Incidental Findings of COVID-19 Pneumonia in Chest CT scan of Trauma Patients; a Case Series

Introduction: COVID-19 is an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a strain of coronavirus. The first cases were reported in Wuhan, China, in December 2019, later was officially recognized as a pandemic on March 11th, 2020. Case presentation: Here we report five trauma cases admitted to our hospital, not for COVID-19 related symptoms, but chest computed tomography (CT) scan findings were suspicious of COVID-19 infection. Real-time reverse-transcription polymerase chain reaction (RT-PCR) assays for COVID-19 were reported as positive in these cases. Conclusion: COVID-19 usually manifests with mild respiratory and constitutional symptoms, even some cases are asymptomatic

Incidental Findings of COVID-19 Pneumonia in Chest CT scan of Trauma Patients; a Case Series

Introduction: COVID-19 is an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a strain of coronavirus. The first cases were reported in Wuhan, China, in December 2019, later was officially recognized as a pandemic on March 11th, 2020. Case presentation: Here we report five trauma cases admitted to our hospital, not for COVID-19 related symptoms, but chest computed tomography (CT) scan findings were suspicious of COVID-19 infection. Real-time reverse-transcription polymerase chain reaction (RT-PCR) assays for COVID-19 were reported as positive in these cases. Conclusion: COVID-19 usually manifests with mild respiratory and constitutional symptoms, even some cases are asymptomatic

Phantom Tumor of the Lung

Background: Localized interlobar effusions in congestive heart failure (phantom or vanishing lung tumor/s) are uncommon but well-known entities.Case Report: The patient is a 60-year-old male with a history of dyspnea and surgical removal of kidney stonein 1 year ago.Results: In chest-X-ray prior to the surgery an olive-shaped homogenous density, with a size of 30 mm × 20 mm in the right lung have been detected. Computed tomography (CT) scan has been performed, and a homogenous mass with a well-delineated border in major fissure of the right lung and mediastinal lymphadenopathy had been detected. Serial CT scans revealed mass enlargement. In Ct guided, Transthoracic biopsy fluid collection along the major fissure of the right lung had been detected. Biopsy of mediastinal lymph node silicoanthracotic changes with focal hyaline fibrosis had been shown.Conclusions: The diagnosis of the phantom tumor must be considered in any patient with congestive heart failure and lung mass. In this patient, there was no history of congestive heart failure which shows that phantom tumor could happen in non-chronic heart failure patients. Although the accurate diagnosis of the phantom tumor with imaging modalities in patients without congestive heart failure is very difficult but at least this diagnosis must be considered in a patient with a lung mass in the major fissure of the lungs

The clinical significance of biliary findings in magnetic resonance enterography of patients with inflammatory bowel disease

Purpose: Given the association of inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC), we aimed to investigate the clinical relevance of abnormal hepatobiliary findings on magnetic resonance enterography (MRE) of IBD patients considering the risk of over- or underestimation of PSC at MRE. Material and methods: Using the MRE dataset of patients referring to a tertiary hospital and the National Registry of Crohn’s and Colitis, 69 MREs, including 23 IBD-PSC, 23 IBD-without PSC, and 23 healthy controls (HC), were retrospectively reviewed by 2 experienced radiologists blinded to the clinical data, to evaluate hepatobiliary abnormalities. Sensitivity, specificity, and likelihood ratios were calculated. Results: Bile duct irregularities were the most common finding in the IBD-PSC group, with a frequency of 91%. Intra- and extrahepatic bile duct (IHBD and EHBD) irregularities were observed in 87% and 78% of PSC patients, respectively. Higher frequency of IHBD and EHBD wall thickening, bile duct dilation, EHBD stricture, and periportal oedema were observed in the IBD-PSC group. Peribiliary T2-weighted hyperintensities and contrast-enhancement were significantly more common in the IBD-PSC group than in the IBD and HC groups (48% and 35%, respectively) (p < 0.001). Detection of biliary irregularities on MRE had a specificity of 94% (95% CI: 82-99%), a sensitivity of 91% (95% CI: 72-99%), and a positive likelihood ratio of 14.0 (95% CI: 4.7-42.1) for the diagnosis of PSC. Conclusions: This study emphasizes the importance of assessing and reporting hepatobiliary abnormalities visible in the MRE of patients with IBD to avoid a delayed diagnosis of PSC

Screening COVID-19 Based on CT/CXR Images & Building a Publicly Available CT-scan Dataset of COVID-19

The rapid outbreak of COVID-19 threatens humans life all around the world. Due to insufficient diagnostic infrastructures, developing an accurate, efficient, inexpensive, and quick diagnostic tool is of great importance. As chest radiography, such as chest X-ray (CXR) and CT computed tomography (CT), is a possible way for screening COVID-19, developing an automatic image classification tool is immensely helpful for detecting the patients with COVID-19. To date, researchers have proposed several different screening methods; however, none of them could achieve a reliable and highly sensitive performance yet. The main drawbacks of current methods are the lack of having enough training data, low generalization performance, and a high rate of false-positive detection. To tackle such limitations, this study firstly builds a large-size publicly available CT-scan dataset, consisting of more than 13k CT-images of more than 1000 individuals, in which 8k images are taken from 500 patients infected with COVID-19. Secondly, we propose a deep learning model for screening COVID-19 using our proposed CT dataset and report the baseline results. Finally, we extend the proposed CT model for screening COVID-19 from CXR images using a transfer learning approach. The experimental results show that the proposed CT and CXR methods achieve the AUC scores of 0.886 and 0.984 respectively

Diagnostic Accuracy of Age and Alarm Symptoms for Upper GI Malignancy in Patients with Dyspepsia in a GI Clinic: A 7-Year Cross-Sectional Study

<div><h3>Objectives</h3><p>We investigated whether using demographic characteristics and alarm symptoms can accurately predict cancer in patients with dyspepsia in Iran, where upper GI cancers and <em>H. pylori</em> infection are common.</p> <h3>Methods</h3><p>All consecutive patients referred to a tertiary gastroenterology clinic in Tehran, Iran, from 2002 to 2009 were invited to participate in this study. Each patient completed a standard questionnaire and underwent upper gastrointestinal endoscopy. Alarm symptoms included in the questionnaire were weight loss, dysphagia, GI bleeding, and persistent vomiting. We used logistic regression models to estimate the diagnostic value of each variable in combination with other ones, and to develop a risk-prediction model.</p> <h3>Results</h3><p>A total of 2,847 patients with dyspepsia participated in this study, of whom 87 (3.1%) had upper GI malignancy. Patients reporting at least one of the alarm symptoms constituted 66.7% of cancer patients compared to 38.9% in patients without cancer (p<0.001). Esophageal or gastric cancers in patients with dyspepsia was associated with older age, being male, and symptoms of weight loss and vomiting. Each single predictor had low sensitivity and specificity. Using a combination of age, alarm symptoms, and smoking, we built a risk-prediction model that distinguished between high-risk and low-risk individuals with an area under the ROC curve of 0.85 and acceptable calibration.</p> <h3>Conclusions</h3><p>None of the predictors demonstrated high diagnostic accuracy. While our risk-prediction model had reasonable accuracy, some cancer cases would have remained undiagnosed. Therefore, where available, low cost endoscopy may be preferable for dyspeptic older patient or those with history of weight loss.</p> </div

Five Common Cancers in Iran

Iran as a developing nation is in epidemiological transition from communicable to non-communicable diseases. Although, cancer is the third cause of death in Iran, ifs mortality are on the rise during recent decades. This mini-review was carried out to provide a general viewpoint on common cancers incidence in Iran and to explain incidental differences that may help us to establish early detection programs and investigate population risk factors. A detailed Pub Med, Scopus and Google scholar search were made from 2000 to 2009. The basic inclusion criteria were all relevant studies focused on cancer epidemiological data from Iran. Overall age-standard incidence rate per 100,000 population according to primary site is 110.43 in males and 98.23 in females. The five most common cancers (except skin cancer) are stomach, esophagus, colon-rectum, bladder and leukemia in males, and in females are breast, esophagus, stomach, colon-rectum and cervix uteri. The incidence rates of gastrointestinal cancers are high in Iran (it is one of the known areas with a high incidence of GI cancers). Breast cancer mainly affects Iranian women about a decade earlier than Western countries and younger cases are affected by an increasing rate of colorectal cancer in Iran, near the Western rates

Diffuse Large B Cell Lymphoma of the Rectosigmoid Junction:

Primary colorectal lymphoma (PCL) is a rare condition that accounts for a small percentage of all gastrointestinal (GI) malignancies. There are several reports in the literature regarding the most common features of PCL. However, primary lymphoma in the rectosigmoid junction has been rarely reported. Our case was a 67-year-old male who presented with non-specific symptoms of bowel obstruction which, upon further workup, was diagnosed as a rare case of PCL located in the rectosigmoid junction