scholarly journals TP1.2.4The incidence, implications and risk factors for extracolonic findings at CT colonography in a bowel screening population

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Domenic Di Rollo ◽  
Donald McMillan ◽  
Paul Horgan ◽  
David Mansouri
Keyword(s):  
Risk Factors ◽  
Health Service ◽  
Medical Records ◽  
Ct Colonography ◽  
Screening Programme ◽  
Virtual Colonoscopy ◽  
Benign Disease ◽  
Screening Population ◽  
Extracolonic Findings

Abstract Aim CT virtual colonoscopy (CTC) is increasingly relied upon in bowel screening programmes. Concern remains regarding the prevalence of incidental extra-colonic findings (ECF). The present study reports on the prevalence and implications of ECF as part of a UK bowel screening programme. Methods Reports for 400 consecutive CTCs carried out as part of the Scottish Bowel Screening Programme were examined. Intra and extracolonic findings were recorded using the CT Colonography Reporting and Data System (C-RADS). Medical records pertaining to ECF follow-up were examined. Cost analysis was performed. Results 394 patients were included. 146 (37%) were males. Median age was 65 years, median follow-up was 72 months (Range 32-110). 92 (23%) patients had CTC as their primary investigation, 302 (77%) patients underwent CTC due to failed colonoscopy. Overall, 244/394 (62%) patients had ECF with only 45/394 (11%) found to have colonic pathology. 65/394 (16%) had moderately or highly significant ECF, (C-RADS E3-4). Of the 244 patients with ECF, 59 (24%) underwent further investigation, estimated cost £17,589. The majority, 37/59 (63%) were found to have benign disease after follow-up. Conclusion ECF at CTC are more frequent than colonic findings. The majority of ECF investigated are found to be benign yet a quarter of ECF are further investigated at a cost to the health service and the patient. Clinicians should be judicial when ordering and consenting patients with regards ECF and its implications if CTC is considered. Particularly when the test is part of a public funded and voluntary screening programme.

Incidental Extra-Colonic Findings in CT Colonography at Riyadh Region (Preprint)

2020 ◽  
Author(s):  
Muhannad Alanazi
Keyword(s):  
Computed Tomography ◽  
Colon Cancer ◽  
Medical Records ◽  
Medical Attention ◽  
Mortality And Morbidity ◽  
Computed Tomography Colonography ◽  
Screening Population ◽  
Extracolonic Findings ◽  
Atherosclerotic Changes

BACKGROUND Computed tomography colonography (CTC) is a new radiologic technique for examination of the colorectum. The search for, analysis and interpretation of extracolonic findings (ECFs) are a matter of permanent debate and review, given the arguments for and against them. OBJECTIVE To assess the prevalence and type of extracolonic findings (ECFs) in a screening population undergoing computed tomography colonography (CTC) in Riyadh region. METHODS This retrospective study was conducted in Riyadh region. To achieve the objectives of this study 305 subjects medical records were reviewed, where male represented 55% of participants and female represented only 45%. RESULTS About 21% of subjects had any type Extra Colonic Findings (ECFs) where about 74 incidental findings were identified in 65 patients. Out of these findings; 6 patients (9%) required immediate medical attention or urgent imaging/intervention, these included high suspicious of extracolonic malignancy or active infection, 16 patients (25%) required either further imaging and characterization, or follow up imaging, these included undetermined masses or nodules, while 43 patients (66%) required either reassurance or life style modification, which included extensive atherosclerotic changes, fatty liver or spondylolisthesis. CONCLUSIONS Colon cancer is one of the leading cause of mortality and morbidity in our Saudi Arabia community. Early detection of colon cancer and its precursor (i.e. polyps) is essential for successful management.

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

2021 ◽  
pp. 000348942110155
Author(s):  
Leonard Haller ◽  
Khush Mehul Kharidia ◽  
Caitlin Bertelsen ◽  
Jeffrey Wang ◽  
Karla O’Dell
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Assessment Tool ◽  
Demographic Data ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

Extracolonic findings at CT colonography: Evaluation of prevalence and cost in a screening population

2003 ◽  
Vol 124 (4) ◽  
pp. 911-916 ◽  
Author(s):  
Thomas M. Gluecker ◽  
C.Daniel Johnson ◽  
Lynn A. Wilson ◽  
Robert L. MacCarty ◽  
Timothy J. Welch ◽  
...  
Keyword(s):  
Ct Colonography ◽  
Screening Population ◽  
Extracolonic Findings

Risk factors for screw migration after triple pelvic osteotomy

2001 ◽  
Vol 37 (3) ◽  
pp. 269-273 ◽  
Author(s):  
S Simmons ◽  
AL Johnson ◽  
DJ Schaeffer
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Medical Records ◽  
Pelvic Osteotomy ◽  
Factors Associated

The objective of this retrospective study was to identify risk factors for screw migration after triple pelvic osteotomy (TPO) in clinical patients. The medical records, radiographs made immediately after surgery, and follow-up radiographs documenting a healed osteotomy were reviewed for 52 dogs treated with unilateral TPO and 38 dogs treated with bilateral TPO. Signalment, surgeon expertise, length of surgery, sequence of surgery in dogs treated bilaterally, use of ischial or ilial wires or both, screw depth in the sacrum, and screw migration were documented for each of the 128 pelvic osteotomies. Screws placed in the first and second plate hole, securing the cranial portion of the plate, loosened most frequently. Factors associated with decreased screw migration included use of an ischial hemicerclage wire and increased depth of sacral purchase with the first and second cranial screws.

scholarly journals The Crazy-paving Pattern in Chest CT of Coronavirus Disease 2019 Patients; an Alarming Sign for Hospitalization 

2020 ◽  
Author(s):  
Mehdi Gholamzadeh Baeis ◽  
Abolfazl Mozafari ◽  
Fatemeh Movaseghi ◽  
Mehdi Yadollahzadeh ◽  
Ahmad Sohrabi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Public Hospital ◽  
Human Beings ◽  
Epidemiological Features ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
The Mean ◽  
Bilateral Lung

Abstract Background: The outbreak of coronavirus disease 2019 (COVID-19) becomes an enormous threat to all human beings. Via this retrospective study conducted on medical records of confirmed COVID-19 pneumonia patients on admission, we investigate the CT manifestation and clinical and laboratory risk factors associated with progression to severe COVID-19 pneumonia and assessed the association among clinical and laboratory records, CT findings, and epidemiological features. The medical records and radiological CT Features of 236 confirmed COVID-19 patients were reviewed at one public hospital and one respiratory clinic in Quom, from 1 August to 30 September 2020. Results: Among a total of 236 confirmed Covid-19 cases, 62 were infected with moderate to severe COVID-19 disease and required hospital admission, and 174 were followed up on outpatient bases. A significant difference was verified in the mean age between outpatients and hospitalized groups. The incidences of bilateral lung involvement, consolidation, linear opacities, crazy-paving pattern, air bronchogram sign, and the number of lobe involvement were significantly higher in hospitalized groups. However, only the crazy-paving pattern was significantly associated with an SpO2 level lower than 90%, with clinical sign of cough severity. Our data indicate that this pattern is also significantly associated with inflammatory levels and the presence of this pattern along with SpO2 level lower than 90%, older age, diabetes, on admission are independent risk factors for COVID-19 progression to severe level.Conclusions: The crazy-paving pattern can predict the severity of COVID-19, which is of great significance for the management and follow-up of COVID-19 pneumonia patients. The clinical factors of aging, male gender, and diabetes, may be risk factors for the crazy-paving pattern, whereas severe coughing is considered to be the most important clinical symptom related to this pattern, and SpO2 level lower than 90%, which is a matter of more severity.

Growth-Related Major Recanalization of Coiled Aneurysms: Incidence and Risk Factors

Neurosurgery ◽  
2017 ◽  
Vol 82 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Young Dae Cho ◽  
Jin Pyeong Jeon ◽  
Dong Hyun Yoo ◽  
Won-Sang Cho ◽  
Hyun-Seung Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Coil Embolization ◽  
Multivariate Analyses ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Endovascular Techniques ◽  
Radiological Data ◽  
Aneurysm Volume

Abstract BACKGROUND Though endovascular techniques and procedural devices continue to advance, recurrence of embolized aneurysms is still problematic. Enlarging size during follow-up is the presumed basis of recanalization in some lesions, but such growth has not been adequately investigated. OBJECTIVE To generate estimates of growth in coiled aneurysms with major recanalization, focusing on incidence and risk factors involved. METHODS A cohort of 134 patients harboring 139 aneurysms were retrospectively reviewed, each subjected to re-embolization for major recanalization after initial coil embolization. Cumulative medical records and radiological data were assessed. The aneurysms were grouped by nature of recanalization, either related or unrelated to growth. Growth was defined as >50% increase in aneurysm volume (including coil mass) at the time of re-embolization, compared initial status. Aneurysm volumes were determined by volume of coil mass within full confines of the aneurysm. Univariate and multivariate analyses were performed to identify risk factors predisposing to growth. RESULTS Major recanalization was growth related in 74 coiled aneurysms (53.2%) and unrelated to growth (by coil compaction) in 65 (46.8%). Multiple logistic regression analysis indicated that growth of coiled aneurysm was linked to aneurysms initially ruptured at presentation (P = .002) and aneurysm size <7 mm (P < .001). Cumulative growth rates were as follows: 14 (18.9%), 6 mo; 18 (24.3%), 12 mo; 13 (17.6%), 24 mo; 10 (13.5%), 36 mo; and 19 (25.7%), >36 mo. CONCLUSION Our data suggest that aneurysms presenting with hemorrhage and small-sized aneurysms (<7 mm) are predisposed major recanalization by growth after coil embolization, as opposed to coil compaction.

scholarly journals Surdez Congénita ou Precocemente Adquirida: Do Rastreio ao Seguimento, um Retrato de Portugal

2019 ◽  
Vol 32 (12) ◽  
pp. 767
Author(s):  
Catarina Oliveira ◽  
Marta Machado ◽  
Raquel Zenha ◽  
Luísa Azevedo ◽  
Luísa Monteiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
National Health Service ◽  
Health Service ◽  
Hearing Screening ◽  
Newborn Hearing Screening ◽  
Congenital Deafness ◽  
Universal Newborn Hearing Screening ◽  
Maternity Hospitals ◽  
Newborn Hearing

Introduction: Congenital deafness or early acquired deafness affects 1 to 3 out of 1000 newborns without risk factors and 20 to 40 out of 1000 newborns with risk factors. The universal newborn hearing screening enables its early identification. Children with congenital deafness/early acquired deafness have a higher prevalence of other conditions, especially ophthalmologic and neurodevelopmental ones, and at least 30% to 40% have at least one associated comorbidity.Material and Methods: We carried out a cross-sectional, multicenter study in which 83% (n = 30) of the hospitals/maternity hospitals of the National Health Service participated.Results: All surveyed hospitals/maternity hospitals routinely performed universal newborn hearing screening to all newborns before discharge; 63% referred children with risk factors for hearing loss to Otorhinolaryngology. All children with congenital deafness/early acquired deafness are referred to: Pediatrics in 23% hospitals/maternity hospitals. In 23 hospitals/maternity hospitals, all children with congenital deafness/early acquired deafness are referred to: Speech Therapy in 44% hospitals/ maternity hospitals; Ophthalmology in 17% hospitals/maternity hospitals; National System of Early Intervention in Childhood in 30% hospitals/maternity hospitals; 22% of hospitals/maternity hospitals refer all children with congenital deafness/early acquired deafness, with no identified cause, to Clinical Genetics clinics. The number of diagnoses of deafness in the years 2014 and 2015 was 2.5 and 1.5 per 1000 newborns, respectively, in 15 hospitals/maternity hospitals.Discussion: Awareness of universal newborn hearing screening seems to be widely spread in the National Health Service. The number of children with SC / SPA, as well as the percentage of different types of deafness diagnosed, were identical to those found in other studies and shows its importance. The assessment / follow-up of these children by specialties other than the otolaryngology was heterogeneous in different health entities and revealed that not all children with risk factors for deafness follow up advised by existing standards.Conclusion: Results show that Portugal made an important path in the screening and follow-up of children with SC / SPA. It is important, with the ultimate aim of continually improving the care of these children, to reflect on the involvement of specialties other than otolaryngology, such as the National Early Childhood Intervention System in the follow-up of these children.

scholarly journals Risk factors for chronic non-communicable diseases: A follow-up model

2002 ◽  
Vol 55 (11-12) ◽  
pp. 470-474 ◽  
Author(s):  
Jaroslava Hovan-Somborac
Keyword(s):  
Risk Factors ◽  
General Practice ◽  
Occupational Health ◽  
Medical Records ◽  
Communicable Diseases ◽  
World Health ◽  
Medical Documentation ◽  
Non Communicable Diseases ◽  
Basic Medical

Chronic non-communicable diseases are caused by interaction between numerous environmental and socio-economic factors and biological response of the human body. They are gaining importance due to the fact that they largely depend on common risk factors, of which more than 70% can be prevented. In 1996, an integrated health prevention program for chronic non-communicable disease based on the Aims of the World Health Organization ?Health for all in the 21st century? was designed in the Republic of Serbia. This program concerns the whole population and measures for its implementation. For its successful realization it is necessary to define standard procedures: uniform terminology, diagnostics, therapy and rehabilitation, its risk factors. The aim of this study was to establish data from basic medical documentation of the primary health care and propose a more efficient and effective evidence, as well as to establish a program for surveillance, prevention and control of mass non-communicable diseases within the existing medical documentation. The data were gathered from medical records of the general practice and occupational health services. A special questionnaire was designed to register data from medical records. Medical records of general practice and occupational health service in Kikinda have been analyzed. The existing medical documentation is insufficient regarding data necessary for evidence, surveillance and analysis of risk factors for chronic non-communicable diseases. A follow-up model for surveillance and evidence of risk factors in basic medical documentation, which should be incorporated in routine statistical reports, would actively include medical professionals - doctors and medical staff in prevention and detection of risk factors.

Selective compromise of hypoplastic posterior communicating artery variants with aneurysms treatable by coil embolization: clinical and radiologic outcomes

2018 ◽  
Vol 11 (4) ◽  
pp. 373-379
Author(s):  
Hyun Ho Choi ◽  
Young Dae Cho ◽  
Dong Hyun Yoo ◽  
Eung Koo Yeon ◽  
Jeongjun Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Coil Embolization ◽  
Statistical Significance ◽  
Significant Risk ◽  
Posterior Communicating Artery ◽  
Adjunctive Treatment ◽  
Complete Occlusion ◽  
The Mean

BackgroundPosterior communicating artery (PcoA) compromise may serve as adjunctive treatment in patients with hypoplastic variants of PcoA who undergo coil embolization of PcoA aneurysms. However, procedural safety and the propensity for later recanalization are still unclear.ObjectiveTo evaluate clinical and radiologic outcomes of coil embolization in this setting, focusing on compromise of PcoA.MethodsAs a retrospective review, we examined 250 patients harboring 291 aneurysms of hypoplastic PcoAs, all consecutively treated by coil embolization between January 2004 and June 2016. PcoA compromise was undertaken in conjunction with 81 of the treated aneurysms (27.8%; incomplete 53; complete 28). Medical records and radiologic data were assessed during extended monitoring.ResultsDuring the mean follow-up of 33.9±24.6 months (median 36 months), a total of 107 (36.8%) coiled aneurysms showed recanalization (minor 50; major 57). Recanalization rates were as follows: PcoA preservation 40.5% (85/210); incomplete PcoA occlusion 34.0% (18/53); complete PcoA occlusion 14.3% (4/28). Aneurysms >7 mm (HR 3.40; P<0.01), retreatment for recanalization (HR 3.23; P<0.01), and compromise of PcoA (P<0.01) emerged from multivariate analysis as significant risk factors for recanalization. Compared with PcoA preservation, complete PcoA compromise conferred more favorable outcomes (HR 0.160), whereas incomplete compromise of PcoA fell short of statistical significance. Thromboembolic infarction related to PcoA compromise did not occur in any patient.ConclusionPcoA compromise in conjunction with coil embolization of PcoA aneurysms appears safe in hypoplastic variants of PcoA, helping to prevent recanalization if complete occlusion is achieved.

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