OBJECTIVE To investigate the clinical and CT features associated with severe and critical Corona Virus Disease 2019 (COVID-19) pneumonia. MATERIALS AND METHODS Eighty-three patients with COVID-19 pneumonia including 25 severe/critical cases and 58 ordinary cases were enrolled. The chest CT images and clinical data of them were reviewed and compared. The risk factors associated with disease severity were analyzed. RESULTS Compared with the ordinary patients, the severe/critical patients had older ages, higher incidence of comorbidities, cough, expectoration, chest pain and dyspnea. The incidences of consolidation, linear opacities, crazy-paving pattern and bronchial wall thickening in severe/critical patients were significantly higher than those of the ordinary patients. Besides, severe/critical patients showed higher incidences of lymph node enlargement, pericardial effusion and pleural effusion than the ordinary patients. The CT scores of severe/critical patients were significantly higher than those of the ordinary patients (P 50 years old, comorbidities, dyspnea, chest pain, cough, expectoration, decreased lymphocytes and increased inflammation indicators were risk factors for severe/critical COVID-19 pneumonia. CT findings of consolidation, linear opacities, crazy-paving pattern, bronchial wall thickening, high CT scores and extrapulmonary lesions were features of severe/critical COVID-19 pneumonia. CONCLUSIONS There are significant differences in clinical symptoms, laboratory examinations and CT manifestations between the ordinary patients and the severe/critical patients. Many factors are related to the severity of the disease, which can help clinicians to judge the severity of the patient and evaluate the prognosis.BACKGROUND Osteonecrosis of the femoral head (ONFH) is a cause of hip pain and early joint arthrosis in the young patient. Nonarthroplasty interventions aim to decompress vascular congestion in the femoral head and stimulate new bone growth to prevent progression and collapse. Therefore, the purpose of this study is to evaluate the available evidence on the effect of adjuvant bone marrow stem cells (BMSCs) for early stage ONFH. https://www.selleckchem.com/products/pnd-1186-vs-4718.html METHODS We performed a systematic review of the MEDLINE, PubMed, Embase, and Cochrane databases in search of published reports comparing the core decompression (CD) with/without adjuvant BMSCs for ONFH. The cohort was divided into two groups (1) CD with BMSCs (intervention) and (2) CD alone (control subject). The various outcome parameters including hip pain and function, progression of ONFH, rate of revision surgeries, and complications were analyzed. Data were extracted and aggregated for meta-analysis. Cases with staging beyond Ficat II, UPENN II, or ARCO II were excluded. RESULTS Of the published reports, 16 met our inclusion criteria with an aggregated 583 hips in the intervention and 468 hips in the control subject groups, respectively. Addition of bone marrow cells to CD resulted in lower hip pain score (VAS) (MD = -10.88, 95% CI = -16.84 to -4.92, P = 0.003) and higher HHS score (MD = 5.59, 95% CI = 1.13 to 10.04, P = 0.01) compared with CD alone at the 24-month follow-up. For rates of progression to higher stages, 138 progressed in the intervention group compared with 202 in the control subject group (P = 0.0002). Finally, subsequent patients who required total hip arthroplasty surgery were lower in the intervention group (22.5% versus 42.3%, P = 0.001). CONCLUSIONS Despite heterogeneous and poor data, there is evidence that addition of bone marrow cells to CD appears to result in better clinical outcomes and lower rates of disease progression compared with cored decompression alone. LEVEL OF EVIDENCE Therapeutic Level III.INTRODUCTION Attending clinic appointments after injury is crucial for orthopaedic trauma patients to evaluate healing and to update recommendations. However, attendance at these appointments is inconsistent. The purpose of this study was to assess the effect of a personalized phone call placed 3 to 5 days after hospital discharge on attendance at the first postdischarge outpatient clinic visit. METHODS This prospective study was done at an urban level 1 trauma center. One hundred fifty-nine patients were exposed to a reminder phone call, with 33% of patients being reached for a conversation and 28% receiving a voicemail reminder. Phone calls were made by a trained trauma recovery coach, and the main outcome measure was attendance at the first postdischarge clinic visit. RESULTS Eighty-six patients (54%) attended their scheduled appointments. Appointment adherence was more common among the group reached for a conversation (70% versus 51% for voicemail cohort and 34% for no contact group). Patients exposed to the Trauma Recovery Services (TRS) during their hospital stay attended appointments more often (91% versus 61%, P = 0.026). Age, sex, mechanism of injury, and distance from the hospital were not associated with specific follow-up appointment adherence. Insured status was associated with higher attendance rates (71% versus 46%, P = 0.0036). Other economic factors such as employment were also indicative of attendance (64% versus 48%, P = 0.05). Current tobacco use was associated with poor appointment attendance (30%) versus 56% for nonsmokers (P = 0.001). DISCUSSION Patients reached by telephone after discharge had better rates of subsequent clinic attendance. Economic factors and substance use appear vital to postoperative clinic visit compliance. Patients with met psychosocial needs, as identified by individuals with satisfactory emotional support, and exposure to TRS had the highest rates of postdischarge appointment attendance.OBJECTIVES Gemcitabine plus cisplatin (GC) is recommended as first-line treatment for advanced cholangiocarcinoma. We investigated the impact of GC in patients with unresectable hilar cholangiocarcinoma (HC) based on the time taken for effective biliary drainage (EBD). MATERIALS AND METHODS We retrospectively enrolled 113 patients with unresectable HC. Thirty-nine and 74 patients received GC chemotherapy and best supportive care (BSC), respectively. EBD was defined as a reduction in total bilirubin >50% or to a value less then 2 mg/dL after the drainage procedure. Early EBD (eEBD) and delayed EBD (dEBD) were separated by 2 weeks. Overall survival (OS) was estimated. RESULTS The GC group showed a significantly longer median OS than the BSC group (12.8 vs. 6.1 mo; P less then 0.001). Moreover, the eEBD group experienced a significantly longer OS than the dEBD group (8.2 vs. 4.3 mo; P less then 0.001). GC led to improved OS in the eEBD (12.8 vs. 6.8 mo; P=0.003) and dEBD (12.2 vs. 3.4 mo; P=0.009) groups. In multivariate analysis, dEBD (adjusted hazard ratio [aHR], 1.