COVID-19 after 2 Years from Hospital Discharge: A Pulmonary Function and Chest Computed Tomography Follow-Up Study.

INTRODUCTION: Serial follow-up with pulmonary function testing (PFT) and chest computed tomography (CT) after severe COVID-19 are recommended. As a result, many longitudinal studies have been published on COVID-19 of different grade of severity up to 1-year follow-up. Therefore, we aimed at a long-term observational study throughout 2 years after severe COVID-19. METHODS: Severe COVID-19 patients were consecutively recruited after hospital discharge between March and June 2020 and prospectively followed up for 24 months, with mMRC dyspnea scale and PFT at 6, 12, and 24 months. Chest CT was performed when clinically indicated. RESULTS: One hundred one patients enrolled completed the observational study. At 24 months, those with reduced total lung capacity (TLC) were 16%, associated with fibrotic ground glass opacity (GGO) and mMRC score >1, respectively, in 75% and 69% of them. At 24 months, those with a reduced diffusing capacity of the lung for CO were 41%, associated with fibrotic GGO and mMRC score >1, respectively, in 53% and 22% of them. CONCLUSION: Two years after hospitalization for severe COVID-19, a non-negligible number of patients still suffer from "long COVID" due to respiratory damage.

Artificial intelligence and pelvic fracture diagnosis on X-rays: a preliminary study on performance, workflow integration and radiologists' feedback assessment in a spoke emergency hospital.

Purpose: The aim of our study is to evaluate artificial intelligence (AI) support in pelvic fracture diagnosis on X-rays, focusing on performance, workflow integration and radiologists' feedback in a spoke emergency hospital. Materials and methods: Between August and November 2021, a total of 235 sites of fracture or suspected fracture were evaluated and enrolled in the prospective study. Radiologist's specificity, sensibility accuracy, positive and negative predictive values were compared to AI. Cohen's kappa was used to calculate the agreement between AI and radiologist. We also reviewed the AI workflow integration process, focusing on potential issues and assessed radiologists' opinion on AI via a survey. Results: The radiologist performance in accuracy, sensitivity and specificity was better than AI but McNemar test demonstrated no statistically significant difference between AI and radiologist's performance (p = 0.32). Calculated Cohen's K of 0.64. Conclusion: Contrary to expectations, our preliminary results did not prove a real improvement of patient outcome nor in reporting time but demonstrated AI high NPV (94,62%) and non-inferiority to radiologist performance. Moreover, the commercially available AI algorithm used in our study automatically learn from data and so we expect a progressive performance improvement. AI could be considered as a promising tool to rule-out fractures (especially when used as a "second reader") and to prioritize positive cases, especially in increasing workload scenarios (ED, nightshifts) but further research is needed to evaluate the real impact on the clinical practice.

Does Immunocastration Affect Behaviour and Body Lesions in Heavy Pigs?

Immunocastration has been pointed out as an alternative to surgical castration; though, most of the scientific studies were performed in light pig production. This study aimed to evaluate the effect of immunocastration on animal welfare in heavy pig production through the evaluation of behaviour and body lesions. A total of 188 commercial-hybrid pigs were randomly allocated into two treatment groups: surgical castration (SC) and immunocastration with Improvac® (IC). Data on behaviour, body lesions, and salivary testosterone levels were collected the day before each vaccination at 15, 22, 32, and 36 weeks of age. IC and SC pigs were slaughtered at 40 and 41 weeks of age, respectively; productive and carcass traits data were also collected. Considering productive performance, our results confirmed that IC pigs grew faster and presented a higher weight at slaughter. A critical period for pig welfare was observed before 32 weeks: testosterone concentration and body lesion score were significantly higher in IC pigs compared to SC pigs; active behaviours were significantly more frequent in IC at 15 weeks. Immunocastration may represent a suitable alternative to surgical castration with profitable productive performances, whereas the impairment of welfare during the period before the effective vaccination should be further investigated as a potential critical aspect in heavy pig production.

How embryology knowledge can help radiologists in the differential diagnosis of canal of Nuck pathologies.

The Canal of Nuck (CN) is an anatomical structure which is often forgotten. It is the female equivalent of the male processus vaginalis and corresponds to a protrusion of parietal peritoneum that extends from the inguinal canal to labia majora. Radiologists rarely encounter patients with pathology of CN, especially in adult population. It is well known that CN diseases can occur in paediatric patient (especially younger than 5 years of age) and they are associated to high morbidity (for example ovarian hernia with high risk of incarceration and torsion). The aim of our work is to review embryology, anatomy and pathologies of the CN thanks to a multi modal approach-ultrasound (US), Computed Tomography (CT) and Magnetic Resonance imaging (MRI)-to make radiologists more aware of such conditions and guarantee a prompt and correct diagnosis not only in paediatric patients but also in the adult population.

Pre-Slaughter Sources of Fresh Meat Quality Variation: The Case of Heavy Pigs Intended for Protected Designation of Origin Products.

This study focused on loin quality in Italian heavy pigs intended for the production of PDOs (Protected Designation of Origin) products, and investigated the pre-slaughter factors which negatively affect the quality of fresh meat. Data were collected on 44 shipments (loads) of pigs. Shipments were carried out under commercial conditions. Several pre-slaughter parameters were recorded within the entire process (on-farm, during transport, and at the slaughterhouse). On a subset of pigs (10 animals from every load, N = 440), serum cortisol and creatine kinase were measured and loin samples were analyzed for pH, instrumental color, drip loss, cooking loss, shear force, and sensory quality. Cluster analysis of the instrumentally-assessed meat quality parameters allowed the categorization of the shipments into two clusters: lower quality (LQ) and higher quality (HQ). Our results showed that the factors with significant differences between the two clusters were journey duration, ambient temperature, distance traveled, and irregular behaviors (slipping, falling, and overlapping) at unloading (all greater in LQ, p < 0.05). The pre-slaughter conditions associated with lower loin quality were ambient temperatures above 22 °C, distance traveled above 26 km, travel duration between 38-66 min, more than 5.9% of animals showing irregular behaviors at unloading.

Identification of Possible Pre-Slaughter Indicators to Predict Stress and Meat Quality: A Study on Heavy Pigs.

This study aimed at identifying possible pre-slaughter indicators and/or indexes to be used to predict pig stress response and meat quality variation. Data were collected on 44 shipments (loads) of Italian heavy pigs. For each shipment, several pre-slaughter parameters were recorded on farm, during transport, and at the slaughterhouse. Blood and meat samples were taken from 10 pigs from every of the 44 loads included in the study (N = 440). Blood samples were used to assess cortisol and creatine kinase levels, whereas meat samples were used to assess meat quality (pH, instrumental color, tenderness, water-holding capacity, and sensory analysis). Cluster analysis of blood parameters allowed the categorization of the shipments into two main clusters: Lower Stress (LS) and Higher Stress (HS). The variables/indexes statistically differing between the two clusters were: average vehicle speed during transport, welfare index at slaughter (i.e., "slaughter score"), overall transport and slaughter welfare index (TSWI), distance travelled, and behaviors (slips, falls, overlaps) during unloading, which appeared to be the best descriptors of the welfare conditions experienced by Italian heavy pigs during pre-slaughter handling. No consistent effects of the stress level experienced on meat quality was detected, which warrants the need for further studies conducted under more variable pre-slaughter conditions, with the aim of simplifying and improving the TSWI.

CT colonography: patient tolerance of laxative free fecal tagging regimen versus traditional cathartic cleansing.

PURPOSE: The aim of our prospective study was to compare patient tolerance of laxative free fecal tagging regimen (LFT) versus traditional cathartic cleansing (TC). MATERIALS AND METHODS: 264 patients, at average risk for development of colorectal cancer (105 men and 159 women; mean age 62 years ± 5 SD), underwent 32 rows CT colonography. Patients were alternatively placed into 2 study groups: Group 1 (n = 132) followed TC and Group 2 (n = 132) LFT. TC protocol consisted of no fiber diet and Phospho-lax(®) 80 mL in 2 L of water the day before imaging. LFT protocol consisted of no fiber diet and ingestion with meals of 30 mL of water-soluble iodinated contrast agent (Gastrografin(®)) for 2 days before imaging. No frank laxative drugs were administered. All studies were reviewed in a combined fashion, primary 2D followed by 3D endoluminal and dissected views. After the examination all patients were asked to provide a feedback about tolerance to the each bowel preparation. The first 30 patients of each group were also investigated with optical colonoscopy (OC) used as gold standard to confirm our diagnosis (Group 1* and Group 2*). CONCLUSIONS: LFT reduces discomfort and seems to improve diagnostic accuracy of CTC.