Romanian Journal of Internal Medicine最新文献

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Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience. COVID-19合并肝损伤患者的特征和结局:回顾性分析和多中心经验
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0027
Andrei Voiosu, Adina Roman, Ruxandra Pop, Alina Boeriu, Cristiana Popp, Sabina Zurac, Theodor Voiosu, Daniela Dobru, Bogdan Mateescu
{"title":"Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience.","authors":"Andrei Voiosu,&nbsp;Adina Roman,&nbsp;Ruxandra Pop,&nbsp;Alina Boeriu,&nbsp;Cristiana Popp,&nbsp;Sabina Zurac,&nbsp;Theodor Voiosu,&nbsp;Daniela Dobru,&nbsp;Bogdan Mateescu","doi":"10.2478/rjim-2021-0027","DOIUrl":"https://doi.org/10.2478/rjim-2021-0027","url":null,"abstract":"<p><p><b>Background and aims.</b> Patients with COVID-19 frequently present abnormal elevated liver function tests of unknown clinical significance. We aimed to investigate the characteristics and factors influencing outcome in patients with confirmed SARS-CoV-2 infection and liver injury on admission.<b>Methods.</b> This is a retrospective observational study of patients hospitalized in two COVID units in Romania. Relevant data on clinical and laboratory parameters and medication administered during the admission were analyzed to identify predictors of a negative outcome. Patients with confirmed COVID-19 and liver function tests (LFTs) above the upper limit of normal were included in the analysis.<b>Results.</b> From 1,207 patients, we identified 134 patients (11%) with abnormal LFTs during hospitalization. The majority of patients had mildly elevated levels and a predominantly cholestatic pattern of liver injury. Patients who received lopinavir/ritonavir were more likely to have increased ALAT levels (<i>p</i><0.0001). Sixteen patients had pre-existing chronic liver disease, and they were more likely to suffer from severe COVID-19 (p=0.009) and have a negative outcome (p<0.001), but on multivariate analysis, only the severity of COVID-19 was predictive of death (OR 69.9; 95% CI 6.4-761.4).<b>Conclusions.</b> Mild liver injury is relatively common in COVID-19 and possibly influenced by medication. Patients with chronic liver disease are at high risk for negative outcome, but the severity of the infection is the only predictor of death.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"49-55"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39177254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
The role of thyroid hormones in carotid arterial wall remodeling in women. 甲状腺激素在女性颈动脉壁重塑中的作用。
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0028
Maida Seferovic Saric, Miljenka-Jelena Jurasic, Hrvoje Budincevic, Milan Milosevic, Bojana Kranjcec, Sanja Kovacic, Jana Leskovar, Vida Demarin
{"title":"The role of thyroid hormones in carotid arterial wall remodeling in women.","authors":"Maida Seferovic Saric,&nbsp;Miljenka-Jelena Jurasic,&nbsp;Hrvoje Budincevic,&nbsp;Milan Milosevic,&nbsp;Bojana Kranjcec,&nbsp;Sanja Kovacic,&nbsp;Jana Leskovar,&nbsp;Vida Demarin","doi":"10.2478/rjim-2021-0028","DOIUrl":"https://doi.org/10.2478/rjim-2021-0028","url":null,"abstract":"<p><p><b>Introduction:</b> Thyroid hormones affect the cardiovascular system, but the precise mechanisms of their effects on the development of atherosclerosis are not entirely clear. The relationship between subclinical hypothyroidism, dyslipidemia and carotid atherosclerosis has been widely investigated, but the findings were controversial. The aim of the present study was to determine whether female subjects with subclinical hypothyroidism (SHypo) have increased carotid intima-media thickness (IMT) compared with euthyroid subjects, as well as to examine the association of SHypo, carotid atherosclerosis and dyslipidemia.<b>Methods:</b> This research included 100 women aged 30 to 70 years who were divided into two groups: the SHypo group including subjects with signs of subclinical hypothyroidism and the control group of euthyroid subjects. Carotid IMT thickness using B mode ultrasound was determined and its correlation with serum concentrations of fT4, TSH, CRP, and lipid profile including small dense LDL (sdLDL) was analysed.<b>Results:</b> Subjects with SHypo had significantly increased carotid IMT (IMT ≥ 75th centile) in all three measured segments of the right (<i>p</i> <0.001) and the left (<i>p</i> = 0.001) carotid artery compared to the control group, with a significantly more frequent appearance of plaque (25% vs. 9%; <i>p</i> = 0.05). Significant positive correlations were found between higher TSH and higher IMT values. Increased age, LDL cholesterol, and TSH predicted thickening of the carotid artery IMT.<b>Conclusions:</b> It is important to screen people showing early, subclinical signs of thyroid gland dysfunction due to its impact on carotid atherosclerosis development.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"24-33"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39217175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Association between admission blood glucose and prognosis in non-diabetic patients with first-ever acute myocardial infarction. 非糖尿病患者首次急性心肌梗死入院血糖与预后的关系
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0033
Ramin Eskandari, Parisa Matini, Sepideh Emami, Yousef Rezaei
{"title":"Association between admission blood glucose and prognosis in non-diabetic patients with first-ever acute myocardial infarction.","authors":"Ramin Eskandari,&nbsp;Parisa Matini,&nbsp;Sepideh Emami,&nbsp;Yousef Rezaei","doi":"10.2478/rjim-2021-0033","DOIUrl":"https://doi.org/10.2478/rjim-2021-0033","url":null,"abstract":"<p><p><b>Background:</b> Admission hyperglycemia has been associated with major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with acute coronary syndrome.<b>Methods:</b> In this study we sought to determine the association between admission blood sugar (ABS) and the outcomes of non-diabetic patients with first-ever acute myocardial infarction (MI). Non-diabetic patients with MI were evaluated from March 2016 to March 2019. Baseline characteristics, laboratories, electrocardiogram, and baseline left ventricular ejection fraction (LVEF) were recorded. All patients were followed up and outcomes were obtained. Follow-up data comprised of repeating electrocardiogram and echocardiography at 1 year, and MACCE, including re-MI, stroke, and mortality.<b>Results:</b> A total of 312 patients with a mean age of 54.2 ± 11.9 years were evaluated. All patients were followed up for a median of 38 months. The frequencies of in-hospital mortality and MACCE at late follow-up were higher in third tertile of ABS compared with those in first and second tertiles (both p <0.05). Based on the Cox regression analysis, the independent predictors of MACCE included age (hazard ratio [HR] 1.068, 95% confidence interval [CI] 1.033 - 1.105, p <0.001), third tertile of ABS >172 mg/dL (HR 21.257, 95% CI 2.832 - 159.577, p=0.003), and baseline LVEF (HR 0.947, 95% CI 0.901 - 0.995, p=0.031).<b>Conclusion:</b> Admission stress hyperglycemia is associated with increased rates of in-hospital mortality and MACCE at late follow-up in non-diabetic patients with MI. Moreover, elevated ABS, older ages, and a decreased value of baseline LVEF predicted MACCE during follow-up.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"34-41"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39325276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Discontinuation of Eculizumab treatment after hematological remission in patients with atypical and drug-induced hemolytic uremic syndrome. 非典型和药物性溶血性尿毒症综合征患者血液学缓解后停用Eculizumab治疗。
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0034
Hasan H Yeter, Ulver Derici, Turgay Arinsoy, Kadriye Altok, Yasemin Erten, Galip Guz
{"title":"Discontinuation of Eculizumab treatment after hematological remission in patients with atypical and drug-induced hemolytic uremic syndrome.","authors":"Hasan H Yeter,&nbsp;Ulver Derici,&nbsp;Turgay Arinsoy,&nbsp;Kadriye Altok,&nbsp;Yasemin Erten,&nbsp;Galip Guz","doi":"10.2478/rjim-2021-0034","DOIUrl":"https://doi.org/10.2478/rjim-2021-0034","url":null,"abstract":"<p><p><b>Introduction.</b> The aim was to evaluate the effect of therapeutic plasma exchange (TPE) and eculizumab on hematological and renal survival in atypical hemolytic uremic syndrome (aHUS), and additionally, to examine the reliability of discontinuation of eculizumab treatment.<b>Methods.</b> This was an observational and retrospective study of 18 patients diagnosed with aHUS.<b>Results.</b> The median age of the study population was 30 (22-66) years. Four of 18 patients achieved hematological remission with the TPE alone. However, one patient died after three sessions of TPE. Eculizumab was used in 13 patients and no death was observed. One year after treatment, improved kidney function was observed in 2 of 3 (66%) patients for TPE and 5 of 9 (56%) patients for Eculizumab. We discontinued eculizumab treatment in 9 patients. One of the patients who had a C3 gene mutation experienced disease relapse after Eculizumab discontinuation. None of the patients who had drug associated aHUS developed disease relapse after Eculizumab discontinuation.<b>Conclusion.</b> Eculizumab treatment is a life-saving therapy in aHUS. Treatment discontinuation may be considered at least six months after hematologic remission in patients who had stable renal function or no expectancy for renal survival. Moreover, drug-associated cases seem to tend not to develop disease relapse in the long term.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"56-65"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39358222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Cardiac biomarkers alterations in patients with SARS-CoV-2 infection. SARS-CoV-2感染患者心脏生物标志物的改变
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0037
Eleousa Oikonomou, Themistoklis Paraskevas, Dimitrios Velissaris
{"title":"Cardiac biomarkers alterations in patients with SARS-CoV-2 infection.","authors":"Eleousa Oikonomou,&nbsp;Themistoklis Paraskevas,&nbsp;Dimitrios Velissaris","doi":"10.2478/rjim-2021-0037","DOIUrl":"https://doi.org/10.2478/rjim-2021-0037","url":null,"abstract":"<p><p>Reliable biomarkers are necessary for the risk stratification of patients infected with SARS-CoV-2. This novel coronavirus is now established to affect several organs in addition to the lungs, most prominently the heart. This is achieved through direct damage to the myocardium and indirect immune-associated effects during the cytokine storm. We performed a literature review aiming to identify the prognostic value of alterations of cardiac biomarkers in SARS-CoV-2 infection. Cardiac biomarkers are significantly elevated in patients with severe COVID-19 and are independent predictors of mortality. High-sensitivity troponin I and T are correlated with multiple inflammatory indexes and poor outcomes. Although cut-off values have been established for most of cardiac biomarkers, lower limits for troponins may have better prognostic values and longitudinal monitoring of cardiac biomarkers can help the clinician assess the patient's course. Additional measurements of NT-proBNP, can detect the subgroup of patients with poor prognosis.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"6-13"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39487910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Hyper-inflammation after COVID-19 mARN vaccination: at the crossroads of multisystem inflammatory disease and adult-onset Still's disease. Does terminology matter? COVID-19 - mARN疫苗接种后的高度炎症:处于多系统炎症性疾病和成人发病斯蒂尔氏病的十字路口术语重要吗?
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0035
Cristian Baicus, Caterina Delcea, Larisa Pinte, Gheorghe Andrei Dan
{"title":"Hyper-inflammation after COVID-19 mARN vaccination: at the crossroads of multisystem inflammatory disease and adult-onset Still's disease. Does terminology matter?","authors":"Cristian Baicus,&nbsp;Caterina Delcea,&nbsp;Larisa Pinte,&nbsp;Gheorghe Andrei Dan","doi":"10.2478/rjim-2021-0035","DOIUrl":"https://doi.org/10.2478/rjim-2021-0035","url":null,"abstract":"As the pandemic evolves, different facets of the SARS-CoV-2 infection, as well as immunization, with varying complexity and prognostic implications are discovered. One of them is the multisystem inflammatory syndrome (MIS)[1]. Characterized by elevated ferritin levels and hyper-inflammation with vital implications, MIS was proposed as the fifth clinical entity to constitute the “hyperferritinaemic syndromes”, alongside the macrophage activation syndrome (MAS), adult-onset Still’s disease (AOSD), catastrophic anti-phospholipid syndrome and septic shock [2]. Although most reports were related to SARS-COV-2 infection, MIS was recently described in relation to COVID-19 vaccination as well [3]. We hereby report the case of a previously healthy 22-year-old male, who received the first dose of BNT162b2 vaccine on May 1 2021. Thirteen days after vaccination, he developed a hyperinflammatory state, fulfilling the criteria for adult multisystem inflammatory syndrome (MIS-A) [2] (fever, sore throat, myalgias, myocarditis, hepatic injury, maculo-papular rash, diarrhoea, hypotension, and highly elevated inflammatory markers including a procalcitonin level of 33 ng/ml). He was initially admitted in another hospital’s Cardiology department with a diagnosis of acute coronary syndrome. At that moment the patient presented with chest pain, ST elevation on ECG, high troponin level, segmental left ventricular hypokinesia, and mid-range ejection fraction. The coronary angiography was normal,","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"3-5"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39406490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
The frailty phenotype in hemodialysis patients and its association with biochemical markers of mineral bone disorder, inflammation and nutrition. 血液透析患者的脆弱表型及其与骨矿物质紊乱、炎症和营养生化指标的关系。
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0030
Alma Mutevelić-Turković, Halima Resić, Badema Čengić Roljić, Amela Dervišević, Amela Bećiragić
{"title":"The frailty phenotype in hemodialysis patients and its association with biochemical markers of mineral bone disorder, inflammation and nutrition.","authors":"Alma Mutevelić-Turković,&nbsp;Halima Resić,&nbsp;Badema Čengić Roljić,&nbsp;Amela Dervišević,&nbsp;Amela Bećiragić","doi":"10.2478/rjim-2021-0030","DOIUrl":"https://doi.org/10.2478/rjim-2021-0030","url":null,"abstract":"<p><p><b>Introduction:</b> Frailty is a state of increased vulnerability to physical stressors. It is common in patients with end-stage renal disease (ESRD) who are on hemodialysis (HD).The aim of this study was to analyze the presence of frailty phenotype among HD patients and to evaluate their interrelationship with different biochemical markers.<b>Methods:</b> For the frailty assessment the Frailty Phenotype by Fried <i>et al</i>. was used, where frailty was reported if three of the following criteria were met: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed and low physical activity. From 281 HD patients, 126 patients were frail, 58 were pre-frail (two criteria were met) and the rest of the study population were robust (97 patients). BMI was calculated for all patients and venous blood samples were taken to determine laboratory parameters for bone alkaline phosphatase (BAP), phosphate (P), potassium (K), C-reactive protein (CRP) and albumin.<b>Results:</b> Patients who were on HD longer than 60 months have more characters of frailty. (p=0.019). A statistically significant positive correlations between frailty score and BAP (rho = 0.189; p = 0.001), and CRP (rho = 0.233; p < 0.001) were observed, and significant negative correlations between frailty score and albumin (rho = - 0.218; p < 0.001) and K (rho = - 0.198; p = 0.001).<b>Conclusions:</b> The associations of frailty with markers of mineral bone disorder, inflammation and nutrition indicate the importance of these parameters in the indirect assessment of the frailty phenotype in HD patients.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"42-48"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39264374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
A practical review of diabetes mellitus type 2 treatment in primary care. 初级保健中2型糖尿病治疗的实践综述。
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0031
Justin T Call, Pedro Cortés, Dana M Harris
{"title":"A practical review of diabetes mellitus type 2 treatment in primary care.","authors":"Justin T Call,&nbsp;Pedro Cortés,&nbsp;Dana M Harris","doi":"10.2478/rjim-2021-0031","DOIUrl":"https://doi.org/10.2478/rjim-2021-0031","url":null,"abstract":"<p><p>The treatment of diabetes mellitus type 2 (DM2) is becoming more complex as new medications are approved. Primary care providers must maintain their medical knowledge on emerging medications for best patient care. This review simplifies the non-insulin treatments of diabetes with an emphasis on the cardio-renal protectants, sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1).</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"14-23"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39263800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Imaging characteristics of nontuberculous mycobacterial pulmonary nodules. 非结核性分枝杆菌肺结节的影像学特征。
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0016
Kengo Nishino, Kesato Iguchi, Osamu Ishibashi, Yuika Sasatani, Gen Ohara, Katsunori Kagohashi, Hiroaki Satoh
{"title":"Imaging characteristics of nontuberculous mycobacterial pulmonary nodules.","authors":"Kengo Nishino,&nbsp;Kesato Iguchi,&nbsp;Osamu Ishibashi,&nbsp;Yuika Sasatani,&nbsp;Gen Ohara,&nbsp;Katsunori Kagohashi,&nbsp;Hiroaki Satoh","doi":"10.2478/rjim-2021-0016","DOIUrl":"https://doi.org/10.2478/rjim-2021-0016","url":null,"abstract":"Abstract Introduction. Nontuberculous mycobacteriosis (NTM) of the lungs can develop nodules. In order to clarify some of the characteristics of lung NTM nodules, we examined volume doubling time (VDT) and maximum standardized uptake value (SUVmax) in positron emission tomography (PET) of pathologically diagnosed NTM nodules. Methods. From November 2012 to August 2018, clinical and radiological information were retrospectively investigated in eight patients who were surgically resected and diagnosed as NTM. These eight patients were followed up until November 2020 and were confirmed to have no appearance of lung cancer or reappearance of lung NTM nodules. The VDT was calculated using the Schwartz formula. Results. The median maximum diameter of the nodule at the time of the first CT scan was 16.0 (range: 9.9–20.0) mm. The median maximum diameter of the nodule on CT performed before the surgical biopsy was 18.8 (range: 10.4–32.8) mm. The median doubling time calculated from these results was 203 (range: 20–568) days. Caseous granulomas and acid-fast bacilli were histologically confirmed in all eight patients. Culture of excised nodules revealed Mycobacterium intracellulare in five patients and Mycobacterium avium in three patients. Six patients received PET, and median SUVmax was: 7.0 (range: 3.3–21.0). Median VDT was around 200 days. Some patients had irregular-shaped nodules. Conclusions. CT/PET-CT characteristics of lung nodules are not reliable in differentiating lung NTM nodules from malignant ones. To avoid unnecessary resection, it may be better to collect various information on imaging findings in the nodule itself and in opacities other than the nodule.","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"59 4","pages":"369-374"},"PeriodicalIF":1.9,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38867544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of severity scoring systems in patients with severe community acquired pneumonia. 重度社区获得性肺炎患者严重程度评分系统的评价。
IF 1.9
Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0025
Katerina Spasovska, Krsto Grozdanovski, Zvonko Milenkovic, Mile Bosilkovski, Marija Cvetanovska, Nikola Kuzmanovski, Kosta Kapsarov, Emilija Atanasovska
{"title":"Evaluation of severity scoring systems in patients with severe community acquired pneumonia.","authors":"Katerina Spasovska,&nbsp;Krsto Grozdanovski,&nbsp;Zvonko Milenkovic,&nbsp;Mile Bosilkovski,&nbsp;Marija Cvetanovska,&nbsp;Nikola Kuzmanovski,&nbsp;Kosta Kapsarov,&nbsp;Emilija Atanasovska","doi":"10.2478/rjim-2021-0025","DOIUrl":"https://doi.org/10.2478/rjim-2021-0025","url":null,"abstract":"<p><p><b>Background.</b> The aim of this study was to evaluate the ability of severity scoring systems to predict 30-day mortality in patients with severe community-acquired pneumonia. <b>Methods.</b> The study included 98 patients aged ≥18 years with community acquired pneumonia hospitalized at the Intensive Care Unit of the University Clinic for Infectious Diseases in Skopje, Republic of North Macedonia, during a 3-year period. We recorded demographic, clinical and common biochemical parameters. Five severity scores were calculated at admission: CURB 65 (Confusion, Urea, Respiratory Rate, Blood pressure, Age ≥65 years), SCAP (Severe Community Acquired Pneumonia score), SAPS II (Simplified Acute Physiology Score), SOFA (Sequential Organ Failure Assessment Score) and MPM (Mortality Prediction Model). Primary outcome variable was 30-day in-hospital mortality. <b>Results.</b> The mean age of the patients was 59.08 ± 15.76 years, predominantly males (68%). The overall 30-day mortality was 52%. Charlson Comorbidity index was increased in non-survivors (3.72 ± 2.33) and was associated with the outcome. All severity indexes had higher values in patients who died, that showed statistical significance between the analysed groups. The areas under curve (AUC) values of the five scores for 30-day mortality were 0.670, 0.732, 0,726, 0.785 and 0.777, respectively. <b>Conclusion.</b> Widely used severity scores accurately detected patients with pneumonia that had increased risk for poor outcome, but none of them individually demonstrated any advantage over the others.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"59 4","pages":"394-402"},"PeriodicalIF":1.9,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39035764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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