CT Scan Finding Characteristics of Confirmed Covid-19 Patients Based on Clinical Symptom Onset Patterns

ABSTRACTObjective:There is increasing evidence of an association between depressive symptoms and mild cognitive impairment (MCI) in cross-sectional studies, but the longitudinal association between depressive symptoms and risk of MCI onset is less clear. The authors investigated whether baseline symptom severity of depression was predictive of time to onset of symptoms of MCI.Method:These analyses included 300 participants from the BIOCARD study, a cohort of individuals who were cognitively normal at baseline (mean age = 57.4 years) and followed for up to 20 years (mean follow-up = 2.5 years). Depression symptom severity was measured using the Hamilton Depression Scale (HAM-D). The authors assessed the association between dichotomous and continuous HAM-D and time to onset of MCI within 7 years versus after 7 years from baseline (reflecting the mean time from baseline to onset of clinical symptoms in the cohort) using Cox regression models adjusted for gender, age, and education.Results:At baseline, subjects had a mean HAM-D score of 2.2 (SD = 2.8). Higher baseline HAM-D scores were associated with an increased risk of progression from normal cognition to clinical symptom onset ≤ 7 years from baseline (p= 0.043), but not with progression > 7 years from baseline (p= 0.194). These findings remained significant after adjustment for baseline cognition.Conclusions:These results suggest that low levels of depressive symptoms may be predictive of clinical symptom onset within approximately 7 years among cognitively normal individuals and may be useful in identifying persons at risk for MCI due to Alzheimer’s disease.

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The Effect of Age on Characteristics and Mortality of Intracerebral Hemorrhage in the Oldest-Old

Cerebrovascular Diseases ◽

10.1159/000448813 ◽

2016 ◽

Vol 42 (5-6) ◽

pp. 485-492 ◽

Cited By ~ 8

Author(s):

Paola Forti ◽

Fabiola Maioli ◽

Michele Domenico Spampinato ◽

Carlotta Barbara ◽

Valeria Nativio ◽

...

Keyword(s):

Elderly Patients ◽

Intracerebral Hemorrhage ◽

Ct Scan ◽

Symptom Onset ◽

Oldest Old ◽

Hematoma Expansion ◽

Elderly Subjects ◽

Supporting Evidence ◽

Hematoma Volume ◽

Young Old

Background: Incidence of acute intracerebral hemorrhage (ICH) increases with age, but there is a lack of information about ICH characteristics in the oldest-old (age ≥85 years). In particular, there is a need for information about hematoma volume, which is included in most clinical scales for prediction of mortality in ICH patients. Many of these scales also assume that, independent of ICH characteristics, the oldest-old have a higher mortality than younger elderly patients (age 65-74 years). However, supporting evidence from cohort studies is limited. We investigated ICH characteristics of oldest-old subjects compared to young (<65 years), young-old (65-74 years) and old-old (75-84 years) subjects. We also investigated whether age is an independent mortality predictor in elderly (age ≥65 years) subjects with acute ICH. Methods: We retrospectively collected clinical and neuroimaging data of 383 subjects (age 34-104 years) with acute supratentorial primary ICH who were admitted to an Italian Stroke Unit (SU) between October 2007 and December 2014. Measured ICH characteristics included hematoma location, volume and intraventricular extension of hemorrhage on admission CT scan; admission Glasgow Coma Scale ≤8 and hematoma expansion (HE) measured on follow-up CT-scans obtained after 24 h. General linear models and logistic models were used to investigate the association of age with ICH characteristics. These models were adjusted for pre-admission characteristics, hematoma location and time from symptom onset to admission CT scan. Limited to elderly subjects, Cox models were used to investigate the association of age with in-SU and 1-year mortality: the model for in-SU mortality adjusted for pre-admission and ICH admission characteristics and the model for 1-year mortality additionally adjusted for functional status and disposition at SU discharge. Results: Independent of pre-admission characteristics, hematoma location and time from symptom onset to admission CT-scan, oldest-old subjects had the highest admission hematoma volume (p < 0.01). Age was unrelated to all other ICH characteristics including HE. In elderly patients, multivariable adjusted risk of in-SU and 1-year mortality did not vary across age categories. Conclusions: Oldest-old subjects with acute supratentorial ICH have higher admission hematoma volume than young and young-old subjects but do not differ for other ICH characteristics. When taking into account confounding from ICH characteristics, risk of in-SU and 1-year mortality in elderly subjects with acute supratentorial ICH does not differ across age categories. Our findings question use of age as an independent criterion for stratification of mortality risk in elderly subjects with acute ICH.

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Depressive symptoms and CSF Alzheimer's disease biomarkers in relation to clinical symptom onset of mild cognitive impairment

Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring ◽

10.1002/dad2.12106 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Carol K. Chan ◽

Anja Soldan ◽

Corinne Pettigrew ◽

Jiangxia Wang ◽

Marilyn Albert ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Mild Cognitive Impairment ◽

Clinical Symptom ◽

Symptom Onset ◽

Disease Biomarkers

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Optimization of CT Scan to Angiography Time Can Reduce Variability in Time Intervals from Symptom Onset to Recanalization in Acute Ischemic Stroke Patients (P06.213)

Neurology ◽

10.1212/wnl.78.1_meetingabstracts.p06.213 ◽

2012 ◽

Vol 78 (Meeting Abstracts 1) ◽

pp. P06.213-P06.213

Author(s):

S. Hassan ◽

A. Hassan ◽

S. Chaudhry ◽

N. Rostambeigi ◽

G. Rodriguez ◽

...

Keyword(s):

Ischemic Stroke ◽

Ct Scan ◽

Acute Ischemic Stroke ◽

Symptom Onset ◽

Stroke Patients ◽

Time Intervals

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Abstract P11: Clinical Utility of Aspects in Late Window Stroke Thrombectomy Patients: Insights From Star

Stroke ◽

10.1161/str.52.suppl_1.p11 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Guilherme B Porto ◽

Zachary Hubbard ◽

Sami Al Kasab ◽

Eyad Almallouhi ◽

Robert Starke ◽

...

Keyword(s):

Ct Scan ◽

Symptom Onset ◽

Mechanical Thrombectomy ◽

Multivariable Analysis ◽

Star Collaboration ◽

Outcome Data ◽

Large Vessel ◽

Large Vessel Occlusion ◽

Vessel Occlusion ◽

Aspiration Thrombectomy

Introduction: Recent trials have proven safety and efficacy of mechanical thrombectomy for patients presenting with emergent large vessel occlusion beyond 6 hours of symptom onset. While evidence supports using baseline CT scan to evaluate the candidacy for mechanical thrombectomy for patients presenting in the early window, late window trials have used advanced imaging such as CT and MR perfusion. We aim to assess outcomes of MT stratified by admission Alberta Stroke Program Early CT Score (ASPECTS). Methods: We used data from the prospectively maintained registries of 28 stroke centers in the Stroke Thrombectomy and Aneurysm (STAR) collaboration. Demographics, comorbidities, LVO site, ASPECTS, MT technique, radiographic and clinical outcome data were collected. Patients with M1 or ICA occlusion were included in these analyses. Multivariable analysis was performed using a generalized linear model with logit link to assess for variables associated with favorable outcomes. Results: 3356 patients in the STAR database were reviewed and 347 (10.3%) of those underwent MT in the late window (table). Median age was 69, 189 (54.5%) were female, and 181 (52.2%) were white. 295 patients ASPECTS ≥6. In this group, 200 (68.8%) had M1 occlusion, and the remaining had ICA occlusion. Aspiration thrombectomy was used in 139 (47.1%) of patients. Successful reperfusion was achieved (mTICI≥2b) in 264 (76.1%). sICH was observed in 15 (5.1%). Excellent functional outcome (mRS 0-2) was observed in 124 (42%) patients. ASPECTS score was independently associated with favorable outcomes (aOR 1.2, 95% CI 1.1-1.4, P=0.006). Conclusion: Excellent outcomes are observed in patients with good ASPECT score presenting in the late window irrespective of perfusion criteria. Admission CT scan could be used to triage patients presenting with emergent large vessel occlusion beyond 6 hours of symptom onset.

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Seorang Wanita Mengalami Aspirasi Barium Dengan Komplikasi Pneumonia

Jurnal Respirasi ◽

10.20473/jr.v5-i.1.2019.5-9 ◽

2019 ◽

Vol 5 (1) ◽

pp. 5

Author(s):

Isnin Anang Marhana ◽

Adhari Ajipurnomo

Keyword(s):

Computed Tomography ◽

Ct Scan ◽

Clinical Symptom ◽

Atomic Number ◽

Aspiration Pneumonia ◽

Major Complication ◽

X Ray ◽

High Atomic Number ◽

Chest X Ray

Background. Barium aspiration is one of rare major complication of esophagography. Aspiration pneumonia occurs about 40% without clinical symptom and can cause 30% of dead. Case. A female 62 years old choked a mount of barium when swallowing barium liquid in esophagography procedure. There was ronkhi on lower left haemithorax and granuler pattern on left paracardial impressed the rest of barium in chest x-ray photo. Patient suffered symptom of infection in eight days evaluation with infiltrate and rest of barium from chest x-ray photo. Microbiology examination of bronchus lavage founded pathogen microbe Burcholderia Gladioli and Pseudomonas and containing 1,22 mg/L of barium. Discussion. Barium aspiration can occur in esophagography procedure in extreme age. Chest x-ray and Computed Tomography can be used as primer tool to diagnose and evaluate barium aspiration which imaging hiperdens pattern due to barium with high atomic number (56). Prognosis of aspiration barium can be affected by the quantity and density of barium liquid which is choked and comorbid factor in patient. Barium aspiration mixed with secrete of oropharing which containing colony of pathogen can cause penumonia as disease complication. There is still no guideline for barium aspiration management, but bronchoscopy is recommended by many clinician. Conclusion. Pneumonia occur when aspiration barium mixed with secrete oropharing which containing colony of pathogen. Chest x-ray and CT scan can be used as tool to diagnose barium aspiration. Bronchoscopy is recommended to diagnose and to manage barium aspiration. When pneumonia is suspicious, antibiotic with anaerob activity is recommended given.

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Acute Lumbar Paraspinal Compartment Syndrome after a Tug of War: A Case Report and Review of the Literature

International Journal of Surgical Case Reports ◽

10.31487/j.ijscr.2020.04.03 ◽

2020 ◽

pp. 1-4

Author(s):

Moritz C. Deml ◽

Raphael Sedlmayer ◽

Irakli Tinikashvili ◽

Sebastian F. Bigdon ◽

Helena Milavec ◽

...

Keyword(s):

Emergency Medicine ◽

Back Pain ◽

Case Report ◽

Conservative Treatment ◽

Ct Scan ◽

Compartment Syndrome ◽

Symptom Onset ◽

Clinical Importance ◽

Review Of The Literature ◽

Acute Back Pain

Compartment syndrome of the upper and the lower extremities is a well-known entity in emergency medicine and traumatology. However, compartment syndrome of the paraspinal musculature is a very rare cause of acute back pain and may be missed at presentation despite its clinical importance. Therefore, we present a case of paraspinal compartment syndrome embedded in an overview of the actual literature. A 21- year-old woman presented with acute back pain refractory to analgesia with opiates after a tug of war match. A CT-scan of the abdomen demonstrated paraspinal swelling and an MRI ruled out intra-spinal pathologies. A compartment measurement yielded a pressure of 135mmHg. Even though conservative treatment attempts are often described, an emergency fasciotomy was carried out. Further rehabilitation was uneventful. Nevertheless, the timing of fasciotomy in the paraspinal region is under discussion, especially due to very rare experiences. Even if surgery is delayed by more than 24 hours following symptom onset, favourable postoperative outcomes have been observed.

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