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Emergency Radiology

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https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#1
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#2
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28212836/point-of-care-ultrasonography-for-evaluation-of-acute-dyspnea-in-the-emergency-department
#3
Maurizio Zanobetti, Margherita Scorpiniti, Chiara Gigli, Peiman Nazerian, Simone Vanni, Francesca Innocenti, Valerio T Stefanone, Caterina Savinelli, Alessandro Coppa, Sofia Bigiarini, Francesca Caldi, Irene Tassinari, Alberto Conti, Stefano Grifoni, Riccardo Pini
BACKGROUND: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile. METHODS: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled...
February 14, 2017: Chest
https://www.readbyqxmd.com/read/28210788/surgical-management-of-degenerative-meniscus-lesions-the-2016-esska-meniscus-consensus
#4
Ph Beaufils, R Becker, S Kopf, M Englund, R Verdonk, M Ollivier, R Seil
PURPOSE: A degenerative meniscus lesion is a slowly developing process typically involving a horizontal cleavage in a middle-aged or older person. When the knee is symptomatic, arthroscopic partial meniscectomy has been practised for a long time with many case series reporting improved patient outcomes. Since 2002, several randomised clinical trials demonstrated no additional benefit of arthroscopic partial meniscectomy compared to non-operative treatment, sham surgery or sham arthroscopic partial meniscectomy...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28209110/bilateral-inguinal-hernia-with-an-uncommon-content%C3%A2-a-case-report
#5
L Soydan, H Gündoğdu, A Aslan, I Inan, A O Balık
Here we present a sixty-two year old man with bilateral swellings palpated in inguinal areas on physical examination. Ultrasonography and abdominal multi-detector computed tomography revealed a bladder herniation through the right inguinal canal and a sigmoid colon herniation through the left inguinal canal. Radiologic imaging methods are important and can guide clinicians for preemptive or emergent surgery. (Acta gastroenterol. belg., 2016, 79, 495-496).
September 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/28207968/mri-vs-ultrasound-as-the-initial-imaging-modality-for-pediatric-and-young-adult-patients-with-suspected-appendicitis
#6
Daniel Imler, Christine Keller, Shyam Sivasankar, Nancy Ewen Wang, Shreyas Vasanawala, Matias Bruzoni, James Quinn
BACKGROUND: While ultrasound (US), given its lack of ionizing radiation is currently the recommended initial imaging study of choice for the diagnosis of appendicitis in pediatric and young adult patients, it does have significant shortcomings. US is time intensive, operator dependent, and results in frequent inconclusive studies, thus necessitating further imaging, and admission for observation or repeat clinical visits. A rapid focused Magnetic Resonance Imaging (MRI) for appendicitis has been shown to have definitive sensitivity and specificity, similar to Computed tomography (CT) but without radiation and offers a potential alternative to US...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28206941/spontaneous-hepatic-hemorrhage-a-single-institution-s-16-year-experience
#7
Armando Rosales, Florencia G Que
Spontaneous hemorrhage from hepatic tumors is an uncommon but serious complication. Recently, interventional radiologic (IR) techniques are being used increasingly in the management of these patients. We report our 16-year experience in managing spontaneous hemorrhage from liver tumors. Twenty-six consecutive patients were diagnosed with spontaneous liver hemorrhage between 1995 and 2011. Initial management was operative in eight, IR in six, and supportive in 12 patients. Of those managed operatively, five were segmentectomies; one hemihepatectomy; one wedge resection; and one packing who later died from coagulopathy...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28202221/elastoplasty-as-a-promising-novel-technique-vertebral-augmentation-with-an-elastic-silicone-based-polymer
#8
Alessandro Gasbarrini, Riccardo Ghermandi, Yunus Emre Akman, Marco Girolami, Stefano Boriani
OBJECTIVE: Percutaneous vertebroplasty with polymethylmethacrylate (PMMA) restores the stiffness and the strength of fractured vertebral bodies, but changes the pattern of the stress transfer. This effect may cause a secondary fracture of the adjacent vertebrae. Elastoplasty has emerged as a new technique to overcome this complication. The aim of this study is to retrospectively evaluate the clinical results of the elastoplasty procedure. MATERIALS AND METHODS: Thirthy nine patients (9 males, 30 females, 87 spinal levels) were clinically evaluated pre and postoperatively in terms of pain relief, leakage and silicone embolism...
February 12, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28195246/cellular-fibroma-in-the-douglas-cavity-mimicking-a-malignant-neoplasia-fibroma-fibrosarcoma-or-mitotically-active-cellular-fibroma
#9
A Di Lorito, P Viola, S Rosini, G Lattanzio
INTRODUCTION: Ovarian fibroma is a benign stromal tumour composed of spindle/ovoid fibroblastic cells producing collagen. Approximally 10% of fibromas are densely cellular with small amount of collagen. In these cases, if mild nuclear atypia is present, they are best addressed as cellular fibroma. However cellular fibroma may show a greater mitotic activity and therefore they should be referred as mitotically active cellular fibromas. Mostly benign, it is necessary to differentiate them from malignant tumours such as fibrosarcomas...
March 2016: Pathologica
https://www.readbyqxmd.com/read/28193378/image-sharing-in-radiology-a-primer
#10
REVIEW
Arindam R Chatterjee, Seth Stalcup, Arjun Sharma, T Shawn Sato, Pushpender Gupta, Yueh Z Lee, Christopher Malone, Morgan McBee, Elise L Hotaling, Akash P Kansagra
By virtue of its information technology-oriented infrastructure, the specialty of radiology is uniquely positioned to be at the forefront of efforts to promote data sharing across the healthcare enterprise, including particularly image sharing. The potential benefits of image sharing for clinical, research, and educational applications in radiology are immense. In this work, our group-the Association of University Radiologists (AUR) Radiology Research Alliance Task Force on Image Sharing-reviews the benefits of implementing image sharing capability, introduces current image sharing platforms and details their unique requirements, and presents emerging platforms that may see greater adoption in the future...
March 2017: Academic Radiology
https://www.readbyqxmd.com/read/28193297/pre-hospital-transfusion-of-packed-red-blood-cells-in-147-patients-from-a-uk-helicopter-emergency-medical-service
#11
Richard M Lyon, Eleanor de Sausmarez, Emily McWhirter, Gary Wareham, Magnus Nelson, Ashley Matthies, Anthony Hudson, Leigh Curtis, Malcolm Q Russell
BACKGROUND: Early transfusion of packed red blood cells (PRBC) has been associated with improved survival in patients with haemorrhagic shock. This study aims to describe the characteristics of patients receiving pre-hospital blood transfusion and evaluate their subsequent need for in-hospital transfusion and surgery. METHODS: The decision to administer a pre-hospital PRBC transfusion was based on clinical judgment. All patients transfused pre-hospital PRBC between February 2013 and December 2014 were included...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#12
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28182978/modeling-background-radiation-in-southern-nevada
#13
Daniel A Haber, Pamela C Burnley, Christopher T Adcock, Russell L Malchow, Kara E Marsac, Elisabeth M Hausrath
Aerial gamma ray surveys are an important tool for national security, scientific, and industrial interests in determining locations of both anthropogenic and natural sources of radioactivity. There is a relationship between radioactivity and geology and in the past this relationship has been used to predict geology from an aerial survey. The purpose of this project is to develop a method to predict the radiologic exposure rate of the geologic materials by creating a high resolution background model. The intention is for this method to be used in an emergency response scenario where the background radiation environment is unknown...
February 6, 2017: Journal of Environmental Radioactivity
https://www.readbyqxmd.com/read/28181109/a-retrospective-review-of-farm-injuries-presenting-to-an-irish-hospital-emergency-department-in-2013
#14
A Abdulkarim, P Carroll, P Coffey, E Sheehan
BACKGROUND: The agricultural and equestrian businesses are an important source of employment in the Midlands. This is a retrospective study examining the demographics, characteristics, and outcomes of agricultural and equestrian related injuries presenting to the Midland Regional Hospital, Tullamore, Co. Offaly. There were a total of 30,700 attendances to the Emergency Department for 2013. AIMS: This study is an epidemiological review of agricultural injuries, their mechanisms, and consequences presenting to a rural regional hospital over a 1 year period...
February 8, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28180124/does-a-negative-emergency-celiotomy-exclude-the-possibility-of-significant-diaphragmatic-injury-a-case-report-and-review-of-the-literature
#15
Alireza Hamidian Jahromi, David Pennywell, John T Owings
INTRODUCTION: Diaphragmatic rupture (DR) is an uncommon, potentially serious complication following blunt or penetrating abdominal trauma. Even with a high index of suspicion, the diagnosis of DR can easily be missed for a long period post injury. Delayed or missed diagnosis [delayed diagnosis of diaphragmatic rupture (DDDR)] and delayed diaphragmatic rupture (DDR) are possible explanations in cases where the initial operative exploration fails to show the diaphragmatic damage. CASE PRESENTATION: Here we present a patient with suspected DR that was not seen on initial open abdominal exploration, but was suggested by subsequent serial imaging...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28179286/italian-prostate-biopsies-group-2016-updated-guidelines-insights
#16
REVIEW
Andrea Fandella, Vincenzo Scattoni, Andrea Galosi, Pietro Pepe, Michelangelo Fiorentino, Caterina Gaudiano, Marco Giampaoli, Roberta Gunelli, Pasquale Martino, Vittorino Montanaro, Rodolfo Montironi, Tiziana Pierangeli, Armando Stabile, Alessandro Bertaccini
AIM: To present a summary of the updated guidelines of the Italian Prostate Biopsies Group following the best recent evidence of the literature. MATERIALS AND METHODS: A systematic review of the new data emerging from 2012-2015 was performed by a panel of 14 selected Italian experts in urology, pathology and radiology. The experts collected articles published in the English-language literature by performing a search using Medline, EMBASE and the Cochrane Library database...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28174413/-emergency-surgery-for-intercostal-lung-hernia-after-right-upper-lobe-resection-for-lung-cancer-report-of-a-case
#17
Shin Shomura, Hitoshi Suzuki, Masaki Yada, Chiaki Kondo
We report an operative case of intercostal lung hernia after resection of a Lung cancer. A 60-year-old man with asthma consulted our hospital because of an abnormal shadow on a chest X-ray. A chest computed tomography revealed a tumor in the right upper lobe. A diagnosis of lung cancer was suspected and the patient underwent right upper lobectomy with standard nodal dissection from 4th intercostal space with right anterolateral incision. Intercostal space was directly closed by three stitches. A chest drain was removed on the 5th operative day...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28171688/diagnostic-value-and-effect-of-bedside-ultrasound-in-acute-appendicitis-in-the-emergency-department
#18
Faruk Gungor, Taylan Kilic, Kamil Can Akyol, Gizem Ayaz, Umut Cengiz Cakir, Mehmet Akcimen, Cenker Eken
OBJECTIVE: Early and accurate diagnosis of acute appendicitis (AA) with ultrasound can minimize the morbidity and mortality of the patients. In this regard, ultrasound can help to the emergency physicians (EPs) in the diagnosing process and clinical decision making for AA. Therefore, we primarily aimed to evaluate the effectiveness of point of care ultrasound (POCUS) in clinical decision making of EPs for the diagnostic evaluation for AA in the emergency department (ED). METHODS: The study sample consisted of patients aged >18 years that presented to the ED with an abdominal pain and underwent diagnostic evaluation for AA...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28168816/lactate-levels-and-pneumonia-severity-index-are-good-predictors-of-in-hospital-mortality-in-pneumonia
#19
Bulut Demirel
INTRODUCTION: Pneumonia is an inflammatory disease caused by micro-organisms. The pneumonia severity index (PSI) and CURB_65 scores are widely used to predict the mortality risk. We wanted to calculate the value of lactic acid level in predicting the mortality risk. MATERIAL AND METHODS: This prospective cross-sectional study performed in a third level education and research hospital. The pneumonia diagnosis was determined by symptoms, physical examination findings, and radiological findings...
February 7, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28168797/pre-oncall-key-conditions-training-for-first-year-radiology-registrars
#20
Nicholas I Brown, Paul Leschke, Mandy Way, David D Smith, Perry Cleland
INTRODUCTION: The Royal Australian and New Zealand College of Radiology (RANZCR) recognised the importance of experience in on-call and emergency radiology for first-year registrars by introducing 'Key conditions in Year 1 training'. This list of common radiological pathologies can help to focus preparations for new registrars as they prepare for after-hours duties. METHODS: The Royal Brisbane and Women's Hospital (RBWH) implemented a 12-week formal training programme, based on this curriculum, for new registrars prior to commencing after-hours work...
February 7, 2017: Journal of Medical Imaging and Radiation Oncology
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