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  • Medicine  (24)
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  • 1
    Online Resource
    Online Resource
    Computer-assisted detection of acute pulmonary embolism at CT pulmonary angiography in children and young adults: a diagnostic performance analysis
    SAGE Publications ; 2019
    In:  Acta Radiologica Vol. 60, No. 8 ( 2019-08), p. 1011-1019
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 60, No. 8 ( 2019-08), p. 1011-1019
    Abstract: To diagnose pulmonary embolism (PE) in children and adults since evaluating tiny pulmonary vasculature beyond segmental level is a challenging and demanding task with thousands of images. Purpose To evaluate the effect of computer-assisted detection (CAD) on acute PE on CTPA in children and young adults by readers with varying experience levels. Material and Methods Six radiologists were retrospectively divided into three groups according to experience levels and assessed the CTPA studies on a per-emboli basis. All readers identified independently the PE presence, and ranked diagnostic confidence on a 5-point scale with and without CAD. Reading time, sensitivities, specificities, accuracies, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated for each reading. Results The sensitivities and NPVs differed significantly in most readers ( P = 0.004, 0.001, 0.010, 0.010, and 0.012 for sensitivities and P = 0.011, 0.003, 0.016, 0.017, and 0.019 for NPVs) except for reader 6 ( P = 0.148 and 0.165, respectively), and the accuracies of all readers differed significantly (all P  〈  0.05) in peripheral PE (beyond segmental level) detection readings with CAD versus without CAD between two reading methods. The overall time using CAD was longer than those without CAD (76.6 ± 54.4 s vs. 49.4 ± 17.7 s, P = 0.000) for all readers. Significant differences were found for confidence scores in inter-group measurements with CAD ( P = 0.045) and without CAD ( P  〈  0.001). Conclusion At the expense of longer reading time, the use of the CAD algorithms improves sensitivities, NPVs, and the accuracies of readers in peripheral PE detection, especially for readers with a poor level of interpretation experience.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185118808547
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 2
    Online Resource
    Online Resource
    A comparison and review of three sets of classification criteria for systemic lupus erythematosus for distinguishing systemic lupus erythematosus from pure mucocutaneous manifestations in the lupus disease spectrum
    SAGE Publications ; 2020
    In:  Lupus Vol. 29, No. 14 ( 2020-12), p. 1854-1865
    Details
    In: Lupus, SAGE Publications, Vol. 29, No. 14 ( 2020-12), p. 1854-1865
    Abstract: Although the original purpose of the systemic lupus erythematosus (SLE) classification criteria was to distinguish SLE from other mimic diseases, and to facilitate sample selection in scientific research, they have become widely used as diagnostic criteria in clinical situations. It is not known yet if regarding classification criteria as diagnostic criteria, what problems might be encountered? This is the first study comparing the three sets of classification criteria for SLE, the 1997 American College of Rheumatology (ACR’97), 2012 Systemic Lupus International Collaborating Clinics (SLICC’12) and 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR’19), for their ability to distinguish patients with SLE from patients with pure mucocutaneous manifestations (isolated cutaneous lupus erythematosus without internal disease, i-CLE) in the lupus disease spectrum. 1,865 patients with SLE and 232 patients with i-CLE were recruited from a multicenter study. We found that, due to low specificity, none of the three criteria are adept at distinguishing patients with SLE from patients with i-CLE. SLICC’12 performed best among the original three criteria, but if a positive ANA was removed as an entry criterion, EULAR/ACR’19 would performed better. A review of previous studies that compared the three sets of criteria was presented in this work.
    Type of Medium: Online Resource
    ISSN: 0961-2033 , 1477-0962
    URL: Article
    DOI: 10.1177/0961203320959716
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2008035-9
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  • 3
    Online Resource
    Online Resource
    A Multicenter Study of the Clinical Features of Allergic Rhinitis in Central China
    SAGE Publications ; 2014
    In:  American Journal of Rhinology & Allergy Vol. 28, No. 5 ( 2014-09), p. 392-396
    Details
    In: American Journal of Rhinology & Allergy, SAGE Publications, Vol. 28, No. 5 ( 2014-09), p. 392-396
    Abstract: Several epidemiological surveys of allergic rhinitis (AR) have been conducted in China. However, the clinical features of AR are still not clear enough. The aim of the current study was to perform a multicenter investigation to evaluate the clinical features of AR in China. Methods A multicenter investigation was performed in 13 allergy centers in central China. A disease-related questionnaire was completed by each patient themselves or with guardian assistance after the diagnosis of AR. The clinical features of AR and allergen profile were analyzed. Results Eleven thousand four patients who were diagnosed with AR were recruited in this study. The percentages of classification of AR according to the Allergic Rhinitis and Its Impact on Asthma guidelines were 9.7% intermittent mild (IM), 3.1% persistent mild (PM), 33.9% intermittent moderate–severe (IMS), and 53.3% persistent moderate–severe (PMS). There were 61.6 and 42.2% AR patients who had concomitant ocular or lower respiratory symptoms in clinic. The occurrence of ocular and lower respiratory symptoms was found to be gradually increased from IM, PM, and IMS to PMS. Cold air and temperature change were the two most common factors triggering the nasal symptoms. Dermatophagoides pteronyssinus and Dermatophagoides farinae were the most important allergens of central China. Conclusions This study has contributed to a better understanding of clinical features of AR in China.
    Type of Medium: Online Resource
    ISSN: 1945-8924 , 1945-8932
    URL: Article
    DOI: 10.2500/ajra.2014.28.4075
    RVK:
    XA 20278
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2554548-6
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  • 4
    Online Resource
    Online Resource
    Induction treatment of proliferative lupus nephritis with leflunomide combined with prednisone: a prospective multi-centre observational study
    SAGE Publications ; 2008
    In:  Lupus Vol. 17, No. 7 ( 2008-07), p. 638-644
    Details
    In: Lupus, SAGE Publications, Vol. 17, No. 7 ( 2008-07), p. 638-644
    Abstract: To evaluate the efficacy and safety of leflunomide in the treatment of proliferative lupus nephritis, a prospective multi-centre observational study was conducted. Patients with biopsy proven proliferative lupus nephritis were assigned to receive either leflunomide or cyclophosphamide with concomitant prednisone. Leflunomide was given orally with a loading dose of 1 mg/kg/day for 3 days followed by 30 mg/day. Intravenous cyclophosphamide was administered monthly at a dose of 0.5 g/m 2 of body-surface area. A total of 110 patients were enrolled, 70 in the leflunomide group and 40 in the cyclophosphamide group. The complete remission rate in the leflunomide group was 21% and partial remission rate 52%, as compared with 18% and 55%, respectively, in the cyclophosphamide group. Renal parameters and systemic lupus erythematosus disease activity index improved significantly and similarly in both groups. Serum creatinine decreased or stabilized in both treatment groups. No significant difference was noted with respect to clinical outcome between groups. Repeat biopsy also showed a significant reduction of active lesions in kidney pathology after 6 months of leflunomide treatment. Major adverse events, similar in both treatment groups, included infection, alopecia and hypertension. Leflunomide, compared with cyclophosphamide, in combination with prednisone was effective in the induction therapy of proliferative lupus nephritis and was generally well-tolerated.
    Type of Medium: Online Resource
    ISSN: 0961-2033 , 1477-0962
    URL: Article
    DOI: 10.1177/0961203308089408
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
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  • 5
    Online Resource
    Online Resource
    Abnormal expression pattern of histone demethylases in CD4 + T cells of MRL/lpr lupus-like mice
    SAGE Publications ; 2009
    In:  Lupus Vol. 18, No. 14 ( 2009-12), p. 1327-1328
    Details
    In: Lupus, SAGE Publications, Vol. 18, No. 14 ( 2009-12), p. 1327-1328
    Type of Medium: Online Resource
    ISSN: 0961-2033 , 1477-0962
    URL: Article
    DOI: 10.1177/0961203309104869
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
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  • 6
    Online Resource
    Online Resource
    A Prospective Multicenter Study of Systemic Reactions in Standardized Specific Immunotherapy for Allergic Rhinitis in China
    SAGE Publications ; 2014
    In:  American Journal of Rhinology & Allergy Vol. 28, No. 1 ( 2014-01), p. e40-e44
    Details
    In: American Journal of Rhinology & Allergy, SAGE Publications, Vol. 28, No. 1 ( 2014-01), p. e40-e44
    Abstract: Standardized allergen-specific immunotherapy (SIT) has been used in China for years. However, there is no extensive study of the safety of standardized SIT in Chinese patients until now. The aim of the current study is to perform a prospective and multicenter study to evaluate the systemic reactions (SRs) of standardized SIT in Chinese patients. Methods The study was performed in 13 allergy centers in China, using the same vaccine and practice procedure. The length of observation period was 2 years. SRs were recorded and analyzed. Results There were 666 patients included (261 children and 405 adults). All patients finished the initial phase and 47 patients withdrew during the maintenance phase. There were 0.47% (94/19,963) SRs in all injections (0.72 in children and 0.31% in adults); 8.26% (55/666) patients experienced SRs (12.26% children and 5.68% adults). The occurrence of SRs was significantly higher in children than that in adults (p 〈 0.01). A higher ratio of SRs was found among patients accompanied with asthma. There were 74.47% SRs of grade I, 15.96% SRs of grade II, 7.45% SRs of grade III, and 2.13% SRs of grade IV. There were 90.43% of SRs associated with the discomfort of lower respiratory tract. Conclusion This multicenter study showed that properly conducted standardized SIT was a safe treatment for allergic rhinitis in China. The incidence of SRs was higher in children than that in adults.
    Type of Medium: Online Resource
    ISSN: 1945-8924 , 1945-8932
    URL: Article
    DOI: 10.2500/ajra.2014.28.4005
    RVK:
    XA 20278
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2554548-6
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  • 7
    Online Resource
    Online Resource
    Similarity and diversity of spontaneous brain activity in functional dyspepsia subtypes
    SAGE Publications ; 2020
    In:  Acta Radiologica Vol. 61, No. 7 ( 2020-07), p. 927-935
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 61, No. 7 ( 2020-07), p. 927-935
    Abstract: Functional dyspepsia (FD) subtypes may differ in terms of pathophysiology, but the underlying mechanisms remain poorly understood. Purpose To explore spontaneous brain activity in two main FD subtypes, namely epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS), using the amplitude of low-frequency fluctuation (ALFF). Material and Methods Thirty-one FD patients (18 EPS and 13 PDS) and 22 matched healthy controls (HC) underwent resting-state functional MRI scanning. Spontaneous brain activity was evaluated by measuring the ALFF and then compared among the EPS, PDS, and HC groups with ANOVA test. Pearson correlation analysis was performed between the ALFF values and clinical indices. Results Compared to healthy controls, both EPS and PDS patients had increased ALFF in the bilateral precentral/postcentral gyri, insula, and thalami. Furthermore, only the EPS patients displayed increased ALFF in the right middle and inferior frontal gyri, and only the PDS patients showed increased ALFF in the left posterior cingulate cortex (PCC). The ALFF values in the left thalamus were positively correlated with the sleep disturbance in EPS patients, and the ALFF values in the right precentral/postcentral gyri showed a positive correlation with the symptom score in PDS patients. Conclusion EPS and PDS had similarities of higher spontaneous brain activity in the primary motor/sensory areas and homeostatic-afferent network regions, and differences in the prefrontal region and PCC, providing evidence to suggest the similarity and diversity of pathophysiology in FD subtypes.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185119883391
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 8
    Online Resource
    Online Resource
    Image quality and radiation dose of lower extremity CT angiography at 70 kVp on an integrated circuit detector dual-source computed tomography
    SAGE Publications ; 2015
    In:  Acta Radiologica Vol. 56, No. 6 ( 2015-06), p. 659-665
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 56, No. 6 ( 2015-06), p. 659-665
    Abstract: Despite the well-established requirement for radiation dose reduction there are few studies examining the potential for lower extremity CT angiography (CTA) at 70 kVp. Purpose To compare the image quality and radiation dose of lower extremity CTA at 70 kVp using a dual-source CT system with an integrated circuit detector to similar studies at 120 kVp. Material and Methods A total of 62 patients underwent lower extremity CTA. Thirty-one patients were examined at 70 kVp using a second generation dual-source CT with an integrated circuit detector (70 kVp group) and 31 patients were evaluated at 120 kVp using a first generation dual-source CT (120 kVp group). The attenuation and image noise were measured and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Two radiologists assessed image quality. Radiation dose was compared. Results The mean attenuation of the 70 kVp group was higher than the 120 kVp group (575 ± 149 Hounsfield units [HU] vs. 258 ± 38 HU, respectively, P  〈  0.001) as was SNR (44.0 ± 22.0 vs 32.7 ± 13.3, respectively, P = 0.017), CNR (39.7 ± 20.6 vs 26.6 ± 11.7, respectively, P = 0.003) and the mean image quality score (3.7 ± 0.1 vs. 3.2 ± 0.3, respectively, P  〈  0.001). The inter-observer agreement was good for the 70 kVp group and moderate for the 120 kVp group. The dose-length product was lower in the 70 kVp group (264.5 ± 63.1 mGy × cm vs. 412.4 ± 81.5 mGy × cm, P  〈  0.001). Conclusion Lower extremity CTA at 70 kVp allows for lower radiation dose with higher SNR, CNR, and image quality when compared with standard 120 kVp.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185114535391
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
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  • 9
    Online Resource
    Online Resource
    Timing of recanalization and outcome in ischemic-stroke patients treated with recombinant tissue plasminogen activator
    SAGE Publications ; 2015
    In:  Acta Radiologica Vol. 56, No. 9 ( 2015-09), p. 1119-1126
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 56, No. 9 ( 2015-09), p. 1119-1126
    Abstract: Intravenous administration of recombinant tissue plasminogen activator (rtPA) is approved treatment for acute ischemic stroke 〈 3 h of symptom onset. Purpose To determine the impact of the timing and degree of recanalization on clinical outcome after rtPA infusion in patients. Material and Methods Seventy-five patients with ischemic stroke in the middle cerebral artery territory treated with intravenous rtPA within 3 h were studied consecutively. Magnetic resonance imaging (MRI), including magnetic resonance angiography (MRA), before, 6 h, and 24 h after thrombolytic therapy was undertaken. Depending on the MRA results acquired 6 h after rtPA infusion, recanalization was graded as: early recanalization (ER), delayed recanalization (DR), and no recanalization (NR). Clinical outcome was assessed using the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Results Of patients in the ER, DR and NR groups, 71.4% (15/21), 13.3% (2/15), and 30.7% (12/39), respectively, showed dramatic improvement in NIHSS score 7 days after rtPA administration compared with those scores upon hospital admission. The 6-h and 24-h NIHSS scores and 3-month mRS scores of ER patients were significantly lower than those of the other two groups ( P  〈  0.05). The 24-h, 7-d NHISS and mRS scores of DR patients were significantly higher than NR patients ( P = 0.001, 0.002, 0.049, respectively). Three patients in the DR group died during follow-up. Conclusion These data suggest that DR is associated with clinical deterioration. Patients treated with rtPA thrombolysis should be under close observation for 6–24 h. Corresponding treatment should be considered once DR appears.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185114545151
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
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  • 10
    Online Resource
    Online Resource
    Thickness of soft tissue of lower extremities measured with magnetic resonance imaging as a new indicator for staging unilateral secondary lower extremity lymphedema
    SAGE Publications ; 2015
    In:  Acta Radiologica Vol. 56, No. 8 ( 2015-08), p. 1016-1024
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 56, No. 8 ( 2015-08), p. 1016-1024
    Abstract: Chronic progressive swelling of the lower extremity due to secondary lower extremity lymphedema (LEL) can affect a patient’s quality of life, both physically and psychologically. A feasible and reproducible method for detecting and staging LEL will facilitate decision-making about appropriate management strategies. Purpose To determine whether the thickness of the soft tissues of the lower extremities, measured with magnetic resonance imaging (MRI), could stage unilateral secondary LEL. Material and Methods Seventy-two women with unilateral LEL and 22 participants without LEL underwent lower extremity MRI after treatment of uterine malignancies. LEL was classified clinically as stage 0, 1, 2, or 3. On fat-suppressed T2-weighted mid-axial images of calves and thighs, the total thickness of the soft tissue (TT), muscle thickness (MT), subcutaneous tissue thickness (STT), and the differences in TT (DTT), MT (DMT), and STT (DSTT) values and corresponding measurements in the contralateral lower extremity, were obtained and analyzed statistically for staging LEL. Results There was a trend for the TT and STT of the affected calf and thigh to increase with increasing LEL stage. These parameters were strongly and moderately correlated with LEL stage, respectively ( P  〈  0.001). Both the DTT and DSTT of the calves or thighs were strongly correlated with LEL stage ( P  〈  0.001). Among the parameters, the DSTT of the calves could best stage LEL, with an area under the receiver operating curve of more than 0.89. Conclusion The DSTT of the calves could be recommended as an informative indicator for staging LEL.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185114542995
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2024579-8
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