Clinical Outcome After a Negative Spiral CT Pulmonary Angiographic Finding in an Inpatient Population From Cardiology and Pneumology Wards*

IntroductionAsthma exacerbations are a leading cause of paediatric hospitalisations. Corticosteroids are key in the treatment of asthma exacerbations. Most current corticosteroids treatment regimens for children admitted with asthma exacerbation consist of a 5-day course of prednisone or prednisolone. However, these medications are associated with poor taste and significant vomiting, resulting in poor compliance with the treatment course. While some centres already use a short course of dexamethasone for treating children hospitalised with asthma, there is no evidence to support this practice in the inpatient population.Methods and analysisThis single-site, pragmatic, feasibility randomised controlled trial will determine the feasibility of a non-inferiority trial, comparing two treatment regimens for children admitted to the hospital and receiving asthma treatment. Children 18 months to 17 years presenting to a Canadian tertiary care centre will be randomised to receive either a short course of dexamethasone or a longer course of prednisone/prednisolone once admitted to the inpatient units. The primary clinical outcome for this feasibility study will be readmission to hospital or repeat emergency department visits, or unplanned visits to primary healthcare providers for asthma symptoms within 4 weeks of hospital discharge. Feasibility outcomes will include recruitment and allocation success, compliance with study procedures, retention rate, and safety and tolerability of study medications. We plan on recruiting 51 children, and between-group comparisons of the clinical outcome will be conducted to gain insights on probable effect sizes.Ethics and disseminationResearch Ethics Board approval has been obtained for this study. The results of this study will inform a multisite trial comparing prednisone/prednisolone to dexamethasone in inpatient asthma treatment, which will have the potential to improve the delivery of asthma care, by improving compliance with a mainstay of treatment. Results will be disseminated through peer-reviewed publications, organisations and meetings.Trial registration numberNCT03133897; Pre-results.

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Pulmonary embolism: diagnosis with spiral CT and ventilation-perfusion scanning--correlation with pulmonary angiographic results or clinical outcome.

Radiology ◽

10.1148/radiology.208.1.9646814 ◽

1998 ◽

Vol 208 (1) ◽

pp. 201-208 ◽

Cited By ~ 165

Author(s):

K Garg ◽

C H Welsh ◽

A J Feyerabend ◽

S W Subber ◽

P D Russ ◽

...

Keyword(s):

Pulmonary Embolism ◽

Clinical Outcome ◽

Spiral Ct ◽

Pulmonary Embolism Diagnosis

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Endovascular thrombectomy for M2 occlusions: comparison between forced arterial suction thrombectomy and stent retriever thrombectomy

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2016-012466 ◽

2016 ◽

Vol 9 (7) ◽

pp. 626-630 ◽

Cited By ~ 38

Author(s):

Yong-Won Kim ◽

Seungnam Son ◽

Dong-Hun Kang ◽

Yang-Ha Hwang ◽

Yong-Sun Kim

Keyword(s):

Clinical Outcome ◽

Cerebral Infarction ◽

Stent Retriever ◽

Angiographic Finding ◽

Distal Embolization ◽

Endovascular Thrombectomy ◽

Significant Difference ◽

Reperfusion Rate ◽

Fast Group

BackgroundTo date there has been no direct comparison of two frequently used endovascular thrombectomy (EVT) methods (forced arterial suction thrombectomy (FAST) and stent retriever thrombectomy) in M2 occlusions. We review our experiences with EVT performed using FAST and stent retriever thrombectomy in such cases.MethodsThe subjects comprised 41 patients with an M2 occlusion who underwent EVT (25 with FAST, 16 with stent retriever thrombectomy). The patients' data were retrospectively analyzed to evaluate the technical characteristics and angiographic outcome of the two EVT techniques.ResultsThrombolysis In Cerebral Infarction (TICI) grades 2b–3 using the first chosen technique did not differ significantly between the two techniques (FAST 64.0% vs stent retriever thrombectomy 81.2%, p=0.305). Time from groin puncture to reperfusion was significantly shorter for stent retriever thrombectomy (53.0 vs 38.5 min; p=0.045). Distal embolization occurred in three cases (12.0%) in the FAST group and in four (26.7%) in the stent retriever group (p=0.362). However, the two techniques did not differ significantly in the final TICI 2b–3 rate (72.0% vs 87.5%; p=0.441). A frequent angiographic finding regarding the failure of FAST was that the M2 occlusion was located immediately after severe acute angulation between M1 and M2.ConclusionsStent retriever thrombectomy may provide faster reperfusion than FAST, while the FAST technique might be associated with lower distal embolization and a higher reperfusion rate for the first thrombectomy attempt, but without any significant difference in clinical outcome. When choosing the EVT method for M2 occlusions, consideration of the location of the occlusion and tortuosity between M1 and M2 might be helpful to achieve a better angiographic outcome.

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Assigning computed tomography involvement score in COVID-19 patients: prognosis prediction and impact on management

BJR|Open ◽

10.1259/bjro.20200024 ◽

2020 ◽

Vol 2 (1) ◽

pp. 20200024

Author(s):

Nilu Malpani Dhoot ◽

Usha Goenka ◽

Somali Ghosh ◽

Surabhi Jajodia ◽

Rashmi Chand ◽

...

Keyword(s):

Clinical Outcome ◽

Disease Burden ◽

Ground Glass Opacity ◽

Spiral Ct ◽

Medical Attention ◽

Ct Scanner ◽

Patient Load ◽

Increasing Trend ◽

Score Range ◽

Ct Features

Objective: Chest CT can provide a simple quantitative assessment of the extent of the parenchymal opacities in COVID-19 patients. In this study, we postulate that CT findings can be used to ascertain the overall disease burden and predict the clinical outcome. Methods: In this prospective study undertaken from March 28, 2020, until May 20, 2020, 142 patients with CT features suggestive of viral pneumonia, and positive RT-PCR for COVID-19 were enrolled. A dedicated spiral CT scanner was used for all COVID-19 suspects. CT features were reported as typical, indeterminate, or atypical for COVID-19 pneumonia. A CT involvement score (CT-IS) was given to each scan and assigned mild, moderate, or severe category depending on the score range. The patients were followed up for at least 15 days. Results: Ground glass opacity was present in 100% of the patients. There was a significant association between CT-IS and the final outcome of the patients. A statistically significant increasing trend of mortality and requirement of critical medical attention was observed with the rising value of CT-IS in COVID-19. Conclusion: The severe CT-IS score group has a high mortality. The CT-IS score could be valuable in predicting clinical outcome and could also be useful in triage of patients needing hospital admission. In situations where healthcare resources are limited, and patient load high, a more careful approach for patients with higher CT-IS scores could be indispensable. Advances in knowledge: CT-IS is a simple quantitative method for assessing the disease burden of COVID-19 cases. It can be invaluable in places with limited resources and high patient load to segregate patients requiring critical medical attention.

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Comparative Analysis of Transmittal Biplane Intracranial Ultrasound and Multi-Slice Spiral CT in the Diagnosis of Perianal Abscess

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3623 ◽

2021 ◽

Vol 11 (3) ◽

pp. 1013-1019

Author(s):

Xuemei Tang ◽

Pengfei Kong ◽

Xuegui Tang

Keyword(s):

Comparative Analysis ◽

Clinical Outcome ◽

Perianal Abscess ◽

Spiral Ct ◽

Common Disease ◽

Anorectal Abscess ◽

Surgical Drainage ◽

Anorectal Disease ◽

Diagnosis Rate ◽

Ultrasound Group

Perianal abscess is a relatively common disease in the anorectal department, and its incidence accounts for more than 20% of anorectal disease. Once diagnosed in the clinic, surgical drainage is needed immediately, which is of great significance for the clinical outcome. In this study, patients with anorectal abscess diagnosed by transmittal biplanar intracranial ultrasound and multi-slice spiral CT were selected in our hospital. They were randomly divided into the ultrasound group and the MSCT group. Transrectal biplanar intracranial ultrasound has a higher diagnosis rate for perianal abscess, and the localization has a unique advantage, which provides a powerful image basis for the choice of clinical treatment.

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