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https://www.readbyqxmd.com/read/28449017/a-multifaceted-intervention-to-improve-primary-care-radiology-referral-quality-and-value-in-canterbury
#1
Kieran Holland, Graham McGeoch, Carolyn Gullery
AIMS: This article describes a seven-year multifaceted intervention leading to sustained improvement in primary care radiology referral quality and value in Canterbury, New Zealand, and discusses the transferability to other health systems. METHODS: Access criteria were developed with input from general practitioners and hospital-based specialists, and embedded in locally developed clinical pathways. A referral management service was created to streamline referral processes...
April 28, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28448707/-joint-replacement-and-giant-cell-tumor-report-of-8-cases
#2
J G Martínez-Estrada, O Santamaría-Bahena
INTRODUCTION: The giant-cell tumor is an aggressive neoplasia, represents approximately from the 5 the 8.6% of primary bone tumors; more of 50% affects the pelvic extremity, being able to affect the totality of the bones. OBJECTIVE: To present the case series of tumors around the knee and hip that we offered a tumoral joint replacement as an alternative to amputation. MATERIAL AND METHODS: We present eight cases of extensive giant cells tumors, we did en bloc resection and tumoral joint replacement...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28444438/effect-and-safety-of-early-weight-bearing-on-the-outcome-after-open-wedge-high-tibial-osteotomy-a-systematic-review-and-meta-analysis
#3
O-Sung Lee, Soyeon Ahn, Yong Seuk Lee
INTRODUCTION: The purpose of this systematic review and meta-analysis was to evaluate the effectiveness and safety of early weight-bearing by comparing clinical and radiological outcomes between early and traditional delayed weight-bearing after OWHTO. MATERIALS AND METHODS: A rigorous and systematic approach was used. The methodological quality was also assessed. Results that are possible to be compared in two or more than two articles were presented as forest plots...
April 25, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28439353/improving-timely-resident-follow-up-and-communication-of-results-in-ambulatory-clinics-utilizing-a-web-based-audit-and-feedback-module
#4
Joel C Boggan, Aparna Swaminathan, Samantha Thomas, David L Simel, Aimee K Zaas, Jonathan G Bae
BACKGROUND: Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. OBJECTIVE: This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. METHODS: We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28438503/expanding-role-of-certified-electronic-health-records-technology-in-radiology-the-macra-mandate
#5
Gregory N Nicola, Andrew B Rosenkrantz, Joshua A Hirsch, Ezequiel Silva, Keith J Dreyer, Michael P Recht
Radiology has historically been at the forefront of innovation and the advancement of technology for the benefit of patient care. However, challenges to early implementation prevented most radiologists from adopting and integrating certified electronic health record technology (CEHRT) into their daily workflow despite the early and potential advantages it offered. This circumstance places radiology at a disadvantage in the two payment pathways of the Medicare Access and CHIP Reauthorization Act of 2015: the Merit-Based Incentive Payment System (MIPS) and advanced alternative payment models (APMs)...
April 19, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28438322/water-fat-dixon-sequences-in-the-evaluation-of-breast-implants-proposal-of-a-time-effective-rapid-approach-in-the-clinical-practice
#6
M Marcon, A S Becker, E J Ulbrich, T Frauenfelder, A Boss
AIM: To evaluate the diagnostic accuracy achieved from a fat-water Dixon sequence alone compared to a combination of a silicone-specific magnetic resonance imaging (MRI) sequence and a water-specific MRI sequence in the assessment of breast implants. MATERIALS AND METHODS: In this institutional review board (IRB)-approved study the integrity of breast implants was assessed retrospectively in 27 patients undergoing breast MRI at 3 T. A qualitative evaluation of (set 1) a silicon-selective water-saturated short tau inversion recovery (STIR) sequence in combination with a water-only Dixon dataset (total acquisition time 7 minutes 17 seconds), and of (set 2) fat-only and water-only Dixon datasets (4 minutes 8 seconds) was performed by two readers independently evaluating the following features: margin definition of the implant, water suppression homogeneity, image quality, presence of artefacts and their effects on the imaging interpretation, and diagnostic confidence...
April 21, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28437346/correlations-between-sagittal-spinal-balance-and-quality-of-life-in-rheumatoid-arthritis
#7
Hong Seok Lee, Jung Sub Lee, Jong Ki Shin, Tae Sik Goh
STUDY DESIGN: Prospective study. OBJECTIVE: To identify relationships between spinopelvic parameters and health-related quality of life in rheumatoid arthritis (RA). SUMMARY OF BACKGROUND DATA: Little data are available on relationships between sagittal spinopelvic parameters and health-related quality of life in RA. MATERIALS AND METHODS: The study and control groups comprised 120 RA patients and 60 controls. All subjects underwent anteroposterior and lateral radiography of the whole spine, including hip joints, and all completed clinical questionnaires...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437189/metformin-attenuates-radiation-induced-pulmonary-fibrosis-in-a-murine-model
#8
Jian Wang, Ye Wang, Jun Han, Hong Mei, Dandan Yu, Qian Ding, Tao Zhang, Gang Wu, Gang Peng, Zhenyu Lin
While radiotherapy continues to be a major cancer treatment option, its dose-limiting side effects, such as pulmonary fibrosis, severely impair the quality of life in these patients. In this study, we evaluated the radioprotective effects of metformin, a commonly used biguanide antidiabetic medication, in a murine model of pulmonary damage. Sprague Dawley(®) rats received whole lung 20 Gy irradiation with or without metformin treatment. Computed tomography (CT) was performed and Hounsfield units (HU) were determined during the observation period...
April 24, 2017: Radiation Research
https://www.readbyqxmd.com/read/28436368/-pseudo-pseudoaneurysm-following-robotic-assisted-partial-nephrectomy
#9
Eric Schommer, Julio Gundian, David D Thiel
A 65-year-old female presented to clinic requesting follow up for a history of right robotic partial nephrectomy done at an outside institution 2 years prior. Initial pathology demonstrated a grade 2/4 3.4 cm clear cell renal cell carcinoma with negative margins. There was no tumor necrosis, sarcomatoid differentiation, or lymphovascular invasion. High quality follow up imaging initially revealed a pseudoaneurysm in the central portion of the right kidney. The patient was sent to interventional radiology for angioembolization...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#10
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433848/instrumented-circumferential-fusion-in-two-stages-for-instable-lumbar-fracture-long-term-results-of-a-series-of-74-patients-on-sagittal-balance-and-functional-outcomes
#11
Mourad Ould-Slimane, Camille Damade, Guillaume Lonjon, André Gilibert, Jérôme Cochereau, Rémi Gauthé, Nicolas Lonjon
AIM: To report the radiological and functional results of a multicentre, prospective case series of patients with comminuted lumbar fractures treated with two-stage circumferential arthrodesis. METHODS: A multicentre, prospective case series of 74 patients with comminuted lumbar fractures was analyzed. The strategy entailed initial posterior osteosynthesis then physical replacement with an expandable titanium cage filled with autologous bone, via retroperitoneal lumbotomy...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28431197/serum-c-reactive-protein-procalcitonin-and-lactate-dehydrogenase-for-the-diagnosis-of-pancreatic-necrosis
#12
REVIEW
Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with pancreatic necrosis differs from that of people with oedematous pancreatitis. It is important to know the diagnostic accuracy of serum C-reactive protein (CRP), serum procalcitonin, and serum lactate dehydrogenase (LDH) as a triage test for the detection of pancreatic necrosis in people with acute pancreatitis, so that an informed decision can be made as to whether the person with pancreatic necrosis needs further investigations such as computed tomography (CT) scan or magnetic resonance imaging (MRI) scan and treatment for pancreatic necrosis started...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28429878/a-systematic-review-of-ultrasound-imaging-as-a-tool-for-evaluating-haemophilic-arthropathy-in-children-and-adults
#13
REVIEW
C C Ligocki, A Abadeh, K C Wang, T Adams-Webber, V S Blanchette, A S Doria
The purpose of this study was to semi-quantitatively assess the evidence on the value of ultrasound (US) for assessment of haemophilic arthropathy (HA) in children and adults based on the following questions: (1) Does early diagnosis of pathological findings, using available US techniques, impact the functional status of the joint? (2) Do current available US techniques have the ability to accurately detect pathological changes in target joints in haemophilic patients? (3) Does treatment (prophylaxis) improve US evidence of haemophilic arthropathy in children and adults? (4) Is there any association between various US scoring systems and other clinical/radiological constructs? Of the 6880 citations identified searching databases such as MEDLINE, Embase, CENTRAL and Web of Science, 20 articles investigating either the diagnostic accuracy of US and/or US scanning protocols and scoring systems for assessment of HA met the inclusion criteria for the study...
April 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#14
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28429207/organizational-and-welfare-mode-of-breast-centers-network-a-survey-of-sicilian-radiologists
#15
Maria Adele Marino, Orazio Pennisi, Annalisa Donia, Carmelo Sofia, Claudio Guerra, Carmelo Privitera, Placido Romeo
The European Society of Breast Cancer Specialists has created quality indicators for breast units to establish the minimum standards of care for patients. In Italy, each region differs, indeed, in terms of health care and services warranted to patients suffering from breast cancer. Since Sicilian Regional Administration today is still disregarding implementation of the provisions contained in the proposal of the Ministry of Health entitled "Guidelines on Organizational and Health Care Methods of Breast Centers Network" in November 2015 the Sicilian Regional Group of the Italian Society of Radiology (SIRM) decided to carry out a survey to see the position of the Sicilian Healthcare System and define the gap to bridge over...
April 20, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28429173/a-new-approach-to-local-dco-in-ankle-fracture-dislocations-external-fixation-with-diaphyseal-unicortical-screws-applied-by-local-anaesthesia
#16
F Lavini, T Maluta, G Carpeggiani, C Dall'Oca, E Samaila, G Marconato, B Magnan
PURPOSE: Ankle fracture dislocations represent a great threat for soft tissue viability and articular instability. The use of a temporary ankle bridging ExFix plays a fundamental role in the local damage control orthopaedics while waiting for definitive synthesis. METHODS: For this prospective research, we have developed a full application protocol of innovative diaphyseal monocortical screws fixator (Unyco-Orthofix(TM)) exclusively under local anaesthesia. Rigid selection criteria allowed us to collect nine patients during a period of almost 2 years...
April 20, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28428140/automated-annotation-and-classification-of-bi-rads-assessment-from-radiology-reports
#17
Sergio M Castro, Eugene Tseytlin, Olga Medvedeva, Kevin Mitchell, Shyam Visweswaran, Tanja Bekhuis, Rebecca S Jacobson
The Breast Imaging Reporting and Data System (BI-RADS) was developed to reduce variation in the descriptions of findings. Manual analysis of breast radiology report data is challenging but is necessary for clinical and healthcare quality assurance activities. The objective of this study is to develop a natural language processing (NLP) system for automated BI-RADS categories extraction from breast radiology reports. We evaluated an existing rule-based NLP algorithm, and then we developed and evaluated our own method using a supervised machine learning approach...
April 17, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28427841/localized-shape-abnormalities-in-the-thalamus-and-pallidum-are-associated-with-secondarily-generalized-seizures-in-mesial-temporal-lobe-epilepsy
#18
Linglin Yang, Hong Li, Lujia Zhu, Xinfeng Yu, Bo Jin, Cong Chen, Shan Wang, Meiping Ding, Minming Zhang, Zhong Chen, Shuang Wang
Mesial temporal lobe epilepsy (mTLE) is a common type of drug-resistant epilepsy and secondarily generalized tonic-clonic seizures (sGTCS) have devastating consequences for patients' safety and quality of life. To probe the mechanism underlying the genesis of sGTCS, we investigated the structural differences between patients with and without sGTCS in a cohort of mTLE with radiologically defined unilateral hippocampal sclerosis. We performed voxel-based morphometric analysis of cortex and vertex-wise shape analysis of subcortical structures (the basal ganglia and thalamus) on MRI of 39 patients (21 with and 18 without sGTCS)...
April 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28422806/improvement-of-image-quality-in-unenhanced-dual-layer-ct-of-the-head-using-virtual-monoenergetic-images-compared-with-polyenergetic-single-energy-ct
#19
Victor Neuhaus, Nuran Abdullayev, Nils Große Hokamp, Gregor Pahn, Christoph Kabbasch, Anastasios Mpotsaris, David Maintz, Jan Borggrefe
OBJECTIVES: The aims of this study were to compare virtual monoenergetic images and polyenergetic images reconstructed from unenhanced dual-layer detector computed tomography (DLCT) of the head and to determine kiloelectron volt levels that optimize image quality, particularly the gray-white matter contrast, and reduce beam hardening artifacts caused by the skull. MATERIALS AND METHODS: Institutional review board approval was obtained. Forty patients that received DLCT were included in this retrospective study; of these patients, 22 were women and 18 were men...
April 19, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28420247/clinical-and-radiological-outcomes-after-decompression-and-posterior-fusion-in-patients-with-degenerative-scoliosis
#20
Majid Reza Farrokhi, Mohammad Jamali, Mehrnaz Gholami, Farnaz Farrokhi, Khadijeh Hosseini
OBJECTIVE: The prevalence of degenerative scoliosis (DS) increases with age and an overall increase is seen due to the aging population. This study aims to evaluate the clinical and radiological outcomes after decompression and posterior fusion in patients with DS. METHODS: In this is prospective study, 43 patients with DS, aged 37 to 70 years, were eligible to undergo decompression and posterior fusion. Primary outcomes were low back pain (LBP) with or without radicular pain, which was evaluated preoperatively and at 12 and 24 months after surgery with the use of a visual analog scale (VAS), and the quality of life (QOL), which was assessed at the same time periods by the Oswestry Disability Index (ODI) questionnaire...
April 19, 2017: British Journal of Neurosurgery
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