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1.
J Pak Med Assoc ; 72(9): 1746-1749, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2067708

ABSTRACT

Objective: To investigate chest radiography findings in suspected coronavirus disease-2019 patients in a tertiary care setting. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of coronavirus disease-2019 cases admitted to the tertiary care centre from March 1 to March 30, 2020. A predesigned proforma was used to gather data, including demographics, like age and gender, co-morbidities, presenting symptoms and chest radiography findings during the admission. Length of stay and mortality were the outcome measures. Data was analysed using SPSS 22. RESULTS: Of the 154 suspected cases, 46(29.8%) tested positive for coronavirus disease-2019; 29(63%) males and 17(37%) females with a mean age of 50.7±19.1 years. Abnormal chest radiography was noted in 25(54.3%) cases, with bilateral pulmonary infiltrates being the most common finding 19(41.3%). Mortality was the outcome in 7(28%) of these cases, and the mean length of hospital stay was 9.3±7.3 days. Abnormal chest radiography findings were associated with an increased risk of mortality (p=0.009) and a longer hospital stay (p=0.017). Conclusion: Abnormal chest radiography findings were frequently seen in coronavirus disease-2019 patients and were also associated with increased risk of mortality and prolonged hospital stay.


Subject(s)
COVID-19 , Male , Female , Humans , Adult , Middle Aged , Aged , COVID-19/epidemiology , SARS-CoV-2 , Retrospective Studies , X-Rays , Radiography , Radiography, Thoracic
2.
Am J Trop Med Hyg ; 102(5): 940-942, 2020 05.
Article in English | MEDLINE | ID: covidwho-2066918

ABSTRACT

This case report underlines the appearance of a "walking pneumonia" in a novel coronavirus disease (COVID-19) patient, with evidence of progressive lung involvement on chest imaging studies. The patient traveled from Wuhan, Hubei, China, to Thailand in January 2020. One of her family members was diagnosed with COVID-19. She presented to the hospital because of her concern, but she was without fever or any respiratory symptoms. Three days earlier, her nasopharyngeal and throat swabs revealed a negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Her initial chest radiography was abnormal, and her first sputum SARS-CoV-2 test yielded inconclusive results. A subsequent sputum test was positive for SARS-CoV-2. Diagnosis in this patient was facilitated by chest imaging and repeat viral testing. Thus, chest imaging studies might enhance capabilities for early diagnosis of COVID-19 pneumonia.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques , Coronavirus Infections , Lung/diagnostic imaging , Pandemics , Pneumonia, Viral , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Female , Humans , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Radiography , SARS-CoV-2
4.
5.
Radiography (Lond) ; 28 Suppl 1: S68-S76, 2022 10.
Article in English | MEDLINE | ID: covidwho-2049835

ABSTRACT

INTRODUCTION: Following the emergence of the COVID-19 pandemic in January 2020, a radical restructure of NHS services occurred, prioritising the acute needs of infected patients. This included suspending routine procedures, leading to an inevitable resurgence in the future, placing increased demands on the NHS, including diagnostic and therapeutic radiographers. With radiography departments already experiencing staff shortages due to COVID-19 related illnesses and vulnerable staff shielding, there is a need to implement plans within radiography departments to ensure their sustainability in the future. METHODS: A mixed methods study was undertaken in Northern Ireland, involving distribution of a survey to diagnostic and therapeutic radiographers alongside conducting interviews with radiography department managers. RESULTS: 106 radiographers completed the survey, with 9 radiography managers and 2 band eight superintendents participating in interviews. Over 60% of participants felt that morale declined in their departments, with the majority feeling that the pandemic had a negative impact on their physical or mental health and wellbeing. Managers felt that to improve staff morale and motivation, incentives need to be offered including remuneration, flexible working and support for professional development. CONCLUSION: Whilst predicting when the next wave of a COVID-19 variant or the next pandemic will occur is impossible, preparation and planning will help manage the situation better. This requires identifying clinical areas for expansion/retraction and having access to additional staff to meet the demands on the service to ensure all patients receive care not just those acutely ill. IMPLICATIONS FOR PRACTICE: This study has identified key lessons learned from the pandemic within the radiography departments. This will enable preparation and strategic planning for future pandemics.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19 Testing , Humans , Northern Ireland/epidemiology , Radiography , SARS-CoV-2
6.
J Digit Imaging ; 35(4): 796-811, 2022 08.
Article in English | MEDLINE | ID: covidwho-2048330

ABSTRACT

Developing an enterprise approach to imaging technology rather than a radiology focus has recently increased. The communicator needs to be aware of this shift.The Middle East countries participated in the survey have confirmed the following major benefits of Medical Image Exchange: ✔ Fast access to both image and report ✔ Enable tele-services for second opinion, consulting and reporting ✔ Improve patient journey, workflow and diagnosis ✔ Allowed more patient engagement to be in place The Middle East countries that participated in this survey have agreed on the following shared challenges regarding Medical Imaging Exchange: ✔ Lack of enterprise imaging governance at the early stage of implementation. It will organize the who, when, and how. In addition, any fees and or payment involved for physicians ✔ Infrastructure availability to handle such large volume of data. Growing from mega-byte to petabyte per year is challenge for infrastructure. Cloud against On Premises-Installation implementation model ✔ Interoperability and integration to connect multi specialties from different systems. In addition, how far existing systems are ready for that. A standard-based framework is mature for image exchange, but what follows for other domains? There is a need to move beyond radiology images so as to include images from pathology, ophthalmology, and dermatology There are other countries in the region requiring guidance, support, and funding to move forward from the compact disc into internet-based interoperable image exchange. This should be considered part of the World Health Organization and the United Nation development to the region in the healthcare sector.


Subject(s)
Radiology Information Systems , Radiology , Diagnostic Imaging , Humans , Radiography , Workflow
7.
Acta Med Indones ; 54(3): 419-427, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2045695

ABSTRACT

BACKGROUND: COVID-19 is an infection caused by SARS-COV 2.For screening the patient, Rapid antigen for COVID-19 is used with a high diagnostic value. However, there are still some cases of false-negative even with clinical symptoms suggesting COVID-19. Undetected COVID-19 patients certainly will increase  transmission. A simple and practical diagnostic model, using determining factors, is required to guide physicians through a quicker decision making process, especially when deciding the need for the isolation rooms for patients with COVID-like symptoms. METHODS: This study is a cross-sectional study. The study was conducted at CiptoMangunkusumo Hospital, Jakarta.History of contact with COVID-19, clinical symptoms, laboratory examination, and chest radiograph data were taken from medical records. Bivariate and multivariate analyses were conducted to assess the effect sizes of patient factors on the diagnostic results.ROCcurve and Hosmer-Lemeshow calibration was used to make the scoring. RESULTS: There were 187 patients with the majority of subjects in the age group < 60 years old. The selected variables in this scoring systemwere contact history,fever/history of fever, dyspnea with respiratory rate >20 breaths/minute, leucocyte ≤ 10.000 cells/mLand typical chest radiography. The area under the curve for this model was 0,777 (CI95% (0,706-0,847), P<0,001). The probability was 82% with a cut-off point ≥ 4. CONCLUSION: Determinant models based on the combination of contact history, presence or history of fever, dyspnea, leucocyte count ≤ 10.000 cells/mL and typical chest radiography provides good accuracy to aid physicians in managing isolation room needs for patients with suspected COVID-19.


Subject(s)
COVID-19 , COVID-19/diagnostic imaging , COVID-19 Testing , Cross-Sectional Studies , Dyspnea/complications , Fever/etiology , Humans , Middle Aged , Radiography , SARS-CoV-2
8.
Am J Case Rep ; 23: e936641, 2022 Aug 04.
Article in English | MEDLINE | ID: covidwho-2033413

ABSTRACT

BACKGROUND Odontogenic keratocysts are odontogenic cysts that increase in dimension based on growth factors and have a high recurrence rate. The radiological features of odontogenic keratocysts can be confusing owing to their similarity with other intraosseous cysts. The aim of treatment is to minimize patient morbidity and to reduce the risk of recurrence, along with complete surgical excision. CASE REPORT We report a case of a young man who presented to our hospital for a cystic lesion located in the posterior left mandible with clinical and radiological features of a dentigerous cyst. The lesion was treated accordingly for this diagnosis by enucleation. During surgery, a thick and firm cystic membrane was identified. Histopathological examination of the specimen established the final diagnosis of odontogenic keratocyst by identifying squamous epithelium with focal parakeratosis and ulceration and a diffuse inflammatory lymphoplasmacytic infiltrate. The patient's evolution was favorable, with no sign of recurrence on cone beam computed tomography examination at the 6-month follow-up and with healing of the surgical defect. CONCLUSIONS The diagnosis of odontogenic keratocyst is challenging, requiring preoperative 3-dimensional imaging and biopsy for extensive lesions. Adjuvant biochemical and immunological examination of cystic aspirate could sometimes be helpful for making a correct diagnosis. The treatment needs to be individualized according to the patient's age and the tumor's histopathological type and features. If the histopathological examination of surgical specimen indicates a more aggressive lesion than expected, a careful and individualized follow-up is imperative. No reintervention is needed if the patient does not present evidence of recurrence.


Subject(s)
Odontogenic Cysts , Odontogenic Tumors , Humans , Male , Odontogenic Cysts/diagnostic imaging , Odontogenic Cysts/surgery , Odontogenic Tumors/pathology , Radiography
10.
Diagn Interv Imaging ; 103(9): 385-386, 2022 09.
Article in English | MEDLINE | ID: covidwho-2031237
11.
Eur Rev Med Pharmacol Sci ; 26(16): 5946-5955, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2026356

ABSTRACT

OBJECTIVE: To investigate acute cerebrovascular diseases (stroke and intracranial hemorrhage) by cranial radiologic examinations of patients infected with coronavirus disease 2019 (COVID-19) and with neurological signs. PATIENTS AND METHODS: Between March 2020 and May 2021, patients who were admitted to the Emergency Department and had a positive reverse transcription-polymerase chain reaction (RT-PCR) test and underwent Multidetector Computed Tomography (MDCT) and/or Magnetic Resonance Images (MRI), and/or diffusion MRI due to neurological findings were included in the study. RESULTS: The study reviewed a total of 925 patients, including 404 (43.67%) female and 521 (56.32%) male patients. The distribution of imaging methods was as follows: 805 (71%) patients had cranial MDCT, 71 (6.35%) patients had MRI, and 241 (21.57%) patients had diffusion MRI. Of the total 925 patients, 128 (13.8%) patients were detected with cerebrovascular diseases, 92 (9.9%) patients were detected with ischemic or hemorrhagic stroke, 37 (4%) patients were detected with intraparenchymal hemorrhage, 10 (1.1%) patients were detected with subarachnoid hemorrhage, and four (0.43%) patients were detected with subdural hemorrhage. There was no statistically significant difference in the incidence of subdural, subarachnoid, parenchymal hemorrhage, and stroke in terms of gender. While there was a significant difference in stroke according to age, there was no statistically significant difference in subdural, subarachnoid, and parenchymal hemorrhagic. Three (0.32%) patients were diagnosed with acute disseminated encephalomyelitis (ADEM)'s-like demyelinating lesions. CONCLUSIONS: Cerebrovascular diseases, which may cause severe disability and even threaten the patient's life, should be kept in mind, especially in COVID-19 patients who present with neurological symptoms.


Subject(s)
COVID-19 , Cerebrovascular Disorders , Stroke , COVID-19/diagnostic imaging , Cerebrovascular Disorders/diagnostic imaging , Cerebrovascular Disorders/epidemiology , Female , Humans , Intracranial Hemorrhages , Magnetic Resonance Imaging , Male , Radiography , Stroke/diagnostic imaging , Stroke/epidemiology
12.
Stud Health Technol Inform ; 296: 58-65, 2022 Aug 17.
Article in English | MEDLINE | ID: covidwho-2022597

ABSTRACT

Within the scope of the two NUM projects CODEX and RACOON we developed a preliminary technical concept for documenting clinical and radiological COVID-19 data in a collaborative approach and its preceding findings of a requirement analysis. At first, we provide an overview of NUM and its two projects CODEX and RACOON including the GECCO data set. Furthermore, we demonstrate the foundation for the increased collaboration of both projects, which was additionally supported by a survey conducted at University Hospital Frankfurt. Based on the survey results mint Lesion™, developed by Mint Medical and used at all project sites within RACOON, was selected as the "Electronic Data Capture" (EDC) system for CODEX. Moreover, to avoid duplicate entry of GECCO data into both EDC systems, an early effort was made to consider a collaborative and efficient technical approach to reduce the workload for the medical documentalists. As a first effort we present a preliminary technical concept representing the current and possible future data workflow of CODEX and RACOON. This concept includes a software component to synchronize GECCO data sets between the two EDC systems using the HL7 FHIR standard. Our first approach of a collaborative use of an EDC system and its medical documentalists could be beneficial in combination with the presented synchronization component for all participating project sites of CODEX and RACOON with regard to an overall reduced documentation workload.


Subject(s)
COVID-19 , Animals , Documentation , Humans , Raccoons , Radiography , Workflow
13.
Comput Math Methods Med ; 2022: 2484435, 2022.
Article in English | MEDLINE | ID: covidwho-2020483

ABSTRACT

The worldwide outbreak of the new coronavirus disease (COVID-19) has been declared a pandemic by the World Health Organization (WHO). It has a devastating impact on daily life, public health, and global economy. Due to the highly infectiousness, it is urgent to early screening of suspected cases quickly and accurately. Chest X-ray medical image, as a diagnostic basis for COVID-19, arouses attention from medical engineering. However, due to small lesion difference and lack of training data, the accuracy of detection model is insufficient. In this work, a transfer learning strategy is introduced to hierarchical structure to enhance high-level features of deep convolutional neural networks. The proposed framework consisting of asymmetric pretrained DCNNs with attention networks integrates various information into a wider architecture to learn more discriminative and complementary features. Furthermore, a novel cross-entropy loss function with a penalty term weakens misclassification. Extensive experiments are implemented on the COVID-19 dataset. Compared with the state-of-the-arts, the effectiveness and high performance of the proposed method are demonstrated.


Subject(s)
COVID-19 , Deep Learning , COVID-19/diagnosis , Humans , Neural Networks, Computer , Radiography
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2058-2061, 2022 07.
Article in English | MEDLINE | ID: covidwho-2018750

ABSTRACT

The novel coronavirus infection (COVID-19) is still continuing to be a concern for the entire globe. Since early detection of COVID-19 is of particular importance, there have been multiple research efforts to supplement the current standard RT-PCR tests. Several deep learning models, with varying effectiveness, using Chest X-Ray images for such diagnosis have also been proposed. While some of the models are quite promising, there still remains a dearth of training data for such deep learning models. The present paper attempts to provide a viable solution to the problem of data deficiency in COVID-19 CXR images. We show that the use of a Wasserstein Generative Adversarial Network (WGAN) could lead to an effective and lightweight solution. It is demonstrated that the WGAN generated images are at par with the original images using inference tests on an already proposed COVID-19 detection model.


Subject(s)
COVID-19 , Deep Learning , COVID-19/diagnostic imaging , Humans , Radiography , SARS-CoV-2 , X-Rays
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1444-1447, 2022 07.
Article in English | MEDLINE | ID: covidwho-2018745

ABSTRACT

It is generally believed that vision transformers (ViTs) require a huge amount of data to generalize well, which limits their adoption. The introduction of data-efficient algorithms such as data-efficient image transformers (DeiT) provided an opportunity to explore the application of ViTs in medical imaging, where data scarcity is a limiting factor. In this work, we investigated the possibility of using pure transformers for the task of chest x-ray abnormality detection on a small dataset. Our proposed framework is built on a DeiT structure benefiting from a teacher-student scheme for training, with a DenseNet with strong classification performance as the teacher and an adapted ViT as the student. The results show that the performance of transformers is on par with that of convolutional neural networks (CNNs). We achieved a test accuracy of 92.2% for the task of classifying chest x-ray images (normal/pneumonia/COVID-19) on a carefully selected dataset using pure transformers. The results show the capability of transformers to accompany or replace CNNs for achieving state-of-the-art in medical imaging applications. The code and models of this work are available at https://github.com/Ouantimb-Lab/DeiTCovid.


Subject(s)
COVID-19 , Algorithms , COVID-19/diagnostic imaging , Humans , Neural Networks, Computer , Radiography , X-Rays
16.
Rofo ; 194(9): 1035-1036, 2022 09.
Article in German | MEDLINE | ID: covidwho-2016914
17.
Pediatr Radiol ; 52(9): 1724-1729, 2022 08.
Article in English | MEDLINE | ID: covidwho-2014097

ABSTRACT

Over the last decade, health care professionals in the field of radiology have experienced increasing rates of burnout. A study in 2017 showed high prevalence of burnout in pediatric radiology, and other studies have identified several drivers for burnout. An important factor in promoting wellness and mitigating burnout is leveraging diversity, equity and inclusion in the workplace. This manuscript highlights the importance of diversity in high-functioning teams as well as the critical role of equity and inclusion in the workplace to help create an organization where people belong and can effectively succeed.


Subject(s)
Burnout, Professional , Health Promotion , Radiology , Work Engagement , Burnout, Professional/prevention & control , Child , Humans , Pediatrics , Radiography , Salaries and Fringe Benefits , Workplace
18.
Am J Case Rep ; 23: e936278, 2022 Jul 26.
Article in English | MEDLINE | ID: covidwho-2010498

ABSTRACT

BACKGROUND Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection that commonly occurs in immunocompromised patients, especially those with HIV. Early diagnosis and prompt treatment are important because PJP is a potentially life-threatening infection. However, the diagnosis of PJP in the early stage can be challenging due to various factors. Furthermore, the early presentation of PJP, which includes normal chest radiograph and examination findings along with the subacute presentation of PJP in patients with HIV, makes an early diagnosis of the disease even more challenging for doctors. CASE REPORT In this case report, we present the case of a 39-year-old man who had normal chest X-ray findings during the initial stage of his presentation. Coupled with non-disclosure of HIV status, these led to a delay in PJP diagnosis. The diagnosis of PJP with underlying HIV was later supported by the patient's clinical features, initial blood investigations, and presence of high-risk sexual activity. The diagnosis was confirmed when the PJP polymerase chain reaction test from the respiratory sample was positive. He was successfully treated with oral trimethoprim-sulfamethoxazole. However, he subsequently developed rare adverse effects of drug-induced immune hemolytic anemia, which was diagnosed based on the presence of hemolytic anemia and recent exposure to a new drug. Trimethoprim-sulfamethoxazole was promptly discontinued, which resulted in symptom improvement. CONCLUSIONS This case report aims to create awareness among primary care doctors to be vigilant of the PJP diagnosis and its nonspecific presentations as well as to the rare adverse effects of medications to treat PJP.


Subject(s)
Anemia, Hemolytic , HIV Infections , Pneumocystis carinii , Pneumonia, Pneumocystis , Adult , Anemia, Hemolytic/chemically induced , HIV Infections/complications , HIV Infections/drug therapy , Humans , Immunocompromised Host , Male , Pneumonia, Pneumocystis/diagnostic imaging , Pneumonia, Pneumocystis/drug therapy , Radiography , Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects
19.
Radiography (Lond) ; 28 Suppl 1: S84-S92, 2022 10.
Article in English | MEDLINE | ID: covidwho-2004442

ABSTRACT

INTRODUCTION: A clinical visit (work experience) provides an opportunity for prospective students, prior to registration, to visit a clinical department to observe health professionals in practice. The Covid-19 pandemic interrupted access to clinical visits; this article explores the value of clinical visits and the alternatives implemented as a response to Covid-19 restrictions from an academic perspective. METHODS: This article reports the quantitative phase of a three-phase mixed methods study. A survey was distributed to Higher Education Institution (HEI) education leaders for onward distribution to academics supporting recruitment for diagnostic radiography, therapeutic radiography and operating department practice programmes. Qualtrics online survey software was used to administer the survey which was launched in October 2020. Descriptive statistics summarised the data. RESULTS: Representing 37.7% (n = 18/49) of eligible universities, 34 responses from 18 HEIs across England and Wales were received Seventy-eight percent of respondents strongly agreed that they are vital in confirming career choices. Prior to the Covid-19 pandemic, 64% of respondents' programmes had a clinical visit requirement, yet with improvements in simulation and online learning alternatives, 48% agreed that in the longer-term clinical visits will become obsolete. CONCLUSION: Requirements for clinical visits vary between professions and HEIs; academics welcome an opportunity to standardise work experience. Regardless of prospective student background and selected profession/university, all should have equitable and easily available access to high quality resources to support career decision-making. IMPLICATIONS FOR PRACTICE: The enforced withdrawal of clinical visits may impact upon subsequent attrition associated with 'misinformed career choice'. Alternatives to clinical visits, while less onerous for students, admissions staff and clinical colleagues alike, need to be carefully evaluated to ensure they offer prospective students a realistic understanding of the profession.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19 Testing , Career Choice , Humans , Pandemics , Radiography , Surveys and Questionnaires
20.
Radiography (Lond) ; 28 Suppl 1: S77-S83, 2022 10.
Article in English | MEDLINE | ID: covidwho-2004441

ABSTRACT

INTRODUCTION: Clinical visits (work experience opportunities) are a recommended part of admissions processes for many diagnostic and therapeutic radiography courses but not for operating department practice (ODP) where observational visits are challenging for applicants to obtain. The Covid-19 pandemic interrupted access to visits for all prospective students; this study presents a review of the value of clinical visits and alternatives. METHODS: This article reports the initial qualitative phase of a three-phase mixed methods study. Using a critical realist approach, focus groups explored first year student experiences of the 'ideal' pre-admission clinical visit and alternative resources. A structured review of Online Prospectus (OLP) entries was undertaken by two student researchers to ascertain the requirements for clinical visits for the three professions. RESULTS: Four focus groups included 25 first year students interviewed prior to their first clinical placement (14 therapeutic radiography, 5 diagnostic radiography and 6 ODP students). Three themes were constructed, namely: informing career choices, the clinical visit experience, and the value of clinical visits. Clinical visits affirmed rather than inspired career choices. The best timing for a visit was before admission interviews and optimal duration was a full day. Interacting with current students was the most valued aspect. Videos and simulations provided in-depth information about the professional role and allowed replay, but some participants found the videos uninspiring. OLP entries present a confusing picture for applicants who may be researching several Universities and professions. CONCLUSION: Clinical visits were deemed 'vital' to radiography student career choices, yet ODPs who could not access visits were comfortable with videos. Simulated visits are a safe option amidst the pandemic but must capture the dynamic and patient-centred nature of practice to accurately inform career choices.


Subject(s)
COVID-19 , Pandemics , COVID-19 Testing , Career Choice , Humans , Radiography , Students
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