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Emergency CT imaging

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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/28213758/influence-of-a-combined-ct-c-arm-system-on-periprocedural-workflow-and-procedure-times-in-mechanical-thrombectomy
#2
Johannes Pfaff, Silvia Schönenberger, Christian Herweh, Mirko Pham, Simon Nagel, Peter Arthur Ringleb, Sabine Heiland, Martin Bendszus, Markus Alfred Möhlenbruch
OBJECTIVE: To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. METHODS: This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device...
February 17, 2017: European Radiology
https://www.readbyqxmd.com/read/28209559/irreversible-electroporation-for-the-ablation-of-renal-cell-carcinoma-a-prospective-human-in-vivo-study-protocol-ideal-phase-2b
#3
Mara Buijs, Krijn P van Lienden, Peter Gk Wagstaff, Matthijs Jv Scheltema, Daniel M de Bruin, Patricia J Zondervan, Otto M van Delden, Ton G van Leeuwen, Jean Jmch de la Rosette, M Pilar Laguna
BACKGROUND: Irreversible electroporation (IRE) is an emerging technique delivering electrical pulses to ablate tissue, with the theoretical advantage to overcome the main shortcomings of conventional thermal ablation. Recent short-term research showed that IRE for the ablation of renal masses is a safe and feasible treatment option. In an ablate and resect design, histopathological analysis 4 weeks after radical nephrectomy demonstrated that IRE-targeted renal tumors were completely covered by ablation zone...
February 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28208932/spontaneous-rupture-of-the-main-pancreatic-duct-synchronous-with-a-multi-focal-microscopic-pancreatic-adenocarcinoma-a-case-report
#4
Shirly Shohat, Katerina Shulman, Boris Kessel, Oren Gal, Abdel Rauf Zeina
Pancreatic cancer is one of the most lethal types of malignant tumours, commonly diagnosed at an advanced stage. The only curative treatment for this fatal disease is surgery and early diagnosis is the key to a better outcome and prognosis. In this case report we present a 57-year-old woman presenting to the emergency room with abdominal pain and weight loss. Computer Tomography (CT) imaging showed a rupture of the main pancreatic duct and a peri-pancreatic fluid collection with no evidence of a pancreatic mass...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208906/association-of-serum-uric-acid-level-with-the-severity-of-brain-injury-and-patient-s-outcome-in-severe-traumatic-brain-injury
#5
Masoud Hatefi, Masoud Moghadas Dastjerdi, Bahareh Ghiasi, Asghar Rahmani
INTRODUCTION: The prognostic value of serum Uric Acid (UA) levels in Traumatic Brain Injury (TBI) is unclear. AIM: To investigate the relationship between serum UA levels and prognosis of patients with TBI when in hospital and at six months after discharge. MATERIALS AND METHODS: All patients attended our emergency department during July 2014 and December 2015 and were consecutively entered into the study and among 890 evaluated candidates based on inclusion criteria we finally investigated the serum UA levels of 725 TBI patients...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
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/28194631/development-of-a-new-folate-derived-ga-68-based-pet-imaging-agent
#7
Christian Brand, Valerie A Longo, Mike Groaning, Wolfgang A Weber, Thomas Reiner
PURPOSE: The folate receptor (FR) has emerged as an interesting diagnostic and therapeutic drug target with many potential applications in oncologic and inflammatory disorders. It was therefore the aim of this study to develop a folate-derived Ga-68-based positron emission tomography (PET) imaging tracer that is straightforward to radiolabel and could be broadly used in clinical studies. We validated its target binding affinity and specificity and compared it to [(99m)Tc]EC20, the folate single-photon emission computed tomography (SPECT) imaging tracer that has been most extensively studied clinically so far...
February 13, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28187489/-dentogene-focus-as-a-rare-cause-of-necrotizing-fasciitis
#8
Christopher Kloth, Sebastian Hoefert, Till Fischborn, Christina Schraml
History and clinical findings We elaborate the case of a 72-year-old patient who presented with a painful swelling of the lower jaw in the emergency unit. Investigations and diagnosis In the clinical examination and the CT scan, a widespread cervical emphysema was found which raised suspicion for the presence of a necrotizing fasciitis of the head and neck due to aerogenic infection. Close spatial vicinity to the teeth of the left upper and lower jaw was present, so that the necrotizing fasciitis was assumed to be odontogenic...
February 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28179982/spontaneous-biloma-due-to-an-intrahepatic-cholangiocarcinoma-an-extremely-rare-case-report-with-long-term-survival-and-literature-review
#9
Georgios K Georgiou, Athina Tsili, Anna Batistatou, Alexandra Papoudou-Bai, Georgios Papadopoulos, Michalis Fatouros, Georgios K Glantzounis
Cholangiocarcinomas are tumors that arise from the ductal epithelium of the intrahepatic or extra-hepatic bile ducts. Patients are usually asymptomatic or may present with weight loss, fatigue, loss of appetite and abdominal pain (intrahepatic cholangiocarcinomas) or jaundice (extra-hepatic cholangiocarcinomas). Subcapsular bile vessel rupture, due to intrahepatic cholangiocarcinoma, is an extremely rare clinical presentation, which is an emergent and potentially life-threatening complication. We report the case of a 79-year-old female patient suffering from an intrahepatic cholangiocarcinoma that completely obliterated the left main hepatic duct...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28169864/utilization-of-ultrasound-for-diagnostic-evaluation-and-management-of-peritonsillar-abscesses
#10
Michael H Froehlich, Zhen Huang, Brian K Reilly
PURPOSE OF REVIEW: We outlined the management of peritonsillar abscess (PTA) through the use of ultrasound, an imaging modality that continues to emerge as a diverse diagnostic and treatment tool. Our review compares the use of ultrasound to alternative diagnostic modalities, particularly computed tomography (CT). Further, the review evaluates how ultrasound can be used to help facilitate guided drainage of PTA and serve as a suitable alternative to more invasive management options. RECENT FINDINGS: Studies over the past 5 years have demonstrated that the initial management of PTA with ultrasound is a more cost-efficient and lower-risk option than imaging with CT...
February 4, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28165875/multidetector-ct-of-surgically-proven-blunt-bowel-and-mesenteric-injury
#11
David D B Bates, Michael Wasserman, Anita Malek, Varun Gorantla, Stephan W Anderson, Jorge A Soto, Christina A LeBedis
Blunt traumatic injury is one of the leading causes of morbidity and mortality in the United States. Unintentional injury represents the leading cause of death in the United States for all persons between the ages of 1 and 44 years. In the setting of blunt abdominal trauma, the reported rate of occurrence of bowel and mesenteric injuries ranges from 1% to 5%. Despite the relatively low rate of blunt bowel and mesenteric injury in patients with abdominal and pelvic trauma, delays in diagnosis are associated with increased rates of sepsis, a prolonged course in the intensive care unit, and increased mortality...
February 10, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28164409/emergency-physician-knowledge-attitudes-and-behavior-regarding-acep-s-choosing-wisely-recommendations-a-survey-study
#12
Michelle P Lin, Thomas Nguyen, Marc A Probst, Lynne D Richardson, Jeremiah D Schuur
OBJECTIVE: In 2013, the American College of Emergency Physicians joined the Choosing Wisely campaign; however, its impact on emergency physician behavior is unknown. We assessed knowledge, attitudes and self-reported behaviors regarding the Choosing Wisely recommendations. METHODS: We performed a cross-sectional survey of emergency physicians at a national meeting. We approached 819 physicians; 765 (93.4%) completed the survey. RESULTS: As a result of the Choosing Wisely campaign, most respondents (64...
February 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28162864/use-of-computed-tomography-to-determine-perforation-in-patients-with-acute-appendicitis
#13
Cameron E Gaskill, Vlad V Simianu, Jonathan Carnell, Daniel S Hippe, Puneet Bhargava, David R Flum, Giana H Davidson
PURPOSE: Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined...
December 7, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28161602/characterizing-mandibular-growth-using-three-dimensional-imaging-techniques-and-anatomic-landmarks
#14
Michael P Kelly, Houri K Vorperian, Yuan Wang, Katelyn K Tillman, Helen M Werner, Moo K Chung, Lindell R Gentry
OBJECTIVE: To provide quantitative data on the multi-planar growth of the mandible, this study derived accurate linear and angular mandible measurements using landmarks on three dimensional (3D) mandible models. This novel method was used to quantify 3D mandibular growth and characterize the emergence of sexual dimorphism. DESIGN: Cross-sectional and longitudinal imaging data were obtained from a retrospective computed tomography (CT) database for 51 typically developing individuals between the ages of one and nineteen years...
January 23, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/28161351/trends-in-imaging-use-for-the-evaluation-and-follow-up-of-kidney-stone-disease-a-single-center-experience
#15
Kevan M Sternberg, Benjamin Littenberg
PURPOSE: Recent reports support the use of renal ultrasonography (US) as the initial imaging study for the evaluation of patients with suspected renal colic. Urologists, however, often advocate for computed tomography (CT) to better define stone size and location, especially prior to proceeding with endourologic intervention. One concern with using US as the initial imaging study is that CT may be required at a later time, obviating the reduction in costs and radiation gained by using US...
February 1, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28157745/diagnosis-and-management-of-transient-ischemic-attack
#16
Shelagh B Coutts
PURPOSE OF REVIEW: This article reviews the diagnosis, investigation, and recommended management after a transient ischemic attack (TIA) and discusses how to make an accurate diagnosis, including the diagnosis of mimics of TIAs. RECENT FINDINGS: Up to a 10% risk of recurrent stroke exists after a TIA, and up to 80% of this risk is preventable with urgent assessment and treatment. Imaging of the brain and intracranial and extracranial blood vessels using CT, CT angiography, carotid Doppler ultrasound, and MRI is an important part of the diagnostic assessment...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28156051/ct-of-the-head-for-acute-stroke-diagnostic-performance-of-a-tablet-computer-prior-to-intravenous-thrombolysis
#17
Patrick D McLaughlin, Fiachra Moloney, Siobhan B O'Neill, Karl James, Lee Crush, Oisin Flanagan, Michael M Maher, Gerald Wyse, Noel Fanning
INTRODUCTION: The authors propose that tablet computers could benefit patients with acute stroke in the remote care setting, where time to and accuracy of CT interpretation greatly influences patient outcome. METHODS: One hundred and fifty consecutive patients who presented to the Emergency Department of a tertiary referral neurosciences centre within a time window suitable for intravenous thrombolytic therapy were included. Images were wirelessly transmitted to a tablet computer (iPad 3rd Generation, model = A1430, Apple, Cupertino, CA) and were reviewed by radiologists with three levels of experience for signs of intracranial haemorrhage, large vessel occlusion and parenchymal infarction...
February 3, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28153014/towards-best-practice-in-acute-stroke-care-in-ghana-a-survey-of-hospital-services
#18
Leonard Baatiema, Michael Otim, George Mnatzaganian, Ama De-Graft Aikins, Judith Coombes, Shawn Somerset
BACKGROUND: Stroke and other non-communicable diseases are important emerging public health concerns in sub-Saharan Africa where stroke-related mortality and morbidity are higher compared to other parts of the world. Despite the availability of evidence-based acute stroke interventions globally, uptake in low-middle income countries (LMIC) such as Ghana is uncertain. This study aimed to identify and evaluate available acute stroke services in Ghana and the extent to which these services align with global best practice...
February 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28152279/pulmonary-vein-stenosis-of-ex-premature-infants-with-pulmonary-hypertension-and-bronchopulmonary-dysplasia-epidemiology-and-survival-from-a-multicenter-cohort
#19
Linda Mahgoub, Tarek Kaddoura, A Rebecca Kameny, Paloma Lopez Ortego, Rachel D Vanderlaan, Ashok Kakadekar, Frank Dicke, Ivan Rebeyka, Christopher A Calderone, Andrew Redington, Maria Jesus Del Cerro, Jeff Fineman, Ian Adatia
BACKGROUND: Pulmonary vein stenosis is emerging as an important clinical problem in ex-premature infants. METHODS: We sought to describe the epidemiology of pulmonary vein stenosis affecting ex-premature infants by a multicenter retrospective cohort study of patients from seven children's hospitals diagnosed between 2000-2014. RESULTS: We identified 39 ex-premature patients (26 males, median gestational age 28 weeks range 22-36 weeks, birth weight 1...
February 2, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28147464/acute-appendicitis-in-adults-diagnostic-accuracy-of-emergency-doctors-in-a-university-hospital-in-hong-kong
#20
Yuk-Ki Leung, Cangel Py Chan, Colin A Graham, Timothy H Rainer
OBJECTIVE: The aim of this study was to assess the diagnostic accuracy of ED doctors with variable training levels in detecting acute appendicitis, without access to advanced imaging in admitted patients with acute abdominal pain in a university hospital of Hong Kong. METHODS: A retrospective analysis was performed on data collected from prospectively identified patients presenting to the ED with acute abdominal pain and admitted to either a surgical or emergency medical ward between December 2011 and October 2012...
February 2017: Emergency Medicine Australasia: EMA
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