scholarly journals Normal Chest X-Ray in Patients with Pulmonary Embolism May Involve Increased Risk of Massive Pulmonary Embolism

2022 ◽  
Vol 4 (1) ◽  
pp. 1-4
Author(s):  
Hatice Kilic ◽  
Habibe Hezer ◽  
Berker Ozturk ◽  
Muhammed Sait Besler ◽  
Huseyin Cetin ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Severity ◽  
Systolic Pulmonary Artery Pressure ◽  
Pathological Findings ◽  
X Ray ◽  
Increased Risk ◽  
Normal Chest ◽  
Chest X Ray ◽  
Group 2 ◽  
Group 1

Purpose: Chest radiography is normal in approximately 20-40% of acute pulmonary embolism (PE) patients without cardiopulmonary disease. The aim of this study was to determine whether there is any difference between the patients with normal chest X-ray and those with pathological findings in terms of clinical severity and prognosis. Methods: 178 of PE patients were included in the study. 110 patients had no parenchymal pathology, whereas group 1 (n = 110); group 2 (n = 68) had various pathological parenchymal findings in 68 patients. Clinical and radiological parameters were compared between these groups. Following the diagnosis of PE, the cases were recorded in the fifth year. Results: In 178 participants; those with normal chest X-ray (group 1), with parenchymal pathological findings on the chest X-ray (group 2); echocardiographic systolic pulmonary artery pressure (sPAP) (p = 0.68), gender (p = 0.9) and thrombus type (p = 0.41) were similar. The patients in group 1 were not different in terms of central thrombus detected in computed tomography pulmonary angiogram compared to the patients in group 2; however, the chest radiograph of the patients in group 1 had no parenchymal pathology. Central thrombus group 1, group 2, respectively; 97 (89.0%), 53 (77.9%), p = 0.07. There was no significant difference between the two groups in terms of mortality which was followed up in fifth year (p > 0.05). Conclusions: Normal chest X-ray in PE can determine mortality and may involve increased risk of massive PE.

scholarly journals Esophageal High Pressure Zones: Effect of Perisophageal Structures on Esophageal Manometric Recording

1994 ◽  
Vol 8 (4) ◽  
pp. 239-245
Author(s):  
G Bédard ◽  
A Pellicano ◽  
R Ste-Marie
Keyword(s):  
High Pressure ◽  
Lower Esophageal Sphincter ◽  
Radiopaque Marker ◽  
X Ray ◽  
Group A ◽  
Chest X Ray ◽  
Esophageal Sphincter ◽  
Group 2 ◽  
High Pressure Zone ◽  
Group 1

During the course of esophageal motility studies, short zones of elevated esophageal baseline pressure are occasionally noticed. The aim of this study is to determine their frequency and their cause. Among 77 consecutive esophageal manometries (group 1), 17 cases (22%) of ‘esophageal high pressure zones’ (EHPZs) were recorded. Thirty-three additional patients (group 2) were evaluated and 18 other cases of EHPZ were found; in the latter group, a miniature sound microphone was positioned on a carotid artery. When a high pressure zone was identified, the manometric catheter was immobilized; the patient underwent a chest x-ray, with the radiopaque marker imbedded in the catheter used to locate the thoracic structures adjacent to EHPZs. In both groups, indentations (pressure spikes) over the high pressure zones occurred synchronously with the patients’ radial or carotid pulse. Results suggest that EHPZs are caused by the compression and pulsations of vascular or cardiac periesophageal structures; the aortic arch is responsible for the manometric EHPZ when it is found between 10 and 14 cm above the lower esophageal sphincter whereas the left auricle is the cause of the EHPZ if it is located between 4 and 7 cm above the lower esophageal sphincter.

scholarly journals Carnitine for Body Composition in Hemodialysis Patients

2020 ◽  
pp. 5-8
Author(s):  
Hideki Kakutani ◽  
Yoshikane Kato ◽  
Tomomi Fujikawa ◽  
Takafumi Kawata ◽  
Masami Yamamoto ◽  
...  
Keyword(s):  
Body Composition ◽  
Pilot Study ◽  
Statistical Significance ◽  
Hemodialysis Patients ◽  
The Body ◽  
X Ray ◽  
Chest X Ray ◽  
Group 2 ◽  
Fat Volume ◽  
Group 1

Background: Authors and colleagues have continued clinical research for hemodialysis patients. Currently, a pilot study presents intervention of carnitine for changes of the body composition. Subjects and Methods: Subjects were six patients on hemodialysis with intervention of carnitine (group 1). Average data were 74.3 years, 65.4 kg, 22.6 in BMI. As levocarnitine, L-Cartin FF injection 1000 mg was administered three times a week for six months. Group 2 has six control patients for age-, sex-, body weight, BMI-matched (group 2). Body composition of muscle and fat tissues were measured by InBody 770 on 0 and 6 months. Results: In group 1, muscle volume and skeletal muscle showed increasing tendency without statistical significance. In contrast, there were significant decreases of body fat volume (22.3 kg vs 20.5 kg, 39.0% vs 35.8%) (p<0.05). No significant differences were found in hemoglobin, total protein, albumin and Cardio-Thoracic Ratio (CTR) of chest X-ray. Group 2 showed no significant changes. Discussion and Conclusion: Hemodialysis patients often have muscular reduction. Previous reports showed improved lean body mass by carnitine administration, which may support our result. These results from current pilot study would be expected to become useful reference data in the pathophysiological investigation in patients on hemodialysis.

scholarly journals SAT0306 SEMIQUANTITATIVE AND QUANTITATIVE ANALYSIS OF LUNG CT IN THE ASSESSMENT OF INTERSTITIAL LUNG DISEASE IN IDIOPATHIC INFLAMMATORY MYOPATHIES WITH A FOCUS ON ANTISYNTHETASE.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1098.2-1098
Author(s):  
S. Barsotti ◽  
C. Roncella ◽  
A. Valentini ◽  
L. Cavagna ◽  
R. Castellana ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Special Focus ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Increased Risk ◽  
Group 2 ◽  
Lung Ct ◽  
Group 1

Background:Interstitial lung disease (ILD), is common in patients with idiopathic inflammatory myopathies (IIM) and strongly impact on patients’ morbidity and mortality. Patients with anti-aminoacyl-transfer RNA-synthetases (anti-ARS) antibodies are associated with an increased risk of ILD.Objectives:Defining the radiological characteristics of IIM patients, with special focus on serological groups, through qualitative, semiquantitative and quantitative analysis of lung CT.Methods:This was a prospective study conducted from 2016 to 2019. Ninety-eight IIM patients (35 men, 63 women) were included. Myositis specific autoantibodies (MSA) were assessed with Myositis Prophyle III (Euroimmune, Lubeck).Each patient had a baseline CT; the total score of Warrick (WS) was obtained at semiquantitative analysis. The radiological scores ILD% (interstitial lung disease %) and PVRS% (pulmonary vascular related structure) were the result of quantitative analysis in 61 patients (CALIPER). Pulmonary function tests (PFTs) included TLC%, FVC% and DLCO% (65 patients). The analysis was conducted in the whole group and divided in subgroups based on their MSA pattern: in particular anti-ARS (Group 1) and patients negative to MSA (Group 2) were analysed.Results:Positive correlations between ILD% and PVRS% (Rho=0.916; ρ=0.000), WS and ILD% (Rho=0.663; ρ=0.000) and WS and PVRS% (Rho=0.637; ρ<0.001) were found.The most relevant inverse correlations were found between ILD% and DLCO% (Rho=-0.590; ρ=0.001), PVRS% and DLCO% (Rho=-0.549; ρ<0.001) and WS and DLCO% (Rho=-0.471; ρ<0.001).Statistically significant higher values of WS, ILD% and PVRS% were found in Group 1 (WS=15, ILD%=11 and PVRS%=3.5), compared to Group 2 (WS=2.5, ILD%=0.84 and PVRS%=2.2). NSIP pattern resulted dominant represented in the two groups (80% Group 1, 75% Group 2). No statistically significant differences of DLCO%, FVC% and TLCO% were found.Conclusion:The inverse correlations between the radiological scores and the functional data TLC% and DLCO% (ρ<0.001) confirm the role of lung CT in the clinical management of ILD in IIM patients, and may represent a promising tool for clinical trials. For the first time anti-ARS and serological negative patients were defined through qualitative, semiquantitative and quantitative analysis of lung CT. Further study should be conducted in order to define the prognostic value of the quantitative analysis of lung CT in the follow up of IIM patients.Disclosure of Interests:None declared

A normal chest X-ray does not rule out the patient’s version

2021 ◽  
Author(s):  
Elena Forcén ◽  
María José Bernabé ◽  
Roberto Larrosa-Barrero
Keyword(s):  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Rule Out

scholarly journals Reliable Learning with PDE-Based CNNs and DenseNets for Detecting COVID-19, Pneumonia, and Tuberculosis from Chest X-Ray Images

Mathematics ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 434
Author(s):  
Anca Nicoleta Marginean ◽  
Delia Doris Muntean ◽  
George Adrian Muntean ◽  
Adelina Priscu ◽  
Adrian Groza ◽  
...  
Keyword(s):  
Transfer Learning ◽  
Negative Impact ◽  
X Ray ◽  
Domain Specific ◽  
Direct Training ◽  
Public Data ◽  
Normal Chest ◽  
Chest X Ray ◽  
The Stability ◽  
Definition Of

It has recently been shown that the interpretation by partial differential equations (PDEs) of a class of convolutional neural networks (CNNs) supports definition of architectures such as parabolic and hyperbolic networks. These networks have provable properties regarding the stability against the perturbations of the input features. Aiming for robustness, we tackle the problem of detecting changes in chest X-ray images that may be suggestive of COVID-19 with parabolic and hyperbolic CNNs and with domain-specific transfer learning. To this end, we compile public data on patients diagnosed with COVID-19, pneumonia, and tuberculosis, along with normal chest X-ray images. The negative impact of the small number of COVID-19 images is reduced by applying transfer learning in several ways. For the parabolic and hyperbolic networks, we pretrain the networks on normal and pneumonia images and further use the obtained weights as the initializers for the networks to discriminate between COVID-19, pneumonia, tuberculosis, and normal aspects. For DenseNets, we apply transfer learning twice. First, the ImageNet pretrained weights are used to train on the CheXpert dataset, which includes 14 common radiological observations (e.g., lung opacity, cardiomegaly, fracture, support devices). Then, the weights are used to initialize the network which detects COVID-19 and the three other classes. The resulting networks are compared in terms of how well they adapt to the small number of COVID-19 images. According to our quantitative and qualitative analysis, the resulting networks are more reliable compared to those obtained by direct training on the targeted dataset.

CHEST X RAY SCORE AND CLINICAL SEVERITY IN COVID-19 PATIENTS

2021 ◽  
pp. 31-32
Author(s):  
Sheeba Rana ◽  
Vicky Bakshi ◽  
Yavini Rawat ◽  
Zaid Bin Afroz
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Scoring Systems ◽  
Clinical Severity ◽  
X Rays ◽  
Antigen Test ◽  
X Ray ◽  
Classi Cation ◽  
Chest X Ray ◽  
Male Subjects

INTRODUCTION: Various chest X-ray scoring systems have been discovered and are employed to correlate with clinical severity, outcome and progression of diseases. With, the coronavirus outbreak, few chest radiograph classication were formulated, like the BSTI classication and the Brixia chest X-ray score. Brixia CXR scoring is used for assessing the clinical severity and outcome of COVID-19. This study aims to compare the Brixia CXR score with clinical severity of COVID-19 patients. MATERIAL& METHODS:This was a retrospective study in which medical records of patients aged 18 years or above, who tested for RTPCR or st st Rapid Antigen Test (RAT) for COVID positive from 1 February 2021 to 31 July 2021 (6 months) were taken. These subjects were stratied into mild, moderate and severe patients according to the ICMR guidelines. Chest X Rays were obtained and lesions were classied according to Brixia scoring system. RESULTS: Out of these 375 patients, 123 (32.8%) were female and 252 (67.2%) were male subjects. The average brixia score was 11.12. Average Brixia CXR score for mild, moderate and severe diseased subjects were 5.23, 11.20, and 14.43 respectively. DISCUSSION:The extent of chest x-ray involvement is proportional to the clinical severity of the patient. Although, a perplexing nding was that the average Brixia score of the female subjects were slightly higher than their male counterparts in the same clinical groups. CONCLUSION: Brixia CXR score correlates well with the clinical severity of the COVID-19.

Calcium phosphate product level as a predictor for arteriovenous fistula re-operations in patients with chronic renal failure

Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 284-290 ◽  
Author(s):  
Mehmet Erin Tüysüz ◽  
Mehmet Dedemoğlu
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Calcium Phosphate ◽  
Arteriovenous Fistula ◽  
Product Level ◽  
Increased Risk ◽  
High Calcium ◽  
Phosphate Product ◽  
Group 2 ◽  
Group 1

Objectives There is an increased calcium phosphate product level causing the formation of calcification in the arterial wall and thus decreased quality of fistula in patients with chronic renal failure. The purpose of our study is to verify the relationship between arteriovenous fistula re-operation and high calcium phosphate product level. Methods Seventy-nine consecutive patients with chronic renal failure between April 2016 and February 2018 were included in the study. Patients having calcium phosphate product level ≥50 mg2/dl2 were defined as group 1, whereas those having <50 mg2/dl2 were defined as group 2. Primary outcome of interest was the need for re-operation during the follow-up and to determine the risk factors for re-operation. To determine independent predictors for re-operation, multivariate logistic regression model was used. Results The rates of redo and tredo operation were significantly higher in group 1 compared to group 2 ( p = 0.01 and 0.04). In multivariate analysis, phosphate (OR: 1.84, 95% CI: 1.00–3.40, p = 0.05) and triglyceride (OR: 1.01, 95% CI: 1.00–1.02, p = 0.04) levels for redo operation and calcium phosphate product level (OR: 1.11, 95% CI: 1.01–1.22, p = 0.03) for tredo operation were found to be independent predictors. Conclusions High calcium phosphate product level leads to increased risk of arteriovenous fistula re-operation by causing arterial stiffness in this patient group. Additionally, these re-operations place additional burden on morbidity and cost efficacy. Thus, we recommend keeping the calcium phosphate product level at the optimal level in these patients to avoid both the risk of arteriovenous fistula re-operation and the other cardiovascular problems.

The normal chest X-ray

2017 ◽  
pp. 15-34
Author(s):  
Thomas Kurka
Keyword(s):  
X Ray ◽  
Normal Chest ◽  
Chest X Ray

Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography

2018 ◽  
Vol 35 (10) ◽  
pp. 1032-1038 ◽  
Author(s):  
Aaron S. Weinberg ◽  
William Chang ◽  
Grace Ih ◽  
Alan Waxman ◽  
Victor F. Tapson
Keyword(s):  
Pulmonary Embolism ◽  
Chest Radiograph ◽  
High Probability ◽  
Hemodynamic Instability ◽  
X Rays ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Low Probability ◽  
Clinically Significant

Objective: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. In this retrospective study, we demonstrate that portable V/Q scans can be helpful in ruling in or out clinically significant pulmonary embolism (PE) despite an abnormal chest x-ray in the ICU. Design: Two physicians conducted chart reviews and original V/Q reports. A staff radiologist, with 40 years of experience, rated chest x-ray abnormalities using predetermined criteria. Setting: The study was conducted in the ICU. Patients: The first 100 consecutive patients with suspected PE who underwent a portable V/Q scan. Interventions: Those with a portable V/Q scan. Results: A normal baseline chest radiograph was found in only 6% of patients. Fifty-three percent had moderate, 24% had severe, and 10% had very-severe radiographic abnormalities. Despite the abnormal x-rays, 88% of the V/Q scans were low probability for a PE despite an average abnormal radiograph rating of moderate. A high-probability V/Q for PE was diagnosed in 3% of the population despite chest x-ray ratings of moderate to severe. Six patients had their empiric anticoagulation discontinued after obtaining the results of the V/Q scan, and no anticoagulation was started for PE after a low-probability V/Q scan. Conclusion: Despite the large percentage of moderate-to-severe x-ray abnormalities, PE can still be diagnosed (high-probability scan) in the ICU with a portable V/Q scan. Although low-probability scans do not rule out acute PE, it appeared less likely that any patient with a low-probability V/Q scan had severe hypoxemia or hemodynamic instability due to a significant PE, which was useful to clinicians and allowed them to either stop or not start anticoagulation.

scholarly journals Detection of COVID-19 Using Transfer Learning and Grad-CAM Visualization on Indigenously Collected X-ray Dataset

Sensors ◽  
2021 ◽  
Vol 21 (17) ◽  
pp. 5813
Author(s):  
Muhammad Umair ◽  
Muhammad Shahbaz Khan ◽  
Fawad Ahmed ◽  
Fatmah Baothman ◽  
Fehaid Alqahtani ◽  
...  
Keyword(s):  
Transfer Learning ◽  
Input Image ◽  
Fine Tuning ◽  
Feature Maps ◽  
Virus Family ◽  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Confusion Matrices

The COVID-19 outbreak began in December 2019 and has dreadfully affected our lives since then. More than three million lives have been engulfed by this newest member of the corona virus family. With the emergence of continuously mutating variants of this virus, it is still indispensable to successfully diagnose the virus at early stages. Although the primary technique for the diagnosis is the PCR test, the non-contact methods utilizing the chest radiographs and CT scans are always preferred. Artificial intelligence, in this regard, plays an essential role in the early and accurate detection of COVID-19 using pulmonary images. In this research, a transfer learning technique with fine tuning was utilized for the detection and classification of COVID-19. Four pre-trained models i.e., VGG16, DenseNet-121, ResNet-50, and MobileNet were used. The aforementioned deep neural networks were trained using the dataset (available on Kaggle) of 7232 (COVID-19 and normal) chest X-ray images. An indigenous dataset of 450 chest X-ray images of Pakistani patients was collected and used for testing and prediction purposes. Various important parameters, e.g., recall, specificity, F1-score, precision, loss graphs, and confusion matrices were calculated to validate the accuracy of the models. The achieved accuracies of VGG16, ResNet-50, DenseNet-121, and MobileNet are 83.27%, 92.48%, 96.49%, and 96.48%, respectively. In order to display feature maps that depict the decomposition process of an input image into various filters, a visualization of the intermediate activations is performed. Finally, the Grad-CAM technique was applied to create class-specific heatmap images in order to highlight the features extracted in the X-ray images. Various optimizers were used for error minimization purposes. DenseNet-121 outperformed the other three models in terms of both accuracy and prediction.

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