The purpose of this study was to analyse factors for interobserver disagreements in two scales used for the assessments of the amount of blood in subarachnoid space (Fisher grading) and of acute hydrocephalus on computerized tomographic (CT) scans. The assessments made by four neuroradiologists on 59 CT scans obtained in the acute stage after subarachnoid hemorrhage were analysed by a statistical method by Svensson and Holm. This method permits the separation of the inter-observer disagreements in their random and systematic components. The overall consistency of the assessments was significant (p < 0.0005) but the neuroradiologists disagreed on half of the CT-scans. The kappa values were 0.50-0.63. The analysis showed that the main reason for disagreements was systematic inter-observer differences in their use of the clinically most important parts of staging, i.e. subarachnoid clot or intraventricular blood (Fisher grading) and too low categories (hydrocephalus). The main conclusion from this study is that the proper remedy for Fisher grading and for grading of hydrocephalus is a sharpening of the criteria of specific category levels and given this improvement both grading systems will show a high level of reliability.
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http://dx.doi.org/10.1080/01616412.1996.11740459 | DOI Listing |
Gut
January 2025
Barts Cancer Institute, Queen Mary University of London, London, UK
Background: The risk of developing advanced neoplasia (AN; colorectal cancer and/or high-grade dysplasia) in ulcerative colitis (UC) patients with a low-grade dysplasia (LGD) lesion is variable and difficult to predict. This is a major challenge for effective clinical management.
Objective: We aimed to provide accurate AN risk stratification in UC patients with LGD.
J Matern Fetal Neonatal Med
December 2025
Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, Warsaw, Poland.
Introduction: Small-for-gestational age (SGA) newborns are at increased risk of adverse neonatal outcomes and the risk is related to the etiology of growth restriction: highest in placental insufficiency, lowest in constitutional SGA. The aim of this study was to investigate if placental growth factor (PlGF), soluble fms-like tyrosine kinase-1(sFlt-1) or sFlt-1/PlGF ratio are efficient in prediction of adverse neonatal outcomes in SGA newborns delivered ≥34 weeks of gestation.
Methods: A prospective observational multicenter cohort study was performed.
Crit Care Sci
January 2025
Department of Neurointensive Care, Instituto Estadual do Cérebro Paulo Niemeyer - Rio de Janeiro (RJ), Brazil.
Objective: To define the incidence of ventriculostomy-associated infections and their impact on the mortality and functional outcomes of patients with aneurysmal subarachnoid hemorrhage.
Methods: We prospectively included all consecutive adult aneurysmal subarachnoid hemorrhage patients admitted to the neurological intensive care units of the Instituto Estadual do Cérebro Paulo Niemeyer (Rio de Janeiro, Brazil) and Hospital Cristo Redentor (Rio Grande do Sul, Brazil) who required external ventricular drains from July 2015 to December 2020. Daily clinical and laboratory variables were collected at admission and during the hospital stay.
Objective: The Laparoscopic Approach to Cervical Cancer trial demonstrated that minimally invasive radical hysterectomy was associated with worse disease-free survival and overall survival among women with early-stage cervical cancer. It is unknown whether this applies to patients with low-risk disease following simple hysterectomy.
Methods: Among patients who underwent simple hysterectomy in the Simple Hysterectomy And PElvic node assessment trial, univariate and multivariate Cox models were used to assess the association of minimally invasive versus open surgery with clinical outcomes, including pelvic and extra-pelvic recurrence-free survival, overall recurrence-free survival, and overall survival.
Niger Med J
January 2025
Department of Surgery, Kings Hospitals, NHS Foundation Trust, United Kingdom.
Background: Prostate cancer is the most common urologic malignancy in men, it is witnessing a huge burden in developing countries. Prostate-specific antigen has served as a tool in diagnosis and prognostication. To improve its sensitivity, Prostate-specific antigen density is being used to discriminate between benign and malignant conditions to avoid the incidence of unnecessary biopsy.
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