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https://www.readbyqxmd.com/read/29149393/challenges-in-minor-tbi-and-indications-for-head-ct-in-pediatric-tbi-an-update
#1
Navneet Singh, Ash Singhal
INTRODUCTION: Pediatric head trauma is one of the commonest presentations to emergency departments. Over 90% of such head injuries are considered mild, but still present risk acute clinical deterioration and longer term morbidity. Identifying which children are at risk of clinically important brain injuries remains challenging and much of the data on minor head injuries is based on the adult population. CHALLENGES IN PEDIATRICS: Children, however, are different, both anatomically and in terms of mechanism of injury, to adults and, even within the pediatric group, there are differences with age and stage of development...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29130874/do-routine-radiographs-obtained-at-initial-outpatient-postoperative-visit-change-management
#2
Eric Grenier, Dave Tennent, Jean Patzkowski, Joseph Hsu, Anthony Johnson
Routine postoperative radiographs are commonly obtained at the initial postoperative visit. The purpose of this study was to demonstrate the clinical utility of routine postoperative radiographs and quantify the radiation exposure and cost to the health care system. All orthopaedic surgeries performed during 2007 at a level I trauma center were retrospectively analyzed. Surgical procedures that were likely to require follow-up radiographs were included. Analysis demonstrated 878 procedures with 471 procedures (54%) receiving initial postoperative radiographs...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29125812/is-talon-tibial-intramedullary-nailing-clinically-superior-compared-to-conventional-locked-nailing
#3
Yalkın Çamurcu, Hakan Sofu, Ahmet Issın, Nizamettin Koçkara, Erdinç Genç, Mehmet Çetinkaya
OBJECTIVES: This study aims to compare the results of talon tibial intramedullary (IM) nailing with the results of conventional distal locked tibial IM nailing. PATIENTS AND METHODS: The study included 60 patients (37 males, 23 females; mean age 42.2 years; range 18 to 92 years) who underwent tibial IM nailing with the diagnosis of unilateral, closed or open (Gustilo-Anderson type 1) tibial diaphyseal fracture (Orthopaedic Trauma Association 42) between January 2013 and January 2016...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29116329/digital-tomography-for-detection-of-acute-occult-scaphoid-fractures
#4
Anthony M Barcia, Liang Zhou, Jay B Cook, Kenneth K Lindell, Rey D Gumboc, Aaron D Dykstra, Robert J Lachky, Steven H Shaha, Kenneth F Taylor
Diagnosis of occult scaphoid fractures remains a challenge. Traditional management consisting of 2 weeks of immobilization and repeat radiographs results in unnecessary immobilization of many patients without fracture. Magnetic resonance imaging (MRI) is sensitive but expensive. Digital tomography (DT) is an imaging technique that provides fine-cut visualization with minimal radiation exposure and may be used when there is high clinical suspicion despite negative findings on initial radiographs. The authors compared the ability of DT vs MRI to detect acute occult scaphoid fractures...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29074334/robotically-assisted-long-bone-biopsy-under-mri-imaging-workflow-and-preclinical-study
#5
Kevin Cleary, Sunghwan Lim, Changhan Jun, Reza Monfaredi, Karun Sharma, Stanley Thomas Fricke, Luis Vargas, Doru Petrisor, Dan Stoianovici
RATIONALE AND OBJECTIVES: Our research team has developed a magnetic resonance imaging (MRI)-compatible robot for long bone biopsy. The robot is intended to enable a new workflow for bone biopsy in pediatrics under MRI imaging. Our long-term objectives are to minimize trauma and eliminate radiation exposure when diagnosing children with bone cancers and bone infections. This article presents our robotic systems, phantom accuracy studies, and workflow analysis. MATERIALS AND METHODS: This section describes several aspects of our work including the envisioned clinical workflow, the MRI-compatible robot, and the experimental setup...
October 23, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29057711/the-effects-of-childhood-maltreatment-on-brain-structure-in-adults-with-eating-disorders
#6
Alessio Maria Monteleone, Palmiero Monteleone, Fabrizio Esposito, Anna Prinster, Valeria Ruzzi, Antonietta Canna, Marco Aiello, Francesco Di Salle, Mario Maj
OBJECTIVES: Childhood maltreatment is a non specific risk factor for eating disorders (EDs). However, no study assessed so far the impact of childhood maltreatment on brain structure of adults with EDs. Therefore, we investigated brain areas volumes and fiber tracts integrity of childhood maltreated (Mal) and non-maltreated (noMal) patients with EDs. METHODS: Thirty-six ED women and 16 healthy women underwent a MRI scanning including acquisition of a diffusion tensor imaging (DTI) sequence and a high resolution T1-weighted scan...
October 23, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/29049266/the-cost-and-utility-of-postreduction-radiographs-after-closed-reduction-of-pediatric-wrist-and-forearm-fractures
#7
Avi D Goodman, Mark Zonfrillo, Daniel Chiou, Craig P Eberson, Aristides I Cruz
BACKGROUND: Formal radiographs are frequently obtained after reduction of closed pediatric wrist and forearm fracture performed under mini C-arm fluoroscopy. However, their utility has not been clearly demonstrated to justify the increased time, cost, and radiation exposure. We hypothesized that formal postreduction radiographs do not affect the rereduction rate of pediatric wrist and forearm fractures. We further sought to determine the time, monetary, and opportunity costs associated with obtaining these radiographs...
October 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29033151/is-it-adequate-to-carry-out-a-chest-ct-in-patients-with-mild-moderate-chest-trauma
#8
V García de Pereda de Blas, M Carreras Aja, S Carbajo Azabal, E Arana-Arri
Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan...
October 12, 2017: Radiología
https://www.readbyqxmd.com/read/29021952/the-forgotten-view-chest-x-ray-lateral-view
#9
Abraham M Ittyachen, Anuroopa Vijayan, Megha Isac
With CT (computed tomography) chest gaining more importance as a diagnostic tool, chest X-ray especially the lateral view is taken less commonly nowadays. Besides CT chest is also proven to be superior to chest X-ray in patients with major blunt trauma. We are presenting a 68-year old male who was partially treated from outside for a left sided pneumonia. He came to our hospital because of persisting chest pain. Chest X-ray, frontal view (postero-anterior) was almost normal except for a mild opacity in the left lower zone...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28979663/finger-pad-squamous-cell-carcinoma-report-of-squamous-cell-carcinoma-of-the-distal-palmar-digit-and-review-of-associated-risk-factors-mimickers-and-treatment-of-squamous-cell-carcinoma-of-ventral-hand-digits
#10
Philip R Cohen, S Brian Jiang
BACKGROUND: Squamous cell carcinoma of the palmar digits is rare. PURPOSE: The authors describe a man with squamous cell carcinoma of the pulp of his left fourth finger, and review the risk factors that may be associated with squamous cell carcinoma development on the ventral digits of the hand. the authors also summarize the clinical differential diagnoses and treatment of squamous cell carcinoma at this location. METHODS: the authors retrospectively reviewed the literature using PubMed and searched for the following terms: squamous cell carcinoma, squamous cell carcinoma in situ, finger, thumb, palmar, and ventral...
August 2017: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/28964934/a-nomogram-predicting-the-need-for-abdominal-and-pelvic-computed-tomography-in-blunt-trauma-patients-a-retrospective-cohort-study
#11
Jin Young Lee, Dae Hyun Cho, Jae Gil Lee, Hyejung Shin, Yeon Ju Lee, Seung Hwan Lee
BACKGROUND: Abdominal and pelvic computed tomography (APCT) has become the preferred means for the initial evaluation of blunt trauma patients. However, computed tomography examination has some disadvantages, such as radiation exposure, the requirement for intravenous iodinated contrast medium, high cost, and time. We aimed to develop a nomogram to predict the need for APCT scanning after the primary survey of blunt trauma patients. MATERIALS AND METHODS: We conducted a retrospective observational cohort study at a single-center and reviewed medical records of 972 trauma patients admitted between January 2013 and June 2016...
November 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28948571/isolated-loc-in-head-trauma-associated-with-significant-injury-on-brain-ct-scan
#12
Muhammad Waseem, Patrick Iyahen, Hilary Bryan Anderson, Kevin Kapoor, Ramnath Kapoor, Mark Leber
BACKGROUND: A report of loss of consciousness (LOC) is frequently considered reason enough to obtain a computed tomography (CT) scan in the evaluation of head trauma. We conducted this study to reduce exposure to radiation from CT, while still not overlooking clinically significant injuries. OBJECTIVE: The objective of the study is to determine the correlation between LOC status and brain CT scan results in patients with blunt head trauma and to determine whether there is a subset of patients for whom CT scan need not be performed, without missing clinically significant intracranial injuries...
September 25, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28948295/routine-versus-selective-chest-and-abdominopelvic-ct-scan-in-conscious-blunt-trauma-patients-a-randomized-controlled-study
#13
N Moussavi, H Ghani, A Davoodabadi, F Atoof, A Moravveji, S Saidfar, H Talari
PURPOSE: CT-scan is increasingly used in blunt trauma, but the real impact on patient outcome is still unclear. This study was conducted to assess the effect of performing routine (versus selective) chest and abdominopelvic CT-scan on patient admission time and outcome in blunt trauma. METHODS: Conscious and hemodynamically stable high-energy trauma patients were included (n = 140). Routine chest and abdominopelvic CT-scan was requested in addition to the conventional radiography and ultrasound for the intervention group and selective CT-scan according to clinical presentation was done for the control group...
September 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28941740/fetal-radiation-dose-in-three-common-ct-examinations-during-pregnancy-monte-carlo-study
#14
A Kelaranta, T Mäkelä, T Kaasalainen, M Kortesniemi
PURPOSE: To determine fetal doses in different stages of pregnancy in three common computed tomography (CT) examinations: pulmonary CT angiography, abdomino-pelvic and trauma scan with Monte Carlo (MC) simulations. METHODS: An adult female anthropomorphic phantom was scanned with a 64-slice CT using pulmonary angiography, abdomino-pelvic and trauma CT scan protocols. Three different sized gelatin boluses placed on the phantom's abdomen simulated different stages of pregnancy...
September 20, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#15
Joseph P Drain, Douglas S Weinberg, James S Ramey, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk. SUMMARY OF BACKGROUND DATA: VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular injury (BCVI)...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28899768/missed-opportunities-to-decrease-radiation-exposure-in-children-with-renal-trauma
#16
Thomas W Gaither, Mohannad A Awad, Natalia V Leva, Gregory P Murphy, Benjamin N Breyer, Hillary L Copp
PURPOSE: Efforts have been made to reduce use of computerized tomography in children with blunt abdominal injury. Computerized tomography may be overused in pediatric patients with renal trauma. MATERIALS AND METHODS: We performed a retrospective chart review of all renal trauma patients younger than 18 years old treated at 2 urban trauma centers from 2002 to 2016. We collected demographic and clinical characteristics, renal trauma grades, urological interventions, and timing and use of computerized tomography and renal ultrasound...
September 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28877594/a-medial-malleolar-fleck-sign-may-predict-ankle-instability-in-ligamentous-supination-external-rotation-ankle-fractures
#17
Kenneth Nwosu, Brian Andrew Schneiderman, Stephen Joseph Shymon, Thomas Harris
BACKGROUND: Ankle joint stability dictates treatment in ligamentous supination external rotation ankle injuries (LSERAI). Investigation of the medial structures that support the ankle mortise is critical, and a small avulsion fracture, or "fleck", of the medial malleolus is occasionally encountered. This study aimed to assess the utility of this medial malleolus fleck sign (MMFS) in diagnosing instability requiring surgery in LSERAI. METHODS: This retrospective observational study examined 166 LSERAI at a single level I trauma center...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28872156/indications-of-cone-beam-ct-in-head-and-neck-imaging-in-children
#18
U Walliczek-Dworschak, I Diogo, L Strack, M Mandapathil, A Teymoortash, J A Werner, C Güldner
For imaging of bony structures, especially for the anterior and lateral skull base in ORL medicine, cone beam computed tomography (CBCT) is an increasingly used alternative to CT, with a lower exposition to plain radiography that makes its use for imaging, particularly in children, very interesting. The aim of this study was to analyse possible indications and settings for CBCT in children and compare them to those of adults. A total of 554 patients (age range 0-18 years, mean age 10.36 years), who underwent CBCT between 01/2004-06/2013 in the ENT department at the university clinic of Marburg were enrolled in this retrospective analysis to evaluate technical parameters and indications...
August 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28834822/a-prospective-randomized-study-on-operative-treatment-for-simple-distal-tibial-fractures-minimally-invasive-plate-osteosynthesis-versus-minimal-open-reduction-and-internal-fixation
#19
Ji Wan Kim, Hyunuk Kim, Chang-Wug Oh, Joon-Woo Kim, Ki Chul Park
OBJECTIVES: To compare the radiological and clinical results of minimally invasive plate osteosynthesis (MIPO) and minimal open reduction and internal fixation (ORIF) for simple distal tibial fractures. DESIGN: Randomized prospective study. SETTING: Three level 1 trauma centers. PATIENTS: Fifty-eight patients with simple and distal tibial fractures were randomized into a MIPO group (treatment with MIPO; n=29) or a minimal group (treatment with minimal ORIF; n=29)...
August 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28798994/intra-operative-fluoroscopic-radiation-exposure-in-orthopaedic-trauma-theatre
#20
Mustafa S Rashid, Sheweidin Aziz, Syed Haydar, Simon S Fleming, Amit Datta
INTRODUCTION: Radiation exposure from intra-operative fluoroscopy in orthopaedic trauma surgery is a common occupational hazard. References for fluoroscopy use in the operating room for commonly performed operations have not been reported adequately. This study aimed to report appropriate intra-operative fluoroscopy use in orthopaedic trauma and compare the effect of surgery type and surgeon grade on radiation exposure. METHODS: Data on 849 cases over an 18-month period were analysed retrospectively...
August 10, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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