V(mean) measurements in the middle cerebral artery, distal internal carotid artery, and anterior cerebral artery did not vary substantially between nonimaging and imaging transcranial Doppler US. RI data did not yield comparable measurements.
OBJECTIVE. Thepurpose ofthisstudy wastodetermine predictors ofaccelerated deterioration in radiographic manifestations of cystic fibrosis. The incidence and distribution of fo cally accentuated disease were also studied.
MATERIALSAND METHODS. From230 patients, 3038chest radiographs werescored using the Brasfield system. Scores were plotted against age, and a single age-based se verity curve was created. Specific observations (at least one episode in the first 5 years of life of air trapping, linear markings, nodular cystic lesions, or large lesions) were assessedto de termine predictors of accelerateddecline in scorescompared with the aggregatescoresplotted in the age-based severity curve. Specific observations were noted as present or absent and graded as to severity. A specific observation was counted as present if seen on at least one oc casion. (The number of occasions on which the observation was made did not affect statistical analysis.) We also evaluated the distribution of lung disease by assessing the severity and na ture of disease through specific lobar distribution.
RESULTS. Malesshowed aslightly greater rateofradiologic decline. Earlydevelopmentof air trapping or bronchiectasis was associated with an accelerated rate of decline over time.Lobe-dominant diseaseoccurred in one third of all images and in two thirds of the patients. It varied with age in its incidence, location, and etiology. (Fig. 1). This curve mimics the de dine in pulmonary function studies seen in patientswith cysticfibrosis[2â€"4]. This simi larity suggests that pulmonary function stud ies and radiographic changes represent parallel physiologic and structural aspects of the evolving damage to the lung and that extrapolation of the rate of decline may be de rived from both types of studies [2â€"4].In this study we examined specific predictors of in creased rate of decline. The Brasfield system is traditionally used to follow the progression of disease in individual patients. The age based severity curve previously published [2] includes Brasfield scores of serial radiographs (n = 3038) performed on 230 patients. These data were used to develop a curve reflecting the cumulative rate of decline in Brasfield scoresfor the patientsstudied.The current study reports specific radiographic observa tions that are correlatedwith an accelerated rate of decline in that same population of pa tients with cystic fibrosis. It hasbeenreportedthatcysticfibrosisis a disease that predominately affects the upper lobes of the lungs [5â€"7].To examine this con cept, we assessed lobe-dominantdiseaseto determine the incidence and distribution of focally accentuated abnormalities.
CONCLUSION. Hyperinflation orbronchiectasis thatoccurs
Materials and Methods
PatientsAll 456 patients in the cystic fibrosis clinic A power calculationindicatedthatto develop data with 95% confidence limits of one Brasfield point across the age range, 3000 radiographs would be needed. Patients were therefore sequen
Abdominal CT had a strong effect on surgeons' clinical diagnoses and initial treatment plans in children with blunt trauma. CT information enabled surgeons to safely reduce the intensity of care provided to injured children.
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