Since its first outbreak, coronavirus disease 2019 (COVID-19) has led to a great deal of published literature highlighting the short-term determinants of morbidity and mortality. Recently, several ...studies have reported radiological and functional sequelae from 3 months to 1 year among hospitalized COVID-19 survivors; however, long-term (more than 1 year) respiratory consequences in this population remain to be evaluated.
To assess the long-term radiological and pulmonary function outcomes of patients with COVID-19 2 years after resolution of the initial infection.
Hospitalized COVID-19 patients with moderate to severe disease who survived acute illness were included in this prospective and partially retrospective study. Clinical assessment, laboratory tests, high-resolution computed tomography scans, and pulmonary function tests (PFTs) were performed at baseline, followed by radiological and lung function assessments at 6 and 24 months.
Among 106 enrolled participants (mean age 62 ± 13.5 years; males: 61), 44 (41.5%) and 27 (25.4%) underwent radiological assessment at 6 and 24 months, respectively. Overall, 22.6% (24) of patients had residual radiological abnormalities. Overt fibrosis was observed in 12.2% of patients. Computed tomography disease severity and extent diminished significantly at 6 (13 ± 6,
< 0.001) and 24 months (11 ± 6,
< 0.001) from baseline. PFTs were performed in 65 (61.3%), 22 (20.7%), and 34 (32%) patients at baseline, 6 and 24 months, respectively. Impaired diffusion capacity (median diffusion capacity for carbon monoxide: 60%, interquartile range IQR: 51-80), restrictive lung defect (mean total lung capacity: 73.4% ± 18% predicted), and reduced exercise tolerance (median 6-min walk distance: 360 m, IQR: 210-400) were the predominant features at baseline. With the exception of exercise tolerance, a statistically significant improvement was observed in lung function parameters at the extended follow-up (2 years).
Hospitalized COVID-19 survivors are at increased risk of developing long-term pulmonary complications, including lung fibrosis. A protocol-based approach to the management of post-COVID-19 patients is mandatory to improve future outcomes.
Background: Portable radiography machines are excellent diagnostic tools, but prolonged exposure to X-rays can damage tissue. The most severe concerns include increased cancer risk, cataract ...development, and fetal harm in pregnant workers. This study investigates whether healthcare personnel in the emergency department (ED) are exposed to X-ray ionizing radiation in excess of the National council on radiation protection and measurements limit.
Methods: A 5-month prospective cohort study was conducted. The sample population included healthcare professionals in the ED at King Abdulaziz Medical City, Saudi Arabia. All physicians and nurses were requested to wear thermoluminescent dosimeter (TLD) monitors while working in the ED. TLD monitors worn by consultants, residents, and nurses were assessed at the end of the study.
Results: Sixty-one participants met the inclusion criteria, and two TLDs served as controls to quantify natural background radiation levels. One of the 61 participants measured 0.1 mSv, and the rest measured lower, indicating that the average radiation dose to health professionals in the ED, such as consultants, residents, and charge nurses, is below 0.1 mSv. A total of 9,327 X-ray examinations were conducted by the participants, most
commonly of the chest, followed by the pelvis.
Conclusion: Radiation exposure is not a major occupational concern, even during peak ED hours. The degree of radiation exposure measured in this study was far below the minimum permissible exposure level for ED staff. Therefore, additional protective equipment or individual surveillance with dosimeters appears unnecessary.
To determine compliance rates and characteristics and to investigate factors affecting patients' adherence to treatment with anti-vascular endothelial growth factors (anti-VEGFs) for diabetic macular ...edema (DME) in a cohort of Jordanian patients.
A retrospective case series wherein the files of DME patients treated with anti-VEGFs were reviewed and analyzed for factors affecting treatment compliance was undertaken. Demographic, clinical and ocular characteristics were recorded. All patients were also interviewed by phone using a structured questionnaire. Univariate and multivariate analyses were performed to determine factors associated with compliance.
A total of 117 patients (65 males 52 females) were included in this study with a mean age of 62.93 years (±9.75). Approximately, 85% of patients were compliant to their treatment and follow-up plan during the first year of management. Subjective perception of visual improvement after receiving three loading doses was the only independent variable with a unique statistically significant contribution to compliance. All other studied factors in this group of patients were not significantly associated with patient compliance.
VEGF suppression via the intravitreal route to treat DME is a long-term process that requires caregiver dedication but also proper patient compliance. Addressing real-life barriers in those patients may help guide future strategies to improve the treatment experience, lower the financial burden and contribute to better outcomes. Patients' perceptions of possible treatment outcomes at the short term may influence their long-term commitment to therapy.
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