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Khan MS, Janjua MBA, Jamal AM, Qaiser S, Attiq A, Raza A, Razzaq MT, Bhatti AA, Afzal N, Zahra A. Diagnostic Value of High-Resolution Computed Tomography Scan in COVID-19: Do We Need to Think Outside the Box? Cureus 2021; 13:e15849. [PMID: 34322339 PMCID: PMC8299315 DOI: 10.7759/cureus.15849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 12/23/2022] Open
Abstract
Background and objective The ambiguous nature and high infectivity of the coronavirus disease 2019 (COVID-19) have caused soaring morbidity and mortality worldwide. Real-time polymerase chain reaction (RT-PCR) is preferred for detecting COVID-19. However, its poor sensitivity and the emerging use of high-resolution CT (HRCT) scan for disease severity make the use of RT-PCR quite obsolete. In light of this, our study aimed to explore the beneficial role of HRCT and compare the HRCT findings across various patient demographics and parameters. Methods This cross-sectional study included 100 patients with clinical suspicion of COVID-19. All patients underwent a chest HRCT scan preceded by RT-PCR testing. We used the CT severity score (CTSS) of the chest to calculate disease severity. Demographical data and results of radiological findings were tabulated and compared across RT-PCR positivity, age, and gender. Independent samples t-test and chi-square test were used to analyze the data. Results Glass ground opacity was the most prevalent finding in 99% of the patients, followed by lymph node involvement, consolidation, and crazy-paving pattern. Pleural effusion was observed in only 10% of the patients while pericardial effusion and hiatal hernia were present in 5%. In RT-PCR-positive patients, the posterior basal segment of the lower lobe of the right and left lungs were found to be dominantly involved; however, the upper and middle lobes of the right lung were more commonly involved than the left lung. The mean CTSS was significantly higher in patients aged above 50 years (p<0.001). The mean CTSS of RT-PCR-negative patients was higher than that of RT-PCR-positive patients (15.18 vs. 14.31, p=0.537). Conclusion RT-PCR has a limited role in the diagnosis of COVID-19. The HRCT scan can detect typical COVID-19 findings even in patients with negative RT-PCR results. Moreover, the use of HRCT scan in determining the disease severity and extent of lung damage can lead to a better assessment of critically ill patients.
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Affiliation(s)
| | | | - Ali Murad Jamal
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Shehrbano Qaiser
- Internal Medicine, Foundation University Medical College, Islamabad, PAK
| | - Aamna Attiq
- Internal Medicine, Rahbar Medical and Dental College, Lahore, PAK
| | - Arsalan Raza
- Internal Medicine, Rashid Latif Medical College, Lahore, PAK
| | | | | | - Nitasha Afzal
- Radiology, University College of Medicine and Dentistry, Lahore, PAK
| | - Aiman Zahra
- Radiology, Sargoda Medical College, Sargoda, PAK
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Abstract
BACKGROUND Major urological complications (MUCs) after kidney transplantation contribute to patient morbidity and compromise graft function. The majority arise from the vesico-ureteric anastomosis and present early after transplantation. Ureteric stents have been successfully used to treat such complications. A number of centres have adopted a policy of universal prophylactic stenting, at the time of graft implantation, to reduce the incidence of urine leaks and ureteric stenosis. Stents are associated with specific complications and some centres advocate a policy of only stenting selected anastomoses. OBJECTIVES To examine the benefits and harms of routine ureteric stenting to prevent urological complications in kidney transplant recipients. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library), MEDLINE, EMBASE, reference lists of articles, books and abstracts and contacted companies, authors and experts to identify relevant randomised controlled trials (RCTs). SELECTION CRITERIA All RCTs and quasi-RCTs were included in our meta-analysis. DATA COLLECTION AND ANALYSIS Four reviewers assessed the trials for quality against four criteria (allocation concealment, blinding, intention-to-treat and completeness of follow-up). The primary outcome was the incidence of MUCs. Further outcomes of interest were graft and patient survival and the incidence of adverse events (urinary tract infection (UTI), haematuria, irritative symptoms, pain and stent migration). Statistical analyses were performed using the random effects model and the results expressed as relative risk (RR) with 95% confidence intervals (CI). MAIN RESULTS Seven RCTs (1154 patients) of low or moderate quality were identified. The incidence of MUCs was significantly reduced (RR 0.24, 95% CI 0.07 to 0.77, P = 0.02, NNT 13) by universal prophylactic stenting. This was dependent on whether the same surgeon performed, or was in attendance, during the operations. Two patients lost their grafts to infective urinary tract complications in the stented group. UTIs, in general, were more common in stented patients (RR 1.49, 95% CI 1.04 to 2.15) unless the patients were prescribed cotrimoxazole 480 mg/d: in which case the incidence was equivalent (RR 0.97, 95% CI 0.71 to 1.33). Stents appeared generally well tolerated, although trials using longer stents (>/= 20 cm) for longer periods (> 6 weeks) had more problems with encrustation and migration. AUTHORS' CONCLUSIONS Routine prophylactic stenting reduces the incidence of MUCs. Trials comparing selective stenting and universal prophylactic stenting, whilst difficult to design and analyse, would address the unresolved quality of life and economic issues.
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Affiliation(s)
- C H Wilson
- Freeman Hospital, Liver/Renal Unit, High Heaton, Newcastle-upon-Tyne, Tyne and Wear, UK NE7 7DN.
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Asher J, Wilson C, Gok M, Balupuri S, Bhatti AA, Soomro N, Rix D, Jaques B, Manas D, Shenton B, Talbot D. Factors predicting duration of delayed graft function in non-heart-beating donor kidney transplantation. Transplant Proc 2005; 37:348-9. [PMID: 15808639 DOI: 10.1016/j.transproceed.2004.11.036] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Non-heart-beating donors (NHBDs) are an important potential source of donor organs, but kidneys from such donors are prone to delayed graft function (DGF) and primary nonfunction, which are multifactorial in origin but believed to be mainly due to warm ischemic injury. This retrospective study examined a series of 88 transplants from Maastricht category II and III NHBDs to examine the role of factors to predict the duration of DGF. The main factors affecting duration of DGF were total warm ischemic time, cold ischemic time, product of perfusate GST concentration and donor age, quality of postoperative graft perfusion, incidence of acute rejection, recipient cardiovascular risk score, maximum pressure on machine perfusion, and weight gain during machine perfusion. Primary nonfunction was not accurately predicted from these factors for kidneys that had passed the viability assessment.
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Affiliation(s)
- J Asher
- Liver and Renal Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.
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Gok MA, Shenton BK, Buckley PE, Peaston R, Cornell C, Leung E, El-Sheikh MFA, Mantle D, Soomro N, Jacques BC, Manas DM, Talbot D, Bhatti AA. Use of thrombolytic streptokinase as a preflush in the NHBD procurement. Transplant Proc 2003; 35:769-70. [PMID: 12644129 DOI: 10.1016/s0041-1345(03)00036-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M A Gok
- Renal/Liver Transplant Unit, The Freeman Hospital, Newcastle Upon Tyne, UK.
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Adams MR, Aïd S, Anthony PL, Averill DA, Baker MD, Baller BR, Banerjee A, Bhatti AA, Bratzler U, Braun HM, Carroll TJ, Clark HL, Conrad JM, Davisson R, Derado I, Dietrich FS, Dougherty W, Dreyer T, Eckardt V, Ecker U, Erdmann M, Fang GY, Figiel J, Finlay RW, Gebauer HJ, Geesaman DF, Griffioen KA, Guo RS, Haas J, Halliwell C, Hantke D, Hicks KH, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Jin Z, Kaufman S, Kennedy RD, Kinney ER, Kobrak HG, Kotwal AV, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Madden P, Magill S, Manz A, Melanson H, Michael DG, Montgomery HE, Morfin JG, Nickerson RB, Novak J, O'Day S, Olkiewicz K, Osborne L, Otten R, Papavassiliou V, Pawlik B, Pipkin FM, Potterveld DH, Ramberg EJ. Proton and deuteron structure functions in muon scattering at 470 GeV. Phys Rev D Part Fields 1996; 54:3006-3056. [PMID: 10020979 DOI: 10.1103/physrevd.54.3006] [Citation(s) in RCA: 152] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Adams MR, Aïd S, Anthony PL, Averill DA, Baker MD, Baller BR, Banerjee A, Bhatti AA, Bratzler U, Braun HM, Carroll TJ, Clark HL, Conrad JM, Davisson R, Derado I, Dhawan SK, Dietrich FS, Dougherty W, Dreyer T, Eckardt V, Ecker U, Erdmann M, Fang GY, Figiel J, Finlay RW, Gebauer HJ, Geesaman DF, Griffioen KA, Guo RS, Haas J, Halliwell C, Hantke D, Hicks KH, Hughes VW, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Jin Z, Kaufman S, Kennedy RD, Kinney ER, Kobrak HG, Kotwal AV, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Madden P, Magill S, Manz A, Melanson H, Michael DG, Montgomery HE, Morfin JG, Nickerson RB, Novak J, O'Day S, Olkiewicz K, Osborne L, Otten R, Papavassiliou V, Pawlik B, Pipkin FM. Extraction of the Ratio Fn2/Fp2 from Muon-Deuteron and Muon-Proton Scattering at Small x and Q2. Phys Rev Lett 1995; 75:1466-1470. [PMID: 10060305 DOI: 10.1103/physrevlett.75.1466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Adams MR, Aïd S, Anthony PL, Averill DA, Baker MD, Baller BR, Banerjee A, Bhatti AA, Bratzler U, Braun HM, Breidung H, Busza W, Carroll TJ, Clark HL, Conrad JM, Davisson R, Derado I, Dhawan SK, Dietrich FS, Dougherty W, Dreyer T, Eckardt V, Ecker U, Erdmann M, Fang GY, Figiel J, Finlay RW, Gebauer HJ, Geesaman DF, Griffioen KA, Guo RS, Haas J, Halliwell C, Hantke D, Hicks KH, Hughes VW, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Jin Z, Kaufman S, Kennedy RD, Kinney ER, Kirk T, Kobrak HG, Kotwal AV, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Madden P, Magill S, Manz A, Melanson H, Michael DG, Montgomery HE, Morfin JG, Nickerson RB, O'Day S, Olkiewicz K, Osborne L, Otten R, Papavassiliou V. Nuclear decay following deep inelastic scattering of 470 GeV muons. Phys Rev Lett 1995; 74:5198-5201. [PMID: 10058707 DOI: 10.1103/physrevlett.74.5198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Adams MR, Aïd S, Anthony PL, Averill DA, Baker MD, Baller BR, Banerjee A, Bhatti AA, Bratzler U, Braun HM, Breidung H, Busza W, Carroll TJ, Clark HL, Conrad JM, Davisson R, Derado I, Dhawan SK, Dietrich FS, Dougherty W, Dreyer T, Eckardt V, Ecker U, Erdmann M, Faller F, Fang GY, Figiel J, Finlay RW, Gebauer HJ, Geesaman DF, Griffioen KA, Guo RS, Haas J, Halliwell C, Hantke D, Hicks KH, Hughes VW, Jackson HE, Jancso G, Jansen DM, Jin Z, Kaufman S, Kennedy RD, Kinney ER, Kirk T, Kobrak HG, Kotwal AV, Kunori S, Lancaster S, Lord JJ, Lubatti HJ, McLeod D, Madden P, Magill S, Manz A, Melanson H, Michael DG, Montgomery HE, Morfin JG, Nickerson RB, O'Day S, Olkiewicz K, Osborne L, Otten R. Measurement of nuclear transparencies from exclusive rho 0 meson production in muon-nucleus scattering at 470 GeV. Phys Rev Lett 1995; 74:1525-1529. [PMID: 10059051 DOI: 10.1103/physrevlett.74.1525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Adams MR, Aïd S, Anthony PL, Baker MD, Bartlett J, Bhatti AA, Braun HM, Busza W, Carroll T, Conrad JM, Coutrakon G, Davisson R, Derado I, Dhawan SK, Dougherty W, Dreyer T, Dziunikowska K, Eckardt V, Ecker U, Erdmann M, Eskreys A, Figiel J, Gebauer HJ, Geesaman DF, Gilman R, Green MC, Haas J, Halliwell C, Hanlon J, Hantke D, Hughes VW, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Kaufman S, Kennedy RD, Kirk T, Kobrak HG, Krzywdzinski S, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Magill S, Malecki P, Manz A, Melanson H, Michael DG, Mohr W, Montgomery HE, Morfin JG, Nickerson RB, O'Day S, Olkiewicz K, Osborne L, Papavassiliou V, Pawlik B, Pipkin FM, Ramberg EJ, Röser A, Ryan JJ, Salvarani A, Schellman H. Scaled energy (z) distributions of charged hadrons observed in deep-inelastic muon scattering at 490 GeV from xenon and deuterium targets. Phys Rev D Part Fields 1994; 50:1836-1873. [PMID: 10017821 DOI: 10.1103/physrevd.50.1836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Adams MR, Arndotïd S, Anthony PL, Baker MD, Bartlett J, Bhatti AA, Braun HM, Busza W, Conrad JM, Coutrakon G, Davisson R, Derado I, Dhawan SK, Dougherty W, Dreyer T, Dziunikowska K, Eckardt V, Ecker U, Erdmann M, Eskreys A, Figiel J, Gebauer HJ, Geesaman DF, Gilman R, Green MC, Haas J, Halliwell C, Hanlon J, Hantke D, Hughes VW, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Kaufman S, Kennedy RD, Kirk T, Kobrak HG, Krzywdzinski S, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Magill S, Malecki P, Manz A, Melanson H, Michael DG, Mohr W, Montgomery HE, Morfin JG, Nickerson RB, O'Day S, Olkiewicz K, Osborne L, Papavassiliou V, Pawlik B, Pipkin FM, Ramberg EJ, Röser A, Ryan JJ, Salgado CW, Salvarani A, Schellman H. Q2 dependence of the average squared transverse energy of jets in deep-inelastic muon-nucleon scattering with comparison to perturbative QCD predictions. Phys Rev Lett 1994; 72:466-469. [PMID: 10056440 DOI: 10.1103/physrevlett.72.466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Adams MR, Aïd S, Anthony PL, Baker MD, Bartlett J, Bhatti AA, Braun HM, Busza W, Conrad JM, Coutrakon G, Davisson R, Derado I, Dhawan SK, Dougherty W, Dreyer T, Dziunikowska K, Eckardt V, Ecker U, Erdmann M, Eskreys A, Figiel J, Gebauer HJ, Geesaman DF, Gilman R, Green MC, Haas J, Halliwell C, Hanlon J, Hantke D, Hughes VW, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Kaufman S, Kennedy RD, Kirk T, Kobrak HG, Krzywdzinski S, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Magill S, Malecki P, Manz A, Melanson H, Michael DG, Mohr W, Montgomery HE, Morfin JG, Nickerson RB, O'Day S, Olkiewicz K, Osborne L, Papavassiliou V, Pawlik B, Pipkin FM, Ramberg EJ, Röser A, Ryan JJ, Salgado CW, Salvarani A, Schellman H. Perturbative QCD effects observed in 490 GeV deep-inelastic muon scattering. Phys Rev D Part Fields 1993; 48:5057-5066. [PMID: 10016164 DOI: 10.1103/physrevd.48.5057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Adams MR, Aïd S, Anthony PL, Baker MD, Bartlett J, Bhatti AA, Braun HM, Busza W, Conrad JM, Coutrakon G, Davisson R, Derado I, Dhawan SK, Dougherty W, Dreyer T, Dziunikowska K, Eckardt V, Ecker U, Erdmann M, Eskreys A, Figiel J, Gebauer HJ, Geesaman DF, Gilman R, Green MC, Haas J, Halliwell C, Hanlon J, Hantke D, Hughes VW, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Kaufman S, Kennedy RD, Kobrak HG, Krzywdzinski S, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Magill S, Malecki P, Manz A, Michael DG, Mohr W, Montgomery HE, Morfin JG, Nickerson RB, O'Day S, Olkiewicz K, Osborne L, Papavassiliou V, Pawlik B, Pipkin FM, Ramberg EJ, Röser A, Ryan J, Salgado CW, Salvarani A, Schellman H, Schmitz N, Schüler KP. First measurements of jet production rates in deep-inelastic lepton-proton scattering. Phys Rev Lett 1992; 69:1026-1029. [PMID: 10047104 DOI: 10.1103/physrevlett.69.1026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Adams MR, Aïd S, Anthony PL, Baker MD, Bartlett J, Bhatti AA, Braun HM, Busza W, Carroll TJ, Conrad JM, Coutrakon G, Davisson R, Derado I, Dhawan SK, Dougherty W, Dreyer T, Dziunikowska K, Eckardt V, Ecker U, Erdmann M, Eskreys A, Figiel J, Gebauer HJ, Geesaman DF, Gilman R, Green MC, Haas J, Halliwell C, Hanlon J, Hantke D, Hughes VW, Jackson HE, Jaffe DE, Jancso G, Jansen DM, Kaufman S, Kennedy RD, Kirk T, Kobrak HG, Krzywdzinski S, Kunori S, Lord JJ, Lubatti HJ, McLeod D, Magill S, Malecki P, Manz A, Melanson H, Michael DG, Mohr W, Montgomery HE, Morfin JG, Nickerson RB, O'Day S, Olkiewicz K, Osborne L, Papavassiliou V, Pawlik B, Pipkin FM, Ramberg EJ, Röser A, Ryan JJ, Salvarani A, Schellman H. Saturation of shadowing at very low Bjorken x. Phys Rev Lett 1992; 68:3266-3269. [PMID: 10045658 DOI: 10.1103/physrevlett.68.3266] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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