scholarly journals Radiological and functional pulmonary complications in patients recovered from COVID-19

2021 ◽  
Vol 1 ◽  
pp. e1217
Author(s):  
Henry Mejía-Zambrano
Keyword(s):  
Ground Glass Opacity ◽  
Pulmonary Complications ◽  
Assessment Tools ◽  
Diffusion Capacity ◽  
Republic Of China ◽  
Blood Institute ◽  
Interlobular Septum ◽  
National Heart Lung ◽  
Restrictive Pattern

Background: The COVID-19 disease caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which appeared at the end of 2019 in Hubei Province, Wuhan Region of the People's Republic of China. Objective: To determine radiological and functional pulmonary complications in patients recovered from COVID-19. Methods: We included observational studies, studies of radiological and functional pulmonary complications related to COVID-19 in patients discharged from hospital, studies of available text and studies in English and Spanish. A formal narrative synthesis of the collected data was carried out; no formal statistical synthesis was carried out. The synthesis focused on qualitative analysis. The methodological quality of the articles was assessed using the quality assessment tools of the National Heart, Lung, and Blood Institute. Results: In this systematic review it was observed that the functional pulmonary complications that the patients manifested were: 45.05 % of impaired diffusion capacity (DLCO), 30.1 % of restrictive pattern (FEV1) and 20.4 % of obstructive pattern (FEV1/FVC). Radiological complications were: 59.7% ground-glass opacity (GGO), 18.75% consolidation, 9.3% bronchiectasis, 6% thickening of the underlying pleura, 3.9% thickening of the interlobular septum, 3.83% crazy-paving and 0.96% pleural effusion. Conclusion: This review concludes that post-COVID-19 infection patients showed impaired lung and radiological functions, with DLCO and GGO being the most important.  

scholarly journals A systematic review of the systematic review of post COVID-19 syndrome

2022 ◽  
Vol 2 (1) ◽  
pp. 64-69
Author(s):  
Abdulmohsen Alhumayn ◽  
Ibrahim Alsaif ◽  
Joud Enabi ◽  
Sharafaldeen Bin Nafisah
Keyword(s):  
Systematic Review ◽  
Reference Lists ◽  
Ground Glass Opacity ◽  
Common Symptom ◽  
General Health Status ◽  
Diffusion Capacity ◽  
Appropriate Care ◽  
And Diffusion

Background: The declaration of the COVID-19 pandemic triggered a global inquiry into the transmission, mortality, risk factors, and management of the disease. Recently, however, attention has shifted toward its long-term consequences. There is a need for a better understanding of the predictors and symptoms of post-COVID syndrome, to ensure appropriate care for patients recovering from COVID-19 beyond the acute phase. Methods: We searched PubMed, Google Scholar, Cochrane databases, and available data in the PROSPERO databases. We also explored the reference lists of included articles and any systematic reviews identified therein. We searched the keywords "Post Covid", "Post COVID syndrome", "Post- Covid" and "PostCOVID", until July 2021. Results: Of 8167 articles, 13 were included. The syndrome affects several systems with variable prevalence. Fatigue and sleep disturbance is the most common symptom of acute post-COVID syndrome, observed in more than two-thirds of patients, while a reduction in quality of life and general health status was noted in up to 69%. Furthermore, a reduced aerobic and diffusion capacity was seen in 38% of patients up to one month after presumed recovery from infection. Radiologically, in up to 52% of patients, a ground-glass opacity (GGO) was noted beyond three months post-infection. The incidence of new psychiatric illness increased from as early as 14 days after infection and up to three or six months. Hearing impairment or loss, whether sensorineural or conductive, was noted in up to 8.3% of patients, and tinnitus was seen in up to 4.2%. Conclusion: Overall, given the variability in the manifestation of post-COVID syndrome, a multidisciplinary team is required to better serve these patients. We therefore urge the establishment of such teams, encompassing internal medicine, pulmonology, cardiology, and neurocognitive services.

scholarly journals Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems

2020 ◽  
Author(s):  
Sahar Zare ◽  
Zahra Meidani ◽  
Mohammad Shirdeli ◽  
Ehsan Nabovati
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Blood Institute ◽  
Time Period ◽  
National Heart Lung ◽  
Quasi Experimental ◽  
Test Ordering

Abstract Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. Studies using CDSSs as an intervention to improve laboratory test ordering as the primary aim were included. The study populations in the included studies were laboratory tests, physicians ordering laboratory tests, or the patients for whom laboratory tests were ordered. The included papers were evaluated for their outcomes related to the effect of CDSSs which were categorized based on the outcomes related to tests, physician, and patients. The primary outcome measures were the number and cost of the ordered laboratory tests. The instrument from The National Heart Lung and Blood Institute (NIH) was used to assess the quality of the included studies. Moreover, we applied a checklist for assessing the quality and features of the CDSSs presented in the included studies. A narrative synthesis was used to describe and compare the designs and the results of included studies.Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. In addition, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However, the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.

scholarly journals Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sahar Zare ◽  
Zahra Meidani ◽  
Mohammad Shirdeli ◽  
Ehsan Nabovati
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Blood Institute ◽  
Time Period ◽  
National Heart Lung ◽  
Quasi Experimental ◽  
Test Ordering

Abstract Background Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals. Method Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. Studies using CDSSs as an intervention to improve laboratory test ordering as the primary aim were included. The study populations in the included studies were laboratory tests, physicians ordering laboratory tests, or the patients for whom laboratory tests were ordered. The included papers were evaluated for their outcomes related to the effect of CDSSs which were categorized based on the outcomes related to tests, physician, and patients. The primary outcome measures were the number and cost of the ordered laboratory tests. The instrument from The National Heart Lung and Blood Institute (NIH) was used to assess the quality of the included studies. Moreover, we applied a checklist for assessing the quality and features of the CDSSs presented in the included studies. A narrative synthesis was used to describe and compare the designs and the results of included studies. Result Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. In addition, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare. Conclusion CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However, the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.

scholarly journals Laboratory test ordering in inpatient hospitals: a systematic review on the effects and features of clinical decision support systems

2020 ◽  
Author(s):  
Sahar Zare ◽  
Zahra Meidani ◽  
Mohammad Shirdeli ◽  
Ehsan Nabovati
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Blood Institute ◽  
Time Period ◽  
National Heart Lung ◽  
Quasi Experimental ◽  
Test Ordering

Abstract Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review aimed at evaluating the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. Studies using CDSSs as an intervention to improve laboratory test ordering as the primary aim were included. The study populations in the included studies were laboratory tests, physicians ordering laboratory tests, or the patients for whom laboratory tests were ordered. The included papers were evaluated for their outcomes related to the effect of CDSSs which were categorized based on the outcomes related to tests, physician, and patients. The primary outcome measures were the number and cost of the ordered laboratory tests. The instrument from The National Heart Lung and Blood Institute (NIH) was used to assess the quality of the included studies. Moreover, we applied a checklist for assessing the quality and features of the CDSSs presented in the included studies. A narrative synthesis was used to describe and compare the designs and the results of included studies.Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. In addition, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However, the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.

Superselective Radioembolization of Hepatocellular Carcinoma: 5-Year Results of a Prospective Study

1994 ◽  
Vol 33 (05) ◽  
pp. 206-214 ◽  
Author(s):  
J. Triller ◽  
H. U. Baer ◽  
Livia Geiger ◽  
H. F. Beer ◽  
C. Becker ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Rates ◽  
Absorbed Dose ◽  
Pulmonary Complications ◽  
Pulmonary Shunt ◽  
Recurrent Tumour ◽  
Activity Distribution ◽  
A Prospective Study ◽  
Overall Survival Rates

SummaryTwenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after ≥300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided.

Assessing Medical Evidence

2018 ◽  
Author(s):  
Jacob Stegenga
Keyword(s):  
Quality Assessment ◽  
Randomized Trials ◽  
Empirical Studies ◽  
Allocation Concealment ◽  
Assessment Tools ◽  
Medical Evidence ◽  
Empirical Methods ◽  
First Order ◽  
First Order Methods

Medical scientists employ ‘quality assessment tools’ to assess evidence from medical research, especially from randomized trials. These tools are designed to take into account methodological details of studies, including randomization, subject allocation concealment, and other features of studies deemed relevant to minimizing bias. There are dozens of such tools available. They differ widely from each other, and empirical studies show that they have low inter-rater reliability and low inter-tool reliability. This is an instance of a more general problem called here the underdetermination of evidential significance. Disagreements about the quality of evidence can be due to different—but in principle equally good—weightings of the methodological features that constitute quality assessment tools. Thus, the malleability of empirical research in medicine is deep: in addition to the malleability of first-order empirical methods, such as randomized trials, there is malleability in the tools used to evaluate first-order methods.

Evaluating Qualitative Research

2017 ◽  
Author(s):  
Jeasik Cho
Keyword(s):  
Qualitative Research ◽  
Large Scale ◽  
Academic Research ◽  
Research Community ◽  
Assessment Tools ◽  
Journal Articles ◽  
Journal Editors ◽  
The Past ◽  
Grant Proposals

This book provides the qualitative research community with some insight on how to evaluate the quality of qualitative research. This topic has gained little attention during the past few decades. We, qualitative researchers, read journal articles, serve on masters’ and doctoral committees, and also make decisions on whether conference proposals, manuscripts, or large-scale grant proposals should be accepted or rejected. It is assumed that various perspectives or criteria, depending on various paradigms, theories, or fields of discipline, have been used in assessing the quality of qualitative research. Nonetheless, until now, no textbook has been specifically devoted to exploring theories, practices, and reflections associated with the evaluation of qualitative research. This book constructs a typology of evaluating qualitative research, examines actual information from websites and qualitative journal editors, and reflects on some challenges that are currently encountered by the qualitative research community. Many different kinds of journals’ review guidelines and available assessment tools are collected and analyzed. Consequently, core criteria that stand out among these evaluation tools are presented. Readers are invited to join the author to confidently proclaim: “Fortunately, there are commonly agreed, bold standards for evaluating the goodness of qualitative research in the academic research community. These standards are a part of what is generally called ‘scientific research.’ ”

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