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10 Most studies that evaluated the sensitivity of computed
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26 Dec, 2012


The West Coast network that is organizing WTO anarchist protests has agreed to abide by the nonviolence code being promulgated by Seattle direct action organizers but that won’t necessarily stop individuals or small affinity groups from acting on their own outside the mainstream protests. Aside from the pointlessness and counterproductivity of such acts, they’re not likely to meet with much more tolerance here than in Eugene. All indications are that the historic laissez faire attitude toward protests typical of Seattle is out the window for the WTO.

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pandora essence Such patients can be difficult to diagnose and yet have the most to lose by a missed diagnosis.4 Moreover, nearly half of all patients with a subarachnoid haemorrhage have normal results on neurological examination and normal vital signs at initial presentation.To exclude subarachnoid haemorrhage, traditional teaching says that patients should undergo a lumbar puncture if the initial computed tomogram yields negative results.5 6 7 8 9 Lumbar puncture https://www.pandorajewellry-canada.com, however, causes pain and delays discharge from the emergency department and can lead to postdural puncture headache.10 Most studies that evaluated the sensitivity of computed tomography for subarachnoid haemorrhage were retrospective reviews and found that sensitivity deteriorates rapidly over time because of erythrocyte dissipation and lysis.11 12 13 14 15 16 These prospective studies were small or used older computed tomography technology, used 12 or 24 hours as a cut off point, and found sensitivities ranging from 90.5% to 100%.13 14 15 17 18 19 20 There have been no large prospective studies of emergency department patients with acute headache involving modern, multi detector row third generation scanners (that is, x ray emitter and detector rigidly linked and operating in rotate/rotate geometry; multiple rows of detectors in z axis).21We determined the sensitivity of modern computed tomography for identifying subarachnoid haemorrhage in neurologically intact patients who present to the emergency department with acute headache, especially when scans are performed within six hours of headache onset.MethodsDesign and settingThis prospective multicentre cohort study was conducted in the emergency departments of 11 university affiliated tertiary care teaching hospitals in Canada, November 2000 to December 2009. Study sites had a mean of 52000 emergency visits a year (range 39000 65000) and a mean of 445 inpatient beds (range 289 622). Nine of the 11 sites had neurosurgical units pandora essence.

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