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https://www.readbyqxmd.com/read/28635149/underuse-of-risk-assessment-and-overuse-of-ctpa-in-patients-with-suspected-pulmonary-thromboembolism
#1
Michael Perera, Leena Aggarwal, Ian A Scott, Nicholas Cocks
INTRODUCTION: Evidence suggests potential overuse of computerised tomography pulmonary angiography (CTPA) in patients with suspected pulmonary thromboembolism (PTE) in the absence of consistent use of pre-test clinical prediction rules and D-dimer assays. METHODS: 344 consecutive patients undergoing CTPA at a tertiary hospital were studied for use of D-dimer assays and clinical prediction rules for PTE. For each patient, a modified Wells score (mWS), revised Geneva score (rGS) and PISA model were calculated retrospectively; performance characteristics for each rule for PTE were determined in reference to results of CTPA...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28627987/computerised-tomography-and-magnetic-resonance-imaging-of-laryngeal-squamous-cell-carcinoma-a-practical-approach
#2
Francesco Agnello, Francesco Cupido, Gianvincenzo Sparacia, Federico Midiri, Martina Miroddi, Emanuele Grassedonio, Massimo Galia
Squamous cell carcinoma is the most common head and neck cancer. This review describes the state-of-the-art computerised tomography and magnetic resonance imaging protocols of the neck and the normal larynx anatomy, and provides a practical approach for the diagnosis and staging of laryngeal squamous cell carcinoma.
June 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28589313/effect-of-a-collar-on-subsidence-and-local-micromotion-of-cementless-femoral-stems-in-vitro-comparative-study-based-on-micro-computerised-tomography
#3
Valérie Malfroy Camine, Hannes A Rüdiger, Dominique P Pioletti, Alexandre Terrier
PURPOSE: The aim of this study is to quantitatively compare the difference in primary stability between collarless and collared versions of the same femoral stem. Specifically, we tested differences in subsidence and micromotion. METHODS: Collarless and collared versions of the same cementless femoral stem were implanted in two groups of six fresh-frozen cadaveric femurs. Each implanted femur was then subsequently tested for axial compressive and torsional loadings...
June 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28585398/genetic-status-determines-18-f-fdg-uptake-in-pheochromocytoma-paraganglioma
#4
Ankita Tiwari, Nalini Shah, Vijaya Sarathi, Gaurav Malhotra, Ganesh Bakshi, Gagan Prakash, Kranti Khadilkar, Reshma Pandit, Anurag Lila, Tushar Bandgar
INTRODUCTION: Although few studies have demonstrated utility of (18) F- fluoro-2-deoxy-d-glucose positron emission tomography/computerised tomography ((18) F-FDG PET/CT) in benign pheochromocytoma/paragangliomas (PCC/PGLs), there limited data on factors predicting the FDG uptake in PCC/PGL. METHODS: The study was conducted at a tertiary health care centre. In addition to the routine investigations, all patients (n = 96) with PCC/PGL were evaluated with (18) F-FDGPET/CT and majority (n = 78) underwent (131) I-metaiodobenzyl guanidine ((131) I-MIBG) scintigraphy...
June 5, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28579245/dentigerous-cysts-associated-with-impacted-third-molars-in-adults-after-decompression-a-prospective-survey-of-reduction-in-volume-using-computerised-analysis-of-cone-beam-computed-tomographic-images
#5
G Lizio, L Tomaselli, L Landini, C Marchetti
We prospectively investigated in adults the decompression of dentigerous cysts associated with impacted third molars at high risk of iatrogenic damage during extraction. The computerised calculated volumetric postoperative reductions measured by cone-beam computed tomography at four and eight months were correlated with the duration of treatment, initial volume, and patient's age. We prospectively monitored 14 adult patients with 14 dentigerous cysts that were associated with impacted third molars, for eight months after decompression...
June 1, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28574117/combined-anteversion-technique-in-total-hip-arthroplasty-for-crowe-iv-developmental-dysplasia-of-the-hip
#6
Biao Zhu, Changzheng Su, Yeteng He, Xingyu Chai, Zhen Li, Zhenyang Hou, Tengteng Lou, Xinfeng Yan
BACKGROUND: A high rate of postoperative dislocation in total hip arthroplasty (THA) for Crowe IV developmental dysplasia of the hip (DDH) has been reported, 1 of the main reasons being higher true acetabular anteversion. If the cup is fixed with normal anteversion, the anterior rim will be excessively exposed, which reduces the contact areas of the cup and bone, affects prosthesis stability, and leads to iliopsoas tendinitis and persistent hip pain after THA. The aim of this study was to demonstrate that when cup anteversion is larger, adjusting femoral anteversion to bring the combined anteversion (CA) into the "safe zone" might prevent dislocation...
May 27, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28572234/lesson-of-the-month-2-contusion-confusion
#7
Helen Wood, Thomas Mayes, Susan King, Joanna Kasznia-Brown, Tarun Solanki
This lesson of the month highlights that certain radiology terminology may be used to report bleeding on head computerised tomography (CT) reports. On-call junior doctors should not be expected to interpret CT head images, so often their decisions will be based on the written report. The wording used can change the clinical decision and therefore the treatment given by a junior doctor. Clinical teams and junior doctors should be educated on terminology in relation to bleeding on CT head reports.
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28572221/the-2016-update-to-nice-cg95-guideline-for-the-investigation-of-new-onset-stable-chest-pain-more-innovation-but-at-a-cost
#8
Khaled Alfakih, John P Greenwood, Sven Plein
The National Institute for Health and Care Excellence (NICE) published an update on its guideline on chest pain of recent onset in 2016. The new guideline makes three key changes to the 2010 version. NICE recommend that the previously proposed pre-test probability risk score should no longer be used. They also recommend that a calcium score of zero should no longer be used to rule out coronary artery disease in patients with low pre-test probability. However, the most radical change is that NICE now recommend that all patients with new onset chest pain should be investigated with a computerised tomography coronary angiogram as a first-ine investigation...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28571951/update-in-mild-traumatic-brain-injury
#9
REVIEW
María Dolores Freire-Aragón, Ana Rodríguez-Rodríguez, Juan José Egea-Guerrero
There has been concern for many years regarding the identification of patients with mild traumatic brain injury (TBI) at high risk of developing an intracranial lesion (IL) that would require neurosurgical intervention. The small percentage of patients with these characteristics and the exceptional mortality associated with mild TBI with IL have led to the high use of resources such as computerised tomography (CT) being reconsidered. The various protocols developed for the management of mild TBI are based on the identification of risk factors for IL, which ultimately allows more selective indication or discarding both the CT application and the hospital stay for neurological monitoring...
May 29, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28567107/a-case-of-adult-intussusception-with-greyscale-contrast-enhanced-ultrasound-and-computerised-tomography-correlation
#10
Vasileios Rafailidis, Claudette Phillips, Gibran Yusuf, Paul Sidhu
Intussusception is often misdiagnosed as a cause of bowel ischemia and obstruction among adults due to its relatively rare presentation outside of the paediatric population. Ultrasound is often the first-line investigation for non-specific abdominal pain and can identify the presence of intussusception. In the adult population, it is essential to evaluate for causes and consequences of intussusception; as a result, computerised tomography is often deemed necessary. However, contrast-enhanced ultrasound allows for evaluation of potential causes and complications, including a neoplastic lead point and ischaemia of the bowel, whilst avoiding ionising radiation or nephrotoxic iodinated contrast...
May 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/28551834/increased-bone-tracer-uptake-in-symptomatic-patients-with-acl-graft-insufficiency-a-correlation-of-mri-and-spect-ct-findings
#11
Dominic T Mathis, Anna Hirschmann, Anna L Falkowski, Tommi Kiekara, Felix Amsler, Helmut Rasch, Michael T Hirschmann
PURPOSE: Magnetic resonance imaging (MRI) and single-photon emission computerised tomography/computerised tomography (SPECT/CT) are used as diagnostic tools in symptomatic patients after reconstruction of the anterior cruciate ligament (ACL). The benefit of SPECT/CT in comparison with MRI is under debate. The purpose of this study was to investigate whether and how bone tracer uptake (BTU) intensity and distribution in SPECT/CT correlate with MRI findings in symptomatic patients after ACL reconstruction...
May 27, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28513613/defects-in-the-acid-phosphatase-acpt-cause-recessive-hypoplastic-amelogenesis-imperfecta
#12
Claire El Smith, Laura LE Whitehouse, James A Poulter, Steven J Brookes, Peter F Day, Francesca Soldani, Jennifer Kirkham, Chris F Inglehearn, Alan J Mighell
We identified two homozygous missense variants (c.428C>T, p.(T143M) and c.746C>T, p.(P249L)) in ACPT, the gene encoding acid phosphatase, testicular, which segregates with hypoplastic amelogenesis imperfecta in two unrelated families. ACPT is reported to play a role in odontoblast differentiation and mineralisation by supplying phosphate during dentine formation. Analysis by computerised tomography and scanning electron microscopy of a primary molar tooth from an individual homozygous for the c.746C>T variant revealed an enamel layer that was hypoplastic, but mineralised with prismatic architecture...
May 17, 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28507634/multi-system-complications-after-intravenous-cocaine-abuse
#13
Lidija Petkovska, Andon Chibishev, Aleksandra Stevcevska, Ivica Smokovski, Dusan Petkovski, Emilija Antova
BACKGROUND: Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration. AIM: We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome. CASE PRESENTATION: Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28497441/-cryptogenic-stroke-in-a-young-patient-with-heart-disease-and-kidney-failure
#14
B Oyanguren, R Segoviano, E Alegria, E Besada, M Gonzalez-Salaices, M Eimil-Ortiz, C Lopez de Silanes
INTRODUCTION: Fabry's disease is an infrequent metabolic pathology linked to the X chromosome which causes a wide variety of signs and symptoms. CASE REPORT: A 39-year-old male who was admitted to our stroke unit with right-side hemiparesis (1 + 0) and dysarthria (1). The score on the National Institute of Health Stroke Scale was 2. The patient presented angiokeratomas in both thighs. A computerised axial tomography scan of the head showed left thalamic acute infarction...
May 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28475998/refractory-focal-motor-seizures-controlled-with-intramuscular-botulinum-toxin
#15
Wei-I Lee, Patrick W Carney, Andrew J Hughes, John S Archer
Patients with recurrent focal motor seizures present a management dilemma, as anti-convulsants are often ineffective, and resective surgery poses a high risk of motor deficit. We describe three patients with recurrent focal motor seizures that remained refractory despite numerous anti-convulsant trials. All patients showed either hyperperfusion on Single-Photon Emission Computerised Tomography (SPECT) or hypermetabolism on Positron Emission Tomography (PET) in primary motor cortex during periods of sustained jerking, although EEG abnormalities were uncommon...
July 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28464835/streamlining-staging-of-lung-and-colorectal-cancer-with-whole-body-mri-study-protocols-for-two-multicentre-non-randomised-single-arm-prospective-diagnostic-accuracy-studies-streamline-c-and-streamline-l
#16
Stuart A Taylor, Sue Mallett, Anne Miles, Sandy Beare, Gauraang Bhatnagar, John Bridgewater, Rob Glynne-Jones, Vicky Goh, Ashley M Groves, Sam M Janes, Dow Mu Koh, Steve Morris, Alison Morton, Neal Navani, Alf Oliver, Anwar R Padhani, Shonit Punwani, Andrea G Rockall, Steve Halligan
BACKGROUND AND AIMS: Rapid and accurate cancer staging following diagnosis underpins patient management, in particular the identification of distant metastatic disease. Current staging guidelines recommend sequential deployment of various imaging platforms such as computerised tomography (CT) and positron emission tomography (PET) which can be time and resource intensive and onerous for patients. Recent studies demonstrate that whole body magnetic resonance Imaging (WB-MRI) may stage cancer efficiently in a single visit, with potentially greater accuracy than current staging investigations...
May 2, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28440286/size-and-shape-variations-of-the-bony-components-of-sperm-whale-cochleae
#17
Joseph G Schnitzler, Bruno Frédérich, Sven Früchtnicht, Tobias Schaffeld, Johannes Baltzer, Andreas Ruser, Ursula Siebert
Several mass strandings of sperm whales occurred in the North Sea during January and February 2016. Twelve animals were necropsied and sampled around 48 h after their discovery on German coasts of Schleswig Holstein. The present study aims to explore the morphological variation of the primary sensory organ of sperm whales, the left and right auditory system, using high-resolution computerised tomography imaging. We performed a quantitative analysis of size and shape of cochleae using landmark-based geometric morphometrics to reveal inter-individual anatomical variations...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28417258/in-vivo-facial-soft-tissue-depths-of-a-modern-adult-population-from-germany
#18
Nicolle Thiemann, Volker Keil, Uwe Roy
Forensic facial reconstruction may be the final option available to draw public attention in cases where the identity of an individual cannot be established by standard identification methods. Two fundamental components of all forensic facial reconstruction techniques are cranial morphology and soft tissue depth databases. The purpose of this study was to extend such databases by providing a complete set of accurate facial soft tissue thickness measurements, acquired from a contemporary adult population from Germany...
April 17, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28409743/pet-neck-a-multicentre-randomised-phase-iii-non-inferiority-trial-comparing-a-positron-emission-tomography-computerised-tomography-guided-watch-and-wait-policy-with-planned-neck-dissection-in-the-management-of-locally-advanced-n2-n3-nodal-metastases-in-patients
#19
Hisham Mehanna, Chris C McConkey, Joy K Rahman, Wai-Lup Wong, Alison F Smith, Chris Nutting, Andrew Gj Hartley, Peter Hall, Claire Hulme, Dharmesh K Patel, Sandra Ventorin von Zeidler, Max Robinson, Bal Sanghera, Lydia Fresco, Janet A Dunn
BACKGROUND: Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28407334/time-to-cranial-computerised-tomography-for-acute-traumatic-brain-injury-in-paediatric-patients-effect-of-the-shorter-stays-in-emergency-departments-target-in-new-zealand
#20
Peter G Jones, Bridget Kool, Stuart Dalziel, Michael Shepherd, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: Timely access to computerised tomography (CT) for acute traumatic brain injuries (TBIs) facilitates rapid diagnosis and surgical intervention. In 2009, New Zealand introduced a mandatory target for emergency department (ED) stay such that 95% of patients should leave ED within 6 h of arrival. This study investigated whether this target influenced the timeliness of cranial CT scanning in children who presented to ED with acute TBI. METHODS: We retrospectively reviewed a random sample of charts of children <15 years with acute TBI from 2006 to 2012...
April 13, 2017: Journal of Paediatrics and Child Health
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