ABSTRACT
Background: Although chest X-ray is the main imaging approach in many settings, many limitations for it exist. Ultrasound has quite similar performances to CT with many advantages. Methods: From January 2017 till May 2018, a prospective cohort study conducted in emergency ICU at Zagazig university hospitals including 124 critically ill patients older than 18 years with respiratory distress, cough, fever, or hypoxemia. We excluded from the study pregnant females, patients with massive chest wall emphysema or hematoma, morbidly obese and finally patients with risk of transportation. All patients underwent thorough physical examination, history, laboratory investigations & Chest radiology (X-rays, chest ultrasound & CT). We measured the sensitivity and specificity of chest ultrasound and chest X-rays in comparison with CT with measurement of the learning curve of chest US. Results: 124 patients were assessed for eligibility. 24 patients were excluded for different causes and 100 patients (69 males & 31 females) completed the study with mean age of 49.22±11.52 years. Regarding all study population, whatever diagnosis, sensitivity and specificity of chest ultrasound and chest X-rays were 91.4%, 98.3% and 61.7%, 96.2% respectively. Concordance of the results of ultrasound with results of X-rays and clinical diagnosis increased sensitivity, specificity and overall accuracy to highly comparable results with chest computed tomography. Sensitivity, specificity and accuracy of chest ultrasound increased with time and with number of patients. Conclusions: Chest ultrasound is reliable, quick, bedside, low-cost, non-invasive, non-ionizing, more accurate, and easily educated for early detection of chest diseases and their follow up
Subject(s)
Critical Illness , Egypt , LungABSTRACT
Schistosomiasis is a chronic disease with considerable social impact. Despite the availability of affordable chemotherapy, drug treatment has not significantly reduced the overall number of disease cases. Among other mechanisms, the parasite produces PGE2 and PGD2 to evade host immune defenses. To investigate the role of PGE2 and PGD2 in schistosomiasis, we evaluated the effects of L-161,982, Ah6809 [PGE2 receptor antagonists alone or combined with each other] and MK-0524 [PGD2 receptor antagonist] during prepatent Schistosoma mansoni infection. Drugs were administered intraperitoneally an hour before and 24 hours after infection of C57BL/6 mice with 100 Schistosoma mansoni cercariae. L-161,982, Ah6809, their combination and MK-0524 caused partial protection against pre-patent S. mansoni infection which was mediated by biasing the immune response towards Th1 phenotype. These results showed that blockade of PGE2 and PGD2 receptors confers partial protection against pre-patent S. mansoni infection in mice and that they may be useful as adjunctive therapy to current anti-schistosomal drugs or vaccines