Different Patellar Indices and Their Role in Decision-Making: An MRI-Based Study

2020 ◽  
Author(s):  
Sivashanmugam Raju ◽  
Karthikeyan Chinnakkannu ◽  
Balasubramanian Balakumar ◽  
Ramanivas Sundareyan ◽  
Saravanakumar P. Kaliappan ◽  
...  
Keyword(s):  
Decision Making ◽  
Patellofemoral Pain ◽  
Mr Images ◽  
Strong Negative Correlation ◽  
Mean Values ◽  
Patellar Position ◽  
Asymptomatic Patients ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
The Many

AbstractMagnetic resonance imaging (MRI) of knee has become the integral part of knee evaluation, hence any MRI based study adds more value if it helps in the decision-making process, especially for surgery in treating patellofemoral pain. We tried to determine normal patellar indices using knee MR images and the correlation between them and also compared the results with different ethnic population. We analyzed the prospectively collected MR images of 117 knees/patients, and Insall–Salvati (IS) index, modified IS index, patellotrochlear (PT) index, and patellophyseal (PP) index were calculated. Two standard deviations from the mean were used to define the normal and abnormal patellar position. Cohen's kappa values were used to assess the agreement between the indices and the correlation between them was analyzed using Pearson's correlation. The mean values for IS index, modified IS index, PT index, and PP index were 1.00, 1.53, 0.40, and 0.58, respectively. There was very good agreement between PT index and PP index. There was weak correlation between all the indices except the one between PT and PP indices which had a strong negative correlation. Based on commonly used methodology, there were 4% of asymptomatic patients who were outside the standardized cut-off values and different indices classified different knees as abnormal. This indicates patellar position should be one among the many other factors, not as a sole factor when making a surgical decision in patellofemoral pain. We also noted that the indices compared fairly with other populations. Further research is needed to determine the clinical applicability of these indices.

scholarly journals Postarthroscopy Imaging in Femoroacetabular Impingement: Persistent Pain May Be Due to an Insufficient Correction of Preoperative Abnormalities

Joints ◽  
2017 ◽  
Vol 05 (01) ◽  
pp. 021-026 ◽  
Author(s):  
Cosimo Tudisco ◽  
Salvatore Bisicchia ◽  
Sandro Tormenta ◽  
Amedeo Taglieri ◽  
Ezio Fanucci
Keyword(s):  
Case Series ◽  
Persistent Pain ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Mean Values ◽  
Center Edge ◽  
Patient Groups ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Purpose The purpose of this study was to evaluate the effect of correction of abnormal radiographic parameters on postoperative pain in a group of patients treated arthroscopically for femoracetabular impingement (FAI). Methods A retrospective study was performed on 23 patients affected by mixed-type FAI and treated arthroscopically. There were 11 males and 12 females with a mean age of 46.5 (range: 28–67) years. Center-edge (CE) and α angles were measured on preoperative and postoperative radiographic and magnetic resonance imaging (MRI) studies and were correlated with persistent pain at follow-up. Results The mean preoperative CE and α angles were 38.6 ± 5.2 and 67.3 ± 7.2 degrees, respectively. At follow-up, in the 17 pain-free patients, the mean pre- and postoperative CE angle were 38.1 ± 5.6 and 32.6 ± 4.8 degrees, respectively, whereas the mean pre- and postoperative α angles at MRI were 66.3 ± 7.9 and 47.9 ± 8.9 degrees, respectively. In six patients with persistent hip pain, the mean pre- and postoperative CE angles were 39.8 ± 3.6 and 35.8 ± 3.1 degrees, respectively, whereas the mean pre- and postoperative α angles were 70.0 ± 3.9 and 58.8 ± 2.6 degrees, respectively. Mean values of all the analyzed radiological parameters, except CE angle in patients with pain, improved significantly after surgery. On comparing patient groups, significantly lower postoperative α angles and lower CE angle were observed in patients without pain. Conclusion In case of persistent pain after arthroscopic treatment of FAI, a new set of imaging studies must be performed because pain may be related to an insufficient correction of preoperative radiographic abnormalities. Level of Evidence Level IV, retrospective case series.

scholarly journals Evaluation of endometrial thickness in postmenopausal women by using 3.0-T MRI

2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Junko Nakamura ◽  
Takeharu Yoshikawa ◽  
Eriko Maeda ◽  
Hiroyuki Akai ◽  
Hiroshi Ohtsu ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Medical Records ◽  
Endometrial Thickness ◽  
Mr Images ◽  
Endometrial Thickening ◽  
3.0 T ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
3.0 T Mri

Background: The accepted threshold for normal endometrial thickness is 5 mm; lesions with endometrial thickness < 5 mm are considered benign, whilst those > 5 mm areconsidered malignant. However, endometrium ≥ 5 mm on transvaginal ultrasonography inpostmenopausal woman is considered as asymptomatic endometrial thickening. However, recent studies suggest that asymptomatic endometrial thickness of even 8 mm – 11 mm in postmenopausal women may be normal.Objectives: The present study investigated the normal endometrial thickness range in 297 asymptomatic postmenopausal women using 3.0-T magnetic resonance imaging (MRI) T2-weighted sagittal images measured retrospectively by a single radiologist.Method: The data were classified according to patient age and postmenopausal duration, and the medical records and follow-up MR images were reviewed to assess the clinical outcome.Results: The mean endometrial thickness was 2.4 ± 0.1 mm (range: 0.1–11.6). The endometriumin 21 of 297 subjects was ≥ 5 mm thick. Follow-up MR images were obtained in 17 of these 21 women, and their endometrial thickness was found to have decreased in all of them. To date,none of the subjects has been diagnosed with endometrial cancer.Conclusion: Although 5 mm is considered the conservative threshold of normal endometrial thickness on MRI of postmenopausal women, this figure should not, to avoid excessive false-positive diagnoses, be assumed as an indication of malignancy.

Approximations of large trunk line systems under heavy traffic

1994 ◽  
Vol 26 (04) ◽  
pp. 1063-1094
Author(s):  
Harold J. Kushner
Keyword(s):  
Fixed Point ◽  
Heavy Traffic ◽  
Service Capacity ◽  
Mean Values ◽  
Reflected Diffusion ◽  
Trunk Line ◽  
Overflow Traffic ◽  
The Mean ◽  
The Many ◽  
Fully Connected

The paper deals with large trunk line systems of the type appearing in telephone networks. There are many nodes or input sources, each pair of which is connected by a trunk line containing many individual circuits. Traffic arriving at either end of a trunk line wishes to communicate to the node at the other end. If the direct route is full, a rerouting might be attempted via an alternative route containing several trunks and connecting the same endpoints. The basic questions concern whether to reroute, and if so how to choose the alternative path. If the network is ‘large’ and fully connected, then the overflow traffic which is offered for rerouting to any trunk comes from many other trunks in the network with no one dominating. In this case one expects that some sort of averaging method can be used to approximate the rerouting requests and hence simplify the analysis. Essentially, the overflow traffic that a trunk offers the network for rerouting is in some average sense similar to the overflow traffic offered to that trunk. Indeed, a formalization of this idea involves the widely used (but generally heuristic) ‘fixed point' approximation method. One sets up the fixed point equations for appropriate rerouting strategies and then solves them to obtain an approximation to the system loss. In this paper we work in the heavy traffic regime, where the external offered traffic to any trunk is close to the service capacity of that trunk. It is shown that, as the number of links and circuits within each link go to infinity and for a variety of rerouting strategies, the system can be represented by an averaged limit. This limit is a reflected diffusion of the McKean–Vlasov (propagation of chaos) type, where the driving terms depend on the mean values of the solution of the equation. The averages occur due to the symmetry of the network and the averaging effects of the many interactions. This provides a partial justification for the fixed point method. The concrete dynamical systems flavor of the approach and the representations of the limit processes provide a useful way of visualizing the system and promise to be useful for the development of numerical methods and further analysis.

scholarly journals Using Network Metrics in Soccer: A Macro-Analysis

2015 ◽  
Vol 45 (1) ◽  
pp. 123-134 ◽  
Author(s):  
Filipe Manuel Clemente ◽  
Micael Santos Couceiro ◽  
Fernando Manuel Lourenço Martins ◽  
Rui Sousa Mendes
Keyword(s):  
Decision Making ◽  
Network Density ◽  
Training Process ◽  
Match Analysis ◽  
Star Topology ◽  
Mean Values ◽  
Network Methods ◽  
The Mean ◽  
Network Metrics ◽  
Support Decision Making

Abstract The aim of this study was to propose a set of network methods to measure the specific properties of a team. These metrics were organised at macro-analysis levels. The interactions between teammates were collected and then processed following the analysis levels herein announced. Overall, 577 offensive plays were analysed from five matches. The network density showed an ambiguous relationship among the team, mainly during the 2nd half. The mean values of density for all matches were 0.48 in the 1st half, 0.32 in the 2nd half and 0.34 for the whole match. The heterogeneity coefficient for the overall matches rounded to 0.47 and it was also observed that this increased in all matches in the 2nd half. The centralisation values showed that there was no ‘star topology’. The results suggest that each node (i.e., each player) had nearly the same connectivity, mainly in the 1st half. Nevertheless, the values increased in the 2nd half, showing a decreasing participation of all players at the same level. Briefly, these metrics showed that it is possible to identify how players connect with each other and the kind and strength of the connections between them. In summary, it may be concluded that network metrics can be a powerful tool to help coaches understand team’s specific properties and support decision-making to improve the sports training process based on match analysis.

scholarly journals Organizational Climate And Its Influence On Organizational Commitment

2010 ◽  
Vol 9 (2) ◽  
Author(s):  
Fauziah Noordin ◽  
Safiah Omar ◽  
Syakirarohan Sehan ◽  
Shukriah Idrus
Keyword(s):  
Decision Making ◽  
Organizational Commitment ◽  
Organizational Climate ◽  
Organizational Design ◽  
Current Situation ◽  
Moderate Level ◽  
Continuance Commitment ◽  
Mean Values ◽  
The Mean ◽  
Positive Correlations

The findings of the study indicate that the employees perceived the organizational climate of their organization to be at a moderate level. The mean values for the components of the organizational climate ranged from the lowest of 3.38 to the highest of 3.77 of the 5-point Likert scale. Continuance commitment appears to be the lowest of the three components of the organizational commitment construct with a mean of 3.22.   In terms of the correlations between the variables, the results indicate that continuance commitment has no correlations with organizational design, teamwork, and decision-making. All other variables show significant positive correlations. Overall, the findings of the present study indicate that there is a need to improve the current situation at ABC Company with respect to all the components of the organizational climate and organizational commitment.

Approximations of large trunk line systems under heavy traffic

1994 ◽  
Vol 26 (4) ◽  
pp. 1063-1094 ◽  
Author(s):  
Harold J. Kushner
Keyword(s):  
Fixed Point ◽  
Heavy Traffic ◽  
Service Capacity ◽  
Mean Values ◽  
Reflected Diffusion ◽  
Trunk Line ◽  
Overflow Traffic ◽  
The Mean ◽  
The Many ◽  
Fully Connected

The paper deals with large trunk line systems of the type appearing in telephone networks. There are many nodes or input sources, each pair of which is connected by a trunk line containing many individual circuits. Traffic arriving at either end of a trunk line wishes to communicate to the node at the other end. If the direct route is full, a rerouting might be attempted via an alternative route containing several trunks and connecting the same endpoints. The basic questions concern whether to reroute, and if so how to choose the alternative path. If the network is ‘large’ and fully connected, then the overflow traffic which is offered for rerouting to any trunk comes from many other trunks in the network with no one dominating. In this case one expects that some sort of averaging method can be used to approximate the rerouting requests and hence simplify the analysis. Essentially, the overflow traffic that a trunk offers the network for rerouting is in some average sense similar to the overflow traffic offered to that trunk. Indeed, a formalization of this idea involves the widely used (but generally heuristic) ‘fixed point' approximation method. One sets up the fixed point equations for appropriate rerouting strategies and then solves them to obtain an approximation to the system loss. In this paper we work in the heavy traffic regime, where the external offered traffic to any trunk is close to the service capacity of that trunk. It is shown that, as the number of links and circuits within each link go to infinity and for a variety of rerouting strategies, the system can be represented by an averaged limit. This limit is a reflected diffusion of the McKean–Vlasov (propagation of chaos) type, where the driving terms depend on the mean values of the solution of the equation. The averages occur due to the symmetry of the network and the averaging effects of the many interactions. This provides a partial justification for the fixed point method. The concrete dynamical systems flavor of the approach and the representations of the limit processes provide a useful way of visualizing the system and promise to be useful for the development of numerical methods and further analysis.

Impact of Subclinical Mastitis on Milk Quality in Different Seasons

2020 ◽  
Keyword(s):  
Chemical Constituents ◽  
Dairy Farm ◽  
Subclinical Mastitis ◽  
Strong Positive Correlation ◽  
Strong Negative Correlation ◽  
Mean Values ◽  
Milk Samples ◽  
Significant Difference ◽  
Different Seasons ◽  
The Mean

This study was carried out to evaluate the influence of subclinical mastitis on chemical constituents of cow’s milk samples in different seasons; which collected from 444 apparently healthy Holstein Frisian dairy animals during the period of December 2016 to November 2017 in a private dairy farm located in Fayoum district, Egypt. The results of chemical analysis of the milk samples along the four seasons of the year which done by the Lactoscan SLC milk analyzer device revealed that; the values of mean for (Fat%, Protein%, SNF%, Lactose%, Salt% and SCC/ml) in winter were (2.22±0.06, 2.90±0.08, 7.79±0.22, 4.14±0.12, 0.72±0.02 and 6.9×105±1.9×104 respectively).While the mean values of the same parameters in spring were (2.72±0.23, 2.58± 0.22, 6.93±0.58, 3.67±0.31, 0.64±0.05 and 9.2×105±7.7×104 respectively). In the summer, the mean values of (Fat%, Protein%, SNF%, Lactose%, Salt% and SCC/ml) were (2.35± 0.24, 2.80 ±0.28, 7.55±0.76, 4.00±0.40, 0.70±0.07 and 7.7×105±7.7×104 respectively), while the mean values in the autumn were (2.89±0.09, 2.69±0.08, 7.25±0.21, 3.84±0.11, 0.67±0.02 and 11.0×105±3.2×104 respectively). The analysis of findings specified that; there is a significant difference (P<0.05) in fat % and SCC between winter and autumn, however there is a significant difference (P<0.05) between (winter and autumn) and (winter and spring) in the parameters of protein, SNF and lactose content. The results reveal that there is a strong negative correlation between SCC and fat %; however there is a strong positive correlation between SCC and salt %.

scholarly journals The Experience of Our Cardiovascular Surgery Intensive Care in Preoperative False-Negative and Asymptomatic Patients with SARS-COV-2 Infection

2021 ◽  
Author(s):  
İsmail Selçuk ◽  
Bülent Barış Güven ◽  
Nehir Selçuk
Keyword(s):  
Outpatient Surgery ◽  
False Negative ◽  
Emergency Operation ◽  
Early Postoperative Period ◽  
Normal Range ◽  
Laboratory Findings ◽  
Mean Values ◽  
Asymptomatic Patients ◽  
The Mean ◽  
Basic Characteristics

Objective: There is little data in the literature on the effects of COVID-19 in patients undergoing cardiac surgery. Our aim in this study is to describe the post-cardiac surgical effects of COVID-19, the basic characteristics of the patients and their laboratory findings; and also to discuss the mechanism underlying the poor diagnostic performance of rRT-PCR. Methods: The data of 191 patients who were operated between 18 May 2020- 07 June 2021 were retrospectively analyzed. A total of 12 patients who were asymptomatic and rRT-PCR (-) preoperatively and rRT-PCR positive postoperatively were included. Patients who required emergency operation, did not perform rRT-PCR in the preoperative period or had rRT-PCR (+), had outpatient surgery were not included. The patients’ age, operation, length of stay in the ICU, intubation times, echocardiography, blood gas and biochemistry results and PCR results were recorded. Results: In the study, postoperative rRT-PCR was studied from 87 patients and the result was (+) in 12 (13.8%) patients. Two of 12 (16.7%) patients died due to SARS-CoV-2 pneumonia. While the mean values of preoperative leukocytes (7.78 103/mcL), lymphocytes (1.52 103/mcL) and CRP (49.27mg/dL) were within the normal range, the mean values of ferritin (823 ng/ml) and D-Dimer (1138 ng/ml) were above the normal range. Conclusion: We recommend that patients has to be isolated for at least 7 days before the operation. Also sputum samples from the tracheal tube should be studied simultaneously nasopharyngeal PCR samples in the preoperative and the early postoperative period in order to minimize false negative PCR results.

scholarly journals Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis

2017 ◽  
Vol 11 (2) ◽  
pp. 278-284 ◽  
Author(s):  
Shardul Madhav Soman ◽  
Jimmy Chokshi ◽  
Naitik Chhatrala ◽  
Gulam Haider Tharadara ◽  
Mukund Prabhakar
Keyword(s):  
Decision Making ◽  
Grading System ◽  
Gender Ratio ◽  
Radiological Findings ◽  
Single Centre ◽  
Dural Sac ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal ◽  
A Prospective Study

<sec><title>Study Design</title><p>This is a prospective study that was undertaken at a single centre and involved 80 consecutive patients diagnosed with lumbar spinal stenosis (LSS).</p></sec><sec><title>Purpose</title><p>The aim of the study was to assess the efficacy of a qualitative grading system as seen on magnetic resonance imaging (MRI) as a tool in the management of multilevel LSS.</p></sec><sec><title>Overview of Literature</title><p>LSS diagnosis is clinical but is usually radiologically supplemented. However, there are often multilevel radiological findings with non-specific or atypical clinical features. We used a qualitative grading system to help in the decision-making process of the management of patients with multilevel LSS.</p></sec><sec><title>Methods</title><p>80 patients with LSS were treated with decompression and prospectively followed-up for a minimum of 12 months. All had failed conservative treatment. Qualitative grading of LSS severity was based on the dural sac in T2 weighted axial MRI images at all disc levels and was done from L1–2 to L5–S1 (n=400). Functional outcome was assessed using the Oswestry disability index (ODI).</p></sec><sec><title>Results</title><p>The mean patient age was 56.6 years, with a gender ratio of 0.6:1. Forty patients had degenerative LSS and 40 had degenerative spondylolysthesis. A total of 178 levels were decompressed, the majority of which were L4–L5 (43.82%), followed by L5–S1 (41.57%). According to our qualitative grading system, grade D stenosis (53.93%) was decompressed most frequently, followed by grade C stenosis (41.57%). The average preoperative ODI score was 58.55%, which later reduced to 19.15%. Seventy percent of patients achieved excellent results, whereas 30% achieved good results.</p></sec><sec><title>Conclusions</title><p>Morphological grading is a useful tool in decision making in surgery for multilevel LSS. Grade C and D stenosis should be decompressed, whereas A and B should not be, unless clinically justified.</p></sec>

scholarly journals The impact of different simulation modalities on target volume delineation in breast-conserving radiotherapy

2020 ◽  
Author(s):  
Meng Jin ◽  
Xia Liu ◽  
Jiabin Ma ◽  
Xiansong Sun ◽  
Hongnan Zhen ◽  
...  
Keyword(s):  
Ct Images ◽  
Conformity Index ◽  
Mr Images ◽  
Mean Values ◽  
Surgical Clips ◽  
Tumor Bed ◽  
Volume Delineation ◽  
Ct Simulation ◽  
The Mean ◽  
The Impact

Abstract Background In the management of breast-conserving radiotherapy, computed tomography (CT) simulation is now commonly used to identify tumor bed while has difficult ies defining precisely. We aimed to evaluate the impact of magnetic resonance (MR) and CT simulation on defining the postoperative tumor bed for breast-conserving radiotherapy in patients without the aid of surgical clips. Methods From August 2018 to March 2019, twenty patients with T 1 - 2 N 0 M 0 breast cancer at our situation were enrolled. All the patients underwent breast-conserving surgery without implantation of surgical clips and were prepared to receive radiotherapy. CT and MR images were acquired on the same day for each patient. Three radiation oncologists independently assigned cavity visualization score (CVS) and delineated the tumor bed based on first the CT then the MR images with a 14-day interval for each patient. Interobserver variability was assessed by volumes, generalized conformity index (CI gen ) and the distance between the centers of mass (dCOM). Differences in mean values for parameters were tested by paired t -test or one-way analysis of variance, as appropriate. Results The median age of the enrolled patients was 48 years old. First, the mean volumes of tumor bed derived from MR were 22%, 27% and 21% smaller than those based on CT images for each observer. Second, the mean CI gen was significantly superior, and dCOM was smaller for MR than for CT images (CI gen : 0.59 vs 0.52, P = 0.008; dCOM: 1.30 cm vs 1.39 cm, P = 0.095). Third, the mean CVS was 3.23±1.34 and 2.43±0.92 for MR and CT images, respectively ( P = 0.035). In the subgroup with a CT-based CVS≥3, the mean dCOM obtained from CT was larger than that from the MR images (1.35 cm vs 1.19 cm, P = 0.048). Last, there was a positive association between the CVS and CI gen for both modalities (CT: r = 0.699, P = 0.001; MR: r = 0.895, P ＜ 0.001). Conclusion Compared to CT, MR can improve the visualization of changes in the postoperative tumor bed. In addition, MR can yield a more precise definition of the tumor bed and improve the consistency of tumor bed contouring in patients without surgical clips.

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