8 research outputs found
Characteristics of Mediastinal Mass Patient and Factors Associated With Mortality During Hospitalizations
No full textMisleading Diagnosis of Radiological Imaging of COVID-19 Pneumonia During Pandemic Era: Risk on the Existence of CMV Infection
Get PDFCoronavirus disease 2019 (COVID-19) is an acute respiratory disease which rapidly disseminated due to Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) virus. Clinical presentations of COVID-19 are fever, non-productive cough, and dyspnea. Although the diagnosis establishment is done by detecting the viral ribonucleic acid (RNA) through reverse transcription-polymerase chain reaction (RT-PCR) method, CT scan has an important role in detection and treatment of COVID-19 especially in high prevalence regions. Chest CT scan has high sensitivity yet low specificity because there are a lot of other pathological spectrums that also present features of COVID-19 such as ground glass opacities (GGO) and consolidation, one of them is CMV infection. The objective of this case report is to raise vigilance towards other diseases that have radiological image similarities with COVID-19, especially in the immunocompromised patients who are susceptible to viral infections like CMV infection so that the delay in the disease treatment can be prevented
Accuracy of Bedside Lung Ultrasound in Emergency (BLUE) Protocol to Diagnose the Cause of Acute Respiratory Distress Syndrome (ARDS): A Meta-Analysis
Get PDFBackground: There is a stigma that ultrasound cannot be used to see abnormalities in the air-filled organs makes ultrasound rarely used to identify lung abnormalities. This study purpose comparing diagnostic accuracy of BLUE protocol with gold standard for each diagnosis causing acute respiratory failure. Methods: Systematic search was done in 6 databases (Pubmed/MEDLINE, Embase, Cochrane Central, Scopus, Ebscohost/CINAHL dan Proquest) and multiple grey-literature sources for cross-sectional studies. We manually extracted the data from eligible studies and calculated pooled sensitivity, pooled specificity, likelihood ratio (LR) and diagnostic odds ratio (DOR). We follow PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline throughout these processes. Results: Four studies has been picked from total 509 studies involved. The results yield parameters indicating BLUE protocol as a reliable modality to diagnose pneumonia with pooled sensitivity 84% (95% CI, 76-89%), pooled specificity 98% (95% CI, 93-99%), LR+ 42 (95% CI, 12-147), LR- 0.12 (95% CI, 0.07-0.2) and DOR 252 (95% CI, 81-788), respectively. It also considerably applicable to diagnose pulmonary oedema with pooled sensitivity 89% (95% CI, 81-93%), pooled specificity 94% (95% CI, 89-96%), LR+ 14 (95% CI, 8-25), LR- 0.165 (95% CI, 0.11-0.24), and DOR 116 (95% CI, 42-320), respectively. Conclusion: BLUE protocol has good diagnostic accuracy to diagnose pneumonia and pulmonary oedema. We recommend implementing BLUE protocol as a tool in evaluating cause of ARF
Nilai Rerata Vascular Pedicle Width, Vascular Pedicle-Cardiac Ratio Vascular Pedicle-Thoracic Ratio Orang Dewasa Normal Indonesia Studi Di RS Dr. Cipto Mangunkusomo
Get PDFVascular pedicle width (VPW) adalah jarak tepi luar vena kava superior ke tepi luar arteri subklavia kiri. Pemeriksaan VPW di foto toraks bersifat non-invasif, cepat dan mudah untuk memprediksi hipervolemia.Penelitian ini bertujuan untuk mengetahui rerata nilai VPW orang dewasa normal Indonesia. VPW diukurdengan dua metode: pertama pengukuran VPW tunggal yang akurasinya terbatas di foto toraks digital karenarelatif tidak dipengaruhi faktor magnifikasi. Metode kedua untuk foto toraks nondigital yaitu pengukuranrasio:vascular pedicle-cardiac ratio (VPCR) dan vascular pedicle-thoracic ratio (VPTR). Pengukuran serupadilakukan terhadap topogram CT scan toraks AP terlentang dan CT scan toraks lalu dibandingkan akurasipengukuran di topogram dengan CT scan toraks sebagai standar baku. Sampel terdiri atas 104 foto toraksPA subyek normal dan 103 CT scan toraks subyek terpilih. Pada pemeriksaan toraks PA didapatkan rerata VPW 48,0±5,5mm, rerata VPCR 40,3±4,6%, dan rerata VPTR 17,2±1,7%. Pada pemeriksaan topogram CTscan didapatkan rerata VPW 50,3±6,2mm, rerata VPTR 45±5,1%, dan rerata VPTR 19,8±2,5%. Rerata VPWpada CT scan toraks 50,4±6,1mm. Pengukuran di foto toraks AP 10% lebih besar dibandingkan pada fototoraks PA dan pengukuranVPW di foto toraks terbukti memiliki akurasi tinggi. Kata kunci: fototoraks, vascular pedicle width, vascular pedicle-cardiac ratio, vascular pedicle-thoracic ratio, hipervolemia. The Mean Value of Vascular Pedicle Width, Vascular Pedicle-Cardiac Ratio,Vascular Pedicle-Thoracic Ratio of Normal Indonesian Adult Study In dr. Cipto Mangunkusomo Hospita
The Importance of Chest CT Scan in COVID-19
Get PDFThe coronavirus disease 2019 (COVID-19) is a highly transmissible acute respiratory disease that is caused by the Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2), a beta coronavirus first discovered in Wuhan, China, in late 2019. COVID-19 has been spreading swiftly globally, and as of March 2020, has been officially declared a pandemic by the World Health Organization (WHO). One of the challenges in managing COVID-19 is the identification of a swift, accessible, and reliable diagnostic modality that could serve as an alternative to a reverse-transcriptase polymerase chain reaction (RT-PCR). As of the writing of this paper, RT-PCR is still the recommended tool in diagnosing COVID-19, but the notion of a more prompt and accurate diagnostic tool is a possibility worth looking into. The objective of this case study is to investigate the importance and utility of chest computed tomography (CT) in the diagnosis of COVID-19, as increasing pieces of evidence suggest that chest CT could prove useful in the clinical pathway in diagnosing COVID-19.
Practical Guidelines Management of Graves Ophthalmopathy
Get PDFGraves’ ophthalmopathy is the most common extra-thyroid manifestation in patients with Graves’ disease, based on inflammatory and autoimmune conditions in orbital tissue. This practical guideline was formed by a multidiciplinary team, and is intended to provide guidance for diagnosis and management of Graves’ ophthalmopathy in daily clinical practice to improve quality of care and treatment outcome
Comparison of the Discrimination Performance of AI Scoring and the Brixia Score in Predicting COVID-19 Severity on Chest X-Ray Imaging: Diagnostic Accuracy Study
No full textBackgroundThe artificial intelligence (AI) analysis of chest x-rays can increase the precision of binary COVID-19 diagnosis. However, it is unknown if AI-based chest x-rays can predict who will develop severe COVID-19, especially in low- and middle-income countries.
ObjectiveThe study aims to compare the performance of human radiologist Brixia scores versus 2 AI scoring systems in predicting the severity of COVID-19 pneumonia.
MethodsWe performed a cross-sectional study of 300 patients suspected with and with confirmed COVID-19 infection in Jakarta, Indonesia. A total of 2 AI scores were generated using CAD4COVID x-ray software.
ResultsThe AI probability score had slightly lower discrimination (area under the curve [AUC] 0.787, 95% CI 0.722-0.852). The AI score for the affected lung area (AUC 0.857, 95% CI 0.809-0.905) was almost as good as the human Brixia score (AUC 0.863, 95% CI 0.818-0.908).
ConclusionsThe AI score for the affected lung area and the human radiologist Brixia score had similar and good discrimination performance in predicting COVID-19 severity. Our study demonstrated that using AI-based diagnostic tools is possible, even in low-resource settings. However, before it is widely adopted in daily practice, more studies with a larger scale and that are prospective in nature are needed to confirm our findings
Nilai Rerata Vascular Pedicle Width, Vascular Pedicle-Cardiac Ratio Vascular Pedicle-Thoracic Ratio Orang Dewasa Normal Indonesia Studi di RS dr. Cipto Mangunkusomo
No full textVascular pedicle width (VPW) adalah jarak tepi luar vena kava superior ke tepi luar arteri subklavia kiri. Pemeriksaan VPW di foto toraks bersifat non-invasif, cepat dan mudah untuk memprediksi hipervolemia.Penelitian ini bertujuan untuk mengetahui rerata nilai VPW orang dewasa normal Indonesia. VPW diukurdengan dua metode: pertama pengukuran VPW tunggal yang akurasinya terbatas di foto toraks digital karenarelatif tidak dipengaruhi faktor magnifikasi. Metode kedua untuk foto toraks nondigital yaitu pengukuranrasio:vascular pedicle-cardiac ratio (VPCR) dan vascular pedicle-thoracic ratio (VPTR). Pengukuran serupadilakukan terhadap topogram CT scan toraks AP terlentang dan CT scan toraks lalu dibandingkan akurasipengukuran di topogram dengan CT scan toraks sebagai standar baku. Sampel terdiri atas 104 foto toraksPA subyek normal dan 103 CT scan toraks subyek terpilih. Pada pemeriksaan toraks PA didapatkan rerata VPW 48,0±5,5mm, rerata VPCR 40,3±4,6%, dan rerata VPTR 17,2±1,7%. Pada pemeriksaan topogram CTscan didapatkan rerata VPW 50,3±6,2mm, rerata VPTR 45±5,1%, dan rerata VPTR 19,8±2,5%. Rerata VPWpada CT scan toraks 50,4±6,1mm. Pengukuran di foto toraks AP 10% lebih besar dibandingkan pada fototoraks PA dan pengukuranVPW di foto toraks terbukti memiliki akurasi tinggi. Kata kunci: fototoraks, vascular pedicle width, vascular pedicle-cardiac ratio, vascular pedicle-thoracic ratio, hipervolemia. The Mean Value of Vascular Pedicle Width, Vascular Pedicle-Cardiac Ratio,Vascular Pedicle-Thoracic Ratio of Normal Indonesian Adult Study In dr. Cipto Mangunkusomo Hospital Abstract Vascular pedicle width (VPW) is the distance, from a perpendicular line at the takeoff point of the left subclavian artery off the aorta to the point at which the superior vena cava. Measurement of VPW on chestx-ray is relatively non-invasive, fast and easy technique as hypervolemia predictor. The purpose of thisstudy is to know the mean VPW value of normal Indonesian adult. There are two measurement methodswas performed, the first is a measurements of single VPW, which its accuracy is limited to digital chest x-ray.The second method for non digital chest x-ray utility is a ratio measurement i.e. the ratio of cardiac vascularpedicle-(VPCR), and vascular pedicle-thoracic ratio (VPTR). Similar measurements method performed onthe thoracic CT scan topogram (AP chest x-ray) and thoracic CT scan, then compared both of measurementto evaluate the accuracy of topogram measurement as thoracic CT scan as gold standard. Data from 104 PAchest x-ray of normal subjects and 103 thoracic CT scan of selected subjects. On PA chest x-ray obtainedmean VPW 48,0±5.5mm, mean VPCR 40.3±4.6%, and mean VPTR 17.2±1.7%. On CT scan topogramobtained mean VPW 50,3±6.2mm, mean VPTR 45±5.1%, and mean VPTR 19.8±2.5%. On thoracic CT scanobtained mean VPW 50.4±6.1mm. Measurements on the AP chest x-ray about 10% greater than in the PAchest x-ray, and measurement of VPW on conventional chest x-ray aproved to have high accuracy. Keyword: chest x-ray, vascular pedicle width, vascular pedicle-cardiac ratio, vascular pedicle-thoracic ratio, hypervolemia
