Development of a model for the differential diagnosis of community-acquired bacterial pneumonia and viral lung injury in hospitalized adult patients

Relevance. During and after the COVID-19 pandemic, viruses have become a more common cause of pulmonary infections in adults; therefore, the distinction between viral lung injury and community-acquired bacterial pneumonia is of increasing importance. Aim. Development of a model for differentiating community-acquired bacterial pneumonia and viral lung injury, including COVID-19. Materials and methods. This retrospective case–control study included 300 adult patients with viral lung injury and 100 adult patients with community-acquired bacterial pneumonia. Clinical, laboratory, and instrumental data were analyzed, significant factors were selected by which the samples differed, and a model was developed using logistic regression to distinguish between community-acquired bacterial pneumonia and viral lung damage, including COVID-19. Results. The developed model included the following parameters: total protein level, neutrophil/lymphocyte index, heart rate, unilateral infiltration on CT or chest x-ray, vasopressor prescription in the first 24 h of hospitalization, altered level of consciousness, chills, and fatigue. The model had the following characteristics: AUC = 0.94 (0.92–0.96), AUC_PR = 0.84 (0.76 to 0.92), prediction accuracy — 90%, sensitivity — 76%, specificity — 95%, positive predictive value — 83 %. Conclusion. The use of this model can facilitate the differential diagnosis of community-acquired bacterial pneumonia and viral lung injury, including COVID-19, in adults in general wards and intensive care units

Remote electrocardiogram monitoring in cancer patients for detecting cardiotoxicity. Case report

Cardiotoxicity is the direct adverse effect of anticancer agents on the function or structure of the heart, occurring both during treatment and many years later. The manifestations of cardiotoxicity can be very different: heart failure, coronary heart disease, cardiomyopathy, myocarditis, pericarditis, and arrhythmias, including atrial fibrillation (AF). The incidence of AF in the cancer patient population during therapy is 20–30%. Current options of remote electrocardiogram monitoring ensure the timely detection and treatment of AF in cancer patients, including the administration of anticoagulants. The article presents a clinical case of a 59-year-old patient with squamous cell carcinoma of the lower third of the esophagus after the first course of the TPF polychemotherapy regimen (docetaxel, cisplatin, 5-fluorouracil) with AF detected using a single-channel electrocardiogram monitor in a smartphone case