Comparison of chest CT scan findings between COVID-19 and pulmonary contusion in trauma patients based on RSNA criteria: Established novel criteria for trauma victims / 中华创伤杂志(英文版)

PROPOSE@#In this study, we re-assessed the criteria defined by the radiological society of North America (RSNA) to determine novel radiological findings helping the physicians differentiating COVID-19 from pulmonary contusion.@*METHODS@#All trauma patients with blunt chest wall trauma and subsequent pulmonary contusion, COVID-19-related signs and symptoms before the trauma were enrolled in this retrospective study from February to May 2020. Included patients (Group P) were then classified into two groups based on polymerase chain reaction tests (Group Pa for positive patients and Pb for negative ones). Moreover, 44 patients from the pre-pandemic period (Group PP) were enrolled. They were matched to Group P regarding age, sex, and trauma-related scores. Two radiologists blindly reviewed the CT images of all enrolled patients according to criteria defined by the RSNA criteria. The radiological findings were compared between Group P and Group PP; statistically significant ones were re-evaluated between Group Pa and Group Pb thereafter. Finally, the sensitivity and specificity of each significant findings were calculated. The Chi-square test was used to compare the radiological findings between Group P and Group PP.@*RESULTS@#In the Group PP, 73.7% of all ground-glass opacities (GGOs) and 80% of all multiple bilateral GGOs were detected (p < 0.001 and p = 0.25, respectively). Single bilateral GGOs were only seen among the Group PP. The Chi-square tests showed that the prevalence of diffused GGOs, multiple unilateral GGOs, multiple consolidations, and multiple bilateral consolidations were significantly higher in the Group P (p = 0.001, 0.01, 0.003, and 0.003, respectively). However, GGOs with irregular borders and single consolidations were more significant among the Group PP (p = 0.01 and 0.003, respectively). Of note, reticular distortions and subpleural spares were exclusively detected in the Group PP.@*CONCLUSION@#We concluded that the criteria set by RSNA for the diagnosis of COVID-19 are not appropriate in trauma patients. The clinical signs and symptoms are not always useful either. The presence of multiple unilateral GGOs, diffused GGOs, and multiple bilateral consolidations favor COVID-19 with 88%, 97.62%, and 77.7% diagnostic accuracy.

Which One is Better? Comparison of the Acute Inflammatory Response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado Scoring Systems

PURPOSE: Acute appendicitis (AA) is one of the most common causes of an acute abdomen. The accuracies of the Alvarado and the acute inflammatory response (AIR) scores in the diagnosis of appendicitis is very low in Asian populations, so a new scoring system, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) system, was designed recently. We applied and compared the Alvarado, AIR, and RIPASA scores in the diagnoses of appendicitis in the Iranian population. METHODS: We prospectively compared the RIPASA, Alvarado, and AIR systems by applying them to 100 patients. All the scores were calculated for patients who presented with right quadrant pain. Appendectomies were performed; then, the postoperative pathology reports were correlated with the scores. Scores of 8, 7, and 5 or more are optimal cutoffs for the RIPASA, Alvarado, and AIR scoring systems, respectively. The sensitivities, specificities, positive predictive values, negative predictive values (NPVs), positive and negative likelihood ratios (LRs) for the 3 systems were determined. RESULTS: The sensitivity and the specificity of the RIPASA score were 93.18% and 91.67%, respectively. The sensitivities of the Alvarado and the AIR scores were both 78.41%. The specificities of the Alvarado and the AIR scores were 100% and 91.67%, respectively. The RIPASA score correctly classified 93% of all patients confirmed with histological AA compared with 78.41% for the Alvarado and the AIR scores. CONCLUSION: The RIPASA scoring system had more sensitivity, better NPV, a positive LR, and a less negative LR for the Iranian population whereas the Alvarado scoring system was more specific.

diagnostic value of surface markers in acute appendicitis; a diagnostic accuracy study

Objective: To determine the diagnostic value of blood cells surface markers in patients with acute appendicitis

Methods: In this cross-sectional study, 71 patients who underwent appendectomy following a diagnosis of appendicitis were recruited during a one-year period. The patients were divided into two groups: patients with histopathologically confirmed acute appendicitis and subjects with normal appendix. Blood cell surface markers of all patients were measured. Univariate and multivariate analytical methods were applied to identify the most useful markers. Receiver operating characteristics [ROC] curves were also used to find the best cut-off point, sensitivity, and specificity

Results: Overall we included 71 patients with mean age of 22.6 +/- 10.7 years. Of the 71 cases, 45 [63.4%] had acute appendicitis while 26 [36.6%] were normal. There was no significant difference between two study groups regarding the age [p=0.151] and sex [p=0.142]. The initial WBC count was significantly higher in those with acute appendicitis [p=0.033]. Maximum and minimum area under the ROC curve in univariate analysis was reported for CD3/RA [0.71] and CD38 [0.533], respectively. Multivariate regression models revealed the percentage of accurate diagnoses based on the combination of gamma/delta TCR, CD3/RO, and CD3/RA markers to be 74.65%. Maximum area under the ROC curve [0.79] was also obtained for the same combination

Conclusion: the best blood cell surface markers in the prediction of acute appendicitis were HLA-DR+CD19, alpha/beta TCR, and CD3/RA. The simultaneous use of gamma/delta TCR, CD3/RA, and CD3/RO showed the highest diagnostic value in acute appendicitis

Factor structure of the General Health Questionnaire- 28 [GHQ-28] from infertile women attending the Yazd Research and Clinical Center for Infertility

Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group

Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women

Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90

Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women

Prognostic factors of first birth interval using the parametric survival models

In recent years, the study of birth intervals has been a main determinant of the levels of fertility in the populations, as it is associated with rates of fertility and population growth. The purpose of this study was to firstly apply survival analysis for modeling of first birth interval and secondly to explore its determinants. In a cross sectional study, the fertility history of 858 women was collected in rural areas of Shiraz [southern Iran] in 2008. We used the survival analysis such as cox regression and alternative parametric models to evaluate the prognostic factors of first birth interval. Among the explanatory variables of interest, age at marriage, level of women's education, and menstrual status had highly significant effects on the duration of birth interval after marriage [p<0.01]. It is concluded that the suitable parametric models would be a useful tool for fitting to first birth interval, the fact that has been less paid attention to in researches