Lung Ultrasound as a First-Line Test in the Evaluation of Post-COVID-19 Pulmonary Sequelae

Background: Interstitial lung sequelae are increasingly being reported in survivors of COVID-19 pneumonia. An early detection of these lesions may help prevent the development of irreversible lung fibrosis. Lung ultrasound (LUS) has shown high diagnostic accuracy in interstitial lung disease (ILD) and could likely be used as a first-line test for post-COVID-19 lung sequelae.Methods: Single-center observational prospective study. Follow-up assessments of consecutive patients hospitalized for COVID-19 pneumonia were conducted 2–5 months after the hospitalization. All patients underwent pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and LUS. Radiological alterations in HRCT were quantified using the Warrick score. The LUS score was obtained by evaluating the presence of pathological B-lines in 12 thoracic areas (range, 0–12). The correlation between the LUS and Warrick scores was analyzed.Results: Three hundred and fifty-two patients who recovered from COVID-19 pneumonia were recruited between July and September 2020. At follow-up, dyspnea was the most frequent symptom (69.3%). FVC and DLCO alterations were present in 79 (22.4%) and 234 (66.5%) patients, respectively. HRCT showed relevant interstitial lung sequelae (RILS) in 154 (43.8%) patients (Warrick score ≥ 7). The LUS score was strongly correlated with the HRCT Warrick score (r = 0.77) and showed a moderate inverse correlation with DLCO (r = −0.55). The ROC curve analysis revealed that a LUS score ≥ 3 indicated an excellent ability to discriminate patients with RILS (sensitivity, 94.2%; specificity, 81.8%; negative predictive value, 94.7%).Conclusions: LUS could be implemented as a first-line procedure in the evaluation of Post-COVID-19 interstitial lung sequelae. A normal LUS examination rules out the presence of these sequelae in COVID-19 survivors, avoiding the need for additional diagnostic tests such as HRCT.

The Utilization of MS-MLPA as the First-Line Test for the Diagnosis of Prader–Willi Syndrome in Thai Patients

Prader–Willi syndrome (PWS) is a genetic disorder caused by the expression disruption of genes on the paternally inherited allele of chromosome 15q11.2-q13. Apart from clinical diagnostic criteria, PWS is confirmed by genetic testing. Methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) is one of the molecular techniques used to analyze this syndrome. This study aimed to evaluate the concordance of the test results of MS-MLPA with conventional techniques in the diagnosis of PWS in Thai patients. Forty leftover specimens from routine genetic testing (MS-PCR and FISH) were tested to obtain MS-MLPA results. By comparison, perfect concordance was shown between the result of MS-MLPA and those of conventional techniques. In conclusion, MS-MLPA is an accurate and cost-effective assay that can be used to confirm PWS diagnosis with explicit deletion of affected genes.

An Approach to the Evaluation and Management of the Obese Child with Early Puberty

With the decline in age at onset of puberty and increasing prevalence of childhood obesity, early breast development in young, obese girls has become a more frequent occurrence. Here, we examine available literature to answer a series of questions regarding how obesity impacts the evaluation and management of precocious puberty. We focus on girls as the literature is more robust, but include boys where literature permits.Suggestions include: (1) Age cut-offs for evaluation of precocious puberty should not differ substantially from those used for non-obese children. Obese girls with confirmed thelarche should be evaluated for gonadotropin-dependent, central precocious puberty (CPP) to determine if further investigation or treatment is warranted. (2) Basal luteinizing hormone (LH) levels remain a recommended first-line test. However, if stimulation testing is utilized, there is a theoretical possibility that the lower peak LH responses seen in obesity could lead to a false negative result. (3) Advanced bone age (BA) is common among obese girls even without early puberty; hence its diagnostic utility is limited. (4) Obesity does not eliminate the need for MRI in girls with true CPP. Age and clinical features should determine who warrants neuroimaging. (5) BA can be used to predict adult height in obese girls with CPP to inform counselling around treatment. (6) Use of gonadotropin-releasing hormone analogues (GnRHa) leads to increased adult height in obese girls. (7) Obesity should not limit GnRHa use as these agents do not worsen weight status in obese girls with CPP.

Review on Detection and Analysis of Partial Discharge along Power Cables

Partial discharge (PD) detection and analysis plays a crucial role for acceptance testing and condition monitoring of power cables. Various aspects are related to PD in power cables from theory to practice. This paper first summarizes the PD mechanism and models used for PD analysis in power cables. Afterwards, PD detection is addressed in the aspects of off-line test, on-line test, and sensors. PD analysis is discussed in detail. Specifically, related quantities and algorithms for PD analysis are outlined. PD characteristics with affecting factors, e.g., dielectric type, load, and applied voltage are discussed. Experience on PD development trend with measurements in field is analyzed. Based on the comprehensive review, challenges of PD detection and analysis along a power cable are proposed.

Long-duration head down bed rest as an analog of microgravity: Effects on the static perception of upright

BACKGROUND: Humans demonstrate many physiological changes in microgravity for which long-duration head down bed rest (HDBR) is a reliable analog. However, information on how HDBR affects sensory processing is lacking. OBJECTIVE: We previously showed (25) that microgravity alters the weighting applied to visual cues in determining the perceptual upright (PU), an effect that lasts long after return. Does long-duration HDBR have comparable effects? METHODS: We assessed static spatial orientation using the luminous line test (subjective visual vertical, SVV) and the oriented character recognition test (PU) before, during and after 21 days of 6° HDBR in 10 participants. Methods were essentially identical as previously used in orbit (25). RESULTS: Overall, HDBR had no effect on the reliance on visual relative to body cues in determining the PU. However, when considering the three critical time points (pre-bed rest, end of bed rest, and 14 days post-bed rest) there was a significant decrease in reliance on visual relative to body cues, as found in microgravity. The ratio had an average time constant of 7.28 days and returned to pre-bed-rest levels within 14 days. The SVV was unaffected. CONCLUSIONS: We conclude that bed rest can be a useful analog for the study of the perception of static self-orientation during long-term exposure to microgravity. More detailed work on the precise time course of our effects is needed in both bed rest and microgravity conditions.

THYROID FUNCTION TESTS: A REVIEW

Thyroid function tests are one of the most common endocrine panels in general practice because a good understanding of when to order them, indications for treatment are important for the optimal treatment of thyroid dysfunction. Thyroid-stimulating hormone (TSH) should be the rst test to be performed on any patient with suspected thyroid dysfunction and in follow-up of individuals on treatment. It is useful as a rst-line test because even small changes in thyroid function are sufcient to cause a signicant increase in TSH secretion. Thyroxine levels may be assessed in a patient with hyperthyroidism, to determine the severity of hyperthyroxinemia. Antithyroid peroxidase measurements should be considered while evaluating patients with subclinical hypothyroidism and can facilitate the identication of autoimmune thyroiditis during the evaluation of nodular thyroid disease. The measurement of TSH receptor antibody must be considered when conrmation of Graves’ disease is needed and radioactive iodine uptake cannot be done.

The effect on critical velocity of runnings with change of direction in soccer

Introduction: The aim of this study was to examine relationships between Yo-Yo intermittent recovery level 1 test (YYIR1T) performance and critical velocity determined by test protocols consisting of runs with a change of direction and straight runs. Material and Methods: Twelve young soccer players voluntarily participated in study (age: 17.07±0.24 years, training experience: 8.42±2.50 years, height: 178.58±5.76 cm, weight: 70.67±6.14 kg, body mass index: 22.16±1.59). To determine critical velocity, 6-, 9- and 12-minute runs were performed with maximum effort on a straight-line running track and a running track with a change of direction. The critical velocity was determined by two linear regression models. YYIR1T was performed to determine players’ aerobic endurance. The critical velocity value of the two test tracks was compared by the paired samples T-test. The correlation between test parameters was determined by Spearman’s correlation coefficient. Results: A significant difference between anaerobic distance capacity and the mean running speed of the two test tracks (p<0.05) was found. There was a significant correlation between critical velocity in the straight-line test track and the YYIR1T performance (p<0.05). Conclusions: Consequently, it might be said that runs with a change of direction might increase energy expenditure and anaerobic distance capacity was highly affected by those compared to critical velocity.

Enhancing hydraulic data reliability in sewers

Recently, water utilities have been making considerable investments in sewers' monitoring; however, in most cases, assuring data reliability is yet a challenge. Often, hydraulic data is collected in sewers overlooking best practice aspects. Assuming confidence on data, while disregarding cautions verifications, might lead to inadequate uses of data. The paper presents a methodology aiming to narrow the gap between science and industry, regarding monitoring programs in urban drainage. A procedure to enhance hydraulic data reliability, in line with ISO/IEC 17025:2017, was developed, applied and validated, enabling a final evaluation on data and site adequacy and an overall identification of improvement opportunities. The availability of a valuable study case comprising 32 flowmeters from Portuguese utilities, in eastern Europe, presented an opportunity to create a story line, test the procedure's coherence, present it to the technical community and evaluate the constraints that utilities, in their everyday working context, face with. The procedure is presented in detail and a collection of examples of its application is shown. In the final evaluation, most monitoring stations alignment with best practice requirements were either high (25%) or acceptable (44%), regarding their overall performance and compliance with both data and site adequacy. For all of them, improvement opportunities were identified.