Patrón de neumonía organizativa en TC de tórax: prevalencia y asociación con resultados clínicos en una cohorte de pacientes con COVID-19 grave/crítico / Organizing Pneumonia Pattern on Chest CT: Prevalence and Association with Clinical Outcomes in a Cohort of Patients with Severe/Critical COVID-19

Introducción: La neumonía por COVID-19 puede presentarse con dos patrones radio-lógicos: daño alveolar difuso o neumonía organizativa. Estos patrones tienen diferente evolución y pronóstico en pacientes sin infección por COVID-19. Nuestro objetivo fue evaluar la prevalencia del patrón radiológico de neumonía organizativa y su asociación con los desenlaces clínicos.Métodos: Se realizó un estudio de cohorte retrospectivo que incluyó a pacientes adultos hospitalizados por COVID-19 grave/crítica a los que se les realizó una tomografía computarizada de tórax en los 21 días posteriores al diagnóstico. Los patrones radiológicos fueron revisados y clasificados por dos radiólogos expertos. Resultados: De los 80 pacientes incluidos, el 89% (n=71) presentaron un patrón compatible con neumonía organizativa. Los principales hallazgos radiológicos fueron la distribución multilobar (98,7%) y bilateral (97,6%) con opacidades en vidrio esmerilado (97,6%). El 44% (n=33) de los sujetos requirió ingreso en cuidados intensivos, de los cuales el 24% (n=19) recibió ventilación mecánica. La presencia de neumonía organizativa se asoció de forma independiente con una disminución de las probabilidades de ventilación mecánica o muerte (Odds ratio 0,14; intervalo de confianza del 95%: 0,02 - 0,96; valor de p 0,045) en un modelo multivariado que incluía la edad, el sexo, el IMC y la afectación pulmonar en la TC.Conclusiones: Un patrón radiológico de neumonía organizativa es altamente prevalen-te en pacientes con COVID-19 grave/crítico y se asocia con mejores resultados clínico

Introduction: COVID-19 pneumonia can present with two distinct radiologic patterns: diffuse alveolar damage or organizing pneumonia. These patterns have been linked to different outcomes in non-COVID-19 settings. We sought to assess the prevalence of organizing pneumonia radiologic pattern and its association with clinical outcomes. Methods: We performed a retrospective cohort study including adult patients hospita- lized for severe/critical COVID-19 who underwent chest computed tomography within 21 days of diagnosis. Radiologic patterns were reviewed and classified by two expert radiologists. Results: Among 80 patients included, 89% (n=71) presented a pattern consistent with organizing pneumonia. The main radiologic findings were multilobar (98.7%) and bilateral (97.6%) distribution with ground glass opacities (97.6%). Intensive care admission was required for 44% (n=33) of subjects, of which 24% (n=19) received mechanical ventilation. The presence of organizing pneumonia was independently associated with a decreased odds of mechanical ventilation or death (Odds ratio 0.14; 95% confidence interval 0.02 - 0.96; p value 0.045) in a multivariate model including age, gender, BMI and lung involvement on CT. Conclusion: A radiologic pattern of organizing pneumonia is highly prevalent in patients with severe/critical COVID-19 and is associated with improved clinical outcomes.

Effects of additional agitation process on the spectrophotometric profiles of homeopathic high dilutions

INTRODUCTION: Conventional homeopathy advocates giving 10 strokes (agitation/succussions) to a prescription bottle containing liquid dilution, before taking it. To scientifically support such activity, it must be based on studies on the physicochemical aspects of the memory of water and agitated water chains, supplemented with spectrometry. OBJECTIVE: To analyze spectrometric profiles of homeopathic high dilutions, comparing additionally agitated and non-agitated dilutions, and to define differences according to each dilution´s kingdom. METHODOLOGY: Homeopathic dilutions were prepared using a ratio of 1:100 obtaining dilutions from 1cH to 15cH. Measurements of absorbance of 15cH dilutions were performed at 340 nm and 200 nm, with and without additional agitation. RESULTS: Statistically significant differences were found between agitated and non-agitated dilutions (p <0.05) for Apis mellifica, Bufo rana, and Calcium iodatum, with a decrease in the mean value of absorbance (340 nm) in agitated solutions. For A nica montana, Matricaria chamomilla, Coffea arabica, Pulsatilla nigricans, Calcium iodatum and Natrum muriaticum, the absorbance values increased; these values decreased for Apis and Bufo. In addition, measurements were performed with a shorter wavelength (200 nm); it was observed that there are significant differences for all homeopathic dilutions studied. Additionally, when comparing the mean values of the absorbance for each kingdom, and observing the agitation factor, a statistically significant difference was found in the animal kingdom (p<0.05), having lower absorbance for agitated dilutions. CONCLUSION: Comparisons of the spectrometric profiles of agitated and non-agitated solutions allow to observe that there is a difference of the absorbance when comparing a previously agitated solution and a solution with no agitation before taking it.