Tuesday, January 19, 2021

Medical Imaging Review: What does a Covid Lung look like?

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A report by: Dr. Robert L. Bard

All research and testing programs undergo an evolutionary staging of its data-gathering and problem solving approach.  The process of getting the right answers often starts with an initial blueprint, then grows in scope over time.

As research efforts mature, different technologies and testing resources could be added into the process to get more information or to expand the view of the problem.  If the target problem is vastly larger than originally anticipated, a complete redesign of the testing strategy may be what is called for.  

In the case of testing for the physiological effects of Covid-19, researchers have employed standard medical diagnostic protocols from genetic/blood testing to biopsies to all available medical imaging devices) to gather all necessary data.  These protocols independently and in concert provide the necessary answers leading to treatment, prevention and early detection. 

Covid-19 Effects on the Lungs + Chest Ultrasound   Written and presented by: Dr. Stephen Chagares (originally published May 7, 2020)

The Coronavirus has been shown to be very lethal to a subset of patients. What happens is that the virus is ingested into the mouth or nose, going down into the back of the throat (called the hypopharynx and the larynx) and then is breathed into the lungs themselves. The lungs are made of millions of little air SACS called alveoli, and the virus gets into these little layer sacks and adheres to the inner lining. That lining is what allows the interface between the blood and the air and the CO2 from the blood is given out. The oxygen from the air is given into the blood. That's how we breathe in oxygen and blow out CO2.

When the virus gets in there and coats that surface, everyone creates some kind of reaction. One is an antibiotic body reaction- which is an immune response. The other thing that happens is a physical inflammatory response where the immune system automatically goes into defense mode and wants to go in and kill the virus. It senses it's there and sends in "defender" cells, and to most people, it can send the proper amount of little soldiers to do the job. But in a small percentage of patients, the body's internal reaction causes too much inflammation causing a large body of fluid to fill up in the alveoli (air sacs) in the lungs. This stops the ability for oxygen to fuse through those air sacks to get oxygen into the entire body, include vital organs like the heart, the brain, the liver etc.  Without oxygen, this could result serious problems like heart and liver failure (and other such symptoms).

To visually identify this problem, existing technologies have to be tuned to track and monitor cardio-pulmonary performance. Chest x-rays or CT/catscans are available and are widely used now- but carry a number of key issues when it comes to regular chest monitoring. Often normal chest X rays are going to miss this because radiation itself will go through the lung tissue and the fluid and it may not show anything too specific. And then a cat scan may show something totally different where you can see how both lungs are all inflamed and have fluid in them.

Covid Lung Imaging: Case Report
37-year old woman with COVID-19 requiring FiO2 of 1.0 delivered via heated humidified high-flow Nasal cannula for 8 days. On day 8, initiation of treatment with ‘pulse-dose’ methylprednisolone 1000 mg intravenously for 3 days was followed by an abrupt reduction in oxygen needs and eventual discharge on ambient air. (A) Contrast-enhanced thin-section CT image 6 days after onset of symptoms shows peripheral and peri-bronchial ground-glass opacity in both lungs typical of an organizing pneumonia pattern of lung injury. (B) Unenhanced CT image 2 weeks after discharge shows marked clearing of ground-glass opacity with small foci of lung consolidation and minimal traction bronchiectasis (arrows) suggesting mild fibrosis. [3]

WHAT ARE B LINES? By: Dr. Pierre Kory
The analysis of lung artefacts has gained increasing importance as markers of lung pathology. B-line artefact (BLA), caused by a reverberation phenomenon. (source link: NCBI/NIH) B-lines in COVID-19 pneumonia are visualized in all their possible forms. We may describe COVID-19 pneumonia as a storm of clusters of B-lines, both in separate and coalescent forms, sometimes giving the appearance of a shining white lung. They can arise from one point of the pleural line and from small peripheral consolidations and spread down like rays maintaining their brightness until the edge of the screen without fading. These artifacts represent the typical signs of the disease, but can be also observed in other interstitial diseases of various etiologies (Source link: The Ultrasound Journal/Springer)

“When conducting lung ultrasound scanning, you look for signs of B-LINES. The more B lines you have equals a bad lung ultrasound score – indicating a high risk of deterioration. For any treatment protocol, if a patient whose lung ultrasound scan was getting worse, I might want to start escalating my therapy.” – Dr. Philippe Kory, MATH+

HOW USEFUL IS LUNG SCANNING FOR COVID-19? For decades, the popularity of ultrasound technology has joined the front lines in identifying and diagnosing disorders from CANCER TUMORS (PROSTATE, BREAST, SKIN, THYROID, MELANOMA etc), musculoskeletal issues and even transcranial (brain) disorders.

With the current pandemic, clinicians worldwide have been earmarking how identifying issues in the lungs (and the cardiopulmonary area) through the use of ultrasound equipment can be quite helpful in monitoring, screening, scanning and tracking pulmonary vulnerabilities and infections that may require follow-up testing for Coronavirus.

Ultrasound for Critical Care and Regular Covid Monitoring of Respiratory Pathogens

Adding to the arsenal of diagnostic solutions for the Covid-19 respiratory pathogen, the LUNG (or CHEST) ULTRASOUND is making great strides in triage facilities and bedside monitoring.  A growing community of European health specialists are joining a procedural movement to "replace" the dependency on stethoscopes with portable ultrasound use to check a patient's immediate cardiopulmonary condition. For Covid-positive patients, today's ultrasound excels in getting immediate answers safely without radiation - allowing for screening and repeated monitoring. Such is the case in this test sample.

According to radiologist Dr. Robert Bard, indication of the presence of Covid-19 will show in the form of B-LINES (or the 2 vertical rays). "B-Lines specifically mean that the lung tissue adjacent to the coating of the lung is abnormal- and that's what generates these lines. Normal lung tissue should never have B-lines. If you don't have B-Lines, you don't have Covid in the lungs..."

The evolution of the portable ultrasound is now being viewed by many as a diagnostic game-changer for patient care in the field. From an interview with professional technical instructor Michael Thury of Terason Ultrasound, he states "the industry just exploded from 30 years ago with the ability and the confidence that ultrasound can give you. The technology enables the physician to really do a much better job diagnosing the patient. As a clinical trainer with clients worldwide, the boom of telemedicine adds to the success of teaching clinicians how to get the most out of remote ultrasound, but also to have fast and easy access to the physician to read and diagnose the patient from any location!"

Vaccine Confidence from a Healthcare Worker
1/15/2021- Dr. Michael Schulder, a leading neurosurgeon at Northwell Health in Long Island, NY shares his insights and his personal research on the safety and efficacy of the recently deployed Coronavirus vaccine.  Dr. Schulder also addresses his views on public skepticism about the vaccine over some of the unknown factors of the coronavirus.  He shares his confidence in the science and the preventive strategy of the vaccine as well as its social impact on the global stage.  (See complete interview)

IVERMECTIN: A Covid-19 Game-Changer?
On Dec 8, 2020, committee chairman Republican Sen. Ron Johnson called ICU Pulmonary specialist Dr. Pierre Kory of the Aurora St. Luke’s Medical Center (WI) and president of the FLCCC to the US Senate Homeland Security and Governmental Affairs Committee.  The hearing was called “Early Outpatient Treatment: An Essential Part of a COVID-19 Solution, Part II.”  Dr. Kory gave his testimony on behalf of frontline physicians about the current state of care in the Covid pandemic and what his group specifies as the logic-based treatment with scientifically proven data that he pleads the NIH to review.  (See complete video and Transcript of Dr. Kory's Testimony)

“After years of procrastinating, my husband Ted finally managed to book a trip to the dermatologist to remove a few annoying skin tags and a tiny mole from his left shoulder. On a routine trip to my radiologist, a simple handheld scanner concluded that Ted's mole was a MALIGNANT MELANOMA - a potentially deadly tumor. Ted discussed what would have been our next appointment and it was then that we realized that if the dermatologist would have applied the freezing solution to this mole under ‘standard procedure’ unaware of what we discovered, the melanoma would have metastasized and fast-tracked to every organ in the body.. . (See Feature article)

Originally published at the Journal of Modern Healing (9/2020)
Did you know that SEAWEED may be used for Anti-Cancer + Inhibitor of Covid-19? A natural health ingredient known as FUCOIDAN has joined our western fight against cancer -native to the cold temperate seas of China, Japan, Korea. According to Memorial Sloan Kettering Cancer Center, "Fucoidan is a complex polysaccharide found in many species of brown seaweed .... shown to slow blood clotting. Laboratory studies suggest that it can prevent the growth of cancer cells and has antiviral, neuroprotective, and immune-modulating effects. (See full article)