The objective of this study is to investigate the association between clinical and laboratory prognostic factors, radiographic severity, and functional limitations in Turkish patients with ankylosing spondylitis (AS). One hundred and two patients with AS were included in this study (66 male patients, 65%). All the necessary information regarding predictor variables, including clinical features, social status, and treatment regimens, were recorded diligently. Their spinal mobility was measured, and then, their disease activities were evaluated by using the Bath Ankylosing Spondylitis Disease Activity Index. Radiological damage (Bath Ankylosing Spondylitis Radiology Index, BASRI) and functional disability (Bath Ankylosing Spondylitis Functional Index, BASFI) were used to evaluate the outcome measures of AS. The male to female ratio was 1.8. Average age at symptom onset was 23.9 ± 28.24 years (6-54 years), and average disease duration was 16.15 ± 10.62 years. Occiput-to-wall distance, hand-to-floor distance, and the modified Schober's test results were worse in males. Hip involvement was more common in male patients, and all radiological measurements were worse in male patients than in the female ones. Disease duration, male sex, and renal stone occurrence were associated with higher radiological score. Erythrocyte sedimentation rate and the disease activity score were associated with high BASFI scores. Higher CRP levels and hip involvement were both associated with high BASRI and BASFI scores. Radiological hip involvement was determined to be an inauspicious predictor for AS (p < 0.0001). We determined a strong association of hip involvement, increased CRP levels, and renal stone history with severe radiographic damage. Hip involvement, disease duration, ESR, CRP levels, and lower socioeconomic status were all associated with a higher BASFI score.
The Wells rule seems to be more accurate among both inpatients and emergency department patients. The Revised Geneva score can be used in emergency department patients with high reliability.
ObjectiveWe wanted to prospectively evaluate the interobserver agreement between radiology residents and expert radiologists for interpreting CT images for making the diagnosis of pulmonary embolism (PE).Materials and MethodsWe assessed 112 consecutive patients, from April 2007 to August 2007, who were referred for combined CT pulmonary angiography and indirect CT venography for clinically suspected acute PE. CT scanning was performed with a 64×0.5 collimation multi-detector CT scanner. The CT studies were initially interpreted by the radiology residents alone and then the CT images were subsequently interpreted by a consensus of the resident plus an experienced general radiologist and an experienced chest radiologist.ResultsTwo of the 112 CTs were unable to be interpreted (1.7%). Pulmonary artery clots were seen on 36 of the thoracic CT angiographies (32%). The interobserver agreement between the radiology residents and the consensus interpretation was good (a kappa index of 0.73). All of the disagreements (15 cases) were instances of overcall by the resident on the initial interpretation. Deep venous thrombosis was detected in 72% (26 of 36) of the patients who had PE seen on thoracic CT. The initial and consensus interpretations of the CT venography images disagreed for two cases (kappa statistic: 0.96).ConclusionIt does not seem adequate to base the final long-term treatment of PE on only the resident's reading, as false positives occurred in 13% of such cases. Timely interpretation of the CT pulmonary angiography and CT venography images should be performed by experienced radiologists for the patients with suspected PE.
Buerger's disease, or thromboangiitis obliterans, is a nonatherosclerotic, noninflammatory, segmentally occlusive disease of unclear etiology. We report a case of late-onset Buerger's disease in a 57-year-old man with erectile dysfunction, an uncommon symptom that occurred shortly after intermittent claudication.
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