The impact of lung ultrasound on coronavirus disease 2019 pneumonia suspected patients admitted to emergency departments

Objective The aim of this study was to identify the sensitivity and specificity of lung ultrasound (LUS) and show its place in diagnosing patients with known coronavirus disease 2019 (COVID-19) pneumonia, according to chest computed tomography and the COVID-19 reporting and data system (CO-RADS). Methods Nineteen patients who admitted to a single university hospital emergency department between March 5, 2020, and April 27, 2020, describing dyspnea were included in the study and underwent LUS by a single emergency specialist. The patient population was divided into 2 groups, COVID-19 positive and negative, and the sensitivity and specificity of LUS according to chest computed tomography were calculated for COVID-19 pneumonia diagnosis. In the subgroup analysis, the patient group was divided into real-time reverse transcription-polymerase chain reaction positive (n = 7) and negative (n = 12), and sensitivity and specificity were calculated according to the CO-RADS. Results According to the CO-RADS, significant differences were detected between the LUS positive and negative groups in terms of COVID-19 pneumonia presence. Only 1 patient was evaluated as CO-RADS 2 in the LUS positive group, and 2 patients were evaluated as CO-RADS 4 in the LUS negative group (P = 0.04). The sensitivity of LUS according to the CO-RADS for COVID-19 pneumonia diagnosis was measured to be 77.78% (95% confidence interval [CI], 39.9%-97.1%), specificity was 90% (95% CI, 55.5%-99.75%), positive predictive value was 87.5% (95% CI, 51.35%-97.8%), and accuracy was 84.21% (95% CI, 60.4%-96.62%; P = 0.004). Conclusions In conclusion, LUS is easily used in the diagnosis of COVID-19 pneumonia because it has bedside application and is fast, easy to apply, reproducible, radiation free, safe for pregnant women, and cheap

Can hematological and biochemical parameters fasten the diagnosis of COVID-19 in emergency departments?

INTRODUCTION: The primary aim of the study was to compare the laboratory and radiological parameters of COVID-19 positive and negative patients confirmed by Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR), and Chest Computed Tomography (CCT) of patients admitting with the suspicion of COVID-19. The secondary purpose of the study was to find objective parameters to speed up the clinician for further examination, treatment or referral decision in COVID-19 suspicion.   MATERIAL AND METHODS: A total of 61 COVID-19 suspected patients were evaluated in the study. Swab samples were taken for RT-PCR analysis. CCT was taken for 42 patients who described dyspnea. According to CCT and RT-PCR results, the patient population was divided into 2 groups as COVID-19 positive group (n = 32); and COVID-19 negative group (n = 29). Between two groups; demographic, clinical, laboratory and radiological parameters were compared.   RESULTS: Male gender (p = 0.03), PLR value (p = 0.021) and CO-RADS scores were higher in the COVID-19 positive group. Oxygen saturation (SaO2) (p = 0.027) and PCT, WBC, Neutrophil count, Lymphocyte count values were significantly low in COVID-19 positive group (p = 0.03, p = 0.001, p = 0.017, p = 0.021, respectively). PLR showed a positive correlation with fever, CRP, neutrophil count and NLR, which are indicators of inflammation.   CONCLUSIONS: SaO2, WBC, lymphocyte count, neutrophil count and low PCT levels, and PLR elevation showed a significant difference in COVID-19 patients in our retrospective cohort study examining the Turkish population. We believe that these results will allow clinicians to make quick decisions in patient management more simply

Anti-inflammatuar effects of inhale corticosteroid and combined therapy with inhale corticosteroid and long-acting beta-2 adrenoceptör in mild asthma

KOAH'lı hastaların tedavisi zor ve sıkıntılıdır. Hastaların çoğunluğunu ileri yaşdaki hastalar oluşturur. Düzenli takip ve tedavi altında olmamaları nedeniyle hastalarda komplikasyonlar kaçınılmazdır. Kor pulmonale bu komplikasyonlarm başında gelir. Sağ ventriküler gerilme kor pulmonalenin ilk dönemim oluşturur. Ventriküler gerilme ile kan BNP hormon düzeyi artar. Çalışmamızda KOAH'lılarda kor pulmonale gelişmeden önce BNP seviyelerini yüksek saptadığımızda diüretik tedavi ile bu hormon düzeyinde nasıl bir değişme olacağını araştırdık. KOAH atağı ile gelen BNP seviyelerini yüksek bulduğumuz 30 hastayı gruplandırdık. 15 stabil dönem KOAH'lıyı kontrol grubu olarak takip ettik. Atakda olan 30 KOAH'lı hastayı grup la ve grup lb olarak ayırdık. Grup la' ya düşük etkili diüretik vererek, BNP seviyelerindeki azalmaları, diüretik tedavi vermediğimiz grup lb ile karşılaştırdık. Diüretik tedavi alan hastalarda BNP kan seviyesinde istatistiksel anlamlı düşüşler saptadık. Sonuç olarak; KOAH' da kor pulmonalenin klinik olarak gözlenmesinden önce, kan BNP düzeyleri ile takip edilerek hastalarda sağ ventriküler yüklenmenin erken tanınabileceği ve diüretik tedavinin bu hastalarda faydalı olabileceği kanısındayız

Uyku apnesi hastalarının uyku pozisyonu verilerini kaydeden bir sistem tasarımı

Sleeping positions have a significant impact on exposure of apnea patients to sleep apnea. In this study, the sleeping position of the patient was read with the STM microcontroller by using the body position sensor (SleepSense 1/8" Plug DC Body Position Sensor Kit) produced by the sleep sense company. This sensor produces results with analog signals between 0-2V. This analog signal was read using the ADC feature of the microcontroller. This signal read by the microcontroller was sent to the computer via the USB port. The C# software prepared on the computer reads the data from the microcontroller and saves this data and the arrival time of the data to the bit TXT file. The data in this TXT file is ready to be evaluated by signal processing methods. These data, together with other data obtained from the polysomnography device, can be used to learn the body position of the patient at the time of apnea.Uyku apnesi hastalarının apneye girmelerinde yatış pozisyonlarının önemli bir etkisi vardır. Bu çalışmada sleep sense firmasının üretmiş olduğu vücut pozisyon sensörü (SleepSense 1/8" Plug DC Body Position Sensor Kit) kullanılarak hastanın yatış pozisyonu STM mikrodenetleyicisi ile okunmuştur. Bu sensör 0-2V arasında ürettiği anolog sinyallerle sonuç üretmektedir. Bu analog sinyal mikrodenetleyicinin ADC özelliği kullanılarak okunmuştur. Mikrodenetleyici tarafından okunan bu sinyal USB port üzerinden bilgisayara gönderilmiştir. Bilgisayarda hazırlanan C# yazılımı mikrodenetleyiciden gelen verileri okumakta ve bit TXT uzantılı dosyaya bu verileri ve verinin geliş saati ile birlikte kaydetmektedir. Bu TXT uzantılı dosya içerisindeki veriler sinyal işleme yöntemleri ile değerlendirilebilmek için hazır hale gelmiştir. Bu veriler, polisomnografi cihazından elde edilen diğer veriler ile birlikte hastanın apneye girdiği anlardaki vücut pozisyonu öğrenmek için kullanılabilecektir

Evaluation of coagulation with TEG in patients diagnosed COVID-19

PubMed ID 34773688WOS:000761923700004Background and aim: A high D-dimer level may indicate the risk of coagulopathy and mortality in COVID-19 patients. Thromboelastography (TEG) is a test that evaluates clot formation and fibrinolysis in real-time, unlike routine coagulation tests. The study aimed to investigate the coagulation process with TEG in patients diagnosed with COVID-19. Materials and Methods: The study was performed at our university hospital, chest diseases outpatient clinic as a cross-section study. A total of 51 patients with 23 high D-dimer levels group (HDG) and 28 low D-dimers group (LDG) were included in the study. TEG analysis was performed at the pretreatment evaluation in these two groups. Results: D-dimer and fibrinogen levels of the HDG were higher than those of the LDG (550 vs. 90 ng/mL, p < 0.001; 521 vs. 269 mg/ dL, p < 0.001, respectively). In TEG analysis, HDG’s R and K values were lower than LDG, and HDG’s Angle, MA, and CI values were higher than LDG (p = 0.037; p < 0.001; p < 0.001; p < 0.001; p [removed]62°, MA was 60.4 mm. Conclusion: Our study showed that the risk of thrombosis might increase in COVID-19 patients who are not hospitalized in the intensive care unit. Thrombosis risk should be investigated with TEG analysis and laboratory tests in every patient diagnosed with COVID-19, and treatment should be started for risky patients

Automatic sleep stage classification for the obstructive sleep apnea patients with feature mining

Automatic sleep scoring systems have been much more attention in the last decades. Whereas a wide variety of studies have been used in this subject area, the accuracies are still under acceptable limits to apply these methods to real-life data. One can find many high-accuracy studies in literature using a standard database but when it comes to using real data reaching such high performance is not straightforward. In this study, five distinct datasets were prepared using 124 persons including 93 unhealthy and 31 healthy persons. These datasets consist of time-, nonlinear-, welch-, discrete wavelet transform- and Hilbert-Huang transform features. By applying k-NN, Decision Trees, ANN, SVM, and Bagged Tree classifiers to these feature sets in various manners by using feature-selection highest classification accuracy was searched. The maximum classification accuracy was detected in the case of the Bagged Tree classifier as 95.06% with the use of 14 features among a total of 136 features. This accuracy is relatively high compared with the literature for a real-data application

Covid-19 hastalarında konvelesan plazma tedavisinin etkinliği

Convalescent plasma (CP) therapy has been used for treatment, although it has not been Corona Virus 2019 Disease (COVID-19) specific antiviral agent so far. However, the effectiveness of CP treatment on prognosis and mortality is still a matter of debate. In this study, we aimed to share our experiences about the effectiveness of CP treatment in COVID-19. Patients and Methods: The study was conducted in 126 patients diagnosed with COVID-19 who received CP treatment in addition to standard treatment between May 2020 and February 2021. 126 patients were divided into two groups as those who underwent SP within the first five days (Group A) and after five days (Group B). The patients in these two groups were evaluated in terms of laboratory parameters, clinical and mortality. Results: A total of 126 patients were identified (86 patients in Group A and 40 patients in Group B). 119 (94.4%) patients were discharged with recovery, 7 (5.5%) patients died. The mean days of hospitalization were found to be 11.4±0.7 in Group A and 18.4±1.7 in Group B (p<0.001). Treatment-related lymphocyte, PLT, fibrinogen and CRP main effect of change was significant (p<0.001). However, the results were marginally significant when the two groups were compared in terms of D-dimer. When the simple effect is evaluated; Group A as not significant, while group B was significant. Starting CP treatment 5 days before or 5 days later did not change the laboratory parameters. However, D-dimer was marginally significant (p=0.058). Conclusion: In our study, it was shown that early initiation of CP treatment reduced the hospitalization, but had no effect on mortality and laboratory parameters.Corona Virüs 2019 Hastalığı (COVID-19)’nda şu ana kadar spesifik antiviral ajan olmamasına rağmen tedavi için konvelesan plazma (CP) tedavisi tedavi için kullanılmıştır. Ancak CP tedavisinin prognoz ve mortalite üzerindeki etkinliği halen tartışma konusudur. Bu çalışmada COVID-19 hastalığında CP tedavisinin etkinliğine ilişkin deneyimlerimizin paylaşması amaçlandı. Hastalar ve Yöntem: Çalışma Mayıs 2020-Şubat 2021 tarihleri arasında standart tedaviye ek olarak CP tedavisi alan 126 COVID-19 tanılı hastada gerçekleştirildi. 126 hasta ilk beş gün içinde (Grup A) ve beş günden sonra (Grup B) CP uygulananlar olarak iki gruba ayrıldı. Bu iki gruptaki hastalar laboratuvar parametreleri, klinik bulgular ve mortalite açısından değerlendirildi. Bulgular: Toplam 126 hasta Grup A'da 86 hasta ve Grup B'de 40 hasta) tespit edildi. 119 (%94.4) hasta şifa ile taburcu olurken 7 (%5,5) hasta kaybedildi. Ortalama hastane yatış süresi Grup A'da 11.4±0.7, Grup B'de 18.4±1.7 gün olarak bulundu (p<0,001). Lenfosit, PLT, fibrinojen ve CRP’nin tedaviye bağlı ana değişim etkisi istatistiksel olarak anlamlıydı (p<0.001). Ancak, iki grup D-dimer açısından karşılaştırıldığında sonuçlar marjinal olarak anlamlıydı. Basit etki değerlendirildiğinde; Grup A’daki değişim anlamlı değilken, Grup B’deki değişim anlamlıydı. CP tedavisine 5 gün önce veya 5 gün sonra başlanması laboratuvar parametrelerini değiştirmedi. Ancak, D-dimer ’daki değişim marjinal olarak anlamlıydı (p=0.058). Sonuç: Çalışmamızda CP tedavisine erken başlamanın hastanede kalış süresini azalttığı ancak mortalite ve laboratuvar parametreleri üzerine etkisinin olmadığı gösterildi

The Impact of Lung Ultrasound on Coronavirus Disease 2019 Pneumonia Suspected Patients Admitted to Emergency Departments

Objective The aim of this study was to identify the sensitivity and specificity of lung ultrasound (LUS) and show its place in diagnosing patients with known coronavirus disease 2019 (COVID-19) pneumonia, according to chest computed tomography and the COVID-19 reporting and data system (CO-RADS). Methods Nineteen patients who admitted to a single university hospital emergency department between March 5, 2020, and April 27, 2020, describing dyspnea were included in the study and underwent LUS by a single emergency specialist. The patient population was divided into 2 groups, COVID-19 positive and negative, and the sensitivity and specificity of LUS according to chest computed tomography were calculated for COVID-19 pneumonia diagnosis. In the subgroup analysis, the patient group was divided into real-time reverse transcription-polymerase chain reaction positive (n = 7) and negative (n = 12), and sensitivity and specificity were calculated according to the CO-RADS. Results According to the CO-RADS, significant differences were detected between the LUS positive and negative groups in terms of COVID-19 pneumonia presence. Only 1 patient was evaluated as CO-RADS 2 in the LUS positive group, and 2 patients were evaluated as CO-RADS 4 in the LUS negative group (P = 0.04). The sensitivity of LUS according to the CO-RADS for COVID-19 pneumonia diagnosis was measured to be 77.78% (95% confidence interval [CI], 39.9%-97.1%), specificity was 90% (95% CI, 55.5%-99.75%), positive predictive value was 87.5% (95% CI, 51.35%-97.8%), and accuracy was 84.21% (95% CI, 60.4%-96.62%; P = 0.004). Conclusions In conclusion, LUS is easily used in the diagnosis of COVID-19 pneumonia because it has bedside application and is fast, easy to apply, reproducible, radiation free, safe for pregnant women, and cheap