Country-based modelling of COVID-19 case fatality rate: A multiple regression analysis.

BACKGROUND: The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection. The determinants of mortality on a global scale cannot be fully understood due to lack of information. AIM: To identify key factors that may explain the variability in case lethality across countries. METHODS: We identified 21 Potential risk factors for coronavirus disease 2019 (COVID-19) case fatality rate for all the countries with available data. We examined univariate relationships of each variable with case fatality rate (CFR), and all independent variables to identify candidate variables for our final multiple model. Multiple regression analysis technique was used to assess the strength of relationship. RESULTS: The mean of COVID-19 mortality was 1.52 ± 1.72%. There was a statistically significant inverse correlation between health expenditure, and number of computed tomography scanners per 1 million with CFR, and significant direct correlation was found between literacy, and air pollution with CFR. This final model can predict approximately 97% of the changes in CFR. CONCLUSION: The current study recommends some new predictors explaining affect mortality rate. Thus, it could help decision-makers develop health policies to fight COVID-19.

Evaluation of Crohn Disease Activity Using a Potential Abbreviated MRE Protocol Consisting of Balanced Steady-State Free Precession MRI Only Versus Full-Protocol MRE.

OBJECTIVE. The purpose of the present study was to compare the diagnostic performance of an abbreviated MR enterography (MRE) protocol consisting of balanced steady-state free-precession (b-SSFP) imaging only versus standard full-protocol MRE for the evaluation of Crohn disease activity. MATERIALS AND METHODS. This single-center retrospective study included 112 patients with Crohn disease (66 women and 46 men; age range, 18-84 years) who underwent MRE between January 2017 and March 2018. Utilizing binary and 5-point Likert confidence scales, two blinded readers independently interpreted and scored disease activity on b-SSFP sequences only and on full-protocol MRE images. Interreader and intrareader agreement on confidence regarding disease activity were calculated using weighted kappa indexes. Correlation between MRE findings of Crohn disease and the Harvey-Bradshaw index was also performed. RESULTS. Perfect intrareader agreement and strong interreader agreement on disease activity were observed (intrareader agreement: κ = 0.97, 0.96, and 0.96 for reader A, reader B, and both readers combined; interreader agreement: κ = 0.82 for b-SSFP imaging only and κ = 0.81 for MRE). For detecting active Crohn disease, b-SSFP sequences had a sensitivity and specificity of 97% and 100%, respectively, for reader A and 98% and 86%, respectively, for reader B. Strong-to-perfect intrareader agreement was achieved between b-SSFP imaging only and MRE for identification of penetrating disease (κ = 0.80 and 0.97) and stenosing disease (κ = 0.87 and 0.95). Perfect intrareader agreement was also obtained between b-SSFP imaging only and MRE for detecting abnormal bowel segments (κ = 0.91 for reader A; κ = 0.98 for reader B). Weak agreement was noted between both b-SSFP imaging only and MRE versus the Harvey-Bradshaw index (κ = 0.08 of reader A; κ = 0.04 for reader B). CONCLUSION. Robust agreement was observed between b-SSFP imaging only and full-protocol MRE for the assessment of Crohn disease activity and complications. An abbreviated MRE protocol that exclusively uses b-SSFP sequences appears feasible and has significant implications for health care resources.

Preliminary evaluation of 18F-FDG-PET/MRI for differentiation of serous from nonserous pancreatic cystic neoplasms: a pilot study.

OBJECTIVES: The aim of the study was to evaluate preliminary feasibility of 18F-FDG-PET/MRI in differentiation of pancreatic serous cystic neoplasms (SCNs) from non-SCNs. METHODS: From August 2017 to June 2019, 10 patients (3 men, 7 women; mean age, 63 years) previously diagnosed with pancreatic cystic neoplasm underwent simultaneous 18F-FDG-PET/MRI prospectively on an integrated 3-Tesla hybrid PET/MRI scanner. PET images were analyzed visually and semiquantitatively measuring standardized uptake values (SUV) including lesion SUVmax and SUVmean, lesion to pancreas and lesion to liver SUVmax and SUVmean ratio independent of MRI diagnosis. The reference standard for lesion diagnosis was by MRI features and interval follow-up. RESULTS: Visual assessment of PET images demonstrated uptake in 57% of SCNs. Lesion to liver SUVmax ratio of ≥0.5 showed the highest accuracy (90%) and area under the curve (0.9) followed by lesion SUVmax of ≥1.6 and lesion to pancreas SUVmax ratio of ≥0.77 for diagnosis of SCN. The sensitivity for lesion SUVmax of ≥1.6 was less than two other ones (71 versus 100%). All non-SCNs exhibited SUVmax value less than 1.6 while 33 and 66% demonstrated lesion to liver SUVmax ratio of >0.5 and lesion to pancreas SUVmax ratio of >0.77, respectively. PET/MRI specificity was 67, 100, 67 and 33% through lesion to liver SUVmax ratio, lesion SUVmax, lesion SUVmean and lesion to pancreas SUVmax ratio, respectively, for diagnosis of SCN. CONCLUSION: Preliminary results show that PET/MRI utilization is promising for differentiation of pancreatic SCN from non-SCN lesions. This could reduce need for surveillance imaging or avoidance of unnecessary intervention in pancreatic cystic neoplasms with uncertain diagnoses.

Evaluation of coronal shift as an indicator of neuroaxial abnormalities in adolescent idiopathic scoliosis: a prospective study.

BACKGROUND: In previous studies, many indicator factors have been proposed to select patients who need an MRI screening of the spinal canal. In current study, the clinical and radiologic factors including coronal parameters of the curve were evaluated to find out which indicator is more important. METHODS: A prospective study included 143 consecutive patients with the diagnosis of adolescent idiopathic scoliosis who were treated between 2010 and 2013 at our spinal clinics. Only patients with normal or subtle neurologic findings were included. All patients were evaluated by a total spine MRI protocol for examination of neuroaxial abnormalities. Known indicators and also coronal shift were analysed in all patients with or without abnormal MRI. RESULTS: The incidence of neuroaxial abnormalities was 11.9% (17 of 143); only 5 patients (3.5%) were operated to treat their neuroaxial problem. The significant indicators of the abnormalities in our patients were: younger age at onset, asymmetric superficial abdominal reflex and, coronal shift more than 15 mm (P = 0.03). Some previously known indicators like atypical curves, male gender, double curves and absence of thoracic lordosis were not different between two groups of the patients. CONCLUSIONS: A total spine MRI is recommended at presentation in patients with younger age, abnormal neurologic findings and severe coronal shift.