Abstract TP39: High Accuracy of Magnetic Resonance T2*- Weighted Sequences for Detection of Intracranial Arterial Thrombus

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Afonso P Liberato ◽  
Santosh Shah ◽  
Noor Maza ◽  
Isabelle Barnaure ◽  
Ramon G Gonzalez ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Imaging Modality ◽  
Arterial Occlusion ◽  
High Accuracy ◽  
Time Interval ◽  
Vessel Occlusion ◽  
Predictive Values ◽  
Arterial Thrombus ◽  
The Mean ◽  
Mean Time

Introduction: Rapid detection and location of vessel occlusion are pivotal in the intra-arterial management of patients with acute stroke in the emergency room. MRI has demonstrated to detect intravascular thrombus but its accuracy compared to CT angiography has not been well established. Hypothesis: Our purpose is to determine the accuracy of 1.5 T MRI T2*-weighted (W) sequences compared to immediate CT angiography as the standard reference imaging modality, for detection of intra-arterial thrombus in patients with suspected acute MCA infarction. Methods: Consecutive patients with suspected middle cerebral artery (MCA) territory stroke were selected from 2008 to 2009. The inclusion criteria for the study subjects: CTA, T2*W sequences included on MRI protocol and restricted diffusion in MCA territory on DWI within 12 hrs of clinical onset. Two investigators reviewed DWI and T2*W sequences for the presence of infarction and thrombus. Intracranial internal carotid artery (ICA), M1 and M2 segments of the MCA were accessed. Consensus was reached with a third reviewer for data analyses. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV/NPV) were calculated. Results: Fifty-one patients were included in the study, of which 40 patients had confirmed arterial thrombus and 11 patients had normal studies on CTA. Of the subjects with arterial occlusion on CTA, the mean time interval from stroke onset to CTA was 4.2 h +/- 2.3 h (range, 0.4-12h). The mean time interval from CTA to MRI was 29.5 min +/- 11.1 min. Twenty-six cases showed M1 thrombus on CTA, of these, 22 cases had corresponding thrombus and 4 cases had no abnormality in T2*W sequences on MRI. Nevertheless, 25 patients demonstrated no M1 thrombus, either on CTA or MRI. After statistical analyses, we observed an accuracy of 92%, sensitivity of 85%, specificity of 100%, PPV 100% and NPV of 86% for M1 occlusion. The Kappa obtained was 0.79. Conclusion: In conclusion, T2*W sequences demonstrated overall high accuracy and specificity for detection of arterial thrombus in the M1 segment of the MCA in patients with suspected acute MCA ischemic stroke.

scholarly journals Time Intervals From Onset of Clinical Manifestations to Treatment in Patients With Cancer at Hospital General San Felipe, Tegucigalpa, Honduras

2019 ◽  
pp. 1-7
Author(s):  
José A. Sánchez ◽  
Mayra G. Handal ◽  
Juan F. Vílchez Rodriguez ◽  
Sinthia I. Mejía ◽  
Annye P. Pagoaga
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Time Interval ◽  
Pathology Report ◽  
Time Intervals ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
The Mean ◽  
Mean Time

PURPOSE In cancer, clinical staging is related to outcomes, and this is linked to the evolution of the disease over time. In Honduras, cancer mortality is high, and time intervals from onset of symptoms to treatment of cancer are not known. We conducted a cross-sectional study to determine these intervals. PATIENTS AND METHODS This investigation was carried out from April 25 to August 30, 2018, and included 202 patients at the main cancer referral center in Honduras. For the purposes of the study, information was obtained from patients, their caregiver, medical records, or treatment cards. Patients older than age 18 years were included after informed consent was signed. RESULTS The mean time interval from onset of symptoms to cancer treatment was 232 days. Different intervals of time were identified, and the mean of these intervals was calculated in days as follows: 68 days from onset of symptoms to first medical evaluation; 146 days from first evaluation to oncologist consultation; 26 days from cancer specialist to the pathology report; and 86 days from the histopathologic diagnosis to the beginning of treatment. Once diagnosis was established, the average elapsed times to chemotherapy, radiotherapy, surgery, and chemoradiotherapy were 88, 102, 76, and 154 days, respectively ( P < .05, when surgery is compared against chemotherapy and radiotherapy). CONCLUSION The mean time interval from symptom presentation to treatment in patients with cancer is more than 7 months. This could explain the advanced stages of disease seen at the time of treatment in Honduras, which decrease chance of cure and increase the mortality rate of cancer). Appropriate intervention to decrease these intervals must be taken to reduce mortality.

scholarly journals Recovery of Adrenal Insufficiency Is Frequent After Adjuvant Mitotane Therapy in Patients with Adrenocortical Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 639 ◽  
Author(s):  
Jonathan Poirier ◽  
Nadia Gagnon ◽  
Massimo Terzolo ◽  
Soraya Puglisi ◽  
Nada El Ghorayeb ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Hpa Axis ◽  
Complete Recovery ◽  
Time Interval ◽  
Zona Fasciculata ◽  
Adrenocortical Cancer ◽  
Hormonal Profile ◽  
Chronic Therapy ◽  
The Mean ◽  
Mean Time

Mitotane is a steroidogenesis inhibitor and adrenolytic drug used for treatment of adrenocortical cancer (ACC). Mitotane therapy causes adrenal insufficiency requiring glucocorticoid replacement in all patients. However, it is unclear whether chronic therapy with mitotane induces complete destruction of zona fasciculata and whether hypothalamic-pituitary-adrenal (HPA) axis can recover after treatment cessation. Our objective was to assess the HPA axis recovery in a cohort of patients after cessation of adjuvant mitotane therapy for ACC. We retrospectively reviewed patient files with stage I-II-III ACC in two referral centers in Canada and Italy. Data on demographics, tumor characteristics, hormonal profile, and HPA axis were collected. Data from 23 patients with pathologically proven ACC treated with adjuvant mitotane for a minimum of two years were analyzed. Eight patients were males and 15 were females and the median age was 41 years old (range 18 to 73). After mitotane cessation, 18/23 (78.3%) patients achieved a complete HPA axis recovery while 3/23 (13.0%) were unable to tolerate glucocorticoid withdrawal despite having normal hormonal test values and 2/23 (8.7%) never achieved recovery. The mean time interval between mitotane cessation and HPA axis recovery was 2.7 years. A high proportion of patients achieved HPA axis recovery following cessation of mitotane adjuvant therapy. However, complete recovery was often delayed up to 2.5 years and regular assessment of the hormonal profile is required.

How promptly nonindustrial private forest landowners regenerate their lands after harvest: a duration analysis

2008 ◽  
Vol 38 (8) ◽  
pp. 2109-2117 ◽  
Author(s):  
Xing Sun ◽  
Ian A. Munn ◽  
Changyou Sun ◽  
Anwar Hussain
Keyword(s):  
Duration Analysis ◽  
Time Interval ◽  
Private Forest ◽  
Forest Types ◽  
Forest Landowners ◽  
Factors Associated ◽  
The Mean ◽  
Nonindustrial Private Forest ◽  
Mean Time ◽  
Private Forest Landowners

Understanding factors that influence how promptly landowners regenerate their timberlands after harvest, if at all, is critical to developing policies to improve forest productivity. Mississippi forest landowners with over 100 acres (1 acre = 0.404 ha) of forestland were surveyed in 2006 to collect harvest and regeneration data from 1996 to 2006. This study investigated the length of the time interval between harvest and reforestation. Nonparametric duration analysis was used to examine how long nonindustrial private forest landowners waited to reforest after harvesting. Parametric duration analysis was used to examine factors that influenced the length of this period. The mean time elapsed from harvest to regeneration was 11 months for landowners that regenerated their lands. The instantaneous probability of regeneration reached its highest value in the 16th month after harvest and, thereafter, decreased steadily until the 28th month, after which the probability of regeneration was essentially nil. Interest in timber production, employing a consultant, and ownerships that were predominantly pine forest types were factors associated with substantially shorter reforestation times. Lower stumpage prices and higher reforestation costs were associated with substantially longer reforestation times.

scholarly journals An Adaptive and Time-Efficient ECG R-Peak Detection Algorithm

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Qin Qin ◽  
Jianqing Li ◽  
Yinggao Yue ◽  
Chengyu Liu
Keyword(s):  
Detection Algorithm ◽  
Peak Detection ◽  
Time Interval ◽  
Detection Accuracy ◽  
Ecg Signal ◽  
Peak Detection Algorithm ◽  
Wavelet Multiresolution Analysis ◽  
The Mean ◽  
Electrocardiogram Ecg ◽  
Mean Time

R-peak detection is crucial in electrocardiogram (ECG) signal analysis. This study proposed an adaptive and time-efficient R-peak detection algorithm for ECG processing. First, wavelet multiresolution analysis was applied to enhance the ECG signal representation. Then, ECG was mirrored to convert large negative R-peaks to positive ones. After that, local maximums were calculated by the first-order forward differential approach and were truncated by the amplitude and time interval thresholds to locate the R-peaks. The algorithm performances, including detection accuracy and time consumption, were tested on the MIT-BIH arrhythmia database and the QT database. Experimental results showed that the proposed algorithm achieved mean sensitivity of 99.39%, positive predictivity of 99.49%, and accuracy of 98.89% on the MIT-BIH arrhythmia database and 99.83%, 99.90%, and 99.73%, respectively, on the QT database. By processing one ECG record, the mean time consumptions were 0.872 s and 0.763 s for the MIT-BIH arrhythmia database and QT database, respectively, yielding 30.6% and 32.9% of time reduction compared to the traditional Pan-Tompkins method.

Lenalidomide Administration In Patients With POEMS Syndrome

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3235-3235 ◽  
Author(s):  
Flora Zagouri ◽  
Efstathios Kastritis ◽  
Maria Gavriatopoulou ◽  
Theodora Psaltopoulou ◽  
Theodoros N. Sergentanis ◽  
...  
Keyword(s):  
Partial Response ◽  
Sample Size ◽  
Conflicts Of Interest ◽  
Small Sample ◽  
Poems Syndrome ◽  
High Dose ◽  
Time Interval ◽  
Efficacy And Safety ◽  
The Mean ◽  
Mean Time

Abstract The most effective treatment for patients with POEMS is high dose therapy with autologous stem cell support (ASCT); however, several patients are not be eligible for this procedure while others may relapse after ASCT. Hence, there is a clear need for the development of new therapies for the management of POEMS. Lenalidomide is an immunomodulatory drug that has proven efficacy in patients with multiple myeloma and seems to represent an attractive option for use in POEMS. The purpose of this study was to synthesize all available data emerging from case reports/case series and our experience so as to evaluate the efficacy and safety of lenalidomide in patients with POEMS. This systematic review was performed in accordance with the PRISMA guidelines. Eligible articles were identified by a search in MEDLINE and ClinicalTrials.gov databases for the period up to April 8, 2013. The search strategy included the following keywords: (POEMS AND (lenalidomide OR revlimid). In addition, we checked all the references of eligible articles, so as to identify potentially eligible papers. Articles in Chinese and Japanese were excluded; two investigators, working independently, searched the literature and extracted data from eligible studies. All studies that examined the efficacy and safety of lenalidomide administration in patients with POEMS diagnosis, regardless of sample size, were considered eligible. Moreover, eligible cases of patients diagnosed with POEMS syndrome and who were treated with lenalidomide in our Department were additionally included in this pooled analysis. POEMS diagnosis was established according to criteria by Dispenzieri et al (Am J Hematol 2012). Hematological, radiological and neurological response was assessed according to the statements of the authors in the individual eligible manuscripts; in case these were not clearly stated, we applied the D'Souza criteria. An overall of 11 articles, which included 51 patients, were analyzed. The mean age of patients at lenalidomide administration was 55.2 years (SD: 10.8; median: 54.5 years; range: 32-79 years). The mean time from POEMS diagnosis to lenalidomide administration was 30.1 months (SD: 37.4; median: 18 months; range: 0- 164 months). In most patients lenalidomide was administered at a dose of 25 mg (days 1-21) in combination with dexamethasone (40 mg weekly in cycles of 28 days), until disease progression or unacceptable toxicity. Lenalidomide was given as first, second, third and fourth line treatment in 19.1%, 50%, 19.1% and 11.9% of patients, respectively. The mean time from last treatment till lenalidomide administration was 17.2 months (SD: 27.0; median: 5 months; range: 0-111 months). There were 43 patients evaluated for hematological response; the latter included complete response in 18.6%, very good partial response in 39.5%, partial response in 37.2% and stabilization of the disease in 4.7% of cases. Of note, VEGF reduction occurred in all reported cases; neuropathy improved in 92.0% of cases and stabilized in 8%. Organomegaly was improved in 87% of cases, skin changes in 73.7% and edema in 95%. In 8 patients, ASCT was performed after lenalidomide treatment and no particular toxicity or harvest issues were observed. Lenalidomide was well tolerated; two cases with respiratory infection grade 3 and one case neutropenia grade 4 were recorded. Data to assess progression were available in 44 patients; among them 6 progressed. Of note, among the 6 patients who progressed during the observation period, only two relapsed within the first year. The Kaplan-Meier PFS estimate at 12 months was equal to 93.9%. No deaths were reported during the follow-up period. Given the small sample size as well as the small number of events, no significant associations emerged. Nevertheless, some trends of marginal significance seem worth observing, i.e. longer time interval between diagnosis and lenalidomide administration was associated with less frequent neuropathy response (OR: 0.98, 95% CI: 0.96-1.00, p=0.053). We conclude that the use of lenalidomide in patients with POEMS seems to be a highly effective and safe therapy, even in patients previously exposed to one or more lines of therapy. The PFS achieved by lenalidomide was rather prolonged (PFS at 12 months 93.9%); furthermore, marked clinical, neurological, hematological and VEGF levels improvement in patients treated with this agent was observed. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Multiple flux rope events at the magnetopause observations by TC-1 on 18 March 2004

2005 ◽  
Vol 23 (8) ◽  
pp. 2897-2901 ◽  
Author(s):  
C. J. Xiao ◽  
Z. Y. Pu ◽  
Y. Wei ◽  
Z. X. Liu ◽  
C. M. Carr ◽  
...  
Keyword(s):  
Flux Rope ◽  
Detailed Comparison ◽  
Dominant Negative ◽  
Time Interval ◽  
Low Latitude ◽  
Guide Field ◽  
Flux Ropes ◽  
The Mean ◽  
Mean Time ◽  
Made In

Abstract. From 23:10 to 23:50 UT on 18 March 2004, the Double Star TC-1 spacecraft detected eight flux ropes at the outbound crossing of the southern dawnside magnetopause. A notable guide field existed inside all ropes. In the mean time the Cluster spacecraft were staying in the magnetosheath and found that the events occurred under the condition of southward IMF Bz and dominant negative IMF By. There are six ropes that appeared quasi-periodically, with a repeated period being approximately 1-4 min. The last flux rope lasts for a longer time interval with a larger peak in the BN variations; it can thus be referred to as a typical FTE. The 18 March 2004 event is quite similar to the multiple flux rope event observed by Cluster on 26 January 2001 at the northern duskside high-latitude magnetopause. A detailed comparison of these two events is made in the paper. Preliminary studies imply that both of these multiple flux ropes events seem to be produced by component reconnection at the dayside low-latitude magnetopause.

scholarly journals Predictors of acute intracranial hemorrhage and recurrence of chronic subdural hematoma following burr hole drainage

2020 ◽  
Author(s):  
FuMei Chen ◽  
Ke Wang ◽  
KangLi Xu ◽  
Li Wang ◽  
TianXiang Zhan ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Time Interval ◽  
Multiple Logistic Regression ◽  
Regression Analyses ◽  
Anticoagulant Drug ◽  
The Mean ◽  
Mean Time

Abstract Objective To investigate predictors of postoperative acute intracranial hemorrhage (AIH) and recurrence of chronic subdural hematoma (CSDH) after burr hole drainage. Methods A multicenter retrospective study of patients who underwent burr hole drainage for CSDH between January 2013 and March 2019. Results A total of 448 CSDH patients were enrolled in the study. CSDH recurrence occurred in 60 patients, with a recurrence rate of 13.4%. The mean time interval between initial burr hole drainage and recurrence was 40.8±28.3 days. Postoperative AIH developed in 23 patients, with an incidence of 5.1%. The mean time interval between initial burr hole drainage and postoperative AIH was 4.7±2.9 days. Bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independent predictors of recurrence in the multiple logistic regression analyses. Preoperative headache was an independent risk factor of postoperative AIH in the multiple logistic regression analyses, however, intraoperative irrigation reduced the incidence of postoperative AIH. Conclusions This study found that bilateral hematoma, hyperdense hematoma and anticoagulant drug use were independently associated with CSDH recurrence. Clinical presentation of headache was the strongest predictor of postoperative AIH, and intraoperative irrigation decreased the incidence of postoperative AIH.

Can leucocyte esterase replace frozen sections in the intraoperative diagnosis of prosthetic hip infection?

2019 ◽  
Vol 101-B (4) ◽  
pp. 372-377 ◽  
Author(s):  
L. Zagra ◽  
F. Villa ◽  
L. Cappelletti ◽  
E. Gallazzi ◽  
G. Materazzi ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Frozen Section ◽  
Joint Infection ◽  
Ease Of Use ◽  
Polymorphonuclear Leucocytes ◽  
Predictive Values ◽  
Intraoperative Diagnosis ◽  
Hip Infection ◽  
The Mean ◽  
Mean Time

AimsLeucocyte esterase (LE) has been shown to be an accurate marker of prosthetic joint infection (PJI), and has been proposed as an alternative to frozen section (FS) histology for intraoperative diagnosis. In this study, the intraoperative assessment of LE was compared with FS histology for the diagnosis of prosthetic hip infection.Patients and MethodsA total of 119 patients undergoing revision total hip arthroplasty (THA) between June 2015 and December 2017 were included in the study. There were 56 men and 63 women with a mean age of 66.2 years (27 to 88). Synovial fluid was collected before arthrotomy for the assessment of LE using enzymatic colourimetric strips. Between five and six samples were stained with haematoxylin and eosin for FS histology, and considered suggestive of infection when at least five polymorphonuclear leucocytes were found in five high-power fields.ResultsThe sensitivity and specificity of the LE assay were 100% and 93.8%, respectively; the positive (PPV) and the negative (NPV) predictive values were 79.3% and 100%, respectively. The mean time between the collection of the sample and the result being known was 20.1 minutes (sd 4.4). The sensitivity and specificity of FS histology were 78.3% and 96.9%, respectively; the PPV and the NPV were 85.7% and 94.9%, respectively. The mean time between the collection of the sample and the result being known was 27.2 minutes (sd 6.9).ConclusionThe sensitivity of LE assay was higher, with similar specificity and diagnostic accuracy, compared with FS histology. The faster turnaround time, its ease of use, and low costs make LE assay a valuable alternative to FS histology. We now use it routinely for the intraoperative diagnosis of PJI. Cite this article: Bone Joint J 2019;101-B:372–377.

Passenger Flow Prediction of Exhibition Based on ARMA

2014 ◽  
Vol 667 ◽  
pp. 11-15 ◽  
Author(s):  
Ling Ling Chen ◽  
Pei Hua He ◽  
Lei Cao ◽  
Shu Guang Liu ◽  
Dan Ping Liu ◽  
...  
Keyword(s):  
Arma Model ◽  
High Accuracy ◽  
Prediction Methods ◽  
Time Interval ◽  
Passenger Flow ◽  
Flow Prediction ◽  
The Mean ◽  
Object Of Study ◽  
Accuracy Of Prediction ◽  
Short Time

In this paper,the means of WiFi was used to access to mobile phone MAC address to get passenger flow data and existing prediction methods were compared. Then N6 of Chongqing International Expo Exhibition Center was taken as the object of study and 5min was taken as the time interval to count N6 hall passenger flow from 9:00 am to 17:00 pm of 5 open days to obtain time series. At last, ARMA model was established to predict passenger flow of short time. The results show that the mean we use in this paper has high accuracy of prediction, MAE is 2.8771,and the means can be used for the passenger flow prediction of exhibition well.

Abstract P248: CSC Implementation of Artificial Intelligence Software Significantly Improves Door-In to Groin Puncture Time Interval and Recanalization Rates

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ameer E Hassan ◽  
Victor M Ringheanu ◽  
Laurie Preston ◽  
WONDWOSSEN TEKLE
Keyword(s):  
Artificial Intelligence ◽  
Treatment Time ◽  
Care Center ◽  
Mass Effect ◽  
Comprehensive Care ◽  
Time Interval ◽  
Vessel Occlusion ◽  
Ct Angiogram ◽  
Detection Technology ◽  
The Mean

Introduction: Viz.ai artificial intelligence (AI) software utilizes AI powered large vessel occlusion (LVO) detection technology which automatically identifies suspected LVO through CT angiogram (CTA) imaging and alerts on-call stroke teams. We performed this analysis to determine if utilization of this AI software can reduce the door-in to groin puncture time interval within the comprehensive care center (CSC) for patients arriving at the CSC for endovascular treatment. Methods: We compared the time interval between door-in to groin puncture for all LVO transfer patients who arrived at our comprehensive care center for approximately two years prior to and after the implementation of the AI software in November of 2018. Using a prospectively collected database at a CSC, demographics, door-in to groin time, modified Rankin Scale at discharge (mRS dc), mortality rate at discharge, length of stay (LOS) in hospital, mass effect, and hemorrhage rates were examined. Results: There were a total of 188 patients during the study period (average age 69.26 ± 14.55, 42.0% women). We analyzed 86 patients from the pre-AI (average age 68.53 ± 13.13, 40.7% women) and 102 patients from the post-AI (average age 69.87 ± 15.75, 43.1% women); see Table 1 for comparison of baseline characteristics and outcomes. Following the implementation of the AI software, the mean door-in to groin puncture time interval within the CSC significantly improved by 86.7 minutes (206.6 vs 119.9 minutes; p < 0.0001); significant improvements were also noted in the rate of good recanalization (mTICI 2B-3) for patients in the post-AI population (p=0.0364). Conclusion: The incorporation of the AI software was associated with a significant improvement in treatment time within the CSC as well as significantly higher rates of good recanalization for patients treated. More extensive studies are warranted to expand on the ability of AI technology to improve transfer times and outcomes for LVO patients.

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