Follow-up evaluation of pulmonary function and computed tomography findings in chronic kidney disease patients after COVID-19 infection.

Pulmonary complications are common after SARS-CoV2- infection. However, data on pulmonary sequelae of COVID-19 after recovery in dialysis patients are limited. We determined the prevalence of abnormal lung function tests and CT findings and investigate the association factors impacting pulmonary dysfunction. This prospective observational cohort study enrolled 100 patients with stage 5 chronic kidney disease (CKD) undergoing dialysis who had recovered from COVID-19 for ≥3 months. Pulmonary function test (PFT) and chest computed tomography (CT) were performed. Demographic data and laboratory results were recorded. The mean patient age was 55.15 ± 12.84 years. Twenty-one patients (21%) had severe COVID-19, requiring mechanical ventilation or oxygen supplementation. Pulmonary function tests revealed a restrictive pattern in 41% (95% confidence interval [CI], 31.73-50.78;) and an obstructive pattern in 7.29% (95% CI, 3.19-13.25) patients. The severe group showed PFT test results similar to the non-severe group, with three patients showing severe obstructive lung disease. The CT scan findings included reticulation (64%), multifocal parenchymal band (43%), ground glass opacities (32%), and bronchiectasis (28%). The median total CT score was 3 (interquartile range, 1-8.5). The CT score and PFT findings showed no association with pulmonary dysfunction extent, except in bronchiectasis. Lung function indices were associated with abnormal CT findings. Abnormal CT findings (bronchiectasis, reticulation, and ground-glass opacities) was associated with higher oxygen requirements than normal CT findings (p = 0.008, bronchiectasis; p = 0.041, reticulation; p = 0.032, ground-glass appearance). Aside from CT findings and CRP levels, no significant lung abnormalities were observed in severe and non-severe patients. Some patients had residual symptoms at follow-up. The findings indicate persistence of both radiological and physiological abnormalities in dialysis patients after COVID-19. However, the prevalence of these abnormalities was comparable to that in the normal population; few patients experienced ongoing symptoms. Follow-up observations and evaluations are warranted. Trial registration. Clinicaltrials.gov Identifier: NCT05348759.

The Role of Pre-Operative MRI for Prediction of High-Grade Intracranial Meningioma: A Retrospective Study.

OBJECTIVE: High histological grade (WHO grade 2 and 3) intracranial meningiomas have been linked to a greater risk for tumor recurrence and worse clinical outcomes compared to low-grade (WHO grade 1) tumors. Preoperative magnetic resonance imaging (MRI) plays a crucial role in tumor evaluation and allows a better understanding of tumor grading, which could potentially alter clinical outcomes. The present study sought to determine whether preoperative MRI features of intracranial meningiomas can serve as predictors of high-grade tumors. METHODS: This retrospective study reviewed 327 consecutive confirmed cases of intracranial meningiomas, among whom 210 (64.2%) had available preoperative MRI studies. Thereafter, imaging features such as intratumoral signal heterogeneity, venous sinus invasion, necrosis or hemorrhage, mass effect, cystic component, bone invasion, hyperostosis, spiculation, heterogeneous tumor enhancement, capsular enhancement, restricted diffusion, brain edema, and unclear tumor-brain interface were obtained and data were analyzed using univariate and multivariate analyses. RESULTS: 249 (76.1%) patients had low-grade (grade I), and 78 (23.9%) had high-grade (grades 2 and 3) intracranial meningioma. The majority of cases were females (274 cases, 83.3%) and most patients were below 60 years of age (mean age, 52.50 ± 11.51 years). The multivariate analysis with Multiple Logistic regression analysis using factors determined to be significant during univariate analysis via a backward stepwise selection method with statistical significance set at 0.05 identified three MRI features including necrosis or hemorrhage (adjusted OR = 2.94, 95% CI: 1.15-7.48, p = 0.024), hyperostosis (adjusted OR = 0.31, 95% CI: 0.12-0.79, p = 0.014), and brain edema (adjusted OR = 2.33, 95% CI: 1.13-4.81, p = 0.022) as significant independent predictors of high-grade meningioma after adjusting for confounders. CONCLUSIONS: Our study suggested that certain preoperative MRI features of intracranial meningiomas including necrosis or hemorrhage and brain edema could potentially predict high-grade tumors while hyperostosis is a predictor for low-grade tumors.

High-resolution computerized tomography for ossicular replacement prostheses.

INTRODUCTION: To study the accuracy of high-resolution computed tomography (HRCT) for assessing the ossicular structures in cadaveric temporal bone by the distance between temporal bone elements is of great interest. OBJECTIVES: To record the distances between the malleal neck and both the stapedial head and footplate by HRCT. Further, after partially opening the temporal bone toward the ossicular structure, to record the actual distances between those structures during surgical dissection. MATERIAL AND METHODS: This study compared actual and HRCT measurements of cadaveric temporal bone. We studied, measured, and recorded distances within and between various structural elements. All data are reported as means and were analyzed to prove the accuracy of HRCT to assess ossicular structure from the temporal bone. RESULTS: This study included the temporal bones of 10 male and 10 female cadavers (mean age, 70.4 years). By surgical dissection, the distances between the malleal neck and the stapedial head and footplate were 3.40 and 5.30 mm, respectively (measured from the bone); by HRCT, the corresponding values were 3.35 and 5.29 mm. The intraclass correlation coefficients for assessing ossicular structure in contrast to the actual measurements were 0.901 (malleal neck to stapedial head) and 0.923 (malleal neck to stapedial footplate) (p < 0.05). There were no differences between the actual malleal neck to stapedial head (p = 0.793) or footplate (p = 0.242) measurements. CONCLUSION: HRCT produced statistically comparable, reliable, and accurate measurements compared with actual measurements in cadaveric temporal bone.