scholarly journals Role of CT scan in evaluation and management of intestinal obstruction

2017 ◽  
Vol 4 (7) ◽  
pp. 2257
Author(s):  
Gaurav Baid ◽  
Manohar Lal Dawan ◽  
Ashok Parmar
Keyword(s):  
Intestinal Obstruction ◽  
Common Symptom ◽  
Inclusion Criteria ◽  
X Ray ◽  
Pain Abdomen ◽  
Ct Findings ◽  
Life Threatening ◽  
Study Population ◽  
And Function

Background: Intestinal obstruction is one of the most common diseases in abdominal surgery. It can slowly lead to changes in intestinal structure and function, and in extreme cases it can be life-threatening. CT allows imaging of the abdominal contents outside the lumen, because of this advantage, the nature and site of the obstruction, especially extraluminal or intramural process, can be established.Methods: Prospective Hospital Based study. From January 2016 to November 2016 (11 months). 50 Patients presenting to Department of Surgery, whether in OPD or Emergency, with complaints suggestive of intestinal obstruction with in study duration eligible as per inclusion criteria will be included in the study.Results: In present study Majority (52.0%) of study population belonged to 41-60 years age group. The most common symptom was pain abdomen (94%). Majority (66%) patients showed multiple air fluid level on X-ray. In CT imaging, maximum 36% presented with dilated bowel loops. 86% were diagnosed as sub-acute intestinal obstruction, in USG. In present study, 60% patients were treated by surgery. Majority of patients (86.67%) CT findings matched with perop/ intraoperative findings. Accurate CT findings were helpful in guiding patient management. In our study, CT had the sensitivity of 86.67%, Specificity75%.Conclusions: Management decisions in intestinal obstruction remain notoriously difficult, relying on a combination of clinical and imaging factors to help stratify patients into conservative or surgical treatment.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

scholarly journals Role of Computed Tomography In Evaluation of Patients With History of Chronic Headache

2015 ◽  
Vol 3 (4) ◽  
pp. 6-9
Author(s):  
Sanju Rawal ◽  
Sadhan Mukhi ◽  
Sandip Subedi ◽  
Surendra Maharjan
Keyword(s):  
Ct Scan ◽  
Chronic Headache ◽  
Lesion Detection ◽  
Common Symptom ◽  
Human Beings ◽  
Cavum Septum Pellucidum ◽  
Ct Findings ◽  
Contrast Enhanced Ct ◽  
History Of

INTRODUCTION: Headache is one of the universal experience and one of the most common symptom in medical practice. It is most frequently suffered illness by human beings. As much as 90 percent of individuals have at least one episode of headache each year and severe headache is reported to occur at least annually in 40 percent of the population. Population based estimates suggest that about 4 percent of adults have daily or near daily headache. Since majority of patients who present with chronic or recurrent headache have no significant intracranial abnormalities to be detected on neuroimaging. The main objective of our study was to obtain socio demographic status of patients presenting with history of chronic headache and to assess the role of CT scan in evaluation of such patients presenting to radiology department from various departments of Universal College of Medical Sciences & Teaching Hospital (UCMSTH). MATERIAL AND METHODS: All patients with complaints of chronic headache and referred to Department of Radiology from August 2013 to April 2014 were included in the study. Total of 193 cases were included. Intravenous contrast medium was given in all 193 cases. Patients were divided into two groups with normal and abnormal CT findings. Results were tabulated and analyzed for the diagnostic yield from imaging in evaluation of patient with history of chronic headache. RESULTS: Out of 193 patients, 182 had normal CT (94.31%) and 11(5.69%) had abnormal CT findings. Contrast enhanced CT scans did not improve lesion detection .Out of 11 abnormal CT findings 3 of them had intracranial space occupying lesion, 3 had calcified granuloma, 2 of them had sinusitis, 1 had hydrocephalus, 1 cerebral atrophy and 1 with persistent cavum septum pellucidum. CONCLUSION: The proportion of intracranial abnormalities detected by CT in patients with history of chronic headache in this study was similar to that of previous studies. This corroborates the evidence that the ability of CT scan in detecting intracranial pathology is low in patient with chronic headache with exclusion of any neurological abnormality.

scholarly journals Contrast-Induced Nephropathy Is Less Common in Patients with Good Coronary Collateral Circulation

2017 ◽  
Vol 7 (4) ◽  
pp. 316-323 ◽  
Author(s):  
Eyup Avci ◽  
Tarik Yildirim ◽  
Hasan Kadi
Keyword(s):  
Collateral Circulation ◽  
Independent Predictor ◽  
Inclusion Criteria ◽  
Contrast Induced Nephropathy ◽  
Coronary Collateral Circulation ◽  
Coronary Collateral ◽  
Major Coronary Artery ◽  
Study Population ◽  
Blood Creatinine

Background/Aims: Contrast-induced nephropathy (CIN) is a typically reversible type of acute renal failure that develops after exposure to contrast agents; underlying endothelial dysfunction is thought to be an important risk factor for CIN. Although the mechanism of coronary collateral circulation (CCC) is not fully understood, a pivotal role of the endothelium has been reported in many studies. The aim of this study was to investigate whether there is a relationship between CCC and CIN. Methods: Patients with at least one occluded major coronary artery and blood creatinine analyses performed before and on the second day after angiography were included in the study. CIN was defined as a 25% or greater elevation of creatinine on the second day after exposure to the contrast agent. Collateral grading was performed according to the Rentrop classification. Patients were grouped according to whether they developed CIN or not, i.e., CIN(-) and CIN(+) group. Results: A total of 214 patients who met the inclusion criteria were included in the study. CIN was diagnosed in 43 patients (20.1%) in the study population. Good CCC was identified in 112 patients (65.5%) in the CIN(-) group, whereas it was identified in 13 patients (30.2%) in the CIN(+) group. In the CIN(-) group, good CCC was significantly more frequent (p < 0.001). Furthermore, collateral circulation was an independent predictor of CIN. Conclusion: Good collateral circulation was associated with a lower frequency of CIN, and poor collateral circulation was an independent predictor of CIN.

scholarly journals GAMBARAN FOTO TORAKS PADA PENDERITA BATUK KRONIK DI BAGIAN/SMF RADIOLOGI FK UNSRAT/RSUP PROF. DR. R.D. KANDOU MANADO PERIODE JULI – SEPTEMBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Divertt Tamaweol ◽  
Ramli H. Ali ◽  
Martin L. Simanjuntak
Keyword(s):  
Chronic Cough ◽  
Medical Records ◽  
Smoking Habit ◽  
Radiological Diagnosis ◽  
Radiology Department ◽  
Common Symptom ◽  
Inclusion Criteria ◽  
X Ray ◽  
X Ray Imaging ◽  
Chest X Ray

Abstract: Chronic cough is defined as cough that lasts 8 weeks or more. Chronic cough itself is not a disease, but a symptom of other diseases. Chronic cough is the most common symptom that occurs among outpatients and is the main cause of morbidity which was reported by 3-40% population. Chronic cough can be caused by some diseases such as pneumonia, tuberculosis, asthma, chronic bronchitis, emphysema, and lung fibrosis. Chronic cough is closely associated with smoking habit which is one of the predisposing factors. Chest x-ray is one of the seed examination for chronic cough because it is very helpful in diagnosing diseases especially pulmonary diseases and others that may cause chronic cough. Objective: To identify the chest x-ray imaging in chronic cough patients. Methods: This study using retrospective description data in November 2015.  Sample is obtained from all the medical records of patients with radiological diagnosis chronic cough who undertook a chest x-ray examination in the Radiology Department of the Medical Faculty of Sam Ratulangi University / Prof. Dr. R. D. Kandou Central General Hospital Manado during July – September 2015. Data was collected from chest x-ray request form and the results show 178 cases of chronic cough that fit the inclusion criteria. The results showed that there was 178 cases of chronic cough based on the radiological diagnosis. The most frequent cases were chronic cough caused by pulmonary tuberculosis (97 patients; 54.49%). Most patients were male (107 patients; 60.11%), and the most frequent age group was 20-49 years (60 patients; 33.71%). Keywords: chronic cough, chest x-ray  Abstrak: Batuk kronik adalah batuk yang berlangsung selama 8 minggu atau lebih. Batuk kronik sendiri bukanlah penyakit, tetapi merupakan suatu gejala dari penyakit-penyakit lain. Batuk kronik merupakan gejala yang paling umum terdapat pada orang dewasa yang melakukan pengobatan rawat jalan dan penyebab utama morbiditas yang dilaporkan oleh 3-40% populasi. Batuk kronik dapat disebabkan oleh beberapa penyakit seperti pneumonia, tuberculosis, asma, bronchitis kronik, emfisema, dan fibrosis paru. Batuk kronik erat hubungannya dengan kebiasaan merokok dimana merokok merupakan salah satu faktor predisposisi. Foto toraks adalah salah satu pemeriksaan pilihan untuk batuk kronik karena sangat bermanfaat dalam mendiagnosis penyakit terutama penyakit paru dan gangguan lain yang dapat menyebabkan batuk kronik. Penelitian ini bertujuan untuk mengetahui gambaran foto toraks pada penderita batuk kronik. Penelitian ini menggunakan metode deskriptif retropektif yang dilakukan pada bulan November 2015. Sampel diambil dari semua data catatan medik pasien dengan diagnosis radiologis batuk kronik yang melakukan foto toraks di Bagian/SMF Radiologi FK Unsrat/RSUP Prof. Dr. R. D. Kandou Manado periode Juli – September 2015. Data diperoleh melalui lembaran permintaan pemeriksaan foto toraks dan didapatkan sebanyak 178 kasus batuk kronik yang masuk dalam kriteria inklusi. Hasil penelitian memperlihatkan 178 kasus batuk kronik berdasarkan diagnosis radiologis. Kasus terbanyak ialah batuk kronik akibat tuberkulosis paru sebanyak 97 orang (54,49%), penderita terbanyak ialah laki-laki yaitu 107 orang (60,11%), dan golongan umur terbanyak ialah 20-49 tahun yaitu 60 penderita (33,71%). Kata kunci: batuk kronik, foto toraks

scholarly journals LINC00261 Inhibits Esophageal Cancer Radioresistance By Downregulating microRNA-552-3p And Promoting DIRAS1

2021 ◽  
Author(s):  
Baolong Yang ◽  
Hongbing Ma ◽  
Yan Bian
Keyword(s):  
Esophageal Cancer ◽  
Survival Fraction ◽  
Protein Coding ◽  
X Ray ◽  
Normal Tissues ◽  
Competing Endogenous Rna Network ◽  
Life Threatening ◽  
Ec Cells

Abstract Background: Esophageal cancer (EC) is a life-threatening tumor with a high increasing incidence rate. Long intergenic non-protein coding RNAs (LINCs) are widely researched in EC. This study set out to investigate the role of LINC00261 in EC radioresistance.Methods: Radioresistant EC cell lines TE-1-R and TE-5-R were established using TE-1 and TE-5 cells. LINC00261, microRNA (miR)-552-3p, and DIRAS1 expression in EC tissues and adjacent normal tissues and EC cells was evaluated. Then, survival fraction (SF), colony formation, apoptosis, and γ-H2AX expression were analyzed. The binding relation between LINC00261 and miR-552-3p and between miR-552-3p and DIRAS1 were detected. Eventually, xenograft transplantation was applied to confirm the effect of LINC00261 on EC radioresistance in vivo.Results: LINC00261 and DIRAS1 were weakly expressed in EC tissues and cells, but miR-552-3p was overexpressed. For EC cells with X-ray radiation, overexpression of LINC00261 reduced SF and cell viability, strengthened γ-H2AX expression, and promoted apoptosis, which were all counteracted by miR-522-3p overexpression or DIRAS1 silencing. Mechanically, the binding relation between LINC00261 and miR-552-3p and between miR-552-3p and DIRAS1 were verified. In addition, LINC00261 overexpression suppressed tumor growth and reduced EC radioresistance in vivo.Conclusion: LINC00261 could suppress EC radioresistance via the competing endogenous RNA network to sponge miR-552-3p and upregulate DIRAS1 transcription.

scholarly journals The Role of Imaging In The Diagnosis of Pulmonary Embolism

2019 ◽  
Vol 2 (1) ◽  
pp. 57
Author(s):  
Alfian Nur Rosyid ◽  
M. Yamin ◽  
Arina Dery Puspitasari
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Gold Standard ◽  
Common Condition ◽  
X Ray ◽  
Life Threatening ◽  
Chest X Ray ◽  
Proper Diagnosis ◽  
D Dimer

Pulmonary embolism is a common condition and sometimes can be life-threatening. A proper diagnosis can reduce mortality. Some examinations are needed to diagnose pulmonary embolism, including assessing the risk factors, clinical examination, D-dimer tests, and imaging. Imaging is necessary when the previous assessment requires further investigation. There are more imaging that can be used to diagnose and assess the severity of pulmonary embolism. However, it is still controversial regarding imaging modalities for optimizing pulmonary embolism diagnose. Chest X-Ray cannot exclude pulmonary embolism, but it is needed to guide the next examinations and to find alternative diagnoses. Pulmonary Multi-Detector CT Angiography is the gold standard to diagnose pulmonary embolism.

scholarly journals Comparative outcomes of inpatients with lung collapse managed by bronchoscopic or conservative means

2019 ◽  
Vol 6 (1) ◽  
pp. e000427 ◽  
Author(s):  
Omesh Gopal Toolsie ◽  
Muhammad Adrish ◽  
Syed Arsalan Akhter Zaidi ◽  
Gilda Diaz-Fuentes
Keyword(s):  
Primary Outcome ◽  
Fibreoptic Bronchoscopy ◽  
Inclusion Criteria ◽  
Lung Collapse ◽  
X Ray ◽  
Conservative Group ◽  
Number Of Patients ◽  
Significant Pathology ◽  
Chest X Ray

BackgroundAlthough the incidence and prevalence of atelectatic lung collapse is unknown, such events are common among inpatients, and there are no guidelines for optimally instituting bronchoscopic techniques. The aim of this study was to evaluate the outcomes of patients with complete or near-complete lung collapse managed via interventional flexible fibreoptic bronchoscopy or a conservative approach.MethodsRetrospective analysis of all adult patients admitted to BronxCare Health System between January 2011 and October 2017 with a diagnosis of lung collapse/atelectasis. The primary outcome was radiological resolution. Timing of bronchoscopy relative to radiological resolution and mortality served as secondary outcomes.ResultsOf the 177 patients meeting inclusion criteria, 149 (84%) underwent bronchoscopy and 28 (16%) were managed through conservative measures only. A significantly greater number of patients in the bronchoscopy group achieved complete or near-complete resolution on chest X-ray, compared with the conservative group (p=0.007). Timing of bronchoscopy had no impact on the rate of radiological resolution, and mortality in the two groups was similar. New endobronchial malignancies were identified in 21 patients (14%).ConclusionsOur data support the central role of bronchoscopy in instances of complete or near-complete lung collapse, ensuring better radiological outcomes. Judicious use of conservative management is warranted to avoid missing significant pathology. A prime consideration in this setting is obstructive malignancy.

The Role of Mesna in the Treatment of Status Asthmaticus in Children

1979 ◽  
Vol 7 (5) ◽  
pp. 423-427 ◽  
Author(s):  
V Kyncl ◽  
J Pokorný ◽  
J Mega ◽  
V Skondia
Keyword(s):  
Status Asthmaticus ◽  
Blood Gas ◽  
X Ray ◽  
Bronchial Lavage ◽  
Threatening Condition ◽  
Life Threatening ◽  
Therapeutic Measures ◽  
Alveolar Gas Exchange ◽  
Parenteral Drug

Status asthmaticus in children is a life-threatening condition that calls for a comprehensive set of therapeutic measures, viz. evacuation of tracheobronchial secretions, parenteral drug administration and improvement of alveolar gas exchange. In the authors' experience, that therapeutic procedure can be much improved by bronchial lavage with mesna. This is illustrated by the good results obtained in fourteen patients with status asthmaticus and in another forty-four cases of global respiratory insufficiency. Evaluation was by blood gas values and X-ray pictures. The method used for bronchial lavage is described.

A retrospective analysis of factors affecting palliative care consult in patients undergoing cytoreductive surgery and HIPEC.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 815-815
Author(s):  
Laila Babar ◽  
Herman Lo ◽  
Obaid Ashraf ◽  
Ashish Sethi ◽  
Zara Alvi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cytoreductive Surgery ◽  
National Average ◽  
P Value ◽  
Inclusion Criteria ◽  
Factors Affecting ◽  
Life Threatening ◽  
Better Than

815 Background: The National Cancer Institute defines palliative care as care given to improve the quality of life (QOL) for patients with life threatening diseases. The role of palliative care (PC) within oncology is ever evolving and as more studies are being conducted, its role in the improvement of QOL for patients is being widely recognized. Patients undergoing cytoreductive surgery (CRS) are at a higher risk for morbidity and mortality and often have severe post-operative symptoms that can worsen their QOL. Here we studied the factors affecting PC consult in order to better overcome them. Methods: We queried our Electronic Medical Record EPIC for a list of patients who underwent cytoreductive surgery with HIPEC or HITEC in the hospital from April 2016-April 2019. Data was manually extracted and patients who didn’t meet our criteria were excluded. Patients were divided on the basis of palliative care consults and differences between the groups were analyzed. Odds ratios(OR) with p-value 0.05 and confidence interval (CI) 95% were calculated. Results: We identified 55 patients of whom 34 met our inclusion criteria, 11 male and 23 female with an average age of 56.3 years at the time of diagnosis. 8 patients (23%) had PC; more than 1 comorbidity and age > 40 was associated with a higher likelihood of PC (OR:0.12; CI:0.02-0.76; p:0.02) and (OR: 0.015; CI: 0.0007-0.3029; P: 0.006) respectively. Gender, insurance type and marital status did not corelate with PC. Mean age (58.1 vs 55.7) showed a trend towards higher rates of PC in older population. Conclusions: Approximately one quarter of patients undergoing CRS with HIPEC had a concurrent PC consult. Though this is better than the national average of 11-16%, it continues to be a very small number. PC is not only an end of life service, in fact studies have shown early consultations lead to higher patient satisfaction, improved QOL and better communication. Efforts must be made to engage PC early in the course of treatment and recognize it as an integral part of cancer care.

Intensive cardiovascular care units: structure, organization, and staffing

2021 ◽  
pp. 11-24
Author(s):  
Eric Bonnefoy-Cudraz ◽  
Tom Quinn
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Working Group ◽  
Life Threatening ◽  
Coronary Care ◽  
The 1960S ◽  
And Function ◽  
Cardiovascular Care

The nature and complexity of acute cardiovascular care has changed markedly since the early days of the coronary care unit (CCU), introduced in the 1960s to prevent and treat life threatening arrhythmias associated with acute myocardial infarction. In the present day, the patient population is older, has more multimorbidity, comprises a range of conditions alongside critical cardiovascular disease and associated multi-organ failure, requiring increasingly sophisticated management. To reflect this, the Acute Cardiovascular Care Association (ACCA) published a comprehensive update of recommendations in 2018, developed by a multinational working group of experts. These recommendations, which inform this chapter, address the definition, structure, organisation and function of the contemporary intensive cardiovascular care unit (ICCU). Reflecting the modern casemix, three levels of acuity of care are described, and corresponding requirements for ICCU organisation defined. Recommendations on ICCU staffing (medical, nursing and allied professions), equipment and architecture, are presented, alongside considerations of the role of the ICCU within the wider hospital and cardiovascular care network.

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