Risk factors for progression to acute respiratory failure after casirivimab and imdevimab administration: A retrospective study

BackgroundCasirivimab and imdevimab are effective in preventing hospitalization in outpatients with coronavirus disease 2019 (COVID-19); however, disease progression after casirivimab and imdevimab administration has been reported. This study aimed to elucidate the risk factors for disease progression after casirivimab and imdevimab administration.MethodsThis retrospective study included patients with COVID-19 who received casirivimab and imdevimab at Hiroshima City Funairi Citizens Hospital between August 6, 2021, and October 10, 2021. All patients had at least one risk factor for severe disease and were treated on admission. The patients’ background characteristics and test results at the first visit were analyzed. The patients were divided into two groups (progressed and improved) based on whether they progressed to acute respiratory failure during hospitalization.ResultsSixty-seven patients were included: 9 patients in the progressed group (median age, 56 years) and 58 patients in the improved group (median age, 51 years). Age, coexistence rate of diabetes, cycle threshold value of polymerase chain reaction test, rate of detectable pneumonia on chest radiographs or chest computed tomography images, lymphocyte count, and the levels of C-reactive protein, interleukin-6, glucose, and glycated hemoglobin were significantly different between the two groups. Multivariate logistic regression analysis revealed that the coexistence of diabetes and the presence of detectable pneumonia on chest radiographs were independent factors predicting the progression to acute respiratory failure.ConclusionAcute respiratory failure after antibody therapy with casirivimab and imdevimab may develop in patients with diabetes or detectable pneumonia on chest radiographs at the first visit.     

42例重症手足口病临床与胸部X线对照分析

目的：分析重症手足口病的临床与胸部X线影像相关性。方法对42例重症手足口病病例的临床表现及X线胸片进行回顾性研究,采用SPSS13.0版本对数据进行统计分析。结果重症手足口病的发病年龄与其临床表现轻重无相关性,胸部X线表现斑片影广泛,双肺透亮度减低的患者其临床表现较重,治疗效果较差。结论手足口病的胸部影像学表现多样,无特异性;对病情突然变化的患者及时行胸部X线检查,动态观察影像学变化有利于了解病情变化及观察疗效,对临床诊疗具有重要的指导作用。     

胸部创伤诊断中数字化成像技术的价值研究

目的：探讨数字化成像技术在胸部创伤诊断中的应用价值。方法选取该院于2012年8月—2014年8月收治58例含有胸部创伤患者的临床资料,所有患者均给予胸部数字化成像技术检查。结果在58例胸部创伤患者中,肋骨骨折患者29例,气胸或血气胸21例,皮下及纵隔气肿20例,创伤性湿肺16例,肺挫损11例,肺血肿6例,肺不张及肺萎缩4例。结论数字化成像技术能有效明确胸部创伤的部位、程度及性质,能为疾病的临床诊断及治疗提供有效的依据。     

Tamponnade tardive : quatre cas de complication rare du traumatisme fermé du thorax

Delayed post-traumatic pericardial effusion is a rare condition after blunt trauma. The diagnosis of the effusion can be made by the clinical signs, which is not very specific and the cardiac echography. The etiological diagnosis remains difficult because it requires the elimination of the other causes of pericarditis. Their treatment consists in evacuating the pericardial effusion. The evolution thereafter is simple. We report four cases of patients with pericardial effusion late after a thoracic injury. Imaging the blood test, the examination of the pericardial fluid and the anatomopathological examination of the pericardium, eliminates the other etiologies.     

The HAS-Choice study: Utilizing the HEART score,an ADP,and shared decision-making to decrease admissions in chest pain patients

Objective

The HAS-Choice pathway utilizes the HEART Score, an accelerated diagnostic protocol (ADP), and shared decision-making using a visual aid in the evaluation of chest pain patients. We seek to determine if our intervention can improve resource utilization in a community emergency department (ED) setting while maintaining safe patient care.

Chest pain as a manifestation of hypokalemia in a pediatric patient

Patients presenting to the emergency department with chest pain are common and a cause of significant concern to patients and families and physicians alike. The causes of chest pain are myriad. These causes span diverse categories including cardiovascular, respiratory, abdominal and gastrointestinal, musculoskeletal, psychiatric, hematologic and oncologic, and neurologic Thull-Freedman (2010) [1]. These diverse etiologies present a diagnostic and management challenge to the ER physician who is tasked to minimize unnecessary diagnostics while not missing any significant disease. Multiple reviews have discussed the various etiologies of chest pain in the pediatric patient presenting to the ER but none of these recent reviews has included hypokalemia as a cause of chest pain Talner and Carboni (2000), Cava and Sayger (2004), Ringstrom and Freedman (2006), Foy and Filippone (2015), Yeh and Yeh (2015) [2], [3], [4], [5], [6]. Additionally, no reviews of hypokalemia describe this condition presenting with chest pain (Mandal, 1997; Gennari, 2002; Medford-Davis and Rafique, 2014 [7], [8], [9]).This case report describes a pediatric patient who presents with chest pain that was attributed to hypokalemia. This report attempts to make practitioners aware that hypokalemia may present with chest pain and to encourage ER providers to include this in the differential diagnosis.     

情绪障碍在彝族冠心病患者胸痛中的作用

目的初步探讨情绪障碍在彝族冠心病患者胸痛中的作用。方法观察彝族冠心病患者抑郁的发生率及严重程度,抗抑郁治疗前后胸痛的特点。结果彝族冠心病患者存在明显的情绪障碍,抗抑郁治疗后胸痛、每周发作次数、发作时 ST 段下移程度和胸痛持续时间均较抗抑郁治疗前明显改善。结论彝族冠心病患者胸痛发作时,抑郁是其中很重要的机制。     

Characteristics and sputum conversion of tuberculosis (TB) patients in Kalutara,Sri Lanka

Background

Tuberculosis (TB) is an infectious bacterial disease; remains as one of the important public health problem affecting every part of the world. Substantial number of TB cases are reported from Sri Lanka every year irrespective of its strong preventive health system. The aim of this analysis is to describe the characteristics of TB patients and to assess the factors associated with sputum conversion. This analysis was based on the data from the District Chest Clinic of Kalutara district, Sri Lanka.