Brain abscess caused by
Listeria monocytogenes
(LM) is a rare, yet serious condition with high mortality if not recognized and treated timely. We present a series of three cases of LM brain abscesses ...and describe their characteristic radiological appearances which can be considered very typical. LM abscesses frequently present as markedly irregular formations, revealing characteristic worm-like tubular pattern of chaotic curvilinear arrangement. Knowledge of this imaging pattern can be very helpful in early recognition of LM abscesses whose initial differential diagnosis can often be misleading initially.
Introduction Non-contrast computed tomography (CT) and CT angiography are the gold standard in neuroimaging diagnostics in the case of suspected stroke. CT perfusion (CTP) may play an important role ...in the diagnosis of stroke mimics (SM), but currently, it is not a standard part of the stroke diagnostic procedure. The project is a multicentre prospective observational clinical research focused on refining the diagnostics of stroke and stroke mimics (SM) in hospital care. Aim This study aimed to evaluate the degree of specificity and sensitivity of multimodal CT (NCCT, CTA, and CTP) in the diagnosis of SM versus stroke. Methodology In this study, we will include 3,000 patients consecutively admitted to the comprehensive stroke centres with a diagnosis of suspected stroke. On the basis of clinical parameters and the results of multimodal CT and magnetic resonance imaging (MRI), the diagnosis of stroke and SM will be established. To clarify the significance of the use of the multimodal CT scan, the analysis will include a comparison of the blinded results for each imaging scan performed by radiologists and AI technology and a comparison of the initial and final diagnosis of the enrolled patients. Based on our results, we will compare the economic indicators and costs that would be saved by not providing inadequate treatment to patients with SM. Conclusion The expected outcome is to present an optimised diagnostic procedure that results in a faster and more accurate diagnosis, thereby eliminating the risk of inadequate treatment in patients with SM. Clinical trial registration clinicaltrials.gov , NCT06045455.
Abstract Objective To evaluate the prevalence of spoke-wheel pattern and typical symptoms of focal nodular hyperplasia (FNH) by means of dynamic contrast-enhanced ultrasonography (CEUS) in relation ...to lesion size. Methods Twenty-eight patients were included in the trial, in whom, based on the CEUS, we raised suspicion of hypervascularized liver lesion; there were 30 lesions altogether. The final diagnosis of FNH was verified by means of CT, MRI or lesion biopsy. Majority of patients (26) were females, compared to 2 male, with average age of 33.3 years. Average lesion size was 45.6 mm. Besides the ultrasound examination, we used also “blood pool” ultrasound contrast agent of second generation, sulphur hexafluoride (BR1); we evaluated enhancement of the lesion until the late stage—within 5 min from application. Results In lesions larger than 3 cm ( n = 20), stellate vascular enhancement was found in 19 cases (95.0%) early in arterial phase. As for lesions smaller than 3 cm ( n = 10), spoke-wheel pattern was observed only in 3 cases (30%) and lesions smaller than 2 cm practically did not show this phenomenon at all ( n = 1; 17%). Generally, symptom of spoke-wheel pattern was observed in 22 cases, i.e. in 73.3%. In total, central scar was present in 63.3% ( n = 19) of cases. In lesions larger than 3 cm, it was present in 85.0% ( n = 17), in lesions smaller than 3 cm in 20% ( n = 2). Conclusion Contrast-enhanced ultrasonography can be the final diagnostic method for FNH larger than 3 cm which has typical spoke-wheel vessel structure on CEUS. If this phenomenon is not present and the central scar is not visible, specific diagnosis of FNH cannot be based solely on CEUS findings.
Surviving pulmonary embolism (PE) brings a risk of thromboembolic disease chronicity. Chronic thromboembolic pulmonary hypertension (CTEPH) develops as a result of one or multiple pulmonary embolic ...events. It is an incapacitating long-term complication of thromboembolic disease with a negative impact on the patient's quality of life and prognosis. Contemporary pharmacological and especially surgical treatment possibilities offer hope for the patient's full recovery, but an early diagnosis is crucial for success.
In a prospective study cohort of 97 consecutive patients with a proven diagnosis of PE as the first documented thromboembolic event we tried to estimate the incidence of CTEPH during a 2-year follow-up.
Four individuals from our study population developed CTEPH, which represents an incidence of 4.2%.
Chronic thromboembolic pulmonary hypertension in pulmonary embolism survivors is a not uncommon complication deserving the attention of clinicians. Patients at risk of CTEPH can be identified for effective follow-up according to echocardiographic finding of elevated pulmonary artery systolic pressure and NT-proBNP levels at the time of hospital discharge.
Sentimentos de culpa vivenciados na pós-graduação Biernaski Kachenski, Ricardo; da Silva Sousa, Rayane Camila; Zepeda Toro, Pavel Elias ...
REVISTA AMBIENTE CONTÁBIL - Universidade Federal do Rio Grande do Norte - ISSN 2176-9036,
07/2021, Letnik:
13, Številka:
2
Journal Article
Odprti dostop
Objetivo: A pesquisa consiste em verificar o nível de concordância dos estudantes quanto aos sentimentos de culpa vivenciados na pós-graduação stricto sensu.
Metodologia: O estudo é de caráter ...descritivo com abordagem quantitativa. A coleta dos dados foi realizada por meio de survey e o instrumento de coleta de dados foi a Escala Multidimensional da Culpabilidade de Aquino e Medeiros (2009). Para análise dos dados utiliza-se Análise Fatorial Exploratória e o teste Kruskal-Wallis (KW) para verificar as diferenças entre os grupos.
Resultados: Os resultados evidenciaram que há diferenças de distribuição do sentimento Culpa Temporal, Culpa Subjetiva e Culpa Objetiva. A maioria dos respondentes concordou totalmente com os sentimentos de culpa descritos no Fator Culpa Temporal. A pós-graduação stricto sensu tem uma alta demanda de estudos, pesquisas e atividades extras que ocupam boa parte do tempo dos estudantes, assim o aspecto temporal acaba sendo uma de suas principais preocupações, desencadeando o sentimento de culpa.
Contribuições do Estudo: O estudo ajuda a compreender se os estudantes se sentem culpados por diversas situações corriqueiras na vida das pessoas e, futuramente, pode-se analisar se o nível de sentimento de culpa interfere no desempenho acadêmico; se desenvolve atitudes tóxicas no relacionamento interpessoal entre outros fatores comportamentais.
Sentimientos de culpa experimentados en la posgraduación Kachenski, Ricardo Biernaski; Sousa, Rayane Camila da Silva; Toro, Pavel Elias Zepeda ...
REVISTA AMBIENTE CONTÁBIL - Universidade Federal do Rio Grande do Norte - ISSN 2176-9036,
07/2021, Letnik:
13, Številka:
2
Journal Article
Odprti dostop
Objetivo: La investigación consiste en verificar el nivel de concordancia de los estudiantes con respecto a los sentimientos de culpa experimentados en la posgraduación stricto sensu.
Metodología: El ...estudio es de carácter descriptivo con enfoque cuantitativo. La recopilación de datos se realizó mediante una encuesta y el instrumento de recopilación de datos fue la Escala Multidimensional de Culpabilidad de Aquino y Medeiros (2009). Para el análisis de los datos, se utilizó el Análisis Factorial Exploratorio y la prueba de Kruskal-Wallis (KW) para verificar las diferencias entre los grupos.
Resultados: Los resultados mostraron que existen diferencias en la distribución del sentimiento de Culpa Temporal, Culpa Subjetiva y Culpa Objetiva. La mayoría de los encuestados estuvo totalmente de acuerdo con los sentimientos de culpa descritos en el Factor de Culpa Temporal. La posgraduación stricto sensu tiene una gran demanda de estudios, investigación y actividades adicionales que ocupan una gran parte del tiempo de los estudiantes, por lo que el aspecto temporal termina siendo una de sus principales preocupaciones, lo que desencadena el sentimiento de culpa.
Contribuciones del Estudio: El estudio ayuda a comprender si los estudiantes se sienten culpables por diversas situaciones comunes en la vida de las personas y, en el futuro, se podría analizar si el nivel de culpa interfiere con el rendimiento académico; si actitudes tóxicas se desarrollan en las relaciones interpersonales entre otros factores de comportamiento.
The purpose of the study was to evaluate the long-term clinical efficacy of Doppler sonography in revealing failure of transjugular intrahepatic portosystemic shunts (TIPS).
During a 5-year period, ...1192 Doppler examinations were performed in 216 patients with TIPS. No regular follow-up shunt venography was performed. Doppler examinations were retrospectively compared with the results of shunt revisions. Sonograms with negative findings were compared with the patients' clinical status so that the number of false-negative sonographic findings leading to an episode of shunt failure (recurrence of gastrointestinal bleeding or ascites) could be ascertained. Sonographic parameters assessed included diameter, velocity, flow volume, and congestion index of the portal vein; and shunt velocities.
Doppler sonography revealed shunt occlusion in 25 of 26 angiographically proven cases (sensitivity, 96%). The combination of velocity criteria (peak intrashunt velocity > or =250 cm/sec, maximum velocity in the portal third of the shunt < or =50 cm/sec, or maximum portal vein velocity less than or equal to two thirds of the baseline value) revealed shunt stenosis in 103 of 110 cases (sensitivity, 94%). Doppler sonography missed a significant shunt stenosis that led to an episode of gastrointestinal bleeding or ascites recurrence in only seven cases. The congestion index of the portal vein showed significant differences between patent and malfunctioning shunts (p < 0.001).
Doppler sonography is an effective primary imaging method for long-term follow-up of patients with TIPS.
Background
Idiopathic pulmonary fibrosis (IPF) is a clinical form of usual interstitial pneumonia (UIP). Computed chest tomography (CT) has a fundamental role in the multidisciplinary diagnostics. ...However, it has not been verified if and how a subjective opinion of a radiologists or pneumologists can influence the assessment and overall diagnostic summary.
Purpose
To verify the reliability of the scoring system.
Material and Methods
Assessment of conformity of the radiological score of high-resolution CT (HRCT) of lungs in patients with IPF was performed by a group of radiologists and pneumologists. Personal data were blinded and the assessment was performed independently using the Dutka/Vasakova scoring system (modification of the Gay system). The final score of the single assessors was then evaluated by means of the paired Spearman’s correlation and analysis of the principal components.
Results
Two principal components explaining cumulatively a 62% or 73% variability of the assessment of the single assessors were extracted during the analysis. The groups did not differ both in terms of specialty and experience with the assessment of the HRCT findings.
Conclusion
According to our study, scoring of a radiological image using the Dutka/Vasakova system is a reliable method in the hands of experienced radiologists. Significant differences occur during the assessment performed by pneumologists especially during the evaluation of the alveolar changes.
Abstract Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, but due to its unfavorable prognosis, feared complication of thromboembolic disease. We assessed the incidence and ...risk factors for pulmonary hypertension (PH) in a cohort of consecutive patients admitted with pulmonary embolism to the tertiary University Hospital. Methods In our cohort of 120 consecutive patients with proved pulmonary embolism (PE) we studied the course of biochemical and echocardiographic parameters with regard to risk factors predicting pulmonary hypertension at the end of hospitalization. Results Echocardiographic signs of pulmonary hypertension were present at the time of discharge in more than one half (50.8%) of patients admitted with pulmonary embolism. Predictors of persisting pulmonary hypertension were initial pulmonary hypertension, high initial NT-proBNP levels and age. Conclusion Residual pulmonary hypertension at discharge was present in 50.8% cases, at this time there was a strong relationship between PH and elevated NT-proBNP on admission. The patients will be followed-up and possible development of CTPEH will be evaluated at 6, 12 and 24-month period.
PDF
