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1.
BMJ Case Rep ; 15(7)2022 Jul 25.
Article in English | MEDLINE | ID: covidwho-1962126

ABSTRACT

Thrombotic complications during COVID-19 infections occur frequently, and anticoagulants to prevent and treat deep vein thrombosis appear to have a good safety profile in these patients. In addition, haemorrhagic complications during COVID-19 infections have also been reported. Hepatic inflammation can occur in COVID-19 infections as a direct consequence of cellular infection and cytopathy. Spontaneous subcapsular hepatic haematoma is extremely rare and can be life-threatening.A woman in her 40s presented to the hospital with fever and shortness of breath and was diagnosed with COVID-19 infection with respiratory failure requiring intubation. On day 49 of hospitalisation, she developed melena and acute anaemia; her haemoglobin dropped from 97g/L (9.7g/dL) to 56g/L (5.6g/dL). Abdominal and pelvic CT scans showed a large subcapsular liver haematoma with retroperitoneal extension. The patient received blood transfusions and remained haemodynamically stable. She was eventually extubated and discharged home.


Subject(s)
COVID-19 , Liver Diseases , Anticoagulants/therapeutic use , COVID-19/complications , Female , Gastrointestinal Hemorrhage/complications , Hematoma/diagnostic imaging , Hematoma/etiology , Hematoma/therapy , Hemoperitoneum/complications , Humans , Liver Diseases/complications
2.
Insights Imaging ; 13(1): 122, 2022 Jul 28.
Article in English | MEDLINE | ID: covidwho-1962891

ABSTRACT

BACKGROUND: The role of chest radiography in COVID-19 disease has changed since the beginning of the pandemic from a diagnostic tool when microbiological resources were scarce to a different one focused on detecting and monitoring COVID-19 lung involvement. Using chest radiographs, early detection of the disease is still helpful in resource-poor environments. However, the sensitivity of a chest radiograph for diagnosing COVID-19 is modest, even for expert radiologists. In this paper, the performance of a deep learning algorithm on the first clinical encounter is evaluated and compared with a group of radiologists with different years of experience. METHODS: The algorithm uses an ensemble of four deep convolutional networks, Ensemble4Covid, trained to detect COVID-19 on frontal chest radiographs. The algorithm was tested using images from the first clinical encounter of positive and negative cases. Its performance was compared with five radiologists on a smaller test subset of patients. The algorithm's performance was also validated using the public dataset COVIDx. RESULTS: Compared to the consensus of five radiologists, the Ensemble4Covid model achieved an AUC of 0.85, whereas the radiologists achieved an AUC of 0.71. Compared with other state-of-the-art models, the performance of a single model of our ensemble achieved nonsignificant differences in the public dataset COVIDx. CONCLUSION: The results show that the use of images from the first clinical encounter significantly drops the detection performance of COVID-19. The performance of our Ensemble4Covid under these challenging conditions is considerably higher compared to a consensus of five radiologists. Artificial intelligence can be used for the fast diagnosis of COVID-19.

3.
Applied Radiology ; 51(4):27-28,30, 2022.
Article in English | ProQuest Central | ID: covidwho-1958327

ABSTRACT

Both the ACR, through its workforce survey, and the American Society of Radiation Oncology (ASTRO), through its Workforce Task Force, are performing "deep dives into data analysis to evaluate the staffing and hiring landscape;final results are not yet available. Statistics for average budgeted FTEs for five other modalities for 2021 vs 2003 are: * Computed tomography, 6.2, up from 3.4;* Magnetic resonance imaging, 4.7, up from 1.7;* Mammography, 4.9, up from 2.1;* Nuclear medicine, 3.6, up from 1.8;and, * Sonography, 5.0, up from 2.6 The U.S. Bureau of Labor Statistics (BLS) projects that radiologic and MRI technologist employment will grow 9% by 2030, about as fast as the average for all occupations, estimating 20,800 openings for these positions each year, on average.2 The BLS statistics point to a trend that more technologists will be needed to meet growing demand for imaging services. In radiation oncology, a lack of programs is contributing to shortages of physicists and dosimetrists and, to a lesser extent, radiation therapists, says Bruce G Haffty, MD, FACR, FASTRO, FASCO, chair of ASTRO's workforce subcommittee, associate vice chancellor of Cancer Programs at Rutgers Biomedical and Health Sciences, and professor and chair of the department of radiation oncology at Robert Wood Johnson and NJ Medical School, Rutgers Cancer Institute of NJ. "People have taken a step back to ask themselves, 'Is this really what I want to continue to do?'" She says the trend may impact her institution's ability to bring new talent into the profession and may even reduce the number of applicants to radiologic technology programs, "because people don't want to work in a hospital anymore."

4.
Applied Radiology ; 51(4):34-35,41, 2022.
Article in English | ProQuest Central | ID: covidwho-1958211

ABSTRACT

A key driver of global radiology disparities is the lack of trained professionals and a lack of formal training programs, despite the increasing availability of previously cost-prohibitive radiology equipment.1 In Africa, limited access to radiology training programs is severe at both the diagnostic radiology (DR) residency and radiology subspecialty (RS) fellowship levels. Tanzania Interventional Radiology Fellowship In 2017, an IR Readiness Assessment at Muhimbili National Hospital (MNH) in Dar es Salaam revealed a complete lack of trained IR personnel and disposable equipment as their two main obstacles to initiating IR service.6,7 Beginning in October 2018, through close collaboration among MNH, Muhimbili University of Health and Allied Sciences (MUHAS), and multiple US institutions including Yale and Emory Universities under the Road2IR consortium, rotating teams of IR faculty, nurses, and technologists were deployed to MNH for hands-on teaching. The two-year fellowship programs provide ample time and structure for trainees to gain the necessary competencies in their subspecialties, compared to unstructured clinical apprenticeships or short-term observer-based models.3,11 Providing in-country training opportunities is a critical step toward addressing the severe radiology disparities in Africa.

5.
J Clin Med ; 11(10)2022 May 19.
Article in English | MEDLINE | ID: covidwho-1953585

ABSTRACT

INTRODUCTION: The Woven EndoBridge (WEB) device is a self-expanding intrasaccular braided-wire device for the treatment of wide-neck bifurcation aneurysms (WNBAs). Even though this device has an excellent safety profile and a low risk of rebleeding, little is known about its long-term effects. MATERIAL AND METHODS: All patients treated with WEB due to ruptured WNBAs were subjected to follow-up digital subtraction angiography (DSA) at 2 and 3 years after device deployment. The degree of residual neck was assessed through BOSS, Lubicz, and WEBCAST scales. Data on modified Rankin scale (mRS), bleeding events, and ischemic events occurring during this time period were collected as well. Lastly, overall and procedure-related mortality rates were calculated. RESULTS: A total of 21 patients were treated between 1 January 2016, and 31 December 2018. DSA demonstrated a patency grade of 57.1% and 61.1% at 2 and 3 years, respectively. The overall 2-year mortality rate due to causes unrelated to the aneurysm was 14.3%. None of the patients were retreated between the 2- and the 3-year follow-up. No rebleeding or stroke events occurred during the follow-up. CONCLUSIONS: WEB-treated ruptured aneurysms showed an excellent degree of stability over time. The overall mortality rate-unrelated to the procedure-observed in our sample was higher than what reported in the literature, a possible bias associated with the COVID-19 pandemic.

6.
BMC Infect Dis ; 22(1): 637, 2022 Jul 21.
Article in English | MEDLINE | ID: covidwho-1951104

ABSTRACT

BACKGROUND: Airspace disease as seen on chest X-rays is an important point in triage for patients initially presenting to the emergency department with suspected COVID-19 infection. The purpose of this study is to evaluate a previously trained interpretable deep learning algorithm for the diagnosis and prognosis of COVID-19 pneumonia from chest X-rays obtained in the ED. METHODS: This retrospective study included 2456 (50% RT-PCR positive for COVID-19) adult patients who received both a chest X-ray and SARS-CoV-2 RT-PCR test from January 2020 to March of 2021 in the emergency department at a single U.S. INSTITUTION: A total of 2000 patients were included as an additional training cohort and 456 patients in the randomized internal holdout testing cohort for a previously trained Siemens AI-Radiology Companion deep learning convolutional neural network algorithm. Three cardiothoracic fellowship-trained radiologists systematically evaluated each chest X-ray and generated an airspace disease area-based severity score which was compared against the same score produced by artificial intelligence. The interobserver agreement, diagnostic accuracy, and predictive capability for inpatient outcomes were assessed. Principal statistical tests used in this study include both univariate and multivariate logistic regression. RESULTS: Overall ICC was 0.820 (95% CI 0.790-0.840). The diagnostic AUC for SARS-CoV-2 RT-PCR positivity was 0.890 (95% CI 0.861-0.920) for the neural network and 0.936 (95% CI 0.918-0.960) for radiologists. Airspace opacities score by AI alone predicted ICU admission (AUC = 0.870) and mortality (0.829) in all patients. Addition of age and BMI into a multivariate log model improved mortality prediction (AUC = 0.906). CONCLUSION: The deep learning algorithm provides an accurate and interpretable assessment of the disease burden in COVID-19 pneumonia on chest radiographs. The reported severity scores correlate with expert assessment and accurately predicts important clinical outcomes. The algorithm contributes additional prognostic information not currently incorporated into patient management.


Subject(s)
COVID-19 , Deep Learning , Adult , Artificial Intelligence , COVID-19/diagnostic imaging , Humans , Prognosis , Radiography, Thoracic , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed , X-Rays
7.
SAGE Open Med Case Rep ; 10: 2050313X221091391, 2022.
Article in English | MEDLINE | ID: covidwho-1950591

ABSTRACT

Pneumocystis jiroveci pneumonia is a common pathology in HIV-infected but also in uninfected immunocompromised individuals. The pandemic coronavirus disease 2019 (COVID-2019) is a new type of coronavirus disease caused by SARS-COV-2, and the chest imaging is often used as complementary tool in patients' evaluation. The imaging finding is similar with many pulmonary pathologies. Chest computed tomography scan is gold standard imaging and shows a central and diffuse distribution, ground- glass pattern with septal thickening with "crazy paving pattern." We reported a case of 57-year-old man patient, followed in oncology for laryngeal cancer who presented of Pneumocystis jiroveci pneumonia during his follow-up. The diagnosis is confirmed by polymerase chain reaction with bronchoalveolar lavage fluid. Other immunochemical tests can be performed but are less specific. Both curative and preventive treatment in subjects at risk remains trimethoprim-sulfamethoxazole. Corticosteroid therapy may be associated depending on the case.

8.
Journal of Emergency Practice and Trauma ; 8(2):115-121, 2022.
Article in English | Scopus | ID: covidwho-1955535

ABSTRACT

Objective: An outbreak of coronavirus disease 2019 (COVID-19) occurred in late 2019. A better understanding of this disease will help us in preventing and managing it. This study evaluated the risk factors and clinical and laboratory characteristics of patients admitted to Shahid Sadoughi hospital in Yazd with a diagnosis of COVID-19. Methods: This cross-sectional study was conducted on patients with the diagnosis of COVID-19 admitted to Shahid Sadoughi hospital in Yazd in May 2020, Iran. Patients’ clinical information, including their symptoms at admission, history of smoking or drug/ alcohol abuse, history of Td (tetanus, diphtheria) vaccine, radiographic/computed tomography (CT) scan findings, and blood oxygen saturation, was recorded. The patients were also asked about their previous history of diabetes, hypertension, autoimmune disorder, and cancer or history of diseases in heart, lung, liver, and thyroid. Laboratory findings, height, weight and body mass index of the patients were also recorded. Statistical analyses were performed using SPSS 21. Results: The mean age of 86 patients enrolled in the study was 61.40±17.37 years, of which 56 (65.11%) had mild pulmonary involvement and 30 (34.89%) had severe pulmonary involvement, according to CT scan results. Also, 26 (30.2%) of all patients had diabetes and about 30 (36%) had high blood pressure, but current smokers (6%) were rare. In patients with severe pulmonary involvement, the level of neutrophil, creatinine, and lactate dehydrogenase (LDH) was higher than patients with mild pulmonary involvement. Out of 56 patients with mild pulmonary involvement, 47 patients had a history of Td vaccination in the last 5 years. Only one patient in the severe group had a history of Td vaccination. Conclusion: A lower percentage of blood lymphocytes as well as higher levels of neutrophils, creatinine, and LDH were observed in patients with severe pulmonary involvement. Numerous factors, especially more prominent laboratory abnormalities, determine the severity of the disease, and a better understanding of these factors can help physicians know the severity of the disease and its prognosis. These findings help us to further clarify the characteristics of COVID-19. Also, the effect of Td vaccine should be investigated in future studies. © 2022 The Author(s).

9.
Radiol Case Rep ; 17(8): 2775-2778, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1946365

ABSTRACT

Several studies have previously documented the development of complications stemming from injection with one of the various COVID-19 vaccines. No study, however, has discussed the spontaneous development of a soft tissue mass shortly after a COVID-19 vaccine injection. We report on 66-year-old female with concerns of a growing shoulder mass, 2 weeks after receiving a COVID-19 vaccine booster. Initial work-up with X-ray and MRI was concerning for a soft tissue neoplasm, specifically a soft tissue sarcoma. Subsequent ultrasound guided biopsy demonstrated a benign granulomatous lesion. No further management was required as the lesion spontaneously resolved during a 3-month follow-up period.

10.
J Am Coll Radiol ; 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1945366

ABSTRACT

OBJECTIVE: To provide an updated evaluation of radiology residency program websites in light of virtual interviewing during the COVID-19 pandemic and encourage programs to improve the quality of their online website presence. METHODS: We evaluated the websites of 197 US radiology residency programs between November and December 2021 for the presence or absence of 30 metrics. The metrics chosen are those considered important by applicants when choosing a program and have been used in other similar papers. RESULTS: Of the 197 programs, 192 (97.5%) had working websites. The average radiology residency website had 16 of 30 (54%) metrics listed on their websites. Five programs did not have accessible websites and were not included in the analysis. The most comprehensive website had 29 of 30 (97%) of metrics listed and the least comprehensive website had 2 of 30 (7%). There is a statistically significant difference in website comprehensiveness between top 20 and non-top 20 radiology program websites. CONCLUSION: Although radiology residency program websites have generally become more comprehensive over time, there is still room for improvement, especially in times of virtual interviews when residency applicants are becoming more and more reliant on program websites to gain essential information about a program. Some key areas to include are diversity and inclusion initiatives, resident wellness, applicant information, program benefits, and showcase of people in the program.

11.
Acad Radiol ; 2022 Jun 10.
Article in English | MEDLINE | ID: covidwho-1943938

ABSTRACT

RATIONALE AND OBJECTIVES: To evaluate the impact of COVID-19 pandemic on diagnostic imaging workload in a tertiary referral hospital. MATERIALS AND METHODS: Radiological examinations performed in pre-pandemic period (2015-2019) and in pandemic period (2020-2021) were retrospectively included. Based on epidemiological data and restriction measures, four pandemic waves were identified. For each of them, the relative change (RC) in workload was calculated and compared to the 5-year averaged workload in the corresponding pre-COVID-19 periods. Workload variations were also assessed according to technique (radiographs, CT, MRI, ultrasounds), body district (chest, abdomen, breast, musculoskeletal, head/neck, brain/spine, cardiovascular) and care setting (inpatient, outpatient, emergency imaging, pre-admission imaging). RESULTS: A total of 1384380 examinations were included. In 2020 imaging workload decreased (RC = -11%) compared to the average of the previous 5 years, while in 2021 only a minimal variation (RC = +1%) was observed. During first wave, workload was reduced for all modalities, body regions and types of care setting (RC from -86% to -10%), except for CT (RC = +3%). In subsequent waves, workload increased only for CT (mean RC = +18%) and, regarding body districts, for breast (mean RC = +23%) and cardiovascular imaging (mean RC = +23%). For all other categories, a workload comparable to pre-pandemic period was almost only restored in the fourth wave. In all pandemics periods workload decrease was mainly due to reduced outpatient activity (p < 0.001), while inpatient and emergency imaging was increased (p < 0.001). CONCLUSION: Evaluating imaging workload changes throughout COVID-19 pandemic helps to understand the response dynamics of radiological services and to improve institutional preparedness to face extreme contingency.

12.
Oncology Times ; 44(13):11-11, 2022.
Article in English | CINAHL | ID: covidwho-1948476
13.
Pediatr Radiol ; 2022 Apr 20.
Article in English | MEDLINE | ID: covidwho-1941532

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) disproportionately affected children from underrepresented minorities and marginalized populations, but little is understood regarding the pandemic's effect on non-COVID-19-related illnesses. OBJECTIVE: To examine the effect of the COVID-19 pandemic and related stay-at-home orders on pediatric emergency department (ED) imaging of non-COVID-19-related diseases across patient demographic groups. MATERIALS AND METHODS: We retrospectively reviewed radiology reports from advanced imaging (US, CT, MRI and fluoroscopy) on children in the ED during the month of April for the years 2017, 2018, 2019 and 2020, excluding imaging for respiratory illness and trauma. We used imaging results and the electronic medical record to identify children with positive diagnoses on advanced imaging, and whether these children were admitted to the hospital. Demographic variables included age, gender, race/ethnicity and insurance type. We used multivariable Poisson regression models to report rate ratio (RR) and binomial logistic regression models to report odds ratio (OR) with 95% confidence interval (CI). RESULTS: We included 1,418 ED encounters for analysis. Compared to pre-2020, fewer children underwent ED imaging in April 2020 (RR 0.63, 95% CI 0.52, 0.76). The odds of positive imaging results increased (OR 2.18, 95% CI 1.59, 3.00) overall, and for all racial/ethnic groups except Hispanic patients (OR 0.83, 95% CI 0.34, 2.03). No differences occurred in admission rates for positive imaging results in 2020 compared to pre-2020. CONCLUSION: In April 2020 compared to pre-2020, there were decreased imaging and increased positivity rates for imaging for non-respiratory and non-trauma ED visits. COVID-19 stay-at-home advisories might have resulted in triaging for urgent health care by families or referring clinicians during this month of the pandemic.

14.
Studies in Big Data ; 109:483-504, 2022.
Article in English | Scopus | ID: covidwho-1941435

ABSTRACT

The SARS-CoV-2 (severe acute respiratory syndrome coronavirus) pandemic, also known as COVID-19 (coronavirus 2019), impacted humanity worldwide and significantly impacted the healthcare community. COVID-19 infection and transmission have resulted in several international issues, including health hazards. Sore throat, trouble breathing, cough, fever, weariness, and other clinical signs have been described. In SARS-CoV-2 patients, the most common infections are in the lungs and the gastric intestine. Lung infections may be caused by viral or bacterial infections, physical trauma, or inhalation of harmful particles. This research presents deep learning-based approaches for COVID-19 infection detection based on radiological images, prevention and therapy based on benchmark publicly available datasets. Finally, the analysis and findings explore evidence-based methodologies and modalities, leading to a conclusion and possible future healthcare planning. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

15.
Journal of Vascular and Interventional Radiology ; 33(6):S225-S226, 2022.
Article in English | EMBASE | ID: covidwho-1936898

ABSTRACT

Purpose: Cholecystitis accounts for more than 200,000 hospital admissions per year in the United States with increasing rates and hospital charges over the past two decades (Wadhwa et al. 2017). Recent evidence-based guidelines have advocated for early surgical cholecystectomy (SC), reserving percutaneous cholecystostomy (PC) for the critically ill or patients with prohibitive co-morbidities. Purpose: To identify management trends of cholecystitis to validate current practice patterns and reimbursement rates Materials and Methods: All patients undergoing PC placement in a tertiary care hospital from 2010 to 2020 were reviewed. Inclusion criteria consisted of age >18, indication of cholecystitis, and no past PC. Additionally, all patients undergoing SC (laparoscopic or open approach) were reviewed, with surgical data becoming available in 2014. Inclusion criteria included age >18 and indication of cholecystitis. Medicare reimbursement was determined by Current Procedural Terminology (CPT) code. Years with multiple reimbursement rates were averaged. Linear regression analysis was performed. Results: A total of 2522 patients presenting for procedural treatment of cholecystitis were included. 391 underwent PC with interventional radiology with an average age (± stdev) of 64 ± 14.9 years (range: 20-96). 2131 patients underwent SC, average age 55.1 ± 17.6 years (range: 20-100). Over the follow up period, there was a significant increasing trend in PC placement (R2=0.58, P=0.006). Trend of surgical data is notable for a non-linear, though upward trend, increasing from a rate of 181 cases/year in 2014 and 2015, peaking at 481 in 2018, then followed by sharp decline over the subsequent two years, with 260 cases in 2020. From 2010-2020, Medicare reimbursement stayed relatively stable with overall small decreases in payment. There were notable declines for PC reimbursement from 2010 to 2011, decreasing from $551.2 to $392.77 and laparoscopic cholecystectomy reimbursement from $817.28 to $728.69 between 2012 and 2013. Conclusion: The increasing rate of cholecystitis over the past decades is associated with increases in both PC and SC and declines in the rates of reimbursement. After trending upward, surgical intervention was shown to decline after 2018, possibly secondary to availability of PC, or macroeconomic factors such as changes in management guidelines, reimbursement rates, or the COVID-19 pandemic.

16.
Journal of Vascular and Interventional Radiology ; 33(6):S197, 2022.
Article in English | EMBASE | ID: covidwho-1936897

ABSTRACT

Purpose: Throughout the COVID-19 pandemic, an increasing hospital occupancy rate has been an ongoing issue, with several hospitals operating at or near full capacity. Emphasis has been placed to improve discharge strategies to maintain bed space and decrease hospital occupancy rate. The interventional radiology (IR) department can play a pivotal role in the discharge process by providing timely interventions that are essential prior to a patient’s discharge. This project aims to define the time intervals between the date of priority request for an IR procedure (in preparation to discharge), date of IR procedure, and date of patient’s actual discharge. Materials and Methods: Between April–September of 2021, a retrospective review of hospitalized patients in a tertiary medical center for whom an IR procedure labeled as “Priority Discharge” was requested by primary teams was performed. Multiple procedure-related variables, including time intervals between the placement of the order, and the patient’s actual discharge were recorded. Results: During the study period, a total of 75 IR procedure requests (42 male, 33 female, mean age of 60y, range 21-98y) were labeled as “Priority Discharge.” Overall 74 of 75 (99%) procedures were completed on the same day of request. Performed procedures were: peripherally inserted catheter (51%) midline (24%), tunneled hemodialysis catheter (16%), and other (9%). The average time interval that patients stayed in the hospital after the IR procedure was 3 days (SD: 4, Range of 0-20 days). Of the total 75 patients, 23 (31%) patients were discharged on the same day as the procedure, 33 (44%) patients were discharged within 1-4 days after the procedure, 12 (16%) patients were discharged within 5-9 days after the procedure, and 7 (9%) patients were discharged 10 or more days after the procedure. The average admission duration for the study population was 10 d (range 2-33 d). Conclusion: Due to the inherent complexity of the hospital operations, strategies aiming to prioritize IR procedures for patients pending discharge could help to improve hospitals’ occupancy rates. Nevertheless as shown in our study a considerable percent of these patients stay in hospital for several days after the procedure is complete. Inefficient application of this system could disrupt the triage of the requested procedures, which may eventually lead to an unnecessary delay for other patients and prolong their hospitalization. Accordingly, tools should be incorporated into these strategies that could improve IR workflow and decrease susceptibility of these strategies to miscommunication and errors.

17.
Journal of Vascular and Interventional Radiology ; 33(6):S133, 2022.
Article in English | EMBASE | ID: covidwho-1936895

ABSTRACT

Purpose: Interventional radiology (IR) residency grew from 7 programs and 15 positions in 2016 to 87 programs and 164 positions in 2021. Analysis of prior years’ match data can reveal the most well-connected schools and programs, communities, influencers that bridge communities, and the network’s evolution over time. Applicants to IR and residency program stakeholders will gain valuable insights from analysis of the IR training network. Materials and Methods: 618 of 726 (85%) IR matches between 2016-2021 were compiled from publicly available sources: NRMP data, department websites, and medical school match lists. Network plots were generated using Gephi 0.9.2. Medical schools and residency programs (nodes) and matches (edges) were assessed for number of connections, communities, and Eigenvector centrality (relative influence based on how well-connected a node is and how well-connected are its connections). Results: Preliminary analysis of the manually sourced public data reveals that medical schools graduating the greatest number of students matched to IR are Rosalind Franklin (15), Georgetown (14), U South Florida (14), and Northwestern (13), while residency programs matching the greatest number of students into IR are Emory (20), Rush (20), Vanderbilt (18), and U Pennsylvania (18). Overall, the most well-connected nodes in the network of IR matches are Rush (29), U Pennsylvania (28), Georgetown (26), Vanderbilt (23), and Yale (23). The most influential node in the 5-year network is U Pennsylvania with an Eigenvector centrality of 1.0, followed by Duke (0.70), Stanford (0.49), Emory (0.45), and Mount Sinai (0.43). A force-directed network algorithm illustrates that even as the number of matched students invariably grows, the number of communities of schools and programs dynamically expands and contracts: 6 in 2016, 16 in 2017, 11 in 2018, 9 in 2019, 8 in 2020, and 8 in 2021. Further analyses are ongoing of year-over-year community stability and geographic trends, as well as impact of COVID and virtual interviews on the network. Interactive images are available. Conclusion: IR is among the most competitive specialties with challenges for applicants and programs alike—an issue exacerbated by the relative ease of virtual interviews and resultant increase in applications. Students may use network analysis to focus on programs within their own or other desirable communities, or to identify an influential program for an away rotation to bridge communities. Programs may use network analysis to guide outreach and inform perceptions of a program’s relative standing within and amongst communities or the broader IR training network.

18.
Medical Journal of Bakirkoy ; 18(2):195-201, 2022.
Article in English | EMBASE | ID: covidwho-1939260

ABSTRACT

Objective: There is no study in the literature investigating the association of hepatic steatosis both gynecomastia and epicardial fat thickness together. We determined the correlations between hepatic steatosis through liver density, gynecomastia and epicardial fat thickness in patients undergoing computed tomography (CT) scans due to suspected coronavirus disease-2019 (COVID-19) symptoms. Methods: A total of 599 male patients who underwent chest CT scans because of a presumed diagnosis of COVID-19 in our radiology clinic were included in the study. Patients’ age, diameters of the subareolar glandular tissues of the right and left breasts, the right retroareolar fatty tissue, liver and spleen density, epicardial fat thickness and biochemical parameters were recorded and analyzed. Laboratory analyses were performed according to the standard methods. Results: The mean age of the patients was 47.21±15.00 years. The left subareolar tissue thickness and the right retroareolar fatty tissue thickness that are used to indicate gynecomastia were significantly correlated with liver density in the negative direction (r=-0.137, p<0.001;r=-0.172, p<0.001;respectively). Epicardial fat thickness was statistically significantly correlated with right subareolar tissue thickness (r=0.085, p=0.037), left subareolar tissue thickness (r=0.101, p=0.014) and right retroareolar fatty tissue thickness (r=0.148, p<0.001). Conclusion: The results of this study showed that gynecomastia was significantly correlated with both age and hepatic steatosis. Epicardial fat thickness is also associated with hepatic steatosis. We demonstrated the significant correlations between epicardial fat thickness and gynecomastia for the first time. Nevertheless, our results need to be confirmed by further comprehensive studies.

19.
Egyptian Journal of Radiology and Nuclear Medicine ; 53(1), 2022.
Article in English | EMBASE | ID: covidwho-1938375

ABSTRACT

Background: Chest radiographs are frequently used to evaluate pediatric patients with COVID-19 infection during the current pandemic. Despite the minimal radiation dose associated with chest radiography, children are far more sensitive to ionizing radiation's carcinogenic effects than adults. This study aimed to examine whether serum biochemical markers could be potentially used as a surrogate for imaging findings to reduce radiation exposure. Methods: The retrospective posthoc analysis of 187 pediatric patients who underwent initial chest radiographs and serum biochemical parameters on the first day of emergency department admission. The cohort was separated into two groups according to whether or not the initial chest radiograph revealed evidence of pneumonia. Spearman's rank correlation was used to connect serum biochemical markers with observations on chest radiographs. The Student's t-test was employed for normally distributed data, and for non-normally distributed data, the Mann–Whitney U test was used. A simple binary logistic regression was used to determine the importance of LDH in predicting chest radiographs. The discriminating ability of LDH in predicting chest radiographs was determined using receiver operating characteristics (ROC) analysis. The cut-off value was determined using Youden's test. Interobserver agreement was quantified using the Cohen k coefficient. Results: 187 chest radiographs from 187 individual pediatric patients (95 boys and 92 girls;mean age ± SD, 10.1 ± 6.0 years;range, nine months–18 years) were evaluated. The first group has 103 patients who did not have pneumonia on chest radiographs, while the second group contains 84 patients who had evidence of pneumonia on chest radiographs. GGO, GGO with consolidation, consolidation, and peri-bronchial thickening were deemed radiographic evidence of pneumonia in group 2 patients. Individuals in group 2 with radiological indications of pneumonia had significantly higher LDH levels (p = 0.001) than patients in group 1. The Spearman's rank correlation coefficient between LDH and chest radiography score is 0.425, showing a significant link. With a p-value of < 0.001, the simple binary logistic regression analysis result validated the relevance of LDH in predicting chest radiography. An abnormal chest radiograph was related to LDH > 200.50 U/L (AUC = 0.75), according to the ROC method. Interobserver agreement between the two reviewers was almost perfect for chest radiography results in both groups (k = 0.96, p = 0.001). Conclusion: This study results show that, compared to other biochemical indicators, LDH has an 80.6% sensitivity and a 62% specificity for predicting abnormal chest radiographs in a pediatric patient with confirmed COVID-19 infection. It also emphasizes that biochemical measures, rather than chest radiological imaging, can detect the pathogenic response to COVID-19 infection in the chest earlier. As a result, we hypothesized LDH levels might be potentially used instead of chest radiography in children with COVID-19, reducing radiation exposure.

20.
British Journal of Neurosurgery ; 36(1):158, 2022.
Article in English | EMBASE | ID: covidwho-1937538

ABSTRACT

Objectives: To assess the effectiveness of virtual peer teaching in easing neurophobia among preclinical medical students at Cardiff University. Design: Quantitative research. Subjects: 94 Year two medical students at Cardiff University. Methods: An evaluative study was conducted to assess the prevalence of neurophobia and the effects of our teaching on it. This was assessed by comparing confidence, anxiety, and neurophobia levels pre-and post-session on a 5-point Likert scale. The quantitative data were collected based on thematic questions (anatomy, physiology, radiology, bone disease, and pathology) relevant to the session with only one correct answer for each question. Results: 62.7% of the students found neurological and neurosurgical concepts the most difficult to learn in medical school (3.70 ± 1.77). We found that the reported scores of neurophobia (3.22 ± 1.60 to 1.39 ± 1.72) and anxiety (3.59 ± 1.71 to 2.99 ± 1.58) decreased, while confidence (2.79 ± 1.60 to 3.71 ± 1.77) increased after one virtual teaching session. We also saw an overall average increase in knowledge across all five quantitative domains by 20.7%. Conclusions: Neurophobia remains rife amongst medical students, even in their preclinical years. Despite difficulties with face-to-face teaching during the COVID-19 pandemic, our results strongly indicate that virtual teaching sessions can effectively alleviate neurophobia and improve clinical neuroscience knowledge.1,2.

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