Predictive Signs Research Articles

Preoperative sonographic prediction of intra-abdominal adhesions using sliding sign at repeat caesarean section at the University of Maiduguri Teaching Hospital, Nigeria: a prospective observational study

ObjectiveTo determine if the presence or absence of sonographic sliding sign preoperatively is a good predictor of the presence and type of intra-abdominal adhesions; and to determine the time taken...

MIoT Based Skin Cancer Detection Using Bregman Recurrent Deep Learning

Mobile clouds are the most common medium for aggregating, storing, and analyzing data from the medical Internet of Things (MIoT). It is employed to monitor a patient’s essential health signs for earlier disease diagnosis and prediction. Among the various disease, skin cancer was the wide variety of cancer, as well as enhances the endurance rate. In recent years, many skin cancer classification systems using machine and deep learning models have been developed for classifying skin tumors, including malignant melanoma (MM) and other skin cancers. However, accurate cancer detection was not performed with minimum time consumption. In order to address these existing problems, a novel Multidimensional Bregman Divergencive Feature Scaling Based Cophenetic Piecewise Regression Recurrent Deep Learning Classification (MBDFS-CPRRDLC) technique is introduced for detecting cancer at an earlier stage. The MBDFS-CPRRDLC performs skin cancer detection using different layers such as input, hidden, and output for feature selection and classification. The patient information is composed of IoT. The patient information was stored in mobile clouds server for performing predictive analytics. The collected data are sent to the recurrent deep learning classifier. In the first hidden layer, the feature selection process is carried out using the Multidimensional Bregman Divergencive Feature Scaling technique to find the significant features for disease identification resulting in decreases time consumption. Followed by, the disease classification is carried out in the second hidden layer using cophenetic correlative piecewise regression for analyzing the testing and training data. This process is repeatedly performed until the error gets minimized. In this way, disease classification is accurately performed with higher accuracy. Experimental evaluation is carried out for factors namely Accuracy, precision, recall, F-measure, as well as cancer detection time, by the amount of patient data. The observed result confirms that the proposed MBDFS-CPRRDLC technique increases accuracy as well as lesser cancer detection time compared to the conventional approaches.

Predictive accuracy of T2-FLAIR mismatch sign for the IDH-mutant, 1p/19q noncodeleted low-grade glioma: An updated systematic review and meta-analysis.

BackgroundThe T2-fluid-attenuated inversion recovery (FLAIR) mismatch sign, has been considered a highly specific imaging biomarker of IDH-mutant, 1p/19q noncodeleted low-grade glioma. This systematic review and meta-analysis aimed to evaluate the diagnostic performance of T2-FLAIR mismatch sign for prediction of a patient with IDH-mutant, 1p/19q noncodeleted low-grade glioma, and identify the causes responsible for the heterogeneity across the included studies.MethodsA systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before November 17, 2020. The pooled sensitivity and specificity values with their 95% confidence intervals were calculated using bivariate random-effects modeling. Meta-regression analyses were also performed to determine factors influencing heterogeneity.ResultsFor all the 10 included cohorts from 8 studies, the pooled sensitivity was 40% (95% confidence interval [CI] 28–53%), and the pooled specificity was 100% (95% CI 95–100%). In the hierarchic summary receiver operating characteristic curve, the difference between the 95% confidence and prediction regions was relatively large, indicating heterogeneity among the studies. Higgins I2 statistics demonstrated considerable heterogeneity in sensitivity (I2 = 83.5%) and considerable heterogeneity in specificity (I2 = 95.83%). Among the potential covariates, it seemed that none of factors was significantly associated with study heterogeneity in the joint model. However, the specificity was increased in studies with all the factors based on the differences in the composition of the detailed tumors.ConclusionsThe T2-FLAIR mismatch sign is near-perfect specific marker of IDH mutation and 1p/19q noncodeletion.

The pentagon fraud theory perspective: understanding of motivation of executives to manipulate with the financial statements of a state-owned enterprise

State-Owned Enterprises (SOEs) in Indonesia are important economic actors in the national economy. However, SOEs have problems with accountability and financial transparency. SOEs problems ultimately lead to high economic costs and reduce efficiency. This study aims to determine the practice of fraudulent financial statements in SOEs. The method used in this research is descriptive. Data was obtained using observation and documentation of the Garuda Indonesia Group company which is a major airline in Indonesia. In addition, data were obtained from the Indonesia Stock Exchange (IDX), which consists of 36 samples. This study analyzes the financial statements from 2010 to 2018 as an independent variable. The dependent variable is measured by the elements of the pentagon fraud theory (pressure, opportunity, rationalization, competence, and arrogance) to detect fraudulent financial statements. Data analysis uses Kernel regression parameters, namely R-squared, predictive sign, and standard error, to detect earnings management in the context of the Garuda Indonesia Group. The results show that all the elements of the pentagon fraud theory affect financial statements. The study results show that the pentagon theory of fraud can be relied upon to detect misreporting in financial statements of SOEs. Furthermore, the study results are expected to be considered by related parties to be better prepared when detecting financial statement fraud using the fraud pentagon theory model.

Glutathione detoxication processes in females suffering from sterility

Thirty females suffering from sterility were examined. Fertility disorders were accompanied by hyperandrogeny. Hormones FSH, LH, testosterone and progesterone in blood were studied. Besides, an activity of enzymes GPO, GTD, GST, G-6-PD in washed erythrocytes and tissue homogenate of ovary was investigated. Findings obtained demonstrate noticeable disorders in glutathione detoxication processes in females with infertility and they are related to hormones level, in particular androgens. An increase of GPO in females with hyperandrogeny showed deepupdates in metabolism processes of steroid hormones in ovary. It manifests beforehand for development of follicle that is predictive sign of unovulation in the beginning of menstrual cycle.

Clinical features of atypical tuberculosis mimicking bacterial pneumonia.

ObjectivesThe aim of this study is to investigate clinical features of atypical pulmonary tuberculosis (aPTB) mimicking bacterial pneumonia, determine imaging features with the highest degree of correlation, and identify predictors for acid-fast bacilli (AFB) positivity.MethodsThe clinical data of 259 patients considered as aPTB were retrospectively analyzed. The correlation of CT patterns was evaluated with Spearman analysis, and the predictors for AFB positivity were assessed with the multivariate analysis.ResultsThe most common symptom of aPTB was cough (84.6%), followed by fever and anorexia (47.1 and 41.7%, respectively). Infiltrated patchy was the most common radiological pattern (84.9%), followed by nodules (3–10 mm), micronodules (<3 mm), and consolidation (79.2, 78.8, and 66.0%, respectively). Nodules (3–10 mm) and micronodules (r = 0.988, p < 0.001), consolidation and air bronchogram (r = 0.590, p < 0.001), and pulmonary atelectasis and consolidation (r = 0.323, p < 0.001) showed high correlation. In the multivariate analysis, hyperpyrexia (OR, 2.29; 95% CI, 1.22–4.29) and bronchiectasis (OR, 2.06; 95% CI, 1.04–4.06) were the predictors of AFB-smear positivity, while bulla (OR, 0.22; 95% CI, 0.05–0.97) was the predictor of AFB-smear negativity.ConclusionThis study demonstrated the clinical and radiological features of aPTB mimicking pneumonia. Several paired radiological findings may guide us to the diagnosis of aPTB. Hyperpyrexia and bronchiectasis may be helpful for predicting AFB positivity, and bulla may be a predictive sign of AFB negativity.

VP45.14: The interest of sliding sign in prediction of intraperitoneal adhesions in parturients with history of Caesarean delivery

VP45.14: The interest of sliding sign in prediction of intraperitoneal adhesions in parturients with history of Caesarean delivery

Relationship of the cardiac biomarkers with COVID-19: A review

This review was designed to find out the effect of biomarkers used as predictive signs for the diagnosis of cardiac injury on COVID-19 patients and the probability of death. The current literature has been reviewed and some results considered. A systematic literary research has been conducted in Google Scholar, Web of Science and Pubmed for research starting from the date the disease appeared In December 2019 until the beginning of April 2020, the references used research phrases containing COVID-19 and its relationship to predictive indicators of cardiac injury. The results of the citations showed 8 researches related to this topic that used cardiac biomarkers that are high sensitive Cardiac troponin (Hs-cTn) and Natriuretic peptides (NP), creatine kinase type MB (CK-MB) and high sensitive C-reactive protein(Hs-CRP) and lactate dehydrogenase(LDH) with COVID-19 patients. This review concluded that there was a significant increase in cardiac biomarkers in those with COVID-19 who had a medical history of cardiac injury who were more likely to die.

Predictive signs of complicated course of essential arterial hypertension in adolescents aged 16–17 years old

Background. The rapid development of complications of essential arterial hypertension (AH) in adolescents 16–17 years old, who expose a psychological overload while studying at a higher school, creates prerequisites for predicting the course of hypertension. Materials and methods. The basic group of the study diagnosed with AH consisted of 84 adolescents, 40 (47.6 %) boys and 44 (52.4 %) girls, who according to the office blood pressure (BP) measurements with an interval of one to two weeks at least 2 times had BP values ≥ 120/80 mm Hg, and were found to have blood pressure load &gt; 95 percentile 25–50 % and more of the day time by ambulatory blood pressure monitoring (ABPM). For comparison of the studied parameters, we used data from the control group, which consisted of 40 adolescents (13 (32.5 %) boys and 27 (67.5 %) girls) with normotension. The results of observations were processed using the medical statistics program Statistica version 6.0. Results. The unfavorable predictors of the development of stable AH revealed an average heart rate at night of more than 62 per mi­nute by Holter monitoring, the average daily pulse pressure on the ABPM was more than 57 mm Hg and the body mass index (BMI) is above 25 kg/m2. The risk factors for left ventricular (LV) remo­deling included the excess increase in the thickness of the posterior wall of the LV of more than 8.0 mm at the time of the diagnosis of hypertension, BMI over 25 kg/m2 and average daily pulse pressure over 57 mm Hg by ABPM. Conclusions. If an unfavorable course of hypertension is predicted, then it is necessary to combine non-pharmacological methods of treatment with drug ones.

Two positioned MRI can visualize and detect the location of peripheral rim instability with snapping knee in the no-shift-type of complete discoid lateral meniscus.

We evaluated the efficacy of two positioned magnetic resonance imaging (MRI) for visualizing the snapping phenomenon and detecting peripheral rim instability (PRI) in no-shift-type complete discoid lateral meniscus (CDLM). The records of 39 patients diagnosed with no-shift-type CDLM under routine MRI who underwent arthroscopic surgery were reviewed. The snapping phenomenon and meniscal shift on two positioned MRI in full extension and deep flexion were evaluated and calculated the agreement between these findings. The positive predictive value (PPV), sensitivity, and specificity of meniscal shift on two positioned MRI for predicting PRI were calculated; PRI was further investigated according to anterior and posterior location. The hypotheses of this study were asfollows: (1) Two positioned MRI can visualize the snapping phenomenon and (2) Meniscal shift on two positioned MRI is an important predictive sign of detecting the instability site in no-shift-type CDLM. The κ values between the snapping phenomenon and meniscal shift on two positioned MRI were 0.84. The snapping and two positioned MRI findings had high PPV (1.0, 0.96), sensitivity (0.82, 0.85), and specificity (1.0, 0.91) for predicting overall PRI. For anterior PRI, the snapping and posterior shift on two positioned MRI had moderate and high PPV (0.78, 0.9), high sensitivity (0.9, 0.9), and specificity (0.8, 0.89). The anterior shift on two positioned MRI findings predicted posterior PRI with high PPV (1.0) and specificity (1.0). Two positioned MRI visualized the snapping phenomenon. Meniscal shift on two positioned MRI was an important predictive sign of overall PRI, anterior PRI, and posterior PRI in no-shift-type CDLM.

A case report of a fingerlike meniscal exostosis.

Introduction and importanceThe menisci are intra-articular fibrocartilagenous structures that optimize the joint function. They have several functions. Meniscal malformations are rare and different in shape. The most common are classified in public and known classifications, but some are very rare like finger like exostosis, so it is useful to highlight these rare malformations, that helps in the development of typing and classification, and may explain some unclear mechanisms of injuries.ProprioceptionWe know that meniscal tears in young people usually result from clear mechanical causes, like twisting or direct trauma, so we always need a cause, but when your patient does not explain a clear movement or mechanical trauma, you will ask and ask to conclude why. Yes, keep in mind that; it may be caused by a very rare congenital malformation.Case presentationA 20 years old male patient presented with a history of left knee pain for 6 months. MRI revealed a horizontal tear with abnormal thickness in the posterior horn of the lateral meniscus. The primary arthroscopic examination discovered a horizontal tear in the PHLM with atypical downward directed fingerlike exostosis. By using an arthroscopic hock, grasper and scissors, the exostosis was removed, and the nearby tear was smoothed with the shaver.Clinical discussionDiagnosis of finger like exostosis is challenging and needs strong clinical suspicion because most of the time, it is not predictable and MRI signs may lead to unclear differential diagnosis. The presence of exostosis give a causative explanation of PHLM horizontal tear especially in absence of clear twisting or direct trauma. It may increase the forward directed pull forces of the nearest part of the meniscus during normal gait and gym exercises.ConclusionFingerlike exostosis and other meniscal malformations should be in mind as rare cases. They may explain the presence of tears in young patients with no clear trauma.

Correction to: Triage of 5 Noncontrast Computed Tomography Markers and Spot Sign for Outcome Prediction After Intracerebral Hemorrhage.

Correction to: Triage of 5 Noncontrast Computed Tomography Markers and Spot Sign for Outcome Prediction After Intracerebral Hemorrhage.

Calcification sign for prediction of benignity in pulmonary nodules: A meta-analysis.

The calcification sign assessed by computed tomography appears to be a potential marker for benignities among patients diagnosed with pulmonary nodules (PNs). The following meta-analysis has been purposefully designed to figure-out the diagnostic value of the calcification signature as a way of identifying benignities from PNs. Cochrane Library, Embase and PubMed were considered as a reference to obtain the required data from January 2000 until October 2020. Stata v12.0 was used as a standard tool for statistical assessment. Eleven retrospective studies were assessed via this meta-analysis, which included 6136 PNs (1827 benign and 4309 malignant). The pooled diagnostic odd ratios, positive likelihood ratio (PLR), negative likelihood ratio (NLR), sensitivity and specificity were 6.79, 6.06, 0.89, 13% and 98%, respectively. The value obtained for the area under the curve was 0.65, showing moderate overall diagnostic accuracy. A significant heterogeneity was found while calculating the pooled sensitivity (I2 =85.5%), specificity (I2 =75.0%), PLR (I2 =59.0%), NLR (I2 =79.5%) and DOR (I2 =100.0%) in the current analysis. Sub-group analyses presented better PLR and specificity values for the study with a sample size ≥ 400. Deeks' funnel plot asymmetry test detected no potential evidence of significant publication bias (p=0.091). Calcification signs have been identified as moderate regulators corresponding to overall diagnostic performance (via marking a distinct differentiation between malignant and benign) for PNs. However, the manifestation of the calcification sign had a good directive property for benign PNs.

Disease Prediction using Voice Analysis

Researchers enlist Machine learning a viable solution to find vocal patterns. Our believe is voice can relay key information about personnel health and, our research proposes working towards medical diagnosis and disease risk through voice analysis. In next few years, to the advent of technology in medical science, we positively believe health conditions will be diagnosed using smartphones and another wearable technology. This paper aims to propose viable techniques to researchers that will work by recording short speech samples and analyzing for underlying diseases. For psychiatric disorders particularly, there are no blood samples and patients are often embarrassed to talk about facing mental health issues therefore, voice analysis can also be used over here to identify peculiar traits. Different countries are collecting voice analysis samples to test their tone pitch, rhythm, rate, and volume for sign of prediction like PTSD and other brain injuries and depression. Using Machine learning algorithms will help identify vocal patterns of personnel suffering diseases or any other conditions by comparing data with healthy individuals’ voice samples.

New ultrasound signs for prediction of early placental Insufficiency

Background: Chronic placental insufficiency is a common condition that affects fetal growth and wellbeing. The response of the fetus to such stress depends on time and degree of placental affection. The acute placental insufficiency rapidly affects the fetal movements, amount of liquor and might lead to fetal demise while the chronic placental insufficiency is more deciduous and affects fetal weight and develops fetal growth restriction more slowly. The prophylaxis against the development of chronic placental insufficiency is more effective to protect growth and avoid perinatal morbidities and moralities.Aim: Evaluation of 2 new ultrasound signs (tent like placenta and turbid liquor) to predict early placental insufficiencyMaterials and Methods: One hundred pregnant women with gestational age between 16 weeks till 28 weeks were included in the study. This cohort of women with singleton pregnancy was evaluated by detailed ultrasound scanning to document gestational age, amniotic fluid index, cerebroplacental ratio (CPR), exclusion of congenital anomalies and other routine ultrasound scanning items. This cohort was divided into two groups, group one was the group with placental tenting and/or turbid liquor while group two was the group with no evidence of placental tenting or turbid liquor.Results: Documentation of all relevant demographic data was done. The follow up was done every two weeks in all cases unless patients complained of decreased or absent fetal movement, passage of liquor, passage of blood. Spontaneous labour was allowed in primigravidae and elective cesarean section in Cases with previous c-section at completed 38 weeks of gestation was done unless one or more of the following signs had appeared that indicated the need for emergency delivery which were : abnormal low CPR less than 0.76, severe oligohydramnios, biophysical profile equal to or less than 4/8, abnormal cardiotocogram and fetal distress. The duration from the beginning of the study and documentation of the new studied signs in the placenta and turbid liquor till the development of placental insufficiency was calculated in weeks. All complications or adverse events were documented in both groups.Conclusions: Both new signs were associated with increased risk for development of chronic placental insufficiency and can be used as predictors for evaluation of all pregnant women in the second trimester.

Effects of paclitaxel in mitochondrial function and cellular phenotype in human peripheral blood mononuclear cells and monocytes

Chemotherapy-induced neuropathy (CIPN) is a common complication of paclitaxel. CIPN affects the quality of life of cancer survivors and frequently leads to discontinuation of treatment. Paclitaxel affects neuronal microtubules and induces neuronal mitochondrial dysfunction. However, there is limited clinical information regarding paclitaxel's effects on monocytes. Preclinical studies suggest that paclitaxel-induced neuronal damage is driven by monocytes/macrophages. Therefore, we evaluated whether paclitaxel selectively induces mitochondrial dysfunction and a pro-inflammatory phenotype in human circulating monocytes. We conducted studies in human primary peripheral blood mononuclear cells (PBMCs) from cancer patients being treated with paclitaxel, and in vitro analysis in PBMC cells and monocytes, and THP-1 monocytes in the presence of paclitaxel (0.1, 1, 10 uM). We used flow cytometric markers to study mitochondrial reactive oxygen species (ROS) and mitochondrial membrane potential, namely MitoSox and DIOC6(3) respectively. We also measured mRNA levels of pro- and anti-inflammatory molecules using qRT-PCR. In vitro paclitaxel induced a depolarization state in mitochondria in THP-1, human primary monocytes, and primary human PBMCs, but it did not change MitoSox. Monocytes in PBMCs cells from patients treated with paclitaxel showed significative depolarization state in mitochondria when compared to cells from control patients. In THP-1 cells, paclitaxel enhanced mRNA levels of the pro-inflammatory cytokines IL-8 and TNF alpha. In human primary PBMCs, paclitaxel reduced the anti-inflammatory factors CD163 and IL-10, and enhanced the TNF alpha, COX-2 and MCP-1 mRNA levels. Our study provides evidence that paclitaxel can induce mitochondrial dysfunction in isolated human monocytes and in monocytes present in total PBMCs cells. The observed depolarizing changes are indicative of a pro-mitophagy state, which is in accordance with the paclitaxel-induced pro-inflammatory phenotype in these cells. Early detection of mitochondria dysfunction in human monocytes could be a predictable sign to CIPN development in cancer patients. Our research was supported by the Early-Career Investigator Award W81XWH-16-1-0438 of the Department of Defense, The Pershing Square Sohn Cancer Research Alliance, Weill Cornell Medicine Funds, Department of Anesthesiology-Wake Forest School of Medicine Funds, Comprehensive Cancer Center-Wake Forest School of Medicine Funds, NIDA R21CA248106, National Center for Advancing Translational Sciences (NCATS)-NIH through Grant Award Number UL1TR001420. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Segmental Bowel Hypoenhancement on CT Predicts Ischemic Mesenteric Laceration After Blunt Trauma.

OBJECTIVE. The objectives of this study were to examine the performance of CT in the diagnosis of ischemic mesenteric laceration after blunt trauma and to assess the predictive value of various CT signs for this injury. MATERIALS AND METHODS. In this retrospective study, consecutive patients with bowel and mesenteric injury diagnosed by CT or surgery from January 2011 through December 2016 were analyzed. Two radiologists evaluated CT images for nine signs of bowel injury. The outcome evaluated was ischemic mesenteric laceration. Univariable analysis followed by logistic regression was performed. RESULTS. The study included 147 patients (96 men and 51 women; median age, 35 years; age range, 23-52 years). Thirty-three patients had surgically confirmed ischemic mesenteric lacerations. CT signs that correlated with ischemic mesenteric laceration were abdominal wall injury, mesenteric contusion, free fluid, segmental bowel hypoenhancement, and bowel hyperenhancement adjacent to a hypoenhancing segment. The regression model developed after inclusion of clinical variables identified two predictors: segmental bowel hypoenhancement (adjusted odds ratio, 22.9 [95% CI, 7.9-66.2; p < .001] for reviewer 1 and 20.7 [95% CI, 7.2-59.0; p < .001] for reviewer 2) and abdominal wall injury (adjusted odds ratio, 5.26 [95% CI, 1.7-15.9; p = .003] for reviewer 1 and 5.3 [95% CI, 1.9-15.0; p = .002] for reviewer 2), which yielded an AUC of 0.87 for predicting injury. For reviewer 1 and reviewer 2, the sensitivities of CT in detecting the injury were 72.3% (95% CI, 54.5-86.7%) and 78.8% (95% CI, 61.0-91.0%), respectively, whereas the specificities were 94.7% (95% CI, 88.9-98.0%), and 92.1% (95% CI, 85.5-96.3%), respectively. CONCLUSION. CT has limited sensitivity but good specificity for detecting ischemic mesenteric laceration, with segmental bowel hypoenhancement considered the most predictive imaging sign.

How to reduce the number of children awaiting the diagnosis of intellectual disability in Brazil?

IntroductionIn Brazil there is high number of children with Intellectual Disability (ID) who begin basic education but did not receive a diagnosis. The basic education teachers can be important agents in identifying signs of ID in the student so that they can be referred to health services.ObjectivesTo develop and implement a decision-making model for basic education teachers to identify students with predictive signs of ID.MethodsThe sample was composed by 51 teachers from 20 public schools and their 1758 students eligible for the study enrolled in a educational network in São Paulo state, Brazil. A standardized model was developed for the evaluation process using an open-source software named BONITA. For the screening of students with ID signs the teachers answered a checklist based on the diagnostic criteria of the DSM-5 and the students were evaluated with neuropsychological test WASI (Wechsler Abbreviated Scale of Intelligence) and neuropsychiatric assessment. A Classification Based on Association Rules (CBA) generated the predictive models of sensitivity for confirming ID from the items in the checklists.Results35 children had suspected ID. The CBA showed an accuracy of 82%, identifying only 1 false-negative case and 3 false-positive cases for ID. According to the teachers, the most accurate signs were deficits in abstract thinking skills, deficits in communication and conversation and difficulties in emotional regulation in social interactions.ConclusionsThe decision-making model by elementary school teachers to identify students with ID showed high levels of sensitivity and can help the waiting for diagnosis.DisclosureNo significant relationships.

Added value of hyperdense lumen sign in prediction of acute central and peripheral pulmonary embolism on non-contrast CT chest

BackgroundPulmonary embolism (PE) is a common condition with considerable morbidity and mortality; it is more often diagnosed post-mortem by pathologists than in vivo by clinicians. Prompt and accurate diagnosis is difficult because PE may be clinically silent, the symptoms are vague and nonspecific, and in addition, there is no definitive, non-invasive diagnostic test to establish its diagnosis. The aim of this study is to assess the reliability of detection of acute central and peripheral pulmonary embolism (PE) on non-contrast CT especially when no possible alternative is available as in allergic cases or emergency, patients with history of renal disease, or in cases where PE is not the leading diagnosis. CT pulmonary angiography study served as our gold standard.ResultsEighty adult patients were included in our study; 44 were females and 36 males most of which were complaining of dyspnea and chest pain. Acute central pulmonary embolism was confirmed by CTPA. They all underwent a pre-contrast study just prior to the CTPA. Presence of high attenuation emboli in any of the main pulmonary vessels was our key for diagnosis of acute embolism. Non-contrast CT chest diagnosed 26 of the 47 cases confirmed by CTPA. The hyperdense lumen sign had an overall sensitivity of 55.3%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value of 61.1%. The accuracy of non-contrast CT chest study was evaluated using CTPA as our gold standard.ConclusionNon-contrast CT chest is a good indicator in predicting central and peripheral pulmonary embolism, particularly in cases of emergency, those unable to take intravenous contrast for angiography, or in cases where pulmonary embolism is not the leading diagnosis.

Aqueous humor inflammatory cytokine levels and choroidal thickness in patients with macular edema associated with branch retinal vein occlusion.

We aimed to investigate the association between subfoveal choroidal thickness (SCT) and the level of aqueous humor (AH) inflammatory cytokines in patients with macular edema (ME) associated with branch retinal vein occlusion (BRVO). Twenty-eight eyes of 28 BRVO ME patients who underwent intravitreal injection treatment (ranibizumab, bevacizumab, or dexamethasone implant) were prospectively recruited. The concentrations of vascular endothelial growth factor (VEGF)-A and inflammatory cytokines were measured from AH samples. We analyzed clinical factors associated with visual gain or the degree of central macular thickness (CMT) decrease and the association between SCT and inflammatory cytokine levels. On multiple linear regression analysis, the AH interleukin (IL)-8 level was significantly associated with visual gain and CMT reduction at 6months. Age, systemic hypertension, and AH monocyte chemo-attractant protein 1 level showed a significant association with baseline SCT, and VEGF-A showed a significant association with baseline SCT ratio (BRVO eye SCT/fellow eye SCT). Those with thick SCT showed a higher level of AH soluble VEGF receptors 2 and IL-8 and showed better visual gain and greater CMT reduction at 2 and 6months compared to the thin SCT group. The level of AH inflammatory cytokines was significantly associated with the ischemic status of the retina, treatment outcomes, and SCT in BRVO ME patients. Thick baseline SCT might be a predictive sign for better treatment outcomes in BRVO ME patients which are thought to be related to a higher level of intraocular inflammatory cytokines in these patients.