A Multicenter Survey on the Trend of Chest CT Scan Utilization: Tracing the First Footsteps of COVID-19 in Iran.

BACKGROUND: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran. OBJECTIVES: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018-2019. RESULTS: A 50.2% increase was noted in the chest CT scan utilization in 2019-2020 compared to 2018-2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1-5 of 2019-2020, respectively. In Month 6 of 2019-2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018-2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018-19. CONCLUSION: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.

Early ultrasound assessment of renal transplantation as the valuable biomarker of long lasting graft survival: a cross-sectional study.

BACKGROUND: To date, there has been little agreement on the use of ultrasonographic parameters in predicting the long-term outcome after transplantation. This study evaluates whether ultrasonography of the graft performed in the early stage after transplantation is a valuable predictor for long-term-outcome. OBJECTIVES: The aim of this study was to evaluate the association of ultrasonographic parameters (resistive index [RI], pulsatility index[PI], end diastolic velocity [EDV], graft length and graft parenchymal volume) measured within the first week after transplantation with 6 months graft function. PATIENTS AND METHODS: A cross-sectional study was performed on 91 (46 males and 45 females) living renal transplants between April 2011 and February 2013. All patients underwent an ultrasonography at the first week after transplantation. Intrarenal Doppler indices including RI, PI and EDV were measured at the interlobar artery level and the graft length and parenchymal volume were defined with gray scale ultrasonography. Graft function was estimated at 6months by glomerular filtration rate (GFR). Unpaired t-test and multivariate-linear and logistic regression analysis were used to estimate the relationship between ultrasonographic parameters and GFR. RESULTS: Fourteen patients (15.4%) had impaired graft function after 6 months (GFR less than 60 ml/min/1.73m2). Multivariate linear regression analysis showed significant correlation between GFR at 6 months and RI, PI and EDV with a P value of 0.026, 0.016 and 0.015, respectively. Logistic regression analysis showed that GFR<60 ml/min/1.73 m2 at 6 months was significantly associated with RI>0.7 (odds ratio=2.20, P value=0.004) and PI>1.3 (odds ratio=2.74, P value<0.001) and EDV<9 cm/Sec (odds ratio=1.83, P value=0.03). CONCLUSIONS: In this study, kidney transplant recipients with a lower RI and PI and a higher EDV at 1week showed better graft function at 6 months after transplantation.

Assessment of NAFLD cases and its correlation to BMI and metabolic syndrome in healthy blood donors in Kerman.

AIM: The aim of this study was to review cases of non-alcoholic fatty liver disease cases and to determine the prevalence of non-alcoholic fatty liver disease as a cause of elevated alanine aminotransferase in healthy blood donors in the Permian area and also assess risk factors of NAFLD such as BMI and correlation with metabolic syndrome in these subjects. BACKGROUND: Non-alcoholic fatty liver disease has been increasingly recognized as the most common pathological conditions affecting the liver. Non-alcoholic fatty liver disease is now recognized as the hepatic component of the metabolic syndrome, which includes hyperlipidemia, glucose intolerance, obesity, and systemic hypertension. PATIENTS AND METHODS: 2002 randomly selected blood donors were recruited for this study. Subjects with elevated serum ALT level (greater than two times the upper limit of normal) were chosen for further follow up. Subjects with a persistently elevated ALT level, evidence of steatosis on computerized tomography and a negative cirrhosis screen (viral hepatitis B and C serology, autoimmune hepatitis, transferrin saturation <45% and a no history of excess alcohol consumption or hepatotoxic medication) were presumed to have non-alcoholic fatty liver disease. RESULTS: 378 donors (20.5% of all subjects recruited) had elevated ALT levels at first measurement. 35 cases had persistently elevated serum ALT level. In 22 of these 35 cases (62.9%) non-alcoholic fatty liver disease was the diagnosis. The mean body mass index of the 22 cases was 31.18 ±5.7 and non-alcoholic fatty liver disease was associated with the metabolic syndrome in these subjects. CONCLUSION: Non-alcoholic fatty liver disease is the most common diagnosis for subjects with elevated serum ALT level in healthy blood donors in Kerman, Iran.