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Does shifting to professional emergency department staffing affect the decision for chest radiography?

World Journal of Emergency Medicine 2021年第2期12卷 87-92页

作者： Marin Pavlov Lucija Klobucar Iva Klobučar Kristinazgela Vesna Degoricija Department of Cardiology Sestre Milosrdnice University Hospital CentreZagreb 10000Croatia Institute of Emergency Medicine Osijek-Baranja CountyOsijek 31000Croatia University of Zagreb School of Medicine Zagreb 10000Croatia Department of Medicine Sestre milosrdnice University Hospital CentreZagreb 10000Croatia

BACKGROUND: The study aims to determine whether shifting to professional emergency department(ED) teams leads to a higher rate of radiologic ***: We retrospectively analyzed a total of 2,000 patients presenting to the ED of a tertiary teaching hospital in two time periods: group 1(G1) comprised 1,000 consecutive patients enrolled from December 21, 2012 to January 5, 2013(all patients were examined by an internal medicine specialist);group 2(G2) comprised 1,000 consecutive patients enrolled from December 21, 2018 to January 3, 2019(all patients were examined by an emergency physician).RESULTS: The chest X-ray(CXR) was performed in 40.6% of all patients. There was no difference in the frequency of CXR(38.9% in G1 vs. 42.3% in G2, P=0.152). More CXRs were performed in G2 patients older than 65 years, in female patients older than 65 years, in patients presenting during the evening and night shifts or off-hours, in patients with a history of malignancy, in patients with gastrointestinal bleeding, and in patients with bradycardia, but fewer in patients presenting with arrhythmia. No difference in the rates of pathological CXR was found(47.3% in G1 vs. 52.2% in G2, P=0.186). Compared with G2, higher sensitivity and specificity were obtained for the binary logistic regression model predicting pathological findings in ***: Shifting to professional ED teams does not increase radiologic workup. By implementing deliberate usage of ultrasound, some self-governing procedures, case-oriented investigations, and center-specific recommendations, unnecessary radiologic workup can be avoided. Professional ED teams could lead to a higher standard of emergency care.

关键词： chest radiography Emergency department Emergency physicians Healthcare organization

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Bedside chest radiography of novel influenza A （H7N9） virus infections and follow-up findings after short-time treatment

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Chinese Medical Journal 2013年第23期126卷 4440-4443页

作者： SONG Feng-xiang ZHOU Jun SHI Yu-xin ZHANG Zhi-yong FENG Feng ZHOU Jian-jun WANG Qing-le Department of Radiology Shanghai Public Health Clinical CenterShanghai 201508 China Department of Radiology Shuguang Hospital Shanghai University of Traditional Chinese Medicine Shanghai 201203 China Department of Radiology Zhongshan Hospital Fudan UniversityShanghai 200032 China

Background Influenza A （H7Ng） virus infections were first observed in China in March *** type virus can cause severe illness and deaths,the situation raises many urgent questions and global public health *** purpose was to investigate bedside chest radiography findings for patients with novel influenza A （H7Ng） virus infections and the followup appearances after short-time *** Eight hospitalized patients infected with the novel influenza A （H7Ng） virus were included in our *** of the patients underwent bedside chest radiography after admission,and all had follow-up bedside chest radiography during their first ten days,using AXIOM Aristos MX and/or AMX-Ⅳ portable X-ray *** exposure dose was generally 90 kV and 5 mAs,and was slightly adjusted according to the weight of the *** initial radiography data were evaluated for radiological patterns （ground glass opacity,consolidation,and reticulation）,distribution type （focal,multifocal,and diffuse）,lung zones involved,and appearance at follow-up while the patients underwent *** All patients presented with bilateral multiple lung *** patients had bilateral diffuse lesions,three patients had unilateral diffuse lesions of the right lobe with multifocal lesions of the left lobe,and the remaining three had bilateral multifocal lung *** lesions were present throughout bilateral lung zones in three patients,the whole right lung zone in three patients with additional involvement in the left middle and/or lower lung zone（s）,both lower and middle lung zones in one patient,and the right middle and lower in combination with the left lower lung zones in one *** most common abnormal radiographic patterns were ground glass opacity （8/8）,and consolidation （8/8）.In three cases examined by CT we also found the pattern of reticulation in combination with CT *** patients had bilateral and four had unilateral pleural *** a short period o

关键词： thorax chest radiography influenza A virus,H7N9 subtype pneumonia

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Evaluation of an asymptomatic COVID-19 patient post-surgery with chest radiography: A surgeon’s dilemma

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World Journal of Virology 2021年第6期10卷 326-328页

作者： Gaurav Govil Lavindra Tomar Pawan Dhawan Department of Orthopaedics Max Super Speciality HospitalPatparganjDelhi 110092India

Routine chest radiography is not a requirement in post-surgery cardiac bypass ***,the safety of abandoning routine chest radiographs in critically ill patients remains *** in an asymptomatic coronavirus disease 2019(COVID-19)patient presents additional challenges in postoperative *** radiography remains a valuable tool for assessment of all patients,even a stable *** of surgical patients as an emergency in an asymptomatic COVID-19 case remains a surgeon’s dilemma.

关键词： COVID-19 Cardiac surgery radiography Critical care chest radiography Intensive care Postoperative

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Accuracy of Patient Age Estimation from Frontal chest Radiographs of Adult Patients

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Open Journal of Radiology 2022年第2期12卷 37-48页

作者： Sarah Chibane Alexandre Semionov John Kosiuk Josephine Pressacco Karl Sayegh Gianni Giancaspro Aline Khatchikian Paul S. Benvenuto Joshua Chin Sukhmanjit Ghumman Abdulrahman Maimani Department of Diagnostic Radiology McGill University Health Centre Montreal Canada

Objective: The objective of this study is to evaluate the accuracy of patient age estimation from frontal chest radiographs of adult patients. Methods: 195 posterior-anterior chest radiographs without significant abnormalities were shown to 5 staff radiologists and 6 radiology residents, who were asked to provide their estimates of patient age to the nearest decade. Real patient age distribution ranged from 16 to 91 years of age. Results: On average, correct estimate of patient age decade was made in 22% of cases. Staff radiologists were overall more accurate in their estimations compared to residents. Best accuracy was achieved by the radiologist with the most years of clinical experience, however overall accuracy did not tend to correlate with number of years in practice for staff, nor years of post-graduate training for residents. Overall, patient age was most often overestimated. The least accurate estimates were made for patients younger than 20 years and older than 90. Best accuracy was seen for patients between 50 and 70 years of age. For patients between 20 and 90 years of age, overall estimates were within 11 - 15 years of their true age. There was no significant difference in accuracy of age estimation between radiographs of women and men. Conclusions: Average rate of correct age estimation to the nearest decade from normal frontal chest radiographs in our study was 22%. Staff radiologists were more accurate than radiology residents. Best estimates were made for middle-aged patients, and worst for extremes of age.

关键词： Age Estimation chest radiography Radiology Residents

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Results of the Evaluation of the Respiratory Condition of Permanent Workers in an Oil Mill in Benin

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Occupational Diseases and Environmental Medicine 2022年第1期10卷 1-12页

作者： Mênonli Adjobimey Vikkey Hinson Serge Ade Rose Mikponhoue Ibrahim Mama Cisse Amélé Adjogou Véronique Dossougbété Paul Ayélo Research and Teaching Unit in Occupational and Environmental Health FSS Cotonou Benin Occupational Health Service of the National University Hospital of Pneumo-Phtisiology of Cotonou Cotonou Benin Pneumology Unit Faculty of Medicine University of Parakou Parakou Benin Occupational Health Training and Research Unit Faculty of Medicine Parakou Benin Louis Pasteur Clinic Porto Novo Benin

Introduction: The process of extracting oil from cotton seeds can create dusty work atmospheres that can cause respiratory problems. The main objective of this study was to determine the prevalence of respiratory problems among permanent workers in an oil mill in Benin. Methods: This cross-sectional study of 52 workers in an oil mill took place in January 2017 as part of the annual medical check-ups of workers. A questionnaire was administered and spirometry using Spirobank II and chest radiography were performed. The spirometry results were interpreted by an occupational physician and a pulmonologist. Data were entered and analyzed using Epidata software. Results: The mean age was 42.7 ± 6.4 years, and 43 of the 52 workers were men. Of these, 58% were in technical production positions and 42% in administrative positions. Most of them had more than 10 years of seniority. The prevalence of respiratory symptoms among production workers was 4 (13%) versus 2 (9%) among administrative workers. A total of 8 (15.4%) abnormal spirometry was identified with 4 obstructive syndrome, 3 restrictive syndrome, 1 a mixed pattern. There were 5 (16.6%) workers in production versus 3 (13.6%) in administration who had abnormal spirometry. The means 25/75 forced expiratory flow (FEF) value of production workers was significantly lower than that of administration workers. Abnormal chest radiographs were 5 (17%) in production workers compared to 3 (14%) in administration workers. Conclusion: Oil mill workers had few respiratory symptoms. However, production workers had more ventilatory disorders than administrative workers. A spirometric follow-up of this group of workers is therefore necessary.

关键词： Cottonseed Oil Mill Respiratory Symptoms Spirometry chest radiography Benin

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