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  • 1
    Online Resource
    Online Resource
    Acute kidney injury after multiphase imaging for lesions detected on hepatocellular carcinoma surveillance in patients with cirrhosis
    BMJ ; 2020
    In:  BMJ Open Gastroenterology Vol. 7, No. 1 ( 2020-05), p. e000394-
    Details
    In: BMJ Open Gastroenterology, BMJ, Vol. 7, No. 1 ( 2020-05), p. e000394-
    Abstract: The risk difference between multiphase multidetector contrast-enhanced CT and MRI for developing acute kidney injury (AKI) has not been previously evaluated in patients with cirrhosis undergoing hepatocellular carcinoma (HCC) surveillance. We aimed to compare the rate of AKI after CT and MRI for evaluation of these lesions. Design A retrospective chart review of all patients with cirrhosis who underwent either multiphase multidetector liver protocol CT or MRI for lesions detected on HCC screening was conducted at West Virginia University. The rate of AKI after imaging was compared between the two groups. Results A total of 416 patients were included. Hepatitis C was the most common aetiology (34.6%) of cirrhosis. Thirty-six patients had chronic kidney disease at the time of imaging. CT imaging was conducted for 173 (41.5%) patients, while 58.5% underwent MRI. Nineteen (4.6%) patients developed AKI after imaging. The incidence of AKI was 2.89% for CT and 5.76% for MRI (p value = 0.25). Multivariate logistic regression analysis revealed that inpatient status (p value = 0.015) and Model for End-Stage Liver Disease score (p value = 0.02) were independently linked to the development of AKI following imaging, while the type of imaging modality was not. Conclusions There is no difference in the risk of AKI after CT or MRI for evaluation of lesions identified on HCC surveillance. The rates of AKI after these imaging studies are low and are attributable to other aetiologies in most cases. We propose that the choice of imaging should be made based on availability, cost, and other patient-related and facility-related factors.
    Type of Medium: Online Resource
    ISSN: 2054-4774
    URL: Article
    DOI: 10.1136/bmjgast-2020-000394
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2884818-4
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  • 2
    Online Resource
    Online Resource
    Acute cerebellitis successfully managed with temporary cerebrospinal fluid diversion using a long tunnel external ventricular drain: a long-term radiological follow-up of two cases
    BMJ ; 2016
    In:  BMJ Case Reports
    Details
    In: BMJ Case Reports, BMJ
    Type of Medium: Online Resource
    ISSN: 1757-790X
    URL: Article
    DOI: 10.1136/bcr-2016-215631
    Language: English
    Publisher: BMJ
    Publication Date: 2016
    detail.hit.zdb_id: 2467301-8
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  • 3
    Online Resource
    Online Resource
    Patients with idiopathic pulmonary fibrosis have poor clinical outcomes with COVID-19 disease: a propensity matched multicentre research network analysis
    BMJ ; 2021
    In:  BMJ Open Respiratory Research Vol. 8, No. 1 ( 2021-08), p. e000969-
    Details
    In: BMJ Open Respiratory Research, BMJ, Vol. 8, No. 1 ( 2021-08), p. e000969-
    Abstract: Outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with pre-existing idiopathic pulmonary fibrosis (IPF) remain understudied, and it is unknown if IPF is an independent predictor of worse disease course. Herein, we report the clinical outcomes in a large cohort of 251 patients with COVID-19 in the setting of known IPF. Outcomes were compared with a propensity matched cohort of patients with COVID-19 without IPF. Methods Analysis of a federated multicentre research network TriNetX was performed including patients more than 16 years of age diagnosed with SARS-CoV-2 infection. Outcomes in patients diagnosed as positive for SARS-CoV-2 infection with concurrent IPF were compared with a propensity matched cohort of patients without IPF. Results A total of 311 060 patients with SARS-CoV-2 infection on the research network were identified, 251 patients (0.08%) carried a diagnosis of IPF. Mean age of patients with IPF was 68.30±12.20 years, with male predominance (n=143, 56.97%). Comorbidities including chronic lower respiratory diseases, diabetes mellitus, ischaemic heart disease and chronic kidney disease were more common in patients with IPF when compared with the non-IPF cohort. After propensity matching, higher rates of composite primary outcome (death or mechanical ventilation) at 30 and 60 days, as well as need for hospitalisation, critical care, and acute kidney injury were observed in the IPF cohort. Conclusion Poor outcomes of COVID-19 disease were observed in patients with IPF after robust matching of confounders. Our data confirm that patients with IPF constitute a high-risk cohort for poor outcomes related to COVID-19 disease.
    Type of Medium: Online Resource
    ISSN: 2052-4439
    URL: Article
    DOI: 10.1136/bmjresp-2021-000969
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2736454-9
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