Predictors of abnormal brain computed tomography findings in patients with acute altered mental status in the emergency department

Objective Brain computed tomography (CT) is commonly performed to diagnose acute altered mental status (AMS), a critically important symptom in many serious diseases. However, negative CT results are common, which result in unnecessary CT use. Therefore, this study aimed to determine the clinical factors associated with positive CT findings. Methods Patients with acute AMS selected from an emergency department-based registry were retrospectively evaluated. Patients with non-traumatic and noncommunicable diseases on initial presentation and with Glasgow Comal Scale scores of <15 were included in the study. Results Among the 367 brain CT results of patients with AMS during the study period, 146 (39.8%) were positive. In a multivariate analysis, the presence of focal neurologic deficit (odds ratio [OR], 132.6; 95% confidence interval [CI], 37.8 to 464.6), C-reactive protein level <2 mg/dL (OR, 3.9; 95% CI, 1.4 to 10.6), and Glasgow Comal Scale score <9 (OR, 2.4; 95% CI, 1.2 to 4.8) were significantly associated with positive brain CT results. Conclusion The presence of focal neurologic deficit, initial Glasgow Comal Scale score of <9, and initial C-reactive protein levels of <2 mg/dL can facilitate the selection of brain CT to diagnose patients with acute AMS in the emergency department

Dynamical Substructures of Galactic Globular Clusters II. NGC 6934

The variations of the dynamical substructures of NGC 6934 have been investigated by means of performing point spread function stellar photometry and the surface photometry on BV CCD images of NGC 6934. Our results show that overall variations of ellipticity and position angle range in 0.02˜0.08 and -90° ˜ +90°, respectively out to three times the half light radius. The inner (reff < rh) substructures of NGC 6934 inferred from the variations of ellipticity and position angle are mainly affected by the bright red giant populations, while the effects of the other giant populations are weaker than those of the bright red giant populations. Horizontal branch populations and faint red giant star populations affect the dynamical substructures of NGC 6934 in the region of rh < reff < 3rh