[Assessment of the effectiveness and predictive value of lung ultrasound in the COVID-19 diagnostic process and its correlation with computed tomography]

The spreading pandemic, successive waves and increasingly inefficient hospital care system contributed to the analysis and inclusion of lung ultrasonography (LUS) in the COVID-19 diagnostic process, which is faster, cheaper, more available and safer method for patients. It is also the method of choice for pregnant women and children.

AIM

The aim of this study was to analyze the effectiveness of lung ultrasound in the diagnostic process, its predictive value and its comparison with computed tomography (CT) of the chest.

MATERIALS AND METHODS

A literature review was conducted with keyword in the title and abstracts in the Pubmed National Library of Medicine database.

RESULTS

Twenty papers were reviewed which showed a high consistency in CT and ultrasound image evaluation, particularly in the inferolateral and posterior lung areas. The association between LUS and CT images with disease severity has also been demonstrated, which translates into the predictive value of these studies related to hospitalization, use of invasive and non-invasive mechanical ventilation, and mortality in COVID-19 patients. An association between the stage of disease severity assessed by LUS and elevated levels of inflammatory markers were revealed. In addition, lung ultrasound showed high sensitivity in the early stages of the disease.

CONCLUSIONS

Ultrasound performed by appropriately trained staff is a good diagnostic and prognostic tool in the Hospital Emergency Department and Intensive Care Unit. Nevertheless, due to the subjectivity and technical limitations of this study, this method needs further research.

[Ocular symptoms in SARS-CoV-2 infection]

The first cases of COVID-19 were reported in Wuhan city, Hubei province, China. Patients reported symptoms such as dry cough, dyspnea, fever. Bilateral infiltrates in the lung parenchyma could be seen in imaging studies. Two years after the diagnosis of the first case of COVID-19, we are confident that symptoms manifest in every organ, including the eyes. Ocular manifestations may result from the COVID- 19 infection itself as well as from associated treatment, including mechanical ventilation or drug therapy. Ocular manifestations may be the first signs of COVID-19, so this knowledge is essential for making a prompt and correct diagnosis. It is important to be aware of the risks associated with the possibility of infection during the ophthalmic examination of these patients.

AIM

The aim of the analysis was to perform a literature review systematizing the knowledge on ocular manifestations in the course of the COVID-19 infection with particular emphasis on the relation between the occurrence of ocular symptoms and the age of patients as well as the severity of the COVID-19 course. The review also included studies that evaluated the detection of the SARS-CoV-2 virus in tears or conjunctival sac swabs of patients with COVID-19.

MATERIALS AND METHODS

Articles for the literature review were collected from the PubMed database. The expression "COVID-19 ocular manifestations" was used as the selection criteria. Finally, fifteen papers published in 2020 and fifteen papers published in 2021 were included in the review. Nineteen of these were original papers, two were meta-analyses, and nine were classified as review papers.

RESULTS

The most commonly reported ocular manifestations include dry eye or foreign body sensation, conjunctival hyperaemia, tearing, itching, and eye pain. Conjunctivitis was the most commonly diagnosed ophthalmic disease among COVID-19 patients. The SARS-CoV-2 infection is also associated with a risk of a significant decrease in visual acuity due to retinal vascular occlusion, ischemic optic neuropathy, inflammation of the choroid, retina and the optic nerve. The incidence of the most common ocular surface-related symptoms was higher in children than in adults. In several studies it has been shown that patients with more severe COVID-19 infection are more likely to have ocular symptoms.

CONCLUSIONS

Physicians, especially ophthalmologists, should be aware of the link between SARS-CoV-2 infection and the possibility of ocular symptoms and should recommend testing for COVID-19 if SARS-CoV-2 infection is suspected to reduce the possibility of infection spread.

Study of system dynamics through recurrence analysis of regular windows

In the recurrence quantification analysis of a dynamical system, the key parameters of the analysis significantly influence the qualitative changes in recurrence measures. Therefore, the values of these parameters must be selected carefully using appropriate rules. The embedding parameters provide rules and procedures for the determination of the above. However, rules for selecting the threshold parameter (ɛ) are still the subject of tests and studies. This study proposes a procedure for selecting appropriate values of ɛ and point density of a vector series based on variability and convergence criteria. A criterion for the linear convergence of recurrence results makes it possible to find a narrow range of the ɛ parameter that would be suitable for the analysis in question.

The anatomy of the fundic branches of the stomach: preliminary results

The fundic branches of the stomach can be defined as a group of vessels that can arise either directly or indirectly from the following source arteries: the left inferior phrenic artery, the accessory left hepatic artery, the left gastric artery, the left middle suprarenal artery, the main trunk of the splenic artery, the posterior gastric artery, the superior polar artery, the gastrosplenic artery, the left gastroepiploic artery and the splenic artery with its inferior and superior terminal branches. It is worth mentioning that the fundic branches of the left gastroepiploic artery and the superior and inferior terminal branches of the splenic artery, like other vessels arising from these three source arteries and supplying the stomach, are defined as short gastric arteries. The anatomy of these fundic branches, particularly relevant to some surgical procedures, is not sufficiently described, and the current literature suffers from lack of publications on this particular topic. We therefore decided to explore in detail the arterial vascularisation of the gastric fundus. The research was carried out on material consisting of 15 human stomach specimens. The anatomical analysis comprised the following: the number of occurrences of fundic branches in each of the source arteries defined above, the distance between the origins of the source artery and its arising fundic branch, the way in which the fundic branches arose, the length, diameter at point of origin and morphology of the fundic branches, as well as the exact point of perforation of each fundic branch on the fundus. The highest incidence of the direct-branching pattern of fundic branches was in the left middle suprarenal artery, the gastrosplenic artery and the left gastrosplenic artery. The accessory left hepatic artery, the left gastric artery and the main trunk of the splenic artery were the most frequent site of the indirectly arising pattern of fundic branch. The highest median value of fundic branch length was 63.05 mm, found in the accessory left hepatic artery group. The largest median diameter value of the vessel was encountered among those originating in the left middle suprarenal artery and reached 2.17 mm. The posterolateral quadrant of the fundus received the largest number of fundic branches, amounting to 46.5% of all the fundic branches studied.