scholarly journals Evaluation of Pregnant Patients with Suspected Pulmonary Embolism: A Descriptive Cross-Sectional Study

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Javad Fallahi ◽  
Behnam Dalfardi ◽  
Reza Jalili ◽  
Seyed Masoom Masoompour ◽  
Behrouz Momeni ◽  
...  
Keyword(s):  
Troponin I ◽  
Clinical Symptoms ◽  
Final Diagnosis ◽  
Pulmonary Perfusion ◽  
Common Symptom ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Perfusion Scan ◽  
D Dimer

Background: Pulmonary thromboembolism (PTE) is a leading cause of maternal mortality. However, diagnosis of PTE can be challenging during pregnancy, and there is no consensus regarding the best diagnostic approach. Objectives: The current study aimed to evaluate the applicability of clinical symptoms and diagnostic tests in ruling in or ruling out PTE during pregnancy. Methods: In this one-year, cross-sectional, descriptive study, we evaluated pregnant or postpartum (six weeks postpartum) women suspected of PTE, who were admitted to the internal medicine intensive care units (ICUs) of hospitals (Namazi and Shahid Faghihi hospitals), affiliated with Shiraz University, Shiraz, Iran, during August 2016-July 2017. The participants underwent electrocardiography (ECG), serum troponin-I and D-dimer measurements, chest X-ray, color-doppler sonography (CDS) of the lower extremity venous system, transthoracic echocardiography, pulmonary perfusion scan, or pulmonary computed tomography angiography (CTA). The participants’ clinical manifestations were also assessed. Results: A total of 103 women, with the mean age of 30.37 ± 5.35 years, were included in this study. Seventy-seven women underwent pulmonary CTA or pulmonary perfusion scan. PTE was documented in nine cases. Dyspnea was the most common symptom. The respiratory rate, cough, dizziness, and fever on admission had significant correlations with the final diagnosis of PTE (P = 0.01, 0.03, 0.007, and 0.04, respectively). The ECG study of one case with PTE showed right axis deviation, while the ECG findings of the other eight cases showed no specific pattern. The chest X-ray findings had no significant correlation with the final diagnosis of PTE. Overall, 38 women underwent CDS, one of whom presented with deep vein thrombosis. The serum D-dimer level was positive in three cases with documented PTE (normal in one patient with PTE), and the serum troponin-I level was positive in one case with the final diagnosis of PTE (normal level in two patients with PTE). Conclusions: Based on the findings, clinical symptoms and biochemical tests alone are not reliable for ruling in or ruling out PTE during pregnancy, and CTA and pulmonary ventilation/perfusion scan should be performed for these cases.

scholarly journals CLINICAL SYMPTOMS AND CHEST X-RAY FINDINGS FOR EVALUATION OF CHEST X-RAY IN MANAGEMENT AND PREDICTION OF CLINICAL OUTCOME OF CONFIRM CASES OF COVID-19

2020 ◽  
Vol 70 (6) ◽  
pp. 1847-52
Author(s):  
Khawaja Muhammad Baqir Hassan ◽  
Tathir Baqir Hassan ◽  
Shakil Sarwar ◽  
Irfan Najam Sheen ◽  
Farrukh Islam ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Patient Management ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
X Rays ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray

Objective: To study clinical symptoms and chest X-ray findings for evaluation of chest X-ray in management ofconfirmed cases of COVID-19 and predicting the clinical outcome. Study Design: Cross sectional study. Place and Duration of Study: The departments of Radiology & Medicine of Combined Military Hospital Malir,from Mar to May 2020. Methodology: The sample used in this study consists of 73 patients. All the standard frontal projections of chest X-ray of PCR confirmed COVID-19 patients were studied on computer and findings were noted Results: At the aggregate, the study indicates that there is no Significant Connection in between the clinicalsymptoms, their severity and chest X-ray findings. Conclusion: There is no significant connection found between the severity of clinical symptoms and chest X-rays suggesting that chest X-Ray cannot be a reliable indicator to predict the clinical outcome of the patient and has limited role in management of patient. Clinical assessment is still the main stay of the patient management.

scholarly journals Analysis of Separability of COVID-19 and Pneumonia in Chest X-ray Images by Means of Convolutional Neural Networks

Proceedings ◽  
2020 ◽  
Vol 54 (1) ◽  
pp. 31
Author(s):  
Joaquim de Moura ◽  
Lucía Ramos ◽  
Plácido L. Vidal ◽  
Jorge Novo ◽  
Marcos Ortega
Keyword(s):  
Neural Networks ◽  
Convolutional Neural Networks ◽  
Clinical Symptoms ◽  
Early Stage ◽  
World Health ◽  
Complete Analysis ◽  
Screening Process ◽  
X Ray ◽  
Chest X Ray ◽  
Health Organization

The new coronavirus (COVID-19) is a disease that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On 11 March 2020, the coronavirus outbreak has been labelled a global pandemic by the World Health Organization. In this context, chest X-ray imaging has become a remarkably powerful tool for the identification of patients with COVID-19 infections at an early stage when clinical symptoms may be unspecific or sparse. In this work, we propose a complete analysis of separability of COVID-19 and pneumonia in chest X-ray images by means of Convolutional Neural Networks. Satisfactory results were obtained that demonstrated the suitability of the proposed system, improving the efficiency of the medical screening process in the healthcare systems.

scholarly journals Sputum smear positivity grade and chest X-ray findings in tuberculosis: A cross-sectional study

2021 ◽  
Author(s):  
R. Behzadmehr ◽  
E. Nejadkehkha
Keyword(s):  
Cross Sectional Study ◽  
Health Concern ◽  
Sputum Smear ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
X Ray ◽  
High Prevalence ◽  
Chest X Ray

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively.  In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.

scholarly journals The diagnostic value of chest X-ray in coronavirus disease 2019: A comparative study of X-ray and CT

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110162
Author(s):  
Fengxia Zeng ◽  
Yong Cai ◽  
Yi Guo ◽  
Weiguo Chen ◽  
Min Lin ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Diagnostic Value ◽  
Rapid Identification ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
X Ray ◽  
Chest X Ray ◽  
Laboratory Examinations ◽  
Sensitivity Specificity

As the coronavirus disease 2019 (COVID-19) epidemic spreads around the world, the demand for imaging examinations increases accordingly. The value of conventional chest radiography (CCR) remains unclear. In this study, we aimed to investigate the diagnostic value of CCR in the detection of COVID-19 through a comparative analysis of CCR and CT. This study included 49 patients with 52 CT images and chest radiographs of pathogen-confirmed COVID-19 cases and COVID-19-suspected cases that were found to be negative (non-COVID-19). The performance of CCR in detecting COVID-19 was compared to CT imaging. The major signatures that allowed for differentiation between COVID-19 and non-COVID-19 cases were also evaluated. Approximately 75% (39/52) of images had positive findings on the chest x-ray examinations, while 80.7% (42/52) had positive chest CT scans. The COVID-19 group accounted for 88.4% (23/26) of positive chest X-ray examinations and 96.1% (25/26) of positive chest CT scans. The sensitivity, specificity, and accuracy of CCR for abnormal shadows were 88%, 80%, and 87%, respectively, for all patients. For the COVID-19 group, the accuracy of CCR was 92%. The primary signature on CCR was flocculent shadows in both groups. The shadows were primarily in the bi-pulmonary, which was significantly different from non-COVID-19 patients ( p = 0.008). The major CT finding of COVID-19 patients was ground-glass opacities in both lungs, while in non-COVID-19 patients, consolidations combined with ground-glass opacities were more common in one lung than both lungs ( p = 0.0001). CCR showed excellent performance in detecting abnormal shadows in patients with confirmed COVID-19. However, it has limited value in differentiating COVID-19 patients from non-COVID-19 patients. Through the typical epidemiological history, laboratory examinations, and clinical symptoms, combined with the distributive characteristics of shadows, CCR may be useful to identify patients with possible COVID-19. This will allow for the rapid identification and quarantine of patients.

scholarly journals Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Joanitah Nalunjogi ◽  
Frank Mugabe ◽  
Irene Najjingo ◽  
Pastan Lusiba ◽  
Francis Olweny ◽  
...  
Keyword(s):  
Screening Tool ◽  
Screening Method ◽  
Cross Sectional Study ◽  
Case Detection ◽  
Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Number Needed To Screen ◽  
Screening Algorithm ◽  
Chest X Ray

The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.

Comparison of granulomatosis with polyangiitis clinical features in patients depending of involvement or absence of kidney involvement

2021 ◽  
Vol 17 ◽  
Author(s):  
Mateusz Puchala ◽  
Andrzej Rydzewski ◽  
Ilona Kowalik ◽  
Małgorzata Wisłowska
Keyword(s):  
Clinical Features ◽  
Crescentic Glomerulonephritis ◽  
Immunosuppressive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
X Ray ◽  
Small Vessels ◽  
Kidney Involvement ◽  
Chest X Ray ◽  
The Mean

Background: GPA is a necrotizing inflammation of the small vessels with granulomas. Kidney involvement deteriorated its prognosis. Objective: Comparison of GPA patients with kidney (KI) and without kidney involvement (nKI). Material and methods: We conducted a cross-sectional study of 50 consecutive adult GPA patients, 25 KI from Nephrology and 25 nKI from Rheumatology Department of Central Clinical Hospital Ministry of Interior in Warsaw. We analyzed clinical features, organ involvement, laboratory, serological, imaging, histopathological data, BVAS, treatment. Results: The mean age of KI patients was statistically older then nKI (67.3±9.5 vs 55.1±15.9, p=0.002). Generalized, severe, resistance disease was observed respectively in 92% vs 44%, p<0.001. The number of red blood cells (3.47 vs 4.41T/l, p<0.001), hemoglobin (10.0 vs 12.9g/dl, p<0.001) was lower in KI, higher mean serum creatinine (3.95 vs. 0.89mg/dl, p<0.001), lower GFR (20.1 vs. 79.3, p<0.001), higher CRP (median: 43.4 vs 2.0mg/l, p<0.001), BVAS (16.6±4.4 vs 10.1±6.2, p<0.001), c-ANCA (median: 119.0 vs 15.2CU, p=0.017). Nodules in 28% KI, in 4% nKI (p=0.048) in chest X-ray, infiltration in 43.5% KI, in 15% nKI (p=0.042) in HRCT were observed. Skin granulomas were found in 61.5% nKI vs 18.2% KI, (p=0.047). Renal biopsy revealed in KI patients focal segmental glomerulonephritis in 11.8%, crescentic glomerulonephritis in 17.6%, pauci-immune crescentic glomerulonephritis in 70.6%. Conclusions: In patients with KI more frequently we found generalized, severe, resistant GPA, higher BVAS in comparison in patients without KI. The results of laboratory parameters, were worse in patients with KI. Aggressive immunosuppressive treatment is often used in KI group.

scholarly journals Cross-sectional imaging of the torso reveals occult injuries in asymptomatic blunt trauma patients

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Gregory J. Roberts ◽  
Lewis E. Jacobson ◽  
Michelle M. Amaral ◽  
Courtney D. Jensen ◽  
Louis Cooke ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Chest Ct ◽  
Physical Exam ◽  
Trauma Patients ◽  
Cross Sectional ◽  
X Ray ◽  
Cross Sectional Imaging ◽  
Normal Chest ◽  
Chest X Ray ◽  
Sectional Imaging

Abstract Background High morbidity and mortality rates of trauma injuries make early detection and correct diagnosis crucial for increasing patient’s survival and quality of life after an injury. Improvements in technology have facilitated the rapid detection of injuries, especially with the use of computed tomography (CT). However, the increased use of CT imaging is not universally advocated for. Some advocate for the use of selective CT imaging, especially in cases where the severity of the injury is low. The purpose of this study is to review the CT indications, findings, and complications in patients with low Injury Severity Scores (ISS) to determine the utility of torso CT in this patient cohort. Methods A retrospective review of non-intubated, adult blunt trauma patients with an initial GCS of 14 or 15 evaluated in an ACS verified level 1 trauma center from July 2012 to June 2015 was performed. Data was obtained from the hospital’s trauma registry and chart review, with the following data included: age, sex, injury type, ISS, physical exam findings, all injuries recorded, injuries detected by torso CT, missed injuries, and complications. The statistical tests conducted in the analysis of the collected data were chi-squared, Fischer exact test, and ANOVA analysis. Results There were 2306 patients included in this study, with a mean ISS of 8. For patients with a normal chest exam that had a chest CT, 15% were found to have an occult chest injury. In patients with a negative chest exam and negative chest X-ray, 35% had occult injuries detected on chest CT. For patients with a negative abdominal exam and CT abdomen and pelvis, 16% were found to have an occult injury on CT. Lastly, 25% of patients with normal chest, abdomen, and pelvis exams with chest, abdomen, and pelvis CT scans demonstrated occult injuries. Asymptomatic patients with a negative CT had a length of stay 1 day less than patients without a corresponding CT. No incidents of contrast-induced complications were recorded. Conclusions A negative physical exam combined with a normal chest X-ray does not rule out the presence of occult injuries and the need for torso imaging. In blunt trauma patients with normal sensorium, physical exam and chest X-ray, the practice of obtaining cross-sectional imaging appears beneficial by increasing the accuracy of total injury burden and decreasing the length of stay.

scholarly journals Laryngo-Tracheal Displacement and Respiratory Distress in an Infant with Congenital Thymic Hyperplasia

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Michael Wolff ◽  
Süha Demirakca ◽  
Anna Kristina Kilian ◽  
Horst Schroten ◽  
Tobias Tenenbaum
Keyword(s):  
Young Children ◽  
Respiratory Distress ◽  
Corticosteroid Therapy ◽  
Clinical Symptoms ◽  
Thymic Hyperplasia ◽  
Feeding Disorder ◽  
X Ray ◽  
Chest X Ray

Thymic hyperplasia is usually an asymptomatic condition observed in infancy. A five-week-old boy presented with respiratory distress and feeding disorder, in which chest X-ray and bronchoscopy revealed a strong laryngotracheal displacement. Sonography and MRI confirmed the diagnosis of a thymic hyperplasia. Corticosteroid therapy led to improvement of clinical symptoms. Thymic hyperplasia may lead to laryngo-tracheal displacement and respiratory distress in neonates and young children.

A cohort study using pulmonary function tests and x-ray examination in toner-handling workers

2014 ◽  
Vol 34 (4) ◽  
pp. 345-356 ◽  
Author(s):  
H Kitamura ◽  
N Terunuma ◽  
S Kurosaki ◽  
K Hata ◽  
M Masuda ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Health Effects ◽  
Pulmonary Function Tests ◽  
Personal Exposure ◽  
Working Environment ◽  
X Rays ◽  
Cross Sectional ◽  
X Ray ◽  
Function Tests ◽  
Chest X Ray

Objectives: This study uses pulmonary function tests and chest x-ray examinations to examine the relationship between toner-handling work and its health effects. Methods: The subjects were 1504 male workers in a Japanese toner and photocopier manufacturing company, in the age range from 19 to 50 years in 2003. Personal exposure measurements, pulmonary function tests, chest x-ray examinations, biomarker measurements, and a questionnaire about respiratory symptoms were conducted. The present study reports the results of pulmonary function tests and chest x-ray examinations conducted in the subjects, which includes a cross-sectional study on the toner handling and non-handling workers and a longitudinal study from 2003 to 2008. Results: Few significant findings were suspected to be caused by toner exposure found in pulmonary function indices in both the cross-sectional and longitudinal studies. Any obvious fibrotic findings in chest x-ray findings related to the toner exposure could not be found out. Conclusion: No evidence of adverse effects on pulmonary function indices and chest x-rays was present in the toner-handling workers as compared to the nonspecifically exposed workers. Although the toner exposure concentration is quite low in the current well-controlled working environment, even among the toner-handling workers, we would like to continue this study in the future to verify the toner exposure health effects.

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