Interdepartmental miscommunication regarding radiology:Addressing chronic challenges and exploring solutions

Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care.Interdepartmental miscommunication poses a significant challenge to healthcare systems,potentially undermining the quality of healthcare services provided.In the same manner,communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes.This article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical practice.Practical solutions are explored and proposed,which should be tailored to the specific needs and issues that each individual institution may face.

Quantifying tissue perfusion after peripheral endovascular procedures:Novel tissue perfusion endpoints to improve outcomes

Peripheral artery disease(PAD)is a flow-limiting condition caused by narrowing of the peripheral arteries typically due to atherosclerosis.It affects almost 200 million people globally with patients either being asymptomatic or presenting with claudication or critical or acute limb ischemia.PAD-affected patients display increased mortality rates,rendering their management critical.Endovascular interventions have proven crucial in PAD treatment and decreasing mortality and have significantly increased over the past years.However,for the functional assessment of the outcomes of revascularization procedures for the treatment of PAD,the same tests that have been used over the past decades are still being employed.Those only allow an indirect evaluation,while an objective quantification of limb perfusion is not feasible.Standard intraarterial angiography only demonstrates post-intervention vessel patency,hence is unable to accurately estimate actual limb perfusion and is incapable of quantifying treatment outcome.Therefore,there is a significant necessity for real-time objectively measurable procedural outcomes of limb perfusion that will allow vascular experts to intraop eratively quantify and assess outcomes,thus optimizing treatment,obviating misinterpretation,and providing significantly improved clinical results.The purpose of this review is to familiarize readers with the currently available perfusion-assessment methods and to evaluate possible prospects.

Clinical presentation and outcomes of chronic dialysis patients with COVID-19:A single center experience from Greece

BACKGROUND Coronavirus disease 2019(COVID-19)is still a menacing pandemic,especially in vulnerable patients.Morbidity and mortality from COVID-19 in maintenance hemodialysis(MHD)patients are considered worse than those in the general population,but vary across continents and countries in Europe.AIM To describe the clinical course and outcomes of hospitalized MHD patients with COVID-19 in a retrospective observational single center study in Greece.METHODS We correlated clinical,laboratory,and radiological data with the clinical outcomes of MHD patients hospitalized with COVID-19 during the pandemic.The diagnosis was confirmed by real-time polymerase chain reaction.Outcome was determined as survivors vs non-survivors and“progressors”(those requiring oxygen supplementation because of COVID-19 pneumonia worsening)vs“non-progressors”.RESULTS We studied 32 patients(17 males),with a median age of 75.5(IQR:58.5-82)years old.Of those,12 were diagnosed upon screening and 20 with related symptoms.According to the World Health Organization(WHO)score,the severity on admission was mild disease in 16,moderate in 13,and severe in 3 cases.Chest computed tomography(CT)showed 1-10%infiltrates in 24 patients.Thirteen“progressors”were recorded among included patients.The case fatality rate was 5/32(15.6%).Three deaths occurred among“progressors”and two in“non-progressors”,irrespective of co-morbidities and gender.Predictors of mortality on admission included frailty index,chest CT findings,WHO severity score,and thereafter the increasing values of serum LDH and D-dimers and decreasing serum albumin.Predictors of becoming a“progressor”included increasing number of neutrophils and neutrophils/lymphocytes ratio.CONCLUSION Patients on MHD seem to be at higher risk of COVID-19 mortality,distinct from the general population.Certain laboratory parameters on admission and during follow-up may be helpful in risk stratification and management of patients.

Machine learning applications in healthcare clinical practice and research

Machine learning(ML)is a type of artificial intelligence that assists computers in the acquisition of knowledge through data analysis,thus creating machines that can complete tasks otherwise requiring human intelligence.Among its various applications,it has proven groundbreaking in healthcare as well,both in clinical practice and research.In this editorial,we succinctly introduce ML applications and present a study,featured in the latest issue of the World Journal of Clinical Cases.The authors of this study conducted an analysis using both multiple linear regression(MLR)and ML methods to investigate the significant factors that may impact the estimated glomerular filtration rate in healthy women with and without non-alcoholic fatty liver disease(NAFLD).Their results implicated age as the most important determining factor in both groups,followed by lactic dehydrogenase,uric acid,forced expiratory volume in one second,and albumin.In addition,for the NAFLD-group,the 5th and 6th most important impact factors were thyroid-stimulating hormone and systolic blood pressure,as compared to plasma calcium and body fat for the NAFLD+group.However,the study's distinctive contribution lies in its adoption of ML methodologies,showcasing their superiority over traditional statistical approaches(herein MLR),thereby highlighting the potential of ML to represent an invaluable advanced adjunct tool in clinical practice and research.