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Emergency CT imaging

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https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#1
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28523383/anterior-sacral-meningocele-presenting-as-intracystic-bleeding
#2
Ignacio Javier Gilete-Tejero, Marta Ortega-Martínez, Jacinto Mata-Gómez, María Rico-Cotelo, Luis Miguel Bernal-García, Beatriz Yerga-Lorenzana, Ignacio Casado-Naranjo
PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum...
May 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28516829/factors-associated-with-failure-of-emergency-wait-time-targets-for-high-acuity-discharges-and-intensive-care-unit-admissions
#3
Ivy Cheng, Merrick Zwarenstein, Alex Kiss, Maaret Castren, Mats Brommels, Michael Schull
OBJECTIVE: Ontario established emergency department length-of-stay (EDLOS) targets but has difficulty achieving them. We sought to determine predictors of target time failure for discharged high acuity patients and intensive care unit (ICU) admissions. METHODS: This was a retrospective, observational study of 2012 Sunnybrook Hospital emergency department data. The main outcome measure was failing to meet government EDLOS targets for high acuity discharges and ICU emergency admissions...
May 18, 2017: CJEM
https://www.readbyqxmd.com/read/28511550/ct-features-in-surgically-proven-cases-of-ovarian-torsion-a-pictorial-review
#4
Sunita Dhanda, Swee Tian Quek, Ying Ting Mok, Clement Yong Hsiang Rong, Yuik Sing Eric Ting, Pooja Jagmohan, Bernard Wee
Ovarian torsion is a surgical emergency characterized by a partial or complete rotation of the ovarian vascular pedicle, causing obstruction to venous outflow followed by arterial inflow. Clinically, ovarian torsion frequently mimics other causes of acute pelvic pain such as appendicitis, diverticulitis, renal colic etc. Ultrasonography (US) is the first line imaging modality of choice for evaluation of ovarian torsion. MRI is useful as a problem solving tool in patients with equivocal or non diagnostic US studies...
May 16, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28511475/colour-doppler-evaluation-of-extracranial-carotid-artery-in-patients-presenting-with-acute-ischemic-stroke-and-correlation-with-various-risk-factors
#5
Samrin Haq, Manoj Mathur, Jasvir Singh, Navkiran Kaur, Raminderpal Singh Sibia, Rajesh Badhan
INTRODUCTION: Stroke is defined as an abrupt onset of neurologic deficit due to vascular cause. It is one of the leading causes of mortality and morbidity all over the world making early diagnosis and treatment inevitable. Lesions of extra cranial carotid arteries are implicated in majority of cases of acute ischemic stroke. Carotid Doppler is a non-invasive imaging technique, with sensitivity approaching that of angiography. Computed Tomography (CT) plays a major role to assess the site and nature of the lesion in patients with acute ischemic stroke...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28511266/diagnosis-and-differential-diagnosis-of-hydrocephalus-in%C3%A2-adults
#6
Sönke Langner, Steffen Fleck, Jörg Baldauf, Birger Mensel, Jens Peter Kühn, Michael Kirsch
Purpose Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. Methods This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus...
May 16, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28506470/coronary-ct-angiography-in-the-emergency-department-utilizing-second-and-third-generation-dual-source-ct
#7
Nandini M Meyersohn, Balint Szilveszter, Pedro V Staziaki, Jan-Erik Scholtz, Richard A P Takx, Udo Hoffmann, Brian B Ghoshhajra
BACKGROUND: Coronary computed tomography angiography (coronary CTA) allows efficient triage of low to intermediate risk patients with suspected acute coronary syndrome (ACS) in the emergency department (ED). Techniques for coronary CTA acquisition in the ED continue to evolve with the establishment of standardized scan protocols and the introduction of newer generations of CT hardware. OBJECTIVES: To evaluate qualitative and quantitative image quality and radiation dose exposure of coronary CTA acquired on 2nd versus 3rd generation dual source CT (DSCT) scanners using a standardized institutional scan protocol designed for the ED...
March 22, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28500579/robotic-repair-of-a-right-sided-bochdalek-hernia-a-case-report-and-literature-review
#8
Amani Jambhekar, Shawn Robinson, Brian Housman, James Nguyen, Kevin Gu, Vadim Nakhamiyayev
BACKGROUND: Bochdalek hernias (BHs) are usually diagnosed in the neonatal period, occurring in 1/2200-1/12,500 live births. There are few reported cases of BHs in adults. Robotic repair has not been described in current literature as opposed to the laparoscopic approach. Here we present a case of an adult with clinical signs of bowel obstruction secondary to a BH which was repaired using a robotic approach. CASE REPORT: A 74-year-old gentleman with past medical history of benign prostatic hyperplasia presented to the emergency department with a 1-week history of nausea, vomiting, diarrhea, and decline in appetite...
May 12, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28495948/introduction-of-a-dedicated-emergency-department-mr-imaging-scanner-at-the-barrow-neurological-institute
#9
M Buller, J P Karis
Use of advanced imaging in the emergency department has been increasing in the United States during the past 2 decades. This trend has been most notable in CT, which has increased concern over the effects of increasing levels of medical ionizing radiation. MR imaging offers a safe, nonionizing alternative to CT and is diagnostically superior in many neurologic conditions encountered in the emergency department. Herein, we describe the process of developing and installing a dedicated MR imaging scanner in the Neuroscience Emergency Department at the Barrow Neurological Institute and its effects on neuroradiology and the emergency department in general...
May 11, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28493498/endoscopic-ultrasound-guided-retrieval-of-a-toothpick-embedded-in-the-stomach-wall
#10
Jinlong Hu, Siyu Sun
Patients with the complaint of ingested foreign body commonly present in the emergency department. Radiographic imaging is always done for the purpose of localization. However, radiolucent materials like wood are not easily picked up on CT scan. We report the case of a 33-year-old male patient who presented with the complaint of progressive abdominal pain and history of ingestion of a toothpick. It was removed by endoscopic ultrasound-guided localization-assisted targeted endoscopic dissection. Endoscopic ultrasound-guided localization reduced the length and depth of the required incision and helped to minimize the risk of damage to the surrounding tissue...
May 11, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28493071/nontraumatic-large-bowel-perforation-spectrum-of-etiologies-and-ct-findings
#11
REVIEW
Kunal Kothari, Barak Friedman, Gregory M Grimaldi, John J Hines
Large bowel perforation is an abdominal emergency that results from a wide range of etiologies. Computed tomography is the most reliable modality in detecting the site of large bowel perforation. The diagnosis is made by identifying direct CT findings such as extraluminal gas or contrast and discontinuity along the bowel wall. Indirect CT findings can help support the diagnosis, and include bowel wall thickening, pericolic fat stranding, abnormal bowel wall enhancement, abscess, and a feculent collection adjacent to the bowel...
May 10, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28492406/routine-computed-tomography-after-recent-operative-exploration-for-penetrating-trauma-what-injuries-do-we-miss
#12
April E Mendoza, Christopher A Wybourn, Anthony G Charles, Andre Campbell, Bruce A Cairns, Margaret M Knudson
BACKGROUND: Patients with penetrating trauma who cannot be stabilized undergo operative intervention without preoperative imaging. In such cases, post-operative imaging may reveal additional injuries not identified during the initial operative exploration. The purpose of this study is to explore the utility of post-operative CT imaging in the setting of penetrating trauma. METHODS: This was a retrospective analysis of patients with penetrating trauma treated at an urban level 1 trauma center between 2010-2015...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28487329/aspects-alberta-stroke-program-early-ct-score-measurement-using-hounsfield-unit-values-when-selecting-patients-for-stroke-thrombectomy
#13
Maxim Mokin, Christopher T Primiani, Adnan H Siddiqui, Aquilla S Turk
BACKGROUND AND PURPOSE: The ASPECTS (Alberta Stroke Program Early CT Score) is a quantitate score that measures the extent of early ischemic changes. Our aim was to investigate how measurement of ASPECTS using Hounsfield unit (HU) values on initial noncontrast head computerized tomography (CT) correlates with the extent of final infarct on follow-up imaging. METHODS: Cases of acute stroke from the middle cerebral artery M1 occlusion in which complete recanalization (TICI [Thrombolysis in Cerebral Infarction] 3) was achieved were included for analysis...
May 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28485976/use-of-nanoparticle-contrast-agents-for-cell-tracking-with-computed-tomography
#14
Johoon Kim, Peter Chhour, Jessica Hsu, Harold I Litt, Victor A Ferrari, Rachela Popovtzer, David P Cormode
Efforts to develop novel cell-based therapies originated with the first bone marrow transplant on a leukemia patient in 1956. Preclinical and clinical examples of cell-based treatment strategies have shown promising results across many disciplines in medicine, with recent advances in immune cell therapies for cancer producing remarkable response rates, even in patients with multiple treatment failures. However, cell-based therapies suffer from inconsistent outcomes, motivating the search for tools that allow monitoring cell delivery and behavior in vivo...
May 9, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/28483547/changes-in-emergency-department-imaging-perspectives-from-national-patient-surveys-over-two-decades
#15
Andrew B Rosenkrantz, Tarek N Hanna, James S Babb, Richard Duszak
PURPOSE: To use patient-generated data to assess the changing role of emergency department (ED) imaging for a spectrum of clinical indications. METHODS: The Household Component Emergency Room Visits File was obtained from 1996 through 2014 for the Medical Expenditure Panel Survey, a nationally representative survey of US households. Percentage of visits associated with various imaging modalities was computed annually, stratified by respondents' self-reported primary condition during the visit...
May 5, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28480751/ct-pulmonary-angiography-in-young-women
#16
Paul D Stein, Fadi Matta, Kate E Hughes, Mary J Hughes
The purpose was to determine whether young women in the emergency department who received computed tomographic (CT) pulmonary angiograms were evaluated to receive lower dose imaging or no imaging, recognizing that the risks of radiation are particularly high in young women. This was a retrospective cohort investigation of women aged 18 to 29 years seen for suspected acute pulmonary embolism in emergency departments of 5 regional hospitals from May 1, 2015 to April 30, 2016. Computed tomographic (CT) pulmonary angiograms were obtained in 379 young women...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28477088/adverse-effects-of-low-preoperative-skeletal-muscle-mass-in-patients-undergoing-gastrectomy-for-gastric-cancer
#17
Katsunobu Sakurai, Naoshi Kubo, Tatsuro Tamura, Takahiro Toyokawa, Ryosuke Amano, Hiroaki Tanaka, Kazuya Muguruma, Masakazu Yashiro, Kiyoshi Maeda, Kosei Hirakawa, Masaichi Ohira
OBJECTIVE: The aim of this study was to determine the impact of preoperative skeletal muscle mass on short- and long-term outcomes of patients with gastric cancer (GC) who undergo gastrectomy. METHODS: A total of 569 patients subjected to gastrectomy for GC at our institution between January 2007 and December 2013 were reviewed and skeletal muscle index (SMI) was measured via cross-sectional, image-based muscle assessment. Computed tomography (CT) and the volume analyzer SYNAPSE VINCENT were required...
May 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28476243/advanced-dual-energy-ct-applications-for-the-evaluation-of-the-soft-tissues-of-the-neck
#18
REVIEW
R Forghani, S K Mukherji
There are multiple emerging advanced computed tomography (CT) applications for the evaluation of the neck, many based on dual-energy CT (DECT). DECT is an advanced form of CT in which scan acquisition is performed at two different energies, enabling spectral tissue characterisation beyond what is possible with conventional single-energy CT and potentially providing a new horizon for quantitative analysis and tissue characterisation, particularly in oncological imaging. The purpose of this review is to familiarise the reader with DECT principles and review different clinical applications for the evaluation of the soft tissues of the neck...
May 2, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28474172/age-estimation-during-the-blow-fly-intra-puparial-period-a-qualitative-and-quantitative-approach-using-micro-computed-tomography
#19
Daniel Martín-Vega, Thomas J Simonsen, Martina Wicklein, Martin J R Hall
Minimum post-mortem interval (minPMI) estimates often rely on the use of developmental data from blow flies (Diptera: Calliphoridae), which are generally the first colonisers of cadavers and, therefore, exemplar forensic indicators. Developmental data of the intra-puparial period are of particular importance, as it can account for more than half of the developmental duration of the blow fly life cycle. During this period, the insect undergoes metamorphosis inside the opaque, barrel-shaped puparium, formed by the hardening and darkening of the third instar larval cuticle, which shows virtually no external changes until adult emergence...
May 4, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28473274/alterations-in-optic-nerve-sheath-diameter-according-to-cerebrovascular-disease-sub-groups
#20
Emre Gökcen, İbrahim Caltekin, Atakan Savrun, Hilal Korkmaz, Şeyda Tuba Savrun, Gökhan Yıldırım
BACKGROUND: ONSD (optic nerve sheath diameter) is a method used for indirect measurement of the increased intracranial pressure. In previous studies, the relation between the increased intracranial pressure and ONSD was analyzed in the patients suffering from cerebrovascular diseases (CVD). In our study, the patients suffering from ischemic CVD were categorized into 4 subgroups according to Oxfordshire Community Stroke Project classification (OCSP); the relationship between each group and ONSD, and the influence on each eye were analyzed...
April 30, 2017: American Journal of Emergency Medicine
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