Impact of COVID-19 on CT-diagnosed acute appendicitis and diverticulitis: was there collateral damage?

AIM: To evaluate the change in diagnosis rates, disease severity at presentation, and treatment of acute appendicitis and diverticulitis during the COVID-19 shutdown. MATERIALS AND METHODS: Following institutional review board approval, 6,002 CT examinations performed at five hospitals for suspected acute appendicitis and/or diverticulitis over the 12 weeks preceding and following the shutdown were reviewed retrospectively. Semi-automated language analysis (SALA) of the report classified 3,676 CT examinations as negative. Images of the remaining 2,326 CT examinations were reviewed manually and classified as positive or negative. Positive cases were graded as non-perforated; perforated, contained; and perforated, free. RESULTS: CT examinations performed for suspected appendicitis and/or diverticulitis decreased from 3,558 to 2,200 following the shutdown. The rates of positive diagnoses before and after shutdown were 4% (144) and 4% (100) for appendicitis and 8% (284) and 7% (159) for diverticulitis (p>0.2 for both). For positive CT examinations, the rates of perforation, hospitalisation, surgery, and catheter drainage changed by -2%, -3%, -2%, and -3% for appendicitis (n=244, p>0.3 for all) and +6% (p=0.2) +9% (p=0.06), +4% (p=0.01) and +1% (p=0.6) for diverticulitis (n=443). CONCLUSION: CT examinations performed for suspected appendicitis or diverticulitis declined after the shutdown, likely reflecting patients leaving urban centres and altered triage of non-COVID-19 patients. The diagnosis rates, disease severity at presentation, and treatment approach otherwise remained mostly unchanged.

Imaging Informatics Fellowship Curriculum: a Survey to Identify Core Topics and Potential Inter-Program Areas of Collaboration.

New consumer technologies and interoperability standards have dated the first standardized curriculum for imaging informatics fellowships suggested by the Society for Computer Applications in Radiology (SCAR) in 2004 (Journal of digital imaging 17(4):244-248, 2004). Last year, analysis from this institution characterized current state fellowship graduation requirements and broad curriculum topics for the first time in over a decade (SIIM Strategic Plan 2017-2020). However, an updated "core" curriculum has not yet been developed. Using the recent current state analysis as a baseline, we aimed to perform a focused assessment and propose that this would work towards an updated consensus "core" curriculum as outlined by the Society for Imaging Informatics in Medicine (SIIM, previously SCAR) strategic plan. A secondary aim was to identify individual program strengths and weaknesses to foster inter-program collaboration. Using sub-topics from the National Imaging Informatics Curriculum (NIIC), a week-long introductory course for residents, we expanded the original 29 broad curriculum categories identified in last year's current state analysis into 114 sub-topics. We surveyed imaging informatics fellowship directors to identify sub-topic prioritization on a 5-item Likert scale, teaching methods for each sub-topic, cross-departmental partnerships, and individual program strengths and weaknesses. Only 8% of sub-topics (10/114) received a "definitely" rating with 100% agreement while the majority of sub-topics 77% (88/114) had mixed grading defined by two or fewer "definitely" ratings. These sub-topics mapped to only 4 of the original 29 broad fellowship curriculum categories including Standards, Programming/Development/Software, Infrastructure, and PACS/RIS/Reporting. Our plan is to use consensus topics to build a "core" informatics fellowship curriculum and initiate discussion surrounding mixed grading topics. Knowledge of individual program strengths and weaknesses can be used to foster inter-program collaboration.

Flexible and stretchable power sources for wearable electronics.

Flexible and stretchable power sources represent a key technology for the realization of wearable electronics. Developing flexible and stretchable batteries with mechanical endurance that is on par with commercial standards and offer compliance while retaining safety remains a significant challenge. We present a unique approach that demonstrates mechanically robust, intrinsically safe silver-zinc batteries. This approach uses current collectors with enhanced mechanical design, such as helical springs and serpentines, as a structural support and backbone for all battery components. We show wire-shaped batteries based on helical band springs that are resilient to fatigue and retain electrochemical performance over 17,000 flexure cycles at a 0.5-cm bending radius. Serpentine-shaped batteries can be stretched with tunable degree and directionality while maintaining their specific capacity. Finally, the batteries are integrated, as a wearable device, with a photovoltaic module that enables recharging of the batteries.

[Endothelial antigenicity in diffuse connective tissue diseases]. / Antigenicidade endotelial nas doenças difusas do tecido conectivo.

The authors review the published data on antibodies to endothelial cells observed in patients suffering from diffuse connective tissue diseases. In these patients the histologic lesions are found in vessels of different sizes and localizations. It is believed that such auto-antibodies may have a role in the pathogenesis and prognosis of these disorders. The preliminary results of a study of the antigenicity of endothelial cells in mixed connective tissue disease are also presented.

[Soft tissue rheumatism: critical approach of clinical aspects]. / Reumatismo de partes moles: abordagem crítica dos aspectos clínicos.

Soft tissue rheumatism or "non-articular rheumatism" represents a group of diverse entities, the common feature of which is muscular stiffness and pain. It is the major cause of morbidity and loss of productive man-hours at work. There is no internationally accepted classification of the soft tissue rheumatism. On hand of an arbitrary classification of the soft tissue rheumatism the affections are divided in localized, regional and generalized conditions.

[Soft tissue rheumatism: therapeutic approach]. / Reumatismo de partes moles: abordagem terapêutica.

The authors review the conventional methods for the management of the soft tissue rheumatism. The success in relieving the patient's chief complaint, i.e. pain, depends on the choice of the appropriate measures that can be used without inconvenience to the patients.

[Superposition syndrome of connective tissue diseases: current view with special focus on mixed connective tissue disease]. / Síndrome de superposição de conectivopatias: visão atual com enfoque especial para a doença mista do tecido conectivo.

Attention is called to mixed connective tissue disease which, twenty years after it's original description, has now reached the syndromic individualization with important therapeutic and prognostic implications. In particular the discussion concerns the pulmonary complications (hypertension and fibrosis) responsible frequently for fatal outcome.