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Kansagra AP, Pham R, Chatterjee AR, Moran CJ. Transient cortical weakness following cerebral angiography: A new syndrome. Radiol Case Rep 2024; 19:2306-2309. [PMID: 38559657 PMCID: PMC10978451 DOI: 10.1016/j.radcr.2024.02.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 04/04/2024] Open
Abstract
Transient cortical blindness is a known complication of iodinated contrast administration and is believed to reflect osmotic injury or autoregulatory dysfunction of the posterior circulation. Here, we report 2 cases of postangiography transient cortical weakness, a rare clinical analog to transient cortical blindness that affects the anterior circulation. The symptoms, timeline, and imaging findings of transient cortical weakness are distinct from more common post-procedural complications such as acute ischemic stroke or transient ischemic attack.
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Affiliation(s)
- Akash P. Kansagra
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Richard Pham
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- University of California Riverside School of Medicine, Riverside, California
| | - Arindam R. Chatterjee
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Christopher J. Moran
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO
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2
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Abazid RM, Pati N, Elrayes M, Chandy M, Hassanin M, Mathew A, De S, Bagur R, Tzemos N. Role of myocardial strain imaging in diagnosing inducible myocardial ischemia with treadmill contrast-enhanced stress echocardiography. BMC Cardiovasc Disord 2024; 24:254. [PMID: 38750460 PMCID: PMC11097493 DOI: 10.1186/s12872-024-03926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION The aim of this study is to analyze the diagnostic value of global longitudinal strain (GLS) in detecting inducible myocardial ischemia in patients with chest pain undergoing treadmill contrast-enhanced stress echocardiography (SE). METHODS We retrospectively enrolled all patients who underwent invasive coronary angiography after treadmill contrast-enhanced SE. Rest and peak-stress myocardial GLS, segmental LS, and LS of 4-chamber (CH), 2-CH, and 3-CH views were reported. Luminal stenosis of more than 70% or fractional flow reserve (FFR) of < 0.8 was considered significant. RESULTS In total 33 patients were included in the final analysis, among whom sixteen patients (48.4%) had significant coronary artery stenosis. Averaged GLS, 3-CH, and 4-CH LS were significantly lower in patients with critical coronary artery stenosis compared to those without significant stenosis (-17.1 ± 7.1 vs. -24.2 ± 7.2, p = 0.041), (-18.2 ± 8.9 vs. -24.6 ± 8.2, p = 0.045) and (-14.8 ± 6.2 vs. -22.8 ± 7.8, p = 0.009), respectively. Receiver operating characteristic (ROC) analysis of ischemic and non-ischemic segments demonstrated that a cut-off value of -20% of stress LS had 71% sensitivity and 60% specificity for ruling out inducible myocardial ischemia (Area under the curve was AUC = 0.72, P < 0.0001). CONCLUSION Myocardial LS measured with treadmill contrast-enhanced stress echocardiography demonstrates potential value in identifying patients with inducible myocardial ischemia.
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Affiliation(s)
- Rami M Abazid
- Northern Ontario Medical School (NOSM) University, Department of Medicine, Sault Area Hospital, Sault Ste. Marie, Canada.
| | - Nilkanth Pati
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, 339 Windermere Road, PO Box 5010, London, ON, N6A 5A5, Canada
| | - Maged Elrayes
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, 339 Windermere Road, PO Box 5010, London, ON, N6A 5A5, Canada
| | - Mark Chandy
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, 339 Windermere Road, PO Box 5010, London, ON, N6A 5A5, Canada
| | - Magdi Hassanin
- Northern Ontario Medical School (NOSM) University, Department of Medicine, Sault Area Hospital, Sault Ste. Marie, Canada
| | - Andrew Mathew
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, 339 Windermere Road, PO Box 5010, London, ON, N6A 5A5, Canada
| | - Sabe De
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, 339 Windermere Road, PO Box 5010, London, ON, N6A 5A5, Canada
| | - Rodrigo Bagur
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, 339 Windermere Road, PO Box 5010, London, ON, N6A 5A5, Canada
| | - Nikolaos Tzemos
- Division of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, 339 Windermere Road, PO Box 5010, London, ON, N6A 5A5, Canada
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Handa A, Bedoya MA, Iwasaka-Neder J, Johnston PR, Lo MS, Bixby SD. Measuring synovial thickness on knee MRI in pediatric patients with arthritis: is contrast necessary? Pediatr Radiol 2024:10.1007/s00247-024-05929-1. [PMID: 38641735 DOI: 10.1007/s00247-024-05929-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The use of contrast-enhanced imaging has long been standard for magnetic resonance imaging (MRI) assessments of synovitis in juvenile idiopathic arthritis (JIA). However, advancements in MRI technology have allowed for reliable identification of synovium without contrast. OBJECTIVE To assess the equivalence of unenhanced MRI with contrast-enhanced MRI in evaluating synovial thickness. MATERIALS AND METHODS This is an institutional review board approved, retrospective study performed in a tertiary children's hospital. Pediatric JIA patients under 21 years old were included who underwent knee MRI scans (1.5 T or 3 T) without and with contrast between January 2012 and January 2022. Two radiologists independently measured synovial thickness at 6 knee sites on contrast-enhanced and unenhanced sequences. Numerical measurements and ordinal scores based on juvenile idiopathic arthritis magnetic resonance imaging scoring (JAMRIS) system were recorded, and tests of equivalence were conducted, as well as between-reader and within-reader reliability by concordance correlation coefficient (CCC). All tests were considered significant at the 5% level. RESULTS A total of 38 studies from 35 patients (25 females, median age 14 years; interquartile range 7 to 15.7) were included. Equivalence was demonstrated at each of the 6 sites for both continuous measurements (P-values < 0.05) and ordinal scores (P-values < 0.05) based on the average over readers. Within-reader reliability was moderate to high (CCC 0.50-0.89), except for the cruciate ligaments site. Averaged over the 6 sites, reliability between readers was low for unenhanced (CCC 0.47, with 95% CI: [0.41, 0.53]) and moderate for contrast-enhanced (CCC 0.64, with 95% CI: [0.59, 0.69]) sequences. CONCLUSION Unenhanced knee MRI is equivalent to contrast-enhanced MRI in assessment of synovial thickness using conventional MRI sequences. Contrast material helped improve inter-reader reliability.
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Affiliation(s)
- Atsuhiko Handa
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
| | - M Alejandra Bedoya
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Jade Iwasaka-Neder
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Patrick R Johnston
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Mindy S Lo
- Department of Immunology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Sarah D Bixby
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
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Tsai LT, Liao KM, Hou CH, Jang Y, Chen CC. Visual field asymmetries in visual word form identification. Vision Res 2024; 220:108413. [PMID: 38613969 DOI: 10.1016/j.visres.2024.108413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/14/2024] [Accepted: 03/30/2024] [Indexed: 04/15/2024]
Abstract
Visual performance across the visual fields interacts with visual tasks and visual stimuli, and visual resolution decreases as a function of eccentricity, varying at isoeccentric locations. In this study, we investigated the extent of asymmetry and the rate of change in visual acuity threshold for visual word form (VWF) identification at horizontal and vertical azimuths across the fovea, and at eccentricities of 1°, 2°, 4°, 6° and 8° for 10%, 20%, 40%, and 80% contrast levels, to determine whether and how the eccentricities, meridians, and contrasts modulated the VWF identification acuity threshold. The stimuli were 16 traditional Chinese characters of similar legibility. Participants pressed a key to indicate the character presented, either monocularly or binocularly, at one of 21 randomly selected locations. A staircase procedure was used to determine the threshold, and a multiple linear regression model was used to fit the linear cortical magnification factor (CMF). We found that (1) the asymmetry was most pronounced on the vertical and superior azimuths, (2) the asymmetry between the right and left azimuths was not significant, (3) the CMF was significantly smaller on the vertical azimuth than on the horizontal azimuth, (4) the CMF was smaller on the superior vertical azimuth than on the inferior azimuth, and (5) monocular viewing and low contrast enhanced the CMF difference between azimuths. In conclusion, vertical and horizontal azimuths, location of eccentricity, contrast levels of word symbols, and monocular/binocular viewing have different effects on visual field asymmetry and cortical magnification factors.
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Affiliation(s)
- Li-Ting Tsai
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 10055, Taiwan; Department of Ophthalmology, Chang Gung Memorial Hospital, and Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Meng Liao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Zhong-Xiao Branch, Taipei City Hospital, Taipei, Taiwan
| | - Chiun-Ho Hou
- Department of Ophthalmology, Chang Gung Memorial Hospital, and Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yuh Jang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 10055, Taiwan
| | - Chien-Chung Chen
- Department of Psychology, National Taiwan University, Taipei 10617, Taiwan.
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Kimura M, Takeda T, Tsujino Y, Matsumoto Y, Yamaji M, Sakaguchi T, Maeda K, Mabuchi H, Murakami T. Assessing the efficacy of saline flush in frequency-domain optical coherence tomography for intracoronary imaging. Heart Vessels 2024; 39:310-318. [PMID: 38062328 PMCID: PMC10920414 DOI: 10.1007/s00380-023-02340-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/08/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND The increased amount of contrast media in frequency-domain optical coherence tomography (FD-OCT) imaging during percutaneous coronary intervention (PCI) has raised potential concerns regarding impairment of renal function. OBJECTIVES This study aimed to evaluate the effectiveness of heparinized saline flush in FD-OCT-guided PCI and identify clinical factors contributing to optimal image quality. METHODS We retrospectively collected 100 lesions from 90 consecutive patients, and a total of 200 pullbacks were analyzed for the initial and final evaluation in which saline was used as the flushing medium. RESULTS The study population had a mean age of 73, with 52% having chronic kidney disease (CKD). The median amount of contrast used was 28 ml, and no complications were observed associated with saline flush OCT. Imaging quality was then categorized as excellent, good, or unacceptable. Among the total runs, 87% demonstrated clinically acceptable image quality, with 66.5% classified as excellent images and 20.5% classified as good images. Independent predictors of excellent images included lumen area stenosis ≥ 70% (adjusted odds ratio [OR] 2.37, 95% confidence interval [CI] 1.02-5.47, P = 0.044), and the use of intensive flushing (adjusted OR 2.06, 95% CI 1.11-3.86, P = 0.023) defined as a deep engagement of guiding catheter (GC) or a selective insertion of guide extension catheter (GE). Intensive flushing was performed in 60% of the total pullbacks, and it was particularly effective in improving image quality in the left coronary artery (LCA). CONCLUSION The use of saline flush during FD-OCT imaging was safe and feasible, which had a benefit in renal protection with adequate imaging quality.
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Affiliation(s)
- Masahiro Kimura
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan.
| | - Teruki Takeda
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Yasushi Tsujino
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Yuichi Matsumoto
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Masayuki Yamaji
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Tomoko Sakaguchi
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Keiko Maeda
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Hiroshi Mabuchi
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
| | - Tomoyuki Murakami
- Department of Cardiovascular Medicine, Koto Memorial Hospital, 2-1, Hiramatsu-Cho, Higashiomi-Shi, Shiga, 527-0134, Japan
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Buffry AD, Currea JP, Franke-Gerth FA, Palavalli-Nettimi R, Bodey AJ, Rau C, Samadi N, Gstöhl SJ, Schlepütz CM, McGregor AP, Sumner-Rooney L, Theobald J, Kittelmann M. Evolution of compound eye morphology underlies differences in vision between closely related Drosophila species. BMC Biol 2024; 22:67. [PMID: 38504308 PMCID: PMC10953123 DOI: 10.1186/s12915-024-01864-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Insects have evolved complex visual systems and display an astonishing range of adaptations for diverse ecological niches. Species of Drosophila melanogaster subgroup exhibit extensive intra- and interspecific differences in compound eye size. These differences provide an excellent opportunity to better understand variation in insect eye structure and the impact on vision. Here we further explored the difference in eye size between D. mauritiana and its sibling species D. simulans. RESULTS We confirmed that D. mauritiana have rapidly evolved larger eyes as a result of more and wider ommatidia than D. simulans since they recently diverged approximately 240,000 years ago. The functional impact of eye size, and specifically ommatidia size, is often only estimated based on the rigid surface morphology of the compound eye. Therefore, we used 3D synchrotron radiation tomography to measure optical parameters in 3D, predict optical capacity, and compare the modelled vision to in vivo optomotor responses. Our optical models predicted higher contrast sensitivity for D. mauritiana, which we verified by presenting sinusoidal gratings to tethered flies in a flight arena. Similarly, we confirmed the higher spatial acuity predicted for Drosophila simulans with smaller ommatidia and found evidence for higher temporal resolution. CONCLUSIONS Our study demonstrates that even subtle differences in ommatidia size between closely related Drosophila species can impact the vision of these insects. Therefore, further comparative studies of intra- and interspecific variation in eye morphology and the consequences for vision among other Drosophila species, other dipterans and other insects are needed to better understand compound eye structure-function and how the diversification of eye size, shape, and function has helped insects to adapt to the vast range of ecological niches.
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Affiliation(s)
- Alexandra D Buffry
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - John P Currea
- Integrative Biology and Physiology, UCLA, Los Angeles, CA, 90095, USA
| | - Franziska A Franke-Gerth
- Molecular Evolution and Systematics of Animals, Institute of Biology, University of Leipzig, Talstrasse 33, 04103, Leipzig, Germany
| | - Ravindra Palavalli-Nettimi
- Institute of the Environment and Department of Biological Sciences, Florida International University, Miami, FL, USA
| | - Andrew J Bodey
- Diamond Light Source Ltd, Harwell Science and Innovation Campus, Didcot, UK
| | - Christoph Rau
- Diamond Light Source Ltd, Harwell Science and Innovation Campus, Didcot, UK
| | - Nazanin Samadi
- Swiss Light Source, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen PSI, Switzerland
| | - Stefan J Gstöhl
- Swiss Light Source, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen PSI, Switzerland
| | - Christian M Schlepütz
- Swiss Light Source, Paul Scherrer Institute, Forschungsstrasse 111, 5232, Villigen PSI, Switzerland
| | - Alistair P McGregor
- Department of Biosciences, Durham University, South Road, Durham, DH1 3LE, UK
| | - Lauren Sumner-Rooney
- Museum Für Naturkunde, Leibniz Institute for Evolution and Biodiversity Research, Berlin, 10115, Germany
| | - Jamie Theobald
- Institute of the Environment and Department of Biological Sciences, Florida International University, Miami, FL, USA
| | - Maike Kittelmann
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK.
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de Freitas JB, de Almeida GLG, de Almeida MB, Dos Santos E Castro D, Gomes VH, de Almeida Balthazar D. Evaluation of the technique of localization of the epidural space with the aid of a peripheral nerve stimulator and epidurographic, comparing two techniques for determining the infused volume, in rabbits (Oryctolagus Cuniculus). Res Vet Sci 2024; 168:105115. [PMID: 38199013 DOI: 10.1016/j.rvsc.2023.105115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/05/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024]
Abstract
Veterinary care for rabbits has been growing, and, consequently, the anesthetic and analgesic management of this species must be improved. The aim of the present study was to evaluate the technique of localization of the epidural space with the aid of a peripheral nerve stimulator and epidurographic, comparing two techniques for determining the infused volume in rabbits (Oryctolagus Cuniculus). In a prospective, randomized blinded study, six healthy New Zealand rabbits, adults, and weighing from 2.2 kg to 3.8 kg received two treatments, at 1 week intervals: 0.33 mL/kg (treatment I) or 0.05 mL per centimeter of the spine (treatment II) of ioexol epidurally. In both treatments, a peripheral nerve stimulator (2 Hz, 0.25 mA and 0.1 milliseconds) was used to determine the location of the epidural space. Latero-lateral and ventro-dorsal radiographs were taken after five (T5) and twenty-five minutes (T25) of iohexol administration. The epidural space was correctly accessed in 92% of attempts. Treatment I received a smaller volume of contrast than treatment II, 1.0 ± 0.2 mL versus 2.1 ± 0.1 mL (mean ± standard deviation), respectively (p = 0.007). At T5, the cranial progression of the contrast varied between L4 and L5 in treatment I, and L5 and T10 in treatment II. At T25, no contrast was observed in any rabbit. In conclusion, peripheral nerve stimulator aided in accessing the lumbosacral epidural space, and the administration of 0.05 mL per centimeter of the spine resulted in greater cranial progression of contrast.
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Affiliation(s)
- Jacqueline Batista de Freitas
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Gustavo Luiz Gouvêa de Almeida
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Marcelo Barbosa de Almeida
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Douglas Dos Santos E Castro
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Viviane Horta Gomes
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil; Department of Veterinary Medicine, Universidade Castelo Branco, UCB, Rio de Janeiro, RJ, Brazil.
| | - Daniel de Almeida Balthazar
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
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Peng YY, Yan J, Li YR, Lu XR, Wang LY, Jia PF, Guo X. Dual-energy CT Portal Venography: Clinical Application Values and Future Opportunities. Curr Med Imaging 2024; 20:CMIR-EPUB-138644. [PMID: 38676517 DOI: 10.2174/0115734056248152231205045231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 04/29/2024]
Abstract
Standard multidetector computed tomography (MDCT) uses a single X-ray tube to emit a mixed energy X-ray beam, which is received by a single detector. The difference is that dual-energy CT (DECT), a new equipment in recent years, employs a single X-ray tube or two X-ray tubes to emit two single-energy X-ray beams, which are received by a single or two detectors. The application of dual-energy technology to portal venography has become one of the research hotspots. This paper will elaborate on the clinical application values of DECT portal venography in improving portal vein image quality, distinguishing the nature of portal vein thrombus, reducing contrast agent dose and radiation dose, and will discuss the possibility of its movement from research to routine practice and future development opportunities.
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Affiliation(s)
- Yu Yang Peng
- Department of Medical Imaging, Changzhi Medical College Affiliated Heping Hospital, Shanxi 046000, PR China
| | - Jing Yan
- Department of Medical Imaging, Changzhi Medical College Affiliated Heping Hospital, Shanxi 046000, PR China
| | - Yu Ru Li
- Department of Medical Imaging, Changzhi Medical College Affiliated Heping Hospital, Shanxi 046000, PR China
| | - Xiao Rui Lu
- Department of Medical Imaging, Changzhi Medical College Affiliated Heping Hospital, Shanxi 046000, PR China
| | - Lu Yao Wang
- Department of Medical Imaging, Changzhi Medical College Affiliated Heping Hospital, Shanxi 046000, PR China
| | - Ping Fan Jia
- Department of Medical Imaging, Changzhi Medical College Affiliated Heping Hospital, Shanxi 046000, PR China
| | - Xing Guo
- Department of Medical Imaging, Changzhi Medical College Affiliated Heping Hospital, Shanxi 046000, PR China
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Maule JJ, Maguire R, Timmis MA, Runswick OR, Wilkins L, Mann DL, Dain SJ, Bosten JM, Allen PM. Difficult at dusk? Illuminating the debate on cricket ball visibility. J Sci Med Sport 2024:S1440-2440(24)00052-5. [PMID: 38423830 DOI: 10.1016/j.jsams.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/20/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Investigate the visibility of new and old red, white and pink cricket balls under lighting and background conditions experienced during a day-night cricket match. DESIGN We modelled the luminance contrast signals available for a typical observer for a ball against backgrounds in a professional cricket ground, at different times of day. METHODS Spectral reflectance (light reflected as a function of wavelength) was derived from laboratory measurements of new and old red, white and pink balls. We also gathered spectral measurements from backgrounds (pitch, grass, sightscreens, crowd, sky) and spectral illuminance during a day-night match (natural afternoon light, through dusk to night under floodlights) from Lord's Cricket Ground (London, UK). The luminance contrast of the ball relative to the background was calculated for each combination of ball, time of day, and background surface. RESULTS Old red and old pink balls may offer little or no contrast against the grass, pitch and crowd. New pink balls can also be of low contrast against the crowd at dusk, as can pink and white balls (of any age) against the sky at dusk. CONCLUSIONS Reports of difficulties with visibility of the pink ball are supported by our data. However, our modelling also shows that difficulties with visibility may also be expected under certain circumstances for red and white balls. The variable conditions in a cricket ground and the changing colour of an ageing ball make maintaining good visibility of the ball a challenge when playing day-night matches.
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Affiliation(s)
| | - Robert Maguire
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, UK
| | - Matthew A Timmis
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, UK
| | - Oliver R Runswick
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Luke Wilkins
- Sport, Performance, and Nutrition (SPAN) Research Group, La Trobe University, Australia
| | - David L Mann
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, the Netherlands
| | - Stephen J Dain
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, UK
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Mariajoseph FP, Chung JX, Lai LT, Moore J, Goldschlager T, Chandra RV, Praeger A, Slater LA. Clinical management of contrast-induced neurotoxicity: a systematic review. Acta Neurol Belg 2024:10.1007/s13760-024-02474-4. [PMID: 38329641 DOI: 10.1007/s13760-024-02474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/04/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Contrast-induced neurotoxicity (CIN) is an increasingly recognised complication following endovascular procedures utilising contrast. It remains poorly understood with heterogenous clinical management strategies. The aim of this review was to identify commonly employed treatments for CIN to enhance clinical decision making. METHODS A systematic search of Embase (1947-2022) and Medline (1946-2022) was conducted. Articles describing (i) patients with a clinical diagnosis of CIN, (ii) with radiological exclusion of other pathologies, (iii) detailed report of treatments, and (iv) discharge outcomes, were included. Data relating to demographics, procedure, symptoms, treatment and outcomes were extracted. RESULTS A total of 73 patients were included, with a median age of 64 years. The most common procedures were cerebral angiography (42.5%) and coronary angiography (42.5%), and the median volume of contrast administered was 150 ml. The most common symptoms were cortical blindness (38.4%) and reduced consciousness (28.8%), and 84.9% of patients experienced complete resolution at the time of discharge. Management included intravenous fluids to dilute contrast in the cerebrovasculature (54.8%), corticosteroids to reduce blood-brain barrier damage (47.9%), antiseizure (16.4%) and sedative (16.4%) medications. Mannitol (13.7%) was also utilised to reduce cerebral oedema. Intensive care admission was required for 19.2% of patients. No statistically significant differences were observed between treatment and discharge outcomes. CONCLUSIONS The clinical management of CIN should be considered on a patient-by-patient basis, but may consist of aggressive fluid therapy alongside corticosteroids, as well as other supportive therapy as required. Further examination of CIN management is required to define best practice.
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Affiliation(s)
- Frederick P Mariajoseph
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia.
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.
| | - Jia Xi Chung
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Leon T Lai
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Justin Moore
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Tony Goldschlager
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Ronil V Chandra
- Monash Imaging, Monash Health, Clayton, Melbourne, Australia
- Department of Radiology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Adrian Praeger
- Department of Neurosurgery, Monash Health, Clayton, VIC, Australia
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
| | - Lee-Anne Slater
- Monash Imaging, Monash Health, Clayton, Melbourne, Australia
- Department of Radiology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia
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11
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Zeljic K, Morgan MJ, Solomon JA. Monocular and binocular mechanisms detect modulations of dot density and dot contrast. Vision Res 2024; 215:108347. [PMID: 38147779 DOI: 10.1016/j.visres.2023.108347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
Strong reciprocity has been demonstrated between (1) spatial modulations of dot density and modulations of dot luminance, and (2) modulations of dot density and modulations of dot contrast, in textures. The latter are much easier to detect when presented in phase with one another than when presented 180° out of phase, although out-of-phase modulations can also be detected given sufficient amplitude. This result supports the existence of two detection mechanisms: one that is excited by both density modulations and contrast modulations (quiescent when those modulations are presented 180° out of phase) and another that is relatively insensitive to either density modulations or contrast modulations (thus remaining stimulated regardless of phase angle). We investigate whether the mechanism responsible for detecting out-of-phase modulations depends on high-level computations (downstream from the confluence of monocular signals) or whether both mechanisms are situated at the monocular level of visual processing. Specifically, density-modulated and/or contrast-modulated stimuli were presented monocularly (i.e., to the same eye) or dichoptically (i.e., to opposite eyes). Out-of-phase modulations of density were much easier to detect when presented dichoptically. A dichoptic advantage was also found for out-of-phase density and contrast modulations. These dichoptic advantages imply conscious access to a mechanism at the monocular level of processing. When density modulations were presented dichoptically, 180° out of phase, detection thresholds were highest. Consequently, a mechanism with binocular input must also contribute to the detection of these modulations. We describe a minimal, image-based model for these results that contains one monocular computation and one binocular computation.
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Affiliation(s)
- Kristina Zeljic
- Centre for Applied Vision Research, City, University of London, London, UK.
| | - Michael J Morgan
- Centre for Applied Vision Research, City, University of London, London, UK
| | - Joshua A Solomon
- Centre for Applied Vision Research, City, University of London, London, UK
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12
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Hashem A, Laymon M, Elgamal M, Hegazy M, Elmeniar AM, Refaie H, Osman Y. Randomized trial to assess the potential role of ascorbic acid and statin for post- contrast acute kidney injury prevention. Int Urol Nephrol 2024; 56:399-405. [PMID: 37742328 PMCID: PMC10808395 DOI: 10.1007/s11255-023-03806-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE To evaluate the effect of using statins and ascorbic acid for the prevention of post-contrast acute kidney injury (PC-AKI) in patients undergoing urologic diagnostic elective contrast-enhanced computed tomography (CECT). METHODS This registered trial (NCT03391830) was for statin naïve patients underwent elective CECT. Patients were randomized allocated to two groups: the first group received atorvastatin 80-mg the day before the study and atorvastatin 40-mg two hours before the CECT and for continue on atorvastatin 40-mg two days after CECT; plus ascorbic acid 500 mg with atorvastatin. The other group received two tablets of placebo once/daily before the procedure and for another 3 days. The primary outcome was to assess the incidence PC-AKI. RESULTS The baseline parameters were comparable between both groups. The final median (interquartile range "IQR") serum creatinine were 0.80 (0.60, 1.00) and 0.80 (0.60, 1.00), respectively, with insignificant p-value (p = 0.8). The median (IQR) final estimated GFR were 95.2 (72.8, 108.1) and 88.6 (71.9, 111.0) mL/min in placebo and statin plus ascorbic acid groups, respectively (p = 0.48). The eGFR difference median (IQR) were - 6.46 (- 11.72, - 4.18) and - 6.57 (- 13.38, - 3.82) ml/min in placebo and statin plus ascorbic acid groups, respectively (p = 0.58). PC-AKI occurred in 11 patients (9.8%) in placebo group and in 3 patients (3%) in statin plus ascorbic acid group (p = 0.04). CONCLUSIONS Statin and ascorbic acid did not statistically improve neither serum creatinine nor eGFR values in patient underwent CECT. However, it can decrease the incidence of the clinically insignificant PC-AKI.
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Affiliation(s)
- Abdelwahab Hashem
- Urology Department, Urology and Nephrology Center, Mansoura, Egypt.
- Urology Department, 30th June Urology and Nephrology Centre, Ismailia, Egypt.
- Urology Department, Shebin Elkom Teaching Hospital, Menofia, Egypt.
- Urology Department, Met-Ghamr Urology and Nephrology Hospital, Dakahlia, Egypt.
- Radiology Department, Urology and Nephrology Center, Mansoura, Egypt.
| | - Mahmoud Laymon
- Urology Department, Urology and Nephrology Center, Mansoura, Egypt
- Radiology Department, Urology and Nephrology Center, Mansoura, Egypt
| | - Mostafa Elgamal
- Urology Department, Urology and Nephrology Center, Mansoura, Egypt
- Radiology Department, Urology and Nephrology Center, Mansoura, Egypt
| | - Mohammed Hegazy
- Urology Department, Urology and Nephrology Center, Mansoura, Egypt
- Radiology Department, Urology and Nephrology Center, Mansoura, Egypt
| | - A M Elmeniar
- Urology Department, Urology and Nephrology Center, Mansoura, Egypt
- Radiology Department, Urology and Nephrology Center, Mansoura, Egypt
| | - Huda Refaie
- Urology Department, Met-Ghamr Urology and Nephrology Hospital, Dakahlia, Egypt
- Radiology Department, Urology and Nephrology Center, Mansoura, Egypt
| | - Yasser Osman
- Urology Department, Urology and Nephrology Center, Mansoura, Egypt
- Radiology Department, Urology and Nephrology Center, Mansoura, Egypt
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13
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Belke TW, Escoffery EXFH. Comparing extinction and contrast effects for operant wheel running and lever pressing on a multiple schedule. Behav Processes 2024; 215:104991. [PMID: 38253111 DOI: 10.1016/j.beproc.2024.104991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/11/2023] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
Extinction and positive contrast effects were assessed on a multiple schedule with lever pressing as the operant in one component and wheel running as the operant in the other component. FR 15 schedules produced 15% sucrose reinforcement in each component. Contrast for both operants was generated by placing responding in the alternate component on extinction. Results showed that extinction decreased and contrast increased both lever-pressing and wheel-running rates. However, the magnitude of the changes was greater for lever pressing. Extinction increased and contrast decreased postreinforcement pause (PRP) duration for lever pressing, but for wheel running, extinction decreased PRP duration while contrast did not change PRP duration. Finally, outcomes for lever pressing decreased with extinction and increased with contrast, but for wheel running, outcomes did not change with extinction and increased with contrast. These differences in contrast and extinction effects were explained by an automatic reinforcement effect generated by wheel-running, but not lever pressing. These findings provide further support for an automatic reinforcement effect generated by wheel running.
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Affiliation(s)
- Terry W Belke
- Mount Allison University, Sackville, New Brunswick, Canada.
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14
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Pepin EW, Unachukwu E, Schultz S, Ananthakrishnan L. Optimization of Iodinated Contrast Media Inventory Management: Effect of Inventory Diversification on Waste Reduction. J Am Coll Radiol 2024; 21:175-181. [PMID: 37543153 DOI: 10.1016/j.jacr.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/09/2023] [Accepted: 06/03/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE Iodinated contrast medium (ICM) is available in single- and multiuse vials of varying sizes, but CT departments often preferentially stock only a single or a limited number of vial sizes. The aims of this study were to assess actual ICM waste at a large safety-net hospital and to compare with estimated waste if single-use vials in a variety of vial sizes or multiuse vials were used. METHODS ICM administrations were retrospectively reviewed for all CT examinations performed in 2021 in a department that stocked only 100-mL ICM vials. Administered ICM dose, opened ICM volume and number of vials, and wasted ICM were compared with hypothetical models using optimally sized single-use vials and multiuse vials. Contrast use was also compared by patient class. RESULTS In total, 40,393 ICM administrations over 49,670 CT examinations among 26,028 patients were reviewed, totaling 4,168,335 mL of contrast media. The mean dose was 103 mL, with mode of 100 mL. Exclusive use of 100-mL vials resulted in 1,006,165 mL waste (mean waste, 26 mL/administration). Optimally sized single-use vials resulted in 436,515 mL waste (mean waste, 11 mL/administration). Multiuse vials resulted in 537,074 mL waste (mean waste, 13 mL/administration). The distribution of optimal single-use vial size differed significantly by patient class (P < .001), with inpatient examinations more amenable to the use of smaller single-use vials. CONCLUSIONS Optimizing ICM inventory can reduce contrast waste by 50% to 59%. Regular monitoring of contrast use may help optimize inventory selection across care settings. This retrospective review supports scrutiny of ICM inventory management to reduce waste, save costs, and mitigate the impacts of supply-chain disruptions.
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Affiliation(s)
- Eric W Pepin
- UT Southwestern Medical Center, Parkland Health, Dallas, Texas; Parkland Health, Dallas, Texas. https://twitter.com/ericwpepin
| | | | | | - Lakshmi Ananthakrishnan
- Medical Director of CT for UT Southwestern and Parkland Health, UT Southwestern Medical Center, Dallas, Texas.
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15
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Kocaoglu M, Pednekar A, Fleck RJ, Dillman JR. Cardiothoracic Magnetic Resonance Angiography. Curr Probl Diagn Radiol 2024; 53:154-165. [PMID: 37891088 DOI: 10.1067/j.cpradiol.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/01/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Catheter-based angiography is regarded as the clinical reference imaging technique for vessel imaging; however, it is invasive and is currently used for intervention or physiologic measurements. Contrast enhanced magnetic resonance angiography (MRA) with gadolinium-based contrast agents can be performed as a three-dimensional (3D) MRA or as a time resolved 3D (4D) MRA without physiologic synchronization, in which case cardiac and respiratory motion may blur the edges of the vessels and cardiac chambers. Ferumoxytol has recently been a popular contrast agent for MRA in patients with chronic renal failure. Noncontrast 3D MRA with ECG gating and respiratory navigation are safe and accurate noninvasive cross-sectional imaging techniques for the visualization of great vessels of the heart and coronary arteries in a variety of cardiovascular disorders including complex congenital heart diseases. Noncontrast flow dependent MRA techniques such as time of flight, phase contrast, and black-blood MRA techniques can be used as complementary or primary techniques. Here we review both conventional and relatively new contrast enhanced and non-contrast enhanced MRA techniques including ferumoxytol enhanced MRA, and bright-blood and water-fat separation based noncontrast 3D MRA techniques.
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Affiliation(s)
- Murat Kocaoglu
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Amol Pednekar
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert J Fleck
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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16
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Shetty YC, Thatte UM, Pal A, Katkar J. Impact of the COVID pandemic on functioning of the institutional ethics committee: A comparison study. Perspect Clin Res 2024; 15:31-37. [PMID: 38282627 PMCID: PMC10810054 DOI: 10.4103/picr.picr_79_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 01/30/2024] Open
Abstract
Purpose and Aim In COVID 19 pandemic, it was essential to document the functioning of the institutional ethics committee (IEC), how the organization adapted and faced challenges posed, thus forming the rationale behind this particular audit. The objectives were to assess the impact of the pandemic on the structure, review process, outcomes, and administration of IEC and to compare the same during its functioning in the prepandemic stage. Subject and Methods The study was conducted as a retrospective audit. After exemption from ethics review, the data were collected from the IEC office situated in KEM Hospital and were segregated into four domains: structure, review process, outcomes, and administration. The data were analyzed using descriptive statistics. Mann-Whitney U-test was used to compare the turnover time for approval of projects between the two study periods at 5% level of significance. SPSS software version 22 was used to analyze the data. Results Constitution changed , more protocols pertaining to COVID 19 studies were reviewed, meetings frequency doubled, and Standard Operating Procedures was amended to incorporate the changes faced during pandemic. Significant decrease in turnover time was noticed with respect to submission to query letter and study completion. There were more protocol deviations. Financial burden and expenditure decreased due to less paperwork and meetings being held online. Conclusion The ethics committee infrastructure and functioning had to undergo a paradigm shift to adapt to the various changes and overcome the various hurdles occurring during the COVID-19 pandemic.
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Affiliation(s)
- Yashashri Chandrakant Shetty
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Urmila Mukund Thatte
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Amitrajit Pal
- Department of Pharmacology and Therapeutics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Janhavi Katkar
- Department of Institutional Ethics Committee, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India
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17
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Dien Esquivel MF, Miller E, Bijelić V, Barrowman N, Putnins R. CT contrast extravasation in children: a single-center experience and systematic review. Pediatr Radiol 2024; 54:34-42. [PMID: 37991500 DOI: 10.1007/s00247-023-05811-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/26/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Extravasation of iodinated contrast material during computed tomography (CT) is a rare complication. A few patients may develop severe complications such as compartment syndrome. OBJECTIVE The purpose of this study was to retrospectively assess the prevalence, severity, management, and outcome of contrast extravasations in our institution and to perform a comparison to what has been reported in the existing literature. MATERIALS AND METHODS This is a research ethics board (REB)-approved retrospective study comprising 11 patients who had intravenous contrast-enhanced CT between 2019 and 2022 in a tertiary pediatric center, and experienced extravasation of iodinated contrast as a complication. Age, weight, sex, co-morbidities, angiocatheter size, venous access location, total contrast volume, flow rate, patient's symptoms, severity of injury, and management were collected. For the systematic review, PRISMA guidelines were followed. RESULTS Only 11 (0.3%) (0.17-0.54 (95%CI)) contrast extravasations occurred in a total of 3638 CTs performed with intravenous contrast during the same period in children. The median age (IQR) was 12.5 (10.0, 15.0) years. In our cohort, 1/11 patients developed compartment syndrome and required fasciotomy. The systematic review assessed 12 articles representing a population of 110 children with extravasations. Pooled prevalence from articles stratified by age was 0.32% (0.06-0.58% (95%CI)). Only three children experienced moderate to severe complications. CONCLUSIONS We confirm that severe complications of contrast extravasation are rare and can occur at any age. No strong associations were seen with the need for surgical consultation (including age, sex, weight, flow rate, injection site, catheter size, and type of contrast).
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Affiliation(s)
- Maria F Dien Esquivel
- Department of Medical Imaging, CHEO, University of Ottawa, Ottawa, ON, Canada.
- Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
| | - Elka Miller
- Department of Medical Imaging, CHEO, University of Ottawa, Ottawa, ON, Canada
- Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Vid Bijelić
- CHEO Research Institute, CHEO, University of Ottawa, Ottawa, ON, Canada
| | - Nick Barrowman
- CHEO Research Institute, CHEO, University of Ottawa, Ottawa, ON, Canada
| | - Rita Putnins
- Department of Medical Imaging, CHEO, University of Ottawa, Ottawa, ON, Canada
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18
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Lee DPH, Ho TW, Wong IMH, Wong ECY, Lee MKY. Novel contrast echocardiographic features of cardiac myxoma with cystic degeneration: a case report. Hong Kong Med J 2023; 29:545-547. [PMID: 38105740 DOI: 10.12809/hkmj2210246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Affiliation(s)
- D P H Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - T W Ho
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - I M H Wong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - E C Y Wong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - M K Y Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China
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19
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Skarabela B, Cuthbert N, Rees A, Rohde H, Rabagliati H. Learning dimensions of meaning: Children's acquisition of but. Cogn Psychol 2023; 147:101597. [PMID: 37827092 DOI: 10.1016/j.cogpsych.2023.101597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/14/2023] [Accepted: 08/26/2023] [Indexed: 10/14/2023]
Abstract
Connectives such as but are critical for building coherent discourse. They also express meanings that do not fit neatly into the standard distinction between semantics and implicated pragmatics. How do children acquire them? Corpus analyses indicate that children use these words in a sophisticated way by the early pre-school years, but a small number of experimental studies also suggest that children do not understand that but has a contrastive meaning until they reach school age. In a series of eight experiments we tested children's understanding of contrastive but compared to the causal connective so, by using a word learning paradigm (e.g., It was a warm day but/so Katy put on a pagle). When the connective so was used, we found that even 2-year-olds inferred a novel word meaning that was associated with the sentence context (a t-shirt). However, for the connective but, children did not infer a non-associated contrastive meaning (a winter coat) until age 7. Before that, even 5-year-old children reliably inferred an associated referent, indicating that they failed to correctly assign but a contrastive meaning. Five control experiments ruled out explanations for this pattern based on basic task demands, sentence processing skills or difficulty making adult-like inferences. A sixth experiment reports one particular context in which five-year-olds do interpret but contrastively. However, that same context also leads children to interpret so contrastively. We conclude that children's sophisticated production of connectives like but and so masks a major difficulty learning their meanings. We suggest that discourse connectives incorporate a class of words whose usage is easy to mimic, but whose meanings are difficult to acquire from everyday conversations, with implications for theories of word learning and discourse processing.
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Affiliation(s)
- Barbora Skarabela
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, United Kingdom.
| | - Nora Cuthbert
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, United Kingdom
| | - Alice Rees
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, United Kingdom
| | - Hannah Rohde
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, United Kingdom
| | - Hugh Rabagliati
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, United Kingdom
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20
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Wernet MF, Roberts NW, Belušič G. Non-celestial polarization vision in arthropods. J Comp Physiol A Neuroethol Sens Neural Behav Physiol 2023; 209:855-857. [PMID: 37874372 DOI: 10.1007/s00359-023-01679-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
Most insects can detect the pattern of polarized light in the sky with the dorsal rim area in their compound eyes and use this visual information to navigate in their environment by means of 'celestial' polarization vision. 'Non-celestial polarization vision', in contrast, refers to the ability of arthropods to analyze polarized light by means of the 'main' retina, excluding the dorsal rim area. The ability of using the main retina for polarization vision has been attracting sporadic, but steady attention during the last decade. This special issue of the Journal of Comparative Physiology A presents recent developments with a collection of seven original research articles, addressing different aspects of non-celestial polarization vision in crustaceans and insects. The contributions cover different sources of linearly polarized light in nature, the underlying retinal and neural mechanisms of object detection using polarization vision and the behavioral responses of arthropods to polarized reflections from water.
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Affiliation(s)
- Mathias F Wernet
- Division of Neurobiology, Institute of Biology, Fachbereich Biologie, Freie Universität Berlin, Chemie and PharmazieKönigin-Luise Strasse 1-3, 14195, Berlin, Germany
| | - Nicholas W Roberts
- Ecology of Vision Group, School of Biological Sciences, University of Bristol, Bristol, BS8 1TQ, UK
| | - Gregor Belušič
- Biotechnical Faculty, Department of Biology, University of Ljubljana, Večna Pot 111, 1000, Ljubljana, Slovenia.
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21
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Lew WH, Coates DR. Impact of monocular vs. binocular contrast and blur on the range of functional stereopsis. Vision Res 2023; 212:108309. [PMID: 37595435 DOI: 10.1016/j.visres.2023.108309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023]
Abstract
Stereopsis depends on the smallest stereo threshold (lower limit) and the upper fusion limit. While studies have shown that the lower limit worsens with reduced contrast and blur, more strongly in monocular than in binocular conditions, the effect on the upper limit remains uncertain. Here, we assess the impact of contrast and blur on the range of the disparity sensitivity function (DSF) in a stereo letter recognition task. Subjects had to identify the stereo letters embedded in a random dot stereogram, and adaptive staircases were used to estimate the two limits. Five subjects performed the experiment at baseline contrast (100%), with different contrast (32% and 10%) and blur (+0.75DS and +1.25DS) in monocular and binocular degradation. We proposed three possible outcomes: 1) the range collapses in both directions 2) the lower limit threshold reduces, but the upper limit is not affected 3) the threshold for both limits increases and the range remains the same. We found that the curve for both limits was lowpass in shape, resulting in a smaller range at higher SFs. The results were similar to the first prediction, where the threshold for the lower limit increased while the upper limit was reduced at lower contrast and higher blur. The shrinkage of DSF is significant in monocular conditions. However, with blur, there was inter-subject variability. A simple cross-correlation stereo-matching algorithm was used to quantify the effect of contrast and blur. The results were consistent with the behavioral result that the range of DSF decreases with image degradation.
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Affiliation(s)
- Wei Hau Lew
- University of Houston College of Optometry, Houston, TX, United States.
| | - Daniel R Coates
- University of Houston College of Optometry, Houston, TX, United States
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22
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Pooler BD, Fleming CJ, Garrett JW, Summers RM, Pickhardt PJ. Artificial intelligence tool detection of intravenous contrast enhancement using spleen attenuation. Abdom Radiol (NY) 2023; 48:3382-3390. [PMID: 37634138 DOI: 10.1007/s00261-023-04020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE To assess the ability of an automated AI tool to detect intravenous contrast material (IVCM) in abdominal CT examinations using spleen attenuation. METHODS A previously validated automated AI tool measuring the attenuation of the spleen was deployed on a sample of 32,994 adult (age ≥ 18) patients (mean age, 61.9 ± 14.7 years; 13,869 men, 19,125 women) undergoing 65,449 supine position CT examinations (41,020 with and 24,429 without IVCM by DICOM header) from January 1, 2000 to December 31, 2021. After exclusions, receiver operating characteristic (ROC) curve analysis was performed to determine the optimal threshold for binary classification of IVCM status (non-contrast vs IVCM enhanced), which was then applied to the sample. Discordant examinations (i.e., IVCM status determined by AI tool did not match DICOM header) were manually reviewed to establish ground truth. Repeat ROC curve and contingency table analysis were performed to assess AI tool performance. RESULTS ROC analysis of the initial study sample of 61,783 CT examinations yielded AUC of 0.970 with Youden index suggesting an optimal spleen attenuation threshold of 65 Hounsfield units (HU). Manual review of 2094 discordant CT examinations revealed discordance due to DICOM header error in 1278 (61.0%) and AI tool misclassification in 410 (19.6%), with 406 (9.4%) meeting exclusion criteria. Analysis of 61,377 CT examinations in the final study sample yielded AUC of 0.999 with accuracy of 99.3% at the 65 HU threshold. Error rate for DICOM header information was 2.1% (1278/61,377) versus 0.7% (410/61,377) for the AI tool. CONCLUSION The automated spleen attenuation AI tool was highly accurate for detection of IVCM at a threshold of 65 HU.
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Affiliation(s)
- B Dustin Pooler
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Cullen J Fleming
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - John W Garrett
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ronald M Summers
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Perry J Pickhardt
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Wahl AD, Saini N, Trinh K, Patel S, Lobner K, Huang J, Deng F. Simulation Training in the Management of Adverse Contrast Reactions: A Systematic Review. J Am Coll Radiol 2023; 20:1110-1120. [PMID: 37517774 DOI: 10.1016/j.jacr.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Simulation-based training has become increasingly prominent within medical education, but its utility within radiology remains underexplored. OBJECTIVE To appraise the evidence for the effectiveness of simulation on the management of adverse reactions to contrast media. METHODS A systematic search of the literature was conducted. Eligible studies recruited radiology residents, provided simulation-based training focused on contrast reaction management, and measured any effectiveness outcome compared with any nonsimulation training or no training. The quality of studies was appraised and outcomes were classified according to Kirkpatrick's hierarchy and the strength of evidence. RESULTS Out of 146 screened results, 15 articles were included that described 17 studies-3 randomized trials and 14 pretest-posttest studies of hands-on or, less commonly, computer-based simulation. In all 16 studies that assessed knowledge before and after intervention, written test scores improved after simulation. Most studies noted improvements in comfort or confidence managing contrast reactions as well. In all three studies that assessed knowledge after simulation and after didactic lecture as a control, posttest scores were not statistically significantly better in the simulation groups than the lecture groups. Common study limitations included single-group designs, measuring only learning outcomes using unvalidated instruments, modest sample sizes, and limited assessment of long-term retention. CONCLUSION Simulation produces subjective improvements and knowledge gain relevant to contrast reaction management. Further research is required to demonstrate superiority of simulation-based contrast reaction management training over traditional didactic lecture-based instruction.
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Affiliation(s)
- Anastacia D Wahl
- Georgetown University School of Medicine, Washington, DC. https://twitter.com/_Anastacia_Wahl
| | - Neginder Saini
- Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Kelly Trinh
- Texas Tech University Health Sciences Center, Lubbock, Texas. https://twitter.com/KellyTrinh114
| | - Sahil Patel
- Northeast Ohio Medical University, Rootstown, Ohio. https://twitter.com/SahilP31
| | - Katie Lobner
- Johns Hopkins University Welch Medical Library, Baltimore, Maryland. https://twitter.com/KatieLobner
| | - Junjian Huang
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama. https://twitter.com/junjian_huang
| | - Francis Deng
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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24
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Kimura R. Flexible information representation to stabilize sensory perception despite minor external input variations. Neurosci Res 2023; 195:1-8. [PMID: 37236268 DOI: 10.1016/j.neures.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/14/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
Sensory information about the environment constantly changes or varies depending on circumstances. However, once we repeatedly experience objects, our brain can perceive and recognize them as identical, even if they are slightly altered or include some diversity. We can stably perceive things without interference from minor external changes or variety. Our recent study focusing on visual perception showed that repeatedly viewing the same oriented grating stimuli enables information representation for low-contrast (or weak-intensity) orientations in the primary visual cortex. We observed low contrast-preferring neurons, whose firing rates increased by reducing the luminance contrast. The number of such neurons increased after the experience, and the neuronal population, including such neurons, can represent even low-contrast orientations. This study indicated that experience leads to flexible information representations that continuously respond to inputs of various strengths at the neuronal population level in the primary sensory cortex. In this perspective article, in addition to the above mechanism, I would discuss alternative mechanisms for perceptual stabilization. The primary sensory cortex represents external information faithfully without alterations, as well as in a state distorted by experience. Both sensory representations may cooperatively and dynamically affect hierarchical downstream, resulting in stable perception.
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Affiliation(s)
- Rie Kimura
- International Research Center for Neurointelligence, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan.
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25
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Entzmann L, Guyader N, Kauffmann L, Peyrin C, Mermillod M. Detection of emotional faces: The role of spatial frequencies and local features. Vision Res 2023; 211:108281. [PMID: 37421829 DOI: 10.1016/j.visres.2023.108281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/18/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
Models of emotion processing suggest that threat-related stimuli such as fearful faces can be detected based on the rapid extraction of low spatial frequencies. However, this remains debated as other models argue that the decoding of facial expressions occurs with a more flexible use of spatial frequencies. The purpose of this study was to clarify the role of spatial frequencies and differences in luminance contrast between spatial frequencies, on the detection of facial emotions. We used a saccadic choice task in which emotional-neutral face pairs were presented and participants were asked to make a saccade toward the neutral or the emotional (happy or fearful) face. Faces were displayed either in low, high, or broad spatial frequencies. Results showed that participants were better to saccade toward the emotional face. They were also better for high or broad than low spatial frequencies, and the accuracy was higher with a happy target. An analysis of the eye and mouth saliency ofour stimuli revealed that the mouth saliency of the target correlates with participants' performance. Overall, this study underlines the importance of local more than global information, and of the saliency of the mouth region in the detection of emotional and neutral faces.
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Affiliation(s)
- Léa Entzmann
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France; Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, 38000 Grenoble, France; Icelandic Vision Lab, School of Health Sciences, University of Iceland, Reykjavík, Iceland.
| | - Nathalie Guyader
- Univ. Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, 38000 Grenoble, France
| | - Louise Kauffmann
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Carole Peyrin
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Martial Mermillod
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
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26
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Mariajoseph FP, Lai LT, Moore J, Chandra RV, Goldschlager T, Praeger A, Slater LA. Current knowledge and perspectives of contrast-induced neurotoxicity: A survey of Australian clinicians. J Clin Neurosci 2023; 116:8-12. [PMID: 37597332 DOI: 10.1016/j.jocn.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Contrast-induced Neurotoxicity (CIN) is an increasingly recognised complication following endovascular procedures. It remains a relatively unexplored clinical entity, and we sought to characterise clinician perspectives towards CIN, as well as identify gaps in knowledge and provide directions for future research. METHODS An online survey was distributed to members of the Australian and New Zealand Society of Neuroradiology, as well as several Australian tertiary hospitals. Questions related to clinical exposure to CIN, diagnosis, management and pathophysiology were explored. Descriptive analysis was conducted on survey responses, and statistical analysis was performed using Chi-square and Fisher's exact test as appropriate. RESULTS A total of 95 survey responses were recorded (26.8% response rate). Only 28.4% of respondents were comfortable in diagnosing CIN, and even fewer (24.2%) were comfortable in independently managing CIN patients. Based on clinician opinion, symptoms including impaired consciousness and cortical blindness were thought to be most associated with CIN, whilst the radiological findings of parenchymal oedema and cortical enhancement were considered to be most indicative of CIN. Most clinicians agreed that further investigation is required related to pathophysiology (86.3%), diagnosis (83.2%), and treatment (82.1%). CONCLUSION CIN is a poorly understood complication following endovascular procedures. Significant gaps in clinical understanding are evident, and further investigation is vital to improve diagnosis and management.
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Affiliation(s)
- Frederick P Mariajoseph
- Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia; Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
| | - Leon T Lai
- Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia; Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Justin Moore
- Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia; Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Ronil V Chandra
- Monash Imaging, Monash Health, Clayton, Melbourne, Australia; Department of Radiology and Radiological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Tony Goldschlager
- Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia; Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Adrian Praeger
- Department of Neurosurgery, Monash Health, Clayton, Victoria, Australia; Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Lee-Anne Slater
- Monash Imaging, Monash Health, Clayton, Melbourne, Australia; Department of Radiology and Radiological Sciences, Monash University, Melbourne, Victoria, Australia
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27
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Kulkarni CS, Kothari JP, Sirsat RA, Almeida AF. A Simplified Risk Score to Estimate the Risk of Contrast-Induced Nephropathy after Contrast Exposure. Indian J Nephrol 2023; 33:333-339. [PMID: 37881743 PMCID: PMC10593291 DOI: 10.4103/ijn.ijn_65_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 11/26/2021] [Accepted: 09/21/2022] [Indexed: 10/27/2023] Open
Abstract
Introduction Scores are available to predict the probability of contrast-induced nephropathy (CIN) after cardiac interventions, but not many scores are available for non-cardiac interventions and there are none for intravenous exposure to contrast. We designed this study to develop a simplified score to determine the probability of developing CIN in patients exposed to the parenteral contrast medium. Methods This was a prospective study of patients who received parenteral contrast. Of 1300 patients, the first 1000 comprised the derivation cohort and the next 300 comprised the validation cohort. The patient variables in the development cohort were studied using univariate analysis. Statistically significant individual variables were used as independent variables, and CIN was used as the dependent variable in the final multivariate logistic regression model. Then, the risk score was obtained and validated. Results The incidence of CIN was 3.8%. The risk factors, namely the presence of diabetes mellitus, e-GFR, and route and volume of contrast material were significantly associated with the risk of CIN (P < 0.05). The developed risk score had a sensitivity of 90.4% and specificity of 98.78%. The overall accuracy was 97.8%. The values of AUC of ROC in the development and validation datasets were high. This indicated that the predicted CIN risk score correlated well with the calibration and discriminative characteristics. Conclusions The route and volume of contrast administered, low e-GFR, and diabetes mellitus were the significant risk factors. The developed risk score exhibited very good sensitivity and specificity and excellent accuracy in predicting the probability of CIN.
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Affiliation(s)
- Chaitanya S. Kulkarni
- Assistant Professor, Department of Nephrology, Gandhi Medical College and HH, Bhopal, Madhya Pradesh, India
| | - Jatin P. Kothari
- Director of Nephrology and Chief Consultant-Renal Transplant Medicine, Nanavati Max Superspeciality Hospital, Mumbai, India
| | - Rashika A. Sirsat
- Consultant Nephrologist and Transplant Physician, Department of Nephrology, P D Hinduja National Hospital and MRC Mahim-Mumbai, India
| | - Alan F. Almeida
- Consultant Nephrologist and Transplant Physician, Department of Nephrology, P D Hinduja National Hospital and MRC Mahim-Mumbai, India
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28
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Arora S, Ali AS, Taneja A, Anand KS. Contrast Induced Sialadenitis with Low Volume Non-ionic Contrast in a Patient with Cerebral Venous Sinus Thrombosis. Indian J Otolaryngol Head Neck Surg 2023; 75:2559-2563. [PMID: 37636809 PMCID: PMC10447748 DOI: 10.1007/s12070-023-03575-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 02/09/2023] [Indexed: 08/29/2023] Open
Abstract
Background: Contrast Induced Sialadenitis or Iodide Mumps refers to non-suppurative inflammation of salivary glands following intravenous iodinated contrast administration. It is a rare adverse effect of iodinated contrast with only a few cases reported worldwide. It is hypothesized to be an idiosyncratic reaction due to toxic accumulation of iodine in salivary glands. Case Report: We report a case of a 40-year-old female patient who underwent CECT brain after intravenous injection of 40ml of non-ionic iodinated contrast and developed symmetric painless swelling in bilateral submandibular triangles within five hours of contrast administration. Ultrasound with color doppler and MR imaging was performed which confirmed the diagnosis of contrast induced sialadenitis. Sialadenitis was managed conservatively and resolved slowly over eight days. Conclusion: Though it is a rare self-limiting adverse event of iodinated contrast, it must be known to the radiologist as well as the clinician to avoid unnecessary work up and manage the patient better. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03575-x.
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Affiliation(s)
- Suryansh Arora
- Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Alfarid Shahid Ali
- Department of Neurology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Anil Taneja
- Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Kuljeet Singh Anand
- Department of Neurology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
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29
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Luo P, Ao W, Xiang D, Wang J, Liu J. Values of serum neutrophil gelatinase-associated lipocalin and cystatin C after percutaneous coronary intervention for early diagnosis of contrast-induced nephropathy. Afr Health Sci 2023; 23:593-598. [PMID: 38357177 PMCID: PMC10862628 DOI: 10.4314/ahs.v23i3.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Objective Serum creatinine (SCr) is not a sensitive and reliable index for the early diagnosis of acute kidney injury caused by contrast-induced nephropathy (CIN). The aim of this study was to explore the values of serum neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (Cys-C) after percutaneous coronary intervention (PCI) for the early diagnosis of CIN. Methods Three hundred patients receiving PCI from January 2018 to December 2020 were assigned to a CIN group (n=25) and a non-CIN group (n=275), respectively. SCr, Cys-C and NGAL levels were measured, and their sensitivities for early CIN diagnosis were evaluated by the area under the receiver operating characteristic curve (AUC) values. Results The NGAL and Cys-C levels of the CIN group began to rise 6 and 12 h after operation, respectively (P<0.05). The CIN group had higher NGAL and Cys-C levels than those of the non-CIN group 12, 24 and 48 h after operation (P<0.05). The AUC values of NGAL, Cys-C and SCr 24 h after operation were 0.885, 0.874 and 0.856, respectively. Conclusion The serum NGAL and Cys-C levels of patients after PCI reflect the early changes of renal function, which are valuable for early CIN diagnosis.
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Affiliation(s)
- Ping Luo
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Wei Ao
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Dikai Xiang
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Jian Wang
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
| | - Jia Liu
- Department of Cardiology, Yueyang People's Hospital, Yueyang 414000, Hunan Province, China
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30
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Chantarojanasiri T, Ratanachu-Ek T, Ohno E, Hirooka Y. Contrast-enhanced endoscopic ultrasound for swollen lymph nodes. J Med Ultrason (2001) 2023:10.1007/s10396-023-01347-2. [PMID: 37542669 DOI: 10.1007/s10396-023-01347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/30/2023] [Indexed: 08/07/2023]
Abstract
Endoscopic ultrasound (EUS) is an important tool for the evaluation of lymphadenopathy, especially in intra-thoracic or intra-abdominal regions. EUS also provides tissue diagnosis via EUS fine-needle aspiration or biopsy. To select the target for biopsy or aspiration, conventional B-mode images are used for the evaluation, but this approach still lacks diagnostic accuracy. Contrast-enhanced EUS has been used to evaluate the vascularity of lesions. Most malignant lymphadenopathy shows heterogenous enhancement or defect of enhancement, while quantitative studies using time-intensity curves in contrast-enhanced harmonic EUS show a rapid decline in enhancement pattern. These findings are useful as an auxiliary method for tissue diagnosis or in cases in which tissue diagnosis is contraindicated.
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Affiliation(s)
- Tanyaporn Chantarojanasiri
- Division of Gastroenterology, Department of Internal Medicine, Rajavithi Hospital, Rangsit University, Bangkok, Thailand.
| | | | - Eizaburo Ohno
- Department of Gastroenterology and Hepatology, Fujita Health University Hospital Cancer Center, Fujita Health University, Aichi, Japan
| | - Yoshiki Hirooka
- Department of Gastroenterology and Hepatology, Fujita Health University Hospital Cancer Center, Fujita Health University, Aichi, Japan
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31
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Bijnens PJ, Van Berkel B. The "cotton ball sign" of the galbladder. Abdom Radiol (NY) 2023; 48:2757-2758. [PMID: 37171587 DOI: 10.1007/s00261-023-03952-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/13/2023]
Affiliation(s)
- Pieter-Jan Bijnens
- Department of Radiology, University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium
| | - Brecht Van Berkel
- Department of Radiology, University Hospitals of Leuven, Herestraat 49, 3000, Louvain, Belgium.
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Sodagari F, Davenport MS, Asch D, Cavallo JJ, Cohan RH, Ellis JH, Pahade JK. A Survey of Practicing Radiologists on the Use of Premedication Before Intravenous Iodinated Contrast Medium Administration. J Am Coll Radiol 2023:S1546-1440(23)00532-X. [PMID: 37516161 DOI: 10.1016/j.jacr.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To determine whether updated guidance by the ACR in 2017 advocating use of intravenous (IV) premedication in emergency department (ED) patients and inpatients with reported iodinated contrast allergy was associated with a change in clinical practice. METHODS An anonymous survey was distributed via e-mail in October 2020 to practicing radiologist members of the ACR interrogating use of corticosteroid premedication for two clinical vignettes: an indicated routine (perform within 24 hours) inpatient contrast-enhanced CT (CE-CT) and an indicated urgent (perform within 6 hours) ED CE-CT. In both scenarios, the patient had a prior moderate hypersensitivity reaction to iodinated contrast media. Clinical management was evaluated. Data were compared to historical controls from 2009. RESULTS The response rate was 11% (724 of 6,616). For the inpatient scenario, 72% (518 of 724) would use corticosteroid premedication with CE-CT, and 28% (200 of 724) would perform noncontrast CT. For the ED scenario, 67% (487 of 724) would use corticosteroid premedication with CE-CT, and 30% (217 of 724) would perform noncontrast CT. Oral premedication (85%, 439 of 518) was preferred for routine inpatients, and rapid IV premedication (89%, 433 of 487) was preferred for urgent ED patients. Of those who provided rapid IV dosing data in the ED, two doses of corticosteroids were used by 53% (216 of 410) and one dose was used by 45% (185 of 410), with academic radiologists more likely than private or hybrid practice radiologists to administer two doses (74% [74 of 100] versus 48% [151 of 312], P < .001, odds ratio, 3.03; 95% confidence interval, 1.84-5.00). Rapid IV premedication was more commonly used in 2020 than in 2009 (60% [433 of 724] versus 29% [20 of 69], P < .001, odds ratio, 3.65; 95% confidence interval, 2.12-6.26). Antihistamine use was common in both inpatient (93%, 480 of 518) and ED settings (92%, 447 of 487). Only 32% (229 of 721) of radiologists practiced in accordance with ACR guidelines, suggesting no need for routine premedication before CE-CT in patients with prior severe hypersensitivity reaction to gadolinium-based contrast media. Nonetheless, most (93%, 670 of 724) said the ACR Manual on Contrast Media was a major determinant of their practice. CONCLUSIONS Use of rapid IV premedication in urgent settings has increased since 2009, following updated ACR guidelines, but there is disagreement over whether one or two corticosteroid doses is required. Despite reported high reliance on ACR guidelines, deviations from those guidelines remain common. In general, when ACR guidelines were not followed, it was in a risk-averse direction.
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Affiliation(s)
- Faezeh Sodagari
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, and Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Chair, ACR RFS Women and Diversity Advisory Group; Past-Past President, RFS of Radiological Society of Connecticut. https://twitter.com/fsodagari
| | - Mathew S Davenport
- Michigan Medicine, Ann Arbor, Michigan; Service Chief and Vice Chair in Department of Radiology at Michigan Medicine, Vice Chair of the Commission on Quality and Safety for ACR, Board of Directors for Society of Advanced Body Imaging. https://twitter.com/MattDavenportMD
| | - Daniella Asch
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Associate Medical Director for Quality & Safety, Yale Radiology; Member, ACR Committee on Drugs and Contrast Media
| | - Joseph J Cavallo
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Medical Director, Emergency Radiology; Assistant Director, Informatics; Member, ACR Committee on Drugs and Contrast Media. https://twitter.com/jcavallo972
| | - Richard H Cohan
- Michigan Medicine, Department of Radiology, University of Michigan Hospital, Ann Arbor, Michigan. https://twitter.com/Rich_Cohan
| | - James H Ellis
- Michigan Medicine, Department of Radiology, University Hospital, Ann Arbor, Michigan; Member, ACR Committee on Drugs and Contrast Media
| | - Jay K Pahade
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Vice Chair of Quality & Safety, Yale Radiology; Member, ACR Committee on Drugs and Contrast Media.
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Lobbes MBI, Neeter LMFH, Raat F, Turk K, Wildberger JE, van Nijnatten TJA, Nelemans PJ. The performance of contrast-enhanced mammography and breast MRI in local preoperative staging of invasive lobular breast cancer. Eur J Radiol 2023; 164:110881. [PMID: 37201248 DOI: 10.1016/j.ejrad.2023.110881] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Breast MRI is considered the best modality for preoperative staging of invasive lobular carcinoma (ILC). However, contrast-enhanced mammography (CEM) shows comparable diagnostic performance to MRI, but evidence of CEM's accuracy in women diagnosed with ILC is scant. We aimed to retrospectively evaluate CEM and MRI accuracy in preoperative staging of ILC. METHODS ILC cases diagnosed between 2013 and 2021 were collected. For both modalities, tumour diameter was extracted from the reports. Bland-Altman plots were used to assess discrepancies between size measurements according to imaging and histopathological findings. CEM and MRI's ability to detect multifocal/contralateral cancer was expressed as sensitivity, specificity, and diagnostic odds ratios (DORs). Pairwise comparison of women undergoing both CEM and MRI was not performed. RESULTS 305 ILC-cases fulfilled preset inclusion criteria. Mean age was 63.7 years. Preoperative staging was performed using MRI or CEM in 266 (87.2%) and 77 (25.2%) cases, respectively. MRI and CEM overestimated tumour size by 1.5 and 2.1 mm, respectively. Sensitivity to detect multifocal disease was higher for MRI than for CEM (86% versus 78%), but specificity was lower for MRI (79% versus 92%). For detection of contralateral breast cancer, sensitivity for MRI was 96% versus 88% for CEM, and specificity was 92% and 99%, respectively. For both indications, DOR was higher for CEM, but differences were non-significant (p = 0.56 and p = 0.78). CONCLUSION CEM and MRI overestimate ILC size with comparable systematic and random errors. MRI's higher sensitivity for detection of multifocal/contralateral cancers is accompanied by lower specificity, but discriminative ability for both modalities was non-significant.
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Affiliation(s)
- Marc B I Lobbes
- Maastricht University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 5800, 6202AZ Maastricht, the Netherlands; Zuyderland Medical Center, Department of Medical Imaging, P.O. Box 5500, 6130MB Sittard-Geleen, the Netherlands; GROW School for Oncology and Reproduction, P.O. Box 616, 6200MD Maastricht, the Netherlands.
| | - Lidewij M F H Neeter
- Maastricht University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 5800, 6202AZ Maastricht, the Netherlands; GROW School for Oncology and Reproduction, P.O. Box 616, 6200MD Maastricht, the Netherlands.
| | - Frank Raat
- Laurentius Hospital, Department of Radiology, P.O. Box 920, 6040AX Roermond, the Netherlands.
| | - Kim Turk
- Zuyderland Medical Center, Department of Medical Imaging, P.O. Box 5500, 6130MB Sittard-Geleen, the Netherlands.
| | - Joachim E Wildberger
- Maastricht University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 5800, 6202AZ Maastricht, the Netherlands; GROW School for Oncology and Reproduction, P.O. Box 616, 6200MD Maastricht, the Netherlands.
| | - Thiemo J A van Nijnatten
- Maastricht University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 5800, 6202AZ Maastricht, the Netherlands; GROW School for Oncology and Reproduction, P.O. Box 616, 6200MD Maastricht, the Netherlands.
| | - Patricia J Nelemans
- Maastricht University, Department of Epidemiology, P.O. Box 616, 6200 MD Maastricht, the Netherlands.
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Lan C, Madani MH, Pawar A, Nardo L, Ghasemiesfe A. Ferumoxytol-enhanced MR venography for diagnosis of venous thoracic outlet syndrome. Radiol Case Rep 2023; 18:2378-2380. [PMID: 37179805 PMCID: PMC10172624 DOI: 10.1016/j.radcr.2023.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 05/15/2023] Open
Abstract
Venous thoracic outlet syndrome commonly results in arm swelling and pain as the subclavian vein is obstructed within the thoracic inlet. We report the use of ferumoxytol-enhanced contrast MRI in the diagnosis of venous thoracic outlet syndrome in a male adolescent. In this patient who presented with right upper extremity thrombosis, ferumoxytol-enhanced MRI of the chest was able to show both chronic subclavian vein thromboses and dynamic occlusion of the subclavian veins with arm abduction consistent with Paget-Schroetter syndrome.
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Affiliation(s)
- Christopher Lan
- School of Medicine, University of California, Davis, 4610 X St, Sacramento, CA 95817, USA
- Corresponding author.
| | - Mohammad H. Madani
- Department of Radiology, University of California, Davis, 4860 Y St, Suite 3100, Sacramento, CA 95817, USA
| | - Anjali Pawar
- Department of Pediatrics, University of California, Davis, 2521 Stockton Blvd, Sacramento, CA 95817, USA
| | - Lorenzo Nardo
- Department of Radiology, University of California, Davis, 4860 Y St, Suite 3100, Sacramento, CA 95817, USA
| | - Ahmadreza Ghasemiesfe
- Department of Radiology, University of California, Davis, 4860 Y St, Suite 3100, Sacramento, CA 95817, USA
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Boswell-Patterson CA, Hétu MF, Pang SC, Herr JE, Zhou J, Jain S, Bambokian A, Johri AM. Novel theranostic approaches to neovascularized atherosclerotic plaques. Atherosclerosis 2023; 374:1-10. [PMID: 37149970 DOI: 10.1016/j.atherosclerosis.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/05/2023] [Accepted: 04/17/2023] [Indexed: 05/09/2023]
Abstract
As the global burden of atherosclerotic cardiovascular disease continues to rise, there is an increased demand for improved imaging techniques for earlier detection of atherosclerotic plaques and new therapeutic targets. Plaque lesions, vulnerable to rupture and thrombosis, are thought to be responsible for the majority of cardiovascular events, and are characterized by a large lipid core, a thin fibrous cap, and neovascularization. In addition to supplying the plaque core with increased inflammatory factors, these pathological neovessels are tortuous and leaky, further increasing the risk of intraplaque hemorrhage. Clinically, plaque neovascularization has been shown to be a significant and independent predictor of adverse cardiovascular outcomes. Microvessels can be detected through contrast-enhanced ultrasound (CEUS) imaging, however, clinical assessment in vivo is generally limited to qualitative measures of plaque neovascularization. There is no validated standard for quantitative assessment of the microvessel networks found in plaques. Advances in our understanding of the pathological mechanisms underlying plaque neovascularization and its significant role in the morbidity and mortality associated with atherosclerosis have made it an attractive area of research in translational medicine. Current areas of research include the development of novel therapeutic and diagnostic agents to target plaque neovascularization stabilization. With recent progress in nanotechnology, nanoparticles have been investigated for their ability to specifically target neovascularization. Contrast microbubbles have been similarly engineered to carry loads of therapeutic agents and can be visualized using CEUS. This review summarizes the pathogenesis, diagnosis, clinical significance of neovascularization, and importantly the emerging areas of theranostic tool development.
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Affiliation(s)
| | - Marie-France Hétu
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Canada
| | - Stephen C Pang
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Julia E Herr
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Canada
| | - Jianhua Zhou
- Department of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China
| | - Shagun Jain
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Canada
| | - Alexander Bambokian
- Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Canada
| | - Amer M Johri
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada; Department of Medicine, Cardiovascular Imaging Network at Queen's (CINQ), Queen's University, Canada.
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Pallenberg R, Fleitmann M, Stroth AM, Gerlach J, Fürschke A, Barkhausen J, Bischof A, Handels H. Random Forest and Gradient Boosted Trees for Patient Individualized Contrast Agent Dose Reduction in CT Angiography. Stud Health Technol Inform 2023; 302:952-956. [PMID: 37203543 DOI: 10.3233/shti230316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This work aims to recognize the patient individual possibility of contrast dose reduction in CT angiography. This system should help to identify whether the dose of contrast agent in CT angiography can be reduced to avoid side effects. In a clinical study, 263 CT angiographies were performed and, in addition, 21 clinical parameters were recorded for each patient before contrast agent administration. The resulting images were labeled according to their contrast quality. It is assumed that the contrast dose could be reduced for CT angiography images with excessive contrast. These data was used to develop a model for predicting excessive contrast based on the clinical parameters using logistic regression, random forest, and gradient boosted trees. In addition, the minimization of clinical parameters required was investigated to reduce the overall effort. Therefore, models were tested with all subsets of clinical parameters and each parameter's importance was examined. In predicting excessive contrast in CT angiography images covering the aortic region, a maximum accuracy of 0.84 was achieved by a random forest with 11 clinical parameters; for the leg-pelvis region data, an accuracy of 0.87 was achieved by a random forest with 7 parameters; and for the entire data set, an accuracy of 0.74 was achieved by gradient boosted trees with 9 parameters.
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Affiliation(s)
- René Pallenberg
- University of Lübeck, Institute of Signal Processing, Germany
- University of Lübeck, Institute of Medical Informatics, Germany
| | - Marja Fleitmann
- German Research Center for Artificial Intelligence, Artificial Intelligence in Medical Imaging, Lübeck, Germany
| | | | - Jan Gerlach
- University Medical Center Lübeck, Department of Radiology and Nuclear Medicine
| | - Alexander Fürschke
- University Medical Center Lübeck, Department of Radiology and Nuclear Medicine
| | - Jörg Barkhausen
- University Medical Center Lübeck, Department of Radiology and Nuclear Medicine
| | - Arpad Bischof
- University Medical Center Lübeck, Department of Radiology and Nuclear Medicine
- IMAGE Information Systems Europe, Rostock, Germany
| | - Heinz Handels
- University of Lübeck, Institute of Medical Informatics, Germany
- German Research Center for Artificial Intelligence, Artificial Intelligence in Medical Imaging, Lübeck, Germany
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Akbarinia A, Morgenstern Y, Gegenfurtner KR. Contrast sensitivity function in deep networks. Neural Netw 2023; 164:228-244. [PMID: 37156217 DOI: 10.1016/j.neunet.2023.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/14/2023] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
The contrast sensitivity function (CSF) is a fundamental signature of the visual system that has been measured extensively in several species. It is defined by the visibility threshold for sinusoidal gratings at all spatial frequencies. Here, we investigated the CSF in deep neural networks using the same 2AFC contrast detection paradigm as in human psychophysics. We examined 240 networks pretrained on several tasks. To obtain their corresponding CSFs, we trained a linear classifier on top of the extracted features from frozen pretrained networks. The linear classifier is exclusively trained on a contrast discrimination task with natural images. It has to find which of the two input images has higher contrast. The network's CSF is measured by detecting which one of two images contains a sinusoidal grating of varying orientation and spatial frequency. Our results demonstrate characteristics of the human CSF are manifested in deep networks both in the luminance channel (a band-limited inverted U-shaped function) and in the chromatic channels (two low-pass functions of similar properties). The exact shape of the networks' CSF appears to be task-dependent. The human CSF is better captured by networks trained on low-level visual tasks such as image-denoising or autoencoding. However, human-like CSF also emerges in mid- and high-level tasks such as edge detection and object recognition. Our analysis shows that human-like CSF appears in all architectures but at different depths of processing, some at early layers, while others in intermediate and final layers. Overall, these results suggest that (i) deep networks model the human CSF faithfully, making them suitable candidates for applications of image quality and compression, (ii) efficient/purposeful processing of the natural world drives the CSF shape, and (iii) visual representation from all levels of visual hierarchy contribute to the tuning curve of the CSF, in turn implying a function which we intuitively think of as modulated by low-level visual features may arise as a consequence of pooling from a larger set of neurons at all levels of the visual system.
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Affiliation(s)
- Arash Akbarinia
- Department of Experimental Psychology, University of Giessen, Germany.
| | - Yaniv Morgenstern
- Department of Experimental Psychology, University of Giessen, Germany; Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
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Brenner E, van Straaten CAG, de Vries AJ, Baas TRD, Bröring KM, Smeets JBJ. How the timing of visual feedback influences goal-directed arm movements: delays and presentation rates. Exp Brain Res 2023; 241:1447-1457. [PMID: 37067561 PMCID: PMC10129945 DOI: 10.1007/s00221-023-06617-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/11/2023] [Indexed: 04/18/2023]
Abstract
Visual feedback normally helps guide movements to their goal. When moving one's hand, such guidance has to deal with a sensorimotor delay of about 100 ms. When moving a cursor, it also has to deal with a delay of tens of milliseconds that arises between the hand moving the mouse and the cursor moving on the screen. Moreover, the cursor is presented at a certain rate, so only positions corresponding with the position of the mouse at certain moments are presented. How does the additional delay and the rate at which cursor positions are updated influence how well the cursor can be guided to the goal? We asked participants to move a cursor to consecutive targets as quickly as they could. They did so for various additional delays and presentation rates. It took longer for the mouse to reach the target when the additional delay was longer. It also took longer when a lower presentation rate was achieved by not presenting the cursor all the time. The fraction of the time during which the cursor was present was more important than the rate at which the cursor's position was updated. We conclude that the way human arm movements are guided benefits from continuous access to recent visual feedback.
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Affiliation(s)
- Eli Brenner
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
| | - Chris A G van Straaten
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - A Julia de Vries
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Tobias R D Baas
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Kirsten M Bröring
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Jeroen B J Smeets
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
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Walker S, Colletta K, Devos H, Gaynes B, Ellison RL, Alsakaji R, Watters K, Todfield A, Chawla J, Kletzel S. A PATIENT'S GUIDE TO VISUAL PERCEPTION CHANGES THAT OCCUR WITH PARKINSON'S DISEASE. Arch Phys Med Rehabil 2023:S0003-9993(23)00188-0. [PMID: 37040864 DOI: 10.1016/j.apmr.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/28/2022] [Indexed: 04/13/2023]
Affiliation(s)
- Sadie Walker
- Edward Hines Jr. VA Hospital, Hines, IL, USA; Shirley Ryan AbilityLab, Chicago, IL, USA.
| | - Kalea Colletta
- Edward Hines Jr. VA Hospital, Hines, IL, USA; Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA
| | - Hannes Devos
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training,University of Kansas Medical Center, Kansas City, KS, USA
| | - Bruce Gaynes
- Edward Hines Jr. VA Hospital, Hines, IL, USA; Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA
| | - Rachael L Ellison
- Edward Hines Jr. VA Hospital, Hines, IL, USA; Illinois Institute of Technology, Chicago, IL, USA
| | | | | | | | - Jasvinder Chawla
- Edward Hines Jr. VA Hospital, Hines, IL, USA; Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA
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Liang Z, Song D, Ge B. Optimizing experimental parameters of integrated differential phase contrast (iDPC) for atomic resolution imaging. Ultramicroscopy 2023; 246:113686. [PMID: 36682324 DOI: 10.1016/j.ultramic.2023.113686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 11/30/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
Integrated differential phase contrast scanning transmission electron microscopy (iDPC-STEM) technique has been well developed for studying atomic structures at sub-Å resolution with the capability of simultaneously imaging heavy and light atoms even at an extremely low electron dose. As a direct phase contrast imaging technique, atomic resolution iDPC-STEM is sensitive to the imaging conditions. Although great achievements have been made both in aspect of theory and experiments, the influence of experimental parameters on the contrast of atomic resolution iDPC-STEM images has not been systematically investigated. Here, we perform the iDPC-STEM simulations on the prototypical example of SrTiO3 with respect to the routine experimental factors, including the defocus, specimen thickness, accelerating voltage, convergence angle, collection angle, sample tilt and electron dose. Through the evaluation of image contrast and atom column intensity, the parameters are discussed to improve the image contrast and the visibility of light elements. Moreover, the dose-dependent simulations demonstrate the advantage of low dose iDPC-STEM imaging over other conventional STEM modes. Our results provide a practical guideline to experimentally obtain accessible atomic resolution iDPC-STEM images.
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Affiliation(s)
- Zhiyao Liang
- Information Materials and Intelligent Sensing Laboratory of Anhui Province, Key Laboratory of Structure and Functional Regulation of Hybrid Materials of Ministry of Education, Institutes of Physical Science and Information Technology, Anhui University, Hefei 230601, China
| | - Dongsheng Song
- Information Materials and Intelligent Sensing Laboratory of Anhui Province, Key Laboratory of Structure and Functional Regulation of Hybrid Materials of Ministry of Education, Institutes of Physical Science and Information Technology, Anhui University, Hefei 230601, China.
| | - Binghui Ge
- Information Materials and Intelligent Sensing Laboratory of Anhui Province, Key Laboratory of Structure and Functional Regulation of Hybrid Materials of Ministry of Education, Institutes of Physical Science and Information Technology, Anhui University, Hefei 230601, China.
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Elder K, Matheson J, Nickson C, Box G, Ellis J, Mou A, Shadbolt C, Park A, Tay J, Rose A, Mann GB. Contrast enhanced mammography in breast cancer surveillance. Breast Cancer Res Treat 2023; 199:221-230. [PMID: 36966271 PMCID: PMC10175447 DOI: 10.1007/s10549-023-06916-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/13/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE Mammography (MG) is the standard imaging in surveillance of women with a personal history of breast cancer or DCIS (PHBC), supplemented with ultrasound. Contrast Enhanced Mammography (CEM) has higher sensitivity than MG and US. We report the performance of CEM compared with MG ± US. METHODS A retrospective study of patients undergoing their first surveillance CEM in an Australian hospital setting between June 2006 and October 2020. Cases where a patient was recalled for assessment were identified, recording radiology, pathology and treatment details. Blinded re-reading of recalled cases was performed to determine the contribution of contrast. Use of surveillance US across the board was assessed for the period. RESULTS 73/1191 (6.1%) patients were recalled. 35 (48%) were true positives (TP), with 26 invasive cancers and 9 cases of DCIS, while 38 (52%) were false positive (FP) with a positive predictive value (PPV) 47.9%. 32/73 were recalled due to MG findings, while 41/73 were only recalled due to Contrast. 14/73 had 'minimal signs' with a lesion identifiable on MG with knowledge of the contrast finding, while 27/73 were visible only with contrast. 41% (17/41) recalled due to contrast were TP. Contrast-only TPs were found with low and high mammographic density (MD). Screening breast US reduced by 55% in the year after CEM was implemented. CONCLUSION Compared to MG, CEM as a single surveillance modality for those with PHBC has higher sensitivity and comparable specificity, identifying additional malignant lesions that are clinically significant. Investigation of interval cancer and subsequent round outcomes is warranted.
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Affiliation(s)
- Kenneth Elder
- The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, 3101, Australia.
| | - Julia Matheson
- The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, 3101, Australia
| | - Carolyn Nickson
- Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Georgia Box
- The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, 3101, Australia
| | - Jennifer Ellis
- The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, 3101, Australia
| | - Arlene Mou
- The Royal Women's Hospital, Flemington Road, Parkville, Melbourne, Australia
| | - Clair Shadbolt
- The Royal Women's Hospital, Flemington Road, Parkville, Melbourne, Australia
| | - Allan Park
- The Royal Women's Hospital, Flemington Road, Parkville, Melbourne, Australia
| | - Jia Tay
- The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, 3101, Australia
| | - Allison Rose
- The Royal Women's Hospital, Flemington Road, Parkville, Melbourne, Australia
| | - Gregory Bruce Mann
- The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, 3101, Australia
- The Royal Women's Hospital, Flemington Road, Parkville, Melbourne, Australia
- Department of Surgery, The University of Melbourne, Parkville, Australia
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Sarhan II, Abdellatif YA, Saad RE, Teama NM. Renoprotective effect of febuxostat on contrast-induced acute kidney injury in chronic kidney disease patients stage 3: randomized controlled trial. BMC Nephrol 2023; 24:65. [PMID: 36949408 PMCID: PMC10035112 DOI: 10.1186/s12882-023-03114-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/09/2023] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Contrast-induced acute kidney injury (CI-AKI) is known to be a complication of using intravascular contrast injection. Unfortunately, it is associated with adverse outcomes such as prolonged length of hospitalization and increased burden of health care costs. So, we aimed to determine the efficacy of febuxostat in the prevention of contrast-induced acute kidney injury among patients with chronic kidney disease Stage 3 performing percutaneous coronary intervention (PCI). METHODS In a randomized controlled trial we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting. Patients were randomly assigned to two arms: Group I (study group): Included 60 patients who received Febuxostat added to the traditional treatment (IV hydration and N-acetylcysteine). The patients received Feburic 80 mg within 6-18 h before and within 6-18 h after the coronary intervention (a time gap of 24 h between two doses). Group II (control group): included 60 patients who received only traditional treatment. RESULTS The incidence of AKI was higher in the control group with a statistically significant difference. We found that Independent Significant risk factors that led to AKI were febuxostate avoidance, DM, high urea level, high creatinine level, CKD stage 3B, high Mehran score and high AKI risk. CONCLUSION We demonstrated that febuxostat has a Reno protective effect and it can help to reduce the incidence CI-AKI in CKD patients stage 3 performing PCI.
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Affiliation(s)
- Iman Ibrahim Sarhan
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo, 11566, Egypt
| | - Yasser A Abdellatif
- Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Nahla Mohamed Teama
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo, 11566, Egypt.
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Bhin J, Kwak HS, Hwang SB, Chung GH. Comparison of imaging findings on three-dimensional black-blood enhanced MR imaging between intracranial atherosclerotic occlusion and thrombotic occlusion. J Stroke Cerebrovasc Dis 2023; 32:106877. [PMID: 36370507 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/20/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The purpose of this study was to compare the imaging findings on three-dimensional (3D) black-blood (BB) contrast-enhanced MR imaging between intracranial atherosclerotic occlusion (IAO) and thrombotic occlusion (TO) of the middle cerebral artery (MCA) territory. MATERIALS AND METHODS From August 2020 to September 2021, we retrospectively reviewed the BB contrast-enhanced MR imaging of patients visiting the emergency room for evaluation of acute ischemic stroke. In total, 77 patients with complete occlusion of the MCA territory on 3D BB contrast-enhanced MR imaging and cerebral angiography were enrolled in this study. We divided the IAO and TO groups according to occlusion causes based on angiography findings. RESULTS Of 77 patients, 44 (57.1%) had an IAO in the M1 and M2 and 33 had a TO. Lesion length contrast enhancement (CE) in patients with a TO was significantly longer than that in patients with an IAO (18.95 mm [IQR: 20.91] vs. 7.1 mm [8.92], p <0.001). Overall, 38 (39.4%) patients showed a disconnection of CE on 3D BB contrast-enhanced MR imaging, and 35 showed CE before and after the stenotic or thrombotic lesion. Symptomatic lesions on diffusion-weighted imaging in the TO group were significantly higher than that of the IAO group (97.0% vs, 70.5%, p = 0.003). CONCLUSION The long segment CE on 3D BB contrast-enhanced MR imaging was related to TO of MCA. CE before and after a stenotic or thrombotic lesion is a common finding on 3D BB contrast-enhanced MR imaging.
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Affiliation(s)
- Jooyeon Bhin
- Medical Student, Jeonbuk National University Medical School, Korea.
| | - Hyo Sung Kwak
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Korea.
| | - Seung Bae Hwang
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Korea.
| | - Gyung Ho Chung
- Department of Radiology and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Korea.
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Park JH, Choi S, Koh DH, Lim DS, Park D, Kim HC, Lee SG, Lee J, Lim JS, Sung Y, Yoon Ko K. A Pilot Establishment of the Job-Exposure Matrix of Lead Using the Standard Process Code of Nationwide Exposure Databases in Korea. Saf Health Work 2022; 13:493-499. [PMID: 36579012 PMCID: PMC9772472 DOI: 10.1016/j.shaw.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 12/31/2022] Open
Abstract
Background The purpose of this study is to construct a job-exposure matrix for lead that accounts for industry and work processes within industries using a nationwide exposure database. Methods We used the work environment measurement data (WEMD) of lead monitored nationwide from 2015 to 2016. Industrial hygienists standardized the work process codes in the database to 37 standard process and extracted key index words for each process. A total of 37 standardized process codes were allocated to each measurement based on an automated key word search based on the degree of agreement between the measurement information and the standard process index. Summary statistics, including the arithmetic mean, geometric mean, and 95th percentile level (X95), was calculated according to industry, process, and industry process. Using statistical parameters of contrast and precision, we compared the similarity of exposure groups by industry, process, and industry process. Results The exposure intensity of lead was estimated for 583 exposure groups combined with 128 industry and 35 process. The X95 value of the "casting" process of the "manufacture of basic precious and non-ferrous metals" industry was 53.29 μg/m3, exceeding the occupational exposure limit of 50 μg/m3. Regardless of the limitation of the minimum number of samples in the exposure group, higher contrast was observed when the exposure groups were by industry process than by industry or process. Conclusion We evaluated the exposure intensities of lead by combination of industry and process. The results will be helpful in determining more accurate information regarding exposure in lead-related epidemiological studies.
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Affiliation(s)
- Ju-Hyun Park
- Department of Statistics, Dongguk University, Seoul, Republic of Korea
| | - Sangjun Choi
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea,Corresponding author. Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
| | - Dong-Hee Koh
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Republic of Korea
| | - Dae Sung Lim
- Hansung Health and Safety Technology Co., Ltd., Daejeon, Republic of Korea
| | - Donguk Park
- Department of Environmental Health, Korea National Open University, Seoul, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University, Incheon, Republic of Korea
| | - Sang-Gil Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Republic of Korea
| | - Jihye Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Republic of Korea
| | - Ji Seon Lim
- Department of Statistics, Dongguk University, Seoul, Republic of Korea
| | - Yeji Sung
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyoung Yoon Ko
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
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45
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O’Driscoll JM, Hawkes W, Beqiri A, Mumith A, Parker A, Upton R, McCourt A, Woodward W, Dockerill C, Sabharwal N, Kardos A, Augustine DX, Balkhausen K, Chandrasekaran B, Firoozan S, Marciniak A, Heitner S, Yadava M, Kaul S, Sarwar R, Sharma R, Woodward G, Leeson P. Left ventricular assessment with artificial intelligence increases the diagnostic accuracy of stress echocardiography. Eur Heart J Open 2022; 2:oeac059. [PMID: 36284642 PMCID: PMC9580364 DOI: 10.1093/ehjopen/oeac059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/26/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
AIMS To evaluate whether left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), automatically calculated by artificial intelligence (AI), increases the diagnostic performance of stress echocardiography (SE) for coronary artery disease (CAD) detection. METHODS AND RESULTS SEs from 512 participants who underwent a clinically indicated SE (with or without contrast) for the evaluation of CAD from seven hospitals in the UK and US were studied. Visual wall motion scoring (WMS) was performed to identify inducible ischaemia. In addition, SE images at rest and stress underwent AI contouring for automated calculation of AI-LVEF and AI-GLS (apical two and four chamber images only) with Ultromics EchoGo Core 1.0. Receiver operator characteristic curves and multivariable risk models were used to assess accuracy for identification of participants subsequently found to have CAD on angiography. Participants with significant CAD were more likely to have abnormal WMS, AI-LVEF, and AI-GLS values at rest and stress (all P < 0.001). The areas under the receiver operating characteristics for WMS index, AI-LVEF, and AI-GLS at peak stress were 0.92, 0.86, and 0.82, respectively, with cut-offs of 1.12, 64%, and -17.2%, respectively. Multivariable analysis demonstrated that addition of peak AI-LVEF or peak AI-GLS to WMS significantly improved model discrimination of CAD [C-statistic (bootstrapping 2.5th, 97.5th percentile)] from 0.78 (0.69-0.87) to 0.83 (0.74-0.91) or 0.84 (0.75-0.92), respectively. CONCLUSION AI calculation of LVEF and GLS by contouring of contrast-enhanced and unenhanced SEs at rest and stress is feasible and independently improves the identification of obstructive CAD beyond conventional WMSI.
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Affiliation(s)
| | | | - Arian Beqiri
- Ultromics Ltd, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Oxford OX4 2SU, UK
| | - Angela Mumith
- Ultromics Ltd, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Oxford OX4 2SU, UK
| | - Andrew Parker
- Ultromics Ltd, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Oxford OX4 2SU, UK
| | - Ross Upton
- Ultromics Ltd, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Oxford OX4 2SU, UK
- Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Annabelle McCourt
- Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - William Woodward
- Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Cameron Dockerill
- Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Nikant Sabharwal
- Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Attila Kardos
- Department of Cardiology, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes MK6 5LD, UK
| | - Daniel X Augustine
- Department of Cardiology, Royal United Hospitals NHS Foundation Trust, Bath BA1 3NG, UK
- Department for Health, University of Bath, Bath BA2 7JU, UK
| | - Katrin Balkhausen
- Department of Cardiology, Royal Berkshire NHS Foundation Trust, Reading RG1 5AN, UK
| | | | - Soroosh Firoozan
- Department of Cardiology, Buckinghamshire Healthcare NHS Trust, High Wycombe HP7 0JD, UK
| | - Anna Marciniak
- Department of Cardiology, St George’s University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - Stephen Heitner
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Mrinal Yadava
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Sanjiv Kaul
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Rizwan Sarwar
- Ultromics Ltd, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Oxford OX4 2SU, UK
- Cardiovascular Clinical Research Facility, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
- Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Experimental Therapeutics, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Rajan Sharma
- Department of Cardiology, St George’s University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London SW17 0QT, UK
| | - Gary Woodward
- Ultromics Ltd, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Oxford OX4 2SU, UK
| | - Paul Leeson
- Corresponding author. Tel: +44 (0)1865 572846, Fax: +44 (0)1865 740449,
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Hull NC, Young PM, Thacker PG. Performing chest computed tomography on pediatric patients on extracorporeal membrane oxygenation (ECMO): a stepwise approach. Pediatr Radiol 2022; 52:1877-1887. [PMID: 35364682 DOI: 10.1007/s00247-022-05336-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/07/2022] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
Chest CT in pediatric patients on extracorporeal membrane oxygenation (ECMO) can be done safely and provide valuable high-quality diagnostic images to help guide patient management. An understanding of the basics of the ECMO circuit, cannula locations, where and how to inject contrast media, and how to time image acquisition is vital for the radiologist. Additionally, understanding the precautions associated with performing these exams is essential to ensure the safety of the child. This article provides a brief review of pediatric ECMO and its challenges and considerations, as well as a stepwise approach to perform and optimize these exams safely.
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Affiliation(s)
- Nathan C Hull
- Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
| | - Phillip M Young
- Department of Radiology, Division of Cardiovascular Radiology, Mayo Clinic, Rochester, MN, USA
| | - Paul G Thacker
- Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
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47
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Opfer EK, Artz NS, Mitchell GS, Chan SS. Pediatric magnetic resonance angiography: to contrast or not to contrast. Pediatr Radiol 2022. [PMID: 35953543 DOI: 10.1007/s00247-022-05467-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/26/2022] [Accepted: 07/21/2022] [Indexed: 10/15/2022]
Abstract
Magnetic resonance (MR) angiography and MR venography imaging with contrast and non-contrast techniques are widely used for pediatric vascular imaging. However, as with any MRI examination, imaging the pediatric population can be challenging because of patient motion, which sometimes requires sedation. There are multiple benefits of non-contrast MR angiographic techniques, including the ability to repeat sequences if motion is present, the decreased need for sedation, and avoidance of potential risks associated with gadolinium administration and radiation exposure. Thus, MR angiography is an attractive alternative to CT or conventional catheter-based angiography in pediatric populations. Contrast-enhanced MR angiographic techniques have the advantage of increased signal to noise. Blood pool imaging allows long imaging times that result in high-spatial-resolution imaging, and thus high-quality diagnostic images. This article outlines the technique details, indications, benefits and downsides of non-contrast-enhanced and contrast-enhanced MR angiographic techniques to assist in protocol decision-making.
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Cheeney SHE, Maloney E, Iyer RS. Safety considerations related to intravenous contrast agents in pediatric imaging. Pediatr Radiol 2022. [PMID: 35941280 DOI: 10.1007/s00247-022-05470-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/25/2022] [Accepted: 07/22/2022] [Indexed: 10/15/2022]
Abstract
Intravenous contrast media are used in MRI, CT and US studies for anatomical evaluation and lesion characterization. Safety is always of paramount importance when administering any contrast media to children, and it is important for radiologists and ordering providers to be knowledgeable of the safety profiles and potential adverse events that can occur. This manuscript reviews the frequency and types of adverse events associated with intravenous contrast agents reported in the pediatric literature. Overall, intravenous contrast agents are very safe to use in children. However, familiarity with how to treat and prevent these uncommon events is crucial in preventing poor outcomes. In addition, an understanding of gadolinium deposition in tissues can help facilitate conversations with concerned physicians and parents. This review provides a concise yet comprehensive reference for radiologists and ordering providers on intravenous contrast safety considerations in the pediatric patient.
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49
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Plummer JP, Chaparro A, Ni R. Effect of target contrast and divided attention on the useful field of view. Vision Res 2022; 197:108050. [PMID: 35405416 PMCID: PMC9968453 DOI: 10.1016/j.visres.2022.108050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
Previous research has shown that there is a cost of dividing attention between the central and peripheral visual fields in a complex environment. However, it is not clear how stimulus factors, such as the contrast of the scene, affect the cost. The current study reports the results of two studies that address this question. In Experiment 1, temporal thresholds of the Useful Field of View (UFOV) tests were measured as a function of contrast and retinal eccentricity. The results showed that central-focused attention thresholds increased (i.e., performance decreased) as contrast decreased. Peripheral and divided attention task performance decreased as eccentricity increased. Surprisingly, peripheral and divided attention task performance were the best for medium rather than high contrast targets. The unexpected poorer performance under the high contrast condition might possibly be explained by the crowding effect. To test this possible explanation, in Experiment 2 the peripheral stimuli were simplified to minimize the potential crowding effect on peripheral target detection. The results showed that the unexpected effect of contrast on the cost of dividing attention could be accounted for by the crowding effect. When combined, the results from the two experiments suggest that the cost of dividing attention between central and peripheral targets is more pronounced for objects at greater eccentricity under lower contrast conditions, consistent with a tunnel effect. The implications of this finding are discussed in the paper.
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Affiliation(s)
| | - Alex Chaparro
- Now at Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University
| | - Rui Ni
- Department of Psychology, Wichita State University, USA.
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50
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Cerón Enríquez AM, Teherán Forero OL, Atencia Niño C, Almanza Benito Revollo R, Ramos Clason EC, Ochoa Díaz MM. Evaluation of clinical and functional sequels of central serous chorioretinopathy. A case series analysis. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:S2173-5794(22)00109-8. [PMID: 35871997 DOI: 10.1016/j.oftale.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate the clinical and functional sequelae of patients with a diagnosis of resolved CSC, through macular OCT, contrast sensitivity test, visual field 10-2 and Farnsworth D-15 color test. METHODS 27 eyes of 26 individuals with CSC resolved by macular OCT were included and evaluated; the patients underwent a contrast sensitivity test with the Optec 6500 equipment, a 10-2 visual field with an Octopus 900 Haag-Streit, and a Farnsworth D-15 color test. RESULTS Sequelae were observed in 20 eyes (74.1%) by macular OCT and in 21 (77.8%) in contrast sensitivity, predominantly type 2 defect. Also 27 (100%) had a visual field 10-2 altered corresponding to reduced foveal sensitivity, 11 eyes (40.7%) corresponded to central and paracentral scotomas. The color test showed alteration in 11 (40.7%) of the total eyes evaluated, finding tritanomaly in 9 of them (81.8%). No significant differences were observed in the studies between observation group vs the treatment group. CONCLUSIONS CSC can leave sequelae in the visual quality of patients despite treatment in the acute phase. Visual acuity before and after treatment in the intervention group had no significant difference.
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Affiliation(s)
- A M Cerón Enríquez
- Universidad del Sinú, Clínica Oftalmológica de Cartagena, Cartagena, Colombia.
| | - O L Teherán Forero
- Departamento de Glaucoma, Clínica Oftalmológica de Cartagena, Cartagena, Colombia
| | - C Atencia Niño
- Departamento de Retina y Vítreo, Clínica Ebenezer, Cartagena, Colombia
| | | | - E C Ramos Clason
- Grupo de investigación GIBACUS, Escuela de Medicina, Universidad del Sinú, Seccional Cartagena, Cartagena, Colombia
| | - M M Ochoa Díaz
- Grupo de investigación GIBACUS, Escuela de Medicina, Universidad del Sinú, Seccional Cartagena, Cartagena, Colombia
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