ObjectivesThe present research was motivated by providing new insight into early pregnancies with a chorionic bump diagnosis in first-trimester sonography and its impact on live birth rate.MethodsTo determine the rate of CB, first trimester sonograms of pregnant women referring to Akbarabadi Hospital, which is a treatment and training center affiliated to Iran University of Medical Sciences as well as those referring to a private center were analyzed. The total number of transvaginal sonographies performed was 1900 cases from whom 8 cases of CB were detected. The chorionic bump size and number and history of infertility or coagulation disorders were considered as our independent variables and multiple gestation with pregnancy outcome as dependent ones.ResultsOverall, the prevalence rate of CB was 0.4% (4 per 1000), with 8 patients diagnosed with CB from 1900 the first trimester pregnant women. Of 8 pregnant women, 5 showed live birth (62.5%) and 3 experienced fetal demise (37.5%). The chorionic bumps ranged in size from 0.1 cc to 1.8 cc (average, 0.73 cc). No significant relationship was found between history of smoking, coagulopathy, infertility, multiple gestation and the size of CB.ConclusionsThe main finding was that the frequency of live birth in our sample was 62.5% (5 from 8). The clinical inference is that a chorionic bump on first-trimester sonography does not definitely guarantee a secure prediction. The correlation between bump size and pregnancy outcome is not clear, which warrants further research.
Background:Acute myeloid leukemia (AML) is the most common type of leukemia. In this study, outcome of intensive chemotherapy in patients treated in a large urban public university hospital in a developing country was investigated.Materials and Methods:The records of all patients treated for AML with 3 + 7 protocol from 2002 to 2010 were analyzed.Results:Among 95 patients, 34 (35.8%) were female and 61 (64.2%) were male patients. Patients’ median age was 37 years, ranging 15-68 years. Complete remission (CR) was observed in 56 (58.9%) of patients treated with this protocol. Median overall survival was 13 months (95% CI: 8.8-17.1 months). The 1-year AML survival rate was 51%, and 2-year survival rate was 26%.Conclusion:Our study shows that in our center in Iran, CR rates and median overall survival rates after induction chemotherapy are less than developed countries.
Background Lung involvement in COVID-19 can be quantified by chest CT scan with some triage and prognostication value. Optimizing initial triage of patients could help decrease adverse health impacts of the disease through better clinical management. At least 6 CT severity score (CTSS) systems have been proposed. We aimed to evaluate triage and prognostication performance of seven different CTSSs, including one proposed by ourselves, in hospitalized COVID-19 patients diagnosed by positive polymerase chain reaction (PCR). Results After exclusion of 14 heart failure and significant preexisting pulmonary disease patients, 96 COVID-19, PCR-positive patients were included into our retrospective study, admitted from February 20, 2020, to July 22. Their mean age was 63.6 ± 17.4 years (range 21–88, median 67). Fifty-seven (59.4%) were men, and 39 (40.6%) were women. All CTSSs showed good interrater reliability as calculated intraclass correlation coefficients (ICCs) between two radiologists were 0.764–0.837. Those CTSSs with more numerous segmentations showed the best ICCs. As judged by area under curve (AUC) for each receiver operator characteristic (ROC) curve, only three CTSSs showed acceptable AUCs (AUC = 0.7) for triage of severe/critical patients. All CTSSs showed acceptable AUCs for prognostication (AUCs = 0.76–0.79). Calculated AUCs for different CTSSs were not significantly different for triage and for prediction of severe/critical disease, but some difference was shown for prediction of critical disease. Conclusions Men are probably affected more frequently than women by COVID-19. Quantification of lung disease in COVID-19 is a readily available and easy tool to be used in triage and prognostication, but we do not advocate its use in heart failure or chronic respiratory disease patients. The scoring systems with more numerous segmentations are recommended if any future imaging for comparison is contemplated. CTSS performance in triage was much lower than earlier reports, and only three CTSSs showed acceptable AUCs in this regard. CTSS performed better for prognostic purposes than for triage as all 7 CTSSs showed acceptable AUCs in both types of prognostic ROC curves. There is not much difference among performance of different CTSSs.
This study uses image analysis techniques for comparative analysis of the lung HRCT features and RT-PCR of 325 suspected patients to COVID-19 pneumonia. Our findings propose more caution in the interpretation of RT-PCR data, promoting, instead, also the quantification of age and sex-based risk factors using HRCT images. Statistical analysis of our methodology reveals a direct relation between intensity, skewness and kurtosis of the radiological features and the gender of patients. Moreover, we investigate the effect of the age of patients on the appearance of COVID-19 pneumonia in the HRCT images. We have also applied our methodology to investigate the effect of time on the severity of COVID-19 pneumonia within the lungs. Subsequently, we find a strong relationship between image analysis and the informed medical diagnosis asserted by the radiologists. Additionally, our results also indicate increase in the severity of lung infection in the first and second week after the onset of the SARS-CoV-2 symptoms. Thereafter, a gradual decrease in the lung damage is observed during the third week. The proposed image analysis methodology can be used as a simple complementary tool for infectious disease diagnostics as demonstrated in this study with an example of SARS-CoV-2 to provide better understanding of the disease for drug and vaccine development.
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