Introduction of helical computed tomography affects patient selection for V/Q lung scan

Summary Aim: Retrospective analysis for determination of the effect of helical computed tomography (HCT) on utilization of V/Q lung scanning to diagnose pulmonary embolism (PE) in a large general hospital. Methods: A total number of 2676 V/Q scans of in- and out-patients referred to our department between March 1992 and December 1998 and between April 1997 and December 1998 were analyzed by an identical group of nuclear physicians. Results: Neither the total number of annually performed V/Q scans (446 ± 135) nor the mean age of patients (56 years ± 17) changed significantly since the introduction of HCT. However, the referral pattern was different. The percentage of patients with high and intermediate probability for PE decreased significantly from 15.2% to 9.4% (p < 0.01) and from 10.2% to 7.3% (p < 0.05), respectively. Low probability scans significantly increased from 37.8% to 42.7% (p < 0.05). The percentage of normal scans did not change significantly, however, there was a highly significant increase summarizing patients with normal and low probability scans (74.6% to 83.3%; p < 0.01). Conclusion: The introduction of HCT affected the selection of patients referred for V/Q lung scanning since V/Q scanning was primarily used to exclude rather to confirm PE.

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Determination of subcarinal angle of trachea using computed tomography

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191526 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1527

Author(s):

Arshed Hussain Parry ◽

Abdul Haseeb Wani ◽

Yassar Shiekh ◽

Tariq A. Gojwari

Keyword(s):

Computed Tomography ◽

Spiral Ct ◽

Helical Computed Tomography ◽

P Value ◽

Study Cohort ◽

Minimum Intensity Projection ◽

Significant Difference ◽

The Mean ◽

Minimum Intensity

Background: Change in tracheal bifurcation angle (subcarinal angle) is an indirect marker of various cardiac, pulmonary and mediastinal pathologies. Helical computed tomography (CT) allows acquisition of volumetric set of data of the chest and can be used for accurate measurements of subcarinal angle using reconstructed images on a workstation using minimum intensity projection (MinIP).The objective of this study was to estimate normal subcarinal angle (SCA) of trachea by computed tomography and to assess its relationship with gender.Methods: This was an observational study comprising a study cohort of 552 patients comprising of 312 males and 240 females who were subjected to CT chest for various indications in our department. Patients with no underlying cardiac, mediastinal or pulmonary disease were included in the study. Spiral CT scan of chest was performed on 64-slice seimens CT SOMATOM and images were reconstructed with thickness of 1.5mm and the images were viewed in coronal reformatted minimum intensity projection (MinIP) for determination of subcarinal angle using the angle measuring tool provided in the workstationResults: The mean subcarinal angle (SCA) in males was (67.60±14.55). The mean subcarinal angle (SCA) in females was (78.90±11.04). Females had a higher mean SCA compared to males with a statistically significant difference (p-value <0.05).Conclusions: The mean SCA in females was higher compared to males with a statistically significant difference between the two. This study holds practical relevance with regard to the performance of invasive trachea-bronchial procedures like bronchoscopy and tracheal/bronchial intubation.

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Determination of enteroglucagon in plasma for detection of celiac disease in children.

Clinical Chemistry ◽

10.1093/clinchem/30.1.77 ◽

1984 ◽

Vol 30 (1) ◽

pp. 77-80 ◽

Cited By ~ 7

Author(s):

A F Kilander ◽

L Stenhammar ◽

G Lindstedt ◽

P A Lundberg

Keyword(s):

Celiac Disease ◽

Intestinal Biopsy ◽

Gastrointestinal Disorders ◽

Small Intestinal Biopsy ◽

The Mean ◽

Small Intestinal ◽

Untreated Celiac Disease ◽

Selection Of Patients ◽

Selection Of

Abstract To evaluate the plasma enteroglucagon assay as a test for the detection of celiac disease, we have determined basal and postprandial concentrations of enteroglucagon in plasma of children who underwent small-intestinal biopsy because of suspected celiac disease. In the 14 children with untreated celiac disease both basal [81 (SD 33) pmol/L] and postprandial [129 (SD 26) pmol/L] concentrations of enteroglucagon were significantly higher (p less than 0.001) than in the 45 children with other gastrointestinal disorders [24 (SD 9) pmol/L, and 50 (SD 22) pmol/L, respectively] and in the 15 children without gastrointestinal disorders [14 (SD 10) pmol/L, and 35 (SD 8) pmol/L, respectively]. All children with celiac disease had either basal or postprandial plasma enteroglucagon concentrations exceeding the mean + 2 SD of the results for the children with other gastrointestinal disorders. Eight of 10 children with celiac disease in whom both concentrations were measured had increased values for both. In our study the sensitivity for detection of celiac disease was 100% and the specificity 97%. Evidently determination of plasma enteroglucagon concentration is effective in diagnosing celiac disease, thereby improving the selection of patients for small-intestinal biopsy.

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Sphenopalatine foramen: endoscopic approach with bony landmarks

The Journal of Laryngology & Otology ◽

10.1017/s0022215115000766 ◽

2015 ◽

Vol 129 (S3) ◽

pp. S47-S52 ◽

Cited By ~ 4

Author(s):

S Nalavenkata ◽

C Meller ◽

D Novakovic ◽

M Forer ◽

N P Patel

Keyword(s):

Computed Tomography ◽

Standard Deviation ◽

Inferior Turbinate ◽

Helical Computed Tomography ◽

Prospective Analysis ◽

Sphenopalatine Foramen ◽

Bony Landmarks ◽

Computed Tomography Scans ◽

The Mean

AbstractObjective:To establish whether nasal bony landmarks on computed tomography could be utilised reliably in endoscopic approaches to the sphenopalatine foramen.Methods:A prospective analysis of 102 consecutive helical computed tomography scans of the paranasal sinuses was carried out by 2 senior ENT surgeons. Distances from the sphenopalatine foramen to endoscopically palpable bony landmarks were measured.Results:There were a total of 102 patients (45 females and 57 males), with a mean age of 62 years. The mean distance from the posterior fontanelle to the sphenopalatine foramen was 14.1 mm (standard deviation = 2.13). The average vertical distance of the sphenopalatine foramen opening from the bony attachment of the inferior turbinate was 14.13 mm. There were no statistically significant differences between any of these measurements (foramen widthp-value = 0.714, distance from fontanellep-value = 0.43 and distance from inferior turbinatep-value = 0.48).Conclusion:Determination of reliable bony landmarks is clinically useful in endoscopic surgery and can aid identification of the sphenopalatine foramen. The inferior turbinate concha and posterior fontanelle may be used as reliable computed tomography landmarks for endoscopic approaches to the sphenopalatine foramen.

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Surgical treatment of bilateral temporal lobe pharmacoresistant epilepsy

Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery) ◽

10.33920/med-01-2008-06 ◽

2020 ◽

pp. 60-82

Author(s):

Igor Sergeevich Trifonov ◽

Mikhail Vladimirovich Sinkin ◽

Elena Vladimirovna Grigoryeva ◽

Rashid Abdurakhmanovich Navruzov

Keyword(s):

Surgical Treatment ◽

Temporal Lobe ◽

Clinical Picture ◽

Clinical Manifestations ◽

Epileptogenic Zone ◽

Pharmacoresistant Epilepsy ◽

Modern Methods ◽

Selection For ◽

Selection Of Patients ◽

Selection Of

Surgical treatment of bilateral temporal lobe pharmacoresistant epilepsy is associated with some difficulties: particularly, the lack of stereotypical clinical picture in the same patient and controversial data on modern methods of diagnostics — all these statements make identifying epileptogenic zone more difficult and lack of clear criteria for the selection of patients for surgical treatment. In this review, issues of aetiology, pathogenesis, clinical manifestations and criteria for the selection for surgical treatment suggested by different authors are presented.

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A Versatile Radioimmunoassay for the Determination of Serum Oestriol in Pregnancy

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456327301000158 ◽

1973 ◽

Vol 10 (1-6) ◽

pp. 159-166 ◽

Cited By ~ 3

Author(s):

J. E. H. Stafford

Keyword(s):

Normal Pregnancy ◽

Optimum Conditions ◽

Random Series ◽

The Mean ◽

Hydrolysis Of ◽

Selection Of ◽

In Pregnancy

A versatile radioimmunoassay for serum oestriol in pregnancy has been developed which requires 10 μ| of serum (for total) or 50 μ| (for unconjugated). Selection of the optimum conditions for the hydrolysis of serum oestriol conjugates, the isolation of free oestriol, the displacement of tritiated oestriol by cold oestriol and the separation of the free and bound fractions is described. Total oestriol levels doubled between weeks 34 and 38 of normal pregnancy, very little change occurring in the mean level after the 38th week of gestation. In a random series of pregnancy sera there was a significant correlation between total and unconjugated oestriol.

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Abstract 4349: Usefulness of Echocardiographic Measures of Dyssynchrony in Patients with Borderline QRS Duration for Selection for Resynchronization Therapy

Circulation ◽

10.1161/circ.118.suppl_18.s_870-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Olusegun Oyenuga ◽

Hideyuki Hara ◽

Hidekazu Tanaka ◽

Han-Na Kim ◽

Samir Saba ◽

...

Keyword(s):

Radial Strain ◽

Tissue Doppler ◽

Cardiac Resynchronization ◽

Class Iii ◽

Resynchronization Therapy ◽

Filling Time ◽

Qrs Duration ◽

Selection For ◽

Selection Of Patients ◽

Selection Of

Although echo dyssynchrony has not replaced routine selection criteria for cardiac resynchronization therapy (CRT) in patients with wide QRS, our objective was to test the hypothesis that dyssynchrony may assist in selection of patients for CRT with borderline QRS duration. We studied 119 heart failure patients referred for CRT; all were Class III-IV with ejection fraction (EF) ≤35%: 79 had Wide-QRS ≥130ms (169 ±28ms), and 40 had Borderline-QRS 100 –130ms (116 ±7ms). Dyssynchrony was assessed using tissue Doppler (TDI) longitudinal velocities from apical views (≥65ms opposing wall delay) and speckle tracking radial strain (≥130 ms septal to post. wall delay). Pulsed Doppler assessed interventricular mechanical delay (IVMD) (≥40ms), and filling time/RR interval (FT/RR ≤40%). Patients were followed for 8±5 months. Response to CRT was defined as ≥15% increase in EF. Overall, 77% of the Wide-QRS group were EF responders in contrast to 65% of the Borderline-QRS group. TDI was 87% sensitive and 67% specific for predicting response in the Wide-QRS group, but only 46% specific in the Borderline-QRS group. Radial dyssynchrony was the best predictor of response in the Borderline-QRS group with 80% sensitivity and 92% specificity. Although IVMD and FT/RR had low sensitivities, they were 100% specific. EF response to CRT is less frequent in patients with Borderline-QRS than in those with Wide-QRS. Radial dyssynchrony appears to be the best predictor of EF response in Borderline-QRS patients; IVMD and FT/RR were highly specific. A combined echo assessment of dyssynchrony has potential to assist in selection of patients for CRT with borderline QRS.

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Upfront cytoreductive surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer in Indian patients

Future Oncology ◽

10.2217/fon-2021-0077 ◽

2021 ◽

Author(s):

Mukur Dipi Ray ◽

Suryanarayana S.V. Deo ◽

Lalit Kumar ◽

Manish Kumar Gaur

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Ovarian Carcinoma ◽

Cytoreductive Surgery ◽

Advanced Ovarian Cancer ◽

Advanced Stages ◽

Selection For ◽

Selection Of Patients ◽

Selection Of

In cases of ovarian carcinoma, primary cytoreductive surgery (CRS) is the standard treatment up to stage IIIB, but patient selection for neoadjuvant chemotherapy (NACT) in selected cases is controversial. A total of 200 patients with advanced ovarian cancer were analyzed retrospectively, according to specific selection criteria. Primary CRS was performed in 95 patients (47.5%) and interval CRS after 3–6 cycles of NACT was performed in 105 patients (52.5%). After median follow-up of 35 months, 5-year overall survival was 53.7% in the upfront CRS group and 42.2% in the NACT group. Primary CRS is the standard in advanced stages of ovarian carcinoma, but in certain subset of patients, NACT is preferred. Identifying that group is challenging but feasible. Proper selection of patients is key to successful outcomes.

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