FRI0491 IS THERE A RELATIONSHIP BETWEEN VOGT-KOYANAGI-HARADA AND INFLAMMATORY RHEUMATOLOGICAL DISEASES

Background:Vogt-Koyanagi-Harada Disease (VKHD) is a systemic autoimmune disease characterized by bilateral granulomatous panuveitis associated with systemic symptoms, including neurological, dermatological and audiovestibular systems. Due to its systemic nature, it may accompany with other autoimmune conditions. However, there is a considerably limited number of reports on the association of VKHD and rheumatologic diseases.Objectives:To investigate the relationship between VKHD and inflammatory rheumatological diseases.Methods:Patients who had bilateral granulomatous uveitis and fulfilled the 2001 revised diagnostic criteria for VKHD were included in our study. All patients were systematically reviewed in terms of the presence of any rheumatological manifestations including connective tissue diseases, spondyloarthritis (SpA), vasculitis, Behcet’s disease and sarcoidosis.Results:Demographic findings: There were fifteen patients in the study (86,7%,female), the mean age at diagnosis was 31,2 ± 11,1 years.Comorbidities: Six patients (4 hashimoto thyroiditis, 2 diabetes mellitus) had comorbid diseases.Rheumatological findings: Mechanical back pain in 4 patients, 1 patient had morning stiffness without any other SpA related features; 2 patients had inflammatory arthralgias in small joints, 4 patients had sicca symptoms, 1 patient had arthritis in knee joint, 3 patients had oral aphthae and 1 patient had photosensitivity.Laboratory tests and autoantibodies: The acute phase reactants were within normal ranges. The mean CRP value at the time of diagnosis was 2,7 ± 3,2 mg/L and ESR was 14,4 ± 9,2 mm/h. Two (15,3%) out of 13 patients had high serum ACE levels. RF, anti-CCP and anti-dsDNA were negative in all patients. ANA was positive (>1/160 titers) in 4 patients (28,6%) and 3 patients had a titer above 1/320. Anti-ENA profile was positive in 2 patients with anti-SS-B and anti-histone components. MPO-ANCA was positive in one patient.HLA test: HLA-B27 was negative in all patients. HLA-B51 and B18 were positive in 2 patients.Radiographic findings: One patient had heel enthesitis on X-ray, 4 patients had bilateral grade 1 and one patient had unilateral grade 2 sacroiliitis. None of them fulfilled the Modified New York criteria for radiographic sacroiliitis. Hand X-rays of all patients were normal. One patient had reticular density on chest X-ray.Pathergy: The pathergy test was negative in all patients.Capilleroscopy: Four patients had pathological capilleroscopy findings (3 patient tortuous loops, 1 patient tortuous loops and microhemorrhages).Conclusion:This study suggests that; 1) inflammatory arthralgias and sicca symptoms were the most common rheumatological findings, 2) the frequency of SpA related features were not increased in VKHD, 3) increased autoantibody frequency, particularly in high titers of ANA could be seen in VKHD possibly reflecting the autoimmune nature of the disease, 4) even though there were signs of rheumatic diseases, none of the patients were grouped into any rheumatologic diagnostic classification.Demographic findings and rheumatological manifestations in VKHD patientsVKHD patients (n=15)Females,n (%)13 (86,7)Age,yrs (mean ± std)34,6 ± 12,6Age of diagnosis, yrs (mean±std)31,2 ± 11,1CRP baseline (mean±std)2,7 ± 3,2 mg/LESR baseline (mean±std)14,4 ± 9,2 mm/HHigh ACE levels,n(%)2/13 (15,3)RF positivity,n(%)0/14 (0)Anti-CCP positivity,n (%)0/6 (0)ANA positivity,n(%)4/14 (28,6)ANA pattern,(n)Homogeneous (2)Nuclear (1)Homogeneous speckled (1)Anti-dsDNA positivity,n(%)0/11 (0)Anti-ENA profile positivity,n(%)2/14 (14,2)ANCA positivity,n(%)1/12 (8,3)Pelvis X-Ray abnormality,n(%)Sacroiliitis (n)5/12 (41,7)Bilateral grade 1 (4)Unilateral grade 2 (1)Capilleroscopy abnormality,n(%)4/9 (44,5)Pathergy,n (%)0/12 (0)Disclosure of Interests:None declared

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An Evaluation of Cellular Neural Networks for the Automatic Identification of Cephalometric Landmarks on Digital Images

Journal of Biomedicine and Biotechnology ◽

10.1155/2009/717102 ◽

2009 ◽

Vol 2009 ◽

pp. 1-12 ◽

Cited By ~ 17

Author(s):

Rosalia Leonardi ◽

Daniela Giordano ◽

Francesco Maiorana

Keyword(s):

Neural Networks ◽

Cellular Neural Networks ◽

Automatic Identification ◽

Cephalometric Analysis ◽

X Rays ◽

X Ray ◽

Automatic Location ◽

Landmark Identification ◽

The Mean ◽

Analogue To Digital

Several efforts have been made to completely automate cephalometric analysis by automatic landmark search. However, accuracy obtained was worse than manual identification in every study. The analogue-to-digital conversion of X-ray has been claimed to be the main problem. Therefore the aim of this investigation was to evaluate the accuracy of the Cellular Neural Networks approach for automatic location of cephalometric landmarks on softcopy of direct digital cephalometric X-rays. Forty-one, direct-digital lateral cephalometric radiographs were obtained by a Siemens Orthophos DS Ceph and were used in this study and 10 landmarks (N, A Point, Ba, Po, Pt, B Point, Pg, PM, UIE, LIE) were the object of automatic landmark identification. The mean errors and standard deviations from the best estimate of cephalometric points were calculated for each landmark. Differences in the mean errors of automatic and manual landmarking were compared with a 1-way analysis of variance. The analyses indicated that the differences were very small, and they were found at most within 0.59 mm. Furthermore, only few of these differences were statistically significant, but differences were so small to be in most instances clinically meaningless. Therefore the use of X-ray files with respect to scanned X-ray improved landmark accuracy of automatic detection. Investigations on softcopy of digital cephalometric X-rays, to search more landmarks in order to enable a complete automatic cephalometric analysis, are strongly encouraged.

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Isoelastic Cementless Total Hip Replacement in Rheumatoid Arthritis. Long-Term Results

Hip International ◽

10.1177/112070009200200202 ◽

1992 ◽

Vol 2 (2) ◽

pp. 43-46

Author(s):

U. Fusco ◽

R. Capelli ◽

A. Avai ◽

M. Gerundini ◽

L. Colombini ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Hip Replacement ◽

The Other ◽

Long Term Results ◽

X Rays ◽

X Ray ◽

The Mean ◽

Cementless Total Hip Replacement

Between 1980 and 1987 we have implanted 46 isoelastic cementless THR in 40 patients affected with rheumatoid arthritis. We have reviewed 38 hips clinically and by X-ray. The mean follow-up was 8,5 years. Harris hip scores ranged from 30.6 preoperatively to 73,4 post-operatively when reviewed. While on the other hand Merle D'Aubigné hip scores ranged from 7,06 pre-operatively to 15,59 post-operatively. All patients have been satisfied, and X-rays showed an improvement for both Charnely and Gruen X-ray score.

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X-Rays from Wolf-Rayet Stars Observed by the Einstein Observatory

Symposium - International Astronomical Union ◽

10.1017/s0074180900029430 ◽

1982 ◽

Vol 99 ◽

pp. 589-595

Author(s):

W. T. Sanders ◽

J. P. Cassinelli ◽

K. A. van der Hucht

Keyword(s):

Mean Value ◽

Spectral Energy ◽

X Rays ◽

X Ray ◽

Total Luminosity ◽

Hydrogen Emission Lines ◽

Flux Level ◽

The Mean ◽

Einstein Observatory ◽

Thin Source

Preliminary results of three X-ray surveys are presented. Out of a sample of 20 stars, X-rays were detected from four Wolf-Rayet stars and two 08f+ stars. The detected stars have about the same mean value as 0 stars for the X-ray to total luminosity ratio, LX/L = 10−7, but exhibit a much larger variation about the mean. The spectral energy distributions are also found to be like that of 0 stars in that they do not exhibit large attenuation of X-rays softer than 1 keV. This indicates that for both the 0 stars and WR stars much of the X-ray emission is coming from hot wisps or shocks in the outer regions of the winds and not from a thin source at the base of the wind. The general spectral shape and flux level place severe restrictions on models that attribute the lack of hydrogen emission lines to extremely high temperatures of the gas in the wind.

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The Utility of Preoperative Magnetic Resonance Imaging for Determining the Flexibility of Sagittal Imbalance

Neurosurgery ◽

10.1093/neuros/nyx431 ◽

2017 ◽

Vol 83 (3) ◽

pp. 465-470

Author(s):

Akshay Sharma ◽

Sina Pourtaheri ◽

Jason Savage ◽

Iain Kalfas ◽

Thomas E Mroz ◽

...

Keyword(s):

Lumbar Lordosis ◽

Surgical Planning ◽

Pelvic Incidence ◽

Sagittal Imbalance ◽

X Rays ◽

Resonance Imaging ◽

Patient Counseling ◽

X Ray ◽

Preoperative Magnetic Resonance ◽

The Mean

Abstract BACKGROUND Scoliosis X-rays are the gold standard for assessing preoperative lumbar lordosis; however, particularly for flexible lumbar deformities, it is difficult to predict from these images the extent of correction required, as standing radiographs cannot predict the thoracolumbar alignment after intraoperative positioning. OBJECTIVE To determine the utility of preoperative MRI in surgical planning for patients with flexible sagittal imbalance. METHODS We identified 138 patients with sagittal imbalance. Radiographic parameters including pelvic incidence and lumbar lordosis were obtained from images preoperatively. RESULTS The mean difference was 2.9° between the lumbar lordosis measured on supine MRI as compared to the intraoperative X-rays, as opposed to 5.53° between standing X-rays and intraoperative X-ray. In patients with flexible deformities (n = 24), the lumbar lordosis on MRI measured a discrepancy of 3.08°, as compared to a discrepancy of 11.46° when measured with standing X-ray. CONCLUSION MRI adequately determined which sagittal deformities were flexible. Furthermore, with flexible sagittal deformities, lumbar lordosis measured on MRI more accurately predicted the intraoperative lumbar lordosis than that measured on standing X-ray. The ability to preoperatively predict intraoperative lumbar lordosis with positioning helps with surgical planning and patient counseling regarding expectations and risks of surgery.

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1700 Using Intra-Operative Imaging as A Tool to Provide Peer Review, Scoring, Feedback and Education for Hand and Wrist Trauma Cases - A Quality Improvement Project

British Journal of Surgery ◽

10.1093/bjs/znab259.923 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Smith ◽

A Thompson ◽

P Stanier ◽

J Rooker ◽

I Lowdon

Keyword(s):

Final Report ◽

X Rays ◽

Improvement Project ◽

X Ray ◽

Constructive Feedback ◽

Wrist Trauma ◽

Specific Feedback ◽

The Mean ◽

Mean Time

Abstract Aim To improve the efficiency of intraoperative hand trauma x-ray review, introduce a scoring system for quality of fixation achieved and use this as an education and feedback tool for trainees. Method A large QI project in 2019 demonstrated that intra-operative images taken using the mini C-arm were not being reviewed. In March 2020 the first QI cycle introduced an Access database to ensure that as cases were removed from the trauma board, they were added to a review list. Each x-ray was also scored in the trauma meeting (good, acceptable, poor) to assess the radiographic quality of fixation. The second QI cycle identified the named surgeon for each case, allowing surgeon specific feedback. Finally, we trained all qualified users of the mini C-arm to upload their own images after each case, reducing the mean time to upload. Results This QI project has improved the review rate of mini C-arm images from 30% to 100% and every x-ray is scored. The mean time to review images has reduced from 4 days to less than 24 hours. All trainees can access their scores for imaged hand and wrist trauma and receive written constructive feedback. Conclusions This project ensures appropriate and prompt review of all hand and wrist trauma cases allowing early identification of any concerns. All x-rays are scored, and this process acts as an educational prompt in the trauma meeting. A final report can be printed for each trainee which can be uploaded to their portfolio to document their surgical progress.

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The reflexion of X-rays from the ‘anti-phase nuclei’ of AuCu 3

Proceedings of the Royal Society of London Series A - Mathematical and Physical Sciences ◽

10.1098/rspa.1943.0013 ◽

1943 ◽

Vol 181 (987) ◽

pp. 360-368 ◽

Cited By ~ 48

Keyword(s):

Mean Value ◽

X Rays ◽

Integral Breadth ◽

X Ray ◽

Structure Factors ◽

Unit Cells ◽

The Mean

Jones & Sykes have observed that the superlattice lines in X-ray photographs of AuCu 3 , are not always as sharp as the main lines, and that the broadening depends markedly on the indices of the line. They explain these phenomena by assuming that the crystals of AuCu 3 contain many ‘anti-phase nuclei’ in which the superlattice is organized in different ways. In the present paper it is shown that the integral breadth of a reflexion from a crystal in which all the unit cells are not the same is λ J 0 /cos θ ƒ J t dt , where J t is the mean value of the product FF* of the structure factors of two unit cells separated a distance t in the hkl direction. Detailed calculations are made of the broadening to be expected from five different ways in which the nuclei can ‘change step’. Closest agreement with the observed broadening is given by a manner of ‘ changing step ’ in which the gold atoms avoid one another.

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RELATIONSHIP BETWEEN DISABILITY AND RADIOGRAPHIC FINDINGS OF LUMBAR DISK DEGENERATION IN SAMPLE OF IRAQI PATIENTS WITH MECHANICAL LOW BACKACHE

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i2.40166 ◽

2021 ◽

pp. 83-88

Author(s):

KHUDAIR AL-BEDRI ◽

RIYAM ALI ◽

ZAINAB A. MAHMOOD

Keyword(s):

Back Pain ◽

X Rays ◽

Radiographic Findings ◽

X Ray ◽

Disk Space ◽

Lumbar Disk ◽

Disk Degeneration ◽

Lumbar Disk Degeneration ◽

Severity Of Disability ◽

Disk Space Narrowing

Objectives: Disability related to chronic low back pain (LBP) is a complex and multidimensional phenomenon all over the world. The prevalence of backache in middle age and elderly is up to 84%. This study aims to evaluate the associations of X-ray features of lumbar disk degeneration with severity of disability among patients with mechanical LBP. Patients and Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical LBP. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0–10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar X-rays. Results: The mean age of our sample was 52.45±7.87 and 71.7% of involved patients were women. Most patients were recorded as overweight or obese. The findings of disk space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two-third of cases were focused on minimal disability, followed by moderate, severe, and crippled as (26%), (6%), and (2%), respectively. There was highly significant association between women and pain radiation to legs (p=0.004). Obesity and overweight had meaningless effects on all markers. Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disk space narrowing on X-ray, and disk degenerative disease score on X-ray, while age, presence of osteophytes and spondylolisthesis, body mass index, and pain duration were not associated with severity of disability.

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Study of Clinical and Biochemical Parameters of Type 2 Diabetic Subjects with Pulmonary Tuberculosis

BIRDEM Medical Journal ◽

10.3329/birdem.v4i1.18545 ◽

2014 ◽

Vol 4 (1) ◽

pp. 5-8

Author(s):

F Afsana ◽

SNAA Jamil ◽

ZA Latif

Keyword(s):

Pulmonary Tuberculosis ◽

Biochemical Parameters ◽

Complete Blood Count ◽

Radiological Finding ◽

X Rays ◽

Radiographic Findings ◽

Bacteriological Culture ◽

X Ray ◽

Chest X Ray

Aims: Type 2 DM is a global epidemic and recognized as a threat to pulmonary tuberculosis (PTB) control worldwide especially in developing countries. When tuberculosis is diagnosed in diabetic subjects both can be affected in term of clinical presentation and course of disease. The aim of the study was to evaluate the demographic, clinical and biochemical parameters of newly detected PTB patients with type 2 diabetes. Methods: Seventy two diabetic subjects with newly detected PTB attending outpatient department, BIRDEM were studied. Patients with fever, cough, hemoptysis and/or weight loss were interviewed by a structured questionnaire. After thorough clinical examination, blood sugar, complete blood count (CBC), ESR, sputum for bacteriological culture and acid fast bacilli (AFB) (3 samples), X-ray chest were done. The diagnosis of PTB was based on a positive sputum AFB test, a suggestive CBC report or typical radiographic findings with high clinical probability. Diagnosed PTB cases were included in the study. All patients were followed up at least at1st, 3rd and 6th month of antitubercular therapy. Result: Mean age of study subjects was 46(19-75) years. The study subjects do not have past history of tuberculosis. Most of the study subjects (98.6%) were on insulin for treatment of diabetes. Mean body mass index (BMI) was 19.9kg/m². Mean ESR (mm in 1st hour) was 94.5 with 60% subjects having ESR >100. Sputum for bacteriological culture revealed no growth in 77.3% patients. Chest X-ray revealed cavity in 47.2%, opacity in 40.3%, both opacity and cavity in 5.6 %, pleural effusion in 5.6% and 5.5% had no detectable lesion. All patients were sputum AFB positive and among them 73.6% (n=53) had AFB positive in all 3 samples. Most of the patients (n=62, 86.6%) become sputum AFB negative after one month of treatment initiation. Rest 10 subjects (13.4%) become sputum negative in 2 months follow up and all of these patients had cavitary lesions in chest X-rays. A good number of the patients (98%) with positive x-ray finding showed radiological improvement after 2 months of antitubercular treatment. All the patients completed their therapy without any interruption for 6 months. Conclusion: Pulmonary cavity and opacity is the commonest radiological finding among study subjects. Sputum positivity for AFB is a good diagnostic tool for PTB in diabetic subjects. Subjects with cavitary lesion in chest X-ray become sputum negative than others. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18545 Birdem Med J 2014; 4(1): 5-8

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Are We Overdoing It? Changes in Diagnostic Imaging Workload during the Years 2010–2020 including the Impact of the SARS-CoV-2 Pandemic

Healthcare ◽

10.3390/healthcare9111557 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1557

Author(s):

Mateusz Winder ◽

Aleksander Jerzy Owczarek ◽

Jerzy Chudek ◽

Joanna Pilch-Kowalczyk ◽

Jan Baron

Keyword(s):

Healthcare Expenditure ◽

University Hospital ◽

X Rays ◽

X Ray ◽

Number Of Patients ◽

The Future ◽

The Mean ◽

The Impact ◽

Annual Amount ◽

Related Increase

Since the 1990s, there has been a significant increase in the number of imaging examinations as well as a related increase in the healthcare expenditure and the exposure of the population to X-rays. This study aimed to analyze the workload trends in radiology during the last decade, including the impact of COVID-19 in a single university hospital in Poland and to identify possible solutions to the challenges that radiology could face in the future. We compared the annual amount of computed tomography (CT), radiography (X-ray), and ultrasound (US) examinations performed between the years 2010 and 2020 and analyzed the changes in the number of practicing radiologists in Poland. The mean number of patients treated in our hospital was 60,727 per year. During the last decade, the number of CT and US examinations nearly doubled (from 87.4 to 155.7 and from 52.1 to 86.5 per 1000 patients in 2010 and 2020 respectively), while X-ray examinations decreased from 115.1 to 96.9 per 1000 patients. The SARS-CoV-2 pandemic did not change the workload trends as more chest examinations were performed. AI, which contributed to the COVID-19 diagnosis, could aid radiologists in the future with the growing workload by increasing the efficiency of radiology departments as well as by potentially minimizing the related costs.

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Chest X-Ray Findings and Temporal Lung Changes in Patients with COVID-19 Pneumonia

10.21203/rs.3.rs-45829/v1 ◽

2020 ◽

Author(s):

Liqa A Rousan ◽

Eyhab Elobeid ◽

Musaab Karrar ◽

Yousef Khader

Keyword(s):

Ct Scan ◽

Chest Ct ◽

Common Finding ◽

X Rays ◽

Radiographic Findings ◽

X Ray ◽

Abnormal Chest ◽

Chest X Ray ◽

Chest Ct Scan

Abstract Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.

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