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https://www.readbyqxmd.com/read/28545887/how-to-identify-high-radiation-burden-from-computed-tomography-an-example-in-obese-children
#1
Daniel L Lodwick, Jennifer N Cooper, Brent Adler, Choonsik Lee, Kelly Kelleher, Peter C Minneci, Katherine J Deans
BACKGROUND: Radiation burden from the use of computed tomography (CT) imaging may not be evenly distributed. We tested whether overweight and obese children receive higher radiation burden from CT imaging. METHODS: An automated software tool (DoseWizard) assessed patient-level radiation dose from CT and merged results with clinical data from the electronic health record. CT scans of the head, chest, and abdomen/pelvis (A/P) performed at our institution from January 2013 to August 2015 on patients aged <16 y were processed using this software...
May 5, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28541855/rate-and-reasons-for-repeat-ct-scanning-in-transferred-trauma-patients
#2
James F Holmes, Blake G Siglock, Michael T Corwin, Michael A Johnson, Edgardo S Salcedo, Gabriel S Espinoza, Ramit Lamba
To describe the reasons and additional radiation for CT scans repeated after transfer to a trauma center. Retrospective study of patients transferred to a trauma center. Patients had repeat CT if a CT of the same region was repeated at the trauma center's emergency department. Indications for repeat CT scanning were abstracted. Radiation dosage was calculated in millisieverts. A total of 370 had CT scans and were transferred. Mean age was 39.1 ± 28.0 years. Seventy-four [20.0%, 95% confidence interval (CI) 16...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541574/accuracy-of-size-specific-dose-estimate-calculation-from-center-slice-in-computed-tomography
#3
Johannes Boos, Patric Kröpil, Oliver Th Bethge, Joel Aissa, Christoph Schleich, Lino Morris Sawicki, Niklas Heinzler, Gerald Antoch, Christoph Thomas
To evaluate the accuracy of size-specific dose estimate (SSDE) calculation from center slice with water-equivalent diameter (Dw) and effective diameter (Deff). A total of 1812 CT exams (1583 adult and 229 pediatric) were included in this retrospective study. Dw and Deff were automatically calculated for all slices of each scan. SSDEs were calculated with two methods: (1) from the center slice; and (2) from all slices of the volume, which was regarded as the reference standard. Impact of patient weight, height and body mass index (BMI) on SSDE accuracy was assessed...
May 25, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/28538630/the-evolution-of-care-improves-outcome-in-blunt-thoracic-aortic-injury-a-western-trauma-association-multicenter-study
#4
Steven R Shackford, Casey E Dunne, Riyad Karmy-Jones, William Long, Desarom Teso, Martin A Schreiber, Justin Watson, Cheri Watson, Robert C McIntyre, Lisa Ferrigno, Mark L Shapiro, Kevin Southerland, Julie A Dunn, Paul Reckard, Thomas M Scalea, Megan Brenner, William A Teeter
BACKGROUND: The management of blunt thoracic aortic injury (BTAI) has evolved radically in the last decade with changes in the processes of care and the introduction of thoracic endovascular repair (TEVAR). These changes have wrought improved outcome, but the direct effect of TEVAR on outcome remains in question as previous studies have lacked vigorous risk adjustment and long-term follow-up. To address these knowledge gaps, we compared the outcomes of TEVAR, open surgical repair, and nonoperative management for BTAI...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28536223/cardiac-compression-due-to-gastric-volvulus-an-unusual-cause-of-chest-pain
#5
Alex Brown, David Austin, Venkatesh Kanakala
A 42-year-old man was admitted to coronary care for assessment with severe retrosternal chest pain. Echocardiography showed significant external compression of the left atrium. A subsequent CT scan revealed him to have a large hiatus hernia, with most of his stomach herniating into his thorax causing left atrial compression and gastric volvulus. He subsequently underwent successful emergency decompression of the gastric volvulus and repair of his hiatus hernia.
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28533639/metastatic-brachial-plexopathy-with-brain-and-spinal-metastasis-in-a-case-of-recurrent-breast-carcinoma-demonstrated-on-18-f-fdg-pet-ct
#6
Sunny J Gandhi, Bhavdeep Rabadiya
We report a case of a 56-year-old woman diagnosed with infiltrating ductal carcinoma of the left breast, who had undergone left modified radical mastectomy followed by radiotherapy and adjuvant chemotherapy. FDG PET-CT showed metastatic brachial plexopathy with intra-spinal and extra-axial brain metastasis. Metastatic brachial plexopathy along with brain and spinal metastasis is a rare condition with very less incidence. The scan also showed left para-sternal anterior chest wall recurrence with antero-superior mediastinal metastasis...
April 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/28529538/emergency-surgery-due-to-diaphragmatic-hernia-case-series-and-review
#7
REVIEW
Mario Testini, Antonia Girardi, Roberta Maria Isernia, Angela De Palma, Giovanni Catalano, Angela Pezzolla, Angela Gurrado
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a congenital abnormality, rare in adults with a frequency of 0.17-6%. Diaphragmatic rupture is an infrequent consequence of trauma, occurring in about 5% of severe closed thoraco-abdominal injuries. Clinical presentation ranges from asymptomatic cases to serious respiratory or gastrointestinal symptoms. Diagnosis depends on anamnesis, clinical signs and radiological investigations. METHODS: From May 2013 to June 2016, six cases (four females, two males; mean age 58 years) of diaphragmatic hernia were admitted to our Academic Department of General Surgery with respiratory and abdominal symptoms...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28526893/do-we-need-3d-tube-current-modulation-information-for-accurate-organ-dosimetry-in-chest-ct-protocols-dose-comparisons
#8
Xochitl Lopez-Rendon, Guozhi Zhang, Walter Coudyzer, Wim Develter, Hilde Bosmans, Federica Zanca
OBJECTIVES: To compare the lung and breast dose associated with three chest protocols: standard, organ-based tube current modulation (OBTCM) and fast-speed scanning; and to estimate the error associated with organ dose when modelling the longitudinal (z-) TCM versus the 3D-TCM in Monte Carlo simulations (MC) for these three protocols. METHOD: Five adult and three paediatric cadavers with different BMI were scanned. The CTDIvol of the OBTCM and the fast-speed protocols were matched to the patient-specific CTDIvol of the standard protocol...
May 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28523201/sarcoidosis-is-it-a-possible-trigger-of-inclusion-body-myositis
#9
Ali Zakaria, Issam Turk, Kenneth Leung, Ana Capatina-Rata, Waseem Farra
Sarcoidosis is a multisystem disorder of unknown etiology, characterized pathologically by the presence of nonnecrotizing granulomatous inflammation in affected organs. Although skeletal muscle is involved in 50-80 percent of individuals with sarcoidosis, symptomatic myopathy has been shown to be a rare manifestation of the disease. Inclusion body myositis (IBM) is a rare acquired idiopathic inflammatory myopathy with the insidious onset of asymmetric and distal muscle weakness that characteristically involves the quadriceps, tibialis anterior, and forearm flexors...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28523200/an-unusual-presentation-of-congenital-lobar-emphysema
#10
Daniel Arnaud, Joseph Varon, Salim Surani
Congenital lobar emphysema is an uncommon bronchopulmonary malformation characterized by lobar overinflation and accompanying alveolar septum damage that leads to compression atelectasis of the lung parenchyma and displacement of mediastinal structures, with the resultant ventilation-perfusion mismatch. We present a case of a 33-year-old lady with progressive exertional dyspnea. Chest radiograph findings lead to the suspicion of congenital lobar emphysema, which was then confirmed by a computed tomography (CT) scan...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28523180/primary-atypical-carcinoid-tumor-of-the-mediastinum-a-very-rare-finding
#11
Luigi Ventura, Letizia Gnetti, Enrico Maria Silini, Guido Rindi, Paolo Carbognani, Michele Rusca, Luca Ampollini
Primary neuroendocrine tumors (NETs) of the mediastinum are very rare. Prognosis is usually poor despite treatment options. We present the case of a primary atypical carcinoid tumor of the mediastinum successfully treated by multimodal approach. A 50-year-old man presented for asthenia, dyspnea, and substernal sense of weight for two weeks. A chest-CT scan revealed a tumor mass of 107×55×95 mm(3) localized in the anterosuperior mediastinum compressing both brachiocephalic veins, the superior vena cava, the pericardium, and lungs...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523162/a-preliminary-exploration-of-the-intravoxel-incoherent-motion-applied-in-the-preoperative-evaluation-of-mediastinal-lymph-node-metastasis-of-lung-cancer
#12
Xin Ye, Shuo Chen, Yaru Tian, Bin You, Wenqian Zhang, Yan Zhao, Tao Jiang, Bin Hu, Hui Li
BACKGROUND: The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for distinguishing non-metastatic from metastatic mediastinal lymph nodes in lung cancer. METHODS: IVIM-diffusion weighted imaging (DWI) exams were performed preoperatively on 66 patients with lung cancer from October 2015 to June 2016 in Beijing Chao-Yang Hospital, Capital Medical University. Fifty patients underwent enhanced chest computed tomography (CT) in our hospital, while the other 16 patients already had enhanced chest CT images when they were admitted...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522112/diffuse-parenchymal-lung-disease-on-chest-radiographs-and-ct
#13
Theodore J Dubinsky, Hardik Shah, Rachelle Sonneborn, Daniel S Hippe
BACKGROUND: We prospectively identified B-lines in patients undergoing ultrasound examinations following liver transplants who also had a chest x-ray (CXR) and/or chest CT scan on the same day to determine if an association between the presence of B-lines s from the thorax on ultrasound images correlates with the presence of pulmonary abnormalities on chest radiographs. MATERIALS AND METHODS: Following IRB approval, patients undergoing routine postoperative liver transplant ultrasound examinations and a CXR and/or CT scan on the same day between 1/1/2015 through 7/1/2016 were prospectively identified...
May 15, 2017: Chest
https://www.readbyqxmd.com/read/28516961/supracricoid-partial-laryngectomy-with-crico-hyoido-epiglottopexy-for-glottic-carcinoma-with-anterior-commissure-involvement
#14
I Atallah, E Berta, A Coffre, J Villa, E Reyt, C A Righini
Glottic cancers discovered at an early stage (T1-T2) can be treated with either radiotherapy or surgery. The aim of our study is to analyse survival and functional results of supra-cricoid partial laryngectomy (SCPL) with crico-hyoido-epiglottopexy (CHEP) as surgical treatment for glottic carcinoma with anterior commissure involvement. We performed a retrospective study (1996-2013) which included patients who underwent SCPL-CHEP for glottic squamous cell carcinoma with involvement of the anterior commissure...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28516098/spontaneous-regression-of-a-large-iatrogenic-dissection-of-the-ascending-aorta
#15
Aurélien Roumy, Matthias Kirsch, René Prêtre, Lars Niclauss
A 74-year-old woman was admitted for right coronary angioplasty. During the procedure, she complained about chest pain, and contrast injection showed an iatrogenic dissection of the ascending aorta. A contrast computed tomography (CT) scan confirmed the diagnosis via visualization of a large non-circulating false lumen, which involved nearly the entire ascending aorta. The patient remained hemodynamically stable and asymptomatic while receiving medical therapy alone. Another CT scan performed 3 days later showed complete regression of the false lumen...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28515753/traumatic-pneumatocele-in-an-11-year-old-boy-report-of-a-rare-case-and-review-of-the-literature
#16
Ewa Matuszczak, Marzanna Oksiuta, Adam Hermanowicz, Wojciech Dębek
The authors present a case of a pneumatocele associated with blunt trauma in a child. An 11-year-old boy was admitted to the emergency department after he was knocked over and his chest was trapped under a soccer goal. Chest computed tomography (CT) revealed several cavities in the lobes of both lungs. The CT of the abdomen revealed traumatic laceration of the liver. The patient was treated conservatively. His condition was stable and subsequently improved. He was discharged 19 days later. After nine months, a chest radiograph showed complete resolution of the pneumatocele, and abdominal ultrasound demonstrated complete resolution of the liver hematoma...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514823/-fulminant-course-of-a-clostridium-perfringens-infection-with-pathognomonic-ct-finding
#17
Christoph Alexander Stückle, Christopher Sonntag, Magdalena Kulik, Thorsten Nitschke
History and clinical findings A 74-year old woman was accepted by the emergency room with severe chest and abdominal pain. She complained about regurgitation after ingestion of food followed by sharp pain in her breast. Investigations A first examination of the patient showed a tachypnoea und tachycardia up to 122 beats per minute, the body temperature measured on admission was 38.7 °C. Due to hemolysis only a few of the requested parameters could be evaluated. CRP was increased with 8.32 mg/dl. The hemoglobin dropped from 12...
May 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28514116/changes-in-main-pulmonary-artery-diameter-during-follow-up-have-prognostic-implications-in-pulmonary-arterial-hypertension
#18
Adriano R Tonelli, Scott Johnson, Laith Alkukhun, Ruchi Yadav, Raed A Dweik
BACKGROUND AND OBJECTIVE: A dilated pulmonary artery (PA) is a common finding in patients with pulmonary arterial hypertension (PAH). Little is known on the variations in PA size over time and whether these changes track with disease severity and/or predict long-term survival. METHODS: We included patients with PAH who had at least two computed tomography (CT) scans of the chest done on different visits. Both scans matched the use of i.v. contrast. RESULTS: Pairs of CT scans were compared in 113 PAH patients...
May 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28513215/presence-of-air-trapping-and-mosaic-attenuation-on-chest-ct-predicts-survival-in-chronic-hypersensitivity-pneumonitis
#19
Jonathan H Chung, Xi Zhan, Mengshu Cao, Tilman L Koelsch, Diana C Gomez, Kevin K Brown, David A Lynch, Gloria Russell, Evans R Fernández Pérez
RATIONALE: Significant heterogeneity of computed tomography (CT) presentation exists within chronic hypersensitivity pneumonitis (CHP). There is limited data aimed at delineating the prognostic value of specific CT features, distribution, and patterns in CHP. OBJECTIVES: To examine whether the presence of CT mosaic attenuation and air-trapping, and the distribution or patterns of fibrosis impact survival in subjects with CHP. METHODS: From the National Jewish Health interstitial lung disease research database, we retrospectively identified 110 consecutively enrolled well-characterized biopsy-proven CHP adult subjects between 1982 and 2015...
May 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28512413/two-cases-of-nivolumab-re-administration-after-pneumonitis-as-immune-related-adverse-events
#20
Keisuke Imafuku, Koji Yoshino, Kei Yamaguchi, Satoshi Tsuboi, Kuniaki Ohara, Hiroo Hata
Nivolumab is a recently approved medication for the treatment of unresectable malignant melanoma. Many immune-related adverse events (irAEs) associated with nivolumab have been reported, such as pneumonitis, hepatitis, dermatitis, and thyroiditis. Prednisolone can effectively treat irAEs. However, it is unclear how or if nivolumab should be administered to patients after they have experienced an irAE. Herein, we show 2 patients who underwent pneumonitis as irAE. Case 1 demonstrated a cryptogenic organizing pneumonia pattern in the CT scan and case 2 had a diffuse alveolar damage (DAD) pattern...
January 2017: Case Reports in Oncology
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