CT Scan Results Research Articles

Risk factors and outcomes of hospitalized stroke patients in Lusaka, Zambia

BackgroundLimited data exists about stroke risk factors and outcomes in sub-Saharan African countries, including Zambia. We aim to fill this gap by describing features of hospitalized stroke patients at University Teaching Hospital (UTH), the national referral hospital in Lusaka, Zambia. MethodsWe conducted a retrospective study of consecutive adults with stroke admitted to UTH's inpatient neurology service from October 2018 to March 2019. Strokes were classified as ischemic or hemorrhagic based on CT scan results and unknown if CT scan was not obtained. Chi-square analyses and t-tests were used to compare characteristics between cohorts with differing stroke subtypes. ResultsAdults with stroke constituted 43% (n = 324) of all neurological admissions, had an average age of 60 ± 18 years, and 62% of the cohort was female. Stroke subtypes were 58% ischemic, 28% hemorrhagic, and 14% unknown. Hypertension was present in 80% of all strokes and was significantly associated with hemorrhagic stroke (p = 0.03). HIV was present in 18% of all strokes and did not significantly differ by stroke subtype. Diabetes (16%), heart disease (34%), atrial fibrillation (9%), and past medical history of stroke (22%) were all significantly more common in patients with ischemic stroke (p < 0.05). In-hospital mortality was 24% overall and highest among individuals with hemorrhagic strokes (33%, p = 0.005). ConclusionsThis Zambian stroke cohort is notable for its young age, significant HIV burden, high in-hospital mortality, and high rates of uncontrolled hypertension. Our results demonstrate Zambia's substantial stroke burden, significant contribution of HIV to stroke, and the need to improve primary stroke prevention.

Preliminary Analysis of Liquid Biopsy after Hepatectomy for Colorectal Liver Metastases

Liquid biopsies are increasingly tested in patients with colorectal cancer to assess tumor burden, response to therapy, and prognosis. The significance of liquid biopsy results after resection of colorectal liver metastases (CLMs) is not well-defined. Sixty-three patients undergoing CLM resection between 2016 and 2018 had plasma drawn postoperatively for liquid biopsy evaluation. Next-generation sequencing analysis was performed to detect somatic mutations in 70 genes. Liquid biopsy after CLM resection was positive in 42 of 63 patients (67%). Eleven patients (18%) had 1 gene mutation, 14 patients (22%) had 2 to 3 mutations, and 17 patients (27%) had 4 or more mutations. The most common mutation was APC, detected in 32 patients (76%), followed by TP53 (74%) and KRAS (38%). Two-year overall survival rate from date of liver resection was significantly worse among patients with a positive liquid biopsy (70% vs 100%; p= 0.005), particularly for those with 4 or more gene mutations detected, whose 2-year overall survival rate was 41%. Sixteen of the 63 patients underwent serial liquid biopsies, resulting in 100 liquid biopsies with matched serum CEA and CT scan results. Metastases were identified in 74 CT scans, which correlated with positive liquid biopsy in 77% of samples (p < 0.001) and CEA > 3 ng/mL in 45% of samples (p < 0.22). Liquid biopsy results provide information about disease burden and prognosis that is complementary to serum CEA and CT imaging. A positive liquid biopsy after CLM resection is associated with worse overall survival, particularly when multiple gene mutations are detected.

The Trend of Direct Medical Cost of Meliodiosis Patients in Kedah: A Retrospective Study from 2014 to 2017.

PurposeThis study was conducted to determine the direct medical cost of treating melioidosis patients. The calculation was made according to the variables extracted from medical records.Materials and MethodsData collection was performed retrospectively on a total of 293 cases from Hospital Sultanah Bahiyah, Kedah, Malaysia. The data consisted of personal information, treatment history, and investigation findings, including blood results, USG abdomen results, and CT scan results. The site of culture and sensitivity were also obtained. The total direct medical cost was based on the antibiotics/treatments received by the patients, diagnostic test and investigations performed. The trend analysis used to see the pattern of costs from 2014 to 2017. All the costs were compared based on patients’ status and duration of stay at the hospital using the independent t-test.ResultsThe overall mean of direct medical cost for melioidosis amounted to US $233.61 (RM931.33). Overall, the finding confirms a huge reduction (44.7%) of direct medical cost from 2014 to 2017 (P = 0.001). From 2015 to 2016, there was a 19.1% reduction of direct medical cost (P>0.95), followed by a 38.8% reduction in costs from 2016 to 2017 (P = 0.019). In the case of the duration of stay, the mean of total direct medical cost among patients with ≥14 duration of stay was higher compared to those with <14 duration of stay (p < 0.001). There was no significant mean difference of direct medical cost between patients who were cured and died.ConclusionDespite the higher mortality of melioidosis cases compared to other infectious diseases, there is a limitation in the amount of published data on the management cost of melioidosis. The importance of cost in managing this disease should be underlined to perform a fully prepared management toward the disease.

A Study on Characteristics of Unsaturated Sandy Soils Based on the CT Scanning Method

In the hydrologic cycle, sandy soils play the role of a connecting reservoir of surface water and groundwater, particularly in arid areas. Therefore, to provide water conservation and ecological environment protection, it is important to study the soil water behavior in the unsaturated zone. At present, the CT-scan method is commonly used to study the soil hydraulic properties. In the field of materials science, the industrial CT high-resolution instruments are applied for quantitative research on the porous microstructure and fluid filtration law in sandy soils. In this study, we have studied five samples of sand scans of the quartz sand and CUGB coarse sand types. The industrial-type CT instrument XTH225ST was used for the sample microstructure scanning. In order to identify water: air, and solid particle distribution of the sample cross section, and to analyze the particle size distribution and moisture content, the scanned images were processed using the VG-Studio and ImageJ software. Comparing the CT-scan results of the four quartz sand samples, it can be concluded that the optimal particle size, ranges from 1 to 2 mm. According to the porosity quantitative analysis, with decrease in the particle size, the total porosity grate soil sample increases. After applying the image recognition and VG- Studio software, we can see that for different particle sizes of the sand sample, the average pore size increases with increase in the particle size. To study the moisture absorption and desorption phenomenon, two samples of the CUGB coarse sand are experimentally studied. The particle size of the samples range: from 1 to 2 mm. The CT scanning analysis is used to obtain the unsaturated characteristic curve of the soil when the moisture content reaches stability. Due to the lag phenomenon, the characteristic curve of the soil moisture has an obvious “loop,” or hysteresis, shape. As shown by a 3D modeling, the distribution of capillary water in the sand column is complex, and the water flow forms multiple winding paths, like “worms” creeping in the soil. The CT-scan method is used to overcome the limitations of the traditional experimental methods and to evaluate the relationship between the moisture content and the matrix suction. The obtained characteristic curve of soil moisture can be used to improve the efficiency of technological operations. The CT-scan method provides a new way of evaluating the water distribution characteristics of unsaturated soil.

Classification of Cerebral Infarction Data Using K-Means and Kernel K-Means

A cerebral infarct is a circumscribed focus or area of brain tissue that dies as a result of localized hypoxia or ischemia due to cessation of blood flow. To diagnose the presence of cerebral infarction, it needs a CT scan result from the patient. But, in this study not only CT scan result will be used, machine learning also will be proposed to diagnosing cerebral infarction. Machine learning can be used to detect and classify of infarcts in the brain using features and label that obtained from the results of the CT scan. In this study, the machine learning method that will be used is K-Means and K-Means based on kernel or kernel K-Means. Kernel K-Means is the application of K-Means that modified by changing the inner product with kernel function. The CT scan result data used in this study was obtained from the Department of Radiology at Dr. Cipto Mangunkusumo Hospital (RSCM). The best result reached with kernel K-Means, it performed with different percentage of training data, started with 50%, 55%, until 95% data training. The average accuracy score of the kernel K-Means method attained an accuracy rate of 95.28%.

Experimental investigation on seepage erosion of the soil–rock interface

Internal erosion under seepage flow affects the hydraulic and mechanical behavior of the soil, which is one of the most important factors of geological disasters. Due to that the soil–rock interface can be the potential preferential seepage channels commonly, the characteristics of erosion are more significant and hazardous at the soil–rock interface. In this study, a series of laboratory experiments are performed to investigate the failure mechanism and evolution of interfacial seepage erosion. The influences of two essential influence factors (i.e., the confining pressure and the roughness of the interface) are investigated by comparing the seepage velocity, hydraulic conductivity, failure hydraulic gradient, and failure hydraulic shear stress in experiments. Furthermore, the failure pattern of interfacial seepage erosion is particular investigated by the CT scanning. The interfacial seepage erosion tests indicate that the interfacial seepage erosion shows a three-phase progressive failure as the hydraulic gradient increases and the hydraulic conductivity decrease with the progress of suffusion in the initiation phase. The increase of confining pressure leads to the increase of failure hydraulic gradient. The results of CT scanning show that the roughness of the soil–rock interface significantly affects the size and shape of resulting zone of erosion.

Case Report: Organic Hallucinosis in Viral Encephalitis

Introduction : Organic mental disorders are diseases we need to put more attentionon because they are related to systemic disorders or disorders of the brain and cancause high mortality. Organic mental disorders often manifest in the form ofpsychiatric symptoms so that they can be treated too late because the physician isnot able to recognize the symptoms which can be fatal. Sequelae can be found inorganic mental disorders and may affect the patient’s quality of life, so a fast andproper management is needed to get a better outcome. Case presentation: A caseof organic hallucinosis in viral encephalitis had been reported in a 18 year-old malewith a history of sudden changes in behaviour. The symptoms appeared after thepatient had problems during OSPEK and was threatened by someone. The patientwas the only child in the family and often spoiled by his parents. Laboratory andimaging studies showed that there was a cerebritis in the CT scan result, a decreasein CD4 count, and an increase in anti-Rubella IgG titers in which the patient wasfinally diagnosed with viral encephalitis. Conclusion: The diagnosis of organicmental disorders can easily be overlooked in daily clinical practice so that patientsdo not receive proper management

Meningioma Infiltrative Accompanied by Organic Delusional Disorders

A B S T R A C TIntroduction. Meningiomas are primary extra-axial tumours of the central nervoussystem (CNS) with an incidence of 2 in 100,000 in adults. There is an estimate of a3: 1 female predominance of these tumours mainly due to the action of estrogen.Meningiomas are commonly associated with headaches, imbalances, visualdisturbances, and other neurological problems which can be very debilitating. Thiscase report will describe a case of a brain tumour accompanied by psychiatricdisorders. Case presentation. Mrs W, a 37 years old woman, a housewife, Javanese,Moslem, married, lower socioeconomic background, came with her family to theNeurology polyclinic because she experienced changes in behaviour since sevenmonths ago in the form of much silence, daydreaming, cannot communicate,sometimes talking to herself, eating drinking and bathing must be helped and served.Four months before being admitted to the hospital, because the patient's headachesworsened and the patient became increasingly withdrawn, accompanied by weaknessin both legs. From the results of CT-scan with contrast, the results showed that themeningioma infiltrates and perifocal oedema, which caused subfalcine herniation asfar as 2.73 cm to the right. Conclusion. Infiltrative meningioma is often accompaniedby mental disorders in the form of personality changes, depressive-like symptomsand neurological symptoms. Clinicians should be able to detect a brain mass so thatmanagement can be undertaken immediately.

High and Mighty

High and Mighty Kathleen Blackburn (bio) Dad liked to run as full dark thinned to morning in West Texas, cotton fields rolling out to the rim of a lilac horizon to touch the final seconds of night. The Texas panhandle escarpment is called the Llano Estacado, the staked plain, a name speaking to the endless flatness that can blind a person to his terrain. The earliest colonizers drove palos into the ground to mark the way from present-day Santa Fe to San Antonio. Otherwise, one might wander in oblivion. On the morning of Dad's CT scan results, I'm sure he stepped into the nautical twilight certain that his path was clear. But the landscape is a semi-arid savannah, a fleeting place. The southwestern plains are a playa wetland, meaning the region's water is a chimera. Sometimes real. Archeologists have discovered Paleo-Indian artifacts in excavated playas on the Llano, linking human and playa origins together. Indigenous peoples in the Paleocene roamed the panhandle along a path of ephemeral lakes. Later, Zuni shepherds followed the same glistening trail in wet seasons before the rain retreated and surface lakes vanished below the earth's surface to quench the aquifer. But to the outsider's eye, water in this place was always invisible. When imperialist Francisco Vásquez de Coronado climbed the northwestern edge of the Llano, the land spread so evenly before him, he couldn't see the shimmering wet surfaces of over twenty-thousand shallow basins carved by wind and filled with rain. Playas emerged like apparitions. When the conquistadors happened upon one, it took them by surprise. A mirage materialized into a well in the sand. Lagunas redondas! Pores for the largest aquifer in the world. But the essence of a playa is its impermanence. When they found no gold, Coronado and his men declared the land forsaken and forced their Apache captives to take them east along an ancient shepherd's path that began in what is now Lubbock. ________ These days, it is for the runner to discover terrain by foot. Dad's pace was slow at first. He had a high step, soft fall. Many mornings, I rode my bike next to him. We usually took a route that shot straight up a northbound street toward a church with a white steeple that grew like a blade from the edge of a field of cotton, marking the one-mile point. The West Texas heat didn't batter in the early hours, but the wind could be relentless. One morning, dust-filled gusts pummeled Dad and me. With each pedal downward, I lifted my body in a climb. My thighs burned. Dirt mixed in my mouth and muddied my throat. Dad moved against the wind like it wasn't there. Did he sense in those gales the mesa's formation of water and man? He made opposing the wind appear easy. When at last he glanced over his shoulder to find me trailing, he turned back. "I'll push you," he said. He took hold of my seat, and the bike jolted aright. "Pedal hard, Kate!" he cheered. "Pedal!" Over the years, there were many mornings where we contested wind, Dad's stamina like a virtue. One time, the gusts were too much for me. The church steeple grew taller, but it was still at least half [End Page 58] a mile off. Dad slowed to a stop. I climbed down from my bike and Dad stood with his hands on his hips. He surveyed the highway, the church ahead. He looked at the sky and the field alongside us, as if to scan wind. His first assignment in the Air Force was weather reconnaissance over the Pacific. As a right hand to the captain on commercial flights, he checked the dials for air pressure and airstream speeds. Watching him calculate the wind and distance, I witnessed him pilot. "You'll be okay if you wait a few minutes while I finish the run," he said, muddling question and statement. "I'll turn back at the church." He told me to take my bike a few yards into the cotton field and watched...

Cytidine deaminase 435C>T polymorphism relates to gemcitabine-platinum efficacy and hematological toxicity in Chinese non-small-cell lung cancer patients.

CDA 435C>T is reported as a functional SNP but there is no relevant research on the efficacy/hematological toxicity of gemcitabine-platinum treatment in Chinese non-small-cell lung cancer (NSCLC) patients. In this study, 63 patients who received radical resection (stage IB or IIIA) and 100 advanced NSCLC (stage IIIB or IV) patients have been collected, and all were treated with gemcitabine-platinum regimens from February of 2017 to February 2019. CDA 435C>T polymorphisms have been detected by PCR and direct sequencing. CT scan results and blood routine examinations have been collected to evaluate the efficacy and hematological toxicity. Then the relationships have been analyzed about CDA 435C>T. We found that T allele carriers have better therapy response (p<0.05). Patients carrying CDA 435C/T or T/T genotypes are statistically associated with a better efficacy (p<0.05) but are more prone to leukopenia (p<0.05). Although there is no difference in grade III-IV hematologic toxicity of 163 patients (p>0.05), in the case of 100 stage IIIB-IV patients, the CDA 435C/T and T/T have an increased risk (p<0.05). Regarding the CDA 435C>T polymorphism in the Chinese population, in patients with the mutant T allele, gemcitabine is more effective, but they are more prone to suffering from hematological toxicity, especially the late-stage patients.

Cement extravasation during kyphoplasty in an intact posterior wall vertebral fracture: A case report

Introduction: In management of vertebral compression fracture, several minimal invasive procedures have been introduced. Some of them are vertebral augmentation techniques such as vertebroplasty and kyphoplasty. Even though the cement leakage rates are significantly lower than vertebroplasty procedures, intracanal extravasation is also uncommon in kyphoplasty procedure. Case Presentation: A 44-year-old male presented with back pain due to pathological vertebral compression fracture of thoracal 10 came to our institution to be treated with kyphoplasty. During the procedure, the cement leaked into the spinal canal due to disruption of the posterior wall of the vertebral body. As a consequence of the deterioration of the neurological status, an immediate exploration and decompression were performed after CT-Scan results were obtained to identify the location and size of the leak. After decompression, the recovery was significant. However, at the final follow up the neurologic recovery has yet to recover. Discussion: Intracanal cement leakage has devastating neurological effects on both vertebroplasty and kyphoplasty procedure. Careful monitoring during the cement administration was paramount. As there are no current guidelines about the rate of administration and how to measure the volume of the cement needed, the insertion technique should be tailored according to the fracture morphology, the height restored, the viscosity of the cement, and the surgeon himself. Conclusion: Intact posterior wall, the amount of cement, and the injection pressure are the main factors that may contribute to cement leakage during the kyphoplasty procedure. Careful evaluation of these factors must be done pre- and intra-operatively in order to prevent leakage.

Case Study: Unlocking resemblance between tuberculosis and cancer

Tuberculosis (TB) has often been found to mimic malignancy in clinical and radiological features, and therefore it is well known as a diagnostic chameleon. Although the differences between pulmonary TB and lung cancer have been highlighted by several reports, TB often gets misdiagnosed as lung cancer and vice versa. It is therefore vital to discern the imaging results specific to pulmonary TB and its diverse forms to distinguish it from lung cancer. In the present study, a 72-year old female (HIV-negative, non-smoker), complaining of persistent cough, low chest pain, pain around kidneys and significant weight loss up to 8 kg in 4 months, was advised to undergo X-ray examination along with CT scan. The CT scan results showed manifestation of ill-defined lesions along the right main bronchus with partial atelectasis and multiple scattered centrilobular nodules in the right upper lobe. There was also a well-defined lesion at the left adrenal gland. Also, several sub-centimetre mediastinal nodes were found. The preliminary assessment by the doctor indicated lung cancer, and therefore PET scan was advised for further confirmation, also to detect any metastasis of malignancy if lung cancer is confirmed. PET scan results ruled out lung cancer; afterwards, the TB test (AFB smear) was recommended by the doctor. The final reports of the test results confirmed tuberculosis. However, this is not the only case where tuberculosis has been found to mimic lung cancer; there have been several case studies reporting misdiagnosis of TB. A correct diagnosis could only be achieved through high-imaging techniques or invasive examination. The present case expanded the clinical knowledge in the diagnosis of TB and also invigorated clinicians to consider pulmonary TB in the differential diagnosis and treatment. The study also accentuates the importance of 18FFDG-PET to differentiate TB from lung cancer.

The Spectrum of Chest CT-Scans in the Hospitalized Patients with the Coronavirus Disease

Background: Coronaviruses are a large family of RNA viruses, which range from the common cold virus to the causative agent of more severe diseases. Coronavirus was declared a pandemic in December 2019 in Wuhan, China. Iran has been an endemic zone for the spread of the coronavirus since the outset of this global epidemic and has remained among the countries largely affected by high rates of the disease. Objectives: The present study aimed to investigate the range of the chest computed tomography (CT) scan findings among the hospitalized patients with COVID-19 in Kermanshah, Iran during March-April 2020 to contribute to the accurate diagnosis of the infected patients. Methods: The sample population consisted of 286 hospitalized patients diagnosed with or suspected of the coronavirus disease. Chest CT-scan images and clinical data were reviewed, and their correlation was analyzed. Results: In total, 176 patients (61.53%) were male, and 110 (38.47%) were female. The mean age of the patients was 56 years. Polymerase chain reaction (PCR) results showed that 35.31% of the cases had coronavirus, while the results were negative in 64.69% of the cases. In addition, the CT-scan findings indicated 77.27% abnormal and 22.73% normal chest CT-scans. Among the patients, 75.87% recovered completely, and 18.53% died. The major CT abnormalities were diffuse ground-glass opacification (35.66%), peripheral ground-glass opacification (bilateral; 21.33%), and a combination of diffuse and peripheral ground-glass lesions (18.88%). The consolidation lesion of one lobe was detected in 16 patients, and the consolidation lesion of more than one lobe was observed in 40 patients. Conclusions: According to the results, the most common chest CT-scan findings in COVID-19 include diffuse ground-glass opacification, peripheral ground-glass opacification (bilateral), central ground-glass opacification (bilateral), a combination of diffuse and peripheral ground-glass opacification, a combination of central and peripheral ground-glass opacification, the consolidation lesion of one lobe, and the consolidation lesion of more than one lobe. Furthermore, significant correlations were observed between the CT-scans and the main clinical symptoms, while no significant correlations were denoted between the chest CT-scan and PCR results.

An unusual presentation of neurosyphilis with complicated pulmonary involvement in a patient without HIV infection

Background: Neurosyphilis could develop at any time in the course of syphilis; with an annual incidence of 0.7 per 100,000 men. Homosexual and HIV were risk factors. Here we report an unusual case of neurosyphilis in non-HIV patient with complicated pulmonary involvement. Case description: A fifty-six-year-old promiscuity, heterosexual man, active smoker presented with a three-month history of pruritic maculopapular rashes on his body associated with low-grade fever, and a two-week history of productive cough with dyspnea. On physical examination, he was tachypnea, with crackles on the base of the right lung. There was plaque hyperpigmentation on his malar area and multiple maculopapular, erythematous lesions on his trunk, extremities including palms of the hands, and scrotal area. No ulcer was found on his penis. Laboratory results revealed leukocytosis (19.9 × 103/μl), non-reactive HIV test, with high titer of serum VDRL (1/8) and TPHA (1/1280). Chest X-ray showed infiltrate on right perihilar area. Patient was diagnosed as pneumonia with secondary syphilis. The patient was treated with a single dose of benzathine penicillin G 2.4 million units intramuscular and azithromycin 500 mg tablet OD. During observation, he had altered mental status, generalized tonic seizure, high-grade fever with respiratory distress. He had Argyll Robertson pupil, left central facial and hypoglossal nerve paralysis, and positive meningeal signs, with normal brain CT scan result, non-reactive CSF-VDRL and TPHA, with high leucocyte (17 cells/μl) and protein (54 mg/dl). He was diagnosed neurosyphilis with hospital-acquired pneumonia and treated with ceftriaxone and vancomycin, 2 g OD and 750 mg OD intravenous, respectively. The patient showed no significant improvement and unfortunately, he progressed to death caused by multiple organ dysfunctions due to septic shock. Discussion: There is no single, highly sensitive and specific diagnostic test exists for neurosyphilis. The diagnosis of neurosyphilis is based on clinical findings and the results of serologic tests and CSF examination. The CSF-VDRL has sensitivity 30–70%, non-reactive test does not exclude neurosyphilis. Neurosyphilis in a patient without HIV infection could be diagnosed by a high WBC or protein in CSF with symptoms or signs of neurosyphilis even with non-reactive CSF-VDRL. Conclusion: Neurosyphilis could be considered even with a non-reactive CSF-VDRL result in non-HIV patient.

Risk factors for the early development of septic shock in patients with severe COVID-19

In a retrospective study, we evaluated factors associated with the early development of septic shock in patients with severe COVID-19. We collected medical records of the intensive care unit patients submitted by the local COVID-19 hospitals across Russia to the Federal Center for the Critical Care at the Sechenov First Moscow State Medical University (Sechenov University). Septic shock in crticially ill patients requiring mechanical ventilation was defined as a need in vasopressors to maintain blood pressure. We studied 1078 patients with severe COVID-19 who were admitted to the intensive care units for respiratory support. There were 611 males and 467 females. The mean age was 61.013.7 years. Five hundred twenty five medical records (48.7%) were received from the Moscow hospitals, 159 (14.7%) from the Moscow region, and 394 (36.5%) from the hospitals located in 58 regions of the Russian Federation. In 613 (56.9%) patients, diagnosis of SARS-CoV-2 infection was confirmed by PCR, and in the other cases it was established on the basis of the clinical picture and the results of the chest CT scan. Septic shock developed in 214 (19.9%) of 1078 patients. In the logistic regression model, the risk of septic shock in patients older than 50 years was higher than in patients of a younger age (OR 2.34; 95% CI 1.533.67; p0.0001). In patients with more severe SARS-CoV-2 infection, there was an increase in the prevalence of cardiovascular diseases, including coronary heart disease and atrial fibrillation, type 2 diabetes and malignant tumors. The risk of septic shock in patients with three or more concomitant diseases was higher than in patients without any concomitant chronic diseases (OR 1.76; 95% CI 1.762.70). The risk of septic shock in patients with acute respiratory distress syndrome induced by SARS-CoV-2 is higher in patients older than 50 years with concomitant diseases, although a severe course of the disease is also possible in younger patients without any concomitant disorders.

An Accidental Discovery of Tracheobronchomegaly: a Case Report

Tracheobronchomegaly is a rare disease with congenital abnormal change in respiratory tract; its image features are also very special. In this case, we described a 57-year-old male with cough, expectoration, chest pain, and dyspnea. In our institution, the result of chest CT scan is highly extraordinary, which showed obvious dilation of the trachea and main bronchi, emphysema, and a number of pulmonary bullae, and there was a big bulla with air-fluid level on the lower lobe of the right lung. Fortunately, after wedge resection for the big bulla on the lower lobe of right lung under video-assisted thoracoscopic surgery, this patient’s symptoms were significantly relieved. The clinical manifestations of tracheobronchomegaly lack specificity; this disease has freakish image features. At present, there are no effective treatments for tracheobronchomegaly, which just was an accidental discovery in this patient; we just mainly take surgical measures to treat the big bulla for relieving symptoms.

Design Of Tumor Image Data Server Aplication Using ITK Library (Insight Toolkit)

In the medical image processing of brain tumors, it is not only focused on the results of CT Scans and MRIs but also supporting software for analyzing brain tumor diseases. Every medical device requires a high specification computer to analyze the disease and this requires a lot of computers so that it requires a lot of funds plus the efficiency of the time needed in the image processing process. ITK is software that will be used to analyze tumors. In saving funds and time efficiency, a centralized computer system based on a network is needed, namely SOAP web service technology.The data to be used is the result of MRI with DICOM format. The system consists of a client application and a server application, the programming language used is C # (C Sharp). The client will send a slice of brain tumor image data on the server and the server will process the image data by segmenting the image data with the threshold segmentation method that is already available on the ITK software and will display the results of segmentation and brain tumor area on the client. Based on the test results, the area of ​​the brain tumor in a slice of 4.45 cm2 by increasing the threshold value will reduce noise and also affect the area of ​​the brain tumor. In testing the system using a standalone computer, the processing time obtained is 2.12 by testing a network-based system using a web service with one client, the processing time is 4.16 seconds, but the results of the black area obtained from the segmentation process are as large as 28.89 cm2. In the addition of four clients, the time difference is obtained by seconds in progress.

Understanding factors influencing the length of hospital stay among non-severe COVID-19 patients: A retrospective cohort study in a Fangcang shelter hospital.

As a novel concept of responding to disease epidemics, Fangcang shelter hospitals were deployed to expand the health system’s capacity and provide medical services for non-severe COVID-19 patients during the outbreak in Wuhan. To give insights on patient management within Fangcang hospitals, we conducted a retrospective analysis to: 1) describe the characteristics of the patients admitted to Fangcang hospitals and 2) explore risk factors for longer length of stay (LOS). We enrolled 136 confirmed COVID-19 patients, including asymptomatic patients and those with mild symptoms, who were hospitalized in the Wuti Fangcang Hospital. 58 patients completed the treatment and discharged before 1 March 2020. After describing patients’ demographic and clinical characteristics, exposure history, treatment received and time course of the disease, we conducted linear regression analysis to identify factors influencing LOS. We found that patients having fever before admission were hospitalized 3.5 days (95%CI 1.39 to 5.63, p = 0.002) longer than those without fever and that patients having bilateral pneumonia were hospitalized 3.4 days (95%CI 0.49 to 6.25, p = 0.023) longer than those with normal CT scan results. We also found weak evidence suggesting that patients with diabetes were hospitalized 3.2 days longer than those without diabetes (95%CI -0.2 to 6.56, p = 0.065). However, we observed no significant differences in LOS between symptomatic and asymptomatic patients and between patients who received treatment and those without treatment. Longer duration of hospitalization among non-severe COVID-19 patients is associated with having fever, bilateral pneumonia on CT scan and diabetes. However, being asymptomatic and using supportive medications at the early stage of infection do not have significant influences on LOS. Our study is a single-centered study with relatively small sample size. The findings provide evidence for predicting hospital bed demand in a novel response scenario and may help decision-makers in preparing for ramping up the health system capacity.

Clinical characteristics of \u201cre-positive\u201d discharged COVID-19 pneumonia patients in Wuhan, China

To analyze the clinical characteristics of re-positive discharged COVID-19 patients and find distinguishing markers. The demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, illness severities and chest CT scan results of 267 patients were collected from 1st January to 15th February 2020. COVID-19 was diagnosed by RT-PCR. Clinical symptoms and nucleic acid test results were collected during the 14 days post-hospitalization quarantine. 30 out of 267 COVID-19 patients were detected re-positive during the post-hospitalization quarantine. Re-positive patients could not be distinguished by demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, chest CT scan results or subsequent clinical symptoms. However, re-positive rate was found to be correlated to illness severity, according the Acute Physiology and Chronic Health Evaluation II (APACHE II) severity-of-disease classification system, and the confusion, urea, respiratory rate and blood pressure (CURB-65) score. Common clinical characteristics were not able to distinguish re-positive patients. However, severe and critical cases classified high according APACHE II and CURB-65 scores, were more likely to become re-positive after discharge.

Clinical Characteristic of Covid-19 Infection in Pediatric: A Systematic Review

SARS-CoV-2 is a new type of corona virus that has been identified as a cause of COVID-19 cases. Thisdisease is transmitted quickly, causes a global pandemic and can affect all ages, including children. Inchildren, cases are still rare and hard to be found. Because the prevalence of events in children tends to besmaller than in adults, information about the clinical characteristics of COVID-19 infection in children isstill lacking. The aim of this research is to find out the clinical characteristics of COVID-19 infections inchildren. Conducting a literature review of various scientific studies related to the clinical characteristicsof COVID-19 infection in children. The most common clinical symptoms found in pediatric patients withCOVID-19 infection are coughing, fever and gastrointestinal symptoms where these symptoms usuallytend to be mild to moderate and often the symptoms are not specific or asymptomatic. Laboratory resultsare generally normal but the CT-Scan results show suspicion towards pneumonia in the majority cases ofchildren.