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Patient Centered Radiology

Soo Won Ko, Jong Seok Lee, Han Sung Choi, Young Gwan Ko, Hoon Pyo Hong
The use of high-pressure air instruments has become more common. Consequently, there have been a number of cases of orbital emphysema caused by contact with high-pressure air. In this case, a 62-year-old male patient visited an emergency medical center after his left eye was shot by an air compressor gun that was used to wash cars. Lacerations were observed in the upper and lower eyelids of his left eye. Radiological examinations revealed orbital emphysema, optic nerve transection, pneumocephalus, and subcutaneous emphysema in the face, neck, shoulder, and mediastinum...
September 2016: Clin Exp Emerg Med
Jonathan J E White, John R Soothill, Marie Morgan, David I Clark, Marius P Espag, Amol A Tambe
BACKGROUND: A large metaphyseal volume shoulder hemiarthroplasty has been in use within our department since 2008; however, no clinical outcome data are available for this prosthesis apart from the designer surgeon series. MATERIALS AND METHODS: During a 5-year period, data were collected for 40 patients (30 women, 10 men) treated consecutively with the Zimmer Anatomical Shoulder Fracture hemiarthroplasty system (Zimmer, Warsaw, IN, USA). RESULTS: The final analysis included 26 patients...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Axel Andres, Pietro Majno, Sylvain Terraz, Philippe Morel, Arnaud Roth, Laura Rubbia-Brandt, Eduardo Schiffer, Frederic Ris, Christian Toso
Colorectal liver metastasis (CRLM) is the most frequent indication for liver resection in many centers. Recent improvements in oncology, surgery, interventional radiology, pathology and anesthesiology allow curative treatment in a larger proportion of patients with CRLM. Areas covered: We illustrate the various aspects of the management of CRLM through 11 questions that summarize the topic, from the current obtained survival to future perspectives such as transplantation. The limits of a curative treatment are also presented from different angles, such as the benefits of pathology, the surgical options for extreme resections, the available chemotherapies and their efficacy, or the non-surgical ablative treatments...
October 17, 2016: Expert Review of Anticancer Therapy
Andrej Spec, Christopher R Barrios, Usama Ahmad, Laurie A Proia
Severe pulmonary or disseminated histoplasmosis often necessitates presumptive antifungal treatment while awaiting definitive diagnosis. Histoplasma antigen assays have improved sensitivity but results may lag up to 7 days. In order to increase diagnostic certainty, "soft clues" may be looked for in laboratory and radiologic data, such as elevated alkaline phosphatase or ferritin levels and findings of mediastinal adenopathy or hepatosplenomegaly. To determine if elevated aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio is specific to histoplasmosis or a non-specific marker for disseminated fungal infection or sepsis in general, we retrospectively examined records of all patients diagnosed with an endemic fungal infection (EFI) at Rush University Medical Center from January of 1997 to October of 2012, and a cohort of septic patients with elevated liver enzymes...
October 14, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
O Leleu, M Auquier, O Carre, B Chauffert, A Dubreuil, V Petigny, B Trancart, P Berna, V Jounieaux
RATIONALE: This feasibility trial proposes to set up in the department of the Somme an annual screening for lung cancer with low-dose thoracic CT. It responds to the first objective of the third cancer plan and follows the publication of the results of the National Lung Screening Trial in 2011. METHODS: The method of this study is to use the existing networks among and between healthcare professionals and the departmental cancer screening structure. The inclusion criteria will be those of the National Lung Screening Trial...
October 12, 2016: Revue des Maladies Respiratoires
M Bricout, J Rezzouk
When implanting the Maia(®) trapeziometacarpal prosthesis, surgeons will be faced with a variety of complications they must be able to recognize and anticipate. Their ability to deal with these complications and possibly even failures is governed by their knowledge of the right steps to take. The aim of this retrospective study was to assess the incidence of complications reported during implantation of the Maia(®) prosthesis, to describe their nature and potential predisposing factors, and to study failures and their outcomes...
June 2016: Hand Surgery and Rehabilitation
Leandro Kasuki, Evelyn de Oliveira Machado, Liana Lumi Ogino, Maria Caroline Alves Coelho, Cintia Marques Dos Santos Silva, Luiz Eduardo Armondi Wildemberg, Carlos Henrique Azeredo Lima, Mônica R Gadelha
Objective: To describe the safety and efficacy of pegvisomant therapy and the predictors of treatment response in acromegaly patients at a single tertiary reference center in Brazil. Materials and methods: We retrospectively reviewed the clinical, hormonal and radiological data of acromegaly patients treated with pegvisomant in our center. We also evaluated the presence of the d3 isoform of the growth hormone receptor (d3GHR). Results: Twenty-seven patients were included (17 women)...
October 10, 2016: Archives of Endocrinology and Metabolism
Mohamed Mansour Elzohairy, Adel Mohamed Salama
INTRODUCTION: The purpose of this study was to evaluate shoulder function following minimally invasive subtotal subscapularis muscle and periarticular capsuloligamentous arthroscopic release in children with Erb's palsy. METHODS: A prospective study was conducted on 15 consecutive children who underwent subtotal subscapularis muscle and periarticular capsuloligamentous arthroscopic release to treat internal rotation contracture of the shoulder joint after Erb's palsy...
October 12, 2016: Journal of Children's Orthopaedics
Hedwig M A D'Agnolo, Wietske Kievit, Kim N van Munster, Jouke J H Vd Laan, Frederik Nevens, Joost P H Drenth
BACKGROUND: Polycystic liver disease (PLD) is a rare genetic disorder with progressive cyst growth as the primary phenotype. Therapy consists of volume reduction through invasive surgical or radiological procedures. In order to understand the process of treatment decision, our aim was to identify factors that increased the likelihood of treatment. STUDY DESIGN: We performed a cross-sectional study using an international population of PLD patients. We collected data on the following therapies: liver transplantation, resection, fenestration and aspiration sclerotherapy...
October 12, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Raiz Ahmad Misgar, Parvez Mohiuddin Dar, Shariq Rashid Masoodi, Munir Ahmad, Khursheed Alam Wani, Arshad Iqbal Wani, Mir Iftikhar Bashir
BACKGROUND: Although primary hyperparathyroidism (PHPT) has become an asymptomatic disease in the West, in India, PHPT is still an uncommonly diagnosed, overtly symptomatic disease with skeletal, muscular, and renal manifestations. AIMS: To describe the profile and surgical outcome of 78 consecutive PHPT patients over a period of two decades at a single center. MATERIALS AND METHODS: All patients who underwent evaluation and surgery for PHPT from January 1996 to December 2015 were included...
September 2016: Indian Journal of Endocrinology and Metabolism
Musaed Alzahrani, Rami Alhazmi, Manon Bélair, Issam Saliba
OBJECTIVE: To evaluate the ability of preoperative mastoid high resolution Computerized tomography (CT Scan) fusion with the postoperative diffusion weighted magnetic resonance imaging (Non-EPI DWI) to accurately localize the residual cholesteatoma thus sparing an unnecessary postoperative CT scan radiation. PATIENTS AND METHODS: this is a prospective study performed in our tertiary care center. We followed up prospectively a consecutive group of patients presenting with middle ear cholesteatoma using preoperative mastoid CT scans, postoperative mastoid CT scan and mastoid diffusion weighted MRI (DWI) between 2012 and 2013...
November 2016: International Journal of Pediatric Otorhinolaryngology
Keith Willett, David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Andrew Briggs, Ranjit Lall, Timothy J S Chesser, Ian Pallister, Sarah E Lamb
Importance: Ankle fractures cause substantial morbidity in older persons. Surgical fixation is the contemporary intervention but is associated with infection and other healing complications. Objective: To determine whether initial fracture treatment with close contact casting, a molded below-knee cast with minimal padding, offers outcome equivalent to that with immediate surgery, with fewer complications and less health resource use. Design, Setting, and Participants: This was a pragmatic, equivalence, randomized clinical trial with blinded outcome assessors...
October 11, 2016: JAMA: the Journal of the American Medical Association
Kerri A Van Arnem, David P Supinski, Jonathan E Tucker, Shawn Varney
BACKGROUND: Trauma patients sustaining blunt injuries are exposed to multiple radiologic studies. Evidence indicates that the risk of cancer from exposure to ionizing radiation rises in direct proportion to the cumulative effective dose (CED) received. The purpose of this study is to quantify the amount of ionizing radiation accumulated when arriving directly from point of injury to San Antonio Military Medical Center (SAMMC), a level I trauma center, compared with those transferred from other facilities...
September 13, 2016: American Journal of Emergency Medicine
Kenneth Habetz, Raghu Ramakrishnaiah, Sunil Kumar Raina, Ryan T Fitzgerald, Archana Hinduja
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is an acute neurotoxic syndrome that, although characteristically reversible, can result in long-term disability. Our aim was to identify the clinical and radiological factors that are unique to children with PRES compared with adults with the syndrome in a single center. METHODS: We retrospectively reviewed the clinical and radiological records of all patients with PRES admitted at a tertiary care medical center from 2007 to 2014...
September 13, 2016: Pediatric Neurology
Xuyi Wang, Jianping Peng, De Li, Linlin Zhang, Hui Wang, Leisheng Jiang, Xiaodong Chen
BACKGROUND: The success of Bernese periacetabular osteotomy depends significantly on how extent the acetabular fragment can be corrected to its optimal position. This study was undertaken to investigate whether correcting the acetabular fragment into the so-called radiological "normal" range is the best choice for all developmental dysplasia of the hip with different severities of dysplasia from the biomechanical view? If not, is there any correlation between the biomechanically optimal position of the acetabular fragment and the severity of dysplasia? METHODS: Four finite element models with different severities of dysplasia were developed...
October 4, 2016: Journal of Orthopaedic Surgery and Research
Wei Lin, Yuan Xue, Ying Zhao, Yaqi Zong, Chao Sun, Bo Pei, Pei Wang
PURPOSE: The generation and tissue origination of disc-associated axial pain is still under exploration. This study was performed to evaluate disc-associated axial pain and to explore whether it originates in the disc or its surrounding components. METHODS: A 6-year series of 88 single-level Smith-Robinson disc and posterior longitudinal ligament (PLL) resections performed to treat single-level cervical spondylotic myelopathy was retrospectively examined. All single-level anterior disc decompressions were performed under local infiltration anesthesia; the PLL was not anesthetized to avoid cervical cord block...
October 6, 2016: European Spine Journal
Pepijn Krielen, Barend A van den Beukel, Martijn W J Stommel, Harry van Goor, Chema Strik, Richard P G Ten Broek
BACKGROUND: Previous research on the costs of treatment for ASBO is outdated and often based on reimbursements, rather than true healthcare provider costs of the admission and related interventions. An accurate estimate of the true costs of treatment is necessary to understand the healthcare burden and to model cost-efficacy of adhesion strategies. The aim of this study was to provide an accurate cost estimate of the in-hospital costs for treatment of adhesive small bowel obstruction (ASBO) using micro-costing methods...
2016: World Journal of Emergency Surgery: WJES
Bapesh K Bollu, Michael J Dawrant, Kunal Thacker, Gordon Thomas, Murthy Chenapragadda, Kevin Gaskin, Albert Shun
PURPOSE: Inspissated bile syndrome (IBS) is a rare cause of obstructive jaundice in neonates and infants with several treatment options reported. We present our experience with the use of minimally invasive ultrasound-guided percutaneous cholecystostomy drain catheter placement with ongoing saline lavage in neonates and infants. METHODS: Retrospective chart review of patients treated with percutaneous cholecystostomy, from February 2010 till June 2015. We reviewed the technical and clinical success along with complications of the procedure...
September 20, 2016: Journal of Pediatric Surgery
Martin Ho, Anindita Saha, K Kimberly McCleary, Bennett Levitan, Stephanie Christopher, Kristen Zandlo, R Scott Braithwaite, A Brett Hauber
BACKGROUND: In response to 2012 guidance in which the US Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) stated the importance of patient-centric measures in regulatory benefit-risk assessments, the Medical Device Innovation Consortium (MDIC) initiated a project. The project was used to develop a framework to help the Food and Drug Administration (FDA) and industry sponsors understand how patient preferences regarding benefit and risk might be integrated into the review of innovative medical devices...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
F Reed Johnson, Mo Zhou
Demands for greater transparency in US regulatory assessments of benefits and risks, together with growing interest in engaging patients in Food and Drug Administration regulatory decision making, have resulted in several recent regulatory developments. Although Food and Drug Administration's Center for Drug Evaluation and Research (CDER) and Center for Devices and Radiological Health (CDRH) have established patient-engagement initiatives, CDRH has proposed guidelines for considering quantitative data on patients' benefit-risk perspectives, while CDER has focused on a more qualitative approach...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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