Aim
To evaluate the clinical factors associated with false‐negative RT‐PCR results and to report the outcome of a cohort of pregnant women with COVID‐19.
Methods
This cohort study was conducted in a tertiary referral pandemic hospital and included 56 pregnant women. A study including pregnant women with either a laboratory or clinical diagnosis for COVID‐19 were included in the study. The primary outcome was clinical factors associated with false‐negative RT‐PCR results defined as a positive immunoglobulin M assessed by rapid testing in clinically diagnosed patients. Clinical outcomes of laboratory diagnosed patients were also reported.
Results
In total, 56 women with either RT‐PCR or clinical COVID‐19 diagnosis were included in the study. Forty‐three women either had RT‐PCR positivity or IgM positivity. The clinical outcome of these pregnancies was as follows: mean maternal age 27.7, immunoglobulin M positive patients 76.7%, RT‐PCR positive patients 55.8%, maternal comorbidities 11.5%, complications in patients below 20 weeks 34.8%, complications in patients above 20 weeks 65.1%, elevated CRP 83.7%, lymphopenia 30.2%, time from hospital admission to final follow‐up days 37 and stillbirth 8.3%. The proportion of women who tested positive for SARS‐CoV‐2 immunoglobulin M was 100% in the RT‐PCR positive group and 56.5% in the clinical diagnosis group (
P
= .002). The symptom onset to RT‐PCR testing interval longer than a week (risk ratio: 2.72, 95% CI: 1.14‐5.40,
P
= .003) and presence of dyspnoea (risk ratio: 0.38, 95% CI: 0.14‐0.89,
P
= .035) were associated with false‐negative RT‐PCR tests. The area under the curve of these parameters predicting false‐negative RT‐PCR was 0.73 (95% CI: 0.57‐0.89).
Conclusions
Symptomatic women with a negative RT‐PCR should not be dismissed as potential COVID‐19 patients, especially in the presence of prolonged symptom onset‐test interval and in women without dyspnoea.
Excessive surgical removal or traumatic loss of the tissues supporting the nasal roof can result in the "saddle nose" deformity. It involves both cartilage and bone deficiencies. Two main resources are used to reconstruct this difficult deformity: autogenous bone and cartilage grafts and alloplastic materials. This study presents the reconstruction of the dorsum, septum, internal nasal valve, and anterior structures and the tip of the nose using a block of molded autogenous bone graft. We called it the "sail graft," because it looks like a sail from a lateral view. The mast of the sail is oriented in a superior-to-inferior direction, beginning in the frontonasal region to the tip of the nose to form a straight, well-rounded dorsum. The longest postoperative follow-up of 13 cases is now 10 years; the median follow-up is 2 years. The results have been satisfactory.
The aim of this study was to compare anatomical and audiological results of boomerang-shaped chondroperichondrial graft (BSCPG) with temporal muscle fascia in type 1 tympanoplasties. Sixty-eight patients in BSCPG group and 54 patients in fascia group were evaluated. Otomicroscopic examination was done periodically till 24 months as for graft perforation, lateralization and retraction and mean air conduction threshold and airbone gap values were measured. At long term controls, in BSCPG group, rates of neomembrane, perforation, retraction and lateralization were 91.17 % (n = 62), 8.82 % (n = 6), 4.41 % (n = 3) and 0 % (n = 0), respectively. In fascia group, the corresponding rates were 79.62 % (n = 43), 20.37 % (n = 11), 12.96 % (n = 7) and 3.7 % (n = 2), respectively. In both groups, mean postoperative PTA and ABG values were significantly better while postoperative same values were significantly different between groups (p = 0.044 and 0.032, respectively). Compared to fascia, BSCPG is an ideal grafting technique in the repair of tympanic membrane perforations.
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