Systemic inflammation in COVID-19 patients may induce various types of venous and arterial thrombosis: A systematic review.

COVID-19 is a global pandemic with a daily increasing number of affected individuals. Thrombosis is a severe complication of COVID-19 that leads to a worse clinical course with higher rates of mortality. Multiple lines of evidence suggest that hyperinflammation plays a crucial role in disease progression. This review compiles clinical data of COVID-19 patients who developed thrombotic complications to investigate the possible role of hyperinflammation in inducing hypercoagulation. A systematic literature search was performed using PubMed, Embase, Medline and Scopus to identify relevant clinical studies that investigated thrombotic manifestations and reported inflammatory and coagulation biomarkers in COVID-19 patients. Only 54 studies met our inclusion criteria, the majority of which demonstrated significantly elevated inflammatory markers. In the cohort studies with control, D-dimer was significantly higher in COVID-19 patients with thrombosis as compared to the control. Pulmonary embolism, deep vein thrombosis and strokes were frequently reported which could be attributed to the hyperinflammatory response associated with COVID-19 and/or to the direct viral activation of platelets and endothelial cells, two mechanisms that are discussed in this review. It is recommended that all admitted COVID-19 patients should be assessed for hypercoagulation. Furthermore, several studies have suggested that anticoagulation may be beneficial, especially in hospitalized non-ICU patients. Although vaccines against SARS-CoV-2 have been approved and distributed in several countries, research should continue in the field of prevention and treatment of COVID-19 and its severe complications including thrombosis due to the emergence of new variants against which the efficacy of the vaccines is not yet clear.

Utility of the Anatomage Virtual Dissection Table in Creating Clinical Anatomy and Radiology Learning Modules.

Purpose: During the COVID-19 pandemic, teaching has required online-learning modalities to facilitate easily accessible yet high-quality education. However, since the nature of anatomy requires hands-on experience in laboratories with cadavers, teaching anatomy in an online setting has proven especially difficult. This matter may be resolved with the Anatomage Table, an advanced anatomy visualization tool, which several studies have suggested can augment learning experiences for students in anatomy courses. Our objective was to provide accessible online modules, through utilization of the Anatomage Table, for medical students to facilitate their learning and enhance online learning experience. Materials and Methods: Ten modules were designed, consisting of a presentation, a pre- and post-self-assessment, as well as anatomical images and radiographs taken from Anatomage Table. The modules were based on a single organ system, and a clinical case pertaining to that organ system was presented. Weill Cornell Medicine-Qatar (WCM-Q) second-year medical students contributed 102 responses in total throughout the 10 modules. Using a paired t-test, the study compared the students' pre- and post-assessment scores to determine how beneficial the modules were. Results: A significant difference in scores on the pre- and post-assessments was found for all 10 modules using a paired t-test. At the end of the modules, the students completed a feedback survey to assess the quality and convenience. Most of the students agreed or strongly agreed that the modules were beneficial to their online anatomy learning and wanted to see similar anatomical modules in the future. Conclusion: The Anatomage Table is an innovative virtual resource that can significantly contribute to a more engaging and productive experience for medical students.

Discordance between invasive coronary flow reserve (CFR) and non-invasive myocardial flow reserve (MFR) in diffuse coronary ectasia (DCE).

Clinical use with evidence base for diagnostic and prognostic value of quantitative positron emission tomography(PET) myocardial perfusion imaging (MPI) in patients with known or suspected coronary artery disease has exponentially increased over the last decade. This case illustrates the very first time that stress myocardial blood flow(MBF) in absolute terms (ml/min/gram) and myocardial flow reserve(MFR) are augmented in three vessel diffuse coronary ectasia by N13-Ammonia PET MPI. Moreover, relative qualitative MPI demonstrated moderate-sized ischemia in right coronary artery territory with chronic total occlusion in middle segment; despite regional myocardial flow reserve remains above ischemic thresholds while regional stress myocardial blood flow is mildly reduced.