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Jia W, Zhang X, Li P, Sun R, Wang D, Song C. Development and validation of an online dynamic nomogram system for pulmonary consolidation in children with Mycoplasma pneumoniae pneumonia. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04834-7. [PMID: 38656425 DOI: 10.1007/s10096-024-04834-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The occurrence of pulmonary consolidation in children with Mycoplasma pneumoniae pneumonia (MPP) can lead to exacerbation of the disease. Therefore, early identification of children with MPP in combination with pulmonary consolidation is critical. The purpose of this study was to develop a straightforward, easy-to-use online dynamic nomogram for the identification of children with MPP who are at high risk of developing pulmonary consolidation. METHODS 491 MPP patients were chosen and divided randomly into a training cohort and an internal validation cohort at a 4:1 ratio. Multi-factor logistic regression was used to identify the risk variables for mixed pulmonary consolidation in children with Mycoplasma pneumoniae (MP). The selected variables were utilized to build the nomograms and validated using the C-index, decision curve analysis, calibration curves, and receiver operating characteristic (ROC) curves. RESULTS Seven variables were included in the Nomogram model: age, fever duration, lymphocyte count, C-reactive protein (CRP), ferritin, T8 lymphocyte percentage, and T4 lymphocyte percentage. We created a dynamic nomogram that is accessible online ( https://ertong.shinyapps.io/DynNomapp/ ). The C-index was 0.90. The nomogram calibration curves in the training and validation cohorts were highly comparable to the standard curves. The area under the curve (AUC) of the prediction model was, respectively, 0.902 and 0.883 in the training cohort and validation cohort. The decision curve analysis (DCA) curve shows that the model has a significant clinical benefit. CONCLUSIONS We developed a dynamic online nomogram for predicting combined pulmonary consolidation in children with MP based on 7 variables for the first time. The predictive value and clinical benefit of the nomogram model were acceptable.
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Affiliation(s)
- Wanyu Jia
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Xue Zhang
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Peng Li
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Ruiyang Sun
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Daobin Wang
- Zhecheng County People's Hospital, Shangqiu, 476200, Henan, China
| | - Chunlan Song
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China.
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王 淑, 张 文, 万 瑜. [Construction of a predictive model for performing bronchoalveolar lavage in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation]. Zhongguo Dang Dai Er Ke Za Zhi 2023; 25:1052-1058. [PMID: 37905763 PMCID: PMC10621064 DOI: 10.7499/j.issn.1008-8830.2305113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/30/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES To investigate the risk factors for performing bronchoalveolar lavage (BAL) in children with Mycoplasma pneumoniae pneumonia (MPP) and pulmonary consolidation, and to construct a predictive model for performing BAL in these children. METHODS A retrospective analysis was performed for the clinical data of 202 children with MPP who were hospitalized in the Department of Pediatrics, Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, from August 2019 to September 2022. According to whether BAL was performed, they were divided into BAL group with 100 children and non-BAL group with 102 children. A multivariate logistic regression analysis was used to identify the risk factors for performing BAL in MPP children with pulmonary consolidation. Rstudio software (R4.2.3) was used to establish a predictive model for performing BAL, and the receiver operator characteristic (ROC) curve, C-index, and calibration curve were used to assess the predictive performance of the model. RESULTS The multivariate logistic regression analysis demonstrated that the fever duration, C-reactive protein levels, D-dimer levels, and presence of pleural effusion were risk factors for performing BAL in MPP children with pulmonary consolidation (P<0.05). A nomogram predictive model was established based on the results of the multivariate logistic regression analysis. In the training set, this model had an area under the ROC curve of 0.915 (95%CI: 0.827-0.938), with a sensitivity of 0.826 and a specificity of 0.875, while in the validation set, it had an area under the ROC curve of 0.983 (95%CI: 0.912-0.996), with a sensitivity of 0.879 and a specificity of 1.000. The Bootstrap-corrected C-index was 0.952 (95%CI: 0.901-0.986), and the calibration curve demonstrated good consistency between the predicted probability of the model and the actual probability of occurrence. CONCLUSIONS The predictive model established in this study can be used to assess the likelihood of performing BAL in MPP children with pulmonary consolidation, based on factors such as fever duration, C-reactive protein levels, D-dimer levels, and the presence of pleural effusion. Additionally, the model demonstrates good predictive performance.
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Wang J, Zhang T, Xu Y, Yang M, Huang Z, Lin J, Xie S, Sun H. Comparison between percutaneous transthoracic co-axial needle CT-guided biopsy and transbronchial lung biopsy for the diagnosis of persistent pulmonary consolidation. Insights Imaging 2023; 14:80. [PMID: 37166531 PMCID: PMC10175526 DOI: 10.1186/s13244-023-01436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/08/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Diagnosing persistent pulmonary consolidation still faces challenges. The purpose of this study is to compare the diagnostic yield and the complication rate between percutaneous transthoracic CT-guided coaxial needle biopsy (PTCNB) and transbronchial lung biopsy (TBLB) of persistent pulmonary consolidation. MATERIALS From January 1, 2016, to December 31, 2020, we have retrospectively enrolled a total of 155 consecutive patients (95 males, 60 females) with persistent pulmonary consolidation who underwent both TBLB and PTCNB. According to the standard reference, the diagnostic yield, accuracy, sensitivity and specificity of PTCNB and TBLB were assessed and compared. RESULTS According to the standard reference, the final biopsy diagnoses of 11 cases were confirmed true malignant based on the surgical resections, the remaining were confirmed by clinical and imaging follow-up for at least 12 months. The overall diagnostic accuracy, sensitivity and specificity of PTCNB for malignant diagnosis were 91.61%, 72.34% and 100%, whereas of TBLB were 87.74%, 59.57% and 100%. The diagnostic yield of PTCNB and TBLB were 50.32% and 25.16%, respectively. For the TBLB-based negative cases, PTCNB provided a definite diagnostic yield of 37.93%. There were 45 (29.03%), 22 (14.19%) and 13 (8.39%) patients who experienced pneumothorax, intrapulmonary hemorrhage and hemoptysis, respectively, in PTCNB, while there were only 5 (3.22%) cases of mild intraprocedural bleeding occurring in TBLB. CONCLUSIONS CT-guided co-axial needle biopsy is an effective and safe modality, associated with higher diagnostic yield and better diagnostic accuracy compared to transbronchial lung biopsy for malignancy presenting as persistent consolidation, especially as the complementary method for TBLB-based negative lung lesions. KEY POINTS Both PTCNB and TBLB showed high diagnostic accuracy for malignancy. PTCNB had a higher diagnostic yield than TBLB for persistent pulmonary consolidation. PTCNB could provide a complementary diagnosis for TBLB-based negative lung consolidation.
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Affiliation(s)
- Juan Wang
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
- Graduate School, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Tongyin Zhang
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
- Graduate School, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yanyan Xu
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
| | - Meng Yang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zhenguo Huang
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
| | - Jie Lin
- Department of Pathology, China-Japan Friendship Hospital, Beijing, China
| | - Sheng Xie
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
| | - Hongliang Sun
- Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.
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de Souza TCGD, Silva VS, Mores MAZ, Kramer B, Leme RA, da Silva Porto G, Alfieri AA. Mycoplasma hyopneumoniae in free-living wild boars in Paraná, Brazil. Braz J Microbiol 2021; 52:1581-1587. [PMID: 33942276 DOI: 10.1007/s42770-021-00516-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/27/2021] [Indexed: 10/21/2022] Open
Abstract
This is the first study conducted in Paraná, Brazil, to investigate Mycoplasma hyopneumoniae (Mhyo) infection in free-living wild boars. Eighty-eight wild boars were managed by authorized controllers between 2017 and 2019 in the state of Paraná in southern Brazil. Management georeferencing, sex, and weight were recorded for each animal. The presence of Mhyo antibodies in wild boar serum samples was evaluated using a commercial indirect ELISA kit. The presence of enzootic pneumonia-like gross lesions was evaluated, and the observed macroscopic lesions were subjected to immunohistochemistry (IHC). The Chi-square test and the intensity of the association with the odds ratio and 95% confidence interval were used to evaluate the differences in the qualitative variables between groups (sex and municipality). Juvenile wild boars exhibited a higher seroprevalence than older ones (p = 0.005). The Teixeira Soares municipality differed in Mhyo seroprevalence in comparison with Castro (p < 0.001), Ponta Grossa (p = 0.004), and Carambeí (p < 0.001). Females were 6.79 times more likely to present consolidation lesions than males (p = 0.004). Among the evaluated lung samples with injuries, 57.1% (8/14) and 53.8% (7/13) were Mhyo positive by IHC in Castro and Ponta Grossa, respectively, confirming that the identified macroscopic lesions were caused by Mhyo. This study demonstrates the circulation of Mhyo in free-living wild boars, which raises concerns regarding the epidemiological role of this animal species for the spread of the pathogen.
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Affiliation(s)
- Tatiana C G D de Souza
- Laboratory of Animal Virology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | | | | | | | - Raquel Arruda Leme
- Laboratory of Animal Virology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Gisele da Silva Porto
- Laboratory of Animal Virology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Amauri Alcindo Alfieri
- Laboratory of Animal Virology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Londrina, Paraná, Brazil.
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Abstract
After taking a patient's history and physical examination, lung ultrasound can immediately reveal numerous causes and complications in patients suffering from respiratory tract infection and/or dyspnea. It can thus facilitate decisions on further diagnostic and first therapeutic procedures, even in patients with a SARS-CoV‑2 infection who present to the emergency room. This review article highlights the typical findings of lung ultrasound in patients with COVID-19 and discusses its value compared to other imaging methods.
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Affiliation(s)
- G. Kunze
- Klinik für Innere Medizin I, Schwarzwald-Baar Klinikum Villingen-Schwenningen GmbH, Klinikstr. 11, 78052 Villingen-Schwenningen, Deutschland
- DRF-Luftrettungsstation Christoph 11, Klinikstr. 20, 78052 Villingen-Schwenningen, Deutschland
| | - E. Kovacikova
- Klinik für Innere Medizin I, Schwarzwald-Baar Klinikum Villingen-Schwenningen GmbH, Klinikstr. 11, 78052 Villingen-Schwenningen, Deutschland
| | - H. Haller
- Klinik für Innere Medizin I, Schwarzwald-Baar Klinikum Villingen-Schwenningen GmbH, Klinikstr. 11, 78052 Villingen-Schwenningen, Deutschland
| | - B. Kumle
- Klinik für Akut- und Notfallmedizin, Schwarzwald-Baar Klinikum Villingen-Schwenningen GmbH, Klinikstr. 11, 78052 Villingen-Schwenningen, Deutschland
- DRF-Luftrettungsstation Christoph 11, Klinikstr. 20, 78052 Villingen-Schwenningen, Deutschland
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Sperandeo M, Del Colle A, Frongillo E, Rea G, Dimitri L, Cipriani C, Lacedonia D. Safety maximization of percutaneous transthoracic needle biopsy with ultrasound guide in subpleural lesions in the evaluation of pulmonary consolidation. Respir Res 2019; 20:68. [PMID: 30953529 PMCID: PMC6451297 DOI: 10.1186/s12931-019-1031-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/25/2019] [Indexed: 12/16/2022] Open
Abstract
The study by Kiranantawat et al. "Clinical role, safety and diagnostic accuracy of percutaneous transthoracic needle biopsy in the evaluation of pulmonary consolidation" highlights how "pulmonary consolidation can be safely evaluated with CT-guided percutaneous needle biopsy". Even if we agree about the role of CT guidance, we would like to point out how Thoracic Ultrasound could be better than CT for biopsy of subpleural lesions that could easily be detected and reached with this "real-time" and quicker technique.
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Affiliation(s)
- Marco Sperandeo
- Unit of Interventional and Diagnostic Ultrasound of Internal Medicine IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Anna Del Colle
- Department of Medical and Surgical Sciences, Institute of Respiratory Disease, University of Foggia, Viale degli Aviatori, 2, 71122, Foggia, FG, Italy.
| | - Elisabettamaria Frongillo
- Unit of Thoracic Surgery IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Gaetano Rea
- Department of Radiology, Ultrasound Diagnostic Unit, Monaldi Hospital, dei Colli, Naples, AO, Italy
| | - Lucia Dimitri
- Unit of Pathology IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Cristiana Cipriani
- Department of Internal Medicine and Medical Discipline, Sapienza University of Rome, Rome, Italy
| | - Donato Lacedonia
- Department of Medical and Surgical Sciences, Institute of Respiratory Disease, University of Foggia, Viale degli Aviatori, 2, 71122, Foggia, FG, Italy
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Abstract
CLINICAL ISSUE The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. STANDARD RADIOLOGICAL METHODS For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. METHODICAL INNOVATIONS Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging. ACHIEVEMENTS/PRACTICAL RECOMMENDATIONS The radiological findings serve as proof or exclusion of pneumonia and can also be used to evaluate the extent of the disease (e.g. monolobular, multilobular, unilateral or bilateral). In cases of prolonged disease, suspicion of complications (e.g. pleural effusion or empyema, necrotizing pneumonia or abscess) or comorbid conditions (e.g. underlying pulmonary or mediastinal diseases) computed tomography is an important diagnostic tool in addition to chest radiography. Ultrasound is often used to diagnose pleural processes (e.g. parapneumonic effusion or pleural empyema).
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Affiliation(s)
- S Poetter-Lang
- Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Medizinische Universität Wien, Währinger Guertel 18-20, 1090, Wien, Österreich.
| | - C J Herold
- Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Medizinische Universität Wien, Währinger Guertel 18-20, 1090, Wien, Österreich
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