Clinical Application of Chest Computed Tomography (CT) in Detection and Characterization of Coronavirus (Covid-19) Pneumonia in Adults.

To analyze diagnostic accuracy of chest computed tomography (CT) and RT-PCR (real-time polymerase chain reaction) for COVID-19 (coronavirus disease 19) pneumonia in early and progressive stages. To evaluate if combination of chest CT with RT-PCR can supplement the shortage of RT-PCR in diagnosis of COVID-19 pneumonia. We conducted a prospective study on 103 male patients. The study population were divided into two groups; early COVID-19 stage (number = 50 patients, with positive RT-PCR but mild symptoms) and progressive COVID-19 stage (number = 53, positive RT-PCR and sever symptoms including fever > 37.5 °C, cough, and shortness of breath). All patients underwent CT imaging. The early stage included typical category; 34% (17 out of 50 cases), 6% indeterminate category (3 cases), 10% atypical category (5 cases) and 50% (25 cases) were normal CT imaging. The progressive stage included typical category that was further divided to five subgroups; (i) peripheral bilateral lower lobe ground-glass opacity (GGO) in (37.7%), (ii) peripheral bilateral lower lobes GGO with peribronchovascular consolidation and bronchiolar dilatation in (18.8%), (iii) peripheral bilateral lower lobes GGO with crazy paving appearance in (15%), (iv) bilateral diffuse GGO in (18.8%), and (v) peripheral bilateral GGO with mediastinal lymph node enlargement (9.4%). Chest CT imaging could aid to supplement the shortages of PCR for clinically suspected patients of COVID-19 in the epidemic area as CT was positive in 50% of patients. Chest CT is very effective in detecting pulmonary parenchymal abnormalities in the progressive stage of COVID-19 patients in 100%.

Pursuing Quality in the Application of Bladder Cancer Quality of Life Research.

Patient-reported outcomes (PRO), including health-related quality of life (HRQOL) measures, represent important means for evaluating patients' health outcomes and for guiding health care decisions made by patients, practitioners, investigators, and policy makers. In spite of the large number of studies examining HRQOL in patients with bladder cancer, very few review articles investigated this topic. Because these review studies report mixed results, incorporating bladder cancer HRQOL measures into standard urological practice is not a viable option. In this non-systematic review of the literature and commentary we note some general concerns regarding PRO research, but our primary focus is on the HRQOL methodology within the context of two types of bladder cancer: muscle invasive and non-muscle invasive bladder cancer. Considering bladder cancer HRQOL as the interaction of four areas of the assessment process (i.e., what model of HRQOL to choose, what instruments are available to fit the choice, how interpretation of the resulting data fits the model, and how to derive some utility from the chosen model) and the two types of disease (i.e., muscle invasive and non-muscle invasive) may move us toward a better understanding of bladder cancer HRQOL. Establishing a useful model of perceived general health or specific symptoms is the first and most important step in developing the responsive bladder cancer HRQOL measures necessitated by clinical settings.

The Role of Calcium in Ameliorating the Oxidative Stress of Fluoride in Rats.

The present study was carried out to investigate the effects of fluoride toxicity on some biochemical, hormonal, and histological parameters of female rats and the protective role of calcium against such effects. Adult female albino rats were divided into five groups; control group received distilled water for 60 days, calcium group received calcium carbonate with dose of 50 mg/kg three times per week for 60 days, fluoride group received sodium fluoride with dose of 20 mg/kg three times per week for 60 days, calcium + fluoride group received calcium carbonate (50 mg/kg) then after 2 h received sodium fluoride (20 mg/kg) three times per week for 60 days, and fluoride + calcium group received sodium fluoride (20 mg/kg) three times per week for 30 days then received calcium carbonate (50 mg/kg) three times per week for another 30 days. The results showed that the levels of thiobarbituric acid reactive substances, urea, creatinine, alkaline phosphatase, triiodothyronine, thyroxine, parathormone, phosphorous, magnesium, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma glutamyl transferase were significantly increased in rats treated with fluoride while serum estradiol, calcium, and organ glutathione were significantly decreased. The histological examination of the femur bone revealed that fluoride treatment induced thinning of bone trabeculae with wilding of marrow space, demineralization, and loss of trabeculae interconnections. Also, the histological examination of hepatic and renal tissues of fluoride-treated rats showed some damages in these tissues while administration of calcium carbonate for 30 or 60 days during fluoride treatment minimized such damages. It could be concluded that administration of calcium to female rats can ameliorate the hazardous effects of fluoride observed in the biochemical, hormonal, and histological parameters.

Muscle invasive bladder cancer: from diagnosis to survivorship.

Bladder cancer is the fifth most commonly diagnosed cancer and the most expensive adult cancer in average healthcare costs incurred per patient in the USA. However, little is known about factors influencing patients' treatment decisions, quality of life, and responses to treatment impairments. The main focus of this paper is to better understand the impact of muscle invasive bladder cancer on patient quality of life and its added implications for primary caregivers and healthcare providers. In this paper, we discuss treatment options, side effects, and challenges that patients and family caregivers face in different phases along the disease trajectory and further identify crucial areas of needed research.

Quantitative proton short-echo-time LASER spectroscopy of normal human white matter and hippocampus at 4 Tesla incorporating macromolecule subtraction.

Accurate quantification of in vivo short-echo-time (TE) (1)H spectra must account for contributions from both mobile metabolites and less mobile macromolecules, which can fluctuate in disease. The purpose of this study was to develop an approach for the acquisition and processing of macromolecule information to optimize metabolite quantification accuracy and precision. Human parietal white matter (8-cm(3) voxel) and posterior hippocampus (1.7-cm(3) voxel) metabolite levels were quantified, following manomolecule subtraction, from short-echo-time spectra (TE = 46 ms) acquired at 4.0 Tesla with localization by adiabatic selective refocusing (LASER). Nineteen metabolites were fit using a time domain Levenberg-Marquardt minimization that incorporated prior knowledge of metabolite lineshapes. The macromolecule contribution to the spectrum was reduced by 87% (P < 0.05) when the acquisition of single averages of the full spectrum and macromolecule spectrum were interleaved to reduce subtraction errors due to motion. Subtracting the Hankel Lanczos singular value decomposition (HLSVD) fit of the macromolecule spectrum, which contained no random noise, did not alter quantified metabolite levels but did not increase metabolite quantification precision. Several metabolites had higher concentrations in the posterior hippocampus compared to parietal white matter, which emphasizes the need to carefully control for partial volume contamination in hippocampal spectroscopy studies.