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Diagnostic exams

Marcin Frączek, Marcin Masalski, Maciej Guziński
BACKGROUND: Paranasal computed tomography (CT) has become the investigation method of choice to confirm or exclude the diagnosis of chronic rhinosinusitis (CRS) on the basis of its ability to deliver objective data regarding the presence of inflamed mucosa or polyps. OBJECTIVES: The aim of the study was to assess the reliability of CT scan findings among untreated CRS patients without the presence of polyps in a nasal endoscopy. MATERIAL AND METHODS: Among patients with clinically demonstrated CRS considered for surgery, 93 subjects who had had 2 CT scans performed at different time points in the diagnostic process were enrolled into the study...
March 19, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
J T Sullivan
No abstract text is available yet for this article.
February 9, 2018: International Journal of Obstetric Anesthesia
Nitika Paudel, Kevin P Bethke, Lilian C Wang, Jonathan B Strauss, John P Hayes, Eric D Donnelly
PURPOSE: The current standard of care for women diagnosed with early stage breast cancer is breast-conserving surgery (BCS) followed by external beam radiation therapy, commonly delivered over 3-6 weeks. As an alternative, select patients can undergo intra-operative radiation therapy (IORT) at the time of BCT. This technique delivers a single fraction of radiation at the time of surgery, enabling patients to undergo both surgery and radiation in a single session. Our current study analyzed the value of incorporating breast MRI into the routine work-up of patients deemed eligible for IORT, to quantify the impact on patient eligibility and requirement for additional work-up...
March 2018: Surgical Oncology
Charalambos Vlachopoulos, Christos Georgakopoulos, Iosif Koutagiar, Dimitrios Tousoulis
Peripheral artery disease (PAD) affects approximately one in five persons older than 70 years of age and it is often present in patients with concomitant vascular disease in different body territories (e.g. coronary artery disease). Diagnosis at an early stage is important in order to achieve improvement in patient's symptoms and prognosis. Remarkable improvements in the field of noninvasive and invasive imaging techniques have led to an advanced level the management of patients with PAD. Throughout this review article, the clinically available diagnostic modalities in PAD are presented...
March 14, 2018: Current Opinion in Pharmacology
Thomas Magee
OBJECTIVE: Post-operative shoulder patients are often difficult to image due to scar tissue, metallic artifact, and residual irregularity of anatomic structures. The purpose of this study was to assess MR versus MR arthrography versus CT arthrography in the post-operative shoulder. Also, we assessed whether injecting CT contrast in addition to MR contrast during arthrography improved patient care. METHODS AND MATERIALS: One hundred consecutive post-operative conventional shoulder MR and MR arthrography exams performed on the same patients were reviewed retrospectively by two musculoskeletal radiologists...
March 17, 2018: Skeletal Radiology
David Barbic, Brian Kim, Qadeem Salehmohamed, Kate Kemplin, Christopher R Carpenter, Skye Pamela Barbic
OBJECTIVES: Cognitive dysfunction (CD) is a common finding in geriatric patients presenting to the emergency department (ED). Our primary objective was to determine the diagnostic accuracy of the Ottawa 3DY (O3DY) and Short Blessed Test (SBT) as screening tools for the detection of CD in the ED. Our secondary objective was to estimate the inter-rater reliability of these instruments. METHODS: We conducted a prospective cross-sectional comparative study at an inner-city academic medical centre (annual ED visit census 86 000)...
March 16, 2018: BMJ Open
A Fauconnier, B Borghese, C Huchon, I Thomassin-Naggara, C-A Philip, T Gauthier, N Bourdel, A Denouel, A Torre, P Collinet, M Canis, X Fritel
Based on the best evidence available, we have provided guidelines for clinical practice to target the nature of endometriosis as a disease, the consequences of its natural history on management, and the clinical and imaging evaluation of the disease according to the level of care (primary care, specialized or referral). The frequency of endometriosis is unknown in the general population; endometriosis requires management when it causes symptoms (pain, infertility) or when it affect the function of an organ...
March 13, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Sarah Mousseau, Annie Lapointe, Jocelyn Gravel
BACKGROUND: The CellScope Oto® is a smartphone otoscope attachment allowing physicians to share diagnostic-quality images of the ears. Our primary objective was to evaluate the residents' accuracy in diagnosing acute otitis media in children using the CellScope Oto® attachment compared to traditional otoscope. METHODS: A randomized crossover controlled trial was performed at a single, tertiary care, pediatric emergency department. Participants were a convenience sample of preschool children, consulting for fever and respiratory symptoms...
January 31, 2018: American Journal of Emergency Medicine
L Alejo, E Corredoira, F Sánchez-Muñoz, C Huerga, Z Aza, R Plaza-Núñez, A Serrada, M Bret-Zurita, M Parrón, C Prieto-Areyano, G Garzón-Moll, R Madero, E Guibelalde
Objective: The new 2013/59 EURATOM Directive (ED) demands dosimetric optimisation procedures without undue delay. The aim of this study was to optimise paediatric conventional radiology exams applying the ED without compromising the clinical diagnosis. METHODS: Automatic dose management software (ADMS) was used to analyse 2678 studies of children from birth to 5 years of age, obtaining local diagnostic reference levels (DRLs) in terms of entrance surface air kerma. Given local DRL for infants and chest exams exceeded the European Commission (EC) DRL, an optimisation was performed decreasing the kVp and applying the automatic control exposure...
March 14, 2018: British Journal of Radiology
Francesco Macrì, Simona Di Pietro, Cyndi Mangano, Michela Pugliese, Giuseppe Mazzullo, Nicola M Iannelli, Vito Angileri, Simona Morabito, Massimo De Majo
BACKGROUND: In veterinary medicine, contrast-enhanced ultrasonography allowed the accurate quantification of liver, splenic and kidney vascularization in healthy dogs and the differentiation between malignant and benign hepatic, renal, and splenic nodules in dogs and cats based on perfusion patterns. The utility of contrast-enhanced ultrasonography in other applications is still under study. The aim of this study was to develop diagnostic criteria by contrast-enhanced ultrasonography in 8 client-owned adult dogs affected by urinary bladder transitional cell carcinoma with definitive diagnosis made by cytopathologic evaluation after suction biopsy...
March 12, 2018: BMC Veterinary Research
S Lindsay Wood, John Owen, Sheri M Jenkins, Lorie M Harper
INTRODUCTION:  Although guidelines recommend repeat ultrasound in the setting of an incomplete fetal anatomic survey, the clinical utility of this practice has not been established. As such, we aimed to assess the yield of repeat ultrasound for anomaly detection following an incomplete survey. MATERIALS AND METHODS:  This is a retrospective cohort study of all singletons who underwent a midtrimester anatomic ultrasound at University of Alabama at Birmingham (UAB) from 2006 to 2014...
February 8, 2018: American Journal of Perinatology
Felipe de Oliveira, José Alberto Landeiro, Igor de Castro
Background: Medulloblastoma is an embryonal neoplasm and accounts for 1% of all adult intracranial tumors. It is associated with many familiar cancer syndromes, but there is no known cause for medulloblastoma. Many studies have documented differences between childhood and adult medulloblastomas in terms of location, proliferation, and apoptotic indices. There are four histological groups - classic and the variant forms (desmoplastic/nodular, anaplasic, and large cell). There are four major subgroups according to molecular configuration: wingless (WNT), sonic hedgehog (SHH), group 3, and group 4 with differences between them according to prognostic outcomes...
2018: Surgical Neurology International
Asad A Khawaja, Dmitry Tumin, Ralph J Beltran, Joseph D Tobias, Joshua C Uffman
OBJECTIVES: General anesthesia or sedation can facilitate the completion of diagnostic radiological studies in children. We evaluated the incidence, predictors, and causes of adverse events (AEs) when general anesthesia is provided for diagnostic radiological imaging. METHODS: Deidentified data from 24 pediatric tertiary care hospitals participating in the Wake-Up Safe registry during 2010-2015 were obtained for analysis. Children 18 years or younger receiving general anesthesia for radiological procedures were identified using Current Procedural Terminology codes, and reported AEs were analyzed if they were associated with anesthetic care at magnetic resonance imaging or computed tomography locations...
March 8, 2018: Journal of Patient Safety
Morgan Schellenberg, Kenji Inaba, James M Bardes, Nicholas Orozco, Jessica Chen, Caroline Park, Tarina Kang, Demetrios Demetriades
BACKGROUND: Portable chest x-ray (CXR) and extended FAST (EFAST) screen patients for thoracic injury in the trauma bay. It is unclear if one test alone is sufficient, if both are required, or if the two investigations are complementary. Study objectives were to define the combined diagnostic yield of EFAST and CXR among stable blunt thoracic trauma patients and to determine if a normal EFAST and CXR might obviate the need for CT scan of the chest. METHODS: All blunt trauma patients ≥15 years presenting to LAC+USC Medical Center in 2016 were screened...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Susanna Nuvoli, Silvia Contu, Bi Llie Joy Pung, Patrizia Solinas, Giuseppe Madeddu, Angela Spanu
Leptomeningeal carcinomatosis (LC) diagnosis is based on cerebrospinal fluid (CSF) cytological analysis and contrast-enhanced magnetic resonance imaging (MRI); however, low sensitivity was evidenced in some cases delaying prompt and adequate treatments. Brain18 F-fluorodeoxyglucose positron emission tomography (18 F-FDG PET) was also employed in doubtful cases. We retrospectively described 4 suspected LC cases with uncertain or undetectable MRI and initially negative CSF cytology. Whole-body (WB) and brain18 F-FDG PET/computed tomography (CT) were used, the latter showing intracranial tracer uptakes suspected for LC in 3/4 cases...
January 2018: Case Reports in Neurology
Allison D Ta, Li-Yueh Hsu, Hannah M Conn, Susanne Winkler, Anders M Greve, Sujata M Shanbhag, Marcus Y Chen, W Patricia Bandettini, Andrew E Arai
BACKGROUND: Dark rim artifacts in first-pass cardiovascular magnetic resonance (CMR) perfusion images can mimic perfusion defects and affect diagnostic accuracy for coronary artery disease (CAD). We evaluated whether quantitative myocardial blood flow (MBF) can differentiate dark rim artifacts from true perfusion defects in CMR perfusion. METHODS: Regadenoson perfusion CMR was performed at 1.5 T in 76 patients. Significant CAD was defined by quantitative invasive coronary angiography (QCA) ≥ 50% diameter stenosis...
March 8, 2018: Journal of Cardiovascular Magnetic Resonance
R Andrew Taylor, Christopher L Moore, Kei-Hoi Cheung, Cynthia Brandt
BACKGROUND: Urinary tract infection (UTI) is a common emergency department (ED) diagnosis with reported high diagnostic error rates. Because a urine culture, part of the gold standard for diagnosis of UTI, is usually not available for 24-48 hours after an ED visit, diagnosis and treatment decisions are based on symptoms, physical findings, and other laboratory results, potentially leading to overutilization, antibiotic resistance, and delayed treatment. Previous research has demonstrated inadequate diagnostic performance for both individual laboratory tests and prediction tools...
2018: PloS One
Edyta Wlaźlak, Tomasz Kluz, Grzegorz Surkont, Jacek Kociszewski
OBJECTIVES: There are different diagnostic methods used in women with urinary incontinence symptoms such as: medical history, voiding diary, cough test, pad test, urodynamic testing. None of them is optimal. The aim of this study is to analyze the correlation between urethral funneling visualized during pelvic floor sonography and symptoms of stress urinary incontinence. MATERIAL AND METHODS: We have performed a retrospective analysis of 657 complete datasets of patients who attended our urogynecological clinic for diagnostics...
2018: Ginekologia Polska
Ali Khalifeh, Tamara Khashab, Michael Huffner, Zahra N Rezvani, Justin Kwan, Shahab Toursavadkohi
Radial artery thrombosis is a rare complication of cannulation. There are no reported cases of acute thrombosis and severe acute neuropathy in the setting of cannula discontinuation. We report a case of acute radial nerve mono-neuropathy following thrombosis after radial arterial line removal. The thrombus was immediately evident on exam and diagnostic imaging after cannula discontinuation. The patient was consented and promptly taken to OR for immediate repair. Mild radial neuropathy persisted despite immediate repair...
2018: SAGE Open Medical Case Reports
André Cavalcante da Silva Barbosa, Roberto Carlos Mourão Pinho, Márcia Maria Vendiciano Barbosa Vasconcelos, Bruno Gama Magalhães, Maria Teresa Botti Rodrigues Dos Santos, Arnaldo de França Caldas Júnior
AIMS: To investigate the symptoms of depression and oral health status in Brazilian public healthcare system users. MATERIALS AND METHODS: Analysis of a cross-sectional study conducted with a sample of 776 individuals aged 15 years or older, in the urban areas of Recife (Brazil), obtained by multistage sampling. Committee on Ethics in Research with Human Beings (CAAE) 0538.0.172.172-11. Depression symptoms were verified by means of Axis II of the Research Diagnostic Criteria in Temporomandibular Disorder...
March 6, 2018: Special Care in Dentistry
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