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critical results reporting in radiology

Bibb Allen, Mythreyi Chatfield, Judy Burleson, William T Thorwarth
In September of 2014, the American College of Radiology joined a number of other organizations in sponsoring the 2015 National Academy of Medicine report, Improving Diagnosis In Health Care. Our presentation to the Academy emphasized that although diagnostic errors in imaging are commonly considered to result only from failures in disease detection or misinterpretation of a perceived abnormality, most errors in diagnosis result from failures in information gathering, aggregation, dissemination and ultimately integration of that information into our patients' clinical problems...
September 26, 2017: Diagnosis
Stephan Schorn, Ulrich Nitsche, Ihsan Ekin Demir, Florian Scheufele, Elke Tieftrunk, Rebekka Schirren, Sarah Klauss, Mine Sargut, Güralp Onur Ceyhan, Helmut Friess
BACKGROUND: Although routinely used, the benefit of surgically placed intraperitoneal drains after pancreas resection is still under debate. To assess the true impact of intraperitoneal drains in pancreas resection, a systematic review with meta-analysis was performed. METHODS: For this, the Preferred-Reporting-Items-for-Systematic-review-and-Meta-Analysis/PRISMA-guidelines were conducted and Pubmed/Medline, Embase, Scopus and The Cochrane Library were screened for relevant studies...
February 23, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Anshit Goyal, Panagiotis Kerezoudis, Mohammed Ali Alvi, Sandy Goncalves, Mohamad Bydon
A variety of surgical approaches have been described to treat low grade lumbar degenerative spondylolisthesis (DS). Minimally invasive spinal fusion techniques were first introduced to minimize morbidities associated with invasive surgical treatments. Minimally invasive lateral transpsoas interbody fusion, also known as lateral lumbar interbody fusion (LLIF), is a relatively new method of lumbar arthrodesis that avoids various approach related complications compared to its posterior and anterior counterparts...
February 16, 2018: Clinical Neurology and Neurosurgery
Joanne Lam, Ryan Coughlin, Luce Buhl, Meghan Herbst, Timothy Herbst, Jared Martillotti, Bret Coughlin
PURPOSE: The purpose of the study was to assess the emergency department (ED) providers' interest and satisfaction with ED CT result reporting before and after the implementation of a standardized summary code for all CT scan reporting. MATERIALS AND METHODS: A summary code was provided at the end of all CTs ordered through the ED from August to October of 2016. A retrospective review was completed on all studies performed during this period. A pre- and post-survey was given to both ED and radiology providers...
February 7, 2018: Emergency Radiology
John Zech, Margaret Pain, Joseph Titano, Marcus Badgeley, Javin Schefflein, Andres Su, Anthony Costa, Joshua Bederson, Joseph Lehar, Eric Karl Oermann
Purpose To compare different methods for generating features from radiology reports and to develop a method to automatically identify findings in these reports. Materials and Methods In this study, 96 303 head computed tomography (CT) reports were obtained. The linguistic complexity of these reports was compared with that of alternative corpora. Head CT reports were preprocessed, and machine-analyzable features were constructed by using bag-of-words (BOW), word embedding, and Latent Dirichlet allocation-based approaches...
January 30, 2018: Radiology
Alessandro Marchioni, Eleonora Casalini, Alessandro Andreani, Gaia Cappiello, Ivana Castaniere, Riccardo Fantini, Maria Cecilia Mengoli, Roberto Tonelli, Enrico M Clini, Giulio Rossi
BACKGROUND: Airways can be affected by non-neoplastic lesions leading to critical stenosis of the lumen. Incidence, etiology, and clinical significance of endobronchial benign lesions are not systematically characterized.This study aimed to assess the epidemiology of nonmalignant processes involving the bronchial tree on clinical, pathologic, endoscopic, and radiologic grounds. METHODS: We retrospectively analyzed bronchoscopy procedures over 10 years at the Bronchoscopy Unit of Modena University Hospital...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
Andrea Galli, Leone Giordano, Piergiorgio Muriana, Alessandro Bandiera, Giampiero Negri, Piero Zannini, Mario Bussi
Liposarcomas are rare mesenchymal tumors that usually develop in lower extremities or retroperitoneum; cervico-mediastinal presentation is quite uncommon. These neoplasms are commonly diagnosed at a late stage because they remain asymptomatic until nearby structures are compressed. This makes radical excision particularly challenging. To date, alternative chemoradiotherapy protocols have not yet been standardized. We report a case of a 55-year-old man with a right laterocervical mass and without substantial symptoms...
December 2017: Ear, Nose, & Throat Journal
Bryan W Buckley, Leslie Daly, Grainne N Allen, Carole A Ridge
OBJECTIVE: To measure recall of structured compared with unstructured radiology reports. METHODS: Institutional review board approval was obtained. Four hypothetical radiology reports, two structured and two unstructured reports, were created for the purposes of this study by an experienced consultant radiologist. The reports, each followed immediately by a multiple-choice questionnaire listing possible diagnoses from the report, were distributed to the members of two national physician associations using a web-based survey tool...
February 2018: British Journal of Radiology
R A Figlin, B C Leibovich, G D Stewart, S Negrier
The success of targeted therapies, including inhibitors of the vascular endothelial growth factor pathway or the mammalian target of rapamycin, in the treatment of metastatic renal cell carcinoma led to interest in testing their efficacy in the adjuvant setting. Results from the first trials are now available, with other studies due to report imminently. This review provides an overview of adjuvant targeted therapy in renal cell carcinoma, including interpretation of currently available conflicting data and future direction of research...
February 1, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Xiaogang Tao, Kun Wang, Jinqian Dong, Zonggang Hou, Zhen Wu, Junting Zhang, Baiyun Liu
Secretory meningioma (SM) is a rare histological subtype of the meningioma family. Few reports investigating SM have been published due to its extremely low incidence; thus, the current understanding of this disease is poor. We analyzed the incidence and clinical, radiological, pathological, and prognostic features of SM. Approximately 12,380 intracranial meningiomas were surgically resected at Beijing Tiantan Hospital between April 2008 and January 2017. All pathologically confirmed SM cases were identified...
November 15, 2017: Journal of Neuro-oncology
Christina Kaiser, Christina Kehrer, Mignon-Denise Keyver-Paik, Thomas Hecking, Tiyasha Hosne Ayub, Claudia Leutner, Hans Schild, Walther Kuhn
Background A published retrospective data of our study group demonstrated that premenopausal women, patients with lobular invasive breast cancer or patients with high breast density [American College of Radiology (ACR) classification 3+4] significantly benefit from magnetic resonance imaging (MRI) leading to additional detection of malignant foci of 20.2% in the index and 2.5% in the contralateral breast, which would otherwise not be detected by routine imaging. Critics of preoperative MRI focus on higher false-positive rates leading to unnecessary surgical procedures and mastectomies...
November 11, 2017: Hormone Molecular Biology and Clinical Investigation
Masashi Nomura, Takahiro Ota, Mitsugu Ishizawa, Shinsuke Yoshida, Takayuki Hara
Cranioplasty is a comparatively simple neurosurgical procedure, and fatal complications are rare. This report describes two cases of critical brain swelling after otherwise uneventful cranioplasty. Both cases had subarachnoid hemorrhage and extremely similar clinical courses. They underwent decompressive craniotomy and clipping in the acute phase and had cranioplasty in the chronic phase, resulting in serious cerebral swelling and death. Deep venous sinus thrombosis was revealed in the autopsy for one case...
October 2017: Asian Journal of Neurosurgery
Mohammad Shakir, Reshma Jolly, Aijaz Ahmed Khan, Syed Sayeed Ahmed, Sharique Alam, Mohd Ahmar Rauf, Mohd Owais, Mohd Ahmadullah Farooqi
It is the first report where different amounts of resol resin (RS) were incorporated with chitosan-hydroxyapatite (CHA) to develop a triconstituent nanoensemble CHA-RS(0.5,1,2), via simple co-precipitation method. The results of SEM, TEM, TGA and mechanical analysis revealed irregular interconnected rough morphology with homogenous distribution of needle shaped particles having average size ranging between 12 and 19nm, possessing higher thermal stability and mechanical strength, respectively relative to CHA (binary) nanocomposite...
January 1, 2018: Carbohydrate Polymers
Shan Ren, Zhigang Chen, Ming Liu, Zhiqun Wang
RATIONALE: Hypoglycemic encephalopathy is a metabolic encephalopathy. Clinical risk is mixed with acute cerebrovascular disease, so it is critical to identify and make the correct diagnosis of the disease as early as possible. PATIENT CONCERNS: Here, we report a case of a 51-year-old male patient with hypoglycemic encephalopathy, who presented confusion and unconsciousness for 1 day. DIAGNOSES: In addition to blood-related indicators and medical histories, magnetic resonance imaging (MRI), especially diffusion-weighted imaging (DWI), can be valuable to the diagnosis of hypoglycemic encephalopathy, which showed diffuse high-signal intensity in the cerebral cortex, and also the hippocampus, head of the caudate nucleus, the lentiform nucleus, and corpus callosum...
October 2017: Medicine (Baltimore)
Elias Fakhoury, Daria Abolghasemi, Justin McKinney, Alena Naumova, Scott Wessner, Osama Elsawy, Jamshed Zuberi, Robert V Madlinger
BACKGROUND: Senior surgical residents are of paramount importance in directing further therapeutic modalities based on their interpretation of critical diagnostic imaging. We propose that senior surgical residents are proficient with interpreting radiologic imaging studies in the trauma patient. METHODS: A prospective cohort study was performed comparing surgery resident interpretations of computed tomography (CT) scans of the head, maxillofacial bones, spine (cervical, thoracic, lumbar), chest, abdomen, pelvis, and chest X-rays versus final radiologists' reports at a Level II trauma center from September 2014 to May 2015...
January 2018: Journal of Trauma and Acute Care Surgery
Patrick Nguyen, Bonnie Davis, Daniel D Tran
The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome...
2017: Case Reports in Surgery
Gregory Kline, Daniel T Holmes
Primary aldosteronism (PA) is the most common form of secondary hypertension and is critical to identify because when caused by an aldosterone-producing adenoma (APA) or another unilateral form, it is potentially curable, and even when caused by bilateral disease, antihypertensives more specific to PA treatment can be employed (ie, aldosterone antagonists). Identification of unilateral forms is not generally accomplished with imaging because APAs may be small and elude detection, and coincidental identification of a non-functioning incidentaloma contralateral to an APA may lead to removal of an incorrect gland...
November 2017: Journal of Clinical Pathology
Kentaro Tanaka, Kimihiro Igari, Mitsuhiro Kishino, Satoshi Usami, Tsutomu Homma, Takahiro Toyofuku, Yoshinori Inoue, Mutsumi Okazaki
Microsurgical procedure of free tissue transfer in critical limb ischemia patients with large ulceration has already been established. The nutrient flap concept was that transferred tissue functioned not only to cover the skin defect but also as a supplementary blood supply to the ischemic lower leg. This report showed the justification for this concept, which was rarely discussed. A 58-year-old male patient with progressive forefoot gangrene caused by arteriosclerosis obliterans was presented. The distal bypass procedure was performed as revascularization surgery, and a latissimus dorsi (LD) myocutaneous flap was transplanted to cover ulceration...
August 2, 2017: Microsurgery
Ram K Alluri, Christine Yin, Matthew L Iorio, Hyuma Leland, Wendy J Mack, Ketan Patel
Background  Vascularized bone grafting (VBG) has the potential to yield reliable results in scaphoid nonunion; however, results across studies have been highly variable. This study critically evaluates surgical techniques, fracture location, and patient selection in relation to radiographic, clinical, and patient-centered outcomes after VBG for scaphoid nonunion. Methods  We conducted a systematic review of the literature for the use of VBG in scaphoid nonunion. Physical examination, radiographic, and patient-centered outcomes were assessed...
August 2017: Journal of Wrist Surgery
Pratik Rachh, Alexa O Levey, Andrew Lemmon, Aurora Marinescu, William F Auffermann, Daniel Haycook, Eugene A Berkowitz
BACKGROUND: Our health system orders a high number of STAT priority portable chest radiographs (62%) compared to Routine (35%) and Today (3%). Retrospective chart review of 1000 chest radiographs ordered with the STAT priority revealed that 38% of studies did not indicate clinical urgency. Given the high number or STAT priority portable chest radiographs ordered, prioritizing acquisition and interpretation of true STATs has become challenging for technologists and radiologists, leading to process inefficiencies, long turnaround times (TATs), communication failures, and patient-safety errors...
June 5, 2017: Current Problems in Diagnostic Radiology
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