Correlation between severity of pulmonary embolism and obstructive sleep apnea using computed tomography pulmonary artery obstruction index and right ventricular to left ventricular diameter ratio as severity indices

Abstract Background Recent studies have shown a bidirectional association between pulmonary embolism (PE) and obstructive sleep apnea (OSA), and due to their morbidity and mortality, this contributes significantly to the global health-care burden, so this study aims to assess the relationship between PE and OSA severity using the obstruction index of the pulmonary artery and the ratio of right ventricular to left ventricular (RV/LV) diameter as severity indices. Results The study comprised 138 patients with a high clinical suspicion of PE that was verified by computed tomography pulmonary angiography. In addition to calculating the RV/LV diameter ratio and pulmonary artery obstruction index (PAOI), the pulmonary embolism severity index was also calculated, and the Epworth Sleepiness Scale and polysomnography (PSG) were used to assess all patients for OSA. Finally, three groups of patients ( 50%) were created based on the PAOI. Age, gender, neck, and waist circumference showed no significant difference between the three groups, but there were significant correlations between higher PAOI and increased BMI, provoked PE, increased rate of thrombolysis, increase in the recurrence of venous thrombosis, a longer length of hospital stay, and a higher ratio of RV/LV diameter (p value was  40%, and the ratio of RV/LV diameter > 1 being found to be predictors of severe sleep apnea. Conclusions We deduced from this study that there is a substantial relationship between the severity of PE and the severity of OSA, as patients with higher obstruction of the pulmonary artery had severe OSA, and both the obstruction index of the pulmonary artery > 40% and the ratio of RV/LV diameter > 1 were considered significant predictors for the severity of OSA among the acute PE patients

Relation of high resolution pulmonary CT findings and clinical condition of COVID-19 patients

Introduction: At present, chest computed tomography (CT) is accepted as a tool for assessment COVID-19 patients. However, there are few data about the relationship between initial imaging results at presentation and the presence of systemic inflamma-tory mediators and outcome in patients with COVID-19. The aim of study is to evaluate the relation of initial high resolution com-puted tomography (HRCT) chest findings to inflammatory indices and clinical course of COVID-19 patients during hospitalization. Material and methods: This is a retrospective cohort study carried out on 108 confirmed COVID-19 patients. Demographic, lab-oratory and radiological data were recorded from patients medical records. Based on predominant HRCT density, patients were classified into either normal, ground glass opacity (GGO) and consolidation groups. By HRCT score, patients were classified into either no infilteration, ≤ 50% infilteration and > 50% infilteration groups. Comparison between clinical and laboratory parameters were observed among the groups.Results: More hypoxemia, higher inflammatory indices (CRP, d-dimer, ferritin), more requirement of ventilatory support and more mortality rate were observed in consolidation group compared to GGO (p < 0.05) and in patients with HRCT score > 50% compared to ≤ 50% infilteration group (p < 0.05). Conclusions: Consolidation pattern and high CT chest quantitative score are associated with elevated inflammatory indices and poor outcome in COVID-19 patients. HRCT chest can be used for risk stratification of COVID-19 patients

Relation of High Resolution Pulmonary CT Findings and Clinical Condition of COVID-19 Patients

Introduction: At present, chest computed tomography (CT) is accepted as a tool for assessment COVID-19 patients. However, there are few data about the relationship between initial imaging results at presentation and the presence of systemic inflammatory mediators and outcome in patients with COVID-19. The aim of study is to evaluate the relation of initial high resolution com-puted tomography (HRCT) chest findings to inflammatory indices and clinical course of COVID-19 patients during hospitalization. Material and Methods: This is a retrospective cohort study carried out on 108 confirmed COVID-19 patients. Demographic, laboratory and radiological data were recorded from patients medical records. Based on predominant HRCT density, patients were classified into either normal, ground glass opacity (GGO) and consolidation groups. By HRCT score, patients were classified into either no infilteration, ≤50% infilteration and >50% infilteration groups. Comparison between clinical and laboratory parameters were observed among the groups. Results: More hypoxemia, higher inflammatory indices (CRP, d-dimer, ferritin), more requirement of ventilatory support and more mortality rate were observed in consolidation group compared to GGO (p < 0.05) and in patients with HRCT score > 50% compared to ≤50% infilteration group (p < 0.05). Conclusions: Consolidation pattern and high CT chest quantitative score are associated with elevated inflammatory indices and poor outcome in COVID-19 patients. HRCT chest can be used for risk stratification of COVID-19 patients

The impact of cyclooxygenase-2 gene polymorphism 899G/C and certain indices on hepatitis C related liver fibrosis

The link between cyclooxygenase-2 (COX-2) gene polymorphisms and liver diseases has been widely reported. Early and precise estimation and staging of hepatic fibrosis are crucial for prognosis and treatment decisions in those patients. We aimed in this study to clarify role of -899G/C polymorphism of COX-2 gene, alteration of CA 19-9 and CA 125 levels, and plasma protein pattern in staging of liver fibrosis comparing them to METAVIR stages of liver fibrosis. We recruited 103 patients with post-hepatitis C liver fibrosis and 42 healthy controls. COX-2 gene polymorphism was detected by PCR- TaqMan probes, while CA19-9, CA125 levels were estimated using quantitative ELISA. Plasma proteins were detected by the capillary electrophoresis method. The results revealed that the frequency of COX-2 -899G/C genotypes GG, GC, and CC were 68.0%, 28.2% and 3.9% in the fibrotic group; 97.06%, 2.4%, and 0.0% in healthy control group respectively. The percent of COX-2 expression for the fibrotic group and the healthy group were 32% and 2.3% respectively. COX-2 expression scores on mild- vs. sever-fibrosis stages (METAVIR stages 1, 2 vs. stages 3,4) were 18.2 %and 81.8% respectively (OR=48.00, 95%CI). The serum level of tested tumor markers were significantly higher in fibrotic patients than in control group (69.40 ±51.82, 13.41 ± 6.49 respectively for CA 19.9 and 59.16 ± 47.23, 10.90 ± 8.36 for CA 125) and in GC/CC genotypes than GG one (116.96 ± 55.00, 33.64 ± 28.39 respectively for CA 19.9 and 101.62 ± 51.29, 27.89 ± 25.51 respectively for CA 125). In conclusion, COX-2 -899 C allele carriers are more vulnerable to develop hepatitis C- related hepatic fibrosis. The combined estimation of CA 19-9 and CA 125 levels are useful for identifying and staging patients with liver fibrosis.Keywords: COX-2 gene polymorphisms, CA 19-9, CA 125, protein electrophoresis, liver fibrosi