1,720,983 research outputs found
Standardized bilateral thoracic ultrasound image comparison as a tool for the diagnosis of pneumothorax: a pilot exploratory study
No full textAim: Pneumothorax is a potentially life-threatening condition whose diagnosis can be challenging. Ultrasound chest examination is generally fast and user-friendly, but in non-expert hands or with uncooperative patients, it may still be difficult and time-consuming. Adding another tool to support the suspicion of pneumothorax might be useful, potentially enhancing the diagnostic accuracy of standard ultrasound chest examination. We evaluated the feasibility of standardized bilateral ultrasound image comparison as a potential new tool for pneumothorax diagnosis. Materials and methods: We enrolled 60 subjects (30 with pneumothorax and 30 controls) and collected bilateral ultrasound images of their chests (each image contained one frame from the left lung and one from the right lung). Ten physicians (eight blinded to diagnosis) divided into five groups according to expertise evaluated the images for potential grayscale differences and/or horizontal artifacts between the two frames. All images were then analyzed with image analysis software for grayscale pixel assessment (one sub-analysis for the entire area under the pleural line, one for a 100-pixel-wide rectangle under the pleural line). Results: All clinicians achieved good results in terms of diagnostic accuracy and inter-operator reliability, even those unexperienced in ultrasound. Mean, range, and median grayscale pixel ratio between the pneumothorax side and the healthy side in a single patient proved to be the most reliable parameters, reaching excellent sensitivity and specificity. Combining these parameters proved to be an excellent diagnostic tool (ROC area under curve = 1.00, p-value = 0.02). Conclusions: Standardized bilateral thoracic ultrasound image comparison may be a potential new tool for the diagnosis of pneumothorax
Treatment of emphysema: procedure planning and follow-up by HRCT
No full textLearning objectives
To review surgical or bronchoscopic treatment for severe emphysema. To describe preoperative characterization of emphysema by HRCT and to define the specific abnormalities that guide the choice of optimal procedure. To show the regular morphological changes that follow the procedures and to describe the complications as detected by chest x-ray and HRCT.
Background
COPD is characterized by incompletely reversible expiratory airflow obstruction, and its severity is rated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, which defines four stages of disease, according to the post-bronchodilator airflow limitation. HRCT allows the categorization of COPD patients into subtypes that are distinguished accordingly to different structural and functional alterations [1].
Findings and procedure details
1. Lung volume reduction surgery (LVRS) The surgical removal of emphysematous tissue has the purpose of revert ventilation in residual healthy parenchyma [2], specifically in patients suffering from upper-lobes predominant emphysema (Fig. 1); therefore, the pre-operative assessment of emphysema through visual scoring or by quantitative analysis of CT images is needed; the latter precisely calculates the percentage of emphysematous tissue, thus guiding the correct strategy [3].
Conclusion
Radiologists should be familiar with HRCT imaging aspects related to this noninvasive treatment option for pulmonary emphysema, which are being increasingly performed in referral centers
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Premorbid vulnerability and disease severity impact on Long-COVID cognitive impairment
No full textBackground Cognitive deficits have been increasingly reported as possible long-term manifestations after SARS-CoV-2 infection. Aims In this study we aimed at evaluating the factors associated with cognitive deficits 6 months after hospitalization for Coronavirus Disease 2019 (COVID-19). Methods One hundred and six patients, discharged from a pneumology COVID-19 unit between March 1 and May 30 2020, accepted to be evaluated at 6 months according to an extensive neurological protocol, including the Montreal Cognitive Assessment (MoCA). Results Abnormal MoCA scores at 6 months follow-up were associated with higher pre-hospitalization National Health System (NHS) score (Duca et al. in Emerg Med Pract 22:1-2, 2020) (OR 1.27; 95% CI 1.05-1.6; p = 0.029) and more severe pulmonary disease expressed by the Brescia-COVID Respiratory Severity Scale (Duca et al. in Emerg Med Pract 22:1-2, 2020) (BCRSS > 1OR 4.73; 95% CI 1.53-14.63; p = 0.003) during the acute phase of the disease. Discussion This longitudinal study showed that the severity of COVID-19, indicated by BCRSS, and a complex score given by age and premorbid medical conditions, expressed by NHS, play a major role in modulating the long-term cognitive consequences of COVID-19 disease. Conclusions These findings indicate that the association of age and premorbid factors might identify people at risk for long-term neurological consequences of COVID-19 disease, thus deserving longer and proper follow-up
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Additive effect on pulmonary function and disability of intensive pulmonary rehabilitation following bronchoscopy lung volume reduction (BLVR) for severe emphysema
No full textBackground: Pulmonary rehabilitation (PR) is mandatory before bronchoscopy lung volume reduction (BLVR); there is scant information about its efficacy post-BLVR. We retrospectively evaluated pulmonary function (PF) and disability in patients pre/post-BLVR and its additive effect on an intensive PR program post-BLVR vs matched non-BLVR controls. We analyzed changes within BLVR patients according to presence or not of atelectasis.Methods: We compared PF and exercise tolerance (6-min walk test, 6MWT) in 39 BLVR patients (FEV1% pred. 28.9 +/- 1.5; RV % pred. 236.1 +/- 7.7) pre-/post-BLVR, and vs. 32 controls (FEV1 % pred. 32.7 +/- 1.5; RV% pred. 217.8 +/- 8.3) before and after PR.Results: BLVR patients showed a greater improvement than controls in PF (difference between groups: 3.8 for FEV1% pred., p = 0.043; -20.5 for RV % pred., p = 0.02) and 6MWT response rate (12/39 vs. 1/39 subjects, p = 0.003). Both groups further improved significantly 6MWT after PR without a significant difference between groups. Atelectasis after BLVR mainly accounted for the improvement in FEV1% pred, RV% pred. and 6MWT compared to both BLVR without atelectasis and controls.Conclusion: BLVR improves PF (particularly RV) and exercise tolerance, patients with lobar exclusion being the best improvers. PR following BLVR yields a further improvement in exercise tolerance in both (atelectasis and non-atelectasis) subgroups
Pulmonary rehabilitation improves functional outcomes and quality of life in post-SARS-CoV-2 mild-to-moderate infection patients: a pilot study
Full text link: SARS-CoV-2 infection impairs functional outcomes and quality of life, even in its mild-to-moderate form. It is therefore appropriate to draw attention to the role played by respiratory rehabilitation and physiotherapists in the pulmonary rehabilitation process that post-SARS-CoV-2 patients must undergo. We enrolled 80 patients in a prospective case-control study; 40 cases (mild-to-moderate post-SARS-CoV-2 infection patients) and 38 control subjects (i.e. patients affected by other respiratory diseases) completed a full pulmonary rehabilitation cycle. 6 Minute Walking Distance, Borg CR10 Scale, modified Medical Research Council (mMRC) Dyspnoea scale, EuroQoL EQ-5D-3L questionnaire, Barthel scale, arterial blood gas test and peripheral oxygen saturation (SpO2) were compared for all patients before and after rehabilitation. All patients experienced significant improvements in all parameters analyzed, except for arterial blood gas test. Results were similar for both groups, in particular both groups experienced improvements in mMRC scale, EuroQoL questionnaire, Barthel scale and 6-minute walking distance. Pulmonary rehabilitation appears to improve exercise tolerance, dyspnea and quality of life in patients recovering from mild-to-moderate SARS-CoV-2 infection. Further studies are needed on larger sample size population to validate these results
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