7 research outputs found
Corrigendum: Post-COVID-19 interstitial lung disease: Insights from a machine learning radiographic model
Post-COVID-19 interstitial lung disease: Insights from a machine learning radiographic model
IntroductionPost-acute sequelae of COVID-19 seem to be an emerging global crisis. Machine learning radiographic models have great potential for meticulous evaluation of post-COVID-19 interstitial lung disease (ILD).MethodsIn this multicenter, retrospective study, we included consecutive patients that had been evaluated 3 months following severe acute respiratory syndrome coronavirus 2 infection between 01/02/2021 and 12/5/2022. High-resolution computed tomography was evaluated through Imbio Lung Texture Analysis 2.1.ResultsTwo hundred thirty-two (n = 232) patients were analyzed. FVC% predicted was ≥80, between 60 and 79 and <60 in 74.2% (n = 172), 21.1% (n = 49), and 4.7% (n = 11) of the cohort, respectively. DLCO% predicted was ≥80, between 60 and 79 and <60 in 69.4% (n = 161), 15.5% (n = 36), and 15.1% (n = 35), respectively. Extent of ground glass opacities was ≥30% in 4.3% of patients (n = 10), between 5 and 29% in 48.7% of patients (n = 113) and <5% in 47.0% of patients (n = 109). The extent of reticulation was ≥30%, 5–29% and <5% in 1.3% (n = 3), 24.1% (n = 56), and 74.6% (n = 173) of the cohort, respectively. Patients (n = 13, 5.6%) with fibrotic lung disease and persistent functional impairment at the 6-month follow-up received antifibrotics and presented with an absolute change of +10.3 (p = 0.01) and +14.6 (p = 0.01) in FVC% predicted at 3 and 6 months after the initiation of antifibrotic.ConclusionPost-COVID-19-ILD represents an emerging entity. A substantial minority of patients presents with fibrotic lung disease and might experience benefit from antifibrotic initiation at the time point that fibrotic-like changes are “immature.” Machine learning radiographic models could be of major significance for accurate radiographic evaluation and subsequently for the guidance of therapeutic approaches
Lower respiratory tract infections treatment recommendations: An overview
Lower respiratory tract infections represent one of the main causes of
morbidity and mortality worldwide and yield a major effect on healthcarerelated
expenditures. The clinical and economic burden of respiratory
infections was highlighted during COVID-19 pandemic. Importantly, the
COVID-19 pandemic demonstrated that irrational use of antibiotics might not
only be ineffective but also lead to adverse events. During the first years of
the pandemic, the incidence of other respiratory infections fell dramatically;
yet, the last months have seen the emergence of the well-known respiratory
infections of the past, again. This article aims to highlight current evidence for
the management of lower respiratory infections, including COVID-19
Pulmonary embolism and abdominal pain in a young patient: A case report of a rare clinical entity
A 20-year-old man with reduced mobility, from a car accident, presented to
the Emergency Department of our hospital due to progressive dyspnea and
heart palpitations the lasted three days. A bedside cardiac ultrasound and
a Computed Tomography Pulmonary Angiogram (CTPA) were immediately
performed, revealing strain of the right ventricle and pulmonary embolism (PE).
The patient subsequently complained about abdominal pain and a Computed
Tomography of the Abdominal Aorta (CTAO) revealed arterial embolism in the
renal and splenic circulations, along with the right common femoral artery.
Phlebography of inferior limbs exhibited deep vein thrombosis in the left
popliteal vein. A percutaneous suction thrombectomy had been performed
successfully.
The patient underwent a transesophageal echocardiography with agitated
saline test that revealed a patent foramen ovale (PFO), a diagnosis which
explained the paradoxical embolism in both arterial and venous circulations.
Paradoxical embolism is quite uncommon and should not be ignored in cases
with indications of arterial embolism after PE
Clinical features and outcomes of patients with myositis associated-interstitial lung disease
Safety and Effectiveness of Mycophenolate Mofetil in Interstitial Lung Diseases: Insights from a Machine Learning Radiographic Model
Introduction: Treatment of interstitial lung diseases (ILDs) other than
idiopathic pulmonary fibrosis (IPF) often includes systemic
corticosteroids. Use of steroid-sparing agents is amenable to avoid
potential side effects.
Methods: Functional indices and high-resolution computed tomography
(HRCT) patterns of patients with non-IPF ILDs receiving mycophenolate
mofetil (MMF) with a minimum follow-up of 1 year were analyzed. Two
independent radiologists and a machine learning software system (Imbio
1.4.2.) evaluated HRCT patterns.
Results: Fifty-five (n = 55) patients were included in the analysis
(male: 30 [55%], median age: 65.0 [95% CI: 59.7-70.0], mean forced
vital capacity %predicted [FVC %pred.] +/- standard deviation
[SD]: 69.4 +/- 18.3, mean diffusing capacity of lung for carbon
monoxide %pred. +/- SD: 40.8 +/- 14.3, hypersensitivity pneumonitis:
26, connective tissue disease-ILDs [CTD-ILDs]: 22, other ILDs: 7).
There was no significant difference in mean FVC %pred. post-6 months
(1.59 +/- 2.04) and 1 year (-0.39 +/- 2.49) of treatment compared to
baseline. Radiographic evaluation showed no significant difference
between baseline and post-1 year %ground glass opacities (20.0 [95%
CI: 14.4-30.0] vs. 20.0 [95% CI: 14.4-25.6]) and %reticulation (5.0
[95% CI: 2.0-15.6] vs. 7.5 [95% CI: 2.0-17.5]). A similar
performance between expert radiologists and Imbio software analysis was
observed in assessing ground glass opacities (intraclass correlation
coefficient [ICC] = 0.73) and reticulation (ICC = 0.88). Fourteen
patients (25.5%) reported at least one side effect and 8 patients
(14.5%) switched to antifibrotics due to disease progression.
Conclusion: Our data suggest that MMF is a safe and effective
steroid-sparing agent leading to disease stabilization in a proportion
of patients with non-IPF ILDs. Machine learning software systems may
exhibit similar performance to specialist radiologists and represent
fruitful diagnostic and prognostic tools