RESUMO
Aim To compare the accuracy of shoulder ultrasound (US) in diagnosing rotator cuff tendon tears between junior and experienced musculoskeletal (MSK) radiologists. Also, to compare the overall ultrasound accuracy referenced to MRI. Methods A retrospective data collection for patients with clinically suspected rotator cuff tears who underwent ultrasound from June 2021 - June 2023 was conducted. Patients who also performed MRI for the same shoulder were only included in the study. US and MRI images were evaluated by two MSK radiologists with different experience levels. The diagnosis of rotator cuff tears was done on MRI through consensus. Ultrasound accuracy referenced to MRI was calculated for each radiologist. A second consensus was conducted for US images to calculate the overall US accuracy. The percentage of agreement and Cohen's kappa correlation coefficient were calculated before and after the US consensus. Results Forty-one patients were included in the study, 12 (29.3%) males and 29 (70.7%) females, with a mean age of 49.6 years. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and accuracy of US interpreted by junior vs experienced MSK radiologists for supraspinatus full thickness tears (FTTs) were 100% vs 91%, 90% vs 93%, 79% vs 83%, 100% vs 97%, and 93% vs 93%, respectively. After the second consensus, sensitivity, specificity, PPV and NPV, and accuracy were 91%, 90%, 77%, 96%, and 90%, respectively. Conclusion The accuracy of shoulder ultrasound in diagnosing supraspinatus FTTs by junior MSK radiologists compares well to the more experienced ones, but not for partial thickness tears (PTTs).
RESUMO
Atrial fibrillation (AF) is the most common sustained arrhythmia and it is a major public health problem worldwide. Hypertension is one of the major risk factors for the development of AF. This study is carried out to determine the prevalence and independent risk factors for atrial fibrillation (AF) in hypertensive patients and to evaluate the relationship of AF with left atrial size. This is a retrospective observational cross - sectional study that used a retrospective electronic chart review of all admitted patients to cardiology department at King Abdullah university hospital (KAUH) in Irbid, Jordan, with a diagnosis of hypertension along with various acute cardiac admissions, including AF during 1-year period (January 1st to December 31 of 2021). Risk factors for AF (age, sex, DM, coronary artery disease, valvular heart disease, Cor-pulmonale, obstructive sleep apnea, and congestive cardiac failure) were retrieved from electronic charts of the patients. A total of 958 patients were admitted to the coronary care unit (CCU) and intermediate care unit (IMCU) during a 1-year period. Among them, 276 had 2 or 3 admissions. The main reason of admission was acute coronary syndrome (n = 491), heart failure (n = 180), and AF (n = 144), indicating AF prevalence of 15%. However, there were 40 patients with combined causes. All patients in the study (n = 958) were diagnosed with hypertension, including patients with atrial fibrillation (n = 144). The mean age of patients was 61.4 (± 11.46) years, and approximately two thirds of them were males (65.4%). The binary logistic regression model demonstrated a significant statistical relationship of age, left atrial size, coronary artery disease, left ventricular ejection fraction, left ventricular dimensions in systole and diastole, and heart failure with the occurrence of AF after controlling for gender, smoking, and diabetes. Findings indicate that left atrial size plays a significant role in the development of AF in patients with hypertension. However, the prevalence of AF significantly increased with advancing age in both sexes because of increased left ventricular hypertrophy, which leads to increased left atrial size.
