Artificial intelligence (AI) adopting deep learning technology has been widely used in the med-ical imaging domain in recent years. It realized the automatic judgment of benign and malig-nant solitary pulmonary nodules (SPNs) and even replaced the work of doctors to some extent. However, misdiagnoses can occur in certain cases. Only by determining the causes can AI play a larger role. A total of 21 Coronavirus disease 2019 (COVID-19) patients were diagnosed with SPN by CT imaging. Their Clinical data, including general condition, imaging features, AI re-ports, and outcomes were included in this retrospective study. Although they were confirmed COVID-19 by testing reverse transcription-polymerase chain reaction (RT-PCR) with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), their CT imaging data were misjudged by AI to be high-risk nodules for lung cancer. Imaging characteristics included burr sign (76.2%), lobulated sign (61.9%), pleural indentation (42.9%), smooth edges (23.8%), and cavity (14.3%). The accuracy of AI was different from that of radiologists in judging the nature of be-nign SPNs (p < 0.001, κ = 0.036 < 0.4, means the two diagnosis methods poor fit). COVID-19 patients with SPN might have been misdiagnosed using the AI system, suggesting that the AI system needs to be further optimized, especially in the event of a new disease outbreak.
Prevotella is often considered a Bacteroides complex associated with a healthy plant-based diet that acts as a “probiotic” throughout the body’s entire digestive tract from the mouth to the anus. Previous studies have not reported that this “probiotic” colonizing the human body could cause severe pneumonia. This case report describes a 56-year-old healthy female worker with gum pain followed by fever. Despite prompt medical attention given by the use of empirical antibiotics and tooth and oral cleaning, the disease rapidly progressed to retropharyngeal abscess and severe pneumonia. Although the surgeon performed pharynx and cervical incisions and drainage, the patient’s symptoms were not significantly relieved. After repeated blood culture and sputum culture, no positive findings were found. Fortunately, Prevotella oris was found in the peripheral blood of the patient by metagenomic next-generation sequencing (mNGS). The disease was controlled quickly by changing the targeted antibiotics according to the guidelines for the detection of pathogenic bacteria. Three months after discharge, the patient’s symptoms did not resolve, and reexamination with computerized tomography (CT) showed that the neck and chest were normal. This case is unique in that it shows that normally colonized Prevotella oris could also cause fatal pneumonia as an opportunistic pathogen. Our goal is to highlight that serious infections that rapidly develop from common symptoms in an era of widespread antibiotic use not only increase patient misunderstanding but also lead to over detection and testing of such symptoms by clinicians. Expanding the pathogenic characteristics of special pathogens through the literature and using accurate mNGS may be the technical tool for resolving this contradiction.
1 March 2023 in Risk Management and Healthcare Policy
Background: The Fangcang shelter hospital has gradually become the primary management mode in China’s fight against this Corona Virus Disease 2019 (COVID-19) in 2020. In early 2022, the Fangcang shelter hospital management model was successfully applied to the new outbreak of COVID-19 in Shanghai also. Although Fangcang shelter hospitals are no longer the prevailing mode of prevention of COVID-19, the management experience of Shanghai makeshift hospitals is worthy of reference for public health. Methods: The authors conducted a descriptive statistical analysis of Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. The whole hall of the Fangcang shelter hospital was managed by the one hospital, and the inclusion of third-party management personnel alleviated the shortage of medical personnel human resources. Through practice, a new procedure for treating batch infected people was introduced. Results: By optimizing ward management, 72 on-duty doctors, 360 on-duty nurses, 3 sense-control administrators, and 15 administrators cured 18,574 infected people in 40 days, and created a record of a doctor managing 700 infected people without compromising the quality of treatment. There have been no deaths and no complaints from the infected people located in Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. Conclusion: Compared with previous data, the new management mode of Fangcang shelter hospitals provides a reference for the management of the new infectious diseases for public health.