.561, p value &lt; 0.001). Bland–Altman analysis showed a mean difference of 0.5 mg/dl (SD ± 4.4) with limits of agreement between −8.2 and +9.1 mg/dl. Conclusion Bilistick as a PoC device is not accurate to estimate TB within the clinically acceptable difference (±2 mg/dl) of TB estimation by spectrophotometry and needs further improvement to make it more accurate.

Point-of-care contrast enhanced lung ultrasound and COVID-19

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110479
Author(s):  
Alice Tee ◽  
Gibran Timothy Yusuf ◽  
Adrian Wong ◽  
Deepak Rao ◽  
Sa Tran ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Contrast Enhanced Ultrasound ◽  
Cross Sectional ◽  
Patient Demographics ◽  
Pulmonary Angiogram ◽  
Contrast Enhanced ◽  
Cross Sectional Imaging ◽  
Ct Pulmonary Angiogram

Objectives Bedside lung ultrasound has been indispensable during the coronavirus disease 2019 (COVID-19) pandemic, allowing us to rapidly assess critically unwell patients. We demonstrate the unique application of contrast-enhanced ultrasound with the aim of further understanding this disease. Methods Patient demographics were recorded alongside recent cross-sectional imaging and inflammatory markers. Ultrasound was conducted by experienced operators in a portable setting. Conventional six-point lung ultrasound method was used to evaluate B-lines, small (subpleural) consolidation and the pleura. Areas of small consolidation were targeted after intravenous administration of ultrasound contrast. Results The areas of small consolidations, a potential sign of pneumonia on B-mode lung ultrasound, usually enhance on contrast-enhanced ultrasound. Our study revealed these areas to be avascular, indicating an underlying thrombotic/infarction process. Findings were present in 100% of the patients we examined. We have also shown that the degree of infarction correlates with CT severity (r = 0.4) and inflammatory markers, and that these areas improve as patients recover. Conclusions We confirmed the theory of immune thrombus by identifying the presence of microthrombi in the lungs of 100% of our patients, despite 79% having had a recent negative CT pulmonary angiogram study. contrast-enhanced ultrasound can be utilised to add confidence to an uncertain COVID-19 diagnosis and for prognosticating and monitoring progress in confirmed COVID-19 patients. Contrast-enhanced ultrasound is clearly very different to CT, the gold standard, and while there are specific pathologies that can only be detected on CT, contrast-enhanced ultrasound has many advantages, most notability the ability to pick up microthrombi at the periphery of the lungs.

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