Medicine
-
Multicenter Study
Abnormal glucose regulation in Chinese patients with coronary artery disease: A cross-sectional study.
The purpose of this study was to investigate the prevalence of abnormal glucose regulation (AGR) in patients with established coronary artery disease (CAD), and the association of AGR and acute coronary events in Chinese patients. A total of 3441 hospitalized patients with established diagnosis of CAD were recruited from 41 centers in 25 cities of China. Oral glucose tolerance test (OGTT) was performed in 2112 patients without known diabetes. ⋯ The prevalence of AGR is increasing in Chinese patients with CAD, as compared with previous report. AGR was independently associated with acute coronary events. Prospective studies are warranted to evaluate the benefit of intervening prediabetes in adult patients with CAD.
-
This study was aimed to evaluate the image quality and lacunar lesion detection of thin-slice brain computed tomography (CT) images with different reconstruction algorithms, including filtered back projection (FBP), hybrid iterative reconstruction (HIR), and iterative model reconstruction (IMR) by comparison of routine slice images with FBP reconstruction. Sixty-one patients underwent noncontrast brain CT and images were reconstructed with a routine slice of 5.0 mm by FBP and thin slice of 1.0 mm by IMR, HIR, and FBP algorithms, respectively. Objective analyses included CT attenuation, noise, artifacts index of posterior cranial fossa, and contrast-to-noise ratio (CNR). ⋯ Both IMR and HIR thin-slice images enabled better scores in subjective image quality than routine slice FBP images. Moreover, both thin-slice IMR and HIR images enabled higher sensitivity and positive predictive value (PPV) in lesion detection of 35-mm lacunar lesions compared with routine slice FBP images. Thin-slice IMR images improve image quality, meanwhile yield better detection of small lacunar lesions in brain CT compared with routine slice FBP images.
-
Observational Study
Characteristics of computed tomography in hemodynamically unstable blunt trauma patients: Experience at a tertiary care center.
Emergent exploratory laparotomy is recommended for hemodynamically unstable blunt trauma patients suspected of having hemoperitoneum. However, given the unreliability of ultrasonography and rapid scan speed of computed tomography (CT), CT might help clinicians provide accurate information even in hemodynamically unstable trauma patients. This observational study aimed to describe the bleeding site and hospital course of severe blunt trauma patients with hemoperitoneum diagnosed by CT scan. ⋯ The rate of intraperitoneal organ injury did not differ between hemodynamically stable (n = 107) and unstable (n = 29) groups (69.2% vs 82.8%, P = .15), while the documented active internal bleeding was high in the unstable group (29.9% vs 69.0%, P < .001). In the unstable group, 14 (48.3%) patients underwent emergent operation, while 3 patients underwent embolization, and the others were treated in a conservative manner. Even in hemodynamically unstable hemoperitoneum patients, 17.2% had no documented intraperitoneal injury and over half of the patients were treated without emergent operation.
-
The purpose is to assess the diagnostic ability for early glaucoma of macular ganglion cell-inner plexiform layer (GCIPL) thickness in a Chinese population including glaucoma suspects. A total of 367 eyes with primary open-angle glaucoma (168 early glaucoma, 78 moderate glaucoma, and 121 advanced glaucoma), 52 eyes with ocular hypertension (OHT), 59 eyes with enlarged cup-to-disc ratio (C/D), and 225 normal eyes were included. GCIPL thickness (average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal), retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters were measured using Cirrus high-definition optical coherence tomography (OCT) and compared. ⋯ There was no statistical significance of AUROC between minimum GCIPL thickness and average RNFL thickness (all P > .05). GCIPL thickness could discriminate early glaucoma from normal and glaucoma suspects with good sensitivity and specificity. The glaucoma diagnostic ability of GCIPL thickness was comparable to that of RNFL thickness.
-
Iatrogenic atrial septal defects caused by cardiac surgery are rare complications that are traditionally repaired through reoperations; unfortunately, reoperations are accompanied by high risk and trauma. ⋯ Percutaneous device treatment can be used as an alternative to surgery in iatrogenic atrial septal defects if the anatomical condition of the septal defect is appropriate for transcatheter closure.