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Radiation exposure trauma

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https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#1
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
#2
Thomas W Gaither, Mohannad A Awad, Natalia V Leva, Gregory P Murphy, Benjamin N Breyer, Hillary L Copp
BACKGROUND: Efforts have been made to reduce computed tomography (CT) scans in children with blunt abdominal injury. CT scans may be over utilized in pediatric patients with renal trauma. METHODS: We performed a retrospective chart review of all renal trauma cases (<18 years old) in two urban trauma centers from 2002-2016. We collected patient demographic and clinical characteristics, renal trauma grades, urologic interventions, and the timing and utilization of CT scans and renal ultrasounds...
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28771181/ghrelin-therapy-decreases-incidents-of-intracranial-hemorrhage-in-mice-after-whole-body-ionizing-irradiation-combined-with-burn-trauma
#7
Nikolai V Gorbunov, Juliann G Kiang
Nuclear industrial accidents and the detonation of nuclear devices cause a variety of damaging factors which, when their impacts are combined, produce complicated injuries challenging for medical treatment. Thus, trauma following acute ionizing irradiation (IR) can deteriorate the IR-induced secondary reactive metabolic and inflammatory impacts to dose-limiting tissues, such as bone marrow/lymphatic, gastrointestinal tissues, and vascular endothelial tissues, exacerbating the severity of the primary injury and decreasing survival from the exposure...
August 3, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28763418/tracking-cumulative-radiation-exposure-in-orthopaedic-surgeons-and-residents-what-dose-are-we-getting
#8
Elizabeth B Gausden, Alexander B Christ, Roseann Zeldin, Joseph M Lane, Moira M McCarthy
BACKGROUND: The purpose of this study was to determine the amount of cumulative radiation exposure received by orthopaedic surgeons and residents in various subspecialties. We obtained dosimeter measures over 12 months on 24 residents and 16 attending surgeons. METHODS: Monthly radiation exposure was measured over a 12-month period for 24 orthopaedic residents and 16 orthopaedic attending surgeons. The participants wore a Landauer Luxel dosimeter on the breast pocket of their lead apron...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28756035/role-of-clinical-suspicion-in-pediatric-blunt-trauma-patients-with-severe-mechanisms-of-injury
#9
Carolinna M Garcia, Sandra J Cunningham
OBJECTIVES: In adult patients with blunt trauma, severe mechanism of injury leads to routine pan-computed tomography (CT). Due to concerns about the risk of radiation, we sought to determine whether clinical suspicion could identify children requiring radiographic imaging. METHODS: A prospective study was conducted in a pediatric emergency department of a Level 1 trauma center. Patients ≤14years presenting with blunt trauma due to predefined severe mechanisms were eligible...
July 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28737067/confirmed-and-suspected-foreign-body-injuries-in-children-during-2008-2013-a-hospital-based-single-center-study-in-oulu-university-hospital
#10
J-J Sinikumpu, W Serlo
INTRODUCTION: Foreign body injuries are common in children. Most of them are not serious but they can be fatal. A suspected foreign body injury in a child results in a high rate of hospitalizations, exposure to radiation, and need for intervention. This study aimed to analyze the current epidemiology of in-hospital or out of hospital treated foreign object injuries and suspected foreign body injuries in children. MATERIAL AND METHODS: All children <16 years of age (N = 152) who suffered or were suspected to suffer (N = 63) from a foreign body injury and were treated in a pediatric trauma unit of Oulu University Hospital, Oulu, Finland, over a 6-year study period (2008-2013) were included...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28692451/the-value-of-musculoskeletal-ultrasound-in-geriatric-care-and-rehabilitation
#11
Büşra Can, Murat Kara, Özgür Kara, Zekeriya Ülger, Walter R Frontera, Levent Özçakar
The WHO reports that one of the major chronic conditions affecting the elderly worldwide is musculoskeletal disorders that are associated with long-term pain and disability. Considering the healthcare needs of the elderly (i.e. comprehensive, accessible, efficient) and the advantages of ultrasound (US) use (patient-friendly, convenient, cost-effective, and does not require exposure to radiation or magnetic fields), there seems to be a 'gap' in the actual clinical practice. In this paper, we aimed to highlight the potential value of US imaging in the management of the elderly with a wide spectrum of musculoskeletal conditions (degenerative/rheumatic joint diseases, falls/trauma, nursing care, peripheral nerve problems, sarcopenia, and interventions)...
July 7, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#12
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28656384/x-ray-vs-ct-in-identifying-significant-c-spine-injuries-in-the-pediatric-population
#13
Andrew T Hale, Abraham Alvarado, Amita K Bey, Sumit Pruthi, Gregory A Mencio, Christopher M Bonfield, Jeffrey E Martus, Robert P Naftel
PURPOSE: Evaluation of cervical spine injury (CSI) in children requires rapid, yet accurate assessment of damage. Given concerns of radiation exposure, expert consensus advises that computed tomography (CT) should be used sparingly. However, CT can provide superior image resolution and detection of pathology. Herein, we evaluate if X-ray offers equal diagnostic accuracy compared to CT imaging in identifying CSI in children. METHODS: We conducted a retrospective study between October 2000 and March 2012 of pediatric patients evaluated for cervical spine injury at a level 1 trauma center...
June 27, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28651263/quality-and-dose-optimized-ct-trauma-protocol-recommendation-from-a-university-level-i-trauma-center
#14
Johannes Kahn, David Kaul, Georg Böning, Roman Rotzinger, Patrick Freyhardt, Philipp Schwabe, Martin H Maurer, Diane Miriam Renz, Florian Streitparth
Purpose As a supra-regional level-I trauma center, we evaluated computed tomography (CT) acquisitions of polytraumatized patients for quality and dose optimization purposes. Adapted statistical iterative reconstruction [(AS)IR] levels, tube voltage reduction as well as a split-bolus contrast agent (CA) protocol were applied. Materials and Methods 61 patients were split into 3 different groups that differed with respect to tube voltage (120 - 140 kVp) and level of applied ASIR reconstruction (ASIR 20 - 50 %)...
September 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28645672/percutaneous-pedicle-screw-placement-under-single-dimensional-fluoroscopy-with-a-designed-pedicle-finder-a-technical-note-and-case-series
#15
Fon-Yih Tsuang, Chia-Hsien Chen, Yi-Jie Kuo, Wei-Lung Tseng, Yuan-Shen Chen, Chin-Jung Lin, Chun-Jen Liao, Feng-Huei Lin, Chang-Jung Chiang
BACKGROUND CONTEXT: Minimally invasive spine surgery has become increasingly popular in clinical practice, and it offers patients the potential benefits of reduced blood loss, wound pain, and infection risk, and it also diminishes the loss of working time and length of hospital stay. However, surgeons require more intraoperative fluoroscopy and ionizing radiation exposure during minimally invasive spine surgery for localization, especially for guidance in instrumentation placement. In addition, computer navigation is not accessible in some facility-limited institutions...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28632654/an-overview-of-cardiac-computed-tomography-in-adults-with-congenital-heart-disease
#16
Pal Suranyi, Akos Varga-Szemes, Anthony M Hlavacek
Familiarity with congenital heart disease (CHD) and its manifestations in adults is becoming increasingly important for the practicing cardiothoracic imager. The use of computed tomographic angiography is becoming commonplace not only in adults with a history and subsequent interventions for CHD as a child but also in de novo detection of-typically-milder, survivable forms of CHD, which are clinically suspected because of declining cardiac performance, cardiac events, or murmurs. Occasionally, adult CHD (ACHD) is found incidentally on scans performed for other indications (eg, trauma or neoplasm staging) because of improvements in computed tomographic technology and advanced visualization...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28625692/implementation-of-clinical-effectiveness-guidelines-for-solid-organ-injury-after-trauma-10-year-experience-at-a-level-1-pediatric-trauma-center
#17
Christine M Leeper, Isam Nasr, Abigail Koff, Christine McKenna, Barbara A Gaines
BACKGROUND: Diagnostic imaging of pediatric blunt abdominal trauma is evolving in light of increased attention to radiation exposure. We hypothesize that the implementation of imaging guidelines has reduced total CT scans without missing clinically significant injury. METHODS: We retrospectively reviewed blunt trauma patients age 0-17 with solid organ injury who underwent CT scan at our academic level 1 pediatric trauma center between 2005 and 2014. Variables including total annual trauma admissions and CT scans, demographics, injury characteristics, and procedures were recorded...
June 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28601333/variability-in-ct-imaging-of-blunt-trauma-among-ed-physicians-surgical-residents-and-trauma-surgeons
#18
Melissa K James, Shi-Wen Lee, Jennifer A Minneman, Maureen D Moore, Taylor R Klein, R Jonathan Robitsek, Phillip S Barie, Sebastian D Schubl
BACKGROUND: Trauma triage decisions can be influenced by both knowledge and experience. Consequently, there may be substantial variability in computed tomography (CT) scans desired by emergency medicine physicians, surgical chief residents, and attending trauma surgeons. We quantified this difference and studied the effects of each group's decisions on missed injuries, cost, and radiation exposure. METHODS: All blunt trauma activations at an urban level 1 trauma center were studied over a 6-mo period...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28493802/placental-imaging-normal-appearance-with-review-of-pathologic-findings
#19
Shaimaa Fadl, Mariam Moshiri, Corinne L Fligner, Douglas S Katz, Manjiri Dighe
The placenta plays a crucial role throughout pregnancy, and its importance may be overlooked during routine antenatal imaging evaluation. Detailed systematic assessment of the placenta at ultrasonography (US), the standard imaging examination during pregnancy, is important. Familiarity with the normal and abnormal imaging appearance of the placenta along with the multimodality and methodical approach for evaluation of its related abnormalities is necessary, so that radiologists can alert clinicians regarding appropriate prompt management decisions...
May 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28427782/prospective-study-of-a-non-restrictive-decision-rule-for-acute-aortic-syndrome
#20
MULTICENTER STUDY
Judah Goldschmiedt, Jeffrey M Levsky, Eran Y Bellin, Esther Mizrachi, David Esses, Linda B Haramati
OBJECTIVES: To determine the impact of a non-restrictive clinical decision rule on CT utilization for Emergency Department patients suspected of having an acute aortic syndrome (AAS). METHODS: We prospectively assessed the performance of a previously described, collaboratively designed, non-restrictive clinical decision rule for AAS. Emergency Department patients with suspected AAS were stratified into low and high-risk groups based on decision rule results, from July 2013-August 2014...
September 2017: American Journal of Emergency Medicine
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