Dataset Information

An analysis of reports concerning overdose evaluated by abdominal computed tomography.

ABSTRACT: Recently, there have been a number of reports concerning the utility of abdominal computed tomography (CT) for diagnosing overdose (OD). We herein report the summary and results of an analysis of these reports to assess the significance of CT for patients with OD. Searches of Ichushi (Japana Centra Revuo Medicine) and PubMed were carried out to identify articles from 1983 to 2019 using the key words "poisoning" and "abdominal computed tomography". Forty-eight cases across 15 articles were defined as subjects in this report. The average age of subjects was 46 years old, and there were 28 women. Forty-five of the 48 subjects (93.8%) had positive findings of residual drugs on CT. The finding of a high-density fluid level in the stomach was the most frequent (60.4%), followed by ill-defined high-density material in the stomach (12.5%) and high-density tablets in the stomach (10.4%). One prospective study suggested the merits of decontamination for patients with positive findings on CT even if more than 60 min had elapsed since the ingestion of drugs. Computed tomography could aid in the diagnosis of OD in comatose patients who cannot talk or who present without any other evidence of OD. In addition, a recent study revealed the merits of decontamination for patients with positive findings on the CT even if more than 60 min had elapsed since the ingestion of drugs.

SUBMITTER: Yanagawa Y

PROVIDER: S-EPMC6773650 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

An analysis of reports concerning overdose evaluated by abdominal computed tomography.

Yanagawa Youichi Y Muramatsu Ken-Ichi KI Nagasawa Hiroki H Takeuchi Ikuto I Kushida Yoshihiro Y Jitsuiki Kei K Ohsaka Hiromichi H Oode Yasumasa Y Omori Kazuhiko K

Acute medicine & surgery 20190531 4

Recently, there have been a number of reports concerning the utility of abdominal computed tomography (CT) for diagnosing overdose (OD). We herein report the summary and results of an analysis of these reports to assess the significance of CT for patients with OD. Searches of Ichushi (Japana Centra Revuo Medicine) and PubMed were carried out to identify articles from 1983 to 2019 using the key words "poisoning" and "abdominal computed tomography". Forty-eight cases across 15 articles were define ...[more]

PMID: 31592090

Similar Datasets

Project description:BACKGROUND:Reliably abstracting outcomes from free-text electronic health records remains a challenge. While automated classification of free text has been a popular medical informatics topic, performance validation using real-world clinical data has been limited. The two main approaches are linguistic (natural language processing [NLP]) and statistical (machine learning). The authors have developed a hybrid system for abstracting computed tomography (CT) reports for specified outcomes. OBJECTIVES:The objective was to measure performance of a hybrid NLP and machine learning system for automated outcome classification of emergency department (ED) CT imaging reports. The hypothesis was that such a system is comparable to medical personnel doing the data abstraction. METHODS:A secondary analysis was performed on a prior diagnostic imaging study on 3,710 blunt facial trauma victims. Staff radiologists dictated CT reports as free text, which were then deidentified. A trained data abstractor manually coded the reference standard outcome of acute orbital fracture, with a random subset double-coded for reliability. The data set was randomly split evenly into training and testing sets. Training patient reports were used as input to the Medical Language Extraction and Encoding (MedLEE) NLP tool to create structured output containing standardized medical terms and modifiers for certainty and temporal status. Findings were filtered for low certainty and past/future modifiers and then combined with the manual reference standard to generate decision tree classifiers using data mining tools Waikato Environment for Knowledge Analysis (WEKA) 3.7.5 and Salford Predictive Miner 6.6. Performance of decision tree classifiers was evaluated on the testing set with or without NLP processing. RESULTS:The performance of machine learning alone was comparable to prior NLP studies (sensitivity = 0.92, specificity = 0.93, precision = 0.95, recall = 0.93, f-score = 0.94), and the combined use of NLP and machine learning showed further improvement (sensitivity = 0.93, specificity = 0.97, precision = 0.97, recall = 0.96, f-score = 0.97). This performance is similar to, or better than, that of medical personnel in previous studies. CONCLUSIONS:A hybrid NLP and machine learning automated classification system shows promise in coding free-text electronic clinical data.

Project description:Inflammation plays a major role in the pathogenesis of several vascular pathologies, including abdominal aortic aneurysm (AAA). Evaluating the role of inflammation in AAA pathobiology and potentially outcome in vivo requires non-invasive tools for high-resolution imaging. We investigated the feasibility of X-ray computed tomography (CT) imaging of phagocytic activity using nanoparticle contrast agents to predict AAA outcome. Methods: Uptake of several nanoparticle CT contrast agents was evaluated in a macrophage cell line. The most promising agent, Exitron nano 12000, was further characterized in vitro and used for subsequent in vivo testing. AAA was induced in Apoe -/- mice through angiotensin II (Ang II) infusion for up to 4 weeks. Nanoparticle biodistribution and uptake in AAA were evaluated by CT imaging in Ang II-infused Apoe -/- mice. After imaging, the aortic tissue was harvested and used from morphometry, transmission electron microscopy and gene expression analysis. A group of Ang II-infused Apoe -/- mice underwent nanoparticle-enhanced CT imaging within the first week of Ang II infusion, and their survival and aortic external diameter were evaluated at 4 weeks to address the value of vessel wall CT enhancement in predicting AAA outcome. Results: Exitron nano 12000 showed specific uptake in macrophages in vitro. Nanoparticle accumulation was observed by CT imaging in tissues rich in mononuclear phagocytes. Aortic wall enhancement was detectable on delayed CT images following nanoparticle administration and correlated with vessel wall CD68 expression. Transmission electron microscopy ascertained the presence of nanoparticles in AAA adventitial macrophages. Nanoparticle-induced CT enhancement on images obtained within one week of AAA induction was predictive of AAA outcome at 4 weeks. Conclusions: By establishing the feasibility of CT-based molecular imaging of phagocytic activity in AAA, this study links the inflammatory signal on early time point images to AAA evolution. This readily available technology overcomes an important barrier to cross-sectional, longitudinal and outcome studies, not only in AAA, but also in other cardiovascular pathologies and facilitates the evaluation of modulatory interventions, and ultimately upon clinical translation, patient management.

Project description:Multiple system atrophy (MSA) is a progressive neurodegenerative disorder. Since patients with MSA often have sleep-related respiratory disorders including upper-airway obstruction and/or central sleep disturbance, appropriate evaluation of the upper airway especially during sleep may be indispensable. Fiberoptic laryngoscopy during diazepam-induced sleep has been reported for upper-airway obstruction verification. However, some patients cannot endure the uncomfortable sensation of the fiberscope. To address these issues, we devised a protocol of four four-dimensional computed tomography (4D-CT) for upper-airway evaluation during sleep. Here, we report the case of patient with MSA who was evaluated for upper-airway obstruction during sleep using 4D-CT. A 46-year-old man (height 1.60 m, weight 79 kg) was admitted to our neurological department for tracheal intubation because of a sudden onset of respiratory failure occurring at night. At the age of 45 years, he was diagnosed as MSA with predominant parkinsonism. As pulmonary disease had been excluded and his swallowing was normal, our differential diagnoses were central sleep apnea or obstructive sleep apnea related to his MSA or obstructive sleep apnea (SA) related to his obesity. A tracheostomy was done to maintain the airway after extubation. Polysomnography showed obstructive SA and not central SA. Awake fiberoptic laryngoscopy showed no upper airway obstruction but bilateral vocal abduction impairment (BVAI) during inspiration. To assess the spatial and temporal conditions of the upper respiratory tract-the patient could not tolerate sleep laryngoscopy-we carried out a 4D-CT. Reconstructed 4D-CT images of respiration during sleep showed clear abnormalities: glottis closure at the terminal stage of inspiration and subsequent velopharyngeal closure. As glottis closure does not occur normally in obesity patients, the cause of the respiratory failure in this patient was considered MSA-related sleep-induced airway obstruction. We decided to keep the tracheostoma, because BVAI in patients with MSA may be getting worse, although central apnea after tracheostomy may cause sudden central origin-related death; 4 months postoperatively, the patient had experienced no further airway-related complications. This report indicates that 4D-CT sequential upper-airway assessment during sleep is useful for determining the abnormalities causing obstructive SA in patients with MSA.

Project description:ObjectiveTo compare image qualities between vendor-neutral and vendor-specific hybrid iterative reconstruction (IR) techniques for abdominopelvic computed tomography (CT) in young patients.Materials and methodsIn phantom study, we used an anthropomorphic pediatric phantom, age-equivalent to 5-year-old, and reconstructed CT data using traditional filtered back projection (FBP), vendor-specific and vendor-neutral IR techniques (ClariCT; ClariPI) in various radiation doses. Noise, low-contrast detectability and subjective spatial resolution were compared between FBP, vendor-specific (i.e., iDose1 to 5; Philips Healthcare), and vendor-neutral (i.e., ClariCT1 to 5) IR techniques in phantom. In 43 patients (median, 14 years; age range 1-19 years), noise, contrast-to-noise ratio (CNR), and qualitative image quality scores of abdominopelvic CT were compared between FBP, iDose level 4 (iDose4), and ClariCT level 2 (ClariCT2), which showed most similar image quality to clinically used vendor-specific IR images (i.e., iDose4) in phantom study. Noise, CNR, and qualitative imaging scores were compared using one-way repeated measure analysis of variance.ResultsIn phantom study, ClariCT2 showed noise level similar to iDose4 (14.68-7.66 Hounsfield unit [HU] vs. 14.78-6.99 HU at CT dose index volume range of 0.8-3.8 mGy). Subjective low-contrast detectability and spatial resolution were similar between ClariCT2 and iDose4. In clinical study, ClariCT2 was equivalent to iDose4 for noise (14.26-17.33 vs. 16.01-18.90) and CNR (3.55-5.24 vs. 3.20-4.60) (p > 0.05). For qualitative imaging scores, the overall image quality ([reader 1, reader 2]; 2.74 vs. 2.07, 3.02 vs. 2.28) and noise (2.88 vs. 2.23, 2.93 vs. 2.33) of ClariCT2 were superior to those of FBP (p < 0.05), and not different from those of iDose4 (2.74 vs. 2.72, 3.02 vs. 2.98; 2.88 vs. 2.77, 2.93 vs. 2.86) (p > 0.05).ConclusionVendor-neutral IR technique shows image quality similar to that of clinically used vendor-specific hybrid IR technique for abdominopelvic CT in young patients.

Dataset Information

An analysis of reports concerning overdose evaluated by abdominal computed tomography.

Publications

An analysis of reports concerning overdose evaluated by abdominal computed tomography.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets