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The current COVID-19 climate has caused an unforeseen supply shortage of iodinated contrast media (ICM) worldwide, disrupting global distribution.1 In addition, the scarcity has resulted in a ripple effect in healthcare facilities such as radiology departments where ICM is required to perform contrast-enhanced examinations. ICM plays a significant part in contrast-enhanced CT, angiography and fluoroscopic procedures within the radiology department, holding a primary role in the differentiation and diagnosis of pathologies which range from pulmonary emboli to tumours.1 Its use extends beyond radiology, where ICM is heavily relied on in cardiology, urology and gastrointestinal studies, further highlighting the heavy dependence on the critical agent.2 With the global increase in the number of CT examinations requested, where approximately 60% of studies require ICM, optimal usage of ICM must be considered to meet heightened demand.3 The shortage has represented an opportunity for imaging providers to re-examine current imaging protocols and identify whether non-contrast imaging, alternative contrast agents and other imaging modalities could be viable options moving forward.1,2 Additionally, current literature has discussed volume-reduction strategies and dual-energy use in newer-generation CT scanners to conserve ICM.1,4 This review will explore currently proposed solutions that can be implemented in the radiology department to maximise ICM supply with minimal impact on patient care.
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BACKGROUND: Chest computed tomography (CT) is important in establishing a diagnosis, including detecting pulmonary vascular dilatation as a radiological feature of COVID-19, and consequently in providing comprehensive treatment. AIM: This study aimed to analyze the relationship between pulmonary vascular dilatation and clinical symptoms on chest CT in patients with confirmed COVID-19. PATIENTS AND METHODS: This retrospective and cross-sectional study was conducted at the Radiology Department of Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital, Makassar, Indonesia, from July to September 2021 in a total of 231 patients with confirmed COVID-19. The Chi-squared correlation test was used to analyze the data, with p < 0.05 considered significant. RESULT(S): Pulmonary vascular dilatation was observed in 31 (37.8%) of the 82 patients with confirmed COVID-19 with mild-to-moderate clinical symptoms and in 51 (69.8%) of the 73 patients with confirmed COVID-19 with severe-to-critical clinical symptoms. The incidence of pulmonary vascular dilatation increased in the patients with confirmed COVID-19 with severe-to-critical clinical symptoms. The chief complaints of most patients were cough, shortness of breath, and fever. In the patients with mild-to-moderate clinical symptoms, the most common chief complaint was cough (n = 53;64.63%), while in those with severe-to-critical clinical symptoms, the most common chief complaint was shortness of breath (n = 60;82.19%). CONCLUSION(S): Based on chest CT findings, pulmonary vascular dilatation is related to clinical symptoms in patients with confirmed COVID-19.Copyright © 2023 Sri Asriyani, Nikmatia Latief, Andi Alfian Zainuddin, Muzakkir Amir, Bachtiar Murtala, Hendra Toreh.
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Background. Large-scale construction of industrial and transport facilities is underway in the Far North of Russia. The process involves more than 10,000 shift workers, and there was a Covid19 outbreak in this population. In order to contain the outbreak and prevent the spread of infection in this area the Russian Emergencies Ministry deployed an airmobile hospital. Purpose. The purpose is to present an experience of work with the mobile CT scanner as part of an airmobile field hospital deployed in the Far North of Russia to combat the Covid-19 outbreak. Materials and methods. On April 6, 2020, the construction site reported a "zero patient" who sought medical aid;the PCR test showed positive results of coronavirus. In the first half of April, over 300 rotation employees applied for medical care, most of them had a positive PCR test. On April 11, a state of emergency was declared in the construction site and, on April 17, 2020, airmobile hospital started operations. Its mission lasted 54 days. The mobile CT scanner (Brightspeed Elite Mobile, GE) was transported by land. The field hospital closely cooperated with the nearest medical institutions and the regional clinical hospital. Results. During its work the airmobile hospital examined 1,678 rotational workers and 408 employees of the Ministry of Emergency Situations of the Murmansk region, with 2,086 CT scans performed. The average age of the patients was 37.8 years, men predominated. In 91.2% of patients, fever was the first symptom of the disease. Blood saturation results ranged from 92% to 99%. The degree of lung involvement ranged from CT 0 to CT 4. During the work of the airmobile hospital, COVID-19 was diagnosed in 500 people, including 328 cases of mild form, 98 - moderate, 74 - severe, no mortalities. Conclusion. A positive experience of application of the mobile CT scanner as part of the AMH field hospital in unfavorable epidemiological conditions of the Far North of the Russian Federation was obtained. CT plays a key role in early detection of infection, differential diagnosis, and identification of complications. Determination of the severity of the disease based on CT data is crucial for patient routing.Copyright © 2021 Medical Visualization. All rights reserved.
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The aim of our study is analysis of the androgenic status including testosterone (T) and dihydrotestosterone (DHT) in men hospitalized with coronavirus disease 2019 (COVID-19) and them relationship with the course of the disease. This is a monocentric prospective study performed on 125 male patients hospitalized for COVID-19. We conducted hematological examination, blood biochemical profile, hemostasis analysis and hormonal examination (T and DHT levels) lung and chest computed tomography and also assessed outcomes of hospitalization. Low DHT serum level was found only in 18 patients (14.4%). Subjects with low DHT were significantly older compare to subjects with normal DHT. At the same time in patients with normal DHT white blood cells (WBC) count, neutrophils at admission were higher than in patients with low DHT. No correlation was observed between T and DHT serum blood levels. C-reactive protein (CRP) has a weak positive correlation of DHT serum blood concentration (r = 0.22;p = 0.016). The inverse pattern was obtained for T serum blood concentration (r = -0.285;p = 0.001). After divided all males according to T concentrations we conducted next correlation analysis for DHT and CRP in two different groups: with normal T levels and with low T levels. We found that in males with normal T DHT levels are not correlated with CRP (r = 0.095;p = 0.462). However, in males with low T DHT and CRP had weak positive correlation with r = 0.317 (p = 0.012). Higher DHT concentrations are associated with higher CRP levels, however correlation is weak and in patients with normal T is absent, that may indicate anti-inflammatory effect of T and possible proinflammatory effect of DHT.Copyright © 2023 The Author(s).
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Calcium levels in the Coronary Artery are an indicative marker of the presence and extent of atherosclerosis. This serves as an additional prognostic indicator in addition to traditional risk factors. Moreover, the coronary calcium test is associated with a descriptor known as the calcium score or calcium score (Cs), which is primarily useful for stratifying the risk of asymptomatic patients, while for patients with acute or chronic chest pain, coronary axial computed tomography is generally required. A retrospective analysis of data was conducted in the radiology department of King Salman Specialist Hospital in Hail City, the kingdom of Saudi Arabia, between January and May 2022. A total of 40 patients were randomly selected, 25 males and 15 females. The study included all patients with or suspected of having a calcium deposit who underwent a CT scan using the Siemens SOMATOM definition MDC scan. Patients underwent a scan with the preparations and laboratory tests required for their coronary artery calcium scores. In this study, males were more likely to be affected by calcium deposits (64%), whereas females were 36%. Approximately 50 percent of the study populations were found to be normal (no identifiable calcium deposits) and 37.5% to have moderate calcium deposits. There is a significant association between CACS and moderate CVD risks based on age and gender in this study. Better control of cardiovascular system (CVS) risks is recommended in all primary care centers in the Kingdom of Saudi Arabia (KSA).Copyright © 2022 International Journal of Pharmaceutical Research and Allied Sciences. All rights reserved.
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University of Oulu and Oulu University of Applied Sciences have established a unique medical imaging teaching and testing laboratory in collaboration with Oulu University Hospital in a European Regional Development Fund -project. Virtually implemented medical imaging devices (CT, MRI, radiography) are unique features of the lab. Many of the virtual tools have been developed by the universities themselves. One of the virtual tools implemented during the project is the CTlab simulator, which can be widely used in computed tomography training for all professionals who use radiation in their work. The CTlab provides fast, comprehensive, and efficient solutions for numerical CT simulations with low hardware requirements. The simulator has been developed to introduce the basic operations and workflow behind the CT imaging modality and to illustrate how the polychromatic x-ray spectrum, various imaging parameters, scan geometry and CT reconstruction algorithm affect the quality of the detected images. Key user groups for the simulator include medical physics, engineering, and radiographer students. CTlab has been created with MATLAB's app designer feature. It offers its user the opportunity to select the virtual imaging target, to adjust CT imaging parameters (image volume, scan angles, detector element size and detector width, noise, algorithm/geometry specific parameters), to select specific scan geometry, to observe projection data from selected imaging target with polychromatic x-ray spectrum, and to select the specific algorithm for image reconstruction (FBP, least squares, Tikhonov regularization). The CTlab has so far been used at a postgraduate course on computed tomography technology with encouraging feedback from the students. At the course, teaching of CT modality were performed by using the simulator, giving students unlimited opportunity to practice the use of virtual imaging device and participate demonstrations remotely during the Covid-19 pandemic. Using CTlab in teaching enhances and deepens the learning experience in the physics behind computed tomography. CTlab can be used remotely (https://www.oulu.fi/fi/projektit/laaketieteellisen-kuvantamisen-opetus-ja-testilaboratorio-0), which makes teaching and training of CT scanner usage successful regardless of time and place. The simulator enables more illustrative and in-depth teaching and offers cost-effectiveness, versatility, and flexibility in education. CTlab can also be used to support teaching in special situations, such as during the Covid-19 pandemic when simulator is utilized remotely to perform teaching-related demonstrations flexibly and safely.Copyright © 2023 Southern Society for Clinical Investigation.
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Background. Postponed coronavirus infection (COVID-19), accompanied by an immunosuppressive state and associated with the risk of secondary diseases such as mucormycosis. Diabetes mellitus is an independent risk factor for both severe COVID-19 and mucormycosis. Aims - our aim was to experience the diagnosis and treatment of rhino-orbitocerebral mucormycosis in post-COVID-19 patients. Materials. A single-center, observational, non-randomized, cohort comparative study was conducted. We assessed the clinical features, risk factors, diagnosis and outcomes of mucormycosis among recovered COVID-19 patients with hospitalisation in the otorhinolaryngology department of the Samara State Medical University Clinics, Samara, from September-December 2021. CT examinations were performed on Revolution EVO CT scanner (GE, Russia) and MRI on Aera MR scanner 1.5 T (Siemens, Germany). Materials for microbiological and histopathological examination were taken from all examined patients intraoperatively. Results. The experience of diagnosing and treating rhinoorbitocerebral mucormycosis in patients after a new coronavirus infection was analyzed, the influence of the complex use of radiation diagnostic methods, histopathological and microbiological methods on the development and effectiveness of mucormycosis treatment was determined. Conclusions. The effectiveness of disease management directly depends on the early initiation of etiotropic treatment, while the role of complex radiological diagnostics, histopathological and microbiological methods is important for early confirmation of the fungal etiology of the disease.Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.
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Aim: In this study, we aimed to show the contribution of the chest computed tomography (CT)-based histogram analysis method, which will enable us to make quick decisions for patients who are clinically suspected of having COVID-19 infection and whose diagnoses cannot be confirmed by polymerase chain reaction (PCR) tests. Material(s) and Method(s): A total of 84 patients, 40 in the PCR-positive group (age range: 17-90 years) and 44 in the PCR-negative group (age range: 15-75 years), were included in the study. A total of 154 lesions with ground-glass density, 78 in the PCR-positive group and 76 in the PCR-negative group, were detected in these patients' thorax CT scans. The region of interest was placed on the ground-glass opacities from the images and numerical data were obtained by histogram analysis. Numerical data were uploaded to the MATLAB program. Result(s): The localizations of ground-glass densities in the CT findings of patients with probable and definite COVID-19 diagnoses were similar;74.7% of the ground-glass areas in both groups showed peripheral distribution. Lesions were frequently observed in right lungs and lower lobes. In histogram analysis, standard deviation, variance, size %L, size %M, and kurtosis values were higher in the PCR-positive than the PCR-negative group. When receiver operating characteristic curve analysis was performed for standard deviation values, the area under the curve was 0.640, and when the threshold value was selected as 123.4821, the two groups could be differentiated with 62.8% sensitivity and 61.8% specificity. Discussion(s): The use of histogram-based tissue analysis, which is a subdivision of artificial intelligence, for clinically highly suspicious patients increases the diagnostic accuracy of CT. Therefore, performing CT analysis with the histogram method will significantly aid healthcare professionals, especially in clinics where rapid decisions are required, such as in emergency services.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Aim: This study aimed to compare clinical data and laboratory results in patients examined for suspected pulmonary embolism (PE) in the emergency department based on three groups: patients with coronavirus disease-2019 (COVID-19), patients with PE and patients with both COVID-19 and PE. Material(s) and Method(s): This retrospective study was approved by the local ethics committee of the university. Patients included in the study were divided into three groups: Group 1, consisting of COVID-19-polymerase chain reaction (PCR) (negative) and PE (positive) patients;Group 2, consisting of COVID-19-PCR (positive) and PE (negative) patients, and Group 3, consisting of COVID-19-PCR (positive) and PE (positive) patients. Result(s): The three patient groups included in the study had no difference in terms of age (p = 0.916) or sex. The laboratory results of the groups were compared using the Kruskal-Wallis test, which showed significant differences in the levels of white blood cells (p = 0.005), lymphocytes (p < 0.001), neutrophils (p = 0.016), D-Dimer (p < 0.001) and lactate (p = 0.001). Receiver operating characteristic curve analysis with a cut-off value of >2590 for D-Dimer showed 71.43% specificity and 78% sensitivity in differentiating Group 1 from Group 2, and with a cut-off value of >3640, it had 80% specificity and 81.82% sensitivity in differentiating Group 3 from Group 2. Discussion(s): COVID-19 leads to increased incidence of PE. In addition to clinical data, D-Dimer and lactate levels can be used in the differentiation of these patients.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Purpose. The analysis of CT and MR patterns of rhinoorbitocerebral mucormycosis (ROCM) among patients with type 2 diabetes (T2D) after COVID-19. Materials and methods. The study included 11 patients with confirmed COVID-19 and invasive ROCM in the long-term period. CT examinations were performed on Revolution EVO CT scanner (GE, Russia) and MRI on Aera MR scanner 1.5 T (Siemens, Germany). Results. We report several CT and MR patterns for a series of patients: involvement of paranasal sinuses, orbits, optic nerves, large arteries;intracranial spread;involvement bones of cranial base. The features of differential diagnosis and recommendations for standard protocols are presented. Conclusion. CT of paranasal sinuses is the method of choice for suspected fungal infections. MRI is recommended if there is a suspicion of orbital, vascular, and intracranial complications or cavernous sinus extension. The combination of both methods makes it possible to showed soft tissue invasion and bony destruction to choose optimal medical tactics ROCM.Copyright © 2022 Russian Electronic Journal of Radiology. All rights reserved.
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Introduction: Stroke units have remarkably reduced morbidity and mortality in patients by bringing together a multidisciplinary team that aids in quick stroke diagnosis, emergency treatment, restoration of homeostasis, prevention of common complications, rehabilitation and secondary prevention. Our audit looks at factors that cause delay in early transfer of patients from emergency department to HASU (hyper-acute stroke unit) and aims to find solutions to reduce transfer time. Method(s): We obtained our data from stroke database maintained by hospital's medical records department. All patients presenting with acute stroke (ischemic and hemorrhagic) during the month of November and December2021 and fulfilling our inclusion criteria were evaluated. Result(s): A total of 138 patients presented to our stroke-care facility in the two months period with 79 eligible for stroke unit admission, out of which 52 (65.8%) were females and 27(34.2%) were males. The mean door to stroke unit time in our study was 278.6 minutes with major delays beyond 4hours caused by non-availability of beds(32.0%), covidrelated issues(25.5%),monetary issues(17.0%) initial referral delays(14.9%) and imaging delays(10.6%) respectively. Conclusion(s): Our audit showed that most of the delays were infrastructure- related like lesser stroke dedicated beds, separate facility for covidaffected stroke patients and no designated Ct scanner/ stroke nurse for acute stroke patients assessment in triage. Additional cause identified was low socioeconomic status hampering affordability of acute stroke care.
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Objective: To survey and supervise the risk of infection control and radiation safety in the radiological diagnostic workplace for COVID-19, and provide data support for the safety protection of radiographers and related staff. Method(s): 4 emergency hospitals for COVID-19 including 2 makeshift hospitals, module hospital and brick pattern hospital in Hubei province were performed for testing and evaluation of imaging performance and radiological protection for the 8 new installed CT scanners and places according to the national standards of WS 519-2019 and GBZ 130-2013. The infection control safety factors such as the layout of the equipment room were monitored and investigated. Two COVID-19 designated hospitals including general hospital and infectious disease specialized hospital were selected to carry out field investigation and sampling of environmental biological samples for 4 CT rooms. Then the samples were detected for the nucleic acid of novel coronavirus. The results of radiodiagnostic workplace overall arrangement, infection prevention and the nucleic acid testing were analyzed, and the biological safety reliability and risk point were evaluated. Result(s): The indicators of imaging performance and radiation protection for 8 CT scanners in emergency hospitals could meet the requirements of national standards.Each of 2 makeshift hospitals had 3 CT rooms with the area of 38.8 m2 and 4 mm Pb equivalent thickness of protective shielding. The CT rooms in module hospital and brick pattern hospital were 20.0 m2, and 35.8 m2 in areas, with 4 mm Pb equivalent and 3 mm Pb equivalent thickness of protection shielding, respectively. The 8 radiological diagnostic workplaces of the emergency hospitals were designed and constructed based on " three zones with two passage ways". The result of the nucleic acid test indicated that the positive samples were found at the multiple sites such as scanning bed, internal of gantry and ground touched by patients in CT scanning room. The areas such as console panel and ground were risked of pollution by the virus infected hands and feet of radiographers. In addition, the similar positive samples were found in the areas in scanning room with no touch of patients, such as observation window and air outlet. Conclusion(s): 8 CT scanners and rooms in 4 emergency hospitals basically meet the requirements of imaging performance and radiation protection. The disinfection of COVID-19 radiodiagnostic workplace should be standardized.Copyright © 2020 by the Chinese Medical Association.
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Aim: In this study, we aimed to analyze the relationship between pulmonary artery (PA) and inferior vena cava (IVC) diameters in non-contrast chest computerized tomography (CT) images of patients with coronavirus disease 2019 (COVID-19) and overall survival. Material(s) and Method(s): This retrospective study consisted of 404 consecutive patients who underwent chest CT after admission to the emergency department between May 1 and June 31, 2021. CT measurements were performed by two radiologists. The prognostic value of PA and IVC diameters, the computerized tomography severity score (CT-SS), quick sequential organ failure assessment (qSOFA), and confusion, urea, respiratory rate, blood pressure, and age >=65 years (CURB-65) score on overall survival were examined. Result(s): The median age of the participants was 62 years (49-72), and 196 (48.5%) were male. Of the 404 patients, 61 died after admission. While main-PA, left-PA, right-PA (p < 0.001) and IVC-transverse (IVC-Tr) (p = 0.045) diameters were larger and statistically significant in the patients who died (AUC;0.686, 0.722, 0.746, and 0.581, respectively), a statistically significant difference was not detected in terms of IVC anteroposterior diameter (IVC-AP) (p = 0.053) and the IVC-Tr/AP (p = 0.754) ratio. There was a statistical difference in mortality in qSOFA, CURB-65, and CT-SS values (AUC;0.727, 0.798, and 0.708 p < 0.001, respectively). Discussion(s): PA diameters measured from chest CT images at admission (main-PA >= 26.5 mm, right-PA >= 22.9 mm, and left-PA >= 21.6 mm) and the IVC-Tr diameter (>=34.5 mm) can be used as mortality predictors for COVID-19, along with other prognostic scores.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Background: The reversed halo sign described in the pre-COVID era in certain pulmonary pathologies, most notably cryptogenic organizing pneumonia, has been reported with varying frequency in coronavirus disease 2019 (COVID-19) pneumonia caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, we aimed to analyze the pattern of the reversed halo sign and its variant, the bullseye sign in patients with COVID-19 pneumonia. Method(s): In this study, a retrospective analysis of chest CT scans performed in the CT unit of Al-Imammain Al-Kadhymain Medical City for a three-month duration (from June to August 2020) was done. Of the 490 CT scans performed for patients with COVID-19, 330 had signs of COVID-19 pneumonia. These were evaluated for the presence of reversed halo or bullseye sign, and only obvious signs detected in at least two orthogonal planes were included. The number of these signs in each scan was documented, and an analysis of individual signs was performed. The following features were recorded;size, location, shape, and type of the peripheral rim (whether complete or incomplete, thin or thick, distinct or hazy, and uniform or non-uniform). Result(s): A total of 26 CT exams were included in the study. The average age of the patients was 44.85 +/- 20.14 years, and the total number of typical reversed halo or bullseye sign lesions was 63. The rate of reversed halo/bullseye sign in this study was 7.88%. In 15 patients, the typical sign of reversed halo was seen, the bullseye sign was noted in eight patients, and three patients had both the reversed halo and bullseye signs. Nearly all the patients had other CT findings of COVID-19 pneumonia, except one with only a solitary bullseye lesion. The number of lesions ranged from one to nine with the average number of lesions per patient being 2.42. The mean size of the lesions was 3.39 cm with a size range 1-8.5 cm. Lesions were located in the periphery of the lung in most patients (93.7%). Basal predominance was seen in 76.19% patients, located in the lower lobes. A higher percent of bullseye lesions located in the upper and right middle lobes was observed (n = 12/23) than the typical reversed halo lesions (n = 3/40). Most lesions were oval (52.38%) or rounded (48.86%). In 77.78%, the peripheral rim was incomplete. The thickness of the peripheral rim was variable ranging from 2-19 mm. Most lesions (92.06%) exhibited a thin peripheral rim (<1 cm). The rim was clearly distinct in 53.97% of lesions. It was non-uniform in thickness in most cases (95.24%). Conclusion(s): The reversed halo sign is not infrequent among CT findings in patients with COVID-19 pneumonia. The typical reversed halo sign is more common than its variant, the bullseye sign. Variability in morphology and size does exist. In patients with COVID-19, these lesions exhibit thin, incomplete peripheral rims and are multiple in most cases.Copyright © 2022 Al-Waely, Fayadh, Shati, licensee HBKU Press
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Aim: Angiotensin-converting enzyme 2 (ACE2) acts not only as an enzyme but also as a thought to be central receptor by which severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) enters host cells. Angiotensin-converting enzyme inhibitors (ACEIs) are thought to $1 are central to SARS-CoV-2 progression. However, its effect on clinical outcomes is still not fully explained. In this study, we investigated the effects of ACEIs use on pulmonary computed tomography findings. Method(s): The data of the patients who were hospitalized for SARS-CoV-2 pneumonia and were using medications for the diagnosis of hypertension from 20th March to 20th June 2020 were evaluated retrospectively. Patients were divided into 2 groups patients using ACEIs and not using ACEIs. Result(s): The study was conducted with 107 patients. Mild cases without signs of pneumonia were excluded from this study. Moderate cases were accepted as patients with symptoms related to the respiratory system and pneumonia detected on imaging. SpO2<=93%, >=30 breaths/min respiratory rate, and patients who developed respiratory failure, mechanical ventilator need, shock, or multiorgan failure were included in the severe and critically ill cases group. Severe and critical cases were evaluated as a single group. When the radiological images of the patients were examined, it was remarkable that multilobar findings were less common in the ACEIs using group (p<0.001). At the clinical end point, mortality rates in patients using ACEIs (12.7%) were significantly lower than patients without using ACEIs (32.7%). Conclusion(s): In our study, we showed that SARS-CoV-2 progresses with less multilobar involvement in pulmonary computed tomography in patients using ACEI.Copyright © 2023 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.
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A 56-year-old woman with new-onset aphasia and mood changes was diagnosed with a left temporal mass. The surgery was done. She was referred for a trial of post-operative study of in vivo evaluation of CXCR4 expression using [68Ga]Ga-Pentixafor (Pars-CixaforTM) PET/CT in high-grade glioma. The imaging from the brain revealed no evidence of tumoral remnant. Furthermore, the patient represented positive COVID-19 PCR about 4 weeks prior to the study. Surprisingly, mild diffuse uptake was noted in the base and periphery of both lungs with ground glass opacities (GGO) and consolidations (SUVmax = 2.60) with CXCR4-avid hilar lymph nodes (SUVmax up to 3.42).Copyright © 2023 The Authors.
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Background: COVID-19 has become a serious health problem worldwide. Objective(s): The current study investigated the prognostic factors associated with demographical parameters, clinical and vital signs, and laboratory results for predicting severity and mortality in patients infected with COVID-19. Method(s): This retrospective analysis was conducted on the medical records of 372 COVID-19-positive patients hospitalized at the Khatam al-Anbiya Hospital, Shoushtar, Iran, from Sep 2020 to Sep 2021. The association of demographic parameters, clinical and vital signs, and laboratory results with severity and patients' outcomes (survival/mortality) was studied. The patients were divided into the non-severe group (n = 275) and the severe group (n = 97). COVID-19 disease severity was determined based on the severity of pulmonary involvement using CT chest images. The collected data were analyzed using IBM SPSS software for Windows (version 18). Logistic regression analysis was employed using the Forward LR method to predict COVID-19 severity and mortality. Result(s): The rates of mortality and the severe form of the disease were 87.1% (n = 324) and 12.9% (n = 48), respectively. A prognostic value was observed in predicting COVID-19 severity and mortality for some clinical and vital signs (diabetes (P < 0.001, P = 0.019), hypertension (P = 0.024, P = 0.012), pulmonary diseases (P = 0.038, P < 0.001), and anosmia (P = 0.043, P = 0.044) and paraclinical parameters (FBS (P = 0.014, P = 0.045), BUN (P = 0.045, 0.001), Cr (P = 0.027, P = 0.047), Neut (P = 0.002, P = 0.005), and SpO2 (P = 0.014, P = 0.001)). Cardiovascular disorders (P = 0.037), fever (P = 0.008), and dyspnea (P = 0.020) were also effective at predicting disease-related mortality. Multiple logistic regression analyses showed that diabetes disease, the place of residence, PCO2, and BUN with R2 = 0.18, and age, pulmonary diseases, and BUN with R2 = 0.21 were involved in predicting the severity and mortality, respectively. Conclusion(s): It seems that in addition to the BUN, diabetes and pulmonary diseases play a more significant role in predicting the severity and mortality due to COVID-19, respectively.Copyright © 2023, Author(s).
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Background: The present radiological COVID literature is mainly confined to the CT findings. Using High Resolution Computed tomography (HRCT) as a regular 1st line investigation put a large burden on radiology department and constitute a huge challenge for the infection control in CT suite. Materials and Methods: A prospective study of 700 consecutive COVID positive cases who underwent Chest Xray (CXR) and HRCT thorax were included in the study. Many of these CXR were repeated and followed up over a duration of time to see the progression of disease. Results: 392/700 (56%) were found to be negative for radiological thoracic involvement. 147/700 (21%) COVID positive patients showed lung consolidations, 115/700 (16.5%) presented with GGO, 40/700 (5.7%) with nodules and 42/700 (6%) with reticular–nodular opacities. 150/700 patients (21.4 %) had mild findings with total RALE severity score of 1-2. More extensive involvement was seen in 104/700 (14.8 %) and 43/700 (6.2%) patients, who had severity scores of 3-4 and 5-6 respectively. 11/700 patients had a severity score of >6 on their baseline CXR. Those with severity score of 5 or more than 5 (54/700, 7.7%) required aggressive treatment with mean duration of stay of 14 days, many of them died also (23/54, 42.5%). Conclusion: In cases of high clinical suspicion for COVID-19, a positive CXR may obviate the need for CT. Additionally, CXR utilization for early disease detection and followup may also play a vital role in areas around the world with limited access to CT and RT-PCR test.
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Introduction: COVID-19, a new coronavirus illness, swiftly spread throughout all continents. However, evidence on all of COVID-19's indications and symptoms is lacking. Patients who have COVID-19 may be more susceptible to fungal infections. Mucormycosis is an uncommon and frequently fatal fungal illness caused by hyphae invading the bloodstream and causing thrombosis and necrosis. Material(s) and Method(s): Patients diagnosed with mucormycosis following a recent COVID-19 infection were included in the case series analysis. Surgical therapy was limited to individuals who tested negative for COVID-19 on PCR. To remove the infection, endoscopic, open, and combination techniques were used. For the first month after surgery, survivors were followed up on on a regular basis. Result(s): About 30 people with a history of Covid-19 were given dexamethasone and remdesivir in this study. Following therapy, these individuals developed mucormycosis, which was treated by Functional Endoscopic Sinus Surgery (FESS). As a consequence, 16 patients (53.34 %) had numerous operations. The most prevalent related condition was diabetes mellitus (60 %). The majority of the patients were men (60 %). Our patients had an average age of 55.53+/-8.093. 43.34 % of the people died. Conclusion(s): In conclusion, mucormycosis is a rare but critical problem complicating the later part of the clinical course of COVID-1, possibly due to improper drug usage during Covid treatment. Copyright © 2023 Authors. All rights reserved.
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Aim/Introduction: Many diseases with high prevalence and socioeconomic impact are caused by, or associated with, altered lung ventilation patterns. These include chronic obstructive pulmonary disease, COVID-19 infection, asthma, or lung cancer. SPECT/ CT images using a dispersion of nanosized (30-60nm) graphite encapsulating technetium-99m metal NG-eTcM (such as Technegas) are widely used to assess regional lung ventilation in the clinical setting. However, evaluation of lung ventilation in experimental animals has been barely explored. The main objective of this study was to develop and construct a system to deliver NG-eTcM to rats and obtain high resolution microSPECT/CT images of the lungs after administration of the radiotracer. Material(s) and Method(s): To adapt the human administration system for rats, a special chamber was designed, in which NG-eTcM was delivered from the NG-eTcM generator. The chamber was designed with pressure gauges, inlet and outlet checkvalves, a vacuum system to simulate deep inhalation and 3D-printend nozzles to place up to two anesthetised rats with their snouts into the chamber to inhale the technetiumgraphite suspension. NG-eTcM was prepared according to the manufacturer instructions (370 MBq in 0,1 mL) from a fresh eluate of a 99Mo/99mTc generator. Anesthetized Wistar rats were placed with the snout into the inhalation chamber for 10 minutes and images were obtained 12 and 50min post-administration in a U-SPECT6/Eclass microSPECT/CT scanner. SPECT images were reconstructed and attenuation correction applied using the CT attenuation map. SPECT/CT images were qualitatively analysed and compared with previously obtained microPET/CT images from our group using [18F] SF6 (1). Result(s): The designed system was shown to be amenable for NG-eTcM administration to rats. MicroSPECT/CT images were properly acquired, and they showed the radiopharmaceutical was able to reach the lungs. The system can easily be modified for studies in mice. When compared to microPET/CT images with [18F] SF6, the distribution pattern is much less homogeneous, probably due to the different nature of NG-eTcM nanoparticle suspension, not optimized for animal use, vs. a pure gas. Conclusion(s): The commercially available administration system of TechnegasTM has been modified for its use in preclinical studies. NG-eTcM can properly be delivered to rats by inhalation, allowing MicroSPECT/ CT studies in animal models of diseases producing altered lung ventilation patterns.