Inter-observer variability with five computed tomography severity scales for COVID-19 pneumonia assessment.

INTRODUCTION: By the end 2019 there was an outbreak of pneumonia caused by a new coronavirus, a disease that was called coronavirus disease 2019 (COVID-19). Computed tomography (CT) has played an important role in the diagnosis of COVID-19 patients. OBJECTIVE: To demonstrate inter-observer variability with five scales proposed for measuring the extent of COVID-19 pneumonia on tomography. METHODS: Thirty five initial chest CT scans of patients who attended respiratory triage for suspected COVID-19 pneumonia were analyzed. Three radiologists classified the tomographic images according to the severity scales proposed by Yang (1), Yuan (2), Chun (3), Wang (4) and Instituto Nacional de Enfermedades Respiratorias-Chung-Pan (5). The percentage of agreement between the evaluators for each scale was calculated using the intra-class correlation index. RESULTS: In most patients were five pulmonary lobes compromised (77.1% of the patients). Scales 1, 2, 4 and 5 showed an intra-class correlation > 0.91 (p < 0.0001), with agreement thus being almost perfect. CONCLUSIONS: Scale 4 (proposed by Wang) showed the best inter-observer agreement, with a coefficient of 0.964 (p = 0.001).

INTRODUCCIÓN: A finales de 2019 se presentó un brote de neumonía causada por un nuevo coronavirus, enfermedad a la que se denominó COVID-19. La tomografía computarizada ha desempeñado un papel importante en el diagnóstico de los pacientes con COVID-19. OBJETIVO: Demostrar la variabilidad interobservador con cinco escalas propuestas para la medición de la extensión de la neumonía ocasionada por COVID-19 mediante tomografía. MÉTODOS: Se analizaron 35 tomografías de tórax iniciales de pacientes que asistieron al triaje respiratorio por sospecha de neumonía por COVID-19. Tres radiólogos realizaron la clasificación de las imágenes tomográficas de acuerdo con las escalas de severidad propuestas por Yang (1), Yuan (2), Chun (3), Wang (4) e INER-Chung-Pan (5). Se calculó el porcentaje de concordancia entre los evaluadores para cada escala con el índice de correlación intraclase. RESULTADOS: La mayoría de los pacientes presentó afección de cinco lóbulos pulmonares (77.1 % de los pacientes). Las escalas 1, 2, 4 y 5 mostraron una correlación intraclase > 0.91, con p < 0.0001, por lo que la concordancia fue casi perfecta. CONCLUSIONES: La escala 4 (de Wang) mostró la mejor concordancia interobservador, con un coeficiente de 0.964 (p = 0.001).

Serum resistin levels inversely associated with cardiovascular risk indices in type 2 diabetics from central Mexico.

AIMS: Since, resistin has been associated with coronary heart disease and with the progression of Type 2 Diabetes (T2D), our objective was to determine the correlation between resistin and cardiovascular risk (CVR) in subjects with increasing degrees of hyperglycemia. METHODS: Using a cross-sectional study design, the anthropometric and biochemical profiles were collected from 180 subjects from Puebla, Mexico. Subjects were separated into Normoglycemic (NGT), pre-diabetic (PT2D), or T2D. CVR was determined by the Atherosclerosis Coefficient ((total cholesterol-high-density lipoprotein)/high-density lipoprotein), Castelli 1 index (total cholesterol/high-density lipoprotein), Castelli 2 index (low-density lipoprotein/high-density lipoprotein), Framingham risk score (https://www.mdcalc.com/framingham-coronary-heart-disease-risk-score#next-steps), and the CVR index (CVRI=triglyceride/high-density lipoprotein). Differences between groups were determined using ANOVA. Partial correlation assessed the association between resistin and CVR indices. Logistic regression was used to determine the risk [Odds ratio (OR)] between resistin and CVR. RESULTS: Serum Resistin levels were similar between NGT, PT2D, and T2D. No correlation was observed between resistin and CVR indices for the NGT and PT2D. However, T2D demonstrated a strong negative association between the Framingham (r=-0.34, p=0.01), the Castelli 1 index (r=-0.29, p<0.01), and the CVRI (r=-0.38, p<0.05), when adjusted for sex and taking treatment for T2D. For T2D, when the subjects were separated by resistin into tertiles, elevated resistin was associated with a benefit for the Castelli 1 index (T1 v T3: OR=0.15, 95% CI: 0.03-0.070) and the CVRI (T1 v T3: OR=0.13, 95% CI: 0.03-0.66). CONCLUSIONS: Here, we demonstrate that, for T2D, elevated resistin levels lowered the CVR in Mexicans.

The impact of parental history of type 2 diabetes on hyperinsulinemia and insulin resistance in subjects from central Mexico.

AIMS: Hyperinsulinemia and insulin resistance are both associated with the development of Type 2 Diabetes and other pathologies; however, the influence of parental history of Type 2 diabetes (PH-T2D) has yet to be investigated. Therefore, this study was conducted to determine the effect of PH-T2D has on the risk of developing hyperinsulinemia and IR. MATERIALS AND METHODS: 1092 subjects (703 non-pregnant females and 389 males) were enrolled for a cross-sectional study. Clinical and biochemical parameters were collected. Subjects were allocated according to their PH-T2D: no parents, one parent, or both parents. Insulin resistance was calculated using the HOMA1 equation (HOMA1-IR). Logistic regression was used to determine the association (odds ratio) between PH-T2D and hyperinsulinemia or insulin resistance. RESULTS: Increasing degrees of PH-T2D were associated with significant increases in fasting plasma glucose, insulin, and HOMA1-IR (p <0.05). Subjects having one or both parents were associated with an increase risk of developing hyperinsulinemia (odds ratio=1.53, 95%CI: 1.12-2.09, and odds ratio=1.92, 95%CI: 1.21-3.06, respectively) and insulin resistance (odds ratio=1.47, 95%CI: 1.08-2.00 and odds ratio=1.77, 95%CI: 1.09-2.87, respectively), when adjusting for age, sex, BMI, fasting plasma glucose, and triglycerides. CONCLUSION: The presences of PH-T2D significantly increased the risk of developing hyperinsulinemia and insulin resistance.