There are growing concerns that some COVID-19 survivors may acquire fibrosis and other irreversible lung abnormalities. The purpose of this prospective study was to assess the rate and predictors of complete resolution of COVID-19 pneumonia by pursuing a hypothetical relation between time and imaging pattern evolution using HRCT findings. A monocentric prospective cohort study with a consecutive-case enrolment design was implemented during a five-month period, having a total of 683 post-COVID patients eligible for inclusion and 635 evaluations with complete follow-up for chest HRCT. The target for post-COVID evaluations consisted of performing HRCT 90 days after a confirmed SARS-CoV-2 infection. The studied patients had an average age of 54 years, ranging between 18 and 85 years old, and an average duration from the first symptoms until HRCT was performed of 74 days. At the post-COVID follow-up, 25.8% had a complete imagistic remission. The most common appearance with HRCT was “ground glass” in 86.6% in patients with persistent COVID-19, followed by reticulations, present in 78.8%, and respectively pleural thickening in 41.2% of cases. The mean total HRCT scores were statistically significantly higher in patients older than 65 years (10.6 ± 6.0) compared to the 40–65 group (6.1 ± 6.1) and the 18–40 age group (2.7 ± 4.8) (p < 0.001). Chest HRCT is a “time window” in documenting temporal persistent radiologic features of lung injury 90 days after SARS-CoV-2 infection, determining the pathologic basis of so-called “long COVID”. The complete remission was associated with a significantly higher average follow-up period and a significantly lower average patient age. Persistent HRCT features of ground glass, reticulation, and pleural thickening are associated with a higher total CT score and older age.
Background: After 10 years of systematically nationwide applied measures for reduction of infection risk, in this national prospective observational study, we reassessed the prevalence of hepatitis virus infection prevalence and its influence on the outcome of end-stage kidney disease (ESKD) patients treated with hemodialysis. Methods: Six-hundred ESKD patients (332 men and 268 women, median age 56 years) treated with chronic HD in seven centers from all the historical regions of Romania have been assigned to this study on 1st of November 2010. The aims of this study were to reevaluate the prevalence of the hepatitis B and C virus infection in a HD population from Romania after 10 years of systematically nationwide applied measures for reduction of infection risk and also to assess the impact of these infections on the prognosis of HD patients. Results: HBsAg was positive in 9.5% (n = 57) of the patients, anti-HCV antibodies were detected in 27.3% (n = 164) and 5% (n = 30) were positive for both HBV and HCV infection. The mortality risk was significantly influenced only by age, the presence of coronary artery disease and the 25 OH vitamin D levels. Conclusions: This study shows that the systematically nationwide applied measures for reduction of infection risk significantly decreased HV infection prevalence in HD patients in Romania. The presence of HV infection did not significantly influence the mortality risk in this population.
BackgroundNon-adherence to treatment is associated with poor asthma control, increased exacerbations, decline in lung function, and decreased quality of life. M-health applications have become increasingly in the last years, but little research regarding the efficiency of the instructional videos for correct inhaler use exist. The aim of this study is to assess and improve the inhalator technique and to establish which types of errors were made more often with the help of a mobile health application.Materials and methodsSeventy-five patients with partially controlled or uncontrolled asthma, using any of turbuhaler, diskus, pressurized metered dose inhaler (pMDI) or soft mist inhaler (SMI), were included in the study. When they first entered the study, the patient’s inhaler technique was assessed by a trained medical professional and the technique errors were categorized in handling, respectively inhalation errors. After the first evaluation, the patients downloaded an application on their Smartphone and were encouraged to use the application as much as needed to remind them the correct inhalation technique. The patients were re-called every three months for evaluation, treatment, and assessment of inhalation technique.ResultsWe analyzed both handling and inhalation errors for each of the four considered inhalers. We observed a significantly reduced number of inhalation technique errors after using the mobile phone application. Turbuhaler median errors were 6.00, and after six months we did not observe errors. Diskus median error was 6.00, and after six months we observed a maximum of one error. pMDI median errors were 7.00, and after six months we observed just one error. Similarly, SMI median error was 7.00, and after six months we observed just one error.ConclusionAlthough technique inhalation errors are very common among asthma patients, video instructions provided through specific mobile phone applications could improve the inhaler technique in order to achieve a better control of the disease.
Background Many studies assessed the effect of mobile phone applications on self-management outcomes in patients with asthma but all of them presented different results. In this paper we examined the effect of a mobile phone application on self-management and disease control in Romanian population.Material and methods This study included 93 patients diagnosed with asthma that were recalled every three months for a year for assessment and treatment. Patients were divided into two groups. The first group included patients that received treatment and the second group received treatment and also used the smartphone application. Number of exacerbations and asthma control test (ACT) were recorded.Results ACT score was significantly higher for patients using also the mobile application than for the patients using the treatment alone, Mann-Whitney U test, p < 0.001. When considering the exacerbations rate, the patients not using the application presented an insignificant lower number of exacerbations than the group using the application, 40.74% vs. 58.97%, respectively, chi-square test, X 2 (1) = 3.105, p = 0.081. The number of exacerbations without hospitalization was significantly higher in case of the first group, when comparing to the second group, 46.3% vs 10.26%, X 2 (1) = 13.71, p < 0.001.Conclusion Our study indicates that smartphone applications are an effective way to improve asthma control and self-management when used continually in our population. We found significant positive effects in disease control and exacerbation frequency.
Given the increased incidence of colorectal cancer worldwide, especially in developed and developing countries, is comes as no surprise that researchers are concentrating on methods to combat this public health issue, through investigating both lifestyle interventions and treatment options. Although treatment options are being constantly discovered and developed, researchers have also begun investigating the influence that nutrition and lifestyle have on CRC. Among the food categories, nuts and seeds boast numerous beneficial effects for cardiovascular health and metabolic balance and they contain a plethora of phytochemicals and antioxidants. The present narrative review aims to offer a broad perspective to date on the known effects of this consumption on colorectal cancer. For this purpose, articles were identified by conducting a search in the PubMed and Google Scholar databases, using search phrases such as ″nut intake and colorectal cancer″ and ″seed consumption and colorectal cancer”, narrowing the search pool to those articles published between 2019 and 2022. The search returned eight relevant papers, all of which were validated by a second author. While the existing research is divided between those studies which have found no significant link between nut consumption and colorectal cancer protection and those which have, there is a consensus regarding the necessity for further research on this subject, as well as the possible mechanisms which might be involved in the protective effect observed by some researchers.
Postoperative edema and lean body mass may contribute to functional outcome in frailty hip fracture patients. Advances in body mass determination have produced consistent results with A-mode ultrasound. We therefore aimed to determine the utility of A-mode ultrasound in analyzing postoperative limb edema in patients receiving treatment for proximal femur fractures. 4 males and 6 females, with an average age of 74.3 years were included. 4 had fractures of the femoral neck treated by hemiarthroplasty and the rest had extracapsular fractures which were stabilized with short intramedullary nails. Measurements were done using a commercially available A-mode 2.5MHz transducer on the thighs approximately 15 cm proximal to the patella. Comparison showed significant difference between the operated and contralateral thigh circumference (P=0.001) as well as muscle layer thickness differences between femoral neck patients and those with fractures of the trochanteric region (P=0.016). There was no correlation between the A-mode ultrasound determined superficial layer difference and entire layer difference (R2=0.037; P=0.59). However, there was linear correlation between the A-mode ultrasound determined entire layer difference and limb circumference difference, (R2=0.414; P=0.044). Postoperative thigh edema is present in all surgically treated patients for proximal femur fractures. A-mode ultrasound might be a reliable tool to examine adipose and muscle layers separately in the immediate postoperative period. There may be a difference in edema distribution between femoral neck and peritrochanteric fractures but larger samples are required.
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