CT Findings in General Practice Patients with Suspected Acute Sinusitis

1996 ◽  
Vol 37 (3P2) ◽  
pp. 708-713 ◽  
Author(s):  
M. Lindbæk ◽  
U. L.-H. Johnsen ◽  
E. Kaastad ◽  
S. Dølvik ◽  
P. Møll ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Diagnosis ◽  
Interobserver Agreement ◽  
Acute Sinusitis ◽  
Fluid Level ◽  
Ct Findings ◽  
Kappa Value ◽  
Ct Evaluation ◽  
Common Combination ◽  
Maxillary Sinuses

Purpose: To study CT findings in general practice patients with a clinical diagnosis of acute sinusitis, and to examine the interobserver variation between 2 radiologists with regard to their CT evaluation. Material and Methods: Two hundred and one patients were examined with coronal CT images of the paranasal sinuses within 2 days of the clinical diagnosis. Patients with chronic sinusitis were excluded. Fluid level or total opacification of any sinus were used as evidence of sinusitis. Results: One hundred and twenty-seven (63%) patients had fluid level or total opacification in a sinus region, most in more than one region. One hundred and fifteen had CT signs of sinusitis in the ethmoid region, 84 in the maxillary, 18 in the frontal, and 10 in the sphenoid. Forty-nine patients had a negative CT. In the evaluation of interobserver agreement, the overall assessment of the CT yielded a kappa value of 0.70. Conclusion: The study demonstrated great variation in the CT findings in general practice patients with suspected acute sinusitis. More than one sinus region was affected in most patients in whom sinusitis was confirmed by CT imaging; the most common combination was ethmoid and maxillary sinuses. The interobserver agreement was substantial.

CT Findings in General Practice Patients with Suspected Acute Sinusitis

1996 ◽  
Vol 37 (5) ◽  
pp. 708-713 ◽  
Author(s):  
M. Lindbæk ◽  
U. L.-H. Johnsen ◽  
E. Kaastad ◽  
S. Dølvik ◽  
P. Møll ◽  
...  
Keyword(s):  
General Practice ◽  
Acute Sinusitis ◽  
Ct Findings

The Role of CO-RADS Scoring System in the Diagnosis of COVID-19 Infection and its Correlation with Clinical Signs

2021 ◽  
Vol 17 ◽  
Author(s):  
Şenol Çomoğlu ◽  
Sinan Öztürk ◽  
Ahmet Topçu ◽  
Fatma Kulalı ◽  
Aydın Kant ◽  
...  
Keyword(s):  
Scoring System ◽  
Clinical Signs ◽  
Assessment System ◽  
Symptom Duration ◽  
Shortness Of Breath ◽  
Laboratory Findings ◽  
Ct Findings ◽  
Chronic Pulmonary Diseases ◽  
Ct Evaluation ◽  
The Difference

Background: Computed tomography (CT) evaluation systematics has become necessary to eliminate the difference of opinion among radiologists in evaluating COVID-19 CT findings. Introduction: The objectives of this study were to evaluate the efficiency of CO-RADS scoring system in our patients with COVID-19 as well as to examine its correlation with clinical and laboratory findings. Method: The CO-RADS category of all patients included in the study was determined by a radiologist who did not know the rtRT-PCR test result of the patients, according to the Covid-19 reporting and data system of Mathias Prokop et al. Results: A total of 1338 patients were included. CT findings were positive in 66.3%, with a mean CO-RADS score of 3,4 ± 1,7. 444 (33.1%) of the patients were in the CO-RADS 1-2, 894 (66.9%) were in the CO-RADS 3-5 group. There were positive correlations between CO-RADS score and age, CMI, hypertension, diabetes mellitus, chronic pulmonary diseases presence of symptoms, symptom duration, presence of cough, shortness of breath, malaise, CRP, and LDH, while CO-RADS score was negatively correlated with lymphocyte count. The results of the ROC analysis suggested that those with age ≥40 years, symptom duration >2 days, CMI score >1 and/or comorbid conditions were more likely to have a CO-RADS score of 3-5. Conclusion: The CO-RADS classification system is a CT findings assessment system that can be used to diagnose COVID-19 in patients with symptoms of cough, shortness of breath, myalgia and fatigue for more than two days.

scholarly journals Antibiotics for acute sinusitis in general practice

BMJ ◽  
1999 ◽  
Vol 318 (7198) ◽  
pp. 1623-1623 ◽  
Author(s):  
G G Browning ◽  
J. P A Ioannidis ◽  
S. D de Ferranti ◽  
M. Barza ◽  
J. Lau
Keyword(s):  
General Practice ◽  
Acute Sinusitis

Interobserver Agreement and Intraobserver Reproducibility of Barzullah Working Classification of Distal End Radius Fractures among Orthopaedic Residents

2016 ◽  
Vol 21 (01) ◽  
pp. 24-29 ◽  
Author(s):  
Younis Kamal ◽  
Hayat Ahmad Khan ◽  
Naseem UI Gani ◽  
Munir Farooq ◽  
Adil Bashir Shah ◽  
...  
Keyword(s):  
Distal Radius ◽  
Interobserver Agreement ◽  
Distal Radius Fractures ◽  
Substantial Agreement ◽  
Radius Fractures ◽  
Intraobserver Reproducibility ◽  
Moderate Agreement ◽  
Kappa Value ◽  
The Mean

Background: The purpose of this study is to test the hypothesis of the new classification system of distal end radius fractures (Barzullah working classification) proposed by one of the author in a prospective cohort study, among the orthopaedic residents. Methods: The initial post-injury radiographs of 300 patients with distal radius fractures in a tertiary centre were classified by two junior residents (JR1 and JR2) and two senior residents (SR1 and SR2) in the emergency department over a period of two years. The collected data was analysed statistically by using Cohan's kappa for measuring Intraobserver reproducibility and Fleiss kappa for measuring Interobserver agreement. Results: The mean kappa value for Interobserver agreement was 0.53 (moderate agreement) at the end of one year and the mean kappa value at the end of study period was 0.64 (substantial agreement). The mean kappa value for Intraobserver reproducibility of JR1 was 0.45 (moderate agreement), JR2 was 0.39 (fair agreement), SR1 was 0.62 (substantial agreement) and SR2 was 0.67 (substantial agreement). Conclusions: Barzullah working classification of distal radius fractures presented in this study has good characteristics compared to those of already studied classification systems among orthopaedic residents.

Acute Sinusitis—Principles of Judicious Use of Antimicrobial Agents

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 174-177 ◽  
Author(s):  
Katherine L. O'Brien ◽  
Scott F. Dowell ◽  
Benjamin Schwartz ◽  
S. Michael Marcy ◽  
William R. Phillips ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Clinical Diagnosis ◽  
Antimicrobial Agents ◽  
Accurate Diagnosis ◽  
Acute Sinusitis ◽  
Persistent Symptoms ◽  
Published Evidence

Establishing an accurate diagnosis of bacterial sinusitis is challenging but critical, because viral rhinosinusitis is at least 20 to 200 times more common than bacterial infection of the sinuses. Strict criteria for clinical diagnosis that require either prolonged and persistent symptoms or an acute severe presentation are supported with published evidence.

scholarly journals Inter- and intraobserver agreement of three classification systems for lateral clavicle fractures – reliability comparison between two specialist groups

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Thomas Rauer ◽  
Matthias Boos ◽  
Valentin Neuhaus ◽  
Prasad Ellanti ◽  
Robert Alexander Kaufmann ◽  
...  
Keyword(s):  
Classification System ◽  
Interobserver Agreement ◽  
Intraobserver Reliability ◽  
Classification Systems ◽  
Neer Classification ◽  
Lateral Clavicle ◽  
Kappa Value ◽  
Clavicle Fractures ◽  
Specialist Groups ◽  
Trauma Surgeons

Abstract Background Although of great value in the management of lateral clavicle fractures, substantial variation in their classification exists. We performed a retrospective study to address the inter- and intraobserver reliability of three different classification systems for lateral clavicle fractures. Methods Radiographs of 20 lateral clavicle fractures that represented a full spectrum of adult fracture patterns were graded by five experienced radiologists and five experienced trauma surgeons according to the Orthopaedic Trauma Association (OTA), the Neer, and the Jäger/Breitner classification systems. This evaluation was performed at two different time points separated by 3 months. To measure the observer agreement, the Fleiss kappa coefficient (κ) was applied and assessed according to the grading of Landis and Koch. Results The overall interobserver reliability showed a fair agreement in all three classification systems. For the OTA classification system, the interobserver agreement showed a mean kappa value of 0.338 ranging from 0.350 (radiologists) to 0.374 (trauma surgeons). Kappa values of the interobserver agreement for the Neer classification system ranged from 0.238 (trauma surgeons) to 0.276 (radiologists) with a mean κ of 0.278. The Jäger/Breitner classification system demonstrated a mean kappa value of 0.330 ranging from 0.306 (trauma surgeons) to 0.382 (radiologists). The overall intraobserver reliability was moderate for the OTA and the Jäger/Breitner classification systems, while the overall intraobserver reliability for the Neer classification system was fair. The kappa values of the intraobserver agreements showed, in all classification systems, a wide range with the OTA classification system ranging from 0.086 to 0.634, the Neer classification system ranging from 0.137 to 0.448, and a range from 0.154 to 0.625 of the Jäger/Breitner classification system. Conclusions The low inter- and intraobserver agreement levels exhibited in all three classification systems by both specialist groups suggest that the tested lateral clavicle fracture classification systems are unreliable and, therefore, of limited value. We should recognize there is considerable inconsistency in how physicians classify lateral clavicle fractures and therefore any conclusions based on these classifications should be recognized as being somewhat subjective.

scholarly journals Interobserver and intraobserver comparison of imaging glenoid morphology, glenoid version and humeral head subluxation

2018 ◽  
Vol 11 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Paul J Cagle ◽  
Birgit Werner ◽  
Dave R Shukla ◽  
Daniel A London ◽  
Bradford O Parsons ◽  
...  
Keyword(s):  
Humeral Head ◽  
Interobserver Agreement ◽  
Weighted Kappa ◽  
Similar Efficacy ◽  
Ct Images ◽  
Glenoid Version ◽  
Kappa Value ◽  
Glenoid Morphology ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

Background Glenoid morphology, glenoid version and humeral head subluxation represent important parameters for the treating physician. The most common method of assessing glenoid morphology is the Walch classification which has only been validated with computed tomography (CT). Methods CT images and magnetic resonance imaging (MRI) images of 25 patients were de-identified and randomized. Three reviewers assessed the images for each parameter twice. The Walch classification was assessed with a weighted kappa value. Glenoid version and humeral head subluxation were comparted with a reproducibility coefficient. Results The Walch classification demonstrated almost perfect intraobserver agreement for MRI and CT images (k = 0.87). Weighted interobserver agreement values for the Walch classification were fair for CT and MRI (k = 0.34). The weighted reproducibility coefficient for glenoid version measured 9.13 (CI 7.16–12.60) degrees for CT and 13.44 (CI 10.54–18.55) degrees for MRI images. The weighted reproducibility coefficient for percentage of humeral head subluxation was 17.43% (CI 13.67–24.06) for CT and 18.49% (CI 14.5–25.52) for MRI images. Discussion CT and MRI images demonstrated similar efficacy in classifying glenoid morphology, measuring glenoid version and measuring posterior humeral head subluxation. MRI can be used as an alternative to CT for measuring these parameters.

Sinus Barotrauma in Divers

1976 ◽  
Vol 85 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Paul Fagan ◽  
Bart McKenzie ◽  
Carl Edmonds
Keyword(s):  
Respiratory Tract ◽  
Occupational Disease ◽  
Upper Respiratory Tract ◽  
Fluid Level ◽  
X Ray ◽  
Sinus Barotrauma ◽  
History Of ◽  
Upper Respiratory ◽  
Mucosal Thickening ◽  
Maxillary Sinuses

Sinus barotrauma is a common occupational disease of divers, with the incidence of descent barotrauma approximately double that of ascent. Pain chronologically associated with the change of pressure is the most dominant symptom and is seen in 92% of the cases presented for treatment. The majority complain of a frontal distribution of pain, with ethmoidal and maxillary being much less significant. Epistaxis is the second commonest symptom, and may be the sole symptom in some ascent cases. A history of recent or past sinus barotrauma or upper respiratory tract pathology is very common. Clinical examination supports the evidence of upper respiratory tract pathology in many cases. The radiological signs of abnormality were present in over three quarters of the cases examined. Of these the maxillary sinus was affected in most cases, the frontal in approximately one quarter and the ethmoidal in less than a fifth. The pathology was more commonly that of mucosal thickening, but in 12% of cases there was a fluid level. It is noted that although symptoms were predominantly frontal, x-ray changes were most often present in the maxillary sinuses.

Acute supraglottitis in adults

2018 ◽  
Vol 11 (6) ◽  
pp. 337-340
Author(s):  
Joshua D Whittaker ◽  
Karan Jolly
Keyword(s):  
General Practice ◽  
Sore Throat ◽  
Clinical Diagnosis ◽  
Clinical Features ◽  
Adult Population ◽  
Life Threatening ◽  
Changing Demographics ◽  
Paediatric Disease

Supraglottitis is a rare life-threatening paediatric disease whose occurrence has declined with the rise of immunization; however, it remains an important clinical diagnosis in the adult population. It is vital to consider in patients presenting with an acute sore throat. Misdiagnosis can lead to serious morbidity. This article will review the pathophysiology of supraglottitis, explain the changing demographics of the disease, important clinical features and management particularly where relevant to presentation in general practice.

scholarly journals Coagulopathy-related soft tissue hematoma: a comparison between computed tomography findings and clinical severity

2020 ◽  
Vol 9 (5) ◽  
pp. 205846012092326
Author(s):  
Manabu Nakayama ◽  
Kenichi Kato ◽  
Kunihiro Yoshioka ◽  
Hirotaka Sato
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Anticoagulant Therapy ◽  
Vital Signs ◽  
Coagulation Factors ◽  
Clinical Severity ◽  
Fluid Level ◽  
Ct Findings ◽  
Significant Difference ◽  
The Relationship

Background Despite increases in the incidence of coagulopathy-related soft-tissue hematoma (CRSH), the relationship between computed tomography (CT) features and clinical severity remains unclear. Purpose To retrospectively evaluate the correlation between CT findings and clinical outcomes in CRSH. Material and Methods We retrospectively reviewed data of patients diagnosed with CRSH between March 2011 and March 2018. CRSH was morphologically classified according to the presence or absence of the fluid level pattern and was also divided into groups with or without extravasation as per CT findings. These CT findings were compared with the patients’ vital signs and laboratory investigation results. Results A total of 47 patients with CRSH were examined. Fluid level and non-fluid level patterns were observed in 28 (60%) and 19 (40%) patients, respectively. Anticoagulant therapy and extravasation were significantly correlated with the fluid level pattern. However, other clinicolaboratory outcomes, including shock index, hemoglobin, hematocrit, platelet count, and coagulation factors, showed no significant difference between the two patterns. In the comparison of hematomas with and without extravasation, none of the clinicolaboratory outcomes except for anticoagulant therapy showed significant differences. Conclusion CRSH with a fluid level pattern is significantly associated with extravasation. However, extravasation, which is generally suggestive of active bleeding, does not seem to be related to clinical severity in CRSH.

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