Purpose
To improve the risk stratification of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an experimental chest X-ray (CXR) scoring system for quantifying ...lung abnormalities was introduced in our Diagnostic Imaging Department. The purpose of this study was to retrospectively evaluate correlations between the CXR score and the age or sex of Italian patients infected with SARS-CoV-2.
Materials and methods
Between March 4, 2020, and March 18, 2020, all CXR reports containing the new scoring system were retrieved. Only hospitalized patients with SARS-CoV-2 infection were enrolled. For each patient, age, sex, and the CXR report containing the highest score were considered for the analysis. Patients were also divided into seven groups according to age. Nonparametric statistical tests were used to examine the relationship between the severity of lung disease and the age or sex.
Results
783 Italian patients (532 males and 251 females) with SARS-CoV-2 infection were enrolled. The CXR score was significantly higher in males than in females only in groups aged 50 to 79 years. A significant correlation was observed between the CXR score and age in both males and females. Males aged 50 years or older and females aged 80 years or older with coronavirus disease 2019 showed the highest CXR score (median ≥ 8).
Conclusions
Males aged 50 years or older and females aged 80 years or older showed the highest risk of developing severe lung disease. Our results may help to identify the highest-risk patients and those who require specific treatment strategies.
•Brixia score is a new chest X-ray scoring system designed for COVID-19 pneumonia.•Brixia score, patient age and immunosuppressive conditions predict fatal outcome.•High Brixiascore and at least one ...other predictor confer the highest risk of death.
This study aimed to assess the usefulness of a new chest X-ray scoring system — the Brixia score — to predict the risk of in-hospital mortality in hospitalized patients with coronavirus disease 2019 (COVID-19).
Between March 4, 2020 and March 24, 2020, all CXR reports including the Brixia score were retrieved. We enrolled only hospitalized Caucasian patients with COVID-19 for whom the final outcome was available. For each patient, age, sex, underlying comorbidities, immunosuppressive therapies, and the CXR report containing the highest score were considered for analysis. These independent variables were analyzed using a multivariable logistic regression model to extract the predictive factors for in-hospital mortality.
302 Caucasian patients who were hospitalized for COVID-19 were enrolled. In the multivariable logistic regression model, only Brixia score, patient age, and conditions that induced immunosuppression were the significant predictive factors for in-hospital mortality. According to receiver operating characteristic curve analyses, the optimal cutoff values for Brixia score and patient age were 8 points and 71 years, respectively. Three different models that included the Brixia score showed excellent predictive power.
Patients with a high Brixia score and at least one other predictive factor had the highest risk of in-hospital death.
The purpose of this study was to compare the prognostic value of chest X-ray (CXR) and chest computed tomography (CT) in a group of hospitalized patients with COVID-19. For this study, we ...retrospectively selected a cohort of 106 hospitalized patients with COVID-19 who underwent both CXR and chest CT at admission. For each patient, the pulmonary involvement was ranked by applying the
Brixia
score for CXR and the percentage of well-aerated lung (WAL) for CT. The
Brixia
score was assigned at admission (A-
Brixia
score) and during hospitalization. During hospitalization, only the highest score (H-
Brixia
score) was considered. At admission, the percentage of WAL (A-CT%WAL) was quantified using a dedicated software. On logistic regression analyses, H-
Brixia
score was the most effective radiological marker for predicting in-hospital mortality and invasive mechanical ventilation. Additionally, A-CT%WAL did not provide substantial advantages in the risk stratification of hospitalized patients with COVID-19 compared to A-
Brixia
score.
The much-heralded second wave of coronavirus disease (COVID-19) has arrived in Italy. Right now, one of the main questions about COVID-19 is whether the second wave is less severe and deadly than the ...first wave. In order to answer this challenging question, we decided to evaluate the chest X-ray (CXR) severity of COVID-19 pneumonia, the mechanical ventilation (MV) use, the patient outcome, and certain clinical/laboratory data during the second wave and compare them with those of the first wave.
During the two COVID-19 waves two independent groups of hospitalised patients were selected. The first group consisted of the first 100 COVID-19 patients admitted to our hospital during the first wave. The second group consisted of another 100 consecutive COVID-19 patients admitted to our hospital during the second wave. We enlisted only Caucasian male patients over the age of fifty for whom the final outcome was available. For each patient, the CXR severity of COVID-19 pneumonia, the MV use, the patient outcome, comorbidities, corticosteroid use, and C-reactive protein (CRP) levels were considered. Nonparametric statistical tests were used to compare the data obtained from the two waves.
The CXR severity of COVID-19 pneumonia, the in-hospital mortality, and CRP levels were significantly higher in the first wave than in the second wave (
≤ .041). Although not statistically significant, the frequency of MV use was higher in the first wave.
This preliminary investigation seems to confirm that the COVID-19 second wave is less severe and deadly than the first wave.
Purpose
To explore the incidence and analyze the morphology of three-rooted maxillary first premolars (MFPs) incidentally detected on cone beam computed tomography (CBCT) scans.
Methods
Of 1328 ...patients who underwent CBCT scans of the maxilla, only patients with three-rooted MFPs were selected. Morphological features, including the lengths and diameters of palatal, mesiobuccal (MB) and distobuccal (DB) roots, the positions of bucco-palatal (B-P) bifurcations, the distances between root canal bifurcations and cementoenamel junctions (CEJs) and the distances between the apical thirds of the roots, were measured. The canal configuration and the visibility of root canals were also evaluated.
Results
A total of 16/1328 (1.2%) patients had one or two three-rooted MFPs, and a total of 22/2656 (0.8%) three-rooted MFPs were enrolled. The lengths and diameters of palatal roots were significantly greater than those of other roots. The positions of B-P bifurcations were located mainly at the middle third of the root. The median distances between root canal bifurcations and CEJs were 3 mm for B-P bifurcations and 5.2 mm for MB–DB bifurcations. The distance between MB and DB roots was significantly shorter than the distances between other root pairs. All teeth had a type VIII canal configuration. Palatal roots exhibited the best visibility of root canals, whereas the worst visibility was observed within DB roots. A gender-related relationship was observed only for the lengths of the roots.
Conclusions
The occurrence of three-rooted MFPs is not unusual; therefore, preoperative CBCT evaluation could be suggested whenever endodontic procedures are planned on an MFP.
The head and neck district represents one of the most frequent sites of cancer, and the percentage of metastases is very high in both loco-regional and distant areas. Prognosis refers to several ...factors: a) stage of disease; b) loco-regional relapses; c) distant metastasis. At diagnosis, distant metastases of head and neck cancers are present in about 10% of cases with an additional 20-30% developing metastases during the course of their disease. Diagnosis of distant metastases is associated with unfavorable prognosis, with a median survival of about 10 months. The aim of the present review is to provide an update on distant metastasis in head and neck oncology. Recent achievements in molecular profiling, interaction between neoplastic tissue and the tumor microenvironment, oligometastatic disease concepts, and the role of immunotherapy have all deeply changed the therapeutic approach and disease control. Firstly, we approach topics such as natural history, epidemiology of distant metastases and relevant pathological and radiological aspects. Focus is then placed on the most relevant clinical aspects; particular attention is reserved to tumours with distant metastasis and positive for EBV and HPV, and the oligometastatic concept. A substantial part of the review is dedicated to different therapeutic approaches. We highlight the role of immunotherapy and the potential effects of innovative technologies. Lastly, we present ethical and clinical perspectives related to frailty in oncological patients and emerging difficulties in sustainable socio-economical governance.
The much-heralded second wave of coronavirus disease (COVID-19) has arrived in Italy. Right now, one of the main questions about COVID-19 is whether the second wave is less severe and deadly than the ...first wave. In order to answer this challenging question, we decided to evaluate the chest X-ray (CXR) severity of COVID-19 pneumonia, the mechanical ventilation (MV) use, the patient outcome, and certain clinical/laboratory data during the second wave and compare them with those of the first wave.
During the two COVID-19 waves two independent groups of hospitalised patients were selected. The first group consisted of the first 100 COVID-19 patients admitted to our hospital during the first wave. The second group consisted of another 100 consecutive COVID-19 patients admitted to our hospital during the second wave. We enlisted only Caucasian male patients over the age of fifty for whom the final outcome was available. For each patient, the CXR severity of COVID-19 pneumonia, the MV use, the patient outcome, comorbidities, corticosteroid use, and C-reactive protein (CRP) levels were considered. Nonparametric statistical tests were used to compare the data obtained from the two waves.
The CXR severity of COVID-19 pneumonia, the in-hospital mortality, and CRP levels were significantly higher in the first wave than in the second wave (p ≤ .041). Although not statistically significant, the frequency of MV use was higher in the first wave.
This preliminary investigation seems to confirm that the COVID-19 second wave is less severe and deadly than the first wave.
An increased risk of contracting HIV infection, suboptimal adherence, and a loss to follow-up have been observed in migrants, particularly if those individuals are transgender or sex workers. A clear ...picture of the HIV epidemic among migrants is complex due to the lack of specific national data.
We developed a qualitative study that describes the barriers and facilitators (cultural, social, and personal) in HIV testing and the continuum of care for a group of migrant transgender women who are sex workers.
A semi-structured interview was conducted with a group of migrant transgender women who are sex workers living with HIV or with unknown HIV serostatus residing in the Florentine metropolitan area.
We included 12 participants: 3 had unknown HIV serostatus and 9 were living with HIV in follow-up at the Clinic of Infectious and Tropical Diseases, Careggi University hospiral, Florence, Italy. Among barriers, the perceived stigma due to their identity as migrants and transgender people, the language lack of ability and the legal position in the host country played a significant role. Moreover, the interviewees claimed having no alternative to sex work: for those individuals, changing their lifestyle condition is perceived as difficult or impossible due to social prejudices. Conversely, the interviewees considered support services, such as cultural mediators/interpreters and street units, as facilitators to HIV testing, access to care, and continuum of care. Having regular and accessible ART and the availability of a more consistent health care system, represent reasons for HIV-positive migrants living with HIV to move to Italy.
Knowledge of this population's personal experience regarding the barriers and factors that facilitate access to the HIV care system is essential for planning public health interventions capable of responding to the real needs of patients.
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