scholarly journals Screening TB in asylum seekers in Switzerland: comparing chest X-ray and interview-based system

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Jackson ◽  
J P Zellweger
Keyword(s):  
Chest Radiography ◽  
Asylum Seekers ◽  
Geographic Origin ◽  
Initial Screening ◽  
Cross Sectional ◽  
X Ray ◽  
Individual Assessment ◽  
Retrospective Comparison ◽  
Chest X Ray ◽  
Higher Sensitivity

Abstract Setting Mandatory initial screening of asylum seekers for tuberculosis (TB) in Switzerland, 2004-2005 and 2007-2008. Objective To compare the yield of screening by chest radiography with an individual assessment based on geographic origin, personal history and symptoms. Design Cross-sectional retrospective comparison of two 2-year periods. Results The prevalence of detected TB cases was defined as the proportion of screenees starting antit tuberculosis treatment for culture-confi rmed pulmonary TB within 90 days. TB prevalence was 14.3 per 10 000 asylum seekers screened (31/21 727) using chest radiography and 12.4 (29/23 402) using individual assessment. The sensitivity of radiography was 100% vs. 55% for individual assessment, but its specifi city was lower (89.9% vs. 96.0%, respectively). The higher sensitivity of radiography meant shorter delays between screening and start of treatment (median 6 vs. 25 days). Its lower specifi city led to a larger proportion of screenees needing further investigations for suspicion of TB (12% vs. 4%). Conclusions The interview-based system initially missed more cases, but the ultimate 90-day yield was comparable for the two periods. The main difference is the delay until start of treatment, which potentially increases transmission and secondary cases. The radiograph system was more burdensome to both the health care system and the screenees, as more suspects required further investigations.

scholarly journals Chest X-Ray Findings in COVID-19 Patients Presenting to Primary Care during the Peak of the First Wave of the Pandemic in Qatar: Their Association with Clinical and Laboratory Findings

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Abdelwahed Abougazia ◽  
Ahmed Alnuaimi ◽  
Amal Mahran ◽  
Tamer Ali ◽  
Ahmed Khedr ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcription ◽  
Chest Radiography ◽  
Cross Sectional Study ◽  
Chain Reaction ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Polymerase Chain

When managing coronavirus disease 2019 (COVID-19) patients, radiological imaging complements clinical evaluation and laboratory parameters. We aimed to assess the sensitivity of chest radiography findings in detecting COVID-19, describe those findings, and assess the association of positive chest radiography findings with clinical and laboratory findings. A multicentre, cross-sectional study was conducted involving all primary health care corporation-registered patients (2485 patients) enrolled over a 1-month period during the peak of the 2020 pandemic wave in Qatar. These patients had reverse transcription-polymerase chain reaction-confirmed COVID-19 and underwent chest radiography within 72 hours of the swab test. A positive result on reverse transcription-polymerase chain reaction was the gold standard for diagnosing COVID-19. The sensitivity of chest radiography was calculated. The airspace opacities were mostly distributed in the peripheral and lower lung zones, and most of the patients had bilateral involvement. Pleural effusion was detected in some cases. The risk of having positive chest X-ray findings increased with age, Southeast Asian nationality, fever, or a history of fever and diarrhoea. Patients with cardiac disease, obesity, hypertension, diabetes, and chronic kidney disease were at a higher risk of having positive chest X-ray findings. There was a statistically significant increase in the mean serum albumin, white blood cell count, neutrophil count, and serum C-reactive protein, hepatic enzymes, and total bilirubin with an increase in the radiographic severity score.

scholarly journals Sputum smear positivity grade and chest X-ray findings in tuberculosis: A cross-sectional study

2021 ◽  
Author(s):  
R. Behzadmehr ◽  
E. Nejadkehkha
Keyword(s):  
Cross Sectional Study ◽  
Health Concern ◽  
Sputum Smear ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
X Ray ◽  
High Prevalence ◽  
Chest X Ray

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively.  In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.

scholarly journals Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Joanitah Nalunjogi ◽  
Frank Mugabe ◽  
Irene Najjingo ◽  
Pastan Lusiba ◽  
Francis Olweny ◽  
...  
Keyword(s):  
Screening Tool ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Case Detection ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Number Needed To Screen ◽  
Screening Algorithm ◽  
Chest X Ray

The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.

Comparison of granulomatosis with polyangiitis clinical features in patients depending of involvement or absence of kidney involvement

2021 ◽  
Vol 17 ◽  
Author(s):  
Mateusz Puchala ◽  
Andrzej Rydzewski ◽  
Ilona Kowalik ◽  
Małgorzata Wisłowska
Keyword(s):  
Clinical Features ◽  
Crescentic Glomerulonephritis ◽  
Immunosuppressive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Small Vessels ◽  
Kidney Involvement ◽  
Chest X Ray ◽  
The Mean

Background: GPA is a necrotizing inflammation of the small vessels with granulomas. Kidney involvement deteriorated its prognosis. Objective: Comparison of GPA patients with kidney (KI) and without kidney involvement (nKI). Material and methods: We conducted a cross-sectional study of 50 consecutive adult GPA patients, 25 KI from Nephrology and 25 nKI from Rheumatology Department of Central Clinical Hospital Ministry of Interior in Warsaw. We analyzed clinical features, organ involvement, laboratory, serological, imaging, histopathological data, BVAS, treatment. Results: The mean age of KI patients was statistically older then nKI (67.3±9.5 vs 55.1±15.9, p=0.002). Generalized, severe, resistance disease was observed respectively in 92% vs 44%, p<0.001. The number of red blood cells (3.47 vs 4.41T/l, p<0.001), hemoglobin (10.0 vs 12.9g/dl, p<0.001) was lower in KI, higher mean serum creatinine (3.95 vs. 0.89mg/dl, p<0.001), lower GFR (20.1 vs. 79.3, p<0.001), higher CRP (median: 43.4 vs 2.0mg/l, p<0.001), BVAS (16.6±4.4 vs 10.1±6.2, p<0.001), c-ANCA (median: 119.0 vs 15.2CU, p=0.017). Nodules in 28% KI, in 4% nKI (p=0.048) in chest X-ray, infiltration in 43.5% KI, in 15% nKI (p=0.042) in HRCT were observed. Skin granulomas were found in 61.5% nKI vs 18.2% KI, (p=0.047). Renal biopsy revealed in KI patients focal segmental glomerulonephritis in 11.8%, crescentic glomerulonephritis in 17.6%, pauci-immune crescentic glomerulonephritis in 70.6%. Conclusions: In patients with KI more frequently we found generalized, severe, resistant GPA, higher BVAS in comparison in patients without KI. The results of laboratory parameters, were worse in patients with KI. Aggressive immunosuppressive treatment is often used in KI group.

scholarly journals Simple Pneumonia or Something More?: A Case Report and Discussion of Unexpected Empyema Identified by Point-of-Care Ultrasound

CJEM ◽  
2015 ◽  
Vol 18 (5) ◽  
pp. 391-394
Author(s):  
Michael Romano ◽  
Tomislav Jelic ◽  
Jordan Chenkin
Keyword(s):  
Emergency Department ◽  
Point Of Care ◽  
Fluid Collection ◽  
Chest Ct ◽  
Point Of Care Ultrasound ◽  
X Ray ◽  
Level Of Consciousness ◽  
Chest X Ray ◽  
Ultrasound Assessment ◽  
Higher Sensitivity

AbstractThere is evidence to suggest that point-of-care ultrasound assessment of the lungs has a higher sensitivity and specificity than chest radiography for the diagnosis of pneumonia. It is unknown if the same is true for pneumonia complications. We present and discuss the case of a 61-year-old woman who presented to the emergency department with confusion, decreased level of consciousness, and signs of sepsis. A chest x-ray revealed a right sided infiltrate. An ultrasound of the patient’s lungs was performed, and revealed a complex loculated fluid collection consistent with an empyema. A chest CT confirmed the diagnosis, and immediate percutaneous drainage was performed.

scholarly journals Cross-sectional imaging of the torso reveals occult injuries in asymptomatic blunt trauma patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Gregory J. Roberts ◽  
Lewis E. Jacobson ◽  
Michelle M. Amaral ◽  
Courtney D. Jensen ◽  
Louis Cooke ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Chest Ct ◽  
Physical Exam ◽  
Trauma Patients ◽  
Cross Sectional ◽  
X Ray ◽  
Cross Sectional Imaging ◽  
Normal Chest ◽  
Chest X Ray ◽  
Sectional Imaging

Abstract Background High morbidity and mortality rates of trauma injuries make early detection and correct diagnosis crucial for increasing patient’s survival and quality of life after an injury. Improvements in technology have facilitated the rapid detection of injuries, especially with the use of computed tomography (CT). However, the increased use of CT imaging is not universally advocated for. Some advocate for the use of selective CT imaging, especially in cases where the severity of the injury is low. The purpose of this study is to review the CT indications, findings, and complications in patients with low Injury Severity Scores (ISS) to determine the utility of torso CT in this patient cohort. Methods A retrospective review of non-intubated, adult blunt trauma patients with an initial GCS of 14 or 15 evaluated in an ACS verified level 1 trauma center from July 2012 to June 2015 was performed. Data was obtained from the hospital’s trauma registry and chart review, with the following data included: age, sex, injury type, ISS, physical exam findings, all injuries recorded, injuries detected by torso CT, missed injuries, and complications. The statistical tests conducted in the analysis of the collected data were chi-squared, Fischer exact test, and ANOVA analysis. Results There were 2306 patients included in this study, with a mean ISS of 8. For patients with a normal chest exam that had a chest CT, 15% were found to have an occult chest injury. In patients with a negative chest exam and negative chest X-ray, 35% had occult injuries detected on chest CT. For patients with a negative abdominal exam and CT abdomen and pelvis, 16% were found to have an occult injury on CT. Lastly, 25% of patients with normal chest, abdomen, and pelvis exams with chest, abdomen, and pelvis CT scans demonstrated occult injuries. Asymptomatic patients with a negative CT had a length of stay 1 day less than patients without a corresponding CT. No incidents of contrast-induced complications were recorded. Conclusions A negative physical exam combined with a normal chest X-ray does not rule out the presence of occult injuries and the need for torso imaging. In blunt trauma patients with normal sensorium, physical exam and chest X-ray, the practice of obtaining cross-sectional imaging appears beneficial by increasing the accuracy of total injury burden and decreasing the length of stay.

scholarly journals COVID-19 Symptoms Detection Based on NasNetMobile with Explainable AI Using Various Imaging Modalities

2020 ◽  
Vol 2 (4) ◽  
pp. 490-504
Author(s):  
Md Manjurul Ahsan ◽  
Kishor Datta Gupta ◽  
Mohammad Maminur Islam ◽  
Sajib Sen ◽  
Md. Lutfar Rahman ◽  
...  
Keyword(s):  
Ct Scan ◽  
Initial Screening ◽  
X Ray ◽  
Learning Techniques ◽  
Alternative Approach ◽  
Number Of Patients ◽  
The Usa ◽  
Chest X Ray ◽  
Interpretable Model ◽  
Potential Opportunity

The outbreak of COVID-19 has caused more than 200,000 deaths so far in the USA alone, which instigates the necessity of initial screening to control the spread of the onset of COVID-19. However, screening for the disease becomes laborious with the available testing kits as the number of patients increases rapidly. Therefore, to reduce the dependency on the limited test kits, many studies suggested a computed tomography (CT) scan or chest radiograph (X-ray) based screening system as an alternative approach. Thereby, to reinforce these approaches, models using both CT scan and chest X-ray images need to develop to conduct a large number of tests simultaneously to detect patients with COVID-19 symptoms. In this work, patients with COVID-19 symptoms have been detected using eight distinct deep learning techniques, which are VGG16, InceptionResNetV2, ResNet50, DenseNet201, VGG19, MobilenetV2, NasNetMobile, and ResNet15V2, using two datasets: one dataset includes 400 CT scan and another 400 chest X-ray images. Results show that NasNetMobile outperformed all other models by achieving an accuracy of 82.94% in CT scan and 93.94% in chest X-ray datasets. Besides, Local Interpretable Model-agnostic Explanations (LIME) is used. Results demonstrate that the proposed models can identify the infectious regions and top features; ultimately, it provides a potential opportunity to distinguish between COVID-19 patients with others.

A cohort study using pulmonary function tests and x-ray examination in toner-handling workers

2014 ◽  
Vol 34 (4) ◽  
pp. 345-356 ◽  
Author(s):  
H Kitamura ◽  
N Terunuma ◽  
S Kurosaki ◽  
K Hata ◽  
M Masuda ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Health Effects ◽  
Pulmonary Function Tests ◽  
Personal Exposure ◽  
Working Environment ◽  
X Rays ◽  
Cross Sectional ◽  
X Ray ◽  
Function Tests ◽  
Chest X Ray

Objectives: This study uses pulmonary function tests and chest x-ray examinations to examine the relationship between toner-handling work and its health effects. Methods: The subjects were 1504 male workers in a Japanese toner and photocopier manufacturing company, in the age range from 19 to 50 years in 2003. Personal exposure measurements, pulmonary function tests, chest x-ray examinations, biomarker measurements, and a questionnaire about respiratory symptoms were conducted. The present study reports the results of pulmonary function tests and chest x-ray examinations conducted in the subjects, which includes a cross-sectional study on the toner handling and non-handling workers and a longitudinal study from 2003 to 2008. Results: Few significant findings were suspected to be caused by toner exposure found in pulmonary function indices in both the cross-sectional and longitudinal studies. Any obvious fibrotic findings in chest x-ray findings related to the toner exposure could not be found out. Conclusion: No evidence of adverse effects on pulmonary function indices and chest x-rays was present in the toner-handling workers as compared to the nonspecifically exposed workers. Although the toner exposure concentration is quite low in the current well-controlled working environment, even among the toner-handling workers, we would like to continue this study in the future to verify the toner exposure health effects.

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