41 research outputs found
COVID-19 pneumonia and the masquerades
During the COVID-19 pandemic, chest CT is frequently used to help with the diagnosis. The classic CT patterns of COVID-19 pneumonia are well-published and recognised among radiologists. However, when there are pre-existing conditions particularly in the elderly population that could mask or result in similar patterns of disease, then the diagnosis is more difficult. This imaging essay highlights the commonly encountered situations including patients with heart failure, other possible infections particularly in the immunodeficient, and when there is trauma to the thorax. We illustrate imaging clues available to the radiologist to either make the diagnosis or at least reduce the differential diagnosi
Сенсибилизация к аллергенам клещей домашней пыли у детей
ДЫХАТЕЛЬНАЯ ГИПЕРЧУВСТВИТЕЛЬНОСТЬАЛЛЕРГОЗЫ РЕСПИРАТОРНЫЕГИПЕРСЕНСИБИЛИЗАЦИЯ РЕСПИРАТОРНАЯРЕСПИРАТОРНАЯ АЛЛЕРГИЯАЛЛЕРГЕНЫКЛЕЩИ ПЫЛЕВЫЕ ДОМАШНИЕDERMATOPHAGOIDES PTERONYSSINUSDERMATOPHAGOIDES FARINAEСЕНСИБИЛИЗАЦИЯ БИОЛОГИЧЕСКАЯСЕНСИБИЛИЗАЦИЯ К АЛЛЕРГЕНАМДЕТИОБЗОР ЛИТЕРАТУРЫАллергические заболевания представляют серьезную проблему современной медицины. Сенсибилизация к ингаляционным аллергенам является одним из ключевых факторов формирования респираторных аллергозов. Среди аэроаллергенов важное значение играют аллергенные компоненты домашней пыли – клещи Dermatophagoides pteronyssinus и Dermatophagoides farinae, составляющие до 90% акарофауны жилых помещений. В формировании сенсибилизации к клещам домашней пыли также предполагается роль индивидуальных источников аллергенов. Сенсибилизация к мажорным компонентам аллергена клещей домашней пыли ассоциируется с риском развития бронхиальной астмы, к минорным (Der p 10) – риском развития перекрестных реакций с тропомиозином других беспозвоночных, тропомиозином человека. Аллергены клещей домашней пыли (Der p 2 и Der f 2) могут быть ответственны за симптомы оральной клещевой анафилаксии, а также способствовать развитию сенсибилизации к бактериальным антигенам Staphylococcus aureus и Escherichia coli. В 1 части статьи изложены биология и источники клеща домашней пыли. Представлена классификация аллергенов, пути сенсибилизации и распространенность сенсибилизации к клещу домашней пыли у детей.Allergic diseases are a serious problem in modern medicine. Sensitization to inhalation allergens is one of the key factors in the formation of respiratory allergoses. Among aeroallergens, allergenic components of domestic dust play an important role – mites Dermatophagoides pteronyssinus and Dermatophagoides farinae, that make up to 90% of the acarofauna of residential premises. In the formation of sensitization to domestic dust mites, the role of individual sources of allergens is also considered. Sensitization to the major components of the domestic dust mite allergens is associated with the risk of developing bronchial asthma, to minor ones (Der p 10) – the risk of cross-reactions with tropomyosin of other invertebrates, human tropomyosin. Domestic dust mite allergens (Der p 2 and Der f 2) may be responsible for the symptoms of oral tick-born anaphylaxis as well as for the development of sensitization to bacterial antigens of Staphylococcus aureus and Escherichia coli. Part 1 of this article outlines biology and sources of the domestic dust mite. The classification of allergens, sensitization pathways and the prevalence of sensitization to domestic dust mite in children are presented
Über eine Klasse polynomialer Scharen selbstadjungierter Operatoren im Hilbertraum
HEK293A cells expressing either mouse MOG (mMOG) or rat MOG (rMOG) C terminally tagged with EGFP. (DOCX 2792Â kb
ICTs connecting global citizens, global dialogue and global governance. A call for needful designs
Humankind is on the transition to a supra-system of humanity, according
to which social relationships – that organise the common good – are re-organised
such that global challenges are kept below the threshold of a self-inflicted
breakdown. In order to succeed, three conditions are imperative: (1) Global governance
needs a global conscience that orients towards the protection of the common
good. (2) Such global governance needs a global dialogue on the state of
the common good and the ways to proceed. (3) Such a global dialogue needs
global citizens able to reflect upon the current state of the common good and the
ways to proceed to desired states. Each of these imperatives is about a space of
possibilities. Each space nests the following one such that they altogether form
the scaffolding along which institutions can emerge that realise the imperatives
when proper nuclei are introduced in those spaces. Such nuclei would already
support each other. However, the clue is to further their integration by Information
and Communication Technologies. An information platform shall be
launched that could cover any task on any of the three levels, entangled with the
articulation of cooperative action from the local to the global, based on the cybersubsidiarity
model. This model is devised to ensure the percolation of meaningful
information throughout the different organisational levels.2019-2
Neurological update: MOG antibody disease
Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOG-AD) is now recognised as a nosological entity with specific clinical and paraclinical features to aid early diagnosis. Although no age group is exempt, median age of onset is within the fourth decade of life, with optic neuritis being the most frequent presenting phenotype. Disease course can be either monophasic or relapsing, with subsequent relapses most commonly involving the optic nerve. Residual disability develops in 50–80% of patients, with transverse myelitis at onset being the most significant predictor of long-term outcome. Recent advances in MOG antibody testing offer improved sensitivity and specificity. To avoid misdiagnosis, MOG antibody testing should be undertaken in selected cases presenting clinical and paraclinical features that are felt to be in keeping with MOG-AD, using a validated cell-based assay. MRI characteristics can help in differentiating MOG-AD from other neuroinflammatory disorders, including multiple sclerosis and neuromyelitis optica. Cerebrospinal fluid oligoclonal bands are uncommon. Randomised control trials are limited, but observational open-label experience suggests a role for high-dose steroids and plasma exchange in the treatment of acute attacks, and for immunosuppressive therapies, such as steroids, oral immunosuppressants and rituximab as maintenance treatment
Reliability Analysis in Geotechnics with Finite Elements - Comparison of Probabilistic, Stochastic and Fuzzy Set Methods
The finite element method is widely used for solving various problems in geotechnical engineering practice. The input parameters required for the calculations are generally imprecise. The paper is devoted to a comparison of probabilistic, stochastic and fuzzy set method for reliability analysis with respect to its applicability for practical problems in geotechnical engineering
Development and validation of clinical prediction models to risk stratify patients presenting with small pulmonary nodules: a research protocol
IntroductionLung cancer is a common cancer, with over 1.3 million cases worldwide each year. Early diagnosis using computed tomography (CT) screening has been shown to reduce mortality but also detect non-malignant nodules that require follow-up scanning or alternative methods of investigation. Practical and accurate tools that can predict the probability that a lung nodule is benign or malignant will help reduce costs and the risk of morbidity and mortality associated with lung cancer. MethodsRetrospectively collected data from 1500 patients with pulmonary nodule(s) of up to 15 mm detected on routinely performed CT chest scans aged 18 years old or older from three academic centres in the UK will be used to to develop risk stratification models. Radiological, clinical and patient characteristics will be combined in multivariable logistic regression models to predict nodule malignancy. Data from over 1000 participants recruited in a prospective phase of the study will be used to evaluate model performance. Discrimination, calibration and clinical utility measures will be presented.</p
Chest CT and hospital outcomes in patients with omicron compared with delta variant SARS-CoV-2 infection
Background The SARS-Cov-2 Omicron variant demonstrates rapid spread but with reduced disease severity. Studies evaluating the lung imaging findings of Omicron infection versus non-Omicron variants remain lacking. Purpose To compare Omicron and Delta variants of SARS-CoV-2 by their chest CT radiological pattern, biochemical parameters, clinical severity and hospital outcomes after adjusting for vaccination status. Materials and Methods Retrospective study of hospitalized adult patients rt-PCR positive for SARS-CoV-2 with CT pulmonary angiography performed within 7 days of admission between December 1, 2021 and January 14, 2022. Blinded radiological analysis with multiple readers including RSNA CT classification, chest CT severity score (CT-SS, range 0 least severe to 25 most severe) and CT imaging features including bronchial wall thickening. Results 106 patients (Delta n=66, Omicron n=40) were evaluated (mean age, 58 years ± 18, 58 men). In the Omicron group, 37% (15/40) of CT pulmonary angiograms were categorized as normal compared with 15% (10/66) in the Delta group (p=.016). Using a generalized linear model to control for confounding variables, including vaccination status, Omicron variant infection was associated with a CT-SS that was lower by 7.2 points compared to infection with Delta variant (β=-7.2, 95%CI: -9.9, -4.5; p <.001). Bronchial wall thickening was more common with Omicron than with the Delta variant (odds ratio [OR] 2.4, 95%CI: 1.01, 5.92, p=.04). Vaccination with a booster shot was associated with a protective effect on chest infection compared with the unvaccinated (CT-SS median 5 (IQR 0-11), CT-SS median 11 (IQR 7.5-14), respectively; p = .03). The Delta variant was associated with a higher odds ratio of severe disease (OR 4.6, 95%CI: 1.2, 26, p=.01) and critical care admission (OR 7.0, 95%CI: 1.5, 66, p=.004) than the Omicron variant. Conclusion The SARS-COV-2 Omicron variant was associated with fewer and less severe changes on chest CT compared with the Delta variant. Patients with Omicron had greater frequency of bronchial wall thickening but lower clinical severity and improved hospital outcomes than those with Delta