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year-old man with group D bifurcation of left internal iliac artery (IIA). Lateral projection 3D volume-rendered reformatted CT angiogram shows left IIA dividing into two branches: posterior division with inferior gluteal artery (thin white arrows) and anterior division (arrowhead). Anterior division gives rise to superior gluteal artery (thick black arrow) and internal pudendal artery (thin black arrows). Thick white arrow indicates obturator artery arising from superior gluteal artery.
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Objective:
Severe acute respiratory syndrome (SARS) was a highly virulent atypical pneumonia caused by a novel coronavirus that resulted in a pandemic in 2003. Singapore was one of the most severely affected countries, and SARS took a heavy toll on our health care system. The lessons learned during the pandemic have shaped our national contagion r...
Context in source publication
Context 1
... group D pattern (Fig. 4) is very rare and has only been described in one pelvic side in cadavers (0.2%). We have seen only one pelvic side with this variant. The IIA di- vides into the common trunk for the superior gluteal and internal pudendal arteries (ante- rior division) and the inferior gluteal artery (posterior ...
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Emerging and re-emerging infections such as SARS (2003) and pandemic H1N1 (2009) have caused concern for public health researchers and policy makers due to the increased burden of these diseases on health care systems. This concern has prompted the use of mathematical models to evaluate strategies to control disease spread, making these models inva...
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Citations
... It is necessary to conduct screenings of patients and ensure that they are properly segregated and wearing masks in order to safely do imaging and make a diagnosis. During the 2003 epidemic, 75% of SARS cases in Singapore were acquired in the hospital environment, specifically with 10 cases directly associated with the imaging department [56]. This emphasizes the need of promptly suspecting and isolating individuals, particularly within the imaging department. ...
... Many radiology department workflow guidelines implemented in 2003 in response to the severe acute respiratory syndrome (SARS) epidemic may be applicable today. 2,3 Given SARS-CoV-2 infection appears to have a higher mortality rate, additional adjunctive measures will likely be necessary. 4 The Society of Interventional Radiology published online guidelines to help interventional radiologists navigate COVID-19 patient care during the pandemic. ...
The COVID-19 pandemic has challenged the capacity of interventional radiology departments worldwide to effectively treat COVID-19 and non-COVID-19 patients while preventing disease transmission among patients and healthcare workers. In this review, we describe the various data driven infection control measures implemented by the interventional radiology department of a large tertiary care center in the United States including the use and novel re-use of personal protective equipment, COVID-19 testing strategies, modifications in procedural workflows and the leveraging of telehealth visits. Herein, we provide effective triage, procedural, and management algorithms that may guide other interventional radiology departments during the ongoing COVID-19 pandemic and in future infectious disease outbreaks.
... • It is recom m ended to w ear a m ask in public because if people come closer to someone having the coronavirus, they can infect the non-infected individual [65]. ...
... • Avoid eating and drinking in public places-the virus can transmit through food utensils, dishes, and cups [65]. ...
In December 2019, a rare case of pneumonia was reported in Wuhan, China. This was later analyzed and known to have similar characteristics as viral pneumonia caused by a novel coronavirus. Later, on 11 February 2020, the World Health Organization (WHO) officially named the disease as COVID19. The Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) ought to taint both the upper respiratory tract and the lower respiratory tract. This COVID-19 is spreading quickly with an immense rise in cases around the world. This infection's mechanism stays obscure, and the medications explicit for the infection were not grown at this point. Infection is highly contagious. Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) is one of seven kinds of crown infection, including the one which causes severe maladies like Middle East respiratory disorder (MERS) and abrupt, intense respiratory syndrome(SARS). Since its revelation, the infection has spread and has caused anxiety and fear among people. Recent vaccines are tracked, and clinical trials can bring an immediate protocol on a medication approach. By including different therapeutic approaches, it is easier to combat the disease quickly. With very low mortality and high transmission rate, new approaches to vaccines and nanomedicines bring down the spread. Controlled patient care is also crucial. On 11 March, the World Health Organization (WHO) declared the disease as 'global pandemic’. COVID-19, therefore, poses a significant threat to global public health. This article reviews the epidemiology, pathogenesis, and diagnostic methods. The review also focuses on repurposed drugs, traced vaccines, and a quick view of prophylactic nanomedicines as an alternative for COVID 19. For this review, the complete database has been collected from various search engines such as PubMed, ScienceDirect, Scopus, Elsevier, etc., from the year 2001-2020 using the following keywords.
... The Severe Acute Respiratory Syndrome (SARS) epidemic had a profound impact on health care systems, resulting in long-term adjustments. In one example (62), transformative changes were instituted in a radiology service that prioritized infection control measures at the individual and system levels. These included scheduling of appointments that consider the infective risks of patients, regular cleaning of facilities undertaken by dedicated staff and including infection control measures in the planning of all future imaging facilities. ...
The COVID-19 pandemic has challenged and changed our healthcare systems around the world. There has been a heterogeneity of disease burden, healthcare resources, and non-imaging testing availability, both geographically and over time. In parallel, there has been a continued increase in understanding of how the disease affects patients, effectiveness of therapeutic options, and factors that modulate transmission risk. Here we detail experiences from radiology experts in representative countries from around the world, to share insights gained from local experience. These insights provide a guidepost to help address management challenges as cases continue to rise in many parts of the world and suggest modifications in workflow that are likely to continue after this pandemic subsides.
... Over the period, the foremost challenge to contain such emerging contagions includes the evolution of novel infectious promoters with the rapid spreading of diseases over the human population. Similar to several pathogenic diagnosis procedures, methods concerning SARS, MERS, and SARS-CoV-2 detection count on various laboratory-based evaluations like electron and cryo-electron microscopy (Gui et al. 2017), in vitro growth and quantification (Coleman and Frieman 2015;Hui et al. 2004;Matsuyama et al. 2020), immunological assays (Kogaki et al. 2005;Lau et al. 2004;Lee et al. 2017), and amplification of nucleic acid Cotten et al. 2013; accompanied with radiological analysis (Gogna et al. 2014;Hamimi 2016;Hosseiny et al. 2020;Jardon et al. 2019;Lin et al. 2005;Nasir et al. 2020). The basic dependency upon these in vitro diagnostic procedures is also documented with several shortcomings. ...
The novel Coronavirus Disease 2019 (COVID-19) pandemic has spread to more than 180 countries of the world. Chest imaging plays a critical role in screening and management of the disease. Chest X-ray is the most viable and economical radiological modality; however, it suffers from a lower sensitivity in the diagnosis of COVID-19. Therefore, CT is recommended for the screening of COVID-19. The predominant CT findings of COVID-19 infection are bilateral and peripheral ground-glass and consolidative pulmonary opacities. CT can be useful in assessing temporal changes in patients recovering from COVID-19. The knowledge about the disease is still evolving, and caution must be taken during the evaluation of chest CT of COVID-19. CT findings in children are also variable, but the most common findings are ground-glass opacities and consolidation. Radiology departments must implement strict infection control protocols. To minimize the COVID-19 spread, radiology departments should adopt team segregation strategies with minimum overlap of the personnel. This chapter discusses the possible role of imaging methods and the recent advancement in key CT findings of COVID-19 infection, preparation of radiology departments, strategies to reduce the transmission, and personnel safety.
... MERS, and SARS-CoV-2 detection count on various laboratory-based evaluations 53 like electron and cryo-electron microscopy (Gui et al. 2017), in vitro growth and 54 quantification (Coleman and Frieman 2015;Hui et al. 2004;Matsuyama et al. 2020), 55 immunological assays (Kogaki et al. 2005;Lau et al. 2004;Lee et al. 2017), and 56 amplification of nucleic acid (Corman et al. 2020;Shen et al. 2020;Cotten et al. 57 2013; Liu et al. 2020) accompanied with radiological analysis (Gogna et al. 2014;58 Hamimi 2016;Hosseiny et al. 2020;Jardon et al. 2019;Lin et al. 2005;Nasir et al. 59 2020). The basic dependency upon these in vitro diagnostic procedures is also 60 documented with several shortcomings. ...
Rapid diagnosis of infectious diseases and up-to-the-minute commencement of relevant treatments are important factors that not only promote positive changes in the clinical scenario but also the health of the mass at large. Surpassing the time-consuming conventional, straightforward in vitro methods for diagnosing infectious diseases, biosensors have shown their tremendous potential in the recent era. Current developments concerning biosensing technologies bring point-of-care diagnostics to the forefront. This proves to be advantageous over conventional practices that demand centralized laboratory facilities, experienced personnel, and colossal machinery. Currently, the infectious pandemic caused by the spreading of the novel coronavirus has created an unprecedented adverse effect on both the global economy and health security. The current situation of growing cases of infection despite several measures and the unavailability of testing kits to diagnose every suspected case point toward the need of urgent upgradation of the conventional diagnostic approaches to advanced, robust, and cost-effective diagnosis. Increasing demand in viral vigilance and directive regulatory steps toward the disease transmission also reveals the need for rapid as well as sensitive devices for viral diagnosis. From the last several decades, biosensors for their noteworthy sensitivity and specificity have been considered as a promising and potent tool for precise and quantifiable detection of viruses. Current developments in genetic engineering inclusive the genetic manipulation and material engineering have introduced several approaches to enhance sensitivity, selectivity, and the overall recognition efficiency of biosensors. This chapter presents an overview of the biosensing methodologies, especially focusing on various labeled and label-free techniques that have been used in the past and are being reported in the recent era for diagnosis.
... Previous experience with SARS has shaped our preparation for subsequent challenges. 1,2 We have employed three broad strategies for addressing the second surge and beyond: (1) build, (2) sustain and (3) adapt. ...
In this opinion piece derived from a webinar organized by the Radiological Society of North America and conducted in the spring of 2020 during the COVID-19 pandemic, leaders from three large North American and Asian academic radiology programs review the strategies employed at their respective institutions to address the impact of the pandemic on their departments. In the first segment, the author describes the approach taken in the radiology department at an 1800-bed Asian hospital system which focuses on the creation of capacity to accommodate over 5000 COVID-19 patients in early 2020, the sustaining of services during the surge, and the development of adaptive mechanisms to address future surges and pandemics. In the second segment, a large southwestern medical system addresses the creation of a long-term strategy to provide imaging services safely for staff and patients while simultaneously utilizing technology to maintain interprofessional connections. The final segment describes how a large multifacility health-care enterprise in the Pacific Northwest of the United States is developing strategies to successfully reemerge from the forced reduction in imaging services experienced during the COVID-19 surge in early 2020.
... This article serves to share our institutional diagnostic US protocol for effective service provision, staff protection, and business continuity planning [9]. The protocols and guidelines detailed were developed in consultation with our colleagues specializing in infectious diseases and specifically for the COVID-19 pandemic, with reference to our experience with the 2003 severe acute respiratory syndrome (SARS) epidemic and expertise from other institutions [10][11][12][13][14]. ...
... Because of the nation's previous encounter with SARS, general infection control measures have become ingrained in the psyche of all staff, and compliance rates are usually maintained at well over 90% [11]. All hospital staff undergo yearly refresher training on basic infection control measures such as the World Health Organization-defined "five moments of hand hygiene" [20]. ...
OBJECTIVE. Parastomal hernia (PSH) is a common complication that can occur after end colostomy and may result in considerable morbidity. To select the best candidates for prophylactic measures, knowledge of preoperative PSH predictors is important. This study aimed to determine the value of clinical parameters, preoperative CT-based body metrics, and size of the abdominal wall defect created during end colostomy and measured at postoperative CT for predicting PSH development. MATERIALS AND METHODS. Sixty-five patients who underwent permanent end colostomy with at least 1 year of follow-up were included. On preoperative CT, waist circumference, abdominal wall and psoas muscle indexes, rectus abdominis muscle diameter and diastasis, intra- and extraabdominal fat mass, and presence of other hernias were assessed. On postoperative CT, size of the abdominal wall defect and the presence of PSH were determined. To identify independent predictors of PSH development, univariate analysis with the Kaplan-Meier method and multivariate Cox regression analysis were performed. RESULTS. PSH developed after surgery in 30 patients (46%). Three independent risk factors were identified: chronic obstructive pulmonary disease (COPD) as a comorbidity (hazard ratio [HR], 6.4; 95% CI, 1.9-22.0; p = 0.003), operation time longer than 395 minutes (HR, 3.9; 95% CI, 1.5-10.0; p = 0.005), and maximum aperture diameter of more than 34 mm (HR, 5.2; 95% CI, 2.1-12.7; p < 0.001). PSH developed in all nine patients with a maximum abdominal wall defect diameter of more than 50 mm at the ostomy site. CONCLUSION. COPD, longer operation time, and larger abdominal wall defect at the colostomy site can predict PSH development. Intraoperative creation of an abdominal wall ostomy opening that is more than 34 mm in diameter should be avoided.
... Another study indicated that the ndings could be unilateral in up to 25% of the cases [11]. In resolving cases with less severity, chest CT images showed bilateral ground-glass opacities, whereas the consolidation had resolved [24]. ...
Background: The World Health Organization (WHO) recommends using corticosteroids in patients with severe coronavirus disease 2019 (COVID-19) and acute respiratory distress syndrome (ARDS), and a large randomized controlled clinical trial in the UK found that dexamethasone was effective in reducing the number of deaths in patients with severe COVID-19.
Case presentation: Herein, we described a case of COVID-19 with the clinical characteristics of the mild-symptomatic stage deteriorating to a critically ill state, who showed dramatic improvement with corticosteroids in the early stage of worsening of COVID-19 pneumonia.
Discussion: This article further discusses the most suitable timing and dosage of corticosteroid to maximize its effect during the worsening of COVID-19 pneumonia.
Learning points:
• One of the main pathophysiological hypotheses for severe COVID-19 pneumonia is related to cytokine storm and viral load.
• The clinical factors should be considered as the initial sign of a cytokine storm, and corticosteroid therapy may be useful in these patients.
... This article serves to share our institutional diagnostic US protocol for effective service provision, staff protection, and business continuity planning [9]. The protocols and guidelines detailed were developed in consultation with our colleagues specializing in infectious diseases and specifically for the COVID-19 pandemic, with reference to our experience with the 2003 severe acute respiratory syndrome (SARS) epidemic and expertise from other institutions [10][11][12][13][14]. ...
... Because of the nation's previous encounter with SARS, general infection control measures have become ingrained in the psyche of all staff, and compliance rates are usually maintained at well over 90% [11]. All hospital staff undergo yearly refresher training on basic infection control measures such as the World Health Organization-defined "five moments of hand hygiene" [20]. ...
OBJECTIVE. Repeated imaging is an unnecessary source of patient radiation exposure, a detriment to patient satisfaction, and a waste of time and money. Although analysis of rates of repeated and rejected images is mandated in mammography and recommended in radiography, the available data on these rates for CT are limited. MATERIALS AND METHODS. In this retrospective study, an automated repeat-reject rate analysis algorithm was used to quantify repeat rates from 61,102 patient examinations obtained between 2015 and 2018. The algorithm used DICOM metadata to identify repeat acquisitions. We quantified rates for one academic site and one rural site. The method allows scanner-, technologist-, protocol-, and indication-specific rates to be determined. Positive predictive values and sensitivity were estimated for correctly identifying and classifying repeat acquisitions. Repeat rates were compared between sites to identify areas for targeted technologist training. RESULTS. Of 61,102 examinations, 4676 instances of repeat scanning contributed excess radiation dose to patients. Estimated helical overlap repeat rates were 1.4% (95% CI, 1.2-1.6%) for the rural site and 1.1% (95% CI, 1.0-1.2%) for the academic site. Significant differences in rates of repeat imaging required because of bolus tracking (11.6% vs 4.3%; p < 0.001) and helical extension (3.3% vs 1.8%; p < 0.001) were observed between sites. Positive predictive values ranged from 91% to 99% depending on the reason for repeat imaging and site location. Sensitivity of the algorithm was 92% (95% CI, 87-96%). Rates tended to be highest for emergent imaging procedures and exceeded 9% for certain protocols. CONCLUSION. Our multiinstitutional automated quantification of repeat rates for CT provided a useful metric for unnecessary radiation exposure and identification of technologists in need of training.
