scholarly journals Predictive Value of Gray-Matter–White-Matter Ratio on Brain Computed Tomography for Delayed Encephalopathy after Acute Carbon Monoxide Poisoning: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Shu Li Wang ◽  
Meng Mei Ma ◽  
Guang Wei Lv ◽  
Meng Zhang ◽  
Yu Sen Du ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carbon Monoxide ◽  
Regression Analysis ◽  
Cohort Study ◽  
Basal Ganglia ◽  
Predictive Value ◽  
Retrospective Cohort ◽  
Co Poisoning ◽  
Brain Computed Tomography ◽  
Delayed Encephalopathy

Background. This study is aimed at determining the predictive value of the gray-matter–white-matter ratio (GWR) on brain computed tomography for delayed encephalopathy after acute carbon monoxide (CO) poisoning (DEACMP). Methods. This retrospective cohort study reviewed 352 patients with acute CO poisoning and who underwent the brain computed tomography test. These patients were admitted to Cangzhou Central Hospital from May 2010 to May 2020. The patients were divided into the DEACMP ( n = 16 ) and non-DEACMP ( n = 336 ) groups. Pearson’s correlation coefficients were computed for correlation analysis. The predictive value of GWR for DEACMP was evaluated by using logistic regression analysis and receiver operator characteristic curves. Results. The morbidity of DEACMP was 4.5% (16/352). The GWR-basal ganglia, GWR-cerebrum, and GWR-average in the DEACMP group were lower than those in the non-DEACMP group. Correlation analysis indicated that GWR-basal ganglia ( r = 0.276 ; P < 0.001 ), GWR-cerebrum ( r = 0.163 ; P = 0.002 ), and GWR-average ( r = 0.20 0; P < 0.001 ) were correlated with DEACMP. Multivariate logistic regression analysis revealed that reduced GWR-basal ganglia, GWR-cerebrum, and GWR-average were independent risk factors ( P < 0.001 ; P = 0.008 ; P = 0.001 ; respectively). Compared with GWR-cerebrum and GWR-average, GWR-basal ganglia had a higher area under the curve of 0.881 (95% confidence interval: 0.783–0.983) with sensitivity and specificity of 93.8% and 68.7%, respectively. The cut-off value of GWR-basal ganglia was 1.055. Conclusion. GWR, especially GWR-basal ganglia, is an early useful predictor for DEACMP.

Pre-operative prediction of cholesteatomas from radiology: retrospective cohort study of 106 cases

2019 ◽  
Vol 133 (06) ◽  
pp. 477-481 ◽  
Author(s):  
D Selwyn ◽  
J Howard ◽  
P Cuddihy
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Retrospective Cohort Study ◽  
Predictive Value ◽  
Retrospective Cohort ◽  
Anatomical Variation ◽  
Predictive Values ◽  
Mastoid Surgery

AbstractObjectivePre-operative imaging is often used to predict the extent of a cholesteatoma and anatomical variation to plan for surgery. This study aimed to measure the predictive accuracy of computed tomography findings.MethodsA retrospective cohort study was conducted of all patients in a district general hospital undergoing mastoid surgery within a consecutive 12-month period, in whom computed tomography had been performed prior to operative intervention. The study measured the key findings of pre-operative computed tomography imaging and compared them to the intra-operative findings.ResultsA total of 106 patients were included. The sensitivity and specificity for predicting cholesteatoma were 79 per cent and 81 per cent respectively. The positive predictive value was 90 per cent and the negative predictive value was 65 per cent. In predicting complications of cholesteatomas, the sensitivity was 70 per cent, whereas the specificity was 91 per cent. The positive predictive value was 88 per cent and the negative predictive value was 76 per cent.ConclusionPre-operative computed tomography conducted prior to mastoid surgery has high positive predictive values for both predicting cholesteatomas and complications (90 per cent and 88 per cent respectively).

scholarly journals Predictors exploration of abnormal brain magnetic resonance versus normal brain computed tomography imaging in acute carbon monoxide poisoning

2021 ◽  
Keyword(s):  
Computed Tomography ◽  
Carbon Monoxide ◽  
Magnetic Resonance ◽  
Brain Mri ◽  
Brain Lesions ◽  
Normal Brain ◽  
Co Poisoning ◽  
Mri Findings ◽  
Brain Computed Tomography ◽  
Abnormal Brain

Acute brain lesions observed on magnetic resonance imaging (MRI) performed during acute-phase carbon monoxide (CO) poisoning were associated with patient prognosis. However, it may be difficult in critically ill patients because of the long examination time and for patients who have economical limitations due to the high price. The purpose of this study was to identify predictive factors for abnormal brain lesions on MRI in cases of normal brain findings on brain computed tomography (CT) in acute CO poisoning patients. This study was retrospectively analyzed at the tertiary emergency medical center located in Gyeonggi-do, Korea by prospectively collecting CO poisoning registry. From August 2016 to August 2019, 287 patients visited the hospital due to CO poisoning. Exclusion criteria included age under 18 years, being discharged against medical advice, no initial MRI data, no initial CT data, and having abnormal lesions on brain CT. Of the 103 patients included in the final study, the median age was 39 years old; 35 (34.0%) were male and 74 (71.8%) were intentionally exposed to CO. 27 (26.2%) patients had abnormal MRI findings. Based on multivariable analysis, elevated blood urea nitrogen (BUN) concentration (odds ratio, 1.165; 95% confidence interval, 1.037–1.308; p = 0.01) showed a significant association with abnormal MRI findings. The area under the curve was 0.753 (95% confidence interval, 0.636–0.869) in the receiver operating characteristic curve of BUN concentration for abnormal brain MRI presentations. Brain injury may be detected on brain MRI in acute CO poisoning patients even there was a normal brain CT scan. Our study revealed that elevated BUN concentration may be significantly correlated with abnormal MRI findings.

scholarly journals Concentric and eccentric isokinetic hamstring injury risk among 582 professional elite soccer players: a 10-years retrospective cohort study

2020 ◽  
Vol 6 (1) ◽  
pp. e000868
Author(s):  
Ricardo Lima Burigo ◽  
Robson Dias Scoz ◽  
Bruno Mazziotti de Oliveira Alves ◽  
Rubens Alexandre da Silva ◽  
Cesar Augusto Melo-Silva ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Risk ◽  
Peak Torque ◽  
Soccer Players ◽  
Complex Data ◽  
Isokinetic Test ◽  
Clinical Records

Background/AimDifferent authors have tried to correlate the peak isokinetic torque values with the incidence of soccer match injuries. However, due to the wide variety of assessment testing protocols, such an inference becomes difficult. This study aimed to verify the capacity of an isokinetic test to establish injury risk reference values for hamstring strain injuries.MethodsA retrospective cohort study based on isokinetic data and clinical records from the last 10 years was conducted in 582 Brazilian elite-professional soccer players, who were subjected to the same isokinetic test protocol, machine, and tester. A Multivariate Logistic Regression Analysis for Complex Data Sampling was used to generate injury risk statistical indexes.ResultsMultivariate regression analysis of both legs provided important data to identify the cut-off values of Concentric Peak Torque (181.82 Newton/*metres), Concentric Work (236.23 watts) and Concentric Power (130.11 joules).ConclusionsThe injury risk indexes indicate that an increase of just one Newton unit in CPT (Concentric Peak Torque) and CJ (Concentric Power) above those cut-off values, can reduce the risk of future injuries by 2% and 2.7%, respectively.

scholarly journals “INTERGROWTH21st vs customized fetal growth curves in the assessment of the neonatal nutritional status: a retrospective cohort study of gestational diabetes”

2019 ◽  
Author(s):  
Juan Jesus Fernández Alba ◽  
Estefania Soto Pazos ◽  
Rocio Moreno Cortes ◽  
Angel Vilar Sanchez ◽  
Carmen Gonzalez Macias ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Nutritional Status ◽  
Positive Predictive Value ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Retrospective Cohort Study ◽  
Predictive Value ◽  
Retrospective Cohort ◽  
Growth Curves

Abstract Background Gestational diabetes mellitus is associated with increased incidence of adverse perinatal outcomes including newborns large for gestational age, macrosomia, preeclampsia, polihydramnios, stillbirth, and neonatal morbidity. Thus, fetal growth should be monitored by ultrasound to limit fetal overnutrition, and thereby, its clinical consequence, macrosomia. However, it is not clear which reference curve to use to define the limits of normality. Our aim is to determine which method, INTERGROWTH21st or customized curves, better identifies the nutritional status of newborns of diabetic mothers.Methods This retrospective cohort study compared the risk of malnutrition in SGA newborns and the risk of overnutrition in LGA newborns using INTERGROWTH21st and customized birth weight references in gestational diabetes. Additionally, to determine the ability of both methods in the identification of neonatal malnutrition and overnutrition, we calculate sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratios.Results 231 pregnant women with GDM were included in the study. The rate of SGA indentified by INTERGROWTH21st was 4.7% vs 10.7% identified by the customized curves. The rate of LGA identified by INTERGROWT21st was 25.6% vs 13.2% identified by the customized method. Newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH21st.(RR 4.24 vs 2.5). LGA newborns according to the customized method also showed a higher risk of overnutrition than those classified as LGA according to INTERGROWTH21st. (RR 5.26 vs 3.57). In addition, the positive predictive value of the customized method was superior to that of INTERGROWTH21st in the identification of malnutrition (32% vs 27.27%), severe malnutrition (22.73% vs 20%), overnutrition (51.61% vs 32.20%) and severe overnutrition (28.57% vs 14.89%).Conclusions In pregnant women with GDM, the ability of customized fetal growth curves to identify the newborns with alterations in nutritional status exceeds that of INTERGROWTH21st.

Association of Bacteria Species with Positive Predictive Value of Bacteria Isolated from Cerebrospinal Fluid Cultures: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Yi Ye ◽  
Guanghui Zheng ◽  
Yueyue Kong ◽  
Jiawei Ma ◽  
Guojun Zhang ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cohort Study ◽  
Positive Predictive Value ◽  
Retrospective Cohort Study ◽  
Predictive Value ◽  
Retrospective Cohort ◽  
Klebsiella Oxytoca ◽  
P Value ◽  
Coagulase Negative Staphylococci ◽  
Predictive Values

Abstract Background: Previous studies discuss the positive predictive value through whether the bacteria are coagulase-negative staphylococci. The view may need to be updated. The aim was to evaluate the positive predictive value of different bacteria species isolated from cerebrospinal fluid cultures and discuss the rationality to view coagulase-negative staphylococci as a group.Methods: This retrospective cohort study recruit all adults with positive cerebrospinal fluid cultures sampled by lumbar puncture 2012-2020 in the Department of Neurosurgery. The exposure was bacteria species, and the outcome was positive predictive value. An episode was defined as a patient with one bacteria. When episodes with a bacteria species reached five, the bacteria species was analyzed specifically. The positive predictive value was defined as the incidence of isolated-bacteria-related infected episodes. The isolated-bacteria-related infected episode was defined as the patient was with clinical features of bacterial meningitis, and the improvement was related to sensitive antibacterial agents. Then the differences of the positive predictive value of different bacteria in all specific bacteria species, coagulase-negative staphylococci, and non-coagulase-negative staphylococci bacteria were calculated, respectively. The results were statistically significant when P-value <.05.Results: 1180 episodes from 1133 patients with 79 bacteria were studied; the positive predictive value was 54.3%. The bacteria included 67 bacteria species, ten bacteria genus, viridans streptococci, and unclassified coagulase-negative staphylococci. Twenty-four specific bacteria species were analyzed. The range of positive predictive values of them was 29.4%-100.0% (P<.0001). The positive predictive value for Enterobacter aerogenes, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca was the highest, while the positive predictive value for Staphylococcus cohnii was the lowest. Moreover, 767 (65.0%) were with coagulase-negative staphylococci, the positive predictive value was 46.4%, and the range was 29.4%-85.7% (P=.0020); 413 (35.0%) were with non-coagulase-negative staphylococci bacteria, the positive predictive value was 69.0%, and the range was 40.0%-100.0% (P<.0001).Conclusions: This study suggests that the positive predictive value of different bacteria species is different. It is more reasonable to discuss the positive predictive value of bacteria isolated from cerebrospinal fluid cultures through the bacteria species rather than whether they are coagulase-negative staphylococci.Trial registration: This is a retrospective study without interventions on participants.

scholarly journals Pre-operative Localisation of the Parathyroid Glands in Secondary Hyperparathyroidism: A Retrospective Cohort Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Takahisa Hiramitsu ◽  
Toshihide Tomosugi ◽  
Manabu Okada ◽  
Kenta Futamura ◽  
Makoto Tsujita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Parathyroid Hormone ◽  
Secondary Hyperparathyroidism ◽  
Retrospective Cohort ◽  
Parathyroid Glands ◽  
Imaging Modalities ◽  
Intact Parathyroid Hormone ◽  
Intact Pth ◽  
Persistent Hyperparathyroidism

Abstract Complete parathyroidectomy (PTx) is essential during total PTx for secondary hyperparathyroidism (SHPT) to prevent recurrent and persistent hyperparathyroidism. Pre-operative imaging evaluations, including computed tomography (CT), ultrasonography (US), and Tc-99m sestamibi (MIBI) scans, are commonly performed. Between June 2009 and January 2016, 291 patients underwent PTx for SHPT after pre-operative evaluations involving CT, US, and MIBI scans, and the diagnostic accuracies of these imaging modalities for identifying the parathyroid glands were evaluated in 177 patients whose intact parathyroid hormone (PTH) levels were <9 pg/mL after the initial PTx. Additional PTx procedures were performed on 7 of 114 patients whose intact PTH levels were >9 ng/mL after PTx, and the diagnostic validities of the imaging modalities for the remnant parathyroid glands were evaluated. A combination of CT, US, and MIBI scans achieved the highest diagnostic accuracy (75%) for locating bilateral upper and lower parathyroid glands before initial PTx. The accuracies of CT, US, and MIBI scans with respect to locating remnant parathyroid glands before additional PTx were 100%, 28.6%, and 100%, respectively. A combination of CT, US, and MIBI scans is useful for initial PTx for SHPT, and CT and MIBI scans are useful imaging modalities for additional PTx procedures.

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