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Emergency Radiology

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https://www.readbyqxmd.com/read/28326464/meningiomas-in-pregnancy-timing-of-surgery-and-clinical-outcomes-as-observed-in-104-cases-and-establishment-of-a-best-management-strategy
#1
REVIEW
Yosef Laviv, Ahmed Bayoumi, Anand Mahadevan, Brett Young, Myles Boone, Ekkehard M Kasper
BACKGROUND: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions...
March 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28325786/impact-on-hospital-resources-of-systematic-evaluation-and-management-of-suspected-nonaccidental-trauma-in-patients-less-than-4-years-of-age
#2
Bethann M Pflugeisen, Mauricio A Escobar, Dustin Haferbecker, Yolanda Duralde, Elizabeth Pohlson
OBJECTIVE: There has been an increasing movement worldwide to create systematic screening and management procedures for atypical injury patterns in children with the hope of better detecting and evaluating nonaccidental trauma (NAT). A legitimate concern for any hospital considering implementation of a systematic evaluation process is the impact on already burdened hospital resources. We hypothesized that implementation of a guideline that uses red flags related to history, physical, or radiologic findings to trigger a standardized NAT evaluation of patients <4 years would not negatively affect resource utilization at our level II pediatric trauma center...
March 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28318981/idiopathic-intradural-dorsal-thoracic-arachnoid-cysts-a-case-series-and-review-of-the-literature
#3
Heath French, Arjuna Somasundaram, Michael Biggs, Jonathon Parkinson, Rodney Allan, Jonathon Ball, Nicholas Little
BACKGROUND: Spinal intradural arachnoid cysts (SIAC) are cerebrospinal fluid (CSF) filled sacs formed by arachnoid membranes and may be either idiopathic or acquired. Idiopathic cysts represent a separate entity and their aetiology remains uncertain. By far the most difficult differential diagnosis is distinguishing between idiopathic anterior spinal cord herniation (IASCH) and dorsal thoracic intradural arachnoid cysts (TIAC), due to their similarity in radiological appearance. Cine-mode (SSFP) is emerging as a novel technique in the diagnosis and operative planning of SIAC...
March 17, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28318954/computed-tomography-perfusion-based-decision-making-for-acute-ischemic-stroke-missing-the-mismatch
#4
J A Molad, M Findler, E Auriel
The emerging use of mechanical thrombectomy for acute ischemic stroke treatment focuses on the importance of patient selection. Computed tomography perfusion (CTP) is one of widely used techniques. However, the accuracy and reliability of this modality is in debate among vascular neurologists. We present a case of an 80-year-old man admitted because of acute ischemic stroke. CT angiography demonstrated left proximal M2 occlusion. As CTP demonstrated signs of large ischemic core with no significant penumbra, mechanical thrombectomy was not performed following tPA administration...
March 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28318729/acute-cerebellitis-in-paediatric-patients-our-experience
#5
J P García-Iñiguez, F J López-Pisón, P Madurga Revilla, I Montejo Gañán, M Domínguez Cajal, L Monge Galindo, S B Sánchez Marco, M C García Jiménez
INTRODUCTION: Acute cerebellitis is a rare inflammatory disease with a highly variable clinical course that ranges from benign self-limiting symptoms to a fulminant presentation associated with a high risk of death due to compression of the posterior fossa, acute hydrocephalus, and intracranial hypertension. METHODS: We reviewed clinical, laboratory, and radiological findings from children diagnosed with acute cerebellitis between May 2007 and November 2016. We analysed treatments and clinical and radiological progression...
March 15, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28318437/case-240-meckel-diverticulitis
#6
R Ashley Milam, Ricardo B Fonseca
History A previously healthy 28-year-old man developed right lower quadrant pain while traveling. The pain progressed over the course of 2-3 days, and his family took him to a local emergency department. He was found to have an elevated white blood cell count of 12.2 × 10(9)/L (reference range, [3.9-10.3] × 10(9)/L), with a predominance of neutrophils. Contrast material-enhanced computed tomography (CT) of the abdomen and pelvis was performed, and findings were abnormal. The patient elected to leave the emergency department without undergoing treatment, and he returned home via airplane...
April 2017: Radiology
https://www.readbyqxmd.com/read/28316308/where-we-fail-location-and-timing-of-failure-to-rescue-in-trauma
#7
Jennifer J Chung, Emily C Earl-Royal, M Kit Delgado, Jose L Pascual, Patrick M Reilly, Douglas J Wiebe, Daniel N Holena
Failure to rescue (FTR) is an outcome metric that reflects a center's ability to prevent mortality after a major complication. Identifying the timing and location of FTR events could help target efforts to reduce FTR rates. We sought to characterize the timing and location of FTR occurrences at our center, hypothesizing that FTR rates would be highest early after injury and in settings of lower intensity of care. We used data, prospectively collected from 2009 to 2013, on patients ≥16 years old with minimum Abbreviated Injury Score ≥2 from a single institution...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28306354/bronchiectasis-phenotyping-a-complex-disease
#8
James D Chalmers
Bronchiectasis is a long-neglected disease currently experiencing a surge in interest. It is a highly complex condition with numerous aetiologies, co-morbidities and a heterogeneous disease presentation and clinical course. The past few years have seen major advances in our understanding of the disease, primarily through large real-life cohort studies. The main outcomes of interest in bronchiectasis are symptoms, exacerbations, treatment response, disease progression and death. We are now more able to identify clearly the radiological, clinical, microbiological and inflammatory contributors to these outcomes...
March 15, 2017: COPD
https://www.readbyqxmd.com/read/28301213/academic-radiologist-subspecialty-identification-using-a-novel-claims-based-classification-system
#9
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Luke A Ginocchio, David A Rosman, Richard Duszak
OBJECTIVE: The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. MATERIALS AND METHODS: Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28299215/intra-abdominal-actinomycosis-mimicking-malignant-abdominal-disease
#10
Ali Ridha, Njideka Oguejiofor, Sarah Al-Abayechi, Emmanuel Njoku
Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28298969/gastric-blunt-traumatic-injuries-a-computed-tomography-grading-classification
#11
Antonio Solazzo, Giulia Lassandro, Francesco Lassandro
AIM: To produce a radiological grading of gastric traumatic injuries. METHODS: In our study, we retrospectively analyzed 32 cases of blunt gastric traumatic injuries and compared computed tomography (CT) data with patients' surgical or medical development. In all cases, a basal phase was acquired, and an intravenous contrast material was administered via an antecubital venous catheter with acquisition in the venous phase (70-90 s). In addition, a further set of delayed scans was performed 4-5 min after the first scanning session, without supplementary intravenous contrast material, to identify or better define areas of active bleeding...
February 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28298577/trauma-imaging-a-literature-review
#12
Jason Heath Vela, Christopher Ira Wertz, Kimberly L Onstott, Joss R Wertz
PURPOSE: To inform radiologic technologists about which imaging modalities and examinations are best suited for evaluating specific anatomical structures in patients who have sustained a traumatic injury. METHODS: Two scholarly research databases were searched to identify articles focused on trauma imaging of the head, cervical spine, thorax, abdomen, and pelvis. Articles focused on trauma diagnosis were excluded. Thirty-two articles were selected for analysis. DISCUSSION: Physical examination and plain-film radiographs typically are used to assess nasal bone fracures...
January 2017: Radiologic Technology
https://www.readbyqxmd.com/read/28298020/the-first-formulation-of-image-based-stereotactic-principles-the-forgotten-work-of-gaston-contremoulins
#13
Cole A Giller, Patrick Mornet, Jean-François Moreau
Although image-based human stereotaxis began with Spiegel and Wycis in 1947, the major principles of radiographic stereotaxis were formulated 50 years earlier by the French scientific photographer Gaston Contremoulins. In 1897, frustrated by the high morbidity of bullet extraction from the brain, the Parisian surgeon Charles Rémy asked Contremoulins to devise a method for bullet localization using the then new technology of x-rays. In doing so, Contremoulins conceived of many of the modern principles of stereotaxis, including the use of a reference frame, radiopaque fiducials for registration, images to locate the target in relation to the frame, phantom devices to locate the target in relation to the fiducial marks, and the use of an adjustable pointer to guide the surgical approach...
February 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28292662/cytomegalovirus-duodenitis-associated-with-life-threatening-duodenal-hemorrhage-in-an-immunocompetent-patient-a-case-report
#14
Lucy Shen, David Youssef, Suzan Abu-Abed, Sangita K Malhotra, Kenneth Atkinson, Elena Vikis, George Melich, Shawn MacKenzie
INTRODUCTION: Cytomegalovirus (CMV) is known to be opportunistic in immunocompromised patients. However, there have been emerging cases of severe CMV infections found in immunocompetent patients. Gastrointestinal (GI) CMV disease is the most common manifestation affecting immunocompetent patients, with duodenal involvement being exceedingly rare. Presented is a case of an immunocompetent patient with life-threatening bleeding caused by CMV duodenitis, requiring surgical intervention. PRESENTATION OF CASE: A 60-year-old male with history of disseminated Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia and aortic valve infective endocarditis, presented with life-threatening upper GI hemorrhage...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28292636/who-we-are-and-what-we-can-become-an-analysis-of-professional-identity-formation-in-ir
#15
Eric J Keller, Katherine A McGee, Scott A Resnick, Scott O Trerotola, Karim Valji, Matthew S Johnson, Jeremy D Collins, Robert L Vogelzang
PURPOSE: To characterize the unique experiences, values, and perspectives of interventional radiology (IR) fellows. MATERIALS AND METHODS: Sixteen fellows from 4 US vascular and IR programs were interviewed within 2 months of beginning and 2-3 months following their 2015-2016 fellowships about patient interactions, training experiences, and views of IR and other specialties. Interviews were systematically analyzed for dominant themes by using constructivist grounded theory...
March 11, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28292519/interventional-radiology-service-provision-and-practice-for-the-management-of-traumatic-splenic-injury-across-the-regional-trauma-networks-of-england
#16
Jane Hughes, Ashley Scrimshire, Laura Steinberg, Petros Yiannoullou, Katherine Newton, Claire Hall, Lyndsay Pearce, Andrew Macdonald
INTRODUCTION: The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28288922/clinical-features-management-and-prognostic-factors-of-spontaneous-epidural-spinal-hematoma-analysis-of-24-cases
#17
Mengmeng Wang, Peizhi Zhou, Shu Jiang
BACKGROUND: Spontaneous spinal epidural hematoma (SSEH) is a rare neurosurgical emergency. It presents as acute spinal cord compression and usually requires surgical decompression. The patients who will benefit most from decompression surgery are unknown and the factors associated with prognosis remain controversial. The purpose of our study was to identify the clinical features, treatments, and main factors related to the prognosis of SSEH. METHODS: We reviewed the records of 24 patients treated for SSEH from September 2010 to January 2016 at West China Hospital...
March 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28287947/abdominal-and-pelvic-trauma-misses-and-misinterpretations-at-multidetector-ct-trauma-emergency-radiology
#18
Michael N Patlas, David Dreizin, Christine O Menias, Nikki Tirada, Sanjeev Bhalla, Savvas Nicolaou, Nataly Farshait, Douglas S Katz
No abstract text is available yet for this article.
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28287010/diagnosis-and-management-of-pneumocystis-jirovecii-infection
#19
P Lewis White, Matthijs Backx, Rosemary A Barnes
Pneumocystis jirovecii is a ubiquitous fungus, which causes pneumonia in humans. Diagnosis was hampered by the inability to culture the organism, and based on microscopic examination of respiratory samples or clinical presentation. New assays can assist in the diagnosis and even aid with the emergence of resistant infections. Areas Covered: This manuscript will provide background information on Pneumocystis pneumonia (PcP). Diagnosis, from radiological to non-microbiological (e.g. Lactate dehydrogenase) and microbiological investigations (Microscopy, PCR, β-D-Glucan) will be discussed...
March 13, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28286822/ability-of-ultrasonography-in-detection-of-different-extremity-bone-fractures-a-case-series-study
#20
Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
INTRODUCTION: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. METHODS: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture...
2017: Emergency (Tehran, Iran)
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