scholarly journals Computed Tomography-based determinants for predicting death and ICU requirement in patients suffering COVID-19

2020 ◽  
Author(s):  
Marzie Dehgan ◽  
Nasrin Khalesi ◽  
Masumeh Akbari ◽  
Rogheyeh Fallah ◽  
Neda Hosseininezhad

Abstract Background: What has received special attention in recent months is the use of a combination of clinical findings, laboratory markers, and, in addition, the findings of lung Computed Tomography (CT) scan in the design and delivery of risk scoring systems for Coronavirus Disease 2019 (COVID -19) patients. The present study aimed to determine main lung CT-related correlates of disease severity (Intensive Care Units (ICU) requiring) as well as death in COVID -19 patients.Methods: This cross-sectional study was performed on 515 consecutive patients with definitive diagnosis of COVID-19 admitted to one of the COVID -19 referral hospitals in Tehran. All patients' information was collected through a review of their archives. All patients were evaluated by CT scan of the lungs.Results: The mean follow-up of patients from the time of admission was 10.85±6.11 days between 1 and 30 days. During this period, a total of 29.1% were admitted to the ICU. Also, the mortality rate of patients was equal to 28.2%. According to multivariable logistic regression model with the presence of death-related correlates, crazy paving pattern, diffuse distribution of lesions, CT Severity Score (CTSS) score >12, the presence of plural effusion or emphysema were the main determinants of COVID -19 related death and should be considered for presenting new scoring system for predicting death following COVID -19 disease. In similar model, CTSS score >12 along with the presence of plural effusion, emphysema, or pulmonary hypertension were the main determinants of requiring ICU admission. Conclusion: The CT score higher than 12 along with observing the pattern of diffuse distribution of lesions especially accompanied with emphysema, pleural effusion or pulmonary hypertension can predict patient mortality or will determine the need for hospitalization in the ICU.

2020 ◽  
pp. 01-14
Author(s):  
Okechukwu Mary-Ann C

The use of x-ray and computed tomography scan is critical in the management of traumatic conditions, particularly head injuries. This study was carried out to assess the level of awareness and attitude of Emergency physicians towards the use of CT in cases of head injury. A cross-sectional study was done among emergency physicians working in five different government hospitals in Anambra State. Among the respondents were 29% males and 4% females: mean age was 35.7 years while their modal age was 31-40 years. All the respondents, 33 (100%) stated they find CT scan as a useful diagnostic medical imaging modality. However less than half of them, 15 (45.5%) stated they refer patients for CT scan for those patients that need it. Whereas most of them, 20 (64.5%) stated that head injury patients should undergo both X-Ray and CT scan virtually all of them 32 (97%), responded that computed tomography, (CT) is better than skull x-ray in the examination of head injury. Though majority of the respondents 31 (93%), stated that CT scan subject the patient to some risks. All those who responded and thought that CT scan should continue to be used as medical diagnostic imaging modality were 33 (100%). The result of the study showed that most of the emergency physicians are aware of the usefulness of CT in the examination of patients presenting with head injury, but the non- availability and cost of services of the CT imaging equipment greatly affected the rate of request for the examination and has affected their attitude towards the use of this imaging modality in the examination of this category of patients in need of it.


2018 ◽  
Vol 34 (5) ◽  
pp. 347-355
Author(s):  
Haytham Al Ewaidat ◽  
Xiaoming Zheng ◽  
Yousef Khader ◽  
Kelly Spuur ◽  
Mostafa Abdelrahman ◽  
...  

The study aims to assess the level of patients’ awareness and knowledge regarding radiation and dosage along with the associated risks from computed tomography (CT) scan. This cross-sectional study used questionnaires, which were distributed to the diagnostic imaging departments of six large local hospitals in Jordan between September 2014 and March 2015. A total of 600 patients completed the questionnaire, out of which, 52.33% of respondents were female and 47.6% male. The findings show insignificant effects of gender on patient’s knowledge ( P = .596) and significant effect of employment and profession on positive scores ( P = .000). Similarly, no statistical differences were found between gender and correct answers ( P = .707). This cohort of patients demonstrated a lack of awareness and knowledge about the use of ionizing radiation for diagnostic imaging. Thus, there may exist a similar lack of information that will require imaging professionals to raise patients’ awareness and offer them the appropriate information.


KYAMC Journal ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 3-8
Author(s):  
Momotaj Begum ◽  
Sabina Yiasmeen ◽  
Mahmud Hossain ◽  
Shafi Ahmed ◽  
Salahuddin Al Azad ◽  
...  

Background. Cerebral palsy is one of the common childhood neurological problem which occurs due to defect or lesion in immature brain. The worldwide incidence of cerebral palsy is approximately 2-2.5 per 1000 live births. There have been many works on the role of computed tomography scan in the diagnosis of cerebral palsy. Objective: The objective information available from careful review of imaging information such as CT brain scans, is an important adjunct to clinical data. Materials and Methods: This cross sectional study was carried out in the department of Radiology and Imaging, BSMMU and department of Paediatric Neurology unit over a period of 12 months from January 2019 to December 2019. We calculated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT scan in diagnosis of CP in children. Results: This cross sectional study was carried out on consecutively selected 94 children below 15 years having clinical evidence of cerebral palsy. Among the study subjects 86.2% were diagnosed as cerebral palsy through CT scan. Conclusion: The sensitivity and specificity of CT scan of present study was found to be quite high in children which suggests a CT scan as an effective investigation for the diagnosis of cerebral palsy. KYAMC Journal Vol. 11, No.-1, April 2020, Page 3-8


Author(s):  
Rivita Putri Nasari ◽  
Aldy Safruddin Rambe ◽  
Aida Fithrie

ASSOCIATION OF LEUKOCYTE, MONOCYTE, AND PROCALCITONIN LEVEL WITH INFECTION AND FUNCTIONAL OUTCOME IN ACUTE STROKEABSTRACTIntroduction: Infection is a common complication in the acute of stroke. Stroke can lead to immediate stage of immunosuppression, increasing the risk of infection.Aims: To evaluate the relationship levels of leukocyte, monocyte, and procalcitonin with infection and functional outcome in acute stroke.Methods: A cross-sectional study of acute stroke patients in RSUP Dr. Adam Malik neurology ward, Medan, from June to October 2015. Diagnosis was made by clinical findings and brain CT scan. Patients with previous stroke, treated as having infection or already treated by antibiotics before admission were excluded from this study. All subjects examined for the levels of leukocytes, monocytes, and procalcitonin and observed the infection and assessed functional outcome (mRS) on day 14 of onset.Results: There were 50 subjects with age mean 57.2 (40-73) years old, mostly male (54%) and had ischemic stroke (82%). Leukocytes and procalcitonin level has positive association with infection in acute stroke significantly. Subjects whom had normal leucocyte at baseline tend not to developed infection 3.69 times compared to whom had high leucocyte at baseline. Similar with PCT, subjects with normal level of PCT at base tend not to developed infection 16.9 times compared to subject with high level of PCT at baseline. High level of leucocyte also related with low functional outcome, significantly.Discussions: There were positive associated between leukocytes and procalcitonin levels with risk of infection, and negative associated between leukocytes levels with functional outcome in acute stroke.Keywords: Infection, leukocytes, monocytes, outcome, procalcitoninABSTRAKPendahuluan: Infeksi merupakan komplikasi yang umum pada stroke akut. Stroke dapat menyebabkan immunosupresi dalam tahap awal, sehingga dapat meningkatkan risiko infeksi.Tujuan: Untuk mengetahui hubungan kadar leukosit, monosit, dan prokalsitonin (PCT) dengan kejadian infeksi dan luaran fungsional pada stroke akut.Metode: Penelitian potong lintang terhadap pasien stroke akut yang dirawat di Ruang Rawat Inap Terpadu Departemen Neurologi RSUP Haji Adam Malik, Medan, pada bulan Juni 2015 hingga Oktober 2016. Diagnosis ditegakkan berdasarkan gejala klinis dan pemeriksaan  CT scan kepala. Kriteria eksklusi adalah mengalami infeksi atau sudah menggunakan antibiotik pada saat masuk rumah sakit (RS) serta mengalami stroke berulang. Subjek dilakukan pemeriksaan kadar leukosit, monosit, dan prokalsitonin, lalu diamati ada tidaknya kejadian infeksi selama perawatan dan penilaian mRS pada hari ke-empat belas awitan.Hasil: Didapatkan 50 subjek dengan rerata usia 57,2 (40-73) tahun, mayoritas laki-laki (54%) dan mengalami stroke iskemik (82%). Terdapat hubungan yang signifikan antara kadar leukosit dan prokalsitonin dengan kejadian infeksi pada stroke akut. Subjek dengan kadar leukosit awal yang normal lebih cenderung untuk tidak mengalami kejadian infeksi sebesar 3,69 kali dibandingkan yang leukositnya tinggi. Demikian pula kadar PCT yang normal di awal cenderung untuk tidak mengalami kejadian infeksi sebesar 16,9 kali dibandingkan subjek dengan PCT tinggi. Kadar leukosit yang tinggi juga berhubungan dengan luaran fungsional yang buruk secara bermakna.Diskusi: Terdapat hubungan positif yang signifikan kadar leukosit dan prokalsitonin dengan kejadian infeksi serta hubungan negatif yang signifikan kadar leukosit dengan luaran fungsional  pada stroke akut.Kata kunci: Infeksi, leukosit, luaran, monosit, prokalsitonin


2020 ◽  
Vol 7 (6) ◽  
pp. 1355
Author(s):  
Priyanka Choudhary ◽  
Amit Kumar Mital ◽  
Sheela Sinha

Background: Seizures are the most common pediatric neurological disorder. The objectives were to know the prevalence and types of intracranial structural lesions diagnosed by Computed Tomography in children with unprovoked seizures.Methods: It is hospital based cross-sectional study done in Patna Medical College, India from August 2005- July 2007. All patients aged 6 months to 12 years admitted in pediatrics department with at least 2 episodes of unprovoked seizures were undergone Computed Tomography brain.Results: Out of total 112 patients admitted, 66.1% had abnormal CT scan. Prevalence of abnormal CT scan increased with advancing age and significant, with maximum percentage found in age group 10-12 years (43.2%). Males had more seizures and intracranial lesion than females but this association was statistically non-significant. 65.2% had generalized seizure and 34.8% had partial seizure. Among patients with abnormal CT scan, generalized seizure (70.3%) and partial seizure (29.7%).The commonest  probable diagnosis was tuberculoma (47.3%) followed by neurocysticercosis (25.7%) and brain abscess (4%). Other were atrophy, gliosis and hydrocephalus, 2.5% each; arachnoid cyst, extradural hematoma, sturge weber syndrome, tuberous sclerosis, infarct, hemiatrophy, caudate lobe hemorrhage, basal ganglia calcification, corpous callosum agenesis, 1.35% each.Conclusions: Inflammatory granuloma is the leading cause of unprovoked seizure in this part of the country. Every seizure case should undergo a CT scan examination. Preventive measures can be applied for tuberculoma and NCC so as to lower down the burden of seizure disorder.


2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yaser Safi ◽  
Reza Amid ◽  
Mahdi Kadkhodazadeh ◽  
Hamed Mortazavi ◽  
Mohamad Payam Sharifi ◽  
...  

Abstract Background Bone volume plays a pivotal role in the success of dental implant treatment. Autogenous bone grafts should be harvested from reliable sites in the maxillofacial region. This study sought to assess the quantity and quality of bone in the mandibular symphysis for autogenous bone graft harvesting using cone-beam computed tomography (CBCT). Methods This cross-sectional study evaluated the CBCT scans of 78 adults presenting to three oral and maxillofacial radiology centers. The vertical (VD) and horizontal (HD) alveolar bone dimensions, cortical thickness (CT), and cancellous to cortical bone ratio (C/C) were measured in the interforaminal region of the mandible at the sites of central incisor to first premolar teeth. The interforaminal distance (ID) and the anterior loop length were also measured. Nonparametric statistical tests were used to analyze the data with respect to sex, age, and tooth position. Results The median VD, HD, and CT of the symphysis were 20.21 (3.26), 4.13 (0.37), and 2.25 (0.23) mm, respectively. The median C/C was 1.51 (0.11). The median ID was 52.24 (8.24) mm, and the median anterior loop length was 1.82 (1.06) mm. Significant differences were observed in all parameters among different teeth. Most of the measured parameters were greater in males compared with females. There were significant differences in ID, VD, and CT between different age groups. Conclusions The quantity and quality of the available bone in the mandibular symphysis for bone graft harvesting vary by gender, age, and harvesting site, necessitating careful preoperative evaluation.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Maryam Kazemi ◽  
Behnam Honarvar ◽  
S. Taghi Heydari ◽  
Hassan Joulaei ◽  
Mohammad Reza Rahmanian Haghighi ◽  
...  

Abstract Background Happiness has multiple levels and determinants in different communities, cultures, and social groups. The current study aimed to investigate happiness and its main determinants in slums in south central Iran. Methods This community-based, cross-sectional study was conducted with the participation of adults at least 18 years of age living in the biggest slum area in Shiraz, south central Iran. To determine levels of happiness, participants were asked to complete the Persian version of the GHQ28 questionnaire and a checklist based on the 2017 World Happiness Report. Data was analyzed using SPSS software version 19. A p-value less than 0.05 was considered significant. Results The mean age of the participants was 42.06 ± 16.34 years. Overall, 542 participants (45 %) were females, 257 (21.3 %) were illiterate, 678 (56.3 %) were married, and 495 (41.1 %) were unemployed and lived with their household. The happiness score, according to the Cantril ladder score, was 6.41 ± 2 (out of a total score of 10). Happiness was not correlated with gender (p = 0.37) or immigration (p = 0.06). Lower levels of happiness were seen in older adults (r=− 0.12, p < 0.001), illiterates (p = 0.03), the unemployed (p < 0.001), and people separated from their spouses (p < 0.001). Job satisfaction (p < 0.001, r = 0.47), total general health (p < 0.001, r=-0.36) and hope (p < 0.001, r = 0.41) were significantly correlated with happiness. Social support (< 0.001) and sufficient income and satisfaction (p < 0.001) were related with a higher score of happiness. Conclusions Marital status, smoking, employment and job satisfaction, social support and trust, feelings of insecurity in the neighborhood, hope for the future, facing violence, and income satisfaction were the main determinants of happiness in the Sang Siah slum area.


BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005947 ◽  
Author(s):  
Cheng-Shyuan Rau ◽  
Hang-Tsung Liu ◽  
Shiun-Yuan Hsu ◽  
Tzu-Yu Cho ◽  
Ching-Hua Hsieh

ObjectivesTo provide an overview of the demographic characteristics of patients with positive blood alcohol concentration (BAC) and to investigate the performance of brain CT scans in these patients.DesignCross-sectional study.SettingTaiwan.Participants2192 patients who had undergone a test for blood alcohol of 13 233 patients registered in the Trauma Registry System between 1 January 2009 and 31 December 2012. A BAC level of 50 mg/dL was defined as the cut-off value. Detailed information was retrieved from the patients with positive BAC (n=793) and was compared with information from those with a negative BAC (n=1399).Main outcome measuresGlasgow Coma Scale (GCS) and Injury Severity Score (ISS) as well as the performance and findings of obtained brain CT scans.ResultsPatients with positive BAC had a higher rate of face injury, but a lower GCS score, a lower rate of head and neck injury, a lower ISS and New Injury Severity Score. Alcohol use was associated with a shorter length of hospital stay (8.6 vs 11.4 days, p=0.000) in patients with an ISS of <16. Of 496 patients with positive BAC who underwent brain CT, 164 (33.1%) showed positive findings on CT scan. In contrast, of 891 patients with negative BAC who underwent brain CT, 389 (43.7%) had positive findings on CT scan. The lower percentage of positive CT scan findings in patients with positive BAC was particularly evident in patients with an ISS <16 (18.0% vs 28.8%, p=0.001).ConclusionsPatients who consumed alcohol tended to have a low GCS score and injuries that were less severe. However, given the significantly low percentage of positive findings, brain CT might be overused in these patients with less severe injuries.


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