Can Thorax Computed Tomography Severity Score in Coronavirus Disease 2019 Patients Differentiate Smokers from Non-smokers?

OBJECTIVE: The aim of this study was to explore the impact of smoking history on the severity of coronavirus disease 2019 radiologic findings. Therefore, we compared the computed tomography severity scores of smoking coronavirus disease 2019 patients with those of non-smoking coronavirus disease 2019 patients. MATERIAL AND METHODS: A total of 121 patients were included in our study group. We retrospectively reviewed 121 patients who underwent reverse transcription-polymerase chain reaction sampling and computed tomography examination in our hospital between April 1, 2020, and July 30, 2020. All computed tomography images were independently reviewed by 2 radiologists. RESULTS: There were 15 (12.4%) active smokers, 38 (31.4%) former smokers, and 68 (56.2%) never-smokers in this study. Among the 85 patients with evidence of pneumonia in thorax computed tomography, mean computed tomography severity scores were 8.02 and standard deviation 5.812. Computed tomography severity scores for patients with pathological computed tomography scans (n = 85) were performed for evaluating smoking status (never-smokers and smokers). We found a statistically significant relationship between computed tomography severity scores of never-smokers (n = 39) and smokers (n = 46) (Z = 2.243, P = .025). The computed tomography severity scores threshold for differentiating smokers in our study group was 8, with a sensitivity of 52.2% and a specificity of 79.5%. Among the 121 patients, 34 (28.1%) were in the asymptomatic group, 36 (29.75%) were in the mild group, 28 (23.14%) were in the common group, and 23 (19.0%) were in the severe group with severe pneumonia and respiratory distress. Five (1.47%), 16 (44.44%), 14 (50%), and 18 (78.26%) of the patients in these groups were smoking, respectively. CONCLUSION: Among coronavirus disease 2019 patients, smoking is associated with the progression of the disease and increased adverse effects. In our study, smoking status was significantly correlated with thorax computed tomography findings on admission. Computed tomography severity scores assessment helps to evaluate the disease extent in coronavirus disease 2019 patients.

Ozone gas applied through nebulization as adjuvant treatment for lung respiratory diseases due to COVID-19 infections: a prospective randomized trial.

The objective of this study was to provide lung disinfection by nebulizing ozone gas with distilled water and olive oil for patients who have clinical symptoms due to coronavirus disease 2019 (COVID-19). The study attempted to reduce the viral load of COVID-19 in the lungs of patients, to provide a faster response to medical treatment. Between August 2020 and September 2020, 30 patients who met the study criteria were prospectively evaluated. There were 2 groups with 15 patients in each group: patients in control group were not treated with ozone and only received standard COVID-19 treatment; patients in ozone group received lung disinfection technique with ozone and standard COVID-19 treatment. A statistically significant difference was found in the length of stay in hospital, change in C-reactive protein, polymerase chain reaction results after 5 days, and computed tomography scores between two groups. There was no statistically significant difference in D-dimer, urea, lactate dehydrogenase, lymphocyte, leukocyte, and platelet between two groups. According to the data, we think that the lung disinfection technique applied with ozone inhalation reduces the rate of pneumonia in COVID-19 patients and makes the patients respond faster to the treatment and become negative according to the polymerase chain reaction tests. The study was approved by the Ethical Committee of the Istanbul Medipol University Clinical Trials (approval No. 0011) on July 2, 2020.

Bilateral Epiphora as Only Presenting Sign of Total Paranasal Sinus Aplasia.

ABSTRACT: A 20-year-old female patient was presented with a bilateral epiphora. She had no history of infection or trauma related to the sinus areas. On examination, her facial appearance was abnormal and fullness on the face was observed. The fluorescein dye disappearance test was positive in both eyes. The lacrimal system irrigation was patent nasolacrimal duct. However, the dacryoscintigraphy imaging scan demonstrated bilateral obstruction at the nasolacrimal duct-inferior meatus junction. Nasal endoscopy did not reveal any pathologic findings, and lateral nasal wall, septum, and nasal cavities were normal. The patient was referred to the radiology department for a computed tomography of the paranasal sinus as a preoperative diagnostic imaging for lacrimal intervention. Computed tomography revealed the absence of all paranasal sinuses on both sides as well as absence of the ostiomeatal complex and ethmoidal air cells. Both bony lacrimal canal was narrow. Epiphora may be initial sign of total paranasal sinus aplasia.

The Role of Real-Time Tissue Elastography and Gray-Scale Ultrasound Histogram Analysis in the Diagnosis of Patients With Sjögren's Syndrome.

OBJECTIVES: This study aims to evaluate gray-scale histogram analysis of B-mode ultrasound (US) images and US elastographic features of the parotid glands in patients with Sjögren's syndrome (SS) and to explore relationships with the ultrasonographic and disease activity scores in the light of histopathological findings. PATIENTS AND METHODS: A total of 57 consecutive female patients (mean age 47.9±10.4 years; range 25 to 76 years) with a diagnosis of SS and 48 healthy female individuals (mean age 51.1±10.8 years; range 20 to 70 years) underwent parotid ultrasonography and real-time tissue elastography imaging. Quantitative measurements of gray-scale US images were performed using the histogram software of the scanner. The histogram ratios of the parotid glands from both sides were obtained (histogram ratio; mean gray-scale histogram parotid/mean gray-scale histogram fat). Strain ratio (SR; ratio of fat to gland parenchyma) was calculated from the color-coded images. Subjective B-mode US scoring of electronically recorded gray- scale US images was performed by two radiologists independently for intra- and inter-observer agreement. Subjective assessments, quantitative measurements, and clinical parameters were compared. RESULTS: The SR of the patient group (1.4±0.8 right side, 1.5±0.9 left side) was significantly higher than that of the control group (1.0±0.3 right side, 1.1±0.3 left side) (p<0.05). The gray-scale histogram ratio of the patient group (1.3±0.5 right side, 1.4±0.9 left side) was lower than that of the control group (1.8±0.7 right side, 1.9±0.7 left side) (p<0.05). Receiver-operating-characteristics curve yielded 66% sensitivity for both sides and 50% and 52% specificity for the right and left sides, respectively, for a cut-off SR of 1.02; 76% and 86% sensitivity for the right and left sides, respectively, and 63% specificity for both sides for a cut-off histogram ratio of 1.35. The quantitative histogram ratio method had a higher positivity rate for the diagnosis of abnormal parotid glands than subjective assessments of US images. CONCLUSION: Sonoelastography and gray-scale histogram analysis of the parotid glands may be used as auxiliary tools to detect parotid gland sonographic abnormalities in patients with SS.

Do altitude and climate affect paranasal sinus volume?

OBJECTIVE: The aim of this study was to evaluate the effect of climate and altitude differences on the volume of paranasal sinuses and on the frequency of anatomic variations by comparing the paranasal sinus tomograms (PNSCT) of patients who were born and living in a cold, dry climate at high altitude with those of patients who were born and living on the coast at sea level in a temperate climate. We also aimed to determine differences relating to gender. MATERIAL AND METHODS: A total of 55 PNSCTs of 55 patients from the city center of Antalya and 60 PNSCTs of 60 patients from the city center of Agri were evaluated and compared prospectively. The study included a total of 115 patients with a mean age of 44.75 ± 9.64 years (range, 27-63 years). Group 1 (Antalya) comprised 26 females (47.3%) and 29 males (52.7%) with a mean age of 36.7 ± 12.4 years. Group 2 (Agri) comprised 25 females (41.7%) and 35 males (58.3%) with a mean age of 35.1 ± 13.4 years. Maxillary sinus volumes were 18.27 cm(3) (range, 5.04-37.62) and 15.06 cm(3) (4.11-41.40); sphenoid sinus volumes were 7.81 cm(3) (1.80-20.63) and 6.35 cm(3) (0.54-16.50); frontal sinus volumes were 5.51 cm(3) (0.50-29.25) and 3.76 cm(3) (0.68-22.81) respectively. RESULTS: There was no statistically significant difference between the groups in term of volumes (p > 0.025). Both maxillary and frontal sinus volumes were greater in males compared to females (p < 0.025). The mean value of the maxillary sinus volume was 15.7 ± 5.3 cm(3) and was significantly larger in males than in females (p = 0.004). There was no statistically significant correlation between the volume of maxillary sinuses with age or side. There was no statistically significant difference between the groups in terms of septum deviation and concha bullosa rates (p = 0.469 and p = 0.388). CONCLUSION: There have been many studies of nasal cavity changes due to climatic conditions but this is the first study to measure the difference of paranasal sinus volumes. No difference was determined in the anatomic variations and volumes of the maxillary, frontal, sphenoid sinuses on PNSCT of patients from different climates and altitudes.